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Neuro II - CNS > CNS Test 4 > Flashcards

CNS Test 4 Flashcards

1
Q

The medial longitudinal fascicules has an ascending limb and a descending limb. What is the function of the ascending limb? (III & IV)

A. integration of the vestibular system with eye movements
B. integration of pain and temperature sensation with eye movements
C. Third order afferents of the visual system
D. limbic system integration with the pain system.

A

A. integration of the vestibular system with eye movements

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2
Q

which of the following tracts initiate voluntary movements of axial/postural muscles?

A. Lateral corticospinal
B. Anterior corticospinal
C. Lateral lemniscus
D. Corticobulbar

A

B. Anterior corticospinal

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3
Q

If your patient cannot wink nor wrinkle the forehead on the right neither can he smile on the right, where is the lesion? Note: there are no other findings for this patient.

A. Left CN VII, outside the stylomastoid foreman
B. Genu of the left internal capsule
C. Genu of the right internal capsule
D. Right CN VII, outside the stylomastoid foreman

A

D. Right CN VII, outside the stylomastoid foreman

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4
Q

The lateral lemniscus is part of the ______________________pathway.

A. Auditory
B. Taste
C. pain and temperature
D. Proprioception

A

A. Auditory

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5
Q

A lower motor neuron lesion of the left CN-VII will result in which one of the following patient presentations?

A. Ipsilateral lower facial paralysis, only
B. Ipsilateral, upper and lower facial paralysis
C. Bilateral facial paralysis
D. Contra lateral upper and lower facial paralysis

A

B. Ipsilateral, upper and lower facial paralysis

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6
Q

Which of the following structures carries information regarding unconscious proprioception from the …
A. Ventral Spinocerebellar tract
B. Lateral lemniscus
C. Dorsal Spinocerebellar tract
D. dorsal medial lemniscus

A

C. Dorsal Spinocerebellar tract

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7
Q

Which one of the following tracts transmits both conscious and unconscious proprioceptive primary afferent axons?

A. fasciculus cuneatus
B. paleospinalthalamic
C. fascicule gracilis
D. cuneocerebellar

A

A. fasciculus cuneatus

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8
Q

Name the tract transmitting primary afferent axons whose receptors include Meissner’s and Pacinian Corpuscles from the lower extremity.

A. medial lemniscus
B. Fasciculus gracilis
C. Fasciculus cuneatus
D. Dorsolateral fasciculus

A

B. Fasciculus gracilis

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9
Q

Which of the following trustees carries information regarding unconscious proprioception from the lower limb a… (HINT: the input is from GTO’s, only)

A. dorsal medial meniscus
B. ventral spinocereberllar tract
C. dorsal spinocerebellar tract
D. lateral lemniscus

A

… B

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10
Q

Which system is most connected with the cingulate gyrus?

A. Limbic
B. Auditory
C. Visual
D. Taste

A

A. Limbic

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11
Q

A patient presents with right arm and right leg paralysis as well as loss of the right side conscious somatosensory p…
Where is the lesion?

A. Genu of the internal capsule
B. Area 3, 1, and 2 of the cortex
C. Area 4 & 6 of the cortex
D. posterior limb of the internal capsule

A

It’s D.

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12
Q

Which ONE of the following is found in the basilar pons?

A. decussating fibers of the medial lemniscus
B. Motor nucleus of the facial nerve
C. deep pontine nuclei
D. inferior cerebellar peduncle

A

C. deep pontine nuclei

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13
Q

Which of the following is a key (“signature”) structure of the pons?

A. inferior olivary nucleus
B. CN-III
C. inferior colliculus
D. middle cerebellar peduncle

A

D. middle cerebellar peduncle

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14
Q

The contents of the menu of the internal capsule include the:

A. Third order somatosensory fibers of the body wall and limbs.
B. second order fibers of the dorsal spinocerebellar tract
C. corticopontine fibers from the frontal lobe of the cerebrum
D. third order somatosensory fibers of the face

A

D. third order somatosensory fibers of the face

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15
Q

The rostral nucleus solitaries receives primary afferents from which of the following systems?

A. pain and temperature from the face
B. Baro- and chemoreception
C. proprioception
D. gustatory sensation

A

D. gustatory sensation

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16
Q

The patient you are seeing today has a small diameter central cervical cord (C5-6) cyst commonly called: syringomyelia. Which of the following is the classic symptom of this type of syringomyelia?

A. Alaxia due to loss of the spinocerebellar tracts
B. bilateral upper extremity paralysis
C. right side upper and lower extremity loss of touch and proprioception
D. “cowl-like” loss of pain and temperature sensation (loss covering both shoulders)

A

D. “cowl-like” loss of pain and temperature sensation (loss covering both shoulders)

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17
Q

The _____________ tract projects bilaterally to the cervical spine controlling movements of the head in r… … medial longitudinal fasciculus for much of its length.

A. Medial Vestebulospinal
B. Pontine Retriculospinal
C. Lateral Vestibulospinal
D. Rubrospinal

A

A. Medial Vestebulospinal

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18
Q

The rostral nucleus solitaries receives primary afferents from which of the following systems?

A. gustatory sensation
B. proprioception
C. baro- and chemoreception
D. pain and temperature from the face

A

A. gustatory sensation

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19
Q

A patient presents with right arm and right leg paralysis, and right side loss of desc… of the upper and lower extremities. They also exhibit loss of pain, temperature and… extremities. Given the losses observed, which one of the following has been damaged?

A. Right posterior limb internal capsule
B. Left posterior limb internal capsule
C. Right half spinal cord (right hemisection)
D. Left half spinal cord (left hemisection)

A

B. Left posterior limb internal capsule

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20
Q

The dorsal spinocerebellar tract consists of second order fibers arising from the _______ nucleus.

A. ipsilateral, Proprius
B. contralateral, Dorsalis (of Clarke)
C. ipsilateral, Dorsalis (of Clarke)
D. Contralateral proprius

A

C. ipsilateral, Dorsalis (of Clarke)

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21
Q

Another new patient presents today (your practice is booming… that always happens before you go on vacation…) with a gradual onset of sensory losses, weakness, ataxia, and fatigue. She is 31 years old and has not seen anyone else for these symptoms. You do a neurological exam and find that she has vibratory loss in the toes on both feet, not following any dermatomal pattern.
You also do some cerebellar tests, and find that she has intention tremor, especially at the terminal ends of the motion. You order blood work for antinuclear antibodies and an MRI. The blood work is positive for anti-myelin basic protein antibodies, and the MRI shows plaquing in various white matter areas. What is your diagnosis?

A. Ankylosing spondylitis
B. Tabes dorsalis
C. Spinal nerve injury
D. multiple sclerosis

A

D. multiple sclerosis

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22
Q

A patient presents with right arm and right leg paralysis. Which area could not be the site of the lesion?

A. open medulla
B. closed medulla
C. cervical cord
D. lumbar cord

A

D. lumbar cord

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23
Q

The parasympathetic nucleus of cranial nerve III is called the ___________ nucleus and is four…

A. chief sensory, middle pons
B. Edinger-Westphal, superior midbrain
C. Accessory of III, inferior pons
D. superior salivatory, superior pons

A

B. Edinger-Westphal, superior midbrain

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24
Q

Which one of the following receive input from the red nucleus?

A. inferior cerebellar peduncle
B. inferior salivatory nucleus
C. inferior olivary nucleus
D. inferior colliculus

A

C. inferior olivary nucleus

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25
Q

The neospinothalamic tract and the medial lemniscus will both end in the _____________.

A. VA
B. VPM
C. VPL
D. VL

A

C. VPL

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26
Q

Cranial nerve IV (CN-IV) is the only cranial nerve to exit ____________ from the brainstem.

A. Ventrally
B. Dorsally
C. medially
D. laterally

A

B. Dorsally

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27
Q

Which one of these tracts terminates bilaterally in diffuse pontine and medullary nuclei that provide ce…

A. archispinothalamic
B. spinoreticular
C. paleospinaothalamic
D. neospinothalamic

A

C. paleospinaothalamic

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28
Q

The ________ tract does not cross the midline, but innervates cells in Laminae VII and VIII bilaterally. Its function… excite large muscle extensor reflexes at all levels fo the cord.

A. Medullary Reticulospinal
B. Rubrospinal
C. Pontine Reticulospinal
D Medial Vestibulospinal

A

C. Pontine Reticulospinal

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29
Q

The dorsal and ventral spinocerebellar tracts are found in the most ____________ p….

A. Ventral
B. Lateral
C. Medial
D. Dorsal

A

B. Lateral

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30
Q

A patient you are seeing today has loss of pain and temperature senstaion of this right face and his… He alos has lsot coordination of his limbs on the left. Other than these deficits, he is neurologically… of the lesion that is causing these symptoms?

A. Closed medulla, medially
B. open medulla, laterally
C. open medulla, medially
D. closed medulla, laterally

A

D. closed medulla, laterally

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31
Q

The preganglionic parasympathetic axons that synapse on parasympatheitic ganglia innervating the lacrimal gland and salivary glands (sublingual and submandibular) arise in the:
A. GVE nucleus of VII
B. SVE nucleus of VII
C. GSA nucleus of VII
D. SVA nucleus of VII

A

A. GVE nucleus of VII

32
Q

Which of the following is found in the basilar pons?

A. decussating fibers o fthe medial lemniscus
B. motor nucleus of the facial nerve
C. fibers of the corticopontine tract
D. inferior cerebellar peduncle

A

C. fibers of the corticopontine tract

33
Q

Where do they climbing fibers o fthe right cerebellar cortex come from?

A. left superior olivary nucleus
B. left inferior olivary nucleus
C. right superior olivary nucleus
D. right inferior olivary nucleus

A

B. Left inferior olivary nucleus

34
Q

The ____________ tract does not cross the midline, but innervates cells in Lam… … excite large muscle extensor reflexes at all levels of the cord.
A. rubrospinal
B. meidal vestibulospinal
C. pontine Reticulospinal
D. medullary reticulospinal

A

C. pontine Reticulospinal

35
Q

Which two of the following structures are considered to be part of the basal nuclei?

A. substantia gelatinosa
B. red nucleus
C. caudate nucleus
D. substantia nigra

A

C. caudate nucleus
D. substantia nigra

36
Q

Which of the following structures carries information regarding unconscious proprioception from the lower limb as a whole?
A. dorsal spinocerebellar tract
B. dorsal medial lemniscus
C. ventral spinocerebellar tract
D. lateral lemniscus

A

A. dorsal spinocerebellar tract

37
Q

The pyramidal tract in the right pons carries axons that originated from the ________ precentral gyrus.
A. Left
B. Right

A

B. Right

38
Q

The superior colliculus is part of the _____ reflex system.
A. vestibular
B. auditory
C. proprioception
D. visual

A

D. visual

39
Q

Embryologically, the muscles of facial expression are dervived from the _____ branchial arch and are innervated by cranial nerve ____.
A. second V
B. first, VII
C. first, V
D. second, VII

A

D. second, VII

40
Q

In which lobe of the cerebrum is the “motor speech” (Broca’s area) system located?
A. parietal
B. occipital
C. temporal
D. frontal

A

D. frontal

41
Q

Which of the following structures transmits axons for unconscious proprioception form the individual muscles of the arms?
A. dorsal spinocerebellar tract
B. fasciculus gracilis
C. ventral spinocerebellar tract
D. cuneocerebellar tract

A

D. cuneocerebellar tract

42
Q

The central tegmental tract is part of the ____ and carries relay fibers to the limbic system for the perception of _______
A. reticular formation, taste
B. pons, auditory
C. medulla, unconscious proprioception
D. spinal cord, touch

A

A. reticular formation, taste

43
Q

The medial longitudinal fasciculus has an ascending limb and a descending limb. What is the function of the ascending limb?
A. third order afferents of the visual system
B. integration of the vestibular system with eye movements
C. integration of pain and temperature sensation with eye movement
D. limbic system integration with the pain system

A

B. integration of the vestibular system with eye movements
Or
C. integration of pain and temperature sensation with eye movement

44
Q

The dorsal and ventral spinocerebellar tracts are found in the most _____ part of the spinal cord.
A. ventral
B. lateral
C. dorsal
D. medial

A

B. lateral

45
Q

A patient presents with right arm and right leg paralysis as well as loss of the right side conscious somatosensory perceptions. Where is the lesion?
A. Area 3, 1, and 2 of the cortex
B. Genu of the internal capsule
C. Posterior limb of the internal capsule
D. Area 4, and 6 of the cortex

A

D. Area 4, and 6 of the cortex

46
Q

A new patient presents today with loss of ability to accomplish medial gaze…… But his left eye stares straight ahead. Which of the following is/would be reason?
A. right lateral midbrain.
B. left superior midbrain.
C. right superior midbrain
D. right ventral pons

A

B. left superior midbrain

47
Q

All of the following represent the origin of the second order afferent tract EXCEPT:
A. chief sensory nucleus of V
B. mesencephalic nucleus of V
C. nucleus proprius
D. nucleus gracilis

A

B. mesencephalic nucleus of V

48
Q

The ____ tract crosses the midline at the ____ of the brainstem and functions in visual/auditory/head movement reflexes.
A. tectospinal, midbrain
B. rubrospinal, pons
C. tectospinal, pons
D. rubrospinal, midbrain

A

A. tectospinal, midbrain

49
Q

Right side corticobulbar fibers innervate:
A. bilateral nuclei of CN XII
B. bilateral nuclei of CN III
C. only contralateral nuclei of CN VI
D. only contralateral nuclei of CN VII for the upper face

A

B. bilateral nuclei of CN III

50
Q

The superior colliculus is part of the _____ reflex system.
A. auditory
B. proprioception
C. visual
D. vestibular

A

C. visual

51
Q

Loss of the dorsal white columns of the cord due to tertiary syphilis will result in the inability to _____.
A. stand still/steady when your eyes are closed
B. track things that you hear in the distance
C. appreciate warming of the skin.
D. track things moving in your visual field.

A

A. stand still/steady when your eyes are closed

52
Q

Which of the following tracts project through the basilar pons?
A. spinothalamic
B. medial lemniscus
C. spinoreticular
D. corticobulbar

A

D. corticobulbar

53
Q

The _______ tract projects bilaterally to the cervical spine controlling movements of the head in response to postural changes; it also contains the medial longitudinal fasciculus for much of its length.
A. Lateral Vestibulospinal
B. Rubrospinal
C. Pontine Reticulospinal
D. Medial Vestibulospinal

A

D. Medial Vestibulospinal

54
Q

Which of the following DO NOT contribute to the auditory pathways?
A. nucleus proprius
B. inferior colliculus
C. lateral lemniscus
D. Superior olive

A

A. nucleus proprius

55
Q

Which one of the following tracts transmits unconscious motor input to contralateral muscles causing excitation of flexor musculature (antigravity muscles) and inhibition of the extensor muscles? (Hint: through this tract contributes to all levels, it is most influential in managing upper extremity movements)
A. rubrospinal
B. tectospinal
C. medial longitudinal fasciculus
D. lateral vestibulospinal

A

A. rubrospinal

56
Q

Which TWO of the following structures are found in the midbrain:
A. nucleus ambiguous
B. inferior cerebellar peduncle
C. red nucleus
D. inferior colliculus
E. substantia gelatinosa

A

C. red nucleus
D. inferior colliculus

57
Q

The nucleus dorsalis of Clarke is the origin of this tract’s axons:
A. ventral spinocerebellar
B. spinothalamic
C. dorsal spinocerebellar
D. cuneocerebellar

A

C. dorsal spinocerebellar

58
Q

Which of the following tracts excites ipsilateral extensor musculature for facilitation and maintenance of upright posture and balance?
A. pontine reticulospinal
B. medial vestibulospinal
C. rubrospinal
D. lateral vestibulospinal

A

D. lateral vestibulospinal

59
Q

Which TWO of the following cranial nerve nuclei are found in the middle pons?
A. dorsal motor nucleus of X
B. nucleus ambiguus
C. chief sensory nucleus of V
D. Motor nucleus of CN-VII
E. motor nucleus of V

A

C. chief sensory nucleus of V
E. motor nucleus of V

60
Q

Which THREE of the following are found in the caudal closed medulla?
A. spinal tract and nucleus of V
B. inferior olivary nucleus
C. internal arcuate fibers
D. pyramids
E. abducens nucleus (CN VI)

A

A. spinal tract and nucleus of V
B. inferior olivary nucleus
D. pyramids

61
Q

The paleospinothalamic tracts provide bilateral input primarily to the ____.
A. deep pontine
B. inter-spinal
C. reticular
D. cerebellar

A

C. Reticular

62
Q

Which one of these contribute the most specific high threshold information to the cerebral cortex?
A. paleospinothalamic tract
B. medial lemniscus
C. dorsal white columns
D. neospinothalamic tract

A

D. neospinothalamic tract

63
Q

Which spinal cord fasciculus allows the divergence of the nociceptive primary afferent neurons?
A. cuneatus
B. Gracilis
C. ventromeidal
D. dorsolateral

A

D. dorsolateral

64
Q

The dentate nucleus of the cerebellum projects primarily to the ___________ nucleus of the thalamus.
A. ventral posterior medial
B. lateral geniculate
C. ventral lateral
D. medial geniculate

A

C. ventral lateral

65
Q

The spinal tract of V (spinal trigeminal tract) carries _________ afferent fibers specific for the __________ modalities.
A. primary, touch and proprioception
B. secondary, touch and proprioception
C. primary, pain and temperature
D. secondary, pain and temperature

A

C. primary, pain and temperature

66
Q

Which of the following tracts contribute input to the third order thalamocortical fibers of the posterior limb of the internal capsule?
A. ventral spinocerebellar
B. medial lemniscal
C. ventral trigeminothalamic
D. lateral corticospinal

A

B. medial lemniscal

67
Q

Which one of the following contribute to the superior cerebellar peduncle?
A. dentatothalamic fibers
B. cerebropontine fibers
C. pontocerebellar fibers
D. olivocerebellar fibers

A

A. dentatothalamic fibers

68
Q

The nucleus ambiguus houses _______ neurons that innervate branchial arch muscles of CN IX, X, and XI.
A. preganglionic GVE
B. GSE
C. SVE
D. postganglionic GVE

A

C. SVE

69
Q

The spinal tract of V transmits primary afferent axons of which one of the following modalities of the face?
A. conscious proprioception
B. discriminating touch
C. nociception/tissue damage
D. unconscious proprioception

A

C. nociception/tissue damage

70
Q

A new patient presents with difficulty swallowing, a soft, whispering voice, and bilateral upper extremity weakness. He has no sensory loss. He denies any flexion / extension type injury. These symptoms have come on gradually, though are getting worse. He has signs of both upper and lower motor neuron lesions. Which one of the following is the most likely differential diagnosis?
A. multiple sclerosis
B. Parkinson’s Disease
C. amyotrophic lateral sclerosis (ALS)
D. syringomyelia

A

B. Parkinson’s Disease

71
Q

Which of the following tracts project through the basilar pons?
A. spinoreticular
B. corticobulbar
C. medial lemniscus
D. spinothalamic

A

B. corticobulbar

72
Q

Which one of the following tracts is transmitted by the inferior cerebellar peduncle?
A. ventral trigeminothalamic
B. dorsal white columns
C. ventral spinocerebellar
D. dorsal spinocerebellar

A

D. dorsal spinocerebellar

73
Q

Which one of the following structures transmit conscious upper motor neuron tract axons?
A. deep pontine nuclei
B. medial longitudinal fasciculus
C. motor nucleus of the facial nerve
D. cerebral peduncle

A

B. medial longitudinal fasciculus

74
Q

The pontine tegmentum defines the: _______________________.
A. floor of the IVth ventricle
B. roof of the IVth ventricle
C. walls of the IVth ventricle

A

A. floor of the IVth ventricle

75
Q

Which one of the following cranial nerve nuclei are found in the medulla and the pons?
A. nucleus ambiguus
B. nucleus solitarius
C. motor nucleus of CN-XII
D. chief sensory nucleus of V

A

A. nucleus ambiguus

76
Q

Which ONE of the following is found in the basilar pons?
A. deep pontine nuclei
B. decussating fibers of the medial lemniscus
C. motor nucleus of the facial nerve
D. inferior cerebellar peduncle

A

A. deep pontine nuclei

Neuro II - CNS (3 decks)

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