OCCTM 6101 Lecture Notes - Lecture 41: Facial Nerve Paralysis, Neurapraxia, Schwannoma

1. Baby Claire (8 pts.) After a long struggle with infertility, Matt and Christine Hoffman are thrilled to find out they are expecting a baby girl. Christine's pregnancy and delivery are uneventful and the proud parents bring baby Claire home after a 3-day stay at the hospital. For the first few months of her life, Claire reaches all of the expected developmental milestones including rolling over, reaching for objects, smiling, and sitting up. Around 10 months of age, however, Matt and Christine notice that she Claire is not showing interest in crawling. When they try to help her stand with assistance they notice that Claire feels "floppy" and does not bear any weight on her legs. This alarms them because just a few months ago Claire's legs seemed quite strong for her age. They also notice that Claire is starting to have trouble with feeding, even though she had progressed nicely from pureed baby foods to soft chunks of food around 8 months. She now appears to choke on during meals, apparently due to difficulty with chewing and swallowing. Finally, they notice that Claire is smiling less than she used to and displays a blank expression most of the time. Concerned, Matt and Christine bring Claire to the pediatrician. After listening to Matt and Christine's concerns and conducting a brief examination, the pediatrician decides that Claire's case is more appropriate for a specialist and refers them to a pediatric neurologist. The neurologist performs a more comprehensive on Claire and finds that in addition to the symptoms noticed by Matt and Christine, Claire also shows a diminished tendon reflex when tested bilaterally on her knees and jaw. Suspecting a congenital disease, the neurologist refers Matt and Christine to a genetic counselor. After conducting testing on Matt, Christine, and Claire, he concludes that Claire's symptoms are a result of a rare hereditary disease. The genetic counselor then provides Matt and Christine with a pamphlet on the disease and the contact information for a nearby children's hospital that specializes in research on and treatment for this condition. a. Based on the description of Claire's symptoms, which muscles of her body seem to be most affected? (4 pts. total; 1 pt. per muscle type) b. Where in the CNS are the cell bodies of the neurons that directly innervate these muscles? Be as specific as possible. Simply stating the two general locations of lower motor neurons is not sufficient. (4 pts. total; 1 pt. per location)

#1 Visceral sensory information enters the CNIS on afferent fibers within

A) dorsal roots 52 to 54.

B) dorsal roots T1 to L2.

C) cranial nerves V VIL DC and X.

D) bothB and C

E) a, n, and C

#2 Which of the following is not a function of the neuroglia?

A) support

B) memory

C) phagocytosis

D) secretion of cerebrospinal fluid

E) maintenance of blood-brain barrier

#3 Mary is in an automobile accident and suffers a spinal cord injury. She has lost feeling in her lower

body. Her doctor tells her that swelling is compressing a portion of her spinal cord. Which part of

her cord is likely to be compressed?

A) the anterior gray commissures

B) the anterior white commissures

C) the anterior gray horns

D) ascending tracts

E) descending tracts

#4 The efferent division of the peripheral nervous system innervates:

A) skeletal muscle cells

B) glandular cells

C) smoothmusdecells

D) heart muscle cells

E) all of the above

#5 Cerebrospinal fluid flows within the

A) pia mater.

B) dura mater.

C) filum terminale.

D) arachnoid mater.

E) subarachnoid space.

#6 A patient develops a tumor of a cranial nerve that leads to difficulty in speaking from a loss of

tongue movement. IA/hich cranial nerve is affected?

A) glossopharyngeal

B) vagus

C) spinai accessory

D) hypoglossal

#7 Parkinson disease is the result of

A) inadequate production of dopamine by substantia nigra neurons.

B) inadequate production of GABA by neurons in the basal nuclei.

C) weak response of the red nuclei of the mesencephalon.

D) decreased levels of acetylcholine from neurons in the substantia nigra.

E) hyperactivity of the limbic system.

#8 Based on the motor homunculus, which of the followingbody regions has the largest motor units?

A) larynx B) hands C) tongue D) face E) back

#9 If the corpus callosum is surgically cu!

A) conscious decisions are made without regard to sensations from the left side.

B) objects toudred by the left hand can be recognized but not verbally identified.

C) symptoms of the "disconnection syndrome" appear.

D) the two cerebral hemispheres operate independently.

E) all of the above

#10 The flexor reflex

A) moves a limb away from a painful stimulus.

B) is an example of a monosynaptic reflex.

C) prevents a musde from generating damaging tension.

D) usually depends on cranial neurons.

E) prevents a muscle from overstretching.

#11 The subdural space lies between

A) the dura mater and the arachnoid mater.

B) the arachnoid mater and the pia mater.

C) the endosteum and the periosteum.

D) the pia mater and the dura mater.

E) the pia mater and the subarachnoid space.

#12 _____ is a condition resulting from an inflammation of a facial nerve.

A) Cerebral palsy

B) Addison disease

C) Bell palsy

D) any of the

#12 Clusters of RER and free ribosomes in neurons are called

A) microglia.

B) neurofilaments.

C) neurofibrils.

D) Nisslbodies.

E) perikaryon.

#1 Visceral sensory information enters the CNS on afferent fibers within

A) dorsal roots S_2 to S_4.

B) dorsal roots T_1 to L_2.

C) cranial nerves V, VII, IX, and X.

D) both B and C

E) A, B, and C

#2 Which of the following is not a function of the neuroglia?

A) support

B) memory

C) phagocytosis

D) secretion of cerebrospinal fluid

E) maintenance of blood-brain barrier

#3 Mary is in an automobile accident and suffers a spinal cord injury. She has lost feeling in her lower

body. Her doctor tells her that swelling is compressing a portion of her spinal cord. Which part of

her cord is likely to be compressed?

A) the anterior gray commissures

B) the anterior white commissures

C) the anterior gray horns

D) ascending tracts

E) descending tracts

#4 The efferent division of the peripheral nervous system innervates:

A) skeletal muscle cells

B) glandular cells

C) smoothmusdecells

D) heart muscle cells

E) all of the above

#5 Cerebrospinal fluid flows within the

A) pia mater.

B) dura mater.

C) filum terminale.

D) arachnoid mater.

E) subarachnoid space.

#6 A patient develops a tumor of a cranial nerve that leads to difficulty in speaking from a loss of

tongue movement.which cranial nerve is affected?

A) glossopharyngeal

B) vagus

C) spinal accessory

D) hypoglossal

E) trigeminal

#7 Parkinson disease is the result of

A) inadequate production of dopamine by substantia nigra neurons.

B) inadequate production of GABA by neurons in the basal nuclei.

C) weak response of the red nuclei of the mesencephalon.

D) decreased levels of acetylcholine from neurons in the substantia nigra.

E) hyperactivity of the limbic system.

#8 Based on the motor homunculus, which of the followingbody regions has the largest motor units?

A) larynx B) hands C) tongue D) face E) back

#9 If the corpus callosum is surgically cu!

A) conscious decisions are made without regard to sensations from the left side.

B) objects toudred by the left hand can be recognized but not verbally identified.

C) symptoms of the "disconnection syndrome" appear.

D) the two cerebral hemispheres operate independently.

E) all of the above

#10 The flexor reflex

A) moves a limb away from a painful stimulus.

B) is an example of a monosynaptic reflex.

C) prevents a musde from generating damaging tension.

D) usually depends on cranial neurons.

E) prevents a muscle from overstretching.

#11 The subdural space lies between

A) the dura mater and the arachnoid mater.

B) the arachnoid mater and the pia mater.

C) the endosteum and the periosteum.

D) the pia mater and the dura mater.

E) the pia mater and the subarachnoid space.

#12 _____ is a condition resulting from an inflammation of a facial nerve.

A) Cerebral palsy

B) Addison disease

C) Bell palsy

D) any of the

#12 Clusters of RER and free ribosomes in neurons are called

A) microglia.

B) neurofilaments.

C) neurofibrils.

D) Nisslbodies.

E) perikaryon.