Neuroanatomy Finals (Batches 2024 and 2025) Flashcards

1
Q
  1. Best modality for cord evaluation
    A. СТ
    B. MRI
    C. MRA
    D. X-ray
A

MRI

MRI (Magnetic Resonance Imaging) is considered the best modality for cord evaluation due to its high resolution and ability to provide detailed images of soft tissue structures, including the spinal cord and surrounding structures.

CT (Computed Tomography) can also be useful for evaluating the spinal cord, especially in cases of acute trauma or to evaluate bony abnormalities. However, CT has limitations in visualizing soft tissue structures and may not provide the level of detail needed for some spinal cord pathologies.

X-ray is not typically used as the primary modality for evaluating the spinal cord, as it does not provide adequate detail of the soft tissues or the spinal cord itself. However, X-ray may be useful in evaluating bony abnormalities or for initial screening in some cases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  1. Carries signals for vibration, visceral pain, deep and discriminative touch and proprioception from lower limbs and lower trunk
    A. Cuneate fasciculus
    B. Spinoreticular tract
    C. Spinothalamic system
    D. Gracile Fasciculus
A

Gracile Fasciculus

The Gracile Fasciculus is a white matter tract in the spinal cord that carries sensory information from the lower limbs and lower trunk, including signals for vibration, visceral pain, deep and discriminative touch, and proprioception.

The Cuneate Fasciculus is another white matter tract in the spinal cord that carries similar sensory information but from the upper limbs and upper trunk.

The Spinothalamic System is a group of tracts that carry pain, temperature, and crude touch sensations from the body to the brain.

The Spinoreticular Tract is a pathway that carries pain signals from the body to the reticular formation in the brainstem, which plays a role in arousal and attention to sensory stimuli.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  1. Location of interpretation of emotional aspect of pain
    A. Post-central gyrus
    B.Cingulate gyrus
    C. Insular gyrus
    D. Reticular formation
A

Cingulate gyrus

Cingulate gyrus is involved with the interpretation of the emotional aspect of pain.

Postcentral gyrus is responsible for the interpretation of pain in relation to past experiences.

Insular gyrus is concerned with the interpretation of pain stimuli from the internal organs of the body and brings about an autonomic response.

The reticular formation is a network of nuclei located in the brainstem that is involved in a wide range of functions, including regulating arousal and consciousness, but it is not specifically involved in the interpretation of the emotional aspect of pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  1. Non-painful input prevents pain sensation from traveling to the central nervous system
    A. Reciprocal inhibition
    B. Reflex arc
    C. Feedback inhibition
    D. Gate control
A

Gate control

Gating Theory

Although the precise mechanism for these phenomena is not understood, the gating theory was proposed some years ago. It was suggested that at the site where the pain fiber enters the central nervous system, inhibition could occur by means of connector neurons excited by large, myelinated afferent fibers carrying information of nonpainful touch and pressure. The excess tactile stimulation produced by massage, for example,“closed the gate” for pain. Once the nonpainful tactile stimulation ceased, however,“the gate was opened,” and information on the painful stimuli ascended the lateral spinothalamic tract.

Reciprocal inhibition refers to the inhibitory effect that occurs when the contraction of one muscle is accompanied by the relaxation of its antagonist muscle, which is not directly related to pain modulation.

Reflex arc is the neural pathway that mediates a reflex action, which is a rapid and automatic response to a stimulus that does not require conscious thought or decision-making.

Feedback inhibition is a regulatory mechanism in which the output of a process or system feeds back to inhibit or regulate the process or system itself, which is also not directly related to pain modulation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  1. The Spinothalamic tracts are,
    A. Autonomous pathways
    B. Descending pathways
    C. Afferent pathways
    D. Efferent pathways
A

Afferent pathways

The Spinothalamic tracts are a group of afferent, or sensory, pathways that carry information about pain, temperature, and crude touch from the body to the brain. These pathways originate in the dorsal root ganglia, where the cell bodies of sensory neurons are located, and then ascend up the spinal cord to synapse with neurons in the brainstem and thalamus, which relay the information to the sensory cortex for processing and interpretation.
Autonomous pathways are those that function independently of conscious control, such as the autonomic nervous system.
Descending pathways are efferent pathways that carry motor commands from the brain to the spinal cord and muscles.
Efferent pathways are also known as motor pathways, which carry motor commands from the brain to the muscles or glands.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  1. This statement best describes the efferent connections of the hypothalamus:
    A. The parasympathetic nucleus of the cranial nerve Ill receives descending fibers from the hypothalamus.
    B. The posterior nucleus of the thalamus receives fibers from the mammillary body.
    C. The mammillotegmental tract connects the hypothalamus to the reticular formation in the pons.
    D. The supraoptic nucleus sends fibers to the cerebellar cortex.
A

The supraoptic nucleus sends fibers to the cerebellar cortex.

The hypothalamus is a complex structure located at the base of the brain that is involved in a wide range of functions, including regulation of the autonomic nervous system, control of hormone secretion, and modulation of behavior and emotions.

The efferent connections of the hypothalamus are extensive and complex, and involve multiple pathways that project to various regions of the brain and spinal cord. One of the most well-known efferent connections of the hypothalamus is the hypothalamic-pituitary-adrenal (HPA) axis, which is involved in the regulation of the stress response.

In the given options, only option D is a correct statement about the efferent connections of the hypothalamus. The supraoptic nucleus is a nucleus located in the hypothalamus that is involved in the synthesis and release of the hormone vasopressin, which regulates water balance in the body. The supraoptic nucleus sends efferent fibers to various regions of the brain, including the cerebellar cortex, which is involved in motor coordination and control.

Option A is incorrect as the parasympathetic nucleus of cranial nerve III (oculomotor nerve) receives efferent fibers from the Edinger-Westphal nucleus, not from the hypothalamus.

Option B is incorrect as the mammillary body receives afferent fibers from the hippocampus and projects to the anterior nucleus of the thalamus, not to the posterior nucleus of the thalamus.

Option C is incorrect as the mammillotegmental tract connects the mammillary bodies to the brainstem reticular formation, not to the hypothalamus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  1. True of the Circle of Willis except:
    A. starts at the internal carotid arteries
    B. Middle cerebral arteries are the main component
    C. hypoplastic or absent segment is common
    D. composed of anterior and posterior circulation
A

Middle cerebral arteries are the main component

The Circle of Willis is an arterial structure located at the base of the brain that provides collateral circulation between the anterior and posterior circulation. It is composed of the following arteries:

  • Two internal carotid arteries
  • Two anterior cerebral arteries
  • Two posterior cerebral arteries
  • One anterior communicating artery
  • Two posterior communicating arteries

Option A is correct. The Circle of Willis begins at the internal carotid arteries, which arise from the common carotid arteries in the neck.

Option C is also correct. Hypoplastic (underdeveloped) or absent segments of the Circle of Willis are relatively common and can contribute to the risk of ischemic stroke.

Option D is correct. The Circle of Willis is composed of both anterior and posterior circulation. The anterior circulation includes the internal carotid arteries and the anterior cerebral arteries, while the posterior circulation includes the posterior cerebral arteries.

Option B is incorrect. While the middle cerebral arteries are an important component of the cerebral circulation, they are not part of the Circle of Willis. The middle cerebral arteries arise directly from the internal carotid arteries and supply blood to the lateral surfaces of the brain, including the primary motor and sensory areas for the face and upper extremity, as well as language centers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  1. Which of the following statements is TRUE concerning the nuclei of the hypothalamus:
    A. The nuclei are separated from each other by distinct margins
    B. The suprachiasmatic nucleus overlaps both the medial and lateral groups of nuclei.
    C. The fornix and the mammillothalamic tract divide the hypothalamic nuclei into anterior and posterior
    D. The preoptic nucleus is confined only to the lateral zone of nuclei.
A

B. The suprachiasmatic nucleus overlaps both the medial and lateral groups of nuclei.

The nuclei of the hypothalamus are a group of specialized neurons that play a critical role in regulating various autonomic and endocrine functions, including body temperature, thirst and hunger, sleep-wake cycles, and the stress response.

Option A is incorrect. The nuclei of the hypothalamus do not have distinct margins, and there is significant overlap between them.

Option C is incorrect. The hypothalamic nuclei are usually divided into three major groups based on their location: medial, lateral, and posterior. The fornix and the mammillothalamic tract are fiber pathways that connect different regions of the hypothalamus with other parts of the brain, and they do not divide the nuclei into distinct subgroups.

Option D is incorrect. The preoptic nucleus is located at the rostral end of the hypothalamus and is involved in the regulation of a variety of functions, including thermoregulation, sexual behavior, and the release of hormones from the pituitary gland. The preoptic nucleus is not confined only to the lateral zone of nuclei, but rather extends across the medial-lateral axis of the hypothalamus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
  1. During the screening neurologic examination, pronator drift tests for
    A. tone of the upper extremities
    B. proprioception
    C. weakness of the upper extremities
    D. sensory loss of the upper extremities
A

weakness of the upper extremities

Pronator drift is a simple clinical test that involves having the patient hold both arms outstretched in front of them with their palms facing up and eyes closed. The examiner then applies a gentle downward force to both arms, and the patient is instructed to resist this force and maintain their position. A positive test is indicated by the affected arm drifting downward and inward, with the palm pronating (turning downward). This finding suggests weakness or pyramidal tract involvement on the contralateral side.

Option A is incorrect because pronator drift is not specifically testing for tone of the upper extremities, but rather for weakness.

Option B is incorrect because proprioception is not directly assessed by pronator drift, but rather by other tests such as joint position sense testing or vibration sense testing.

Option D is incorrect because sensory loss is not specifically assessed by pronator drift, but rather by other tests such as light touch or pinprick sensation testing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  1. Which of the following statements is/are true?
    A. The spinal subarachnoid space extends down as far as the fifth sacral vertebra
    B. Epidural hemorrhage is blood collecting above the periosteal layer of the dura mater
    C. Epidural hemorrhage creates a lens shaped hyperdense collection of blood seen on CT scan
    D. Middle meningeal artery laceration is the most common cause of subarachnoid hemorrhage
    E. All the statements are true
A

C. Epidural hemorrhage creates a lens shaped hyperdense collection of blood seen on CT scan

A. The spinal subarachnoid space extends down to the lower border of the second sacral vertebra, not the fifth sacral vertebra.

B. Epidural hemorrhage is blood collecting above the meningeal layer of the dura mater, not the periosteal layer.

D. Middle meningeal artery laceration is the most common cause of epidural hemorrhage, not subarachnoid hemorrhage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  1. All of the following structures are seen in the dorsal surface of the medulla, EXCEPT
    A. Pyramidal decussation
    B. Floor of the fourth ventricle
    C. Posterior median sulcus
    D. Gracile tubercle
A

Pyramidal decussation

The dorsal surface of the medulla oblongata includes the following structures:
· Floor of the fourth ventricle (B)
· Posterior median sulcus (C)
· Gracile tubercle (D)
The pyramidal decussation (A) is located on the ventral surface of the medulla oblongata.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
  1. The first order neuron of the ascending tract usually comes from the
    A. Substancia gelatinosa
    B. Nucleus dorsalis
    C. Posterior root ganglion
    D. Anterior root ganglion
A

Posterior root ganglion

The substantia gelatinosa (A) is a layer of gray matter in the spinal cord that is involved in processing pain and temperature information.

The nucleus dorsalis (B), also known as the Clarke’s nucleus, is a group of neurons in the spinal cord that is involved in the proprioception of the lower limbs.

The anterior root ganglion (D) contains the cell bodies of motor neurons that send axons out to innervate skeletal muscles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. Through which bone does the olfactory nerve pass through?
    A. Sphenoid
    B. Ethmoid
    C. Squamous portion of temporal bone
    D. Frontal
A

Ethmoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  1. Where is the nucleus of the trochlear nerve found?
    A. Anterior to the cerebral aqueduct at the level of the superior colliculus
    B. Anterior to the cerebral aqueduct at the level of the inferior colliculus
    C. Dorsum of the midbrain at the level of the inferior colliculus
    D. Dorsum of the midbrain at the level of the superior colliculus
A

Dorsum of the midbrain at the level of the inferior colliculus

The trochlear nerve, the most slender of the cranial nerves and the only one to leave the posterior surface of the brainstem, emerges from the midbrain and immediately decussates with the nerve of the opposite side.

The trochlear nucleus is situated in the anterior part of the gray matter that surrounds the cerebral aqueduct of the midbrain. It lies inferior to the oculomotor nucleus at the level of the inferior colliculus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  1. The following intracranial arteries are part of the Posterior circulation except:
    A. Posterior communicating arteries
    B. Basilar artery
    C. Posterior cerebral arteries
    D. Vertebral arteries
A

Posterior communicating arteries

The posterior cerebral circulation (or simply, posterior circulation) is the blood supply to the posterior portion of the brain, including the occipital lobes, cerebellum and brainstem.

Due to the anastomotic circle of Willis, the posterior circulation connects via the posterior communicating arteries to the anterior circulation.

The posterior circulation is supplied by the vertebral arteries that combine to form the basilar artery which then divides into the posterior cerebral arteries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  1. The following clinical features are seen in Lateral Medullary Syndrome, EXCEPT:
    A. Nystagmus
    B. Dysphagia & Dysphonia
    C. Ipsilateral Horner’s syndrome
    D. Contralateral loss of facial pain and temperature sensation
A

Contralateral loss of facial pain and temperature sensation

Lateral Medullary Syndrome of Wallenberg
· The lateral part of the medulla oblongata is supplied by the posterior inferior cerebellar artery, which is usually a branch of the vertebral artery.
· Thrombosis of either of these arteries produces the following signs and symptoms:
o dysphagia and dysarthria due to paralysis of the ipsilateral palatal and laryngeal muscles (innervated by the nucleus ambiguous);
o analgesia and thermoanesthesia on the ipsilateral side of the face (nucleus and spinal tract of the trigeminal nerve);
o vertigo, nausea, vomiting, and nystagmus (vestibular nuclei);
o ipsilateral Horner syndrome (descending sympathetic fibers);
o ipsilateral cerebellar signs—gait and limb ataxia (cerebellum or inferior cerebellar peduncle);
o contralateral loss of sensations of pain and temperature (spinal lemniscus—spinothalamic tract).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  1. This part of the brain is concerned with converting recent memory into long term memory.
    A. Dentate gyrus
    B. Cingulum
    C. Amygdala
    D. Hippocampus
A

Hippocampus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
  1. The following provides the nerve supply to the dura mater except
    A. vagus nerve
    B. trigeminal nerve
    C. first three thoracic spinal nerves
    D. none of the choices
A

first three thoracic spinal nerves

Branches of the trigeminal, vagus, and the first three cervical spinal nerves and branches from the sympathetic trunk pass to the dura.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q
  1. The term “white matter” refers to the,
    A. Neuroglia
    B. Cells in the cerebral cortex
    C. Nerve fibers embedded in neuroglia
    D. Neurons in the brain
A

Nerve fibers embedded in neuroglia

The CNS interior is organized into gray and white matter. Gray matter, which is gray in color, consists of nerve cells embedded in neuroglia. White matter consists of nerve fibers embedded in neuroglia and is white in color because of the presence of lipid material in nerve fiber myelin sheaths.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
  1. Which fibers cross at the level of the optic chiasm?
    A. Both nasal and temporal fibers
    B. Inferior quadrant of the optic nerve
    C. Nasal fibers of the optic nerve
    D. Temporal fibers of the optic nerve
A

Nasal fibers of the optic nerve

The anterolateral corners of the chiasma are continuous with the optic nerves, and the posterolateral corners are continuous with the optic tracts. A small recess, the optic recess of the third ventricle, lies on its superior surface.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
  1. Upon closure of the neural tube, the skin above it separates and the cells that formed the margins of the neural tube separates and lies between the tube and the ectoderm, these important cells form the,
    A. Notochord
    B. Mesoderm 1
    C. Neural plate
    D. Neural crest
A

Neural crest

Neural crest cells migrate to various parts of the body and give rise to various structures such as the sensory ganglia of the cranial and spinal nerves, adrenal medulla, pigment cells of the skin, and many other tissues.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q
  1. Involved in arousing consciousness through cutaneous stimulation
    A. Spinoreticular tract
    B. Anterior spinothalamic tract
    C. Lateral spinothalamic tract
    D. Dorsal spinocerebellar tract
A

Spinoreticular tract

The spinoreticular tract provides an afferent pathway for the reticular formation, which plays an important role in influencing levels of consciousness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q
  1. The following are found in the wall of the cavernous sinus except:
    A. Trochlear
    B. Trigeminal, mandibular branch
    C. Oculomotor
    D. Trigeminal, maxillary branch
A

Trigeminal, mandibular branch

The cavernous sinus is directly related to the side of the body of the sphenoid.
It carries in its lateral wall the third and fourth cranial nerves and the ophthalmic and maxillary divisions of the fifth cranial nerve. The internal carotid artery and the sixth cranial nerve pass forward through the sinus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q
  1. The heart muscle is innervated by,
    A. Sympathetic nervous system
    B. Parasympathetic nervous system
    C. sympathetic and parasympathetic nervous system
    D. Peripheral nervous system
A

sympathetic and parasympathetic nervous system

The sympathetic nervous system increases heart rate and contractility, while the parasympathetic nervous system decreases heart rate and contractility. These two systems work together to maintain proper heart function. The peripheral nervous system includes all the nerves outside of the brain and spinal cord, and it includes both the sympathetic and parasympathetic branches.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q
  1. Periosteum covering the inner surface of the skull bone
    A. arachnoid mater
    B. dura mater-meningeal layer
    C. pia mater
    D. dura mater-endosteal layer
A

dura mater-endosteal layer

The periosteum covering the inner surface of the skull bone is called the dura mater-endosteal layer.
The dura mater is the toughest and most durable of the three layers of the meninges that surround the brain and spinal cord.

It consists of two layers: the endosteal layer, which is attached to the inner surface of the skull bone, and the meningeal layer, which is located beneath the endosteal layer. The other two meningeal layers are the arachnoid mater and the pia mater.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q
  1. The cells of the neural crest migrate ventro-laterally to form the,
    A. Notochord
    B. Autonomic ganglia
    C. Posterior root ganglia
    D. All of the choices
    E. Sensory ganglia of the cranial nerves
A

All of the choices

This strip of ectoderm is called the neural crest subsequently, this group of cells will migrate ventrolaterally on each side around the neural tube. Ultimately, the neural crest cells will differentiate into the cells of the posterior root ganglia, the sensory ganglia of the cranial nerves, autonomic ganglia, the cells of the suprarenal medulla, and the melanocytes. It is also believed that these cells give rise to mesenchymal cells in the head and neck.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q
  1. Small sickle-shaped fold of dura mater attached to the internal occipital crest and projects between the two cerebellar hemispheres
    A. diaphragma sellae
    B. falx cerebelli
    C. falx cerebri
    D. tentorium cerebelli
A

E. falx cerebelli

The falx cerebelli, a small, sickle-shaped fold of dura mater attached to the internal occipital crest, projects forward between the two cerebellar hemispheres.

The diaphragma sellae is a small, circular fold of dura mater that forms the roof for the sella turcica.

The falx cerebri is a sickle-shaped fold of dura mater that lies in the midline between the two cerebral hemispheres

The tentorium cerebelli is a crescent-shaped fold of dura mater that roofs over the posterior cranial fossa.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q
  1. Which is CORRECT among the following statements concerning the hypothalamohypophyseal tract?
    A. The hormones travel through the dendrites of neurons with carbohydrate molecule.
    B. Vasopressin is produced from the nerve cells of the posterior hypothalamic nuclei.
    C. Oxytocin inhibits uterine contraction.
    D. On reaching the axon terminals, the hormones are absorbed in the bloodstream in the capillaries of the posterior lobe of the hypophysis.
A

On reaching the axon terminals, the hormones are absorbed in the bloodstream in the capillaries of the posterior lobe of the hypophysis.

The hormones are passed along the axons together with carrier proteins called neurophysins and are released at the axon terminals. Here, the hormones are absorbed into the bloodstream in fenestrated capillaries of the posterior lobe of the hypophysis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q
  1. This vascular territory supplies most of the inferior surface of the cerebral hemisphere, occipital lobe and corpus callosum
    A. Posterior cerebral artery
    B. Middle cerebral artery
    C. Posterior communicating artery
    D. Anterior cerebral artery
A

Posterior cerebral artery

The posterior cerebral artery curves laterally and backward around the midbrain and is joined by the posterior communicating branch of the internal carotid artery.
· Cortical branches supply the inferolateral and medial surfaces of the temporal lobe and the lateral and medial surfaces of the occipital lobe. Thus, the posterior cerebral artery supplies the visual cortex.
· Central branches pierce the brain substance and supply parts of the thalamus and the lentiform nucleus as well as the midbrain, the pineal, and the medial geniculate bodies.
· A choroidal branch enters the inferior horn of the lateral ventricle and supplies the choroid plexus; it also supplies the choroid plexus of the third ventricle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q
  1. The control of skeletal muscle, somatic and visceral sensation, autonomic nervous system, endocrine system and circadian rhythms is achieved by the
    A. Reticular Formation
    B. Hypothalamus
    C. Reticular Formation and Hypothalamus
    D. Limbic system and Hypothalamus
A

E. Reticular Formation and Hypothalamus

The reticular formation, as its name would suggest, resembles a net (reticular) that is made up of nerve cells and nerve fibers. The net extends up through the axis of the central nervous system from the spinal cord to the cerebrum. It is strategically placed among the important nerve tracts and nuclei. It receives input from most of the sensory systems and has efferent fibers that descend and influence nerve cells at all levels of the central nervous system. The exceptionally long dendrites of the neurons of the reticular formation permit input from widely placed ascending and descending pathways. Through its many connections, it can influence skeletal muscle activity, somatic and visceral sensations, the autonomic and endocrine systems, and even the level of consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q
  1. Regarding the neurotransmission in the Basal Ganglia, which of the following is CORRECT?
    A. The substantia nigra pars compact inhibits the direct pathway via the D1 receptors
    B. Glutamate is the major inhibitory of the basal ganglia
    C. GABA is the major neurotransmitter released in the striatal projections to the globus pallidus and in globus pallidus interna projections to the thalamus
    D. D1 receptors are primarily found on neurons involved in the indirect pathway, and D2 receptors involved in the direct pathway
A

GABA is the major neurotransmitter released in the striatal projections to the globus pallidus and in globus pallidus interna projections to the thalamus

A. The substantia nigra pars compacta actually promotes the direct pathway via the release of dopamine, which binds to D1 receptors on neurons in the striatum.

B. Glutamate is actually the major excitatory neurotransmitter in the basal ganglia.

D. D1 receptors are primarily found on neurons involved in the direct pathway, while D2 receptors are primarily found on neurons involved in the indirect pathway.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q
  1. TRUE or FALSE? The Globose-Emboliform-Rubral Pathway crosses twice, once in the decussation of the superior cerebellar peduncle and again the rubrospinal tract causing the globose and emboliform nuclei to influence the motor activity on the same side of the body.
    A. True
    B. False
A

True

Globose-Emboliform-Rubral Pathway
Axons of neurons in the globose and emboliform nuclei travel through the superior cerebellar peduncle and cross the midline to the opposite side in the decussation of the superior cerebellar peduncles (Fig. 6-12). The fibers end by synapsing with cells of the contralateral red nucleus, which give rise to axons of the rubrospinal tract.
Thus, it is seen that this pathway crosses twice, once in the decussation of the superior cerebellar peduncle and again in the rubrospinal tract close to its origin. By this means, the globose and emboliform nuclei influence motor activity on the same side of the body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q
  1. The ascending tracts terminate in the
    A. The thalamus
    B. Post-central somesthetic cortex of the forebrain
    C. Third order neurons
    D. Second order neurons
A

The thalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q
  1. When a stimulus is applied to a receptor it causes a change in the electrical potential of the plasma membrane of the cell of the receptor, which can be a nerve ending, the process of change in the form of energy is called,
    A. Transformation
    B. Transduction
    C. Transposition
    D. Polarization
A

Transduction

Transduction is the process by which one form of energy (the stimulus) is changed into another form of energy (electrochemical energy of the nerve impulse). The stimulus, when applied to the receptor, brings about a change in potential of the plasma membrane of the nerve ending.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q
  1. The following statement/s regarding the white matter fibers of the cerebellum is/are
    CORRECT:
    A. The afferent fibers enter the cerebellum mainly through the inferior cerebellar peduncle and middle cerebellar peduncles
    B. The intrinsic fibers leave the cerebellum and connect to different regions of the organ
    C. Fibers from all the intracerebellar nuclei leave through the superior cerebellar peduncle
A

The afferent fibers enter the cerebellum mainly through the inferior cerebellar peduncle and middle cerebellar peduncles

The intrinsic fibers do not leave the cerebellum but connect different regions of the organ. Some interconnect folia of the cerebellar cortex and vermis on the same side; others connect the two cerebellar hemispheres together.

The intracerebellar nuclei are composed of large, multi- polar neurons with simple branching dendrites. The axons form the cerebellar outflow in the superior and inferior cerebellar peduncles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q
  1. Which of the following statements regarding the cerebellar cortex is INCORRECT?
    A. Scattered throughout the purkinje layer are Golgi cells
    B. The axons of the Purkinie cells from the efferent fibers from the cerebellar cortex
    C. The Purkinje cells are large Golgi type I neurons
    D. The molecular layer contains the stellate and basket cells
A

The axons of the Purkinie cells from the efferent fibers from the cerebellar cortex

The axons of the Purkinje cells form the efferent fibers from the cerebellar cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q
  1. Which among the following nuclei is confined only to the medial zone?
    A. tuberomammillary nucleus
    B. supraoptic nucleus
    C. paraventricular nucleus
    D. lateral tuberal nuclei
A

paraventricular nucleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q
  1. Which of the following statements is correct regarding the midbrain?
    A. The trochlear nucleus is situated in the central gray matter at the level of the inferior colliculus
    B. The interpeduncular fossa is bounded laterally by the cerebellar peduncles
    C. The tegmentum lies anterior to the substantia nigra
    D. The oculomotor nucleus is seen at the level of the inferior colliculus
A

The trochlear nucleus is situated in the central gray matter at the level of the inferior colliculus

The trochlear nerve, the most slender of the cranial nerves and the only one to leave the posterior surface of the brainstem, emerges from the midbrain and immediately decussates with the nerve of the opposite side.

The trochlear nucleus is situated in the anterior part of the gray matter that surrounds the cerebral aqueduct of the midbrain. It lies inferior to the oculomotor nucleus at the level of the inferior colliculus.

The interpeduncular fossa is bounded anteriorly by the cerebral peduncles, laterally by the medial longitudinal fasciculus, and posteriorly by the superior cerebellar peduncles.

The tegmentum lies posterior to the substantia nigra.

The oculomotor nucleus is seen at the level of the superior colliculus, not the inferior colliculus.

39
Q
  1. Which of the following statements regarding the Basal Ganglia is INCORRECT?
    A. The activity of the basal ganglia is initiated by information received from premotor and supplemental areas of the motor cortex, primary sensory cortex thalamus and brainstem
    B. The neurons of the subthalamic nuclei are glutaminergic and inhibitory
    C. The outflow from the basal nuclei is channeled through the globus pallidus
    D. None, all are correct
A

The neurons of the subthalamic nuclei are glutaminergic and inhibitory

The subthalamic nuclei are not inhibitory, but rather excitatory and glutamatergic.

40
Q
  1. These are the receiving input of the basal ganglia/nuclei:
    A. Putamen and Globus pallidus
    B. Thalamus
    C. Caudate and Putamen
    D. Globus pallidus interna and Globus pallidus externa
A

Caudate and Putamen

Caudate and Putamen are the receiving input of the basal ganglia/nuclei, together they form the striatum/neostriatum

41
Q
  1. What descending tract comes from the primary motor cortex of the brain?
    A. Spinotectal Tract
    B. Lateral Spinothalamic tract
    C. Anterior Spinothalamic tract
    D. Corticospinal Tract
A

Corticospinal Tract


About one-third of the fibers originate from the primary motor cortex (area 4), one-third originate from the secondary motor cortex (area 6), and one-third originate from the parietal lobe (areas 3, 1, and 2); thus, two-thirds of the fibers arise from the precentral gyrus, and one-third of the fibers arise from the postcentral gyrus.

42
Q
  1. Which of the following statements regarding the cerebellum is CORRECT?
    A. The climbing fibers are the terminal fibers of all the cerebellar afferent tracts
    B. The afferent fibers are inhibitory to the Purkinje cells
    C. The climbing fibers make single synaptic contact with a single Purkinje neuron
    D. The climbing and mossy fibers constitute the input to the cortex and both are excitatory to the Purkinje
A

The climbing and mossy fibers constitute the input to the cortex and both are excitatory to the Purkinje

The climbing and mossy fibers of the cerebellum constitute the two main lines of input to the cerebellar cortex

43
Q
  1. Each spinal nerve enters or leaves the spinal cord respectively by the posterior root or the anterior root; the posterior root carries fibers that are.
    A. Sympathetic
    B. Parasympathetic
    C. Efferent
    D. Sensory
A

Sensory

44
Q
  1. Thin vascular membrane that closely invests the brain and descends into the deepest sulci
    A. Arachnoid Mater
    B. Pia mater
    C. Dura mater- endosteal layer
    D. Dura mater- meningeal layer
A

Pia mater

The pia mater is a vascular membrane covered by flattened mesothelial cells. It closely invests the brain, covering the gyri and descending into the deepest sulci.

45
Q
  1. The ff has bilateral connections from cranial motor nuclei except
    A. Muscles for mastication
    B. Muscles for swallowing
    C. Upper half of the face
    D. Genioglossus muscle
A

Genioglossus muscle

The majority of the corticonuclear fibers to the motor cranial nerve nuclei cross the median plane before reaching the nuclei. Bilateral connections are present for all the cranial motor nuclei except for part of the facial nucleus that supplies the muscles of the lower part of the face and a part of the hypoglossal nucleus that supplies the genioglossus muscle.

46
Q
  1. The ff statements are true about the dura mater except
    A. The inferior sagittal sinus can be found in the lower concave free margin of the falx cerebri
    B. The endosteal layer is the periosteum covering the inner skull
    C. The falx cerebri is a crescent shaped fold of dura mater that covers upper cerebellum and supports the occipital lobe
    D. The two layers are closely attached except along lines where they separate to from venous sinuses
A

The falx cerebri is a crescent shaped fold of dura mater that covers upper cerebellum and supports the occipital lobe

The falx cerebri is a sickle-shaped fold of dura mater that lies in the midline between the two cerebral hemispheres

47
Q
  1. Ventral rami of C5-T1
    A. Brachial plexus
    B. Cervical plexus
    C. Lumbar plexus
    D. Sacral plexus
A

Brachial plexus

Brachial plexus: C5- T1
Cervical plexus: C1-C4
Lumbar plexus: L1-L4
Sacral plexus: L4-S4

48
Q
  1. A hypertensive patient had a sudden onset of “thunderclap headache” showing subarachnoid hemorrhage on a plain cranial CT study. Next best imaging modality should be:
    A. Vascular sonography
    B. CT angiogram
    C. MR angiogram
    D. Digital subtraction angiography
A

CT angiogram

49
Q
  1. The choroid plexus can be found in the ff except:
    A. Cerebral aqueduct
    B. Lateral ventricles
    C. Third ventricle
    D. Fourth ventricle
A

Cerebral aqueduct

The cerebrospinal fluid is produced by the choroid plexuses within the lateral, third, and fourth ventricles of the brain.

50
Q
  1. The crus cerebri contains the descending tracts and it is separated from the tegmentum by the
    A. Medial longitudinal fasciculus
    B. Red nucleus
    C. Superior cerebellar peduncle
    D. Substantia nigra
A

Substantia nigra

The crus cerebri contains important descending tracts and is separated from the tegmentum by the substantia nigra.

51
Q
  1. The axons from this cell provide the only output of the cerebellar cortex
    A. Granule
    B. Basket
    C. Golgi
    D. Purkinje
    E. Stellate
A

Purkinje

CEREBELLAR EFFERENT FIBERS
The entire output of the cerebellar cortex is through the axons of the Purkinje cells. Most of the axons of the Purkinje cells end by synapsing on the neurons of the deep cerebellar nuclei. The axons of the neurons that form the cerebellar nuclei constitute the efferent outflow from the cerebellum. A few Purkinje cell axons pass directly out of the cerebellum to the lateral vestibular nucleus. The efferent fibers from the cerebellum connect with the red nucleus, thalamus, vestibular complex, and reticular formation.

52
Q
  1. The ff intracranial arteries are part of the Posterior circulation except:
    A. Basilar artery
    B. Posterior cerebral artery
    C. Vertebral arteries
    D. Posterior communicating artery
A

Posterior communicating arteries

The posterior cerebral circulation (or simply, posterior circulation) is the blood supply to the posterior portion of the brain, including the occipital lobes, cerebellum and brainstem.

Due to the anastomotic circle of Willis, the posterior circulation connects via the posterior communicating arteries to the anterior circulation.

The posterior circulation is supplied by the vertebral arteries that combine to form the basilar artery which then divides into the posterior cerebral arteries.

53
Q
  1. This is a large C-shaped mass of gray matter situated lateral to the thalamus separated by a band of white matter from the corpus striatum. This is the-
    A. Fornix
    B. Habenula
    C. Cingulate gyrus
    D. Caudate nucleus
A

The caudate nucleus, a large C-shaped mass of gray matter that is closely related to the lateral ventricle, lies lateral to the thalamus

It plays a key role in motor control, learning, and cognitive processing.

A. Fornix - a bundle of nerve fibers in the brain that connects the hippocampus with the hypothalamus, mammillary bodies, and septal nuclei. It plays an important role in the formation and retrieval of memories.
B. Habenula - a small, triangular structure in the brain located between the thalamus and the midbrain. It is involved in various functions, including the regulation of the dopaminergic and serotonergic systems, as well as the processing of negative feedback and aversive stimuli.
C. Cingulate gyrus - a part of the cerebral cortex that lies above the corpus callosum, in the medial part of the brain. It is involved in a variety of functions, including emotional regulation, decision making, and pain processing.

54
Q
  1. A 24 y/o female consulted for fever and severe frontal headache. Work up showed meningitis. Which cranial nerve innervates the dura mater?
    A. Oculomotor nerve
    B. Facial nerve
    C. Trigeminal nerve
    D. Optic nerve
A

Trigeminal nerve

Meningeal Headaches
The dura mater receives its sensory nerve supply from the trigeminal and the first three cervical nerves. The dura above the tentorium is innervated by the trigeminal nerve, and the headache is referred to the forehead and face. The dura below the tentorium is innervated by the cervical nerves, and the headache is referred to the back of the head and neck. Meningitis, or inflammation of the meninges, causes severe headache over the entire head and back of the neck.

55
Q
  1. Which of the ff pathways do not decussate?
    A. Cuneate fasciculus
    B. Spinothalamic tract
    C. Medial corticospinal tract
    D. Lateral corticospinal tract
A

Medial corticospinal tract

The remaining fibers do not cross in the decussation but descend in the anterior white column of the spinal cord as the anterior (medial) corticospinal tract

56
Q
  1. Diagnosis for a contrast-enhanced cranial CT showing enhancing abnormal entanglement of vessels:
    A. Ruptured aneurysm
    B. Hemorrhagic mass
    C. Vascular malformation
    D. Epidural hematoma
A

Vascular malformation

57
Q
  1. The ff clinical features are seen in Lateral Medullary Syndrome, except:
    A. Nystagmus
    B. Dysphagia & dysphonia
    C. Contralateral loss of facial pain and temperature sensation
    D. Ipsilateral Homer’s syndrome
A

Contralateral loss of facial pain and temperature sensation

Lateral Medullary Syndrome of Wallenberg
· The lateral part of the medulla oblongata is supplied by the posterior inferior cerebellar artery, which is usually a branch of the vertebral artery.
· Thrombosis of either of these arteries produces the following signs and symptoms:
o dysphagia and dysarthria due to paralysis of the ipsilateral palatal and laryngeal muscles (innervated by the nucleus ambiguous);
o analgesia and thermoanesthesia on the ipsilateral side of the face (nucleus and spinal tract of the trigeminal nerve);
o vertigo, nausea, vomiting, and nystagmus (vestibular nuclei);
o ipsilateral Horner syndrome (descending sympathetic fibers);
o ipsilateral cerebellar signs—gait and limb ataxia (cerebellum or inferior cerebellar peduncle);
o contralateral loss of sensations of pain and temperature (spinal lemniscus—spinothalamic tract).

58
Q
  1. The ligamentum dentaculum of the spinal cord is formed by which meningeal layer?
    A. Arachnoid
    B. Pia mater
    C. Dura mater
A

Pia mater

The pia mater, a vascular membrane that closely covers the spinal cord is thickened on either side between the nerve roots to form the ligamentum denticulatum, which passes laterally to adhere to the arachnoid and dura.

59
Q
  1. This is a wedge-shaped mass of gray matter in the cerebral hemisphere next to the internal capsule and the external capsule which separates it from the claustrum. This is the –
    A. Caudate nucleus
    B. Insula
    C. Thalamus
    D. Lentiform nucleus
A

Lentiform nucleus

The caudate nucleus, a large C-shaped mass of gray matter that is closely related to the lateral ventricle, lies lateral to the thalamus
Insula: A region of the cerebral cortex located deep within the lateral sulcus of the brain, involved in the processing of gustatory and visceral sensations, emotion, and interpersonal experience.
Thalamus: A large, paired, egg-shaped mass of gray matter situated in the dorsal part of the diencephalon of the brain that serves as a major relay center for sensory information from the body to the cortex and for motor information from the cortex to the body.

60
Q
  1. These are the receiving input of the basal ganglia/nuclei:
    A. Globus pallidus interna and Globus pallidus externa
    B. Thalamus
    C. Caudate and Putamen
    D. Putamen and Globus pallidus
A

Caudate and Putamen

Caudate and Putamen are the receiving input of the basal ganglia/nuclei, together they form the striatum/neostriatum

61
Q
  1. The afferent stimuli of the of theANS originate in visceral receptors, travel by the afferent pathways to the CNS, they are integrated at different levels by -
    A. Association neurons
    B. Intersegmental neurons
    C. Connector neurons
    D. Intrasegmental neurons
A

Connector neurons
Interneurons (connector neurons), linking sensory and motor neurons, at the same or different levels, which form spinal reflex arcs.

62
Q
  1. The ff statement/s regarding the white matter fibers of the cerebellum is/are CORRECT:
    A. Fibers from all the intracerebellar nuclei leave through the superior cerebellar peduncle
    B. All statements are correct
    C. The intrinsic fibers leave the cerebellum and connect to different regions of the organ
    D. The afferent fibers enter the cerebellum mainly through the inferior cerebellar peduncle and middle cerebellar peduncles
A

The afferent fibers enter the cerebellum mainly through the inferior cerebellar peduncle and middle cerebellar peduncles

The intrinsic fibers do not leave the cerebellum but connect different regions of the organ. Some interconnect folia of the cerebellar cortex and vermis on the same side; others connect the two cerebellar hemispheres together.

The intracerebellar nuclei are composed of large, multi- polar neurons with simple branching dendrites. The axons form the cerebellar outflow in the superior and inferior cerebellar peduncles

63
Q
  1. The _____of the thalamus forms part of the lateral wall of the 3rd ventricle
    A. Lateral surface
    B. Posterior surface
    C. Medial surface
    D. Anterior surface
A

Medial surface

64
Q
  1. This is a network of cells and nerve fibers extending through the axis of the CNS from the spinal cord to the cerebrum that controls skeletal muscle activity, the ANS, endocrine system, diurnal rhythms. This is the
    A. Hypothalamo-hypophyseal axis
    B. Hypothalamus
    C. Limbic system
    D. Ascending reticular activating system
A

Hypothalamus

  • Hypothalamo-hypophyseal axis: a complex system of communication between the hypothalamus and the pituitary gland, which regulates various physiological functions in the body, including growth, metabolism, stress response, and reproduction. The hypothalamus secretes hormones that stimulate or inhibit the release of hormones from the pituitary gland, which in turn regulates the activity of other endocrine glands in the body.
  • Limbic system: a complex network of brain structures, including the amygdala, hippocampus, cingulate gyrus, and fornix, that is involved in emotion, memory, motivation, and social behavior. The limbic system is thought to play a key role in regulating emotional responses and social interactions, and is also implicated in various psychiatric disorders such as depression, anxiety, and addiction.
  • Ascending reticular activating system: a network of neurons that runs through the core of the brainstem, from the medulla oblongata to the thalamus, and is involved in regulating consciousness, arousal, and attention. The ascending reticular activating system receives input from various sensory and motor systems, and modulates the activity of cortical and subcortical structures to maintain wakefulness and alertness. Dysfunction of the ascending reticular activating system can lead to various neurological disorders, such as coma, vegetative state, and narcolepsy.
65
Q
  1. It influences motor activities and lies on the pathway between corpus striatum & motor areas of frontal cortex
    A. Pulvinar
    B. Ventral anterior nucleus
    C. Ventral lateral nucleus
    D. Dorsal posterior nucleus
A

Ventral anterior nucleus

66
Q
  1. Which of the ff is the correct order of transmission of sound?
    A. Organ corti to superior olivary nucleus to lateral lemniscus to lateral geniculate body to primary auditory cortex
    B. Organ of corti to lateral lemniscus to medial geniculate body to superior olivary nucleus to primary auditory cortex
    C. Organ of corti to superior olivary nucleus to lateral lemniscus to medial geniculate body to primary auditory cortex
    D. Organ of corti to inferior olivary nucleus to medial lemniscus to medial geniculate body to primary auditory cortex
A

Organ of corti to inferior olivary nucleus to medial lemniscus to medial geniculate body to primary auditory cortex

67
Q
  1. This part of the diencephalon extends from the optic chiasma to the caudal border of the mammillary body and controls extensive functions in the body to maintain homeostasis. This is the -
    A. Hypothalamus
    B. Ascending reticular activating system
    C. Limbic system
    D. Autonomic nervous system
A

Hypothalamus

68
Q
  1. The lateral gray column of the spinal cord and the motor nuclei of the IIIrd, VIlth, IXth, Xth cranial nerves are cell bodies of -
    A. Preganglionic neurons of the afferent pathways
    B. Postganglionic neurons of the efferent pathways
    C. Postganglionic neurons of the afferent pathways
    D. Preganglionic neurons of the efferent pathways
A

Preganglionic neurons of the efferent pathways

General Visceral Motor Nuclei The general visceral motor nuclei form the cranial outflow of the parasympathetic portion of the autonomic nervous system. They are the Edinger -Westphal nucleus of the oculomotor nerve, the superior salivatory and lacrimal nuclei of the facial nerve, the inferior salivatory nucleus of the glossopharyngeal nerve, and the dorsal motor nucleus of the vagus.

69
Q
  1. Which of the ff statements is true?
    A. The oculomotor nerve moves the eye laterally
    B. The spinal accessory nerve depresses the shoulder
    C. The facial nerve closes the eyes
    D. The trigeminal nerve receives taste sensation
A

The facial nerve closes the eyes

The facial nerve has five branches that perform distinct motor functions:
(Muscles of facial expressions)
· Frontal (temporal):Controls your forehead muscles.
· Zygomatic:Helps you close your eyes.
· Buccal:Allows you to move your nose, blink and raise your upper lip and corners of your mouth to make a smile.
· Marginal mandibular:Draws your lower lip down (like a frown) and travels through your middle ear to help you respond to loud noises.
· Cervical:Controls movement in your chin and lower corners of your mouth.

The oculomotor nerve innervates several extraocular muscles to move the eye in various directions, not just laterally.
The spinal accessory nerve controls the movement of the trapezius and sternocleidomastoid muscles to elevate the shoulder, not depress it.
The trigeminal nerve carries sensory information from the face, but taste sensation is primarily carried by the facial, glossopharyngeal, and vagus nerves.

70
Q
  1. A 70 y/o female developed sudden onset blurring of vision. On visual field assessment, the ff was noted.

Where is the lesion?
A. Inferior wall of the left calcarine sulcus
B. Superior wall of the left calcarine sulcus
C. Superior wall of the right calcarine sulcus
D. Inferior wall of the right calcarine sulcus

A

Superior wall of the left calcarine sulcus

The calcarine sulcus is a fissure on the occipital lobe of the brain, responsible for the processing and interpretation of visual information. The left calcarine sulcus receives input from the right visual field, while the right calcarine sulcus receives input from the left visual field.
Given that the patient’s visual field assessment reveals a lesion on the superior wall of the left calcarine sulcus, it suggests that there is damage or dysfunction in the area of the brain responsible for processing information from the right visual field. This could result in a loss of vision or blurring of vision in the right visual field.

71
Q
  1. Which of the ff cranial nerves innervate the posterior belly of the digastric and stylohyoid muscles?
    A. Vagus
    B. Glossopharyngeal
    C. Trigeminal
    D. Facial
A

Facial

72
Q
  1. This region forms the core of the cerebrum and its important parts surround the Third Ventricle -
    A. Tegmentum
    B. Telencephalon
    C. Tectum
    D. Diencephalon
A

Diencephalon

The diencephalon is almost completely hidden from the surface of the brain. It consists of a dorsal thalamus and a ventral hypothalamus. The thalamus is a large, egg-shaped mass of gray matter that lies on either side of the third ventricle. The anterior end of the thalamus forms the posterior boundary of the interventricular foramen, the opening between the third and lateral ventricles. The hypothalamus forms the lower part of the lateral wall and floor of the third ventricle.

Tegmentum is the dorsal part of the midbrain that contains the substantia nigra and red nucleus, among other structures.
Telencephalon is the most anterior part of the brain and includes the cerebral cortex, basal ganglia, and limbic system.
Tectum is the dorsal part of the midbrain that includes the superior and inferior colliculi, which are involved in visual and auditory processing, respectively.

73
Q
  1. This structure in the limbic lobe is concerned with the conversion of recent memory to long-term memory.This is the -
    A. Parahippocampal gyrus
    B. Indusium grisium
    C. Uncus
    D. Hippocampus
A

Hippocampus

Parahippocampal gyrus is a region of the brain located in the medial temporal lobe, adjacent to the hippocampus. It plays an important role in memory encoding and retrieval, as well as spatial navigation and perception. The parahippocampal gyrus is also involved in the processing of emotions and is believed to be a key component of the brain’s limbic system.

Indusium Griseum is a thin layer of gray matter located between the corpus callosum and the fornix in the midline of the brain. It is considered a part of the limbic system and is involved in memory and spatial navigation.

Uncus is a small hook-shaped structure located in the medial temporal lobe of the brain. It is part of the limbic system and is involved in olfactory perception and memory, as well as emotion and behavior. The uncus is adjacent to the parahippocampal gyrus and is sometimes considered part of it.

74
Q
  1. The white matter of the cerebrum is composed of nerve fiber groups, commissural fibers and projection fibers and one more group of fibers that interconnect between groups of nuclei which is the -
    A. Habenula
    B. Internal capsule
    C. Corona radiata
    D. Association fibers
A

Association fibers

A. Habenula: A small, cone-shaped structure located in the posterior part of the thalamus. It is involved in regulating the release of certain neurotransmitters, including dopamine and serotonin, which play a role in mood, reward, and addiction.
B. Internal Capsule: A band of white matter fibers that runs between the thalamus and the cerebral cortex. It contains both ascending and descending fibers that transmit information between the brainstem, thalamus, and cerebral cortex. Damage to the internal capsule can result in motor and sensory deficits on the contralateral side of the body.
C. Corona Radiata: A layer of white matter fibers that radiate from the internal capsule to various parts of the cerebral cortex. It is composed of both afferent and efferent fibers that transmit information between the cortex and other parts of the brain. The corona radiata is involved in a wide range of functions, including movement, sensation, and perception.

75
Q
  1. Which of the ff statements regarding the cerebellar cortex isINCORRECT?
    A. The molecular layer contains the stellate and basket cells
    B. Scattered throughout the purkinje layer are Golgi cells
    C. The Purkinje cells are largeGolgi type 1 neurons
    D. The axons of the Purkinje cells from the efferent filers from the cerebellar cortex
A

The axons of the Purkinie cells from the efferent fibers from the cerebellar cortex

The axons of the Purkinje cells form the efferent fibers from the cerebellar cortex

76
Q
  1. Vascular supply for the anterior tip of the temporal lobe and inferolateral frontal lobe:
    A. Anterior cerebral artery
    B. Middle cerebral artery
    C. Basilar artery
    D. Posterior cerebral artery
A

Middle cerebral artery

The posterior cerebral artery curves laterally and backward around the midbrain and is joined by the posterior communicating branch of the internal carotid artery.
· Cortical branches supply the inferolateral and medial surfaces of the temporal lobe and the lateral and medial surfaces of the occipital lobe. Thus, the posterior cerebral artery supplies the visual cortex.
· Central branches pierce the brain substance and supply parts of the thalamus and the lentiform nucleus as well as the midbrain, the pineal, and the medial geniculate bodies.
· A choroidal branch enters the inferior horn of the lateral ventricle and supplies the choroid plexus; it also supplies the choroid plexus of the third ventricle.

77
Q
  1. The major output pathway of the limbic system is the -
    A. Corpus callosum
    B. Fornix
    C. Habenula
    D. Hypothalamus
A

Hypothalamus

78
Q
  1. Which of the ff statements regarding the Basal Ganglia is INCORRECT?
    A. The outflow from the basal nuclei is channeled through the globus pallidus
    B. The neurons of the subthalamic nuclei are glutaminergic and inhibitory
    C. None, all are correct
    D. The activity of the basal ganglia is initiated by information received from premotor and supplemental areas of the motor cortex, primary sensory cortex, thalamus and brainstem.
A

The neurons of the subthalamic nuclei are glutaminergic and inhibitory

The subthalamic nuclei are not inhibitory, but rather excitatory and glutamatergic.

79
Q
  1. This part of the thalamus is associated with limbic system concerned with emotional tone and mechanisms of recent memory
    A. Posterior
    B. Medial
    C. Anterior
    D. Lateral
A

Anterior

The medial part of the thalamus is responsible for the integration of a large variety of sensory information, including somatic, visceral, and olfactory information, and the relation of this information to one’s emotional feelings and subjective states.

80
Q
  1. The vertebral artery, the anterior and posterior spinal arteries, the PICA, the basilar artery, main supply the -
    A. Cervical cord
    B. Cerebellum
    C. Pons
    D. Medulla
A

Medulla

81
Q
  1. Regarding the neurotransmission in the Basal Ganglia, which of the ff is CORRECT?
    A. Glutamate is the major inhibitory of the basal ganglia
    B. GABA is the major neurotransmitter released in the striatal projections to the globus pallidus and in globus pallidus interna projections to the thalamus
    C. D1 receptors are primarily found on neurons involved in the indirect pathway, and D2 receptors involved in the direct pathway
    D. The substantia nigra pars compact inhibits the direct pathway via the D1 receptors
A

GABA is the major neurotransmitter released in the striatal projections to the globus pallidus and in globus pallidus interna projections to the thalamus

A. The substantia nigra pars compacta actually promotes the direct pathway via the release of dopamine, which binds to D1 receptors on neurons in the striatum.

B. Glutamate is actually the major excitatory neurotransmitter in the basal ganglia.

D. D1 receptors are primarily found on neurons involved in the direct pathway, while D2 receptors are primarily found on neurons involved in the indirect pathway.

82
Q
  1. Proprioceptive information originates from inside the body, the muscles, joints and are carried by -
    A. Autonomic tracts
    B. Ascending tracts
    C. Reflex arcs
    D. Descending tracts
A

Ascending tracts

Autonomic tracts refer to the neural pathways that connect the central nervous system (CNS) to the autonomic nervous system (ANS), which controls and regulates involuntary bodily functions such as heart rate, respiration, digestion, and glandular secretion. These tracts are involved in the transmission of sensory information from peripheral receptors to the CNS, as well as the control of motor responses that regulate the activity of smooth muscle, cardiac muscle, and glands throughout the body. Autonomic tracts include both ascending and descending pathways, as well as reflex arcs that allow for rapid and automatic responses to changes in the environment or internal conditions of the body.

Reflex arcs are neural circuits that enable rapid, involuntary responses to sensory stimuli. The basic components of a reflex arc include a sensory receptor, a sensory neuron, an interneuron, a motor neuron, and an effector organ. When a stimulus activates the sensory receptor, the sensory neuron sends an impulse to the spinal cord or brainstem where the interneuron processes the information and relays it to the motor neuron. The motor neuron then stimulates the appropriate effector organ to produce a response, such as muscle contraction or gland secretion.

Descending tracts in the nervous system refer to bundles of axons that carry motor commands from the brain to the spinal cord and other peripheral target organs. These tracts start from the motor areas in the cerebral cortex or brainstem and descend towards the spinal cord, where they synapse with lower motor neurons that innervate the skeletal muscles. The descending tracts are responsible for the voluntary control of body movements, such as walking, running, and reaching.

83
Q
  1. The patellar reflex or knee jerk is dependent on the integrity of the reflex arc at the level of
    A. L1, L2, L3
    B. L3, L4, L5
    C. L2, L3, L4
    T12, L1, L2
A

L2, L3, L4

· Biceps brachii tendon reflex C5-6 (flexion of the elbow joint by tapping the biceps tendon).
· Triceps tendon reflex C6-7 and C8 (extension of the elbow joint by tapping the triceps tendon).
· Brachioradialis tendon reflex C5-6 and C7 (supination of the radioulnar joints by tapping the insertion of the brachioradialis tendon).
· Abdominal superficial reflexes (contraction of underlying abdominal muscles by stroking the skin). Upper abdominal skin T6-7; middle abdominal skin T8-9; lower abdominal skin T10-12.
· Patellar tendon reflex (knee jerk) L2, L3, and LA (extension of knee joint on tapping the patellar tendon).
Achilles tendon reflex (ankle jerk) S1 and 2 (plantar flexion of ankle joint on tapping the Achilles tendon-tendo calcaneus.

84
Q
  1. The ff are normal cerebrospinal fluid parameters except
    A. Cell count 3, neutrophils
    B. Opening pressure of 15 cmH20
    C. None of the choices
    Protein 40mg/100mL
A

None of the choices

85
Q
  1. Space in the spinal cord that contains CSF and blood vessels within web-like strands of arachnoid tissue
    A. Arachnoid
    B. Subarachnoid
    C. Epidural
    Subdural
A

Subarachnoid

86
Q
  1. Which if the ff statements are correct regarding the midbrain?
    A. The interpeduncular fossa is bounded laterally by the cerebellar peduncles
    B. The oculomotor nucleus is seen at the level of the inferior colliculus
    C. The trochlear nucleus is situated in the central gray matter at the level of the inferior colliculus
    The tegmentum lies anterior to the substantia nigra
A

The trochlear nucleus is situated in the central gray matter at the level of the inferior colliculus

The trochlear nerve, the most slender of the cranial nerves and the only one to leave the posterior surface of the brainstem, emerges from the midbrain and immediately decussates with the nerve of the opposite side.

The trochlear nucleus is situated in the anterior part of the gray matter that surrounds the cerebral aqueduct of the midbrain. It lies inferior to the oculomotor nucleus at the level of the inferior colliculus.

The interpeduncular fossa is bounded anteriorly by the cerebral peduncles, laterally by the medial longitudinal fasciculus, and posteriorly by the superior cerebellar peduncles.

The tegmentum lies posterior to the substantia nigra.

The oculomotor nucleus is seen at the level of the superior colliculus, not the inferior colliculus.

87
Q
  1. The cerebral cortex has six layers and this layer contains large and medium-sized pyramidal cells among which are scattered stellate and Martinotti cells. This is the -
    A. Internal granular layer
    B. External granular layer
    C. Ganglionic cell layer
    External pyramidal layer
A

Ganglionic cell layer

· External granular layer. This layer contains large numbers of small pyramidal cells and stellate cells. The dendrites of these cells terminate in the molecular layer, and the axons enter deeper layers, where they terminate or pass on to enter the white matter of the cerebral hemisphere.
· External pyramidal layer. This layer is composed of pyramidal cells, whose cell body size increases from the superficial to the deeper borders of the layer . The apical dendrites pass into the molecular layer, and the axons enter the white matter as projection, association, or commissural fibers.
Internal granular layer. This layer is composed of closely packed stellate cells. There is a high concentration of horizontally arranged fibers known collectively as the external band of Baillarger.

88
Q
  1. The Achilles tendon reflex or the ankle jerk depends on the integrity of the reflex arc at level
    A. S3, S4
    B. L4, L5
    C. L5, S1
    D. S1, S2
A

S1, S2

· Biceps brachii tendon reflex C5-6 (flexion of the elbow joint by tapping the biceps tendon).
· Triceps tendon reflex C6-7 and C8 (extension of the elbow joint by tapping the triceps tendon).
· Brachioradialis tendon reflex C5-6 and C7 (supination of the radioulnar joints by tapping the insertion of the brachioradialis tendon).
· Abdominal superficial reflexes (contraction of underlying abdominal muscles by stroking the skin). Upper abdominal skin T6-7; middle abdominal skin T8-9; lower abdominal skin T10-12.
· Patellar tendon reflex (knee jerk) L2, L3, and LA (extension of knee joint on tapping the patellar tendon).
Achilles tendon reflex (ankle jerk) S1 and 2 (plantar flexion of ankle joint on tapping the Achilles tendon-tendo calcaneus.

89
Q
  1. The gold standard for neurovascular imaging
    A. Digital subtraction angiography
    B. CT angiogram
    C. MR angiogram
    Vascular sonography
A

Digital subtraction angiography

90
Q
  1. This system is a group of structures on the border zone of the cerebral cortex and the hypothalamus that exercise control of memory, behavior, and drive. This is the -
    A. Extrapyramidal motor system
    B. Sympathetic system
    C. Limbic system
    D. Parasympathetic system
A

Limbic system

91
Q
  1. In the somatotropic arrangement of the spinal cord fibers for that of the motor segments, where would fibers for the upper limb be located compared to that of the lower limb on a cross-section of the spinal cord?
    A. Posteriorly
    B. Anteriorly
    C. Laterally
    D. Medially
A

Medially

In the somatotropic arrangement of the spinal cord fibers, the upper limb is located medially compared to the lower limb due to the anatomical organization of the spinal cord. The spinal cord is divided into different levels or segments, each of which contains a pair of dorsal sensory roots and ventral motor roots. The fibers for the upper limb originate from the cervical segments of the spinal cord, which are located more medially compared to the lumbar segments that give rise to the fibers for the lower limb. Therefore, the motor fibers for the upper limb are situated closer to the midline of the spinal cord compared to those for the lower limb.

92
Q
  1. These nerve cells transmit impulses to the skeletal muscles
    A. Lower motor neurons
    B. Tract cells
    C. Neuroglia
    D. Sensory neurons
A

Lower motor neurons

The motor neurons situated in the anterior gray columns of the spinal cord send axons to innervate skeletal muscle through the anterior roots of the spinal nerves. These motor neurons are sometimes referred to as the lower motor neurons and constitute the final common pathway to the muscles.

93
Q
  1. These fibers connect the first motor speech area and the gyri in the inferior surface of the frontal lobe with the cortex of the temporal lobe.
This is the -
    A. Fronto-occipital fasciculus
    B. Cingulum
    C. Uncinate fasciculus
    D. Superior longitudinal fasciculus
A

Uncinate fasciculus

Fronto-occipital fasciculus is a white matter tract that connects the frontal lobe to the occipital lobe. It runs from the posterior end of the frontal lobe, through the parietal lobe and ends in the occipital lobe.

Cingulum is a white matter tract that connects the subcortical structures of the limbic system to the frontal cortex. It forms a loop around the corpus callosum and is involved in emotion, motivation, and memory.

Superior longitudinal fasciculus is a white matter tract that runs along the lateral surface of the cerebral hemispheres, connecting the frontal lobe to the parietal, temporal, and occipital lobes. It is involved in a variety of cognitive functions such as language, spatial perception, and attention.

94
Q
  1. All of the ff structures are seen in the dorsal surface of the medulla, except:
    A. Pyramidal decussation
    B. Gracile tubercle
    C. Floor of the fourth ventricle
    D. Posterior median sulcus
A

Pyramidal decussation

The dorsal surface of the medulla oblongata includes the following structures:
· Floor of the fourth ventricle (B)
· Posterior median sulcus (C)
· Gracile tubercle (D)
The pyramidal decussation (A) is located on the ventral surface of the medulla oblongata.