LDA Neuro QUESTIONS WITH COMPLETE 100% VERIFIED SOLUTIONS 2024/2025, Exams of Health sciences

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LDA Neuro QUESTIONS WITH

COMPLETE 100% VERIFIED

SOLUTIONS 2024/

1) Describe two functions of the meninges. a. Forms a "PAD" around the brain in the skull- almost like a balloon of fluid for the brain to sit in so no pressure is on the bottom of the brain i. It makes movement slower to create less of an impact- therefore protecting the brain from too fast of movement and gravity of the brain b. Carries cerebral-spinal fluid; carrying or being a vehicle in which blood vessels bring nutrients/oxygen to the brain and taking away waste product from the brain 2) Describe two differences between the cerebral hemispheres. a. Left and Right: look similar but not identical; in Right handed adults the Left hemisphere is larger and has a longer lateral fissure b. Handedness plays a role: Most Right and Left handed people are Left hemisphere dominant for language 3) Describe the concept of homunculus man as it relates to brain function. a. It is where on the motor strip contributes to movement on the opposite side of the body; the size of the body part as shown on homunculus man represents the contribution to movement i. The face's size shows that it requires more motor control in comparison to the leg- this would represent homunculus man because it requires more space on the brain to contribute to all of its movements. b. If lesion that causes Brocas- it is likely to have facial problems because of the correlation in location of homunculus man and Brocas Area. i. Most likely dysarthria (unilateral-upper motor neuron); right side of the face would have the drooping and the possibility of right side tongue weakness 4) What is the significance of the location on the primary motor cortex of the site for innervation of the muscles of the oral mechanism? How can this be helpful diagnostically? a. Significance of location (Dr. Kaploun said via email): The location for those muscles on the primary motor cortex is close to Broca's area and the area for contributing to praxis, b. Helpful Diagnostically: leading to increased incidence of specific diagnoses together (Broca's aphasia with apraxia of speech and unilateral upper motor neuron dysarthria) we would look for possibility of one when other is present and would need to rule out others when one is present 5) What is the significance of the location in the frontal cortex of the neurons that contribute to oral praxis? How can this be helpful diagnostically?

a. It is located just in front of the primary motor cortex and is for complex and skilled movements. b. Significance of location that contributes to oral praxis: due to the location in the brain being associated/correlation of location with Broca's Area c. Diagnostically: This would be helpful because someone with Broca's Aphasia would have a higher incidence of having apraxia of speech 6) Explain what an arteriovenous malformation (AVM) is. What type of danger does AVM present? a. It is a convoluted (elaborate collections of weak, thin-walled veins and arteries on the brain's surface or within the brain b. Danger: Can cause subarachnoid hemorrhages- which compromise 8% of all strokes 7) Name three main areas of the frontal lobe and the functions with which they are associated. a. Primary motor cortex- controls motor movement on the opposite side of the body b. Premotor cortex- is for complex and skilled movements c. Prefrontal cortex- is for reasoning, abstract thinking, self monitoring, decision making, planning, and pragmatic behaviors 8) Describe three symptoms of frontal lobe deficit of executive function in the orbital-frontal area. How do symptoms of pathology in this area differ from pathology in the dorso-lateral area of the frontal lobe? a. Orbital-Frontal Area: you would have excess in- impulsive, distractible, and poor emotional control b. Difference from Dorso-Lateral Area: would be that dorso-lateral would have too little rather than too much. With dorso-lateral they would have a decrease in drive, lack of directed behavior, and limited language output. 9) Write a question you might ask during conversation to a client who presents with frontal lobe deficit in the orbital frontal area. How would he respond, given his deficits? How would the client with deficits in the dorso-lateral area of the frontal lobe respond? a. Question for frontal lobe deficit in the orbital frontal area: I could ask them to describe a picture they start becoming tangential and describing the picture and then telling a story about themselves that is only slightly related to the picture. b. Client with dorso-lateral area would respond: by saying very little because they have less spontaneous output so instead of describing the whole scene they would most likely use just a few words 10) List three areas of function for which the temporal lobe is responsible. a. Primary Auditory Cortex- receives information from both ears b. Memory c. Recognition of facial expression and other subtle social signals 11) List three areas of function for which the parietal lobe is responsible. a. Somantic sensation and perceptions b. Manipulating spatial information c. attention

12) List three areas of function for the cerebellum. a. Coordinates sequence of muscle movement b. Received input from sensory system c. Regulates rate, range, direction and force of movements 13) Define contralateral homonymous hemianopsia (define each word and describe its impact on visual acuity for someone with a left hemisphere CVA). Name two areas in the brain where pathology can have this effect. a. Contra lateral- opposite each side of the body; Homonymous- same part of the visual field; Hemianopsia- loss of vision in half of the eye i. Loss of vision to ½ of each eye, on the same side of each eye, on the side of the body opposite to the damage in the brain b. Impact on acuity for someone with L hemisphere CVA: the person would have a visual field cut on the right side of both eyes c. Two areas where pathology can have this effect: Optic Radiation and the optic tract 14) Which type of dysarthria is most commonly seen with aphasia and why? With what type of aphasia is it more commonly seen? a. Unilateral Upper-Motor Neuron because it affects the cortex on one side of the brain, which is usually when aphasia is seen- a lesion on one side of the brain, specifically usually the left side. Type of Aphasia: Broca's because of where it is located on the motor strip (primary motor cortex); in proximity to Broca's Area; therefore Broca's Aphasia would be more commonly seen due to its location on the brain 15) What other communication diagnosis often accompanies Broca's aphasia and why? a. Apraxia of speech because of the locations of the lesions for each disorder may be close to the frontal lobe 16) Name two arteries that lead to the circle of willis, and three that stem from it. a. 2 arteries that lead to it: internal carotid arteries and basilar artery b.3 arteries that stem from it: anterior, middle, and posterior cerebral artery 17) Describe the difference between ischemic and hemorrhagic stroke, in terms of etiology, pattern of recovery, and prognosis. a. Ischemic: happens when there is a restriction in the blood supply, (thrombosis: where blood is clotting and turning solid in a vessel blocking the blood flow; embolism: when debris might have been coating the vessel walls and it travels until it gets narrower and narrower creating a blockage in the blood flow) recovery can be good if given the tPA (tissue plasminogen activator) within the right amount of time which could reduce the deficits caused by the stroke, prognosis is that the first 2 weeks is where the most improvement is observed and then deteriorates until the condition stabilizes- less likely that its fatal, but worse prognosis over time because ischemic the blood supply was insuffient/lost and that caused tissue to die. In a hemorrhagic stroke the compressions can lighten when tumor is removed and the bleeding/drowning of the neurons can eventually SLOWLY be reabsorbed into the tissue.

b. Hemorrhagic: happens when the bleeding is practically drowning the neurons or compression from the outside, treatment is to reduce the blood pressure/ maintain respiration/ regulate the fluid intake, and now they close off the bleeding vessel mechanically through vessel in groin, prognosis is more likely to be fatal, but if the person survives it is more likely that the prognosis most likely to be better in comparison to the ischemic stroke with equivalent deficits at onset- first 4-8 weeks there is little to no progress and then progress picks up until it stabilizes at a level higher than that of the person with the ischemic stroke with equivalent deficits at onset (Revise) 18) Why would the watershed areas of blood supply to the brain be less vulnerable during a stroke? In what medical situation would the watershed areas of blood supply be more vulnerable to oxygen deprivation to the brain cells they feed? a. Those areas could be less vulnerable during an ischemic stroke because the supply to one artery is blocked- its still getting its supply from the other artery that is supplying the blood with oxygen and nutrients. b. In a situation of hypoperfusion there would be more vulnerable to having oxygen deprivation because the heart is not pumping hard enough to reach the watershed areas (smallest vessels, furthest from the heart) so now its not getting enough blood (oxygen/nutrients) causing the recells to die 19) Describe two types of ischemic CVA. a. Thrombosis- the clotting and solidifying of the blood vessels is blocking the blood flow b. Embolism- debris or an object might be coating the walls of the blood vessels that breaks off and travels until the vessel becomes so narrow that it then blocks the blood flow 20) What type of stroke would respond to tPA? What is its effect and what are the limitations of its use? a. An ischemic stroke would respond to tPA. The medication would break down the clot, but it has to be given within a few hours of when the stroke happens or it could be dangerous causing worse results, however there have been cases of it being given in the proper time and having worse results causing the blood to thin too much 21) Which type of aphasia generally shows the best recovery? Which types of aphasia show the greatest amount of recovery? What is the difference between the best recovery and the greatest amount of recovery/greatest improvement? a. Anomic's aphasia would have generally have the best recovery because their deficits are the mildest to begin with. b. Brocas and conduction aphasia show the greatest amount of recovery c. Having the greatest amount of recovery is meaning that there is the greatest amount of change from onset to where they ended up. Having the best recovery means most likely to end up with normal communication skills with recovery **22)Name four prognostic indicators for recovery from stroke.

23. Name three ways in which tumors produce symptoms.**

a. As a space-occupying lesions—cause pressure to rise b. As they get bigger they can block the blood supply to specific regions of the brain or interrupt circulation of CSF c. Damage brain tissue in a localized area 24) Describe three ways that penetrating head injury affects the brain. a. Creates pressure with an explosive effect on the brain b. Bacterial infections from debris c. Stretching and tearing of nerve fibers 25) What are three primary types of damage in closed head injury? a. Coup/contrecoup (site/opposite site of impact) b. Focal lesions c. Diffuse axonal shearing 26) Which parts of the brain are particularly vulnerable to injury in closed head injury and why? a. Anterior-inferior surface of the frontal lobe and the lateral-inferior surface of the temporal lobe, because those are the surfaces that rub during a closed head injury with the friction of the rubbing leading to lesions in those areas 27) Define coup and contre-coup injury. a. It is where the brain hits at the site of impact (coup) and then bounces off to hit the opposite side of the impact (contre-coup) 28) Name four secondary effects of damage in head injury. a. Edema- swelling of the brain b. Hypoxia- low oxygen levels c. Hemorrhage or Hematoma- bleeding and blood clotting d. Seizure- medications may be given preventively 29) Define brain plasticity. a. When parts of the brain take over for other parts of the brain when they are no longer able to accomplish their function 30) Contrast theories of recovery: brain plasticity, functional adaptation, and artifact. a. Brain plasticity- is when parts of the brain take over for other (damaged) parts when they are no longer able to accomplish their function; higher level areas will take over for lower level areas) b. Functional adaptation theory- when the patient relearns something that they knew before the deficit through compensation by learning to do it in a different way. Brain is flexible and can accommodate these changes c. Artifact- the areas that were peripheral to the damage that had some injury but weren't completely destroyed might heal and as those heal that might be where the recovery is taking place (recovery due to the resolution of secondary problems, and not areas of primary deficit/injury) i. Edema- as swelling goes down the neurons that had the swelling are able to function again

ii. Diaschisis- inhibition of function because of the tissue damage- collateral areas regenerate and this is how recovery happens 31) Describe two excitatory mechanisms of recovery. a. Silent synapses- synapse were there but they weren't being used until after the cell damage b. Disinhibition- cells that were disinhibited from a function are no longer disinhibited after injury (person who has enough damage in L hemisphere- areas in R hemisphere could take over to perfrom that function because they were set up to but didn't because L hemisphere was previously doing it already) **32)Discuss two degenerative diseases that impact on communication skills. Describe the nature of the disorder regarding neuropathology, symptoms observed early in the disease, and further in its progression.

33. What are the four subtypes of multiple sclerosis?** a. Relapsing-remitting b. Secondary- progressive c. Primary-progressive d. Progressive-relapsing 34) Describe the typical symptoms of Parkinson's disease. a. Rigidity, resting tremor, bradykinesia, postural instability 35) Describe the type of communication disorder seen in late stage amyotrophic lateral sclerosis. a. anarthria (Look up) b. dysphagia 36) Give two examples of how a nutritional imbalance can impact communication skills. a. Too much- Vitamin A b. Too little- Vitamin B 37) Define the following terms: agnosia, alexia, agraphia, acalculia, apraxia, dysarthria, anosognosia, ischemia, thrombosis, embolism, infarct, atrial fibrillation, tPA, diaschisis, vicaration. a. Agnosia- cannot recognize stimuli in a sensory modality despite the fact the sensation being intact b. Alexia- cannot read c. Agraphia- cannot write d. Acalculia- cannot calculate - cannot perform math e. Apraxia- disruption in volitional movement even in absence of a sensory loss, weakness, or paralysis f. Dysarthria- g. Anosognosia- doesn't recognize errors h. Ischemia- when supply of blood to the brain becomes inadequate for brain cells to function i. Thrombosis- clots in the brain (solidifying) of blood in the vessel, blocking the flow of blood to the brain j. Embolism- when an object (debris) moves through the body creating a blockage in a blood vessel to another part of the body

k. Infarct- death of tissue caused by loss of blood supply l. Atrial fibrillation- m. tPA- medication that breaks down clots and must be used within a few hours after symptom onset n. diaschisis- o. Vicaration-