PT-PNS 301 - Neuroanatomy Quiz

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Questions and Answers

Which of the following is NOT considered a Basic Activity of Daily Living (BADL)?

Meal preparation

Housecleaning

Shopping for clothing (correct)

Driving

Which assessment tool focuses specifically on instrumental activities of daily living?

Katz Index of ADLs

Lawton-Brody IADL Scale (correct)

Barthel ADL Index

Functional Independence Measure (FIM)

What is a key feature of the Functional Independence Measure (FIM)?

It is a proprietary tool used to assess basic mobility only.

It only evaluates the cognitive aspects of daily living.

It is primarily used for assessing dietary habits.

It measures both basic and instrumental activities of daily living. (correct)

Which of the following instruments is specifically mentioned as being proprietary?

Functional Independence Measure (FIM) Signup and view all the answers

According to the provided content, which of the following references is focused on physical medicine and rehabilitation?

Susan O’ Sullivan - Physical medicine and Rehabilitation Signup and view all the answers

What is the characteristic of dyslexia?

Reading ability below expected level despite normal vision and letter recognition Signup and view all the answers

What does a grade of 4+ in Deep Tendon Reflexes indicate?

Increased response with clonus; abnormal Signup and view all the answers

What stage of Brunnstrom's recovery is characterized by flaccidity and no voluntary movement?

Stage 1 Signup and view all the answers

What describes dyscalculia?

Difficulty in performing simple mathematical problems Signup and view all the answers

What does a Manual Muscle Testing grade of 1 represent?

Minimal movement with flicker of contraction Signup and view all the answers

What type of reflexes are absent in cases of upper motor neuron lesions?

Cremasteric reflex Signup and view all the answers

Which symptom is characteristic of lower motor neuron lesions?

Flaccid paralysis of muscles Signup and view all the answers

How does the muscle tone differ between upper motor neuron lesions and lower motor neuron lesions?

Spastic in UMN and flaccid in LMN Signup and view all the answers

What is the expected response of a muscle after 10 days of nerve section?

Response to direct current ceases Signup and view all the answers

In pyramidal symptoms, which of the following characteristics is present?

Presence of Babinski sign Signup and view all the answers

What clinical feature would you observe in lower motor neuron lesions regarding muscle atrophy?

Severe muscle atrophy Signup and view all the answers

Which sign is indicative of lower motor neuron lesions in comparison to upper motor neuron lesions?

Muscle fasciculation present Signup and view all the answers

What term describes a defect in the visual field where one vertical half is impaired?

Hemi Anopia Signup and view all the answers

What is auditory agnosia?

Inability to interpret auditory sensation Signup and view all the answers

Which condition involves a profound unconsciousness from which one cannot be roused?

Coma Signup and view all the answers

What is dysarthria?

Difficulty in speech articulation Signup and view all the answers

What does unilateral neglect refer to?

Reduced attention towards one side of the body Signup and view all the answers

What is the primary function of the lower motor neurons (LMN)?

Providing peripheral motor nerve outputs Signup and view all the answers

Which term describes an impairment in performing known skilled movements?

Apraxia Signup and view all the answers

Which reflex component is primarily responsible for muscle contraction?

Alpha motor neurons Signup and view all the answers

What is the Romberg sign used to assess?

Proprioception Signup and view all the answers

Which sign is indicative of upper motor neuron lesions?

Presence of Babinski sign Signup and view all the answers

Which condition is characterized by excessive neuronal discharge?

Epilepsy Signup and view all the answers

Which of the following defines acalculia?

Difficulty in calculation Signup and view all the answers

What role does the extrapyramidal system play in muscle regulation?

Regulating overall muscle tone Signup and view all the answers

Which areas of the brain are involved in planning and decision making?

Prefrontal cortex Signup and view all the answers

Which neuron type primarily contributes to the pyramidal and extrapyramidal systems?

Upper motor neurons Signup and view all the answers

What physiological process allows for errorless movements?

Higher centers feedback mechanisms Signup and view all the answers

Which characteristic is typical of lower motor neuron lesions?

Significant muscle atrophy Signup and view all the answers

What balance grading indicates that an individual can maintain balance against maximal resistance?

NORMAL Signup and view all the answers

Which grading indicates the ability to sit unsupported with minimal assistance and reach to the ipsilateral side?

POOR+ Signup and view all the answers

Which proprioception test assesses the ability to touch the nose with a finger?

Finger—nose—finger test Signup and view all the answers

What is the primary focus of basic ADLs?

Fundamental self-care skills Signup and view all the answers

How is 'GOOD' defined in the context of dynamic balance grading?

Able to sit unsupported & weight shift across midline moderately Signup and view all the answers

Which instrumental ADL requires organizational skills?

Managing finances Signup and view all the answers

What is indicated by the grading 'FAIR-' in dynamic balance?

Reach to ipsilateral side and unable to weight shift Signup and view all the answers

What does the 'POOR' grading in static balance suggest about an individual?

Requires moderate to maximum support to maintain balance Signup and view all the answers

Study Notes

Introduction to Applied Neuroanatomy and Neurophysiology

Course Title: PT-PNS 301 - Lecture 1
Topic: Applied Neuroanatomy and Neurophysiology
Lecturer(s): Dr. Sukumar Shanmugam, Dr. Meruna Bose
Date: December 8, 2024

Learning Objectives

Students will be able to describe the different parts of the nervous system.
Students will be able to differentiate between lower motor neurons (LMN) and upper motor neurons (UMN).
Students will be able to explain the functional areas of the brain.

Lobes of the Cerebrum

The brain is divided into lobes:
- Frontal lobe
- Parietal lobe
- Temporal lobe
- Occipital lobe
Important sulci/notches are depicted on the slide.

Lobes of the Cerebral Hemispheres

The frontal lobe is involved in planning, decision-making, and speech.
The parietal lobe processes sensory information.
The temporal lobe processes auditory information.
The occipital lobe processes visual information.

Motor/Sensory Cortex

The motor cortex (right hemisphere) controls specific body parts.
The sensory cortex receives sensory input from various body regions.
The diagram illustrates the body parts in relation to their representative areas in the brain's cortex.

Sensory Areas - Sensory Homunculus

Different parts of the body have dedicated sensory areas in the postcentral gyrus.
The representation of body parts is proportional to the sensitivity of that part
The diagram illustrates the sensory cortex representation.

Tone Pathway

The efferent pathway includes α-motor neurons and γ-motor neurons.
α-motor neurons control extrafusal muscle fibers.
γ-motor neurons control intrafusal muscle fibers within the muscle spindle.

Tracts

Descending tracts are categorized as motor tracts.
Lateral corticospinal tract and ventral corticospinal tract are mentioned here.
Ascending tracts are sensory tracts.
Dorsal columns, lateral and ventral spinothalamic tracts are mentioned.

Neurophysiology of Movements

Lower reflex arcs control basic movements.
Higher brain centers govern voluntary movements.
Feedback mechanisms adjust movements for precision.

Components of Reflex

Muscle spindles send information about muscle stretch to the spinal cord.
Sensory neurons deliver this information.
Alpha motor neurons initiate the contraction of extrafusal muscle fibers.
Gamma motor neurons adjust the sensitivity of muscle spindles.

Alpha and Gamma Neurons (Reflex Physiology)

Afferent pathways receive sensory input from muscle spindles.
Alpha motor neurons regulate regular skeletal muscle.
Gamma motor neurons adjust the sensitivity of muscle spindles.

Regulation of Muscle Tone

The pyramidal system facilitates spinal cord and brainstem motor nuclei.
The extrapyramidal system regulates muscle tone.

LMN vs. UMN

UMNs are involved in pyramidal and extrapyramidal systems.
LMNs include anterior horn cells and cranial nerve motor nuclei.

Signs of Upper Motor Neuron Lesions (UMNL)

Paralysis or weakness in the affected area can still cause gross movements.
Muscle atrophy may occur later.
Babinski sign is a characteristic sign.

Additional Signs of Upper Motor Neuron Lesions

Fine-skilled voluntary movements are impaired.
Superficial abdominal and cremasteric reflexes are absent.
Spasticity or hypertonia occurs.

Signs of Lower Motor Neuron Lesions (LMNL)

Flaccid paralysis occurs in affected muscles.
Muscle atrophy develops.
Reflexes vanish in affected muscles.

More Signs of Lower Motor Neuron Lesions

Muscles fasciculation may be visible.
Muscle fibrillation is detectable with EMG.

Clinical Signs: UMN vs. LMN Lesions

The table emphasizes the different clinical manifestations of UMN and LMN lesions.

Pyramidal & Extra Pyramidal Symptoms

This slide highlights clinical symptoms related to pyramidal and extrapyramidal systems.

Common Sensory Symptoms

This slide details several common sensory symptoms.

Special Senses

Anopia refers to defects in the visual field, including hemi-anopia.
Auditory agnosia is the inability to interpret auditory sensation.
Anosmia is the inability to smell.

Alertness

Coma, stupor, and lethargy involve varying degrees of impaired consciousness.

General Symptoms

Epilepsy is a chronic brain dysfunction with paroxysmal episodes.
Romberg sign indicates proprioception loss.

Cognitive & Perceptive Symptoms

Apraxia describes impairments in performing skilled movements.
Agnosia includes identifying familiar faces, objects, and colors.

Executive Functions of Cortex

Aphasia impacts speech and language.
Amnesia and fugue encompass memory loss.
Behavioral changes may involve learning difficulties.

Amnesia/Fugue

Amnesia/fugue is a disturbance in memory, ranging from minutes to months.
Dyslexia involves difficulty in reading.
Dyscalculia is the inability to perform mathematical calculations.

Common Assessment Tools

Various assessment tools are used to assess neurological function.

Muscle Tone: Grading Deep Tendon Reflexes

Grading scales (e.g., 0-4+) characterize the presence, strength, and quality of deep tendon reflexes.

Muscle Power (MRC)

Manual muscle testing grades (MRC) quantitatively evaluate muscle strength.

Brunnstrom's 6 Stages of Recovery

This concept describes stages involved in muscle recovery.

Static Balance Grading

A grading scale evaluates a patient's static balance abilities.

Dynamic Balance Grading

This section details grading scales for dynamic balance.

Multimodal Sensory Testing

This slide explains different sensory systems assessed during testing.

Sensory Grading (ASIA)

This slide details different grading systems for sensory analysis.

Proprioception Testing

Romberg test, heel-shin test, and finger-nose-finger test assess proprioception.

Order of Proprioception Testing

Recommended testing order for upper and lower limb proprioception.

Basic ADLs

Basic activities of daily living (ADLs) include feeding, dressing, toileting, bathing, and transferring.

Instrumental ADLs

Instrumental activities of daily living (IADLs) involve more complex tasks.

Functional Measures

Various tools and indexes assess functional abilities, distinguishing between BADLs and IADLs.

References

A list of references for further study.

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Description

This quiz assesses your understanding of Applied Neuroanatomy and Neurophysiology based on the first lecture of the course. You will explore the different parts of the nervous system, differentiate between lower and upper motor neurons, and explain the functional areas of the brain. Test your knowledge on the lobes of the cerebrum and their specific functions.