Neuro Ana Physio & CVA

Broca's Area is responsible for speech. It is located in the frontal lobe of the cerebrum and is involved in the production of speech and language comprehension. Damage to this area can result in a condition called Broca's aphasia, where individuals have difficulty speaking fluently but can understand language.

The precentral gyrus and corticospinal tract are involved in the control of voluntary movement. The precentral gyrus, also known as the primary motor cortex, is responsible for planning and executing voluntary movements. It sends signals through the corticospinal tract, which is a pathway that connects the motor cortex to the spinal cord and allows for the transmission of motor commands to the muscles. Therefore, these structures are essential for the initiation and coordination of voluntary movements in the body.

The cauda equina is not considered a major part of the brain because it is actually a bundle of nerves located at the bottom of the spinal cord, not within the brain itself. The brainstem, cerebellum, diencephalon, and cerebrum are all major parts of the brain that play important roles in various functions such as controlling basic bodily functions, coordinating movement, processing sensory information, and higher cognitive functions.

The pituitary gland is directly controlled by hormones produced by the hypothalamus. The hypothalamus produces hormones that travel through the blood vessels to the pituitary gland, where they stimulate or inhibit the release of other hormones. This close connection between the hypothalamus and the pituitary gland is known as the hypothalamic-pituitary axis and plays a crucial role in regulating various bodily functions such as growth, reproduction, and metabolism.

The statement is true because the basal ganglia plays a crucial role in inhibiting cortical output that leads to competing or ineffective motor behaviors. The basal ganglia is involved in motor control and helps in selecting and initiating appropriate motor actions while suppressing unwanted or inappropriate movements. By inhibiting cortical output, the basal ganglia ensures that only the desired motor behaviors are executed, preventing conflicting or ineffective actions.

Broca's aphasia is characterized by impaired fluency, meaning that the patient has difficulty in producing speech. In this case, the patient has difficulty in uttering words, which is consistent with the symptoms of Broca's aphasia. The fact that the patient understands what is being said indicates that their comprehension is intact, further supporting the diagnosis of Broca's aphasia. Conduction aphasia is characterized by difficulty in repeating words or phrases, while Wernicke's aphasia is characterized by fluent but meaningless speech. Glocal aphasia is not a recognized aphasic syndrome.

Ataxia is a characteristic symptom of cerebellar disease. It is a neurological condition that affects coordination and balance. Patients with cerebellar disease often experience unsteady movements, difficulty with fine motor skills, and a lack of coordination. This is due to the disruption of normal cerebellar function, which plays a crucial role in coordinating voluntary movements. Therefore, the statement "ataxia is a cardinal sign of cerebellar disease" is correct.

Norepinephrine and acetylcholine are neurotransmitters that bind to autonomic receptors. Autonomic receptors are part of the autonomic nervous system, which controls involuntary bodily functions. Norepinephrine is released by sympathetic neurons and binds to adrenergic receptors, while acetylcholine is released by parasympathetic neurons and binds to cholinergic receptors. Therefore, the correct answer is Norepinephrine and acetylcholine.

The Berg balance scale is the most appropriate test to measure the effectiveness of the physical therapy intervention for a patient with a cerebellar stroke. This test specifically assesses balance and mobility, which are key areas of focus in functional balance training. The Romberg test assesses the ability to maintain balance with eyes closed, but it may not capture the full range of balance improvements achieved through the intervention. The Fugl-Meyer assessment evaluates motor function and the Barthel index measures activities of daily living, which are important but not as specific to balance as the Berg balance scale.

The thalamus is the major relay station for sensory impulses that reach the primary somatosensory areas of the cerebral cortex from the brain stem and the spinal cord. It receives sensory information from various parts of the body and sends it to the appropriate areas of the cerebral cortex for further processing and interpretation. This makes the thalamus an essential structure for sensory perception and integration in the brain.

Strengthening the hip abductors on the right side would help to counteract the lateral trunk bending towards the right during weight-bearing on the right leg at midstance. The hip abductors are responsible for stabilizing the pelvis and preventing excessive lateral trunk bending. By strengthening these muscles, the patient would be able to maintain a more upright posture during gait, thus correcting the problem.

Ideomotor apraxia is the correct answer because it refers to a condition where a person is unable to perform a specific motor task on command, despite being able to perform the same task spontaneously or in a different context. In this case, the patient was unable to whistle when instructed to do so by the physical therapist, but was observed whistling while listening to music. Similarly, the patient was unable to walk in the gym after demonstration, but was observed walking across the room. This inconsistency in performing motor tasks on command but being able to perform them spontaneously is characteristic of ideomotor apraxia.

The sympathetic division of the autonomic nervous system is responsible for the "fight or flight" response, which involves increasing heart rate, decreasing blood flow to non-essential organs such as the kidneys and gastrointestinal tract, and increasing blood flow to skeletal and cardiac muscle, liver, and fat. It also increases blood glucose levels to provide energy for the body. However, airway constriction is not caused by the sympathetic division. Airway constriction is primarily caused by the parasympathetic division, which is responsible for the "rest and digest" response.

The statement is true because the Purkinje cell is the only type of neuron that sends output signals from the cerebellar cortex. These cells use the neurotransmitter GABA to inhibit the activity of other neurons in the cerebellar and vestibular nuclei. Therefore, the Purkinje cell plays a crucial role in regulating and coordinating motor movements and balance.

Damage of the posterior cerebral artery can result in visual problems. The posterior cerebral artery supplies blood to the occipital lobe of the brain, which is responsible for processing visual information. When this artery is damaged, it can lead to various visual impairments such as partial or complete loss of vision, visual field defects, blurred vision, or difficulty perceiving colors and shapes. These symptoms can vary depending on the extent and location of the damage within the posterior cerebral artery.

The cranial epidural space is not the location for injection with a local anesthetic to produce a paravertebral nerve block. The cranial epidural space is located within the skull, while a paravertebral nerve block is typically performed in the thoracic or lumbar regions of the spine. Therefore, the statement is false.

The most likely cause of the knee on the affected side going into recurvatum during stance phase is weakness or severe spasticity of the quadriceps. The quadriceps are responsible for extending the knee, and if they are weak or spastic, they may not be able to adequately control the movement of the knee during gait, causing it to hyperextend or go into recurvatum.

The correct answer is 140ml because the subarachnoid space and cerebral ventricles are the main spaces where cerebrospinal fluid (CSF) is found in the brain. The average volume of CSF in a healthy adult is around 140ml. This fluid plays a crucial role in cushioning the brain and spinal cord, regulating their chemical environment, and removing waste products.

Fracture of the L4 vertebra can cause impingement on the cauda equina. The cauda equina is a bundle of nerves that extends from the lower end of the spinal cord. It is located below the level of the L4 vertebra. When the L4 vertebra is fractured, it can put pressure on the cauda equina, leading to symptoms such as lower back pain, leg pain, numbness, and weakness. Therefore, the correct answer is cauda equina.

The correct answer is Ectoderm. The brain and spinal cord develop from cells that are arranged in a tubular structure called the neural tube. This neural tube is formed from the ectoderm, which is one of the three primary germ layers in the early embryo. The ectoderm gives rise to various structures including the nervous system, skin, and hair. Therefore, the brain and spinal cord develop from the ectoderm.

Rexed lamina I is the correct answer because it is the structure found at all levels of the spinal cord and is associated with light touch, pain, and temperature sensation. It is also known as the dorsomarginal nucleus.

In the case of a patient with Broca's Aphasia, their ability to produce speech is impaired, but their comprehension is relatively intact. By using oral communication that allows the patient to respond with yes or no answers, it allows them to participate in the conversation and express their thoughts and needs. This method takes into consideration their communication limitations while still allowing for interaction and engagement in the rehabilitation process.

The gyri are made because the gray matter grows faster than the white matter. This means that there is an increase in the amount of gray matter in the brain, leading to the formation of folds and ridges known as gyri. The gray matter contains the cell bodies of neurons, while the white matter consists of the axons that connect different areas of the brain. As the gray matter grows faster, it creates more surface area for neuronal connections, resulting in the formation of gyri.

The substantia nigra is the prominent population of melanin-containing cells located immediately internal to the crus cerebri. Melanin is a pigment that gives color to the skin, hair, and eyes, and it is also present in certain brain structures. The substantia nigra is involved in motor control and plays a crucial role in Parkinson's disease. It contains dopamine-producing cells that project to the striatum, another part of the brain involved in movement. Dysfunction of the substantia nigra and the loss of dopamine-producing cells are associated with the motor symptoms of Parkinson's disease.

Right hemisphere damage can affect a person's judgement and decision-making abilities. They may have difficulty assessing risks and making appropriate choices, leading to poor judgement. However, they may also exhibit increased cautiousness and concern for safety as a compensatory mechanism. This is because they may be aware of their impaired judgement and try to compensate for it by being more careful. Therefore, the correct answer is "Poor judgement with increased safety."

The secretomotor parasympathetic nerve fiber of the facial nerve exits at the Stylomastoid foramen. This is the small opening located between the styloid process and mastoid process of the temporal bone. It is through this foramen that the parasympathetic fibers leave the facial nerve to innervate the salivary glands and lacrimal glands, playing a role in tear production and saliva secretion.

The predominant neurons of the striatal system contain GABA, which stands for gamma-aminobutyric acid. GABA is an inhibitory neurotransmitter that helps regulate the balance of excitatory and inhibitory signals in the brain. In the striatal system, GABA plays a crucial role in motor control and movement coordination. These GABAergic neurons help to modulate the activity of other neurons in the striatum, which is involved in various cognitive and motor functions.

Cerebrospinal fluid enters the bloodstream via the arachnoid villi. These small, finger-like projections are located in the arachnoid mater, one of the layers of the meninges that surround the brain and spinal cord. The arachnoid villi protrude into the dural sinuses, which are large veins located within the dura mater. Through a process called reabsorption, the cerebrospinal fluid is able to pass from the subarachnoid space into the bloodstream through the arachnoid villi. This allows for the regulation of cerebrospinal fluid volume and pressure in the central nervous system.

Patients with unilateral neglect typically have difficulty attending to and perceiving stimuli on the side opposite to the brain lesion. This can manifest in various ways, such as neglecting to eat food from one side of the plate or consistently looking at the unaffected side. However, ignoring or denying the existence of the left limbs is not a typical symptom of unilateral neglect.

The third ventricle is a narrow cavity located along the midline superior to the hypothalamus and between the right and left halves of the thalamus. It is one of the interconnected fluid-filled spaces within the brain that helps to circulate cerebrospinal fluid. The third ventricle plays a crucial role in maintaining the balance of fluids and nutrients in the brain, and any abnormalities or blockages in this area can lead to various neurological disorders.

Spasticity is a condition characterized by increased muscle tone and resistance to passive movement. Grade 1 on the Ashworth Scale indicates mild spasticity, where there is a slight increase in muscle tone manifested by a catch and minimal resistance throughout the remainder of the range of motion. In the case of the CVA patient with spasticity of the left triceps surae, the mild increase in muscle tone and catch observed would correspond to Grade 1 on the Ashworth Scale.

The statement is false because the cerebellum does not facilitate cortical output that initiates and produces effective motor behaviors. Instead, the cerebellum is responsible for coordinating and fine-tuning motor movements initiated by the cerebral cortex. It receives input from various sensory systems and compares it with motor commands from the cortex to ensure smooth and accurate movements.

Broca's aphasia, also known as expressive aphasia, is a communication disorder characterized by intact verbal expression but impaired comprehension of words. In this type of aphasia, the individual struggles to find the right words and may speak in short, fragmented sentences. This is consistent with the given scenario where the patient can express themselves verbally but has difficulty understanding words correctly. Therefore, the correct answer is Broca's.

Based on the symptoms described, the patient is presenting with a combination of cranial nerve deficits and contralateral sensory loss. This suggests a lesion in the brainstem. The posterior circulation supplies the brainstem, including the cranial nerve nuclei and the pathways for contralateral sensory information. Therefore, the most likely site of the lesion is in the posterior circulation.

The Achilles reflex is monosynaptic because it involves only one synapse between the sensory neuron and the motor neuron. In this reflex, the sensory neuron detects the stretch in the Achilles tendon and sends a signal directly to the motor neuron, causing the contraction of the calf muscles and the extension of the foot. The absence of interneurons in this reflex pathway makes it a monosynaptic reflex.

The correct answer is spinal nerves because they are the only option that fits the description of containing sensory axons that conduct nerve impulses from sensory receptors in the skin, muscles, and internal organs into the central nervous system (CNS). The other options, such as anterior root, central canal, cauda equina, and posterior root, do not specifically refer to structures that carry sensory information.

An upgoing great toe when the sole of the foot is stroked is known as the Babinski sign. This is a pathological reflex that indicates an upper motor neuron lesion. Sustained ankle clonus is also a sign of an upper motor neuron lesion. Both of these findings suggest dysfunction in the corticospinal tract, which is responsible for voluntary movement and muscle tone. Therefore, it is expected that a patient with sustained ankle clonus would also have an upgoing great toe when the sole of the foot is stroked.

The posterior root is the correct answer because it contains sensory axons that transmit nerve impulses from sensory receptors in the skin, muscles, and internal organs to the central nervous system (CNS). The other options, such as spinal nerves, anterior root, central canal, and cauda equina, do not specifically refer to the structure that conducts sensory impulses.

The caudate nucleus is a round structure located at the base of the forebrain and is the most lateral of the basal ganglia nuclei. It plays a crucial role in motor control, as well as in cognitive functions such as learning, memory, and reward. Dysfunction of the caudate nucleus has been implicated in various neurological disorders, including Parkinson's disease and Huntington's disease.