Neuro Exam 1 USAHS questions and answers all are graded A+

Apraxia - inability to make a motor plan, as a result of brain damage. Ataxia - lack of muscle coordination Aphasia - impairment of language, usually caused by left hemisphere damage either to Broca's area (impairing speaking) or to Wernicke's area (impairing understanding). 1 olfactory - Making client smell something pleasant front of brain 2 optic - thalamus - test visual acuity (Snellen chart, or # of fingers) front of brain 3 Oculomotor - thalamus - looking up, in and left to right midbrain 4 Trochlear - midbrain - cross eyes into nose 5. Trigeminal - pons - - Dull vs light sensation in: Opthalmic (forehead) Maxillary (Cheek)Mandibular (Jawline) - Have the patient open and close mouth (feel around temporomandibular joint) 6 Abducens - pons- looking laterally (left and right)7 Facial - controls most facial expressions secretion of tears & saliva taste pons - Test facial symmetry - Taste on anterior 2/3 of tongue - smile - wrinkle forehead 8 Vestibulocochlear - hearing and equilibrium pons (acoustic) - Whisper test - Rinne Test - Weber Test 9 Glossopharyngeal - medulla - Gag reflex- Taste on posterior 1/3 of the tongue - not gagging is a sign of lesion 10 Vagus - medulla - - Say "aah" - Talk to see if uvula deviates to one side 11 Spinal Accessory - controls trapezius & sternocleidomastoid controls swallowing movements spinal cord - shoulder shrug against resistance medulla 12 Hypoglossal - medulla - stick tongue straight out - will deviate if there is a lesion Somatosensory pathways - Posterior column pathways: Proprioception, vibration, fine touch - Primary afferent sensory information is coming in from the dorsal roots then travels to the ipsilateral white matter columns and ascends all the way to dorsal column nuclei in the medulla then it will synapse onto a second sensory neuron that crosses over to the other side of the medulla and that axon will continue to ascend now on the contralateral synapse on the thalamus will then project up to the primary somatosensory cortex.Somatosensory pathways- Anterolateral pathways: Pain and Temperature - Sensory information comes in through dorsal root ganglia to the spinal cord and crosses over to the other side of the spinal cord, and go up to the thalamus and then go to the primary sensory cortex thalamus (relay station). Main motor pathways - Corticospinal tract - Begins mainly in the primary motor cortex (4), where neuron cell bodies project via axons down through the cerebral white matter and brain stem to reach the spinal cord. In the medulla. The majority of fibers in the tract (85%) cross over to control movement of the opposite side of the body (Pyramidal decussation) occurs at the junction between the medulla and spinal cord. Lesions occurring above the pyramidal decussation produce contralateral weakness with respect to the lesion, while lesions below the pyramidal decussation will produce ipsilateral weakness. Upper motor neurons: project from the cortex down to the spinal cord and form synapses onto lower motor neurons Lower motor neurons: Located in the anterior horns of the central gray matter of the spinal cord or in the brainstem motor nuclei. The axons project out of the CNS via the anterior spinal roots or via the cranial nerves to finally reach muscle cells in the periphery. Frontal lobe - higher executive functioning, motor function, personality Brodmann's Areas Broca's Area: 44, 45 Primary Motor Cortex (precentral gyrus): 4 Broca's Area = expression of speech Deficit = expressive aphasia (unable to express self)