Health Assessment 2: Neuro

Cerebrovascular accidents, commonly known as strokes, are the third leading cause of death in Canada. Preceding a stroke can be a Transient Ischemic Attack (TIA) with symptoms like sudden loss of motor or sensory function on one side, difficulty with speaking or understanding, and altered visual perception. These TIA symptoms may last between 5 to 10 minutes.

The cerebral cortex is responsible for multiple functions such as governing thought, memory, reasoning, sensation, and voluntary movement. Its components include all lobes, not just specific ones as mentioned in the incorrect answers.

Cranial nerves Olfactory (CN I) and Optic (CN II) do not arise from the brainstem, instead originating from the brain itself (olfactory bulb and retina). The other cranial nerves (Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Vestibulocochlear, Glossopharyngeal, Vagus, Accessory, and Hypoglossal) arise from the brainstem.

This question requires in-depth knowledge about the cranial nerves and their numbers, functions, categories, and testing procedures. It is recommended to review relevant material, such as OSCE resources, to ensure accurate understanding and retention of this important anatomical concept.

The correct answer specifies the accurate breakdown of spinal nerves. The incorrect answers provide variations that either increase or decrease the total number of pairs or alter the distribution of nerves, along with incorrect explanations of their compositions.

A loss of consciousness followed by hitting the head can indicate a cardiac or neurological problem. Other options such as muscle strain, dehydration, and inner ear infection are not typically associated with this sequence of events.

The Glasgow Coma Scale rating is typically done on a patient who has already had a full neurological examination to assess their level of consciousness and brain function. It is not used as a first-line assessment or only after regaining consciousness.

When spinal nerves comingle with other nerves outside of the central nervous system, they are referred to as peripheral nerves.

Spinal punctures are usually performed between the L2 and L4 vertebrae in the lower back, known as the lumbar region. This location allows for safe access to the cerebrospinal fluid for diagnostic or therapeutic purposes.

A deep tendon response involves the coordination of sensory nerves, spinal cord synapses, motor nerves, neuromuscular junctions, and muscle fibers to elicit a reflex action.

The abdominal reflex is mediated by thoracic spinal nerves, not cranial nerves, L5, or S1.

Upper motor neurons synapse with brainstem and spinal cord, while lower motor neurons have cell bodies located in the anterior horn.

Because some of the nerves cross over in the spinal cord and some don't.

The corticospinal tracts are responsible for voluntary movement and skilled movements, and another name for them is pyramidal tracts. The incorrect answers provided do not accurately describe the function or name of the corticospinal tracts.

The correct answer explains the functions of the basal ganglia system and the cerebellar system, as well as highlighting the commonality between the two systems being extrapyramidal tracts.

The extrapyramidal tracts do not directly act on motor neurons, but instead, they modify the output signals coming from the cerebral motor cortex to regulate and coordinate voluntary movements.

Damage to upper motor neurons leads to increased muscle tone and reflexes, while damage to lower motor neurons causes decreased or absent muscle tone and reflexes.

The spinothalamic tract transmits pain, temperature and crude/light touch sensations and it does crossover to the opposite side of the brain, known as contralateral projection.

The posterior dorsal column tract is responsible for transmitting position, vibration, and discriminating touch. Unlike other sensory tracts, this tract does not cross over at the level of the spinal cord. It remains ipsilateral throughout its pathway to the brain.

Understanding the distinction between the thalamic level and sensory cortex is crucial in determining the impact of lesions on sensory perception.

Dermatomes are specific areas of skin that are innervated by a single spinal nerve. By understanding the distribution of dermatomes, healthcare professionals can pinpoint the location of lesions or nerve damage based on the affected sensory or motor function.

Superficial reflexes are responses triggered by stimulation of the skin. The correct answers listed are examples of superficial reflexes commonly tested in medical examinations.

The motor system observation involves assessing various aspects related to body movements and muscle functions, not visual acuity, heart rate, blood pressure, liver function, or kidney function.

Coordination involves the interaction of specific systems in the body to enable movement and balance. The correct answer includes the motor system, cerebellar system, vestibular system, and sensory system, each playing a crucial role in coordinating physical actions.

Dysesthesia refers to distorted sensations, not necessarily painful, and lasting longer than the stimulus itself.

Coordination is commonly assessed through various physical movements and balance tests, such as rapid alternating movements, point to point movements, gait assessment, and Romberg/Pronator drift. Blood pressure measurement, temperature readings, and visual acuity tests are not directly related to assessing coordination.

The nose to finger test is used to evaluate the function of the cerebellar system, which is responsible for coordination, precision, and accurate movements.

Sensory ataxia is a neurological condition characterized by a loss of coordination due to a lack of sensory feedback. This can result in a wide stance and unsteadiness while standing, as described in the correct answer.

Parkinsonian gait is characterized by a stooped posture, difficulty initiating gait, and shuffling of feet. It is not characterized by rapid, uncontrolled movements of limbs, tall and upright posture, or inability to maintain balance while walking.

Diabetes can lead to damage to nerves, particularly in the feet, affecting sensations like vibration.