Neuro Ch 12

Front 1

Signs and symptoms in a myotomal and dermatomal distributionindicate that the lesion is in what region of the nervous system

Back 1

ANS: Signs andsymptoms in a myotomal and dermatomal distribution indicate that the lesion isin the spinal region.

Front 2

Match the axons with their classifications.

2. Axons to extrafusal muscle fibers

Back 2

Aα

Front 3

Match the axons with their classifications.

Axons to intrafusalmuscle fibers

Back 3

Aγ

Front 4

Match the axons with their classifications.

Axons that conveysensory information perceived as pain and temperature

Back 4

Aδ or C

Front 5

Match the axons with their classifications.

Axons that conveysensory information perceived as touch and pressure

Back 5

Ia

Front 6

What is themost functionally important branch of the cervical plexus? A. Branch to the sternocleidomastoid muscle B. Branch to the biceps brachii C. Branch to the triceps D. Phrenic nerve E. Musculocutaneous nerve

Back 6

ANS: DRationale: The phrenic nerve is the most importandbranch of the cervical plexus because it innervates the diaphragm

Front 7

Which one ofthe plexes innervates the posterior thigh and most of the leg and foot? A. Cervical B. Brachial C. Lumbar D. Sacral E. None of the above

Back 7

ANS: DRationale: The sacral plexus innervates the posteriorthigh and most of the leg and foot.

Front 8

Miniature endplate potentialsare essential for which of the following? A. Inhibiting the action of lower motorneurons B. Initiating contraction of muscles C. Preventing atrophy of muscle fibers D. A and B E. All of the above

Back 8

ANS: CRationale: Miniature endplate potentials provide trophic factors toskeletal muscle fibers that are essential to prevent atrophy

Front 9

Trophic changes after denervationinclude which of the following? A. Muscle atrophy B. Shiny skin C. Brittleness of fingernails and toenails D. A and B E. All of the above>

Back 9

ANS: ERationale: Tropic changes after denervation include muscle atrophy,shiny skin, and brittleness of fingernails and toenails

Front 10

Match each specific lesion with itsclassification.

Rupture of the ulnarnerve, secondary to the fracture of the humerus

Back 10

Traumatic severance

Front 11

Match each specific lesion with its classification.

Decreased sensationin a stocking/glove distribution

Back 11

Polyneuropathy

Front 12

Match each specific lesion with its classification.

Loss of sensory,autonomic, and motor function of the right musculocutaneous and femoral nervesand the left sciatic nerve

Back 12

Multiple mononeuropathy

Front 13

Match each specific lesion with its classification.

Chronic compressionof the median nerve resulting in mild demyelination

Back 13

. Traumaticmyelinopathy

Front 14

Match each specific lesion with its classification.

Crushing injury ofthe peroneal nerve

Back 14

Traumatic axonopathy

Front 15

. List at least threespecific factors that may cause polyneuropathy.

Back 15

ANS: Polyneuropathymay be caused by diabetes, nutritional deficiency secondary to alcoholism,autoimmune diseases, prolonged use of therapeutic drugs, or exposure toenvironmental toxins.

Front 16

16. What sensory changes commonly occur withdiabetic polyneuropathy?

Back 16

ANS: Decreased sensationin a stocking/glove distribution, pain, paresthesia, and dysesthesia commonlyoccur with diabetic polyneuropathy.

Front 17

17. What autonomic changes may occur withdiabetic polyneuropathy?

Back 17

ANS: Cardiovascular,gastrointestinal, genitourinary, and sweating dysfunctions may occur with diabeticpolyneuropathy.

Front 18

How is botulinumtoxin therapeutically used?

Back 18

ANS: Botulinumtoxin interferes with the release of acetylcholine (Ach) at the neuromuscularjunction and is used to weaken overactive muscles in dystonia and spasticity.

Front 19

In a recording from a nerve conduction velocity (NCV) study,decreased amplitude of recorded potentials, combined with slowing of NCV,indicates which of the following? A. Myelinopathy B. Myopathy C. Myasthenia gravis D. Upper motor neuron lesion E. Axonopathy"

Back 19

ANS: ERationale: Axonopathy reduces both the amplitude and velocity ofrecorded potentials during a nerve conduction velocity study. Traumatic myelinopathycauses decreased velocity but usually not amplitude of recorded potentials.Myopathy only affects muscle and so amplitude of recorded potentials isdecreased but velocity of conduction is normal. Myasthenia gravis damages AChreceptors on the muscle membrane, so conduction velocity is normal but recordedamplitude decreases with repeated muscle contractions. Because NCV studies onlytest peripheral nerves, NCV studies are normal in UMN lesions.

Front 20

If NCV studies show that conduction is slowed at a single site inone nerve, yet the NCV is normal throughout the remainder of the nerve and inother nerves, the disorder is characterized as which of the following? A. Traumatic myelinopathy B. Axonopathy C. Severance injury D. Myopathy E. Polyneuropathy

Back 20

ANS: ARationale: Traumatic myelinopathy is limited to a single site on anerve, so nerve conduction proximal and distal to the site of myelinopathy isnormal.

Front 21

If the NCV is normal along the length of the peripheral nerve, yetthe amplitude of the electromyogram (EMG) potential is decreased, the disorderis: A. Myelinopathy B. Myopathy C. Lower motor neuron lesion D. Upper motor neuron lesion E. Axonopathy

Back 21

ANS: BRationale: Axonopathy reduces both the amplitude and velocity ofrecorded potentials during a nerve conduction velocity study. Traumaticmyelinopathy causes decreased velocity but usually not amplitude of recordedpotentials. Myopathy only affects muscle and so amplitude of recordedpotentials is decreased but velocity of conduction is normal. Myasthenia gravisdamages ACh receptors on the muscle membrane, so conduction velocity is normalbut recorded amplitude decreases with repeated muscle contractions. Because NCVstudies only test peripheral nerves, NCV studies are normal in UMN lesions.pd

Front 22

Myasthenia gravis is an autoimmune diseaseaffecting the: A. Myelin of peripheral nerves B. ACh receptors at the neuromuscularjunction C. Release of ACh from the presynapticterminal D. Storage of calcium in the sarcoplasmicreticulum E. Alpha motor neurons in the ventral hornof spinal cord

Back 22

ANS: BRationale: Myasthenia gravis is an autoimmune disease that damagesACh receptors on the muscle membrane.

Front 23

. Guillian-Barré syndrome is an autoimmunedisease that causes: A. Necrosis of the alpha motor neuron B. Degeneration of the motor endplate C. Spasticity D. Peripheral demyelination E. Degeneration of the C-fiber axons

Back 23

ANS: DRationale: Guillian-Barré syndrome is an autoimmune disease thatcauses peripheral demyelination. This polyneuropathy has a rapid onset, withprogressive paralysis that may require treatment to prevent respiratoryfailure. The motor system is usually more affected than the sensory system, butdeafferentation pain may be severe.

Front 24

Hereditary motor andsensory neuropathy (HMSN; also known as Charcot-Marie-Tooth disease)

Back 24

Genetic neuropathythat begins with paresis of muscles distal to the knee, with resulting footdrop, a steppage gait, frequently tripping, and muscle atrophy. As the diseaseslowly progresses, muscle atrophy and paresis affect the hands and the abilityto sense heat, cold, and painful stimuli decreases. Neuropathic pain is common.

Front 25

Mononeuropathy

Back 25

Dysfunction of asingle peripheral nerve

Front 26

Multiple mononeuropathy

Back 26

Dysfunction ofseveral separate peripheral nerves. Signs and symptoms show an asymmetricaldistribution

Front 27

Myopathy

Back 27

Abnormality ordisease intrinsic to muscle tissue.

Front 28

Polyneuropathy

Back 28

Generalized disorderof peripheral nerves whose presentation is typically distal and symmetrical.

Front 29

Edna's daughter relates that in the last month, Edna's gait has become increasingly unsteady. She has also lost considerable cog function and has urinary incontinence. edna's physician suspects normal pressure hydrocephalus. this disorder results when:

a. a blockage prevents the flow of cerebrospinal fluid

b. the choroid plexus produce an excess of csf

c. the arachnoid villae cant absorb the csf

Back 29

c

Front 30

a 1-month-old infant has been dx-d with hydrocephalus. which of the below symptoms are likely present?

1. compression of neural tissue

2. skull expansion

3. separation of cranial sutures

4. compromised cog development

a. all of the above

b. 1,2,3

c. 2,3,4

Back 30

b

Front 31

this artery commonly ruptures in the occurrence of a tbi, causing fatal hemorrhages in the subdural space if not immediately addressed

Back 31

middle meningeal artery

Front 32

mr simon was brought to the emergency room after experiencing pain in his left arm and jaw. this pain is commonly known as _________ and results from __________.

Back 32

referred pain

stimulation of a spinal nerve that innervates both a specific dermatomal region and a visceral organ

Front 33

mrs. smith presents with pain that begins in her lower back and radiates down both legs. her therapist tells her taht this pain is likely due to a herniated lumbar disc that is impinging upon several spinal nerves innervating the LE. what is the clinical name fo rthis condition?

Back 33

sciatic nerve damage

Front 34

carols deep tendon reflexes are hyhper-reflexive when percussed. the therapist suspects

Back 34

upper motor neuron injury

Front 35

sally and greg's baby was born with a severe spinal cord deformity in which the meninges, spinal cord, and the spinal nerves protrude thru an incomplete closure of the vertebral column. this deformity is called:

Back 35

meningomyelocele

Front 36

tom's third and fourth cranial nerves were damaged in a head-on auto collision in which tom was a passenger. when cranial nerves are damaged, such pathology is considered to be _______ motor neuron injury and presents as ___________ at and below the lesion level.

Back 36

a lower

flaccidity

Front 37

the meninges, protective glial cells, and capillary beds collectively form this structure, whose purpose is protection of the brain from exposure to toxins:

Back 37

blood brain barrier

Front 38

this structure is commonly used shunt placement in the tx of hydrocephalus

Back 38

cisterna magna

Front 39

Ed was admitted to the hospital with an acute inflammatory polyradicuolopathy that was preceded by an infectious illness 3 wks earlier. his condition is characterized by progressive ascending muscular weakness of the limbs- which produces a bilateral symmetric flaccid paralysis. Ed's diagnosis is likely _______________, a condition caused by demyelination of peripheral spinal roots.A. Guillain-BarreB. myasthenia gravisC. diabetes mellitusD. multiple sclerosis

Back 39

A. Guillain-Barre

Front 40

Mrs. Albert has been experiencing an intense burning sensation on the left side of her face. In which tract is pathology likely?A. reticulospinal tractB. trigeminothalamic tractC. spinothalamic tractD. dorsal columns

Back 40

B

Front 41

Upon examination, Mr. Perez's skin on the left lateral aspect of his forearm appears smooth and glossy; hair on this region has also fallen off. These signs have occurred after Mr. Perez was stabbed in an attempted mugging in which his left radial nerve was severed. Such skin changes are referred to as:a. hypalgesiab. analgesiac. thermhyperesthesiad. autonomic trophic changes

Back 41

d. autonomic trophic changes

Front 42

After his left below-the-knee amputation, Greg reports feeling nonpainful sensations in his amputated body part. This is clinically referred to as:a. amputation painb. stump painc. phantom paind. phantom limb

Back 42

d. phantom limb

Front 43

Greg's condition (in BKA) is likely due to which of the following?a. the formation of neurofibromas in the stump of the amputated body partb. the sensory homunculus in the cortex continues to perceive the amputated body part as presentc. stimulation of the sensory nerves in the stump of the amputated body part

Back 43

b. the sensory homunculus in the cortex continues to perceive the amputated body part as present

Front 44

Upon evaluation of sensation in his upper extremities, John demonstrates decreased sensation to pin prick on his right first and second fingers. decreased sensation is referred to as:a. hypoesthesiab. hyperesthesiac. paresthesiad. allodynia

Back 44

a. hypoesthesia

Front 45

after mr. wong sustained cervical nerve impingement in a severe fall he reports the sensation of pins and needles in his left arm. clinically, this condition is referred to as:a. thermesthesiab. hyperesthesiac. paresthesiad. allodynia

Back 45

c. paresthesia

Front 46

ron has diabetes-related neuropathy. he presents a classic pattern of bilateral numbness and tingling, pain, and decreased proprioception in both feet and calves (due to bilateral nerve damage). The same sensations eventually spread to his fingers, hands, and forearms. This classic neuropathy pattern is known as:a. stocking and glove plexopathyb. stocking and glove radiculopathyc. stocking and glove polyneuropathyd. stocking and glove mononeuropathy

Back 46

c. stocking and glove polyneuropathy

Front 47

after tom's neck injury in a motor vehicle accident, he reports intense burning pain radiating from his neck down both shoulders and arms. this type of burning pain is referred to as:a. allodyniab. thermesthesiac. hypoesthesiad. causalgia

Back 47

d. causalgia

Front 48

mr. goodman presents with a classic wrist and finger drop after a severe injury to his brachial plexus. this condition results from:a. medial nerve compressionb. radial nerve compressionc. ulnar nerve compressiond. peroneal nerve compression

Back 48

b. radial nerve compression