MIDTERM LEARNING GUIDE

Question 1

What are the three main functional divisions of the nervous system?

Answer 1

Sensory (afferent)
Integrative
Motor (efferent) divisions

Question 2

Define neuroplasticity and its importance in recovery.

Answer 2

The ability of the brain to reorganize and form new connections after injury or experience, enabling functional recovery.

Question 3

Differentiate upper and lower motor neuron lesions.

Answer 3

UMN lesions: spasticity, hyperreflexia, Babinski sign

LMN lesions: flaccidity, atrophy, fasciculations.

Question 4

Which vitamin deficiency leads to neural tube defects?

Answer 4

Folic acid deficiency.

Question 5

Name two common neural tube defects.

Answer 5

Spina bifida (caudal neuropore fails to close)

Anencephaly (cranial neuropore fails to close).

Question 6

Explain the Monro–Kellie doctrine.

Answer 6

Brain, blood, and CSF volumes are fixed within the skull; increase in one raises ICP unless compensated by reduction in another.

Question 7

Differentiate primary and secondary brain injury.

Answer 7

Primary: immediate mechanical damage

Secondary: delayed effects like ischemia, edema, excitotoxicity.

Question 8

What is diffuse axonal injury?

Answer 8

Widespread axonal shearing due to rotational acceleration, often leading to coma.

Question 9

Define ischemic vs hemorrhagic stroke.

Answer 9

Ischemic = vessel blockage

Hemorrhagic = vessel rupture causing bleeding.

Question 10

What is the ischemic penumbra?

Answer 10

Viable tissue surrounding infarct that may recover if reperfused quickly.

Question 11

What imaging distinguishes stroke type?

Answer 11

Non-contrast CT scan.

Question 12

When can tPA be given?

Answer 12

Within 4.5 hours of ischemic stroke onset if no contraindications.

Question 13

What are symptoms of MCA stroke?

Answer 13

Contralateral face/arm weakness
Aphasia (dominant side)
Neglect (nondominant side).

Question 14

Define spasticity.

Answer 14

Velocity-dependent increase in tone from loss of corticospinal inhibition.

Question 15

Why is early rehabilitation important after stroke or TBI?

Answer 15

Prevents secondary complications and enhances neuroplasticity for motor recovery.

Question 16

Apraxia

Answer 16

Inability to perform purposeful movements despite intact strength.

Question 17

Ataxia

Answer 17

Loss of coordination from cerebellar dysfunction.

Question 18

Dysmetria

Answer 18

Inability to control range of movement, leading to overshoot or undershoot.

Question 19

Abulia

Answer 19

Lack of motivation or initiative from frontal lobe dysfunction.

Question 20

Hypotonia

Answer 20

Decreased muscle tone.

Question 21

Hypertonia

Answer 21

Increased muscle tone, as in spasticity or rigidity.

Question 22

Rigidity

Answer 22

Increased tone independent of velocity; seen in extrapyramidal disorders.

Question 23

Flaccidity

Answer 23

Loss of tone and reflexes due to LMN damage.

Question 24

Hemiplegia

Answer 24

Paralysis on one side of the body.

Question 25

Paresis

Answer 25

Partial loss of motor strength.

Question 26

Aphasia

Answer 26

Impairment of language comprehension or expression.

Question 27

Agnosia

Answer 27

Inability to recognize familiar objects despite intact sensation.

Question 28

Paresthesia

Answer 28

Abnormal tingling or numb sensation.

Question 29

Case: A 3-year-old with spinal bulge and weakness.

Answer 29

Myelomeningocele from failure of caudal neuropore closure.

Question 30

Case: 25-year-old cyclist unconscious, CT normal.

Answer 30

Diffuse axonal injury due to rotational forces.

Question 31

Case: Sudden right weakness + expressive aphasia.

Answer 31

Left MCA infarct affecting motor cortex and Broca’s area.

Question 32

Case: Epidural hematoma with lucid interval.

Answer 32

Middle meningeal artery bleed raising ICP, causing herniation.

Question 33

Case: Newborn missing cerebrum, open skull.

Answer 33

Anencephaly from cranial neuropore closure failure.

Question 34

Case: Post-TBI decerebrate posture + high ICP.

Answer 34

Brainstem compression affecting medulla/pons functions.

Question 35

How to analyze a neuro case on exam?

Answer 35

1. Identify symptoms 2. Localize lesion 3. Determine cause 4. Explain pathophysiology 5. Suggest management or rehab.

Question 36

Case: Post-stroke spasticity + aphasia.

Answer 36

Left MCA stroke; rehab: constraint therapy + speech therapy.

Question 37

Case: Intact strength but cannot initiate movement.

Answer 37

Abulia from frontal–basal ganglia damage.

Question 38

Differentiate cortical vs subcortical stroke symptoms.

Answer 38

Cortical: aphasia, neglect, visual field loss. Subcortical: pure motor/sensory deficits without cortical signs.