Anatomy › Help with Evaluation Methods for the Nervous System
A patient comes in with paralysis of the right side of his face. You ask him to raise his eyebrows and only the left eyebrow is raised. What do these findings suggest is the problem?
Cranial nerve 7
Cranial nerve 5
Cranial nerve 3
Upper motor neuron lesion (stroke)
Cranial nerve 2
These findings suggest that the patient is experiencing Bell's palsy. This is a common finding with the lower motor neuron lesion of facial CN 7. We ask the patient to raise their eye brows to distinguish Bell's palsy from a stroke. If a patient has half sided facial paralysis and can raise both eyebrows this is usually a red flag.
If a person cannot feel pain on the dorsal side of his/her right hand along the outer part of the hand including the little finger he/she likely has damage to the __________.
ulnar nerve
median nerve
radial nerve
sciatic nerve
median cutaneous nerve
The ulnar nerves serves the dorsal and palmar surfaces of the hand from the midline of the ring finger over to the little finger (dorsal and palmar).
At which vertebrae would you enter to remove cerebrospinal fluid (CSF) from the back?
L4/L5
T3/T4
L2
Posterior sacral foramina
When performing a spinal tap you enter the intervertebral space at the L3/L4 or L4/L5 level. This is because the spinal cord ends around L1/L2. Nerves continue past this point as part of the cauda equina, however they are not in danger of being pierced as they move out of the way of the needle. The needle will pass through various layers until the subarachnoid space where CSF is located.
List the order of spinal ligaments that a needle would penetrate in order to administer an epidural injection.
Supraspinous ligament, interspinous ligament, ligamentum flavum
Supraspinous ligament, posterior longitudinal ligament, ligamentum flavum
Interspinous ligament, posterior longitudinal ligament, ligamentum flavum
Interspinous ligament, anterior longitudinal ligament, posterior longitudinal ligament
Posterior longitudinal ligament, anterior longitudinal ligament, ligamentum flavum
When giving an epidural injection the order of structures the needle passes through goes as follows: skin, fascia and subcutaneous fat, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space
Which cranial nerves (CN) are responsible for the pupillary light reflex?
CNs II and III
CNs V and VII
CN V only
CNs IX and X
CN XII
The pupillary light reflex and ocular accommodation reflex involves cranial nerve II for the sensory aspect and cranial nerve III for the motor application. The jaw jerk reflex uses cranial nerve V for both sensory and motor. The corneal (blink reflex) utilizes cranial nerve V for sensory and VII for motor. The gag reflex utilizes cranial nerve IX for sensory and X for motor.
The Romberg test examines function of which cranial nerve?
Vestibulocochlear nerve
Olfactory nerve
Trigeminal nerve
Accessory nerve
Facial nerve
The Romberg test involves maintaining an upright stance with feet together, which tests the vestibular portion of the vestibulocochlear nerve. The accessory nerve controls shoulder girdle and neck movement, the olfactory nerve provides the sense of smell, the hypoglossal nerve controls tongue movement, the facial nerve controls the muscles of facial expression (amon other functions) and the trigeminal nerve controls the muscles of mastication (among other functions). Thus, the Romberg test would not test any of these functions
What is the "soup" method of neurotransmitter and receptor analysis in the CNS? What is its usefulness?
A tissue sample is isolated and ground to form a homogenate which can be analyzed. This is useful for quantifying binding or molecule levels.
A tissue sample is sliced into pieces of tissue that are homogenous and can be analyzed. This is useful for quantifying binding or molecule levels.
A tissue sample is isolated and ground to form a homogenate which can be analyzed. This is useful for macroelectrode application to see what action potentials in specific brain regions do functionally.
A tissue sample is isolated and ground to form a heterogeneous mixture which can be analyzed. This is useful for quantifying binding or molecule levels.
There is no such thing as the "soup" method of neurotransmitter and receptor analysis in the CNS.
The "soup" method involves collecting a tissue sample from the specific CNS are that one is interested in, isolating it and grinding it to form a homogenate which can be analyzed. This is useful for quantifying binding or molecule levels, through the application of radiolabels to specific neurotransmitters and receptors of interest. The radiolabels let you see how much those neurotransmitters and receptors interact, and what their relative levels are.
Which of the following is the nerve root for the sciatic nerve?
L4-S3
L4-S1
L4-S2
L2-L4
L3-L5
The sciatic nerve is a large nerve that runs through the buttocks and down the lower limb. The sciatic nerve innervates skin of the leg, and muscles in the posterior thigh, leg, and foot. The sciatic nerve is derived from spinal nerves L4-S3. The L4-S3 nerve root also supplies the tibial nerve.
L4-S1 is the nerve root for the superior gluteal nerve. Common fibular nerve is supplied by spinal nerves L4-S2. The obturator and femoral nerves are derived from L2-L4.
Testing which of the following reflexes would not help you diagnose a suspected lumbosacral nerve root pathology?
Triceps brachii deep tendon reflex
Cremasteric reflex
Achilles deep tendon reflex
Anal wink reflex
Patellar deep tendon reflex
The triceps brachii deep tendon reflex tests the C7 and C8 nerve roots, so testing it would not provide any information about a lumbosacral nerve root pathology. The cremasteric reflex tests the T12 and L1 nerve roots, the Achilles deep tendon reflex tests the S1 and S2 nerve roots, the anal wink reflex tests the S2, S3, and S4 nerve roots, and the patellar deep tendon reflex tests the L3 and L4 nerve roots.
Which nerve supplies the deltoid muscle?
Axillary
Musculocutaneous
Median
Radial
Ulnar
The axillary nerve supplies three muscles, the deltoid, teres minor, and the long head of the triceps. The deltoid is a muscle of the shoulder and teres minor is a muscle involved in the rotator cuff. The axillary nerve also supplies sensory information from the shoulder joint, and to the skin below the deltoid. The axillary nerve may be injured during an anterior dislocation of the shoulder joint or a fracture of the surgical neck of the humerus.