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DCCJP Year 1
Review (BK questions)
| Question | Answer |
|---|---|
| At what age doe the atlas complete its ossification? | 7 years old (starts at 3 years old) |
| When does the last 'joint' in the body complete its ossification? | 18-25 years old- Spheno-occipital synchondrosis |
| What component of the CCJ begins ossification in the first trimester? | Occiput |
| What foramen do the branches of CN V pass through? | Superior Orbital Fissure (V1), Foramen Rotundum (V2), Foramen Ovale (V3) |
| Occlusion of the left internal jugular vein may lead to immediate back up of fluid in which structure and what symptoms may be associated with this? | Left jugular bulb; tinnitus, dizziness |
| What three contributories feed into the straight sinus? | Thalamostriate veins, inferior sagittal sinus, deep/internal cerebral veins |
| According to Dr. Rosa, what are the strongest ligaments of the CCJ? | Transvers Atlantal Ligament and Alars (Erikson: capsular ligaments) |
| Which sub-occipital muscles attache to C1? | Rectus Capitus Posterior Minor, Inferior Oblique, Superior Oblique |
| What deep cervical flexors attache to C1? | Longus Colli, Longus Capitus |
| What artery supplies the choroid plexus? | anterior choroidal artery from the middle cerebral artery |
| The radiculomedulary veins drain into what vein? | Vertebral Vein |
| The costocervical trunk branches off of what part of the subcalvian artery? | Second part |
| What artery branches off of the third part of the subclavian artery? | Dorsal Scapular Artery |
| What ligament is responsible for maintaining coupled motion at the CCJ? | Alar ligaments |
| What is meant by the paradoxical motion of the atlas? | At the end of cervical flexion C1 extends |
| There is strong evidence of the existence of a my-rural bridge between what muscles? | Rectus Capitus Posterior Minor, Rectus Capitus Posterior Major, Inferior Oblique |
| The myodural bridges seen at C1 and C2 are considered to be an extension of what ligament? | Meningovertebral Ligament |
| Which of the following is false concerning the myodural bridge? a) It may play a role with pumping CSF with head movement b)It may play a role in postural control c)It is made of collagen Type II fibres d) none of the above are false | c)it is made up of collagen type I fibres |
| Name two epidural ligaments. | meningovertebral ligaments (posterior c-spine from C2-C6; attach dura to LF and lamina), Hoffman's Ligaments (anterior spine from C6 to L5; attache dura to PLL) |
| The carotid siphon is a continuation of which part of the carotid artery and where is is located? | internal carotid; cavernous sinus |
| Lateral Lacunae drain into which dural venous sinus? | Superior sagittal sinus |
| What four factors can influence CSF flow? | Circulatory system (heart rate/blood pressure), Breathing, Posture/Head Movements, Traube-Herring Mayer waves |
| A patient presents following a MVC with an unrelenting dilating pupil and reports abnormal smell and taste sensations. Where might the lesion be? | Uncal herniationaffecting CN III |
| What track carry proprioceptive information? | dorsal, ventral, and cuneo spinocerebellar tracks (sub-conscious); dorsal column medial lemniscus track (conscious) |
| Which CN V nucleus receives information about pain and temperature? | spinotrigeminal nucleus |
| A lesion of the sub-thalamic nucleus may result in what symptom? | Chorea (hyperkinesia) |
| Difficulty staying away, poor ability to maintain upright posture, loss of coordination of respiratory musculature, loss of pain regulation may all be associated with damage to what structure? | Reticular Activating System (RAS) |
| The presence of vertical nystagmus is always pathological. Where might the lesion be when vertical nystagmus are present? | Midbrain (horizontal nystagmus= pons) |
| C1 myotome is responsible for what action/movement? | Flexion |
| What ligament attaches the occiput to the anterior tubercle of atlas? | The anterior occipital-atlantal membrane |
| The tectorial membrane contains Type III collagen fibres which contain more elastic fibres. It limits which types of movement and at what degree? | Flexion- 15 degrees Extension- 20 degrees |
| True or False: No significant association has been found between loss of cervical lordosis and vertebral artery hemodynamics has been found. | False- A significant association has been found between a loss of cervical lordosis and VA diameter, flow volume, and peak systolic velocity |
| True or False: The transverse Atlantal ligament is a proatlantal derivative first seen in the embryo when it is 27mm long | True |
| The atlantodental ligament is found where? | Between the fovea dentis and the dens |
| True or False: Barkow's ligament will become taut under flexion. | False- extension |
| True or False: The atlantodental ligament becomes taut prior to the alar ligaments with C1/C2 rotation. | True |
| Which of the following is a function of the alar ligaments? a. Check rotation b. Left alar ligament controls right axial rotation c. The superior part of the contralateral alar ligament becomes taught in lateral flexion d. All of the above | D |
| The accessory atlantoaxial ligament is located between which structures? | occiput, atlas, axis |
| What does the transverse ligament prevent form occurring? | Retroflexion of the dens, increased ADI in neutral position, increased ADI in flexion |
| Which alar ligament restricts overhang of C1 on C2 in left rotation and left lateral flexion? | Right alar ligament |
| Which image plane is least sensitive to find low lying cerebellar tonsils | Sagittal plane |
| A dural hump/tent my indicate a sprain of what ligament? | posterior atlanto-occipital membrane |
| The apical ligament is congenitally absent in what percentage of the population? | 20% |
| For lesions of the limbic system, adjusting the patient can be beneficial why? | midline stimulation can stabilize the limbic system |
| With lesions of the orbitofrontal area patient will often experience social behaviour disinhibition. What other symptom might they experience? | Anosmia |
| Which nucleus of the thalamus is responsible for relay of motor information? | Ventral lateral, ventral anterior nuclei |
| The direct pathway of the basal ganglia is responsible for what? | Promoting movement |
| What is the minimum slippage of C1 on C2 that is indicative of upper cervical ligament instability? | 3.5 mm |
| The track of Lissauer is form by which fibres? | propriospinal fibres, dorsal root fibers |
| Which axis lies in the sagittal plane and extends A-P? | Sagittal axis (z-axis) |
| Experimental studies which simulate a living system are called what? | In vivo studies |
| Basal Ganglia: Which of the following is a true? A. The D1 pathway activates motor movement via the putamen B. The D1 pathway activates motor movement via the caudate C. The hyper direct pathway activates the D1 pathway | A (Caudate- cognition) |
| Which CN feed into the ventral vagal system? | CN 5, 7, 9, 10, 11, 12 |
| Which ascending tract(s) which passes through the superior and inferior cerebellar pedicles? | Spinocerebellar tracks (ventral - superior pedicle, dorsal and cuneate- inferior pedicle) |
| Uncinate fits cause hallucinations involving which senses? | Smell, Vision |
| Which structures pass through the cavernous sinus? | ICA, CN II, III, IV, V1, V2 |
| Hoffman ligaments are found where? | C6-L5 (anterior epidural ligaments) |
| Which of the following is NOT a contribution of the vertebral artery to the brain circulation? A. Posterior Inferior Cerebellar Artery B. Superior Cerebellar Artery C. Posterior Cerebral Artery D. Anterior Choroidal Artery | D |
| Which radiometric line can be use as a modification to Chamberline's line when the opsithion is obscured? | MacGregor's line (posterior hard palate to base of occiput) |
| How may bones are in the human skull? | 22 |
| The posterior arch of C1 typically fuses by which age? | 3 |
| Which primary ossification centre of C2 fuses first? | Ondontoid centrally |
| A Chiari I malformation is classified as the existence of the cerebellar tonsils measured 5 mm or more below what line? | MacRae's Line/Basion-Opisthion line |
| What is the optimal type of imaging used to adequately view all structures of the CCJ? | Upright MRI with sagittal, coronal, and axial slices of 2.8 mm; PD weighted images to best view the ligaments |
| A patient presents with neck pain, headaches, and brain fog. They report that headaches are better lying down than standing. What might you suspect they have? | Possible chiari/tonsillar ectopia- presents with headaches that are better when recumbent than when upright |
| Rotational misalignments of the atlas may compress the internal jugular vein and affect what CNs? | CN 9, 10, 11 |
| The occipital condyles initially develop flatter in kids and become more rounded in adults. Through which type of ossification does this occur? | Endochondral ossification |
| Full ossification of the occipital bone is complete by what age? | 6 years old |
| Secondary ossification centres of a typical vertebrae (C3-L5) appear when? | Puberty |
| During flexion of the CCJ, the neuroaxis stretches approximatelywhat percentage of it's total length? | Approx. 10% |
| A craniobase angle of greater than 143 degrees is likely indicative of what? | Platybasia |
| The marginal sinus drains into what? | internal vertebral plexus |
| The primary ligamentous stabilizers of the CCJ are what? | Transvers Atlantal ligament, Alars |
| Ossification of the occiput begins when? | First trimester |
| CN 5 is the major sensory nerve to the face. It also provides motor input to what muscles? | muscles of mastication, tenser tympani, tensor veli palitine, mylohyoid, anterior belly of the digastric muscle |
| Which branches of CN 5 pass through the cavernous sinus? | V1, V2 |
| Pulsations in the left omoclavicular triangle likely come from what artery? | dorsal scapular artery |
| In which cervical triangle would you feel the pulse of the carotid artery? | Carotid triangle |
| A lesion of the trochlear nerve would result in what symptoms? | Double vision, head may be held in a downward tilted position, inability to look down and outward (eye deviate up and in) |
| An aneurism in the carotid syphon may result in what symptoms? | visual tracking/uncoordinated eye movements due to compromise of CN 3, 4, 6; facial sensation deficits in the ophthalmic and maxillary dermatomes of CN V1, V2 |
| The sensory branch of C1 innervates what? | infratentorial dura mater |
| Which CNs are responsible for innervation of the dura? | CN 5 (supratentorial), CN X (infratentorial) |
| The spinocerebellar tracks carry sub-conscious proprioceptive information to what functional division of the cerebellum? | spinocerebellum |
| A complete lesion at the level of the rostral pons may result in what type of posture? | decerebrated posture (un-resisted extension) due to compromise of the rubrospinal track descending from he midbrain |
| What evidence might a patient present with that would make you suspect a possible compromise of the D1 pathway? | micrographic, un-explained frozen shoulder, constipation |
| which part of the basal ganglia is primarily associated with learning and memory? | Caudate nucleus (caudate=cognition) |
| Which anatomical lobe of the cerebellum is primarily affected by alcohol consumption? | anterior lobe (associated with the spinocerebellum) |
| Symptoms of chronic neck and/or back pain with sitting or standing too long (sustained postures) may be associated with weakness of which deep cerebellar nucleus? | Fastigual nucleus |
| The vermis and paravermal regions make up what functional division of the cerebellum and are associated with which descending motor tracts? | Spinocerebellum; medial vestibulospinal track (vermis) and lateral vestibulospinal track (paravermal region) |
| A lesion of the dentate nucleus may result in what symptoms? | Macrographia, essential tremor |
| The vestibular nuclei work closely with which deep cerebellar nucleus? | Fastigual nucleus |
| A patient presents with abnormal VOR response and dysmetria of saccades. Which functional division of the cerebellum may be compromised? | Vestibulocerebellum |
| Which two fibers enter the cerebellum via the superior cerebellar peduncle? | ventral spinocerebellar track, locus ceruleus NEP fibres |
| Which incoming fiber type directly activates the cerebellar Purkinjie system? | Climbing fibres form the inferior olivary nucleus |
| Output from the cerebellar cortex comes from what cell and does what in regards to activation? | Purkinjie cells; inhibitory |
| The cerebral cortex communicates with which cerebellar deep nucleus and through which cerebellar peduncle? | Dentate nucleus through the middle cerebellar peduncle via corticopontine fibres |
| Which glossus muscle is innervated by CN X instead of CN XII? | Palatoglossus |
| The ransomers occipital ligament is parallel to barrows ligament and lies between which two other upper cervical ligaments? | Apical ligament (anterior) and the superior crus of the cruciate ligament (posterior) |
| The normal position of the cerebellar tonsils should be how many mm above MacRae's Line? | 2 mm |
| The dentate ligaments divide the spinal cord A-P. In the c-spine they are smaller and more numerous and they become larger and less numerous through the t-spine. What is another difference between the cervical and thoracic dentate ligaments? | Cervical dentate ligaments attach to the dura via fibrous bands, thoracic dentate ligaments attach directly to the dura |
| What epidural ligaments attache the dura to the ligaments flavum or the lamina in the cervical spine? | meninigovertebral ligaments (rum from C2-C6) |
| Which cistern may be influenced by the presence or absence of a myodural bridge? | Cisterna magna/cerebelloedullary cistern |
| The attachment of several sub-occipital muscles to the dura mater is formed by what type of fibre? | Collagen Type 1 fibres in the myodural bridge |
| Which epidural ligament attaches the dura mater to the PLL? | Hoffman's ligaments (C6-L5) |
| Which factors drive CSF flow int he cranial/cephalad direction? | Diastole, exhalation, head rotation, coughing (valsalva initially causes a caudal then cephalic movement of CSF) |
| What three components make up the intervertebral disc? | annular fibres (15-25 concentric rings of collagen and elastin fibres), nucleus pulposus (collagen and elastin fibres in an aggrecan gel), the end plate (1mm thick collagen fibres) |
| The outer lamella of the intervertebral disc is innervated by which nerve? | sinuvertebral nerve (meningeal branch of the spinal nerve) |
| The internal jugular vein is found in which cervical triangle? | Carotid triangle in the anterior cervical triangle |
| What boney landmark contains the confluence of sinuses? | Trochleus herophili |
| What major venous sinuses meet at the internal occipital protuberance? | Superior Sagittal Sinus, Straight sinus, Transverse Sinus, Occipital Sinus |
| What physical exam finding(s) might indicate an increase in pressure in the cavernous sinus? | Exopthalmus and papilledema due to decreased drainage from the superior and inferior ophthalmic veins into this sinus; possible extra-ocular muscle involvement |
| What main structures drain into the superior sagittal sinus? | Arachnoid Villi, lateral lacuna, superior cerebral veins Anastomotic vein of Trolard) |
| The trochlear nerve exists the dorsal side of the brainstem and would initially travel through which cistern as it winds around to the ventral side of the brainstem? | Quadrigeminal cistern |
| The middle fossa, suprasellar region, and posterior fossa are the most common places for which congenital anomaly to occur? | intracranial arachnoid cysts |
| A change in volume of either the brain, blood, or CSF requires a change in volume of one or both of the other factors. This is the key concept of what? | Monro-Kelly Doctrine |
| What are the three major influences on CSF flow? | Cardia cycle, respiration, vasomotor (autonomic) systems |
| The marginal sinus drains into which major dura venous sinus? | Occipital sinus |
| A large portion of the deep cerebral blood flow is drained via the great vein of Galen into the straight sinus. What veins act as contributories to the great vein of Galen? | internal cerebral veins, basal veins of Rosenthal, anterior calcarine vein, superior vermin vein |
| Sudden loss of motor and sensation in the lower extremity may be due to what type of stroke? | Anterior cerebral artery stroke |
| A lesion of the left visual motor cortex would result in an inability to perform what type of eye movement? | Looking to the right |
| Which semicircular canal is not completely enclosed in bone? | Superior semicircular canal (herniation of this canal through the dura is called superior semicircular canal dehiscence) |
| A displaced jugular bulb may impede drainage of the perilymph from the inner ear via what structure? | cochlear aquaduct (drains into the subarachnoid space just inferior to the internal acoustic meatus in the anterior segment of the jugular foramen) |
| Which CCJ ligament is a proatlantal derivative and thought to potentially have been a modified intervertebral disc? | Transvers Atlantal Ligament |
| What ligament attaches the anterior dens to the posterior aspect of the anterior arch of the atlas? | Anterior Atlantodental ligament |
| What is the strongest ligament of the CCJ as measured in Newtons of force applied? | Transvers Atlantal ligament (400N), Capsular ligaments (300N), Alar ligaments (200N) |
| Why are the alar ligaments particularly vulnerable to whiplash injuries? | They are designed with a central core of collagen with few elastic fibres peripherally |
| What factors might cause an x-ray image to be over exposed? | KVP too hight, mAS too high |
| In regards to the anode heel effect, where should the atlas be positioned? | At the anode (+)- greater x-ray absorption at the anode |
| What is the primary factor controlling image density? | mAS- increasing this increases the number of electrons reaching the film, thus increasing the density. Increasing kVP and changing the distance will also affect density |
| How can you change contrast on an x-ray film? | Increase or decrease kVP by 15% or double or half mAs (high contrast- short scale, better for bone, low contrast- long scale, better for soft tissue) |
| When imaging a child or elderly person, how might you adjust your technique? | Decrease technique by 30% |
| Removing or changing a grid generally requires a change in mAS by a factor of what? | 4x |
| What is the most detrimental factor to maximizing recorded detail? | Patient movement |
| What is an absolute contraindication to adjusting with a dynamic thrust? | acute arteriopathies, acute fractures or dislocations, unstable os ondontoideum, malignancies of the spine, infections of the spine, myelopathy or cauda equina syndrome, VBI, aneurysm |
| What are relative contraindications to adjusting with a dynamic thrust? | articular hypermobility and/or instability, severe bone demineralization, benign bone tumors, bleeding disorders/anticoagulant therapies, radiculopathy with progressive neurological signs |
| What are the only places that you cannot get an MRI if metal is present? | The eye and the brain |
| What are the two types of radiation effects? | deterministic effects (high dose, acute), stochastic effects (low dose, delayed) |
| Which radiometric lines can be used to detect basilar invagination? | Chamberline's line (dens >3mm above), MacGregor's line (dens>5mm above), McRae's line (dens <5 mm below), digastric line (AO joint projects above), bimastoid line (>10 mm above) |
| What is the term used to describe a developmental anomaly in which the base of the posterior cranial fossa bulges upward? | Platybasia- typically not symptomatic unless associated with basilar invagination |
| The cervical lordosis can be measured via the depth method, Cobb angle, or Harrison posterior tangent. What is considered a normal value in each of these measurements? | Depth method: 12mm, Cobb angle:40 degrees, HPT:31-40 degrees |
| Harris lines measured greater than what on a CT scan might indicate AO dissociation? | 8.5mm (>12mm on x-ray) |
| Which radiometric measurement has the highest diagnostic accuracy for pediatric patients? | Condyle-C1 interval |
| On a sagittal film, how can you determine if a blocked vertebra is congenitally acquired? | sagittally oriented intervertebral foramen |
| What is the line used to distinguish pseudosubluxation from subluxation? | spinolaminar line (if a lamina line is off more than 2mm this is indicative of subluxation) |
| On an APOM view you suspect a type 1 ondontoid fracture. What ligament might be involved in this injury? | allusion fracture due to apical ligament |
| What is the most common type of ondontoid fracture? | Type 2- unstable, non-unoin of the dens |
| Displacement of George’s line more than 50% on a lateral film may indicate what? | bilateral facet dislocation |
| What type of fracture has a large percentage (90%) of associated neurological symptoms? | flexion tear drop fracture |
| Fanning of the spinous processes may indicate ligamentous instability. What should the normal distance between the SP’s of adjacent vertebrae be? | 12 mm |
| What percentage of the population has up to 3mm of asymmetry of the articular pillars? | 30-40% |
| What is the most common contributor to neural foraminal stenosis? | osteophytes off the uncinate process |
| A possible indication of pathology seen on a T1 Fat supressed image will be seen as what: high or low signal intensity? | high signal intensity |
| Normal bone marrow on a T1 weighted MRI should look like what? | high signal intensity - should be brighter than the disc |
| A patient presents to your office after a hockey injury in which he was checked into the boards head first. He presents with neck pain, a headache, dizziness, and numbness and tingling in his right arm. What advanced imaging would you order? | CT w/o contrast, follow by MRI with contrast due to neurological symptoms |
| A forty-year-old female presents with a chief complaint of numbness in her hands and episodes of double vision, and increasingly frequency episodes of temperature intolerance. What is the suspected condition and what imaging would you order to confirm it? | MRI w/o contrast |
| When is the best time to obtain an MRI to investigate possible ligamentous injury? | Within the first 72 hours. With time edema is reduced and sensitivity drops |
| Rounding of the atlas anterior tubercle may be an indication of what? | Chronic transfers Atlantal ligament instability |
| The transverse atlantal ligament is the primary defense against anterior subluxation of the atlas on the axis. Normal anterior movement of atlas on axis shouldnot exceed what distance? | 3 mm for adults, 5 mm for kids |
| Rotational displacement of C0/C1 and C1/C2 is considered to be pathological if it exceeds what degree? | C0/C1 >7 degree, C1/C2 > 54 degrees |
| According to Richardson, maximum normal lateral slippage of axis to atlas is what? | 2 mm |
| Retrolisthesis of C4 on C5 observed in an extension radiograph may indicate instability of which ligament? | ALL |
| Following whiplash injury, which synovial folds are most commonly injured? | The dorsal synovial folds, particularly of the lateral AA joints |
| Decreased or altered neck movement following a WAD injury may result in histological changes of which joint structure? | cervical meniscoids, strong evidence showing fibrosis and decreased meniscoid size in the lateral AA joint and cervical Z-joints following WAD |
| The peripheral nervous system develops largely from which embryological cell type? | neural crest cells |
| The nucleus pulposus is believed to be a remnant of which embryological structure? | notochord; this also drives differentiation of the neural ectoderm into the neural plate and eventually the neural tube |
| The cerebellum develops as an outpouching of which section of the rhombencephalon? | metencephalon (pons and vestibular nuclei) |
| The brainstem develops from which three embryological structures? | mesencephalon (midbrain), metencephalon (pons and cerebellum), myelencephalon (medulla) |
| Damage to which cell may result in a leaky blood-brain barrier? | astrocytes |
| A patient who has had a middle cerebral artery stroke may present with symptoms indicative of damage to what part of the cortex? | primary motor, Broca’s area (in in dominant hemisphere), ssx: unilateral facial weakness in bottom 2/3 of face, trouble producing speech, unilateral upper extremity weakness/flaccid or spastic paralysis |
| A patient demonstrates adequate smooth tracking ability, but scanning difficulty when reading. What part of the cortex might be affected? | Frontal eye fields (voluntary saccadic eye movements and visual search) |
| Inability to perform a sequenced motor task is referred to as what and may indicate weakness in what part of the cortex? | dyspraxia- pre-motor cortex. Patient will test positive for Luria testing deficit |
| A hypermetric saccade to the right might indicate weakness of which cerebellar lobe? | left cerebellum (right frontal eye fields kick the eye to the left cerebellum) |
| Dysfunction of which cortex will result in social disinhibition and anosmia? | orbital frontal cortex |
| In a patient’s history intake, they report that they always seem to bump into things on their left side. In which cortex might they have an issue? | Parietal cortex |
| A patient presents with a severe case of Parkinson’s disease and they lean significantly to the left. When checking their leg length, they can lay straight without lateral spinal curvature. What condition might they have and which cortex may be affected? | Pisa syndrome- parietoinsular cortex |
| What is the name of the syndrome someone might present with if they have had a stroke in the thalamogeniculate artery? | Dejerine Roussy sundrome (boring pain replaced by a feeling of cold slime) |
| A 35-year-old patient presents with a prominent right subclavicular reflex. This may be an indicator of pathology in which system? | left basal ganglia system |
| What are some symptoms of a lesion in the substantia nigra pars reticulata? | diminished motor control for the head, neck, and face; SNr has projections to the tectospinal tract and the reticulospinal tract |
| What part of the basal ganglia is responsible for motor control of the body? | Globus pallidus interna (output is inhibitory, GABA); projects to the thalamas (VA/VL) as well as the reticulospinal tract |
| What causes the musculoskeletal changes seen in dystonia? | A change in subjective visual vertical |
| What are the four clinical types of dystonia? | cortical/cerebellar (loss fo body schema), limbic (psychogenic/functional), INC (head nystagmus theory), basal ganglia (lesion of the indirect pathway) |
| What is the best biomarker for the basal ganglia? | Gait |
| What nucleus does the pill-rolling tremor seen in Parkinson’s come from? | Red Nucleus |
| What tract connects CN 3, 4, 6, 8 for conjugate horizontal eye movements and where is it located? | MLF in the pons |
| Vertical gaze centers are found in which midbrain nuclei? | Interstitial nucleus of Cajal and nucleus of Darkschewitsch |
| Where are the vergence eye centers thought to be located? | midbrain reticular formation |
| Where are the pre-sympathetic neurons housed? | Rostral ventral lateral medulla |
| Where is the main site of interactions between the respiratory and sympathetic neurons located? | Nucleus tractus solitarius |
| Dolicohoectasia of the vertebralbasilar artery is typically asymptomatic, but may cause autonomic symptoms through compression of which nucleus? | Nucleus Tractus Solitarius |
| What type of tremor is seen in a cerebellar lesion? | action tremor, typically worse at end range of motion, ipsilateral to lesion |
| What are the two primary systems involved in maintaining head posture? | Vestibular and ocular systems |
| What nucleus does the vestibular system communicate with to regulate heart rate and blood pressure during changes in posture? | Nucleus tractus solitarius |
| Which vestibulospinal tract, medial or lateral, has connections to the MLF to help mediate the VOR response? | medial vestibulospinal tract, only descends to the cervical spine and works to maintain head and neck position |
| Which vestibular nucleus works with the Nucleus Prepositus Hypoglossi as a gaze stability center for horizontal eye movements? | Medial vestibular nucleus |
| What is the most common peripheral vestibular disorder? | BPPV, most commonly affects the left posterior semicircular canal, nystagmus will beat in the direction of the affected canal |
| Which maneuver would be suited to test the horizontal canals for BPPV? | BBQ roll |
| What type of nystagmus will be seen in anterior canal BPPV? | torsional, this is rare due to the anatomical arrangement of the semicircular canals (torsional nystagmus can also be seen in posterior canal BPPV) |
| Infarct of the left fasciculus gracilis will likely result in what symptoms? | reduced proprioception, fine touch discrimination in the left lower back and extremities ipsilaterally |
| A patient presents with complaints of chest tightness and pain, weakness and numbness in the legs. What might you find when taking their vitals and what is the suspected diagnosis? | low blood pressure; Transverse Myelitis |
| Referred pain from a greater occipital nerve entrapment may be report as being felt where? | Stabbing pain behind the eye |
| Pain that travels from the back of the head around to the forehead may be referred by which nerve? | Sub-occipital nerve |
| Which fiber type is responsible for mediating fast pain and temperature sensation? | Type A delta |
| Lacunar infarcts can be detrimental to which structures? | Basal ganglia and internal capsule due to compromise of the lenticulostriate artery |
| What three main arteries supply the cerebellum? | PICA, AICA, superior cerebellar artery |
| What structure senses stretch of a muscle fiber and sets the resting tone of a muscle? | muscle spindle |
| What structure is sensitive to muscle tension and is innervated by a single unmyelinated 1b neuron? | GTO- located between eh muscle fibres and tendon |
| Why does upper cervical care work from a neurological perspective? | the spine, skin, and nervous system are all connected embryologically- a stimulus in one area will have an effect in areas that are not directly connected by tissue |
| A patient reports weakness and fatigue with repetitive motor tasks, but it does not last long. What might you suspect be the issue? | Problem at the NMJ- myasthenia gravis |
| If a patient reports sustaining a concussion during which they lost consciousness, what part of the midbrain might have been affected? | midbrain reticular activating system (RAS) |
| What is a contraindication for supplementation with creatine? | suspicion of intracranial hypertension |
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msperanza
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