Module 1 Synch Session - Clinical Neuroscience PDF

Welcome to Module 1 Synch Session PHYT 7104 Clinical Neuroscience BGSU  Faculty Introductions BGSU Dr. Jamie O'Brien PT, DPT, DHSc NCS Board Certified Clinical Specialist in Neurologic Physical Therapy Finished DHSc in Decem...

Welcome to Module 1 Synch Session PHYT 7104 Clinical Neuroscience BGSU  Faculty Introductions BGSU Dr. Jamie O'Brien PT, DPT, DHSc NCS Board Certified Clinical Specialist in Neurologic Physical Therapy Finished DHSc in December Neuro work experience: o Trauma ICU o Inpatient rehabilitation ▪ Brain injury ▪ Stroke ▪ Spinal cord injury ▪ Multiple trauma o Outpatient pediatrics o Home health pediatrics o Skilled nursing Primary courses: neuroscience, neuro 1, complex patient, peds Dr. Tawiona Brown PT, DPT Clinical Experience: 25 years Acute Care Trauma Inpatient Rehabilitation SCI, Parkinson's, MS, GB, TBI CVA Skilled Nursing Outpatient Orthopedics Higher Education: 7 years Kinesiology Musculoskeletal Dysfunction Neurology Clinical Reasoning Currently working on board specialist certification for neurology This Photo by Unknown Author is licensed under CC BY-SA Session Plan Review course plan / assessment Discuss tips and tricks related to success in neuroscience Terminology Reference Topic 1: Planes of the brain Topic 2: Homunculus Topic 3: Organization of the nervous system Topic 4: UMN vs LMN lesions On Stage Austin Biddle Adrienne Letner Hailey Chitwood Saher Shafi Kevin Jeudy Tiffany Stevens Course Scope  Mix up the order of study topics Concept How concepts relate to other concepts ▪ Current module to previous modules ▪ Anatomy, pathophysiology, examination Interleaving ▪ Topics within each module Increases the likelihood that you can apply the material to new real- world situations ▪ Helps with retrieval Interleaving Blocked Anatomy Anatomy Pathophysiology Examination Examination Pathophysiology Tips for Success Skill practice Clinical Content Knowledge Labeling integration guides checks activities handouts activities Review of Course Assessment 3 VBAs ▪ Sensory ▪ Tone / Spasticity ▪ Complete neurologic screen Weekly Quizzes due each week Wednesday Weekly Clinical Integration Activities 4 Exams + Final Exam Practical Exam Who’s On Stage!!!! Week 1 Austin Biddle Adrienne Letner Hailey Chitwood Saher Safi Kevin Jeudy Tiffany Stevens  Why Neuroscience? Activity BGSU  Cephalo Caudal Rostral Ventral Terminology Dorsal Review Coronal Sagittal  Topic 1 Orientation and Planes of the brain BGSU Label the Structural Locations in the Brain Labeling Answers A: Ventral Surface of Brain  When looking at a coronal view of the brain from near midline, what structures would you expect to see? Knowledge A. Symmetrical left and right Check #1 appearances B. Asymmetrical appearances left and right C. Structures for orienting to front and back of the brain D. Structures for orienting to superior vs inferior views of the brain  When looking at a coronal view of the brain from near midline, what structures would you expect to see? Knowledge A. Symmetrical left and right Check appearances B. Asymmetrical appearances left and right C. Structures for orienting to front and back of the brain D. Structures for orienting to superior vs inferior views of the brain Imaging and Planes of the Brain Topic 2 Homunculus BGSU  Loss of sensation to the face would MOST likely occur in which of the following brain structures? Knowledge a. Medial precentral gyrus Check #2 b. Lateral precentral gyrus c. Medial post-central gyrus d. Lateral post-central gyrus  Loss of sensation to the face would MOST likely occur in which of the following brain structures? Knowledge a. Medial precentral gyrus Check #2 b. Lateral precentral gyrus c. Medial post-central gyrus d. Lateral post-central gyrus Somatotopic Organization  Homunculus If I had loss of motor function ONLY impacting the LEFT foot. Where is the possible lesion? Medial Superior lateral Lateral Inferior lateral  Topic 3 Organization of the Nervous System BGSU  Which of the following structures separates the two cerebral hemispheres? Knowledge a. Median longitudinal fissure Check b. Lateral sulcus c. Parieto-occipital sulcus d. Central sulcus  Which of the following structures separates the two cerebral hemispheres? Knowledge a. Median longitudinal fissure Check b. Lateral sulcus c. Parieto-occipital sulcus d. Central sulcus Key Landmarks Divides the frontal and Central Sulcus parietal lobes Central Sulcus Parieto- Parieto- Divides the parietal and occipital occipital sulcus occipital lobes medially sulcus Divides the temporal and Lateral sulcus frontal lobes Median Lateral sulcus Separates the right and longitudinal fissure left cerebral hemispheres This image is a screen shot from this supplemental resource: http://www.neuroanatomy.ca/modules/CNSintro/story.html  Which of the structures identified in the image is responsible for executive functions including planning and decision making? A. A Knowledge B. B C. C Check D. D  Which of the structures identified in the image is responsible for executive functions including planning and decision making? A. A – Frontal Lobe Knowledge B. B – Parietal Lobe C. C- Occipital Lobe Check D. D- Temporal Lobe  Which of the structures identified in the image serves as a relay station for sensory and motor information? A. A B. B Knowledge C. C D. D Check A C B D  Which of the structures identified in the image serves as a relay station for sensory and motor information? A. A- Thalamus B. B- Pineal Gland Knowledge C. C- Hypothalamus D. D- Pituitary Gland Check A C B D Medial Brain Structures  Topic 4 Cellular Organization of the Nervous System BGSU  A patient with multiple sclerosis presents with a relapse that includes increased falls, weakness in her legs, and Knowledge decreased motor control. Which of the Check following cellular structures are attacked by antibodies in multiple sclerosis? A. Oligodendrocytes B. Schwann cells C. Astrocytes D. Ependymal cells  A patient with multiple sclerosis presents with a relapse that includes increased falls, weakness in her legs, and Knowledge decreased motor control. Which of the Check following cellular structures are attacked by antibodies in multiple sclerosis? A. Oligodendrocytes B. Schwann cells Knowledge Check Key Information: C. Astrocytes Good practice for NPTE questions D. Ependymal cells CNS vs PNS structures Pathology of multiple sclerosis Cell Types Oligodendrocytes Schwann cells Astrocytes Ependymal cells Topic 5 UMN and LMN Signs BGSU  Your patient has a radial nerve neurotmesis. Which of the following clinical signs might you expect Knowledge with this condition? Check A. Flaccidity of the triceps B. Spasticity of the triceps C. Flaccidity of the biceps D. Spasticity of the biceps  Your patient has a radial nerve neurotmesis. Which of the following clinical signs might you expect Knowledge with this condition? Check A. Flaccidity of the triceps B. Spasticity of the triceps C. Flaccidity of the biceps Key information UMN vs LMN signs D. Spasticity of the biceps What is neurotmesis? Innervation pattern of the radial nerve (prior knowledge from Bonus Question: What clinical examination findings would align anatomy) with this condition. Upper Motor Neuron vs Lower Motor Neuron Upper Motor Neuron Conditions Lower Motor Neuron Conditions  Upper Motor Neuron vs Lower Motor Neuron Upper Motor Neuron Conditions Lower Motor Neuron Conditions Traumatic Brain Injury Brachial plexus injury Stroke Peripheral nerve injury Spinal Cord Injury Neurotmesis axonotmesis Multiple Sclerosis Guillain Barre Parkinson's disease Charcot Marie Tooth Concussion Polyneuropathy CNS Tumors Radiculopathy  Upper Motor Neuron vs Lower Motor Neuron Upper Motor Neuron Exam Lower Motor Neuron Exam Findings Findings Hypertonia Hypotonia Hyperreflexia Flaccidity  May have flaccidity / low tone if entire pathway is lost Hyporeflexia / Areflexia Spasticity Decreased cutaneous reflexes Clonus Fasciculations May have + Babinski Fibrillations May have weakness or paralysis/ paresis in Denervation atrophy impaired pathways  Muscle wasting Muscle atrophy: disuse atrophy (variable) Weakness or absent motor function May have altered movement patterns, synergies  Your patient presents following stroke impacting the left cerebral hemisphere in the medial frontal Knowledge lobe. Which of the following clinical Check signs might you expect with this condition? A. Hyperreflexia of the right quadriceps B. Hyperreflexia of the left quadriceps C. Hyporeflexia of the right quadriceps D. Hyporeflexia of the left quadriceps  Your patient presents following stroke impacting the left cerebral Knowledge Check hemisphere in the medial frontal lobe. Which of the following clinical signs might you expect with this condition? Other clinical Signs: Synergy patterns A. Hyperreflexia of the What else is housed in the frontal right quadriceps lobe? (What do you know so far?) B. Hyperreflexia of the left o Motor function quadriceps o Broca's area C. Hyporeflexia of the right o Judgement, problem quadriceps solving, behavior, speech, D. Hyporeflexia of the left quadriceps Contralateral innervation What other clinical exam findings might this patient have? This Ph oto by Unknown author is licensed und er CC BY-SA-NC. What other clinical exam findings might this patient have? Tone Spasticity (velocity dependent) Hyper-reflexic + Babinski Hypertonic Clonus May have weakness in areas of impairment Muscle bulk: Variable- subject to disuse atrophy Voluntary movements: Impaired or absent, may have synergistic patterns BGSU Housekeeping: Due Date Reminders Weekly Quiz Due by Wednesday of each week! Clinical Integration activities due Sunday of each week!