Neuroscience Fundamentals Rehabilitation 4th Edition Lundy Ekman Test Bank

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Neuroscience Fundamentals Rehabilitation 4th Edition Lundy Ekman Test Bank

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Neuroscience Fundamentals Rehabilitation 4th Edition Lundy Ekman Test Bank

Lundy-Ekman: Neuroscience: Fundamentals for Rehabilitation, 4th Edition

 

Chapter 2: Physical and Electrical Properties of Cells in the Nervous System

 

Test Bank

 

 

  1. Which one of the following neuron structures is specialized for receiving synaptic input from other neurons?
  2. Cell body
  3. Dendrite
  4. Axon
  5. Axon hillock
  6. Presynaptic terminal

 

ANS: B

Rationale: Dendrites, with branchlike extensions that serve as the main input sites for the cell and project from the soma, are specialized to receive information from other cells.

 

  1. Which of the following is the structural part of a neuron that releases a neurotransmitter?
  2. Dendrite
  3. Axon hillock
  4. Soma
  5. Presynaptic terminal
  6. Postsynaptic terminal

 

ANS: D

Rationale: Axons end in presynaptic terminals, or fingerlike projections, which are the transmitting elements of the neuron. Neurons transmit information about their activity via the release of chemicals called neurotransmitters from the presynaptic terminal into the synaptic cleft.

 

  1. Pseudounipolar cells:
  2. Have two dendrites
  3. Have two somas
  4. Are not neurons
  5. Are glial cells
  6. Have two axon extensions

 

ANS: E

Rationale: Pseudounipolar cells, a subclass of bipolar cells, appear to have a single projection from the cell body that divides into two axonal roots. Pseudounipolar cells have two axons and no true dendrites.

 

  1. Retrograde transport:
  2. Recycles substances from the axon back to the soma.
  3. Moves neurotransmitters from the dendrites to the cell body.
  4. Moves substances from the soma toward the axon terminal.
  5. Moves neurotransmitters across the synaptic cleft.
  6. Moves information from astrocyte to astrocyte.

 

ANS: A

Rationale: Axoplasmic transport occurs in two directions: anterograde and retrograde. Anterograde transport moves neurotransmitters and other substances from the soma down the axon toward the presynaptic terminal. Retrograde transport moves substances from the synapse back to the soma.

 

  1. Afferent neurons convey information:
  2. Between interneurons.
  3. From the CNS to skeletal muscles.
  4. From peripheral receptors to the CNS.
  5. Between the soma and presynaptic terminal.
  6. From the CNS to smooth muscles.

 

ANS: C

Rationale: Afferent neurons carry sensory information from the outer body toward the CNS. Efferent neurons relay commands from the CNS to smooth and striated muscles and glands. Interneurons, the largest class of neurons, act throughout the nervous system, processing information locally or conveying information across short distances.

 

  1. The resting membrane potential is:
  2. The same as the membrane equilibrium potential.
  3. The voltage difference across a neurons cell membrane, maintained by an unequal distribution of one specific ion.
  4. Maintained by active transport of sodium ions (Na+) and potassium ions (K+) and passive diffusion of Na+, K+, and chloride ions (Cl) through the cell membrane.
  5. Typically measured at +70 millivolts (mV) because the intracellular environment is more positively charged than the extracellular environment.
  6. Created by a more negative charge inside the membrane than outside because Na+ is continuously moved inside the cell membrane by an active transport pump.

 

ANS: C

Rationale: The resting membrane potential is maintained via passive diffusion of ions across the cell membrane and via active transport of Na+ and K+ by Na+/K+ pumps.

 

  1. Depolarization occurs when:
  2. The membrane potential becomes less negative than the resting membrane potential.
  3. The membrane potential becomes more negative than the resting membrane potential.
  4. Cl influx hyperpolarizes the membrane.
  5. The presynaptic terminal of a neuron is inhibited by another neuron.
  6. All membrane channels are closed, preventing the influx of Na+.

 

ANS: A

Rationale: Sudden changes in membrane potential result from the flow of electrically charged ions through gated channels spanning the cell membrane. The membrane is depolarized when the potential becomes less negative than the resting potential.

 

  1. Local potentials:
  2. Are either receptor or synaptic potentials.
  3. Spread passively only a short distance along the cell membrane.
  4. Result from stimulation of sensory receptors or from the binding of a neurotransmitter with chemical receptor sites on a postsynaptic membrane.
  5. Both A and B
  6. A, B, and C

 

ANS: E

Rationale: Local potentials are categorized as either receptor potentials or synaptic potentials, depending on whether they are generated at a peripheral receptor of a sensory neuron or at a postsynaptic membrane. These local potentials can only spread passively and therefore are confined to a small area of the membrane.

 

  1. Which of the following change the electrical potential across the cell membrane?
  2. Activation and opening of ligand-gated K+ channels.
  3. Activation and opening of modality-gated Na+ channels.
  4. Activation and opening of voltage-gated Cl channels.
  5. Leak channels, which allow continuous diffusion of small ions.
  6. All of the above

 

ANS: E

Rationale: Neurons function by undergoing rapid changes in electrical potential across the cell membrane. An electrical potential across a membrane exists when the distribution of ions creates a difference in electrical charge on each side of the cell membrane. Four types of membrane channels allow ions to flow across the membrane: leak channels, modality-gated channels, ligand-gated channels, and voltage-gated channels.

 

  1. Propagation of an action potential along an axon is dependent on a(n):
  2. Complete myelination of the axon by glial cells.
  3. Anterograde diffusion of the electric potential with active generation of new potentials.
  4. Rapid repolarization associated with passive diffusion of Cl.
  5. Retrograde diffusion of the electrical potential.
  6. Na+/K+ pump moving sufficient quantities of Na+ into of the cell and K+ out of the cell.

 

ANS: B

Rationale: An action potential is a brief, large depolarization in electrical potential that is repeatedly regenerated along the length of an axon. Regeneration allows an action potential to actively spread long distances, transmitting information down the axon to the presynaptic chemical release sites of the presynaptic terminal.

 

  1. The nodes of Ranvier:
  2. Are distributed approximately every 1 to 2 millimeters (mm) along the membrane of the cell axon.
  3. Contain a high density of modality-gated K+ channels for rapid depolarization of the membrane.
  4. Contain a high density of voltage-gated Na+ channels for rapid repolarization of the membrane.
  5. Have low membrane capacitance, preventing the accumulation of electrical charge.
  6. Are heavily myelinated, which allows for rapid diffusion of an electrical potential.

 

ANS: A

Rationale: The nodes are specialized for active propagation of an action potential by allowing ion flow across the membrane. The nodes of Ranvier are distributed every 1 to 2 mm along the axon and contain high densities of voltage-gated Na+ and K+ channels. An action potential spreads rapidly along a myelinated region and then slows when crossing the high-capacitance, unmyelinated region of the nodes of Ranvier.

 

  1. Demyelination of an axon:
  2. Results in decreased membrane resistance, allowing a leakage of electrical current.
  3. Results in slowed propagation of action potentials.
  4. May prevent propagation of action potentials.
  5. Both A and B
  6. A, B, and C

 

ANS: E

Rationale: Myelination increases the speed of action potential propagation and the distance a current can passively spread. Thicker myelin leads to faster conduction and improved action potential propagation. Demyelination allows leakage of electrical current across the membrane, decreasing the amplitude and velocity of the signal as the action potential travels down the axon. Similarly, when a hose has a leaky wall, the flow diminishes as the distance from the faucet increases.

 

  1. Peripheral demyelination:
  2. Typically affects small diameter axons before large diameter axons.
  3. Is a characteristic feature of multiple sclerosis.
  4. Affects the structure of oligodendrocytes.
  5. Typically affects the Schwann cells of large, well-myelinated axons.
  6. Typically affects the axon at the ventral root of the spinal cord.

 

ANS: D

Rationale: Peripheral neuropathies often involve destruction of the myelin surrounding the largest, most myelinated sensory and motor fibers, resulting in disrupted proprioception (awareness of limb position) and weakness. Guillain-Barr syndrome, metabolic abnormalities, viruses, trauma, and toxic chemicals can cause peripheral demyelination.

 

  1. Guillain-Barr syndrome:
  2. Involves demyelination of peripheral axons.
  3. Results from an autoimmune attack on Schwann cells.
  4. May affect cranial nerves controlling the muscles involved in swallowing, breathing, and facial expression.
  5. Both A and B
  6. A, B, and C

 

ANS: E

Rationale: Both Guillain-Barr syndrome (acute idiopathic polyneuritis) and multiple sclerosis are autoimmune disorders that cause demyelination. Guillain-Barr syndrome is a peripheral neuropathy that affects sensory and motor function and, in severe cases, peripheral autonomic function. Lower cranial nerves may also be affected, resulting in facial weakness and difficulty swallowing and breathing.

 

  1. Multiple sclerosis:
  2. Results from an autoimmune attack on oligodendrocytes.
  3. Involves demyelination of axons in the CNS.
  4. Has signs and symptoms associated with both motor and sensory impairment.
  5. Both A and B
  6. A, B, and C

 

ANS: E

Rationale: Both Guillain-Barr syndrome (acute idiopathic polyneuritis) and multiple sclerosis are autoimmune disorders that cause demyelination. In multiple sclerosis, demyelination in the CNS produces plaque in the white matter. Because multiple sclerosis attacks the CNS, a greater variety of symptoms occur, including weakness, lack of coordination, visual problems, impaired sensation, slurred speech, memory problems, and abnormal emotional affect.

 

  1. Which one of the following is not one of the primary components of a neuron?
  2. Axon
  3. Soma
  4. Postsynaptic membrane
  5. Dendrite

 

ANS: C

Rationale: The primary components of a neuron consist of dendrites, which transmit information toward the cell body; the soma or cell body, which synthesizes neurotransmitters; axons, which transmit information away from the cell body to a target cell; and presynaptic terminals, which release neurotransmitters into the synaptic cleft.

 

  1. The strength of local electrical potentials is modulated and integrated via:
  2. Spatial summation, the combined effect of potentials generated in other parts of the neuron.
  3. Temporal summation, the combined effect of small potential changes occurring over several milliseconds.
  4. Both A and B
  5. None of the above. A local potential is an all-or-none phenomenon.

 

ANS: C

Rationale: The strength of local potentials is increased, and the strength of multiple potentials is integrated via spatial summation and temporal summation. Spatial summation refers to the process of summing potentials generated in different parts of the neuron, whereas temporal summation refers to the adding together of small potentials that occur in a period of several milliseconds. If the summation of these local potentials reaches a specific threshold level, an all-or-none action potential is generated.

 

  1. Which one of the following is an example of divergence?
  2. Signals in the neural pathway that leads to contraction of the hip flexor muscles when a painful stimulus is applied to the toe
  3. Integration of taste and smell information in the temporal lobe
  4. Multiple different cells synapsing with a single neuron in the spinal cord
  5. All of the above

 

ANS: A

Rationale: Convergence is the process during which multiple inputs from a variety of neurons are integrated into a single neuron, whereas divergence is the process during which a single neuron communicates with multiple other neurons. The integration of multiple sensory inputs by the cerebral cortex is an example of convergence; conversely, an example of divergence is the stimulation of a single sensory neuron evoking a withdrawal reflex in a large group of muscle cells.

 

  1. Glial cells contribute which of the following?
  2. Communication between neurons and blood vessels
  3. Neural cell death
  4. Action potential propagation
  5. Both A and B
  6. All of the above

 

ANS: E

Rationale: Glial cells, known as astrocytes, participate in cellular signaling with other astrocytes, neurons, and cells such as vascular smooth muscle. Glial cells also play an important role in phagocytosis and CNS development. Oligodendrocytes and Schwann cells aid in the propagation of action potentials generated by the neuron. Macroglial cells clean the extracellular environment; however, hyperactivity of these and other glial cells may result in neurologic damage.

 

 

Lundy-Ekman: Neuroscience: Fundamentals for Rehabilitation, 4th Edition

 

Chapter 10: The Motor System: Motor Neurons

 

Test Bank

 

 

  1. Which one of the following proteins is NOT involved in the active process of muscle contraction?
  2. Myosin
  3. Actin
  4. Tropomyosin
  5. Troponin
  6. Titin

 

ANS: E

Rationale: Binding of Ca2+ with troponin causes tropomyosin to move, exposing active sites on actin for myosin to bind. When the heads of myosin swivel, the sarcomere actively contracts. Titin is a structural protein, not involved in active contraction.

 

  1. Continuous prolonged immobilization of skeletal muscle in a shortened position results in which of the following?
  2. Increased muscle tone from hyperactive reflexes
  3. Contracture from loss of sarcomeres
  4. Increased tensile strength from the addition of titin
  5. Both A and B
  6. A, B, and C

 

ANS: B

Rationale: When skeletal muscle is continually immobilized for a prolonged time, the muscle physiologically adjusts to the shortened position by losing sarcomeres from the ends of myofibrils. This length adjustment enables the shortened muscle to contract optimally at the shortened length.

 

  1. Which one of the following produces weak actin-myosin bonding?
  2. Active muscle contraction
  3. Muscle immobility
  4. Physiologic contracture
  5. Active contraction in lengthened muscles
  6. Reflexive muscle contraction

 

ANS: B

Rationale: When skeletal muscle is at rest, a small number of myosin crossbridges bind to actin but the crossbridge heads do not swivel. The longer muscle is immobile, the greater the number of actin-myosin weak bonds and the greater the muscle resistance to stretch. The hamstring stiffness upon standing after prolonged sitting is due to weak actin-myosin bonds.

 

  1. What is the purpose of alpha-gamma coactivation?
  2. Prevents simultaneous activation of fast twitch and slow twitch muscles.
  3. Coordinates reciprocal reflex innervation.
  4. Coordinates the actions of the basal ganglia and cerebellum.
  5. Maintain muscle spindle sensitivity when extrafusal muscle fibers contract.
  6. Prevents contraction of an antagonist muscle when the agonist is contracting.

 

ANS: D

Rationale: To maintain muscle spindle sensitivity when the extrafusal muscle fibers contract, when alpha motor neurons fire gamma motor neurons to the spindle in the same muscle also fire. The gamma signals cause the ends of the intrafusal muscle fibers to contract, maintaining the stretch of the central region of intrafusal fibers when the extrafusal muscle fibers actively contract.

 

  1. The term phasic stretch reflex is synonymous with which of the following?
  2. Myotatic reflex
  3. Muscle stretch reflex
  4. Deep tendon reflex
  5. Both A and B
  6. A, B, and C

 

ANS: E

Rationale: Myotatic reflex, muscle stretch reflex, and deep tendon reflex are all synonymous with phasic stretch reflex.

 

  1. Reciprocal inhibition produces inhibition of the alpha motor neurons to which of the following?
  2. Agonist muscle
  3. Agonist muscle and its synergists
  4. Antagonist muscle
  5. Agonist muscle, its synergists, and its antagonists
  6. Homologous muscles in the opposite limb

 

ANS: C

Rationale: Reciprocal inhibition inhibits the alpha motor neurons to the antagonist muscle.

 

  1. Which of the following is true about the Golgi tendon organ (GTO)?
  2. Maximum GTO activation occurs before maximum voluntary contraction.
  3. GTO inhibition of the agonist alpha motor neuron causes immediate muscle relaxation via the GTO reflex.
  4. Effectiveness of the contract-relax technique for stretching is dependent on GTO input.
  5. GTO conveys information via a type IIa afferent to the spinal cord.
  6. All of the above are true statements.

 

ANS: B

Rationale: Maximum GTO activation occurs before maximum voluntary contraction. Because maximum GTO activation occurs prior to maximum voluntary contraction, GTO inhibition of the agonist alpha motor neuron cannot cause immediate muscle relaxation; otherwise, muscle could not continue to contract when GTO signals are maximal. Thus there is no GTO reflex. For the same reason, GTO inhibition cannot explain the effectiveness of the contract-relax technique. GTO information is conveyed via type Ib afferents.

 

  1. Which of the following statements about fast twitch muscle fibers is true?
  2. The neuron innervating the muscle determines twitch characteristics.
  3. Alpha motor neurons having large-diameter axons innervate fast twitch muscle fibers.
  4. Using a long train of repetitive contractions identifies twitch characteristics.
  5. Both A and B
  6. A, B, and C

 

ANS: D

Rationale: The neuron innervating the muscle determines twitch characteristics and large-diameter axons innervate fast-twitch muscles.

 

  1. Which of the following contributes to the spinal control of walking?
  2. Afferent input from muscle spindles and GTOs
  3. Adaptable networks of interneurons that modulate lower motor neuron firing patterns
  4. Reciprocal signals crossing the dorsal columns and commissure of the spinal cord
  5. All of the above

 

ANS: D

Rationale: Stepping pattern generators (SPGs) contribute the spinal control of walking. SPGs are adaptable networks of interneurons that receive input from muscle spindles and GTOs and modulate lower motor neuron firing. The cycles of left and right SPGs are coordinated by signals that cross in the anterior commissure, so that the right lower limb hip and knee flex while the left hip and knee extend.

 

  1. Which one of the following involuntary muscle contractions is always abnormal?
  2. Muscle spasms
  3. Cramps
  4. Fasciculations
  5. Fibrillations
  6. All of the above

 

ANS: D

Rationale: Fibrillations, because the affect only a single muscle fiber, are always abnormal. When an alpha motor neuron fires, all of the muscle fibers it innervates contract, so there is no normal mechanism to fire an individual muscle fiber. Muscle spasms, cramps, and fasciculations can occur in normal and pathologic conditions.

 

  1. Myoclonus is:
  2. Severe and painful muscle spasms
  3. Quick twitches of a single motor unit
  4. Brief involuntary contractions of a muscle or group of muscles
  5. Persistent muscle twitching after spinal or cerebral shock
  6. None of the above

 

ANS: C

Rationale: Myoclonus is brief, involuntary contractions of a muscle or group of muscles. Examples are hiccups and the muscle jerks that some people experience when falling asleep. Myoclonus is not painful, affects the entire muscle, and is not characteristic after spinal or cerebral shock.

 

  1. If the lower motor neurons to a muscle are destroyed, which of the following signs affects the denervated muscles?
  2. Loss of reflexes
  3. Atrophy
  4. Muscle hyperstiffness
  5. Both A and B
  6. A, B, and C

 

ANS: D

Rationale: Denervated muscles atrophy and lose reflexes because there is no efferent pathway from the spinal cord to the muscles. Spasticity cannot occur because spasticity is neuromuscular overactivity, and there are no signals from the nervous system to the muscles.

 

  1. After lower neuron motor denervation caused by poliomyelitis, how does recovery of some muscle strength occur?
  2. Cell division of surviving motor neurons produces new motor neurons.
  3. Loss of interneuronal inhibition causes hyperreflexia.
  4. Axonal sprouting of surviving neurons innervates muscle fibers.
  5. Both A and B
  6. A, B, and C

 

ANS: C

Rationale: Post-polio, some muscle strength recovers when surviving neurons innervate muscle fibers. Hyperreflexia and neural cell division do not contribute to the recovery of strength.

 

  1. Abnormal cutaneous reflexes that occur after an upper motor neuron lesion include which of the following?
  2. Emergence of Babinskis sign
  3. Muscle spasms in response to normally innocuous stimuli
  4. Paresthesias
  5. Both A and B
  6. A, B, and C

 

ANS: D

Rationale: Both Babinskis sign and muscle spasms in response to normally innocuous stimuli are abnormal cutaneous reflexes that occur after an UMN lesion. Paresthesia is an abnormal sensation, not a reflex.

 

  1. Which one of the following major factors limits movement in individuals who have had a stroke?
  2. Paresis caused by decreased agonist activation
  3. Loss of ability to fractionate movement
  4. Abnormal timing of muscle activation
  5. Both A and B
  6. A, B, and C

 

ANS: E

Rationale: Paresis caused by decreased agonist activation, loss of ability to fractionate movement, and abnormal timing of muscle activation limit movement in individuals post stroke.

 

  1. Clonus is characterized by which one of the following?
  2. Involuntary, repetitive, and rhythmic muscle contractions in response to muscle stretch
  3. Decrease in resistance to passive stretch of a hypertonic muscle
  4. Excessive resistance to both passive and active muscle stretch
  5. Prolonged contraction of antigravity muscles
  6. Brief, involuntary contraction of a single muscle fiber

 

ANS: A

Rationale: The definition of clonus is involuntary, repetitive, and rhythmic muscle contractions in response to muscle stretch.

 

  1. Decorticate rigidity occurs with which of the following?
  2. Lesions of the medulla
  3. Vascular lesions of the anterior choroidal artery
  4. Lesions superior to the midbrain
  5. Lesions to the cerebellar lobes
  6. All of the above

 

ANS: C

Rationale: In decorticate rigidity, the entire brainstem is intact and the lesion is superior to the midbrain.

 

  1. Myoplasticity results from which of the following?
  2. Contracture
  3. Increased weak actin-myosin binding
  4. Spasticity
  5. Both A and B
  6. A, B, and C

 

ANS: D

Rationale: Myoplasticity is adaptive changes within a muscle in response to changes in neuromuscular activity level and to prolonged positioning. Contracture and increased weak actin-myosin bonding are forms of myoplasticity. Spasticity is neuromuscular overactivity, so spasticity includes neural effects in addition to muscle effects.

 

  1. In an individual with paraparesis secondary to an incomplete spinal cord lesion, the increase in Achilles tendon tension during gait coincides with the stretch of the triceps surae during passive dorsiflexion of the foot in the stance phase. The increase in Achilles tendon tension is not correlated with an increase in EMG. What causes the abnormal muscle resistance to stretch?
  2. Spasticity
  3. Contracture
  4. Cocontraction
  5. Hyperreflexia
  6. Atrophy

 

ANS: B

Rationale: The abnormal triceps surae resistance to stretch is caused by contracture. The shortened muscle cannot stretch as much as a normal length muscle.

 

  1. What is the mechanism by which onabotulinumtoxinA (BOTOX) decreases muscle activation?
  2. Blocks the binding of acetylcholine (ACh) to the motor end plate.
  3. Inhibits the binding of myosin to active sites on actin.
  4. Blocks the release of Ca+2 from the sarcoplasmic reticulum.
  5. Inhibits the release of ACh from the presynaptic terminal.
  6. None of the above occurs.

 

ANS: D

Rationale: Botox decreases muscle activation by inhibiting the release of ACh from the presynaptic terminal. With decreased transmitter release from the alpha motor neuron, the muscle membrane does not get the signal to initiate muscle contraction.

 

 

Lundy-Ekman: Neuroscience: Fundamentals for Rehabilitation, 4th Edition

 

Chapter 18: Cerebrum: Clinical Applications

 

Test Bank

 

 

  1. The inability to understand written or spoken language, including inability to read and write and produce meaningful language, despite the ability to produce fluent speech sounds:
  2. Brocas aphasia
  3. Conduction aphasia
  4. Global aphasia
  5. Wernickes aphasia
  6. Dysarthria

 

ANS: D

Rationale: In Wernickes aphasia, language comprehension (symbolic communication) is impaired. Those with Wernickes aphasia easily produce spoken sounds, but the output is meaningless.

 

  1. Dysarthria is caused by a lesion of which of the following?
  2. Brocas area, usually in the left hemisphere
  3. Brocas area, usually in the right hemisphere
  4. Wernickes area, Brocas area, and the intervening cortical and subcortical structures
  5. Lower motor neurons or corticobrainstem neurons
  6. Neurons connecting Wernickes area with Brocas area

 

ANS: D

Rationale: Damage to lower motor neurons (cranial nerves IX, X, and/or XII) causes paresis of speech muscles, producing flaccid dysarthria. Damage to corticobrainstem neurons that synapse with LMNs to speech muscles causes spastic dysarthria.

 

  1. Synonyms for Brocas aphasia include which of the following?
  2. Motor aphasia
  3. Expressive aphasia
  4. Nonfluent aphasia
  5. A and B
  6. A, B, and C

 

ANS: E

Rationale: Brocas aphasia is the difficulty of expressing oneself using language. People with Brocas aphasia may not produce any language output, or they may be able to generate habitual phrases, such as Hello. How are you? or make brief meaningful statements and may be able to produce emotional speech (e.g., obscenities, curses) when upset. People with Brocas aphasia are usually aware of their language difficulties and are frustrated by their inability to produce normal language. Writing is usually as impaired as speaking. The ability to understand the spoken language and to read is spared. Motor, expressive, and nonfluent aphasia are synonymous with Brocas aphasia.

 

  1. Which of the following best defines anosognosia?
  2. Severe hemiparesis
  3. Hemilateral personal neglect
  4. Denial of functional deficits in the paretic limb
  5. Visual spatial neglect
  6. Constructional apraxia

 

ANS: C

Rationale: Anosognosia is the denial of functional deficits in a paretic limb.

 

  1. If a person speaks in a monotone, is unable to communicate effectively nonverbally, and lacks emotional gestures and facial expressions, the lesion is located in which of the following?
  2. Brocas area in the dominant hemisphere
  3. Area corresponding to Brocas in the nondominant hemisphere
  4. Wernickes area in the dominant hemisphere
  5. Area corresponding to Wernickes area in the nondominant hemisphere
  6. Lower motor neurons or corticobrainstem neurons

 

ANS: B

Rationale: Damage to the right cortex in the area corresponding to Brocas area may cause the person to speak in a monotone, to be unable to communicate effectively nonverbally, and to lack emotional facial expressions and gestures. These consequences are sometimes referred to as flat affect.

 

  1. Which of the following may occur with damage to the area corresponding to Wernickes area?
  2. Inability to understand nonverbal communication
  3. Personal neglect
  4. Spatial neglect
  5. A and B
  6. A, B, and C

 

ANS: E

Rationale: If the area corresponding to Wernickes is damaged on the right side, then the person has difficulty understanding nonverbal communication. The area corresponding to Wernickes area is also important for body image and for understanding the relationship between self and the environment. Damage to the area corresponding to Wernickes area may cause neglect.

 

  1. Which of the following characterize spatial neglect?
  2. Navigation apraxia
  3. Dressing apraxia
  4. Visual agnosia
  5. A and B
  6. A, B, and C

 

ANS: D

Rationale: Spatial neglect is characterized by a unilateral lack of understanding of spatial relationships, resulting in a deranged internal representation of space. People with neglect may have only one sign (e.g., lack of awareness of people or objects on their left) or any combination of signs.

 

  1. Which of the following typically occur after traumatic head injury?
  2. Impulsiveness and inappropriate behaviors
  3. Difficulty in directing attention
  4. Decreased executive functions
  5. A and B
  6. A, B, and C

 

ANS: E

Rationale: People with traumatic brain injury show poor judgment, decreased executive functions, memory deficits, slow information processing, attentional disorders, and poor divergent thinking. The inability to use new information effectively results in concrete thinking, an inability to apply rules appropriately, and trouble distinguishing relevant from irrelevant information.

 

  1. Consequences of violent shaking of an infant may include which of the following?
  2. Cerebral edema
  3. Cerebral hemorrhage
  4. Development of motor abnormalities as the infant matures
  5. Emergence of cognitive deficits as the infant matures
  6. All of the above

 

ANS: E

Rationale: The trauma from shaking is due to the impact of the brain repeatedly striking the skull. Soon after the incident, cerebral edema may increase the infants head circumference and cause bulging of the anterior fontanelle. Brain scans show hemorrhage and edema. Survivors may exhibit motor signs similar to those of developmental delay or cerebral palsy and have a pattern of cognitive deficits similar to that seen in adults with traumatic brain injury.

 

  1. Which of the following describes the motor control approach to regaining function subsequent to a stroke?
  2. Therapist uses hands-on techniques to inhibit excessive muscle tone.
  3. Client is encouraged to use the nonparetic side to substitute for the paretic side.
  4. A rigid lower limb brace is provided to allow early ambulation.
  5. Desired task is practiced in the environment in which the client will be performing the task.
  6. Sequence of preparatory activities is perfected before the desired task is attempted.

 

ANS: D

Rationale: Motor control approaches emphasize task specificity; that is, practicing the desired task in a specific context. If the goal is independent walking, then walking is practiced, rather than preparatory activities. Examples of preparatory activities include standing balance or lateral weight transfers in standing. Using the motor control approach, the client might walk an obstacle course with the therapist guarding for loss of balance.

 

  1. For which condition might a callosotomy be beneficial?
  2. Epilepsy
  3. Parkinsons disease
  4. Arthritis
  5. Dementia

 

ANS: A

Rationale: Callosotomy is a surgical procedure performed in those with intractable epilepsy when the excessive neuronal activity that characterizes epilepsy cannot be controlled by medication or by surgical damage of a single cortical site.

 

  1. Which kind of disorder may be caused by a lesion or dysfunction of the caudate head?
  2. Movement disorders
  3. Apathy
  4. A and B
  5. None of the above

 

ANS: B

Rationale: In contrast to the movement disorders associated with lenticular dysfunction, lesions or dysfunctions of the caudate head rarely cause motor disorders; rather, they cause behavioral disturbances. The most common abnormality secondary to caudate head damage is apathy, with the loss of initiative, spontaneous thought, and emotional responses.

 

  1. Where is pain processed?
  2. Secondary sensory cortex
  3. Primary somatosensory cortex
  4. Visual cortex
  5. None of the above

 

ANS: A

Rationale: Pain information is processed in the secondary sensory cortex, insula, and anterior cingulate cortex, rather than in the primary somatosensory cortex.

 

  1. What is motor perseveration?
  2. Acquisition of a new motor skill through repetition
  3. Inability of a person to perform a movement or sequence of movements despite intact sensation, normal muscle strength and coordination, and understanding of the task
  4. Uncontrollable repetition of a movement
  5. Impairment in the ability to draw and to arrange objects correctly in space

 

ANS: C

Rationale: Motor perseveration is the uncontrollable repetition of a movement. For example, a person may continue to lock and unlock the brakes of a wheelchair, despite intending to lock the brakes.

 

  1. If a patient is unable to button a shirt despite intact sensation, motor control, and understanding of the task, where is the most likely location of a lesion?
  2. Wernickes area
  3. Hippocampus, Wernickes area, or Brocas area
  4. Secondary somatosensory cortex
  5. Premotor or supplementary motor areas

 

ANS: D

Rationale: Apraxia can be considered motor agnosia; the knowledge of how to perform skilled movement is lost. Apraxia occurs as a result of damage to the premotor or supplementary motor areas of the inferior parietal lobe.

 

  1. Which of the following items is an aspect of emotional lability?
  2. Abrupt mood shifts
  3. Lack of emotion
  4. Intentionally ignoring someone elses emotions
  5. None of the above

 

ANS: A

Rationale: Emotional lability has three aspects: (1) abrupt mood shifts, usually to anger, depression, or anxiety; (2) involuntary, inappropriate emotional expression in the absence of subjective emotion (pathologic laughter or crying); and (3) emotion that is triggered by nonspecific stimuli unrelated to the emotional expression.

 

  1. What is Wernickes aphasia?
  2. Inability to use language in any form
  3. Use of unintended words or phrases
  4. Difficulty in expressing oneself using language
  5. Impairment of language comprehension

 

ANS: D

Rationale: In Wernickes aphasia, language comprehension is impaired. Those with Wernickes aphasia easily produce spoken sounds, but the output is meaningless.

 

  1. Spatial neglect includes:
  2. Problems with navigation
  3. Problems with dressing
  4. None of the above
  5. A and B

 

ANS: D

Rationale: Spatial neglect includes problems with navigation, construction, and dressing. One aspect of a deficit in understanding spatial relationships is difficulty finding the correct route to a location. People with spatial neglect may catch part of a wheelchair on an object and continue to try to move forward, unaware that the object is interfering with the intended movement.

 

  1. What differences generally appear in how attention deficit hyperactivity disorder (ADHD) manifests in boys versus in girls?
  2. No differences exist.
  3. Boys with ADHD are more likely to be inattentive than girls; girls tend to be hyperactive or impulsive.
  4. Girls with ADHD are more likely to be inattentive than boys; boys tend to be hyperactive or impulsive.
  5. Girls with ADHD are less likely to be inattentive than boys; boys tend to be hyperactive or impulsive.

 

ANS: C

Rationale: Girls with ADHD are more likely to be inattentive than boys. Boys with ADHD tend to be hyperactive or impulsive. The disorder usually persists into adulthood, impairing social, academic, and work capabilities.

 

  1. If a patient has lesions in the right parietotemporal cortex, which of the following symptoms are they likely to experience?
  2. Disorders of language
  3. Difficulty understanding nonverbal communication
  4. None of the above
  5. A and B

 

ANS: B

Rationale: Lesions in the left parietotemporal association cortex can produce disorders of language (Wernickes aphasia). Lesions in the right parietotemporal cortex may cause contralateral neglect, difficulty understanding nonverbal communication, and anosognosia (denial of deficits).

 

 

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