14. Explain how the mechanical energy is tranduced converted into nerve impulses by the organ Corti and how pitch perception is accomplished.
15. Give examples the following modalities are tested : sense of pain, temperatur, touch, vibration , and sense of positition
16. Distinguish between and compare monosynaptic and polysynaptic reflexes.
III. Scenario case study
a A man falls into deep sleep with one arm under his head. This arm is paralyzed when he awakens, but it tingles, and pain sensation in it is still intact
1. What is the reason for the loss of the motor function without loss of pain sensation is that in the nerves to his arm
2. What is a thorough general physical examination should be made in this case. 3. Which one of the sensory test should be done
4. Which one of the reflex test should be done 5. Describe general physical examination should always be done in motor system of this case
b Arthritis is common painfull condition caused by inflammation of one or more joints. 1. Why the joint to developed hyperalgesia in this case?
c In some diseases of the NS, myelin may be lost over one or more internodes of many axons
without interruption of the axon. For instance Guilain – Barre syndrome, diphtheria, and multple sclerosis
1. Why the conduction of nerve impulses may be slowed or blocked.
d 74-year-old man suddenly found that he couldnot move his left arm and leg.
Examination in the emergency departement demonstrated weakness in the left arm and leg, especially in the distal part of these extremities.The patient also had difficulty in using the
muscles of his lower face, and the left side of his tongue was not as strong as the right side. Babinski’s sign was present on the left side. In an examination 1 month later, the distribution of
weakness had not changed, although the weakness was not quite as profound. The left biceps, triceps, patellar, and ankle jerk reflexes were markedly increase, and there was ankle clonus on
the left. The ability of the patient to recognize tactile and vibratory stimuli was reduced on the left side of the face and body and proprioception was impaired in the left arm and leg.
1. Which part of the NS is most likely affected by the stroke? spinal cord on the left, precentral and post central gyri on the right, internal capsul on the right, cerebellar on the
left, BG on the right. 2. Which of the following provides evidence indicating that the paralysis is of the spastic type
Day 2
nd
NEUROPHYSIOLOGY dr. K. Karna, PFK, M.Erg.
I. ABSTRACT
1. The motor division of the NS as responsible for controlling a variety of bodily activities such contraction of muscle and secretion by exocrine and endocrine glands. Actually, only a
relatively small proportion of the sensory input receive by the brain is use to generate an immediate motor response. Much of it is discarded as irrelevant to the function at hand.
Sensory input can be stored in the form of memory. Information stored as memory can become part of the processing mechanism used to manage subsequent sensory input. The
brain compare new sensory experiences with those stored and in this way develops successfull strategies to form a motor output
Faculty of Medicine Udayana University, DME 13
II. SELF – STUDY , ESSAY QUESTION
1. Give examples of strech reflexes, including those that are frequently tested clinically. 2. Describe the muscle spindles and analyze their function as part of feed back system that
maintains muscle force 3. Describe the Golgi tendon organs and analyze their function as part of feed-back system that
maintains muscle force 4. Define reciprocal innervation, inverse stretch reflex, clonus and lengthening reaction
5. Describe in general terms how posture and movement are regulated 6. Discuss the function of the cerebral cortex, cerebellum, basal ganglia, and corticospinal and
corticobulbar tracts in skilled voluntary movement 7. Describe the postural reflexes that are integrated in the medulla oblongata, the pons, the
midbrain, in the cerebral cortex. 8. What is meant by the terms upper motor neuron and lower motor neuron?.Contrast the effects
of lower motor neuron lesions with those of lesions affecting each of types of upper motor neurons
9. What is the Babinski sign? What is it physiologic and pathologic significance?
III. Scenario case study
