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Questions and Answers
What causes the more severe paralysis in the upper limbs and face compared to the lower limbs during ischaemic stroke?
What causes the more severe paralysis in the upper limbs and face compared to the lower limbs during ischaemic stroke?
What part of the nervous system is likely affected when there is a loss of vision?
What part of the nervous system is likely affected when there is a loss of vision?
After David's brain trauma, which cognitive aspect is most likely impaired?
After David's brain trauma, which cognitive aspect is most likely impaired?
In Jarrod's case of infection in the left foot and absence of pain, which part of the nervous system is likely damaged?
In Jarrod's case of infection in the left foot and absence of pain, which part of the nervous system is likely damaged?
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What behavior change in David indicates a likely area of damage in the brain?
What behavior change in David indicates a likely area of damage in the brain?
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The occlusion of which artery is most commonly associated with ischaemic strokes?
The occlusion of which artery is most commonly associated with ischaemic strokes?
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When examining two patients with muscle paralysis in one leg, which condition could be ruled out if both demonstrate symmetry in reflex responses?
When examining two patients with muscle paralysis in one leg, which condition could be ruled out if both demonstrate symmetry in reflex responses?
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What could the absence of pain perception and yet the ability to move voluntarily indicate about the type of nervous system damage?
What could the absence of pain perception and yet the ability to move voluntarily indicate about the type of nervous system damage?
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What phenomenon likely caused the sudden onset weakness of the facial, arm, trunk, and leg muscles in the 80-year-old man?
What phenomenon likely caused the sudden onset weakness of the facial, arm, trunk, and leg muscles in the 80-year-old man?
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What is indicated by the man's inability to respond to pinpricks on the right side of his body?
What is indicated by the man's inability to respond to pinpricks on the right side of his body?
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At which level of the spinal cord is it most likely that the stab wound affected the tracts described in Case 1?
At which level of the spinal cord is it most likely that the stab wound affected the tracts described in Case 1?
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If a thrombus from the common carotid artery travels to a cerebral artery, which artery is it most likely to occlude?
If a thrombus from the common carotid artery travels to a cerebral artery, which artery is it most likely to occlude?
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What is the likely cause of the resistance to movement experienced when the nurse attempts to extend the man’s arm?
What is the likely cause of the resistance to movement experienced when the nurse attempts to extend the man’s arm?
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What deficit is the man likely experiencing on the left side of his body due to the spinal injuries?
What deficit is the man likely experiencing on the left side of his body due to the spinal injuries?
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In which part of the nervous system would the injury likely need to occur to account for bilateral deficits resulting from a single lesion?
In which part of the nervous system would the injury likely need to occur to account for bilateral deficits resulting from a single lesion?
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When assessing the localization of the problem causing the man's symptoms, which area of the brain is most affected if the eyes deviate to the left?
When assessing the localization of the problem causing the man's symptoms, which area of the brain is most affected if the eyes deviate to the left?
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What does the Wada test assess in an individual?
What does the Wada test assess in an individual?
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If the left hemisphere is anaesthetised during the Wada test, how will the individual likely respond?
If the left hemisphere is anaesthetised during the Wada test, how will the individual likely respond?
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Which area of the cerebral cortex processes visual information?
Which area of the cerebral cortex processes visual information?
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What is the role of the association cortex?
What is the role of the association cortex?
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What do the lateralisation of function and the dominant hemisphere imply?
What do the lateralisation of function and the dominant hemisphere imply?
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What type of sensory information does the spinothalamic tract primarily transmit?
What type of sensory information does the spinothalamic tract primarily transmit?
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Which structure acts as a relay center for sensory and motor information in the brain?
Which structure acts as a relay center for sensory and motor information in the brain?
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What is the primary function of the corticospinal tract?
What is the primary function of the corticospinal tract?
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In terms of structural organization, how is the spinal cord white matter arranged?
In terms of structural organization, how is the spinal cord white matter arranged?
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What protective feature of the brain helps restrict harmful substances from entering neural tissue?
What protective feature of the brain helps restrict harmful substances from entering neural tissue?
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What role does the gray matter in the spinal cord play during reflex actions?
What role does the gray matter in the spinal cord play during reflex actions?
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Which region of the brain is primarily responsible for coordinating voluntary movements and balance?
Which region of the brain is primarily responsible for coordinating voluntary movements and balance?
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What changes occur in the skull as the brain evolves over time?
What changes occur in the skull as the brain evolves over time?
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What role does the Circle of Willis serve in the human brain?
What role does the Circle of Willis serve in the human brain?
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Which layer of the meninges is closest to the surface of the brain?
Which layer of the meninges is closest to the surface of the brain?
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What is one of the main purposes of the cerebrospinal fluid (CSF) in the brain?
What is one of the main purposes of the cerebrospinal fluid (CSF) in the brain?
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Which of the following accurately describes the protective functions of the brain's coverings?
Which of the following accurately describes the protective functions of the brain's coverings?
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Which structure is specifically responsible for maintaining arterial blood supply to the brain?
Which structure is specifically responsible for maintaining arterial blood supply to the brain?
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What is a main issue related to the bony protection of the brain?
What is a main issue related to the bony protection of the brain?
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Which component is NOT considered a part of the protective mechanisms for the brain?
Which component is NOT considered a part of the protective mechanisms for the brain?
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How does the blood-brain barrier primarily protect the brain?
How does the blood-brain barrier primarily protect the brain?
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What is the primary consequence of an increase in cranial volume?
What is the primary consequence of an increase in cranial volume?
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Which of the following represents a classic sign of raised intracranial pressure?
Which of the following represents a classic sign of raised intracranial pressure?
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What effect does increased intracranial pressure have on blood flow to the brain?
What effect does increased intracranial pressure have on blood flow to the brain?
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Which structure is directly involved in emotional learning and response to fear?
Which structure is directly involved in emotional learning and response to fear?
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What role does the hippocampus play in memory function?
What role does the hippocampus play in memory function?
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What happens during herniation of brain structures due to a space-occupying lesion?
What happens during herniation of brain structures due to a space-occupying lesion?
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What is a function of the cerebellum?
What is a function of the cerebellum?
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Which of the following is NOT a consequence of amygdala damage?
Which of the following is NOT a consequence of amygdala damage?
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Which part of the cerebral cortex is involved in the processing of auditory information?
Which part of the cerebral cortex is involved in the processing of auditory information?
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What is a major function of the cerebral cortex?
What is a major function of the cerebral cortex?
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What does widening pulse pressure indicate in relation to intracranial pressure?
What does widening pulse pressure indicate in relation to intracranial pressure?
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Which region of the brain is primarily involved in the integration of sensory information?
Which region of the brain is primarily involved in the integration of sensory information?
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What is one effect of a significant increase in intracranial pressure?
What is one effect of a significant increase in intracranial pressure?
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What is the primary role of the pontine and medullary regions of the brainstem?
What is the primary role of the pontine and medullary regions of the brainstem?
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Study Notes
Case 1 – The Mystery Injury
- 23-year-old male suffered a stab wound near the vertebral column on the left side.
- Post-injury deficits:
- No response to pinpricks on the right side below the nipple.
- No response to light touch on the left side below the nipple.
- Lack of proprioception in the left leg.
- Inability to move the left leg against resistance.
- Affected spinal tracts likely include the corticospinal tract (motor function) and dorsal columns (sensory function).
- A single lesion could potentially account for all deficits if located at the appropriate level of the spinal cord.
Case 2 – The Travelling Thrombus
- A thrombus from the common carotid artery can travel through the internal carotid artery.
- Most likely end up in the middle cerebral artery due to its size and direct connection to the internal carotid.
Case 3 – Reading the Signs
- 80-year-old male exhibits sudden-onset weakness on the right side, especially facial and arm muscles, right-sided loss of sensation, and eye deviation to the left.
- These symptoms likely caused by a stroke affecting the left hemisphere (right side weakness).
- Location of the problem probably in the motor cortex controlling the face and arm.
- Development of spasticity in the right arm and leg occurs due to upper motor neuron damage leading to increased muscle tone and resistance to movement.
Case 4 – Territories
- Ischaemic strokes commonly occur from middle cerebral artery occlusion.
- Muscle paralysis is more severe in the upper limbs and face because these areas have a greater representation in the motor cortex.
Case 5 – Visual Fields
- Loss of vision can be traced to problems in the visual pathways.
- Likely site of the issue in the occipital lobe or along the pathways connecting to visual processing areas.
Case 6 – Video Evidence
- Videos will provide insights into brain damage and resulting deficits in patients.
- Analysis of observed symptoms and behaviors can pinpoint damaged regions in the brain.
Case 7 – Socially Unacceptable
- David experienced trauma resulting in behavioral changes: motivation loss, distraction, inability to problem-solve, and inappropriate behavior.
- Likely damage to the frontal lobe affecting executive functions and social behavior.
Case 8 – Spinal Nerve, Root or Spinal Cord?
- Jarrod's inability to feel pain in the left foot but maintaining voluntary movement suggests issues in the peripheral nervous system or spinal roots.
- Poor withdrawal reflex indicates a problem with sensory pathways or spinal cord damage.
Case 9 – Whose Leg?
- Two individuals exhibit muscle paralysis in one leg, necessitating a thorough neurological examination to determine underlying causes.
Integration in the CNS
- Central Nervous System (CNS) integrates sensory information from both somatic and autonomic systems.
- The CNS formulates and sends motor responses based on sensory input.
- Spinal cord and brain both play vital roles in integration processes.
Spinal Cord and Reflexes
- Integration occurs in the spinal cord's gray matter, influenced by brain input (both excitatory and inhibitory).
- Sensory neurons enter via the dorsal root; motor neurons exit through the ventral root.
- Spinal cord's white matter is segmented into tracts: ascending (sensory) and descending (motor).
Brain Overview
- Composed of the brainstem, cerebellum, limbic system, and cerebral cortex.
- Developmental changes result in brain curvature due to limited cranial expansion.
Blood Supply and Protection
- The Circle of Willis supplies arterial blood; includes internal carotid and vertebral arteries.
- Brain protection encompasses the cranium, meninges, cerebrospinal fluid (CSF), and the blood-brain barrier.
- Intracranial pressure (ICP) increases if there's an addition to cranial volume (e.g., lesions).
Signs of Increased ICP
- “Cushing’s triad” includes irregular respiration, widened pulse pressure, and bradycardia, indicating brain stress.
Brain Regions and Their Functions
- Brainstem: Encompasses midbrain, pons, and medulla; essential for autonomic functions.
- Cerebellum: Coordinates voluntary movements, postural adjustments, rapid movement planning, and movement learning.
- Limbic System: Involved in emotional processing, survival motivation, learning, and memory, including structures like the cingulate cortex, hippocampus, and amygdala.
Amygdala and Emotional Responses
- The amygdala is critical for emotional learning and fear recognition.
- Damage to the amygdala affects fear responses and social interactions.
Hippocampus and Memory
- Facilitates the conversion of short-term memory to long-term memory and spatial memory.
Cerebral Cortex Functions
- Divided by cortical regions, responsible for sensory processing, voluntary movements, reasoning, language, and personality.
- Each sensory and motor function is localized in distinct areas, with well-defined roles.
Sensory and Motor Processing Areas
- Primary sensory areas include somatic, visual, gustatory, olfactory, and auditory cortices.
- Motor areas consist of the primary somatic motor cortex, with areas organized topographically as homunculi.
Lateralization of Brain Function
- Dominance in language and speech areas varies; identified via the Wada test, which assesses hemisphere function by temporarily anesthetizing one side.
Association Areas
- Integrate and process information beyond primary areas, contributing to complex functions like reasoning and emotional regulation.
- Include somatic sensory, visual, auditory, limbic, and prefrontal association areas.
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Description
Explore 9 intriguing cases focused on the Central Nervous System, starting with a harrowing tale of a 23-year-old man who suffered a stab wound. This quiz will challenge your understanding of neurological responses and anatomical implications. Test your knowledge on case studies that reveal the complexities of human anatomy and injury recovery.
