COMPREHENSIVE EXAM 1-50 Flashcards Preview

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Flashcards in COMPREHENSIVE EXAM 1-50 Deck (50)
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1. The cuneus is separated from the lingual gyrus by the
A. rchinal sulcus D. collateral sulcus
B. calcarine sulcus E. intraparietal sulcus
C. parietooccipital sulcus

1-B The calcarine sulcus separates the cunetts from the lingual gyrus. The banks of the calcarine sulcus contain the vistual cortex

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2. Which sinus receives drainage from the greatest number of arachnoid granulations?
A. Straight sinus D. Superior sagittal sinus
B. transverse sinus E. Cavernous sinus
C. Sigmoid sinus

2-D The superior sagittal sinus receives drainage from the greatest number of arachnoid granulations

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3. Which of the following statements connerning the Rathke pouch is true?
A. It is a mesodermal diverticulum D. it gives derived from the neural tube
B. It is derived from the neural tube E. It gives rise to the neurophypophysis
C. It gives rise to the adenohypophysis

3-C The Rathke pouch is an ectodermal outpocketing of the stomodeum anterior to the buccopharyngeal membrane and gives rise to the adenohypophysis (pars distalis, pars tuberalis, and pars intermedia).

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4. Which of the following statements concerning the lateral horn of the spinal cord is true?
A. It contains preganglionic parasympathetic neurons
B. It gives rise to a spinecerebellar tract
C. It is present at all spinal cord levels
D. It gives rise to preganglionic sympathetic fibers
E. It is most prominent at sacral levels

4-D The lateral horn (T1-L3) gives rise to preganglionis sympathetic fibers.

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5. Which of the following statements concerning the nucleus dorsalis of Clarke is true?
A. It is found in the ventral horn
B. It projects to the cerebellum
C. It is present at all spinal levels
D. it is most prominent at upper cervical lovels
E. It is homologous to the cuneate nucleus of the medulla

5-B The nucleus dorsalis of Clarke (C8-L3) gives rise to the dorsal spinocerebellar tract, which ascends and enters the cerebellum through the inferior cerebellar peduncle.

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6. Which of the following groups of cranial nerves is closely related to the corticospinal tract ?
A. CN III, CN IV, and CN V D. CN III, CN VI, and CN XII
B. CN III, CN V, and CN VII E. CN III, CN IX, and CN X
C. CN III, CN VI, and CN VIII

6-D In the midbrain, the pyramidal tract lies in the basis pedunculi; oculomotor fibers of CN III pass through the medial part of the basis peduncuh. In the pons, the pyramidal tract lies in the base of the pons; abducent fibers of CN VI pass through the lateral part of the pyramidal fascicule. In the medulla, the pyramidal tract form the medullary pyramids; hypoglossal fibers of CN XII lie just lateral to the pyramids

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7. The primary auditory cortex is located in the
A. frontal operculum D. inferior parietal lobule
B. posteentral gyrus E. transverse temporal gyri
C. superior parietal lobule

7-E The primary auditory cortex (i.e. areas 41 and 42) is located in the transverse temporal gyri of Heschl, a part of the superior temporal gyrus

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8. The neocerebellum projects to the motor cortex via the
A. anterior thalamic nucleus D. lateral dorsal nucleus
B. ventral anterior nucleus E. lateral posterior nucleus
C. Ventral lateral nucleus

8-C. The neocerebllum (the posterior lobe minus the vermis and the paravermis) sends input to the motor cortex through the ventral lateral nucleus of the thalamus. The pathway is the neocerebellar cortex, dentate nucleus, contralateral ventral lateral nucleus of the thalamus, and motor cortex (are 4).

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9. The dentatothalamic tract decussates in the
A. diencephalon D. rostral pons
B. rostral midbrain E. caudal pons
C. caudal midbrain

9-C The dentatothalamic tract decussates in the caudal midbrain tegmentum at the level of the inferior colliculus. This massive decussation of the superior cerebellar peduncles is characteristic of this leve

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10. A pituitary tumor is most frequently associated with a (an)
A. homonymous hemianopia D. binasal hemianopia
B. homonyumous quadrantonopia E. altitudinal hemianopia
C. bitemporal hemianopia

10-C Pituitary tumors frequently compress the decussating fibers of the optic chiasm and produce a bitemporal hemianopia. Nasal fibers decussate, and temporal fibers remain ipsilateral.

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11. Resection of the anterior portion of the left temporal lobe is most frequently associated with a
A. left homonymous hemianopia
B. right upper homonymous quadrantonopia
C. right lower homonymous quadrantonopia
D. left upper homonymous quadrantanopia
E. left lower hosmonymous quadrantanopia

11-B Resection of the anterior portion of the temporal lobe transects the fibers of the loop of Meyer and results in a contralateral upper homonymous quadrantanopia. Inferior retinal quadrants are represented in the inferior bank of the calcarine suleus.

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12. A 65 year old farmer has experienced dull frontal headaches for the last 3 weeks. Neurologic examination reveals spastic hemiparesis on the right side and a pronator drift on the right side. What is the most likely diagnosis?
A. Brain tumor D. Pseudotumor cerebri
B. Myasthenia gravis E. Subacute combined degeneration
C. Progressive supranuclear palsy

12-A Headache and papilledema are signs of brain tumor, and pronator drift is a fronal lobe sign dua to wakness of the supinator muscle. Tumor pressure on the corticospinal tract results in contralateral spastic hemiparesis. In progressive supranuclear palsy the patient cannot look down, in myasthenia gravis there is weakness of skeletal muscle, in pseudotumor cerebri there are no mass lesions but headache and papilledema, and in subacute combined degeneration the posterior columns and the corticospinal tracts are affected

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13. An 18 year old high school student has fracetured a cervical vertebra in an automobile accident, neurologic examination reveals hemiparesis on the right side. Babinski and Hoffmann signs on the right side, loss of pain and temperature sensation on the left side, and normal pallesthesia in all extremities. The spinal cord lesion that would most likely explain the deficits involves the
A. dorsal column, left side D. lateral column, right side
B. dorsal column, right side E. anterior column, bilateral
C. lateral column, left side

13-D The lateral corticospinal tract and the lateral spinothalamic tract are both found in the lateral column. Trasection of the corticospinal tract results in an ipsilateral paresis, and transaction of the spinothalamic tract results in a contralateral loss of pain and temperature sensation. Pallesthesia (vibration sense) is normal

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14. Light shone into the left eye elicits a direct papillary reflex but no consensual reflex. A lesion in which of the following structures aecounts for this deficit?
A. Optic nerve, left eye D. Oculomotor nerve, right side
B. Optic nerve, right eye E. Oculomotor nerve, left side
C. Optic tract, right side

14-D The contralateral oculomotor nerve is responsible for the consensual reaction

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15. A 53 year old housewife has a normal corneal blink reflex on her left side but no consensual blink on her right side. Which of the following neurologic deficits or signs would you expect to find on the right side?
A. Hyperacusis D. Internal ophthalmoplegia
B. Hemianhidrosis E. Servere ptosis
C. Hemianesthesia

15-A Hyperacusis is an increased acuity of hearing and undue sensitivity to low tones. It results from paralysis of the stapedius muscle (CN VII); the stapedius reduces the amplitude of sound vibrations of the stapes in the oval window.

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16. A 49 year old man has a loss of tactile sensation involving the anterior two thirds of his tongue on the left side. Neurologic examination reveals paralysis of the masseter muscle on the left side and loss of pain and temperature sensation from the teeth of the mandible on the left side. He has a lesion involving which one of the following nerves?
A. Chorda tympani nerve
B. Facial nerve
C. Hypoglossal nerve
D. Trigeminal nerve, mandibular division
E. Trigeminal nerve, ophthalmic division

16-D The mandibular division of the trigeminal nerve (CN VII) the stapedius reduces the muscles of mastication (e. g., masseter muscele) and mediates the tactile sensation of the anterior two thirds of the tongue. The glossopharyngeal nerve (CN IX) provides the tactile, noiceptive, and taste innervations to the anterior two-thirds of the tongue.

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17. A 62 year old lawyer suffers a stroke and fals while cutting his lawn. He does not lose consciousness. Neurologic examination reveals loss of pain sensation on the right side of the face and on the left side of the body, falling and past pointing to the right side, difficulty swallowing, horizontal nystagmus to the right side, deviation of the uvula to the left when asked to say “ah”, and Horner syndrome on the right side. The most likely site of this man’s lesion is the
A. Internal capsule, left side D. Lateral medulla, right side
B. Midbrain, right side E. Medial medulla, right side
C. Pontine tegmentum

17-D This is the classic lateral medullary syndrome, which is also known as Wallenberg syndrome (see Figure 14-1B)

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18. A 64 year old pharmacology professor complains of weakness in his right leg and double vision, especially when moving his eyes to the left. Neurologic examination reveals a dilated pupil and patois’ on the left side and a Babinski sign (extensor plantar reflex) on the right side. The most likely site of this patient’s lesion is the
A. Midbrain crus cerebri, right side D. Pontine tegmentum, right side
B. Midbrain crus cerebri, left side E. Internal capsule, right side
C. Pontine base, left side

18-B This is a classic medial midbrain lesion characteristic of Weber syndrome. It includes the crus cerebri and the exiting intra axial fibers of the oculomotor nerve (see Figure 14-3C).

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19. While working in his shop, a 21 year old machinist is struck by a penetrating metal fragment in the side of the head. Neurologic examination reveals the following language deficits; fluent speech, no ability to read aloud, no ability to repeat what you say, no ability to compensate by writing. The patient understands the problem but cannot resolve it. Where would your expect to find the fragment?
A. Between the supramarginal gyrus and the inferior frontal gyrus
B. In the angular gyrus
C. In the trasverse gyrus
D. In the posterior one-third of the superior temporal gyrus
E. In the paracentral gyrus

19-A The metal fragment is found between the inferior frontal gyrus and the supramarginal gyrus. The two gyri are connected by the arcuate fasciculus; transaction results in conduction aphasia. The arcuate fasciculus interconnects broca area from Wernicke area. The key deficit is the inability to repeat (see Figure 24-1).

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20. The catecholomine norepinephrine is the primary neurotransmitter found in the
A. adrenal cortex
B. adrenal medulla
C. postganglionic parasympathetic neurons to the circular smooth muscle layer of the jrjunum
D. postganglionic sympathetic neurons to the smooth muscle of the renal arterioles
E. postganglionic sympathetic neurons to the sweat glands

20-D Norepinephrine is the neurotransmitter of postganglionie sympathetic neurons, with the exception of sweat glands and some blood vessels that receive cholinergic sympathetic innervations. Epinephrine is produced by the chromaffin cells of the adrenal medulla.

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21. A 30 year old man sustains brain damage as the result of an automobile accident. Neurologic examination reveals incomplete retrograde amnesia and severe anterograde amnesia as well as inappropriate social behavior, including hyperphagia, hypersexuality, and general disinhibition. The brain injury would most likely involve the
A. frontal lobes, lateral convexity D. temporal lobes, medial surface
B. frontal lobes, medial surface E. thalami
C. temporal lobes, lateral convexity

21-D Bilateral damage of the medial temporal gyri, including the amygdalae, may caouse severe memory loss (hippocampal formations). Such damage to the amygdalae may tead to inappropriate social behavior (e.g., hyperphagia, hypersexuality, general disinhibition). Bilateral destruction of the amygdalae results in the kluver-Busy syndrome

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22. A 55 year old woman has difficulty reading small print. She most likely has
A. astigmatism D. macular degeneration
B. cataracts E. presbyopia
C. optic atrophy

22-E Presbyopia is a progressive loss of the ability to accommodate, the decreased ability to focus on near objects. Astigmatism is the difference in refracting power of the cornea and lens in different meridians. Cataracts are opacities of the lens that appear with aging. Optic atrophy is degeneration of the optic nerve and papillomacular bundle and loss of central vision.

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23. The principal postnatal change in the pyramids is due to
A. an increase of corticospinal neurons from the paracentral lobule
B. an increase in the total number of corticospinal axons
C. a large increase of Schwann cells found in the motor cortex
D. an increase in endoneural tubes to guide sprouting axons
E. myelination of preexiating corticospinal axons

23-E The corticospinal fibers are not completely myelinated at birth; this does not occur until between 18 months and 2 years of age. During this time, the babinski reflex is elicitable; later it is suppressed.

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24. Special visceral afferent (SVA) neurons that innervate receptor cells in taste budsynapse in the
A. geniculate ganglion
B. inferior salivatory nucleus
C. nucleus of the solitary tract
D. spinal trigeminal nucleus
E. ventral posteromedial (VPM) nucleus

24-C The nucleus of the solitary tract receives taste fibers from cranial nerves VII, IX, and X. Neurons of this tract project to the ventral posteromedial (VPM) nucleus of the thalamus.

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25. A woman receives an injection of a radioisotope to determine regional blood flow in the brain. She has a positron emission tomography (PET) scan to visualize variations in cortical blood flow. The examiner asks her to think about flexing her index finger without actually doing it. In which of the following cortical areas would you expect to see increased blood flow?
A. Broca area D. Supplementary motor cortex
B. Angular gyrus E. S-I somatosensory cortex
C. Motor strip

25-D The supplementary motor cortex (M-2) plans for motor activity. Broca area is a language center, the angular gyrus is concerned with mnemonic constellations, the motor strip (M-1) gives rise to the corticospinal and corticobular tracts, and the S-1 somatosensory cortex subserves somtic sensibility.

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26. Destruction of the right cuneate nueleus result in which of the following sensory deficits ?
A. Apallasthesia, left hand D. Analesia, left hand
B. Apallesthesia, right hand E. Analgesia. right foot
C. Apallesthesia, left foot

26-B Destruction of the right cuneate nucleus results in apallesthesia (loss of vibration sensation) in the right had. The cuneate nucleus, a way station in the posterior column-medial lemniscus pathway, mediates tactile discrimination and vibration sensation

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27. The elaboration of acetylcholine (Ach) results in winch of the following postganglionic sympathetic responses ?
A. Constriction of eutaneous blood vassels
B. Contraction of arrector pili musales
C. Deereased gastrointestinal motility
D. Inereased ventricular contractility
E. Stimulation of acerine sweat gland

27-E Ecerine sweat glands are innervated by postganglionic sympathetic cholinergic fibers. Apocrine sweat glands are innervated by postganglionic sympathetic norepinephrinergic fibers. (Note: This item is often tested)

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28. Nausea is mediated by which of the following natural structures ?
A. Celia ganglion
B. Greater splanchnic nerve
C. Superior mesenteric ganglion
D. Inferior masentric ganglion
E. vagal nerves

28-A The vagal nerves mediate the feeling of nausea via general visceral afferent (GVA) fibers

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29. A computed tomography (CT) scan of the bloodstream via the
A. aracchnoid villi
B. ehoroid plexus
C. interventricular foramen of marno
D. lateral foramina of luschka
E. median foramen of Magendie

29-A Cerebrospinal fluid (CSF) enters the bloodstream via the arachnoid villi, Hypertrophied arachnoid villi are called arachnoid granulations or pacchionian bodies.

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30. A computed tomography (CT) scan of the head of a nowborn infant revealts enlargement of the lateral ventriceles and the third ventricle. The cause of this bydrocephalus is most likely which of the following ?
A. Aqueduetal stenosis
B. Adhesive arachnoiditis
C. Chorad plexus papilloms
D. Calcifition of the areahnoid granulations
E. Stenosis of the median foramen

30-A Aqueductal stenosis results in enlargement of the third and lateral ventricles. The condition is strongly associated with prenatal infections (e. g., eytomegalovirus infection). Congenital hydrocephalus occurs in 1 : 1000 live births. Mental retardation, spasticity, and tremor are common. Shunting is the treatment of choice; cerebrospinal fluid (CSF) is shunted from the distended ventricle to the peritoneal cavity.