OS 202 Compre Flashcards by UPCM 2018

Kluver-Bucy is caused by bilateral lesions of the amygdala. Which of the following will not result from Kluver-bucy syndrome?
A. Excessive aggression
B. Lack of fear
C. Hypersexuality
D. Hyperrorality

Klüver–Bucy syndrome is a syndrome resulting from bilateral lesions of the amygdala.Klüver-Bucy syndrome may present with hyperphagia, hypersexuality, hyperorality, and docility. The insular cortex mediates aggressive behavior.

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The parahippocampal gyrus and occipito-temporal area is supplied by:
A. ACA anterior cerebral artery
B. MCA middle cerebral artery
C. PCA posterior cerebral artery
D. MMA middle meningeal artery

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. What is an example of commissural fiber
	A. Corticospinal tract
	B. Corpus callosum
	C. Cingulum
	D. Fronix

Commissural fibers connect the two hemispheres of the brain. Examples of these are the corpus callosum, anterior and posterior commissures. The corticospinal tract is a projection fiber (connects brain to the rest of the CNS) along with the internal capsule and corona radiate. The cingulum is a type of association fiber ( connects different parts within the same hemisphere) along with the arcuate fasciculus, unicinate fasciculus, IOF and SOF.

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The vagus nerve exits via the:
	A. Interpeduncular fossa
	B. Pontomedullary sulcus
	C. Anterolateral sulcus
	D. Posterolateral sulcus

To be specific, the vagus nerve exits the MEDULLA via Posterolateral sulcus. However, if the question asked where the vagus nerve exits the skull then the answer would be the jugular foramen along with CN X

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The cerebrospinal fluid escapes the 4th ventricle via
	A. Midline Magendie foramen
	B. Jugular foramen
	C. A pair of Magendie foramen
	D. Pacquiao granules

There are only 3 apertures for CSF to exit via the 4th ventricle: One foramen of Magendie (midline) and two foramen of Luschka (lateral)

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Accounts for Absolute Refractory Period
A. open voltage-gated Na channels
B. Closure of activation gate of voltage gated Na channels
C. Efflux of K via leak channels
D. All of the above

Absolute refractory period is the state when a cell is unable to fire a second action potential no matter how strongly it is stimulated. The cell is refractory because a large fraction of its Na channels are voltage inactivated and cannot be reopened until membrane potential is repolarized. The critical number of Na channels required to produce an action potential cannot be recruited. (Berne & Levy)

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What is the effect of myelin sheaths on action potential transmission?
A. Increased conductance
B. decreased space constant
C. Increased time constant
D. all of the above

Myelination increases conduction velocity of a nerve axon. An action potential is conducted rapidly and with little decrement from one node of Ranvier to the next.

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What is the effect of increased (luminal?) intravascular pressure in the brain vasculature (something like this)
A. Vasoconstriction and reduced blood flow
B. Vasoconstriction and increased blood flow
C. Vasodilation and increased blood flow
D. Vasodilation and reduced blood flow

CBF = (MAP – CVP) / CVR
An increase in intravascular pressure transmits this to the venous system, thereby increasing CVP (Central Venous Pressure), decreasing blood flow, and vasoconstricting the vessels.

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What is the effect of reduced oxygen pressure (PaO2)
A. Vasodilation and increased cerebral blood flow
B. Vasodilation and decreased cerebral blood flow
C. Vasoconstriction and increased cerebral blood flow
D. Vasoconstriction and decreased cerebral blood flow

Decreased PaO2 causes vasodilation and means decreased cerebral blood flow.

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The structure that divides the corpus striatum into the caudate nucleus and the lentiform nucleus is the:
	A. Internal capsule
	B. External capsule
	C. Claustrum
	D. Extreme capsule

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Balance and vestibulo-ocular reflexes are associated with functional zone of the cerebellum
A. Vermis
B. Intermediate
C. Lateral Hemisphere
D. Flocculonodular Lobe

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Connects conus medullaris to coccyx
A. Cauda equina
B. Filium terminale

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. The conus medullaris is found at this level:
	A. S2-S4
	B. L1-L4
	C. S1-S3
	D. L2-L4

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How many pairs of spinal nerves are there?
	A. 30
	B. 31
	C. 32
	D. 33

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What is the structure which separates the frontal bone from the parietal bone?
A. Sagittal suture
B. Coronal suture

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What is the smallest functional unit of a muscle?
A. Myofibril
B. sarcolemma
C. Sarcomere
D. Neuron

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Which of the following post synaptic potentials in millivolts is near the firing rate?
	A. 3, -10, +7, -2
	B. 7, 10, -2, -3
	C. -20, 5, 7, -2
	D. -12, 4, 7, -8

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The structural division of the Cerebellum
A. The anterior commissure divides the anterior from the posterior lobe
B. The paramedian zone of the cerebellum is between the vermis and the lateral zone
C. The posterolateral fissure divides the posterior lobe from the flocculonodular lobe
D. AOTA

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The phrenic nerve is comprised of which of the following cervical roots?
A. C1-C3
B. C3-C5
C. C1-C5
D. C2-C4
E.C2-C5

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What neurotransmitter is produced by the substantia nigra?
A. Norepinephrine
B. Epinephrine
C. Dopamine
D. Acetylcholine
E. Glutamine

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Which neurotransmitter is found in the corticostriate pathway?
A. glutamate
B. dopamine
C. norepinephrine
D. acetylcholine

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What is responsible for myelination in the CNS? 
A. Ependymal cells
B. Astrocyte
C. Oligodendrocyte
D. Schwann Cell
E. Microglial cells

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What is responsible for pruning of the synapse?
A. Microglia
B. Astrocytes
C. Ependymal cells
D. Oligodendrocytes

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Structure most likely to be damaged by rapid enlargement of lateral ventircles: 
A. Fornix 
B. Corona radiata 
C. Posterior commissure 
D. Anterior commissure

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``` The obex is found in the: A. Tectum B. Facial fasciculus C. Superior colliculus D. Rostral medulla ```

``` This tissue serves as origin of DRG, autonomic ganglia, Schwann cells and plexuses A. Alar plate B. Sulcus limitans C. Neural crest D. Basal plate ```

``` Color recognition and identification in the visual pathway: A. cones B. optic chiasm C. superior colliculus D. secondary visual pathway ```

A Cones are for color while Rods are for black and white (contrast)

Lesion of the right CN XII or of the supranuclear corticobulbar fibers on the right side will be manifested by this finding in tongue protrusion: A. Remains midline B. Deviates to right upon tongue protrusion C. Deviates to left upon tongue protrusion D. Poor gag reflex

.Alexia without agraphia. Where is the lesion?

Alexia – cannot read, Agraphia – cannot write Lesion is in the ANGULAR GYRUS. This is found at the junction of association areas for vision, hearing, balance, touch, and position sens. The association area for all association areas. It connects different modalities with Wernickes! Other lesions in the angular gyrus: Alexia with agraphia, pure word blindness, out of body experiences

``` The aphasia where a patient can speak fluently and understand what you say but cannot repeat what you ask her to repeat is A. Wernicke’s aphasia B. Broca’s aphasia C. Conduction aphasia D. Global aphasia ```

C Conduction aphasia: fluency and understanding is good but poor repetition and naming. Wernicke’s aphasia: good fluency but poor understanding, naming and repetition. Broca’s aphasia: poor fluency but good understanding, poor repetition and naming. Broca’s area is for speech production, Wernicke’s for associating speech sounds with meaning

``` Asking what the patient would do if they get somebody else’s mail is an example of a test for the patient’s... A. Intelligence B. Abstract reasoning C. Judgment D. Insight ```

A test where the examiner flicks the distal interphalangeal joint of the third finger upward A. Hoffman B. Tromner C. NOTA

B Tromner equals T. T for top/ Going up!

In the examination of the meninges A. To test for Kernig’s sign, examiner holds the patient’s occiput and passively flexes the neck until the chin touches the neck B. To test for Brudzinski’s sign, examiner asks the patient to lie supine and flexes the patient’s hip and knee to 90 degrees C. A and B are correct D. A and B are incorrect

D They switched the definitions for both signs.

Damage to which of the anatomical structures leads to a lower motor neuron paralysis? A. Neuron of the primary motor center B. Axons of the internal capsule C. Decussating axons of the medullary pyramid D. Corticospinal tract E. Cells of the anterior horn of the spine

E Lower motor neuron begins from the cells of the anterior horn up to the respective peripheral nerve for the myotome.

``` This indirect pathway reaches as far as the cervical spinal cord, where it innervates predominantly alpha motor neurons that innervate flexors of the upper limb A. Tectospinal pathway B. Vestibulospinal pathway C. Pontine Reticulospinal pathway D. Medullary Reticulospinal pathway E. Rubrospinal pathway ```

E Rubrospinal for flexors of arms and hands. Tectospinal: coordinate head and eye movements ; Vestibulospinal: reflex control of posture and balance ; Pontine reticulospinal: extensors, inhibit flexors ; Medullary reticulospinal: inhibitory to segmental reflexes

Edinger Westphal nucleus is for A. blinking B. lateral gaze C. pupil constriction

C Edinger Westphal Nucleus is an accessory parasympathetic CN III nucleus for pupil constriction and accommodation.

``` An 80-year-old male comes to you for a general check-up. Upon doing the neurologic exam, you note that there is decreased reflex at the ____________(knee?). A. Jaw reflex B. Brachioradialis reflex C. Triceps reflex D. Patellar reflex ```

``` Congenital anomaly of dorsal induction? A. Holoprosencephaly B. Anencephaly C. Cleft palate D. Macrocephaly E. Microcephaly ```

``` The particular muscle to zero in to discriminate UMN/LMN lesion. A. Frontalis B. Nasalis C. Buccinator D. Orbicular Oris ```

A Frontalis since this has bilateral innervations while lower half is contralaterally innervated.

The following are effects of oxytocin except: A. Maternal behavior B. Contraction of myoepithelium of the breast C. Inhibition of prolactin release D. Contraction of myometrium of uterus

``` From corticosterone A. cortisol B. aldosterone C. both D. neither ```

``` Which of the following cells produce insulin? A. alpha cells B. beta cells C. D cells D. F cells ```

``` Which of the glucose transporters is present in skeletal and cardiac muscle, and adipose tissue and facilitates insulin-mediated glucose uptake? A. GLUT 1 B. GLUT 2 C. GLUT 3 D. GLUT 4 ```

D The most important glucose transporters are Glut 1, 2, and 4. Glut 1 is insulin-independent and is responsible for protecting the CNS from glucose deprivation. Glut 2 acts as a beta cell glucose sensor. Finally, Glut 4 is insulin-dependent, and is found in insulin-sensitive organs, such as skeletal muscle, cardiac muscle, and adipose tissue. Thus, D is the answer.

The parathyroid hormone primarily mediates the following physiological effect: A. Increased bone resorption B. Increased renal tubular reabsorption of calcium C. Increased intestinal absorption of calcium D. Acid-base balance

``` Which of the following are thyroid hormone transport proteins? A. Thyretin B. Thyroid binding globulin C. Albumin D. All of the above ```

The following statements regarding the Resting Membrane Potential (RMP) being in a “steady state” are true EXCEPT: A. No net flow of ions B. Constant transmembrane potential C. RMP in equilibrium D. The sum of all ionic currents flowing across the membrane must equal zero.

The following decreases Cerebral Blood Flow EXCEPT: a. Anemia b. Atherosclerosis c. Osteoporosis d. Increased intercranial pressure

``` . Abnormalities in what stages of the brain development result in Neurocutaneous Syndrome? A. Neuronal migration B. Neuronal proliferation C. Dorsal induction D. Myelination ```

Compression of what nerve causes Carpal Tunnel Syndrome? A. Radial Nerve B. Ulnar Nerve C. Median Nerve D. Musculocutaneous Nerve

Which nerve innervates the brachialis and biceps brachii? A. Radial nerve B. Common peroneal nerve C. Obturator nerve D. Musculocutaneous nerve

``` What passes from midbrain to cervical cord? a. mesencephalic nucleus of CN V b. principal nucleus of CN V C. Spinal Nucleus of CN V d. spinal accessory ```

``` Which of the following is responsible for the blood supply of the anterior ⅔ of the spinal cord from T8 to conus medullaris? A. Artery of Adamkiewicz B. Posterior spinal artery C. Vertebral artery D. Innominate artery ```

``` What is the dural reflection that separates the cerebrum from the cerebellum? A. Tentorium Cerebelli B. Falx Cerebri C. Falx Cerebelli D. Diaphragma Sella ```

``` These cells stain with Glial fibrillary acidic protein (GFAP) A. Astrocytes B. Oligdendrocytes C. Microglia D. Ependymal Cells ```

``` The outer band of Baillarger or line of Gennari corresponds to which layer? A. External Granular B. External Pyramidal C. Internal Granular D. Internal Pyramidal ```

Which of the following bind to intracellular receptors? a. T3 and TSH b. ACTH and cortisol c. testosterone and estrogen d. insulin and glucagon

Peptide and proteins a. are produced initially as inactive prehormone b. require binding with plasma protein c. bind to nuclear receptors d. derived from cholesterol

Which of the following is true about insulin? a. The active hormone is composed of 4 peptides b. The secretory granules contain insulin and c-peptide in 2:1 ratio c. insulin is released into the duct of Wirsung to reach the liver d. The order of synthesis of the polypeptide chain is n-terminal signal peptide- b-chain- c-peptide- insulin

Transection of pituitary stalk a. Decreased cortisol, decreased ACTH b. Increased cortisol, decreased ACTH c. Decreased cortisol, increased ACTH d. Increased cortisol, increased ACTH

Tuberculous infiltration of adrenal cortex a. Decreased cortisol, decreased ACTH b. Increased cortisol, decreased ACTH c. Decreased cortisol, increased ACTH d. Increased cortisol, increased ACTH

ACTH producing pituitary adenoma a. Decreased cortisol, decreased ACTH b. Increased cortisol, decreased ACTH c. Decreased cortisol, increased ACTH d. Increased cortisol, increased ACTH

ACTH secreting tumor a. Decreased cortisol, decreased ACTH b. Increased cortisol, decreased ACTH c. Decreased cortisol, increased ACTH d. Increased cortisol, increased ACTH

Insulin affects the metabolism of which substances? a. carbohydrates b. carbohydrates and fats c. carbohydrates and proteins d. carbohydrates, fats and proteins

With inactivating mutation to GLUT-2 transporter a. patient loses consciousness and seizure b. pancreas do not produce insulin when glucose increases after meals c. glucose is not transported to muscles and adipose d. fructose is not transported to sperm

What happens after pancreatectomy? a. hypoglycemia b. decreased FFA c. decreased acetoacetate d. metabolic alkalosis

Which of the ff is not a direct effect of PTH? a. increased bone resorption b. increased intestinal absorption of calcium c. increased renal tubular reabsorption of calcium d. decreased renal tubular absorption of phosphate

Your grandmother wants to prevent osteoporosis by taking calcium tablets. However, she takes 20 pcs of 500 mg tablets daily, way more than recommended. What are the physiologic adaptations that occur as a response? a. PTH gland secrete more PTH b. 1-α- hydroxylase enzyme activates Vit D c. Renal tubular absorption of Ca is inhibited d. Increased osteoclastic activity

Basophilic cells of adenohypophysis a. lactotroph b. somatotroph c. thyrotroph d. corticotroph

Salt Loading a. Decreased renin, decreased aldosterone b. Increased renin, decreased aldosterone c. Decreased renin, increased aldosterone d. Increased renin, increased aldosterone

Which is true about insulin secretion? a. Decreased glucose, decreased insulin secretion b. Increased glucose, decreased insulin secretion c. Decreased glucose, increased insulin secretion d. Increased glucose, increased insulin secretion

``` Wakefulness is disrupted in lesions of the: A. Brainstem reticular formation B. Bilateral thalami C. Bilateral cerebral cortex D. AOTA ```

``` Dressing apraxia and left hemineglect are prominent features of lesions in the: A. Frontal lobes B. Right thalamus C. Right parietal D. Non-dominant temporal ```

``` A type of higher cortical impairment wherein a patient can describe objects in their visual field in detail (color, texture, shape) but are unable to recognize the specific objects. A. Visual agnosia B. Apraxia C. Astereognosia D. Anosognosia ```

``` Patients with this kind of aphasia are unable to perform repetition due to a lesion in the arcuate fasciculus (or rather the extreme capsule on MR diffusion tensor imaging) A. Transcortical sensory aphasia B. Disconnection syndrome C. Conduction aphasia D. Wernicke’s aphasia ```

``` Despite a lateralized cerebral dominance for aspects such as music, math abilities, and facial recognition, both the right and left cerebral hemispheres are connected to each other and share information through this all important structure A. Corpus callosum B. Falx cerebri C. Foramen of Monroe D. Arcuate fasciculus ```

``` Brain area in the inferior frontal lobe responsible for speech production and articulation A. Wernicke’s area B. Broca’s area C. Arcuate fasciculus D. Fasciculus cuneatus ```

``` Denotes utter denial of an obvious handicap or illness such as hemiplegia or even blindness A. Anosognosia B. Astereognosia C. Visual agnosia D. Hemineglect ```

``` Echolalia, palilalia, and neologisms are often seen in lesions of the: A. Frontal lobe B. Parietal lobe C. Temporal lobe D. Occipital lobe ```

``` Asking for a historical event or a verifiable personal event (What school did you last attend?) tests: A. Immediate memory B. Recent memory C. Delayed memory D. Remote memory ```

``` Mini-Mental Status Examination is equivalent to doing a full higher cortical function testing: A. True B. False C. Sometimes D. All of the time ```

The structures that ¬initiate lateral gaze are: A. Superior colliculus and medial geniculate body B. Frontal eye fields and parapontine reticular formation C. Abducens nucleus and oculomotor nerve complex D. Rostral interstitial nucleus of Cajal

On looking to the left side (L) to copy a friend’s scantron, your classmate Derpina develops diplopia. She has no problem copying answers off a friend seated to her right (R). She has dysconjugate gaze due to: A. Disconnected medial longitudinal fasciculus between L CN VI and R CN III B. Non-functioning frontal eye field on the R side C. A cerebellar lesion on the L side D. Non-functioning parapontine reticular formation on the L side

``` The particular muscle to zero in while examining a patient with facial weakness to determine whether lesion is either upper or lower motor neuron is: A. Frontalis B. Nasalis C. Buccinator D. Orbicularis oris ```

``` One of the following muscles innervated by the CN V can be tested in the neurologic exam A. Frontalis B. Masseter C. Orbicularis oris D. Mylohyoid ```

``` In assessing the integrity of the motor component of CN V, the ball of the palm is placed on: A. The maxilla B. The mandible C. The glabella D. The chin ```

``` In assessing the integrity of the spinal accessory nerve, the ball of the palm is placed on: A. The maxilla B. The mandible C. The glabella D. The chin ```

A peripheral facial nerve weakness can be differentiated from a central facial nerve palsy by asking the patient to: A. Wrinkle the forehead B. Smile C. Close the eyes tight D. Pull the corners of the mouth downward forcefully

A lesion of the right CN XII or the supranuclear corticobulbar fibers on the right will be manifested by this finding on tongue protrusion A. Remains in midline B. Deviates to right on tongue protrusion C. Deviates to left on tongue protrusion D. Poor gag reflex

``` The cranial nerve that innervates the smallest skeletal muscle in the body A. Oculomotor nerve B. Trigeminal nerve C. Abducens nerve D. Facial nerve ```

``` Which structure has nothing to do with vertical gaze? A. Oculomotor nerve B. Trochlear nerve C. Abducens nerve D. Medial longitudinal fasciculus ```

``` Briskly swiping a wisp of cotton on the limbus of the cornea tests the integrity of the: A. Opthalmic division of CN V B. Maxillary division of CN V C. Mandibular division of CN V D. Mesencephalic nucleus of CN V ```

The corneal reflex may be absent unilaterally due to a cervical cord lesion because: A. Fibers descend from the principal nucleus to meet the gracile and cuneate tracts B. Fibers descend as the spinal nucleus and tract to the 2nd cord segment C. Fibers decussate at the level of the pons to join the medial lemniscus D. Fibers descend and hitchhike on ascending fibers from CN XI

``` Swinging your neurohammer at the patellar tendon activates a reflex arc at dermatome: A. L3 B. L4 C. L5 D. S1 ```

``` Stroking the sole or lateral aspect of the foot to elicit extensor toe sign stimulates: A. L3 B. L4 C. L5 D. S1 ```

``` In the general scheme of sensory nerves, the neuron whose axon decussates is the: A. 1st order neuron B. 2nd order neuron C. 3rd order neuron D. Granule cell in the cerebral cortex ```

``` Dorsal root ganglia and trigeminal ganglia neurons: A. Have axons that cross the midline B. Are pseudounipolar neurons C. Are second order neurons D. Are bipolar neurons ```

The medial lemniscus is seen: A. Within the basis pontis interspersed among the pontocerebellar fibers B. Beneath the 4th ventricle forming an eponymous colliculus C. At the junction of the basis pontis and tegmentum dorsolaterally D. Ventromedially seated atop the pyramids

. This test may also assess the integrity of the dorsal column – medial lemniscal pathway: A. Deep lingering pressure on the sternum B. Briskly touching a wisp of cotton on the limbus of the cornea C. Romberg test D. Libarnes roll

. The decussation of the spinothalamic tract is at: A. The level of the spinal cord B. 1-2 segments above the entry of the dorsal root ganglia fibers C. 1-2 segments below the entry of the dorsal root ganglia fibers D. AOTA

The decussation of the dorsal column – medial lemniscal pathway is at the level of: A. The cervicomedullary junction B. The 2nd cervical cord C. 2 cord segments above or below the entry of the spinal nerve root D. The rostral medulla

``` After emanating from the internal capsules, the electrical signals that represent the superior halves of a visualized object travel within the: A. Superior optic radiations B. Corona radiate C. Inferior optic radiations D. Corpus callosum ```

``` Which of the following is NOT one of the 4 signs seen in Gerstmann syndrome? A. Agraphia B. Alexia C. Right-left confusion D. Acalculia E. Finger agnosia ```

``` “This exam is so ‘waleykomasagutanpagodnakowpowz’” – is an example of: A. Global aphasia B. Autocorrect error C. Conduction aphasia D. Neologism ```

``` Reading a quote attributed to Yoda or Morgan Freeman will activate this area in your brain either in your own voice or in their’s. A. Supramarginal gyrus B. Lingual gyrus C. Angular gyrus D. Fusiform gyrus ```

``` “Raedning this sentence is meda pssobile” by the integrity of the: A. Supramarginal gyrus B. Lingual gyrus C. Angular gyrus D. Fusiform gyrus ```

``` Alexia with or without agraphia results from damage to this structure: A. Supramarginal gyrus B. Lingual gyrus C. Angular gyrus D. Fusiform gyrus ```

``` Planning a romantic getaway with precise timing of roses and a string quartet requires the: A. Frontal lobe B. Temporal lobe C. Insula D. Parietal lobe ```

``` When faced with a difficult multiple choice question you know completely nothing about, you would rely on which structure to “choose the best answer”? A. Orbitofrontal cortex B. Anterior cingulate cortex C. Both A & B D. Neither A nor B ```

``` The association cortex of all other association cortices A. Supramarginal gyrus B. Lingual gyrus C. Angular gyrus D. Fusiform gyrus ```

``` Happiness is a choice. Becoming a doctor is a decision. This part of your brain is at work: A. Hippocampus B. Amygdala C. Ventral tegementum D. Prefrontal cortex ```

Which of the following manifestations is not expected in a disorder of the corticospinal tract? A. Spastic paralysis B. Enhanced tendon reflexes C. Denervation atrophy of muscles D. Babinski sign E. Weakness of muscle groups rather than individual muscles

. Which of the following anatomical structures is not part of the upper motor neuron? A. Neuronal body in the precentral gyrus B. Alpha motor neurons in the anterior horn of the spinal cord C. Corticospinal axons in the lateral funiculus of the spinal cord D. Axons from the primary motor cortex that decussate at the medullary pyramids E. Axons from the primary motor cortex that do not decussate at the medullary pyramids

``` What do you call the lower motor neurons in the brainstem which the corticobulbar fibers from the motor cortex synapse with? A. Cranial nerve motor nuclei B. Anterior horn cells C. Gamma motor neurons D. Interneurons E. Intrafusal cells ```

``` The upper motor neurons from the motor cortex do not synapse with which of the following cranial nerve nuclei? A. Trigeminal nerve B. Oculomotor nerve C. Vestibulocochlear nerve D. Hypoglossal nerve E. Glossopharyngeal nerve ```

Which of the following statements is incorrect with regards to the motor system? A. The corticospinal tract is a direct pathway from the motor cortex to the spinal cord. B. The corticobulbar tract is a direct pathway from the motor cortex to the brainstem. C. The corticospinal fibers are located in the lateral funiculus of the spinal cord. D. The undecussated fibers of the corticopsinal tract are located in the anterior funiculus of the spinal cord. E. A great majority of the corticobulbar fibers decussate in the medullary pyramids.

``` In the lamellation of the corticospinal tract fibers in the thoracic spinal cord, which axons occupy the most medial position? A. Cervical motor axons B. Thoracic motor axons C. Lumbar motor axons D. Sacral motor axons E. Autonomic axons ```

Which of the following manifestations is not expected in a left brachial plexus injury? A. Enhanced left biceps and triceps tendon reflexes B. Flaccid paralysis of the left arm C. Atrophy of the left arm and hand muscles D. Fasciculation and fibrillations of the left arm muscles E. Abnormal ECG-NCV findings in the left arm

``` What is the neurotransmitter used by the corticospinal tract for transmission of impulse? A. Serotonin B. Acetylcholine C. GABA D. Glutamate E. Dopamine ```

What is the classical presentation of a patient with an infarction of the right middle cerebral artery? A. Dense hemiplegia of the left arm and left leg B. Dense hemiplegia of the right arm and right leg C. Left arm weakness that is more severe than the left leg weakness D. Right arm weakness that is more severe than the right leg weakness E. Left leg weakness that is more severe than the left arm weakness

How does a left peripheral facial palsy manifest? A. Paralysis of the left forehead B. Paralysis of the right lower half of the face C. Paralysis of the left lower half of the face D. Paralysis of the entire right half of the face E. Paralysis of the entire left half of the face

Which of the following is not a role of the cerebellum? A. Selective activation and inhibition of specific motor programs B. Control of the execution of motor acts C. Maintenance of balance and posture D. Maintenance of coordinate limb movements E. Adjustment of motor performance

Which of the following manifestations is not expected in a left cerebellar lesion? A. Dysmetria of the left hand B. Weakness of the left arm and leg C. Dysdiadochokinesia of the left arm D. Poor heel-to-shin test of the left foot E. Nystagmus with fast component to the left

In the entire cerebello-corticospinal axis, a cerebellar lesion causes deficits ipsilateral to the lesion because: A. The cerebellum sends out motor fibers directly to the ipsilateral spinal cord B. The corticospinal tract controls the contralateral cerebellum C. The corticospinal tract controls the ipsilateral cerebellum D. Of decussations in the cerebello-thalamic pathway and in the corticospinal tract in the medullary pyramids E. The cerebellum controls the ipsilateral cortical motor neurons

``` Which striatal component in the basal ganglia circuit is primarily involved in controlling motor function? A. Putamen B. Globus pallidus interna C. Globus pallidus externa D. Caudate nucleus E. Subthalamic nucleus ```

``` Which anatomical structure connects the cerebellum to the midbrain and cerebral hemispheres? A. Inferior cerebellar peduncle B. Middle cerebellar peduncle C. Superior cerebellar peduncle D. Brachium pontis E. Restiform body ```

``` The stimuli recommended for CN I examination A. Coffee B. Cigarette C. Garlic D. A, B, & C E. A & B only ```

``` Patients are instructed to close their eyes when doing these examinations EXCEPT: A. Testing for olfaction B. Testing for hearing C. Testing for cerebellar ataxia D. Testing for pronator drift ```

Pure optic nerve (CN II) examination includes: A. Visual acuity using modified Snellen vision chart B. Visual field testing through visual confrontation C. Pupillary examination D. AOTA E. A & B only

TRUE regarding neurologic examination A. If the left pupil is smaller than the right pupil, report this finding as left anisocoria B. In testing for convergence, both eyes are expected to move medially and the pupil will dilate C. For standardization, use the 4th toe for testing for position sense D. AOTA E. A & B only

``` Different ways of doing a cerebellar test EXCEPT: A. Wrist slapping test B. Romberg test C. Heel-to-shin test D. Checking for nystagmus E. Finger to nose test ```

The proper sequence of doing optic nerve examination to determine if a patient is blind A. Counting fingers, hand movement, light projection, light perception B. Hand movement, counting fingers, light projection, light perception C. Hand movement, counting fingers, light perception, light projection D. Counting fingers, hand movement, light perception, light projection

Which statement is not correct in performing the “arm pulling test for overshooting”? A. Student asks the patient to flex the elbow B. The student grasps the right wrist of the patient with his right hand while placing his other hand against the patient’s shoulder C. The student instructs the patient to pull towards his face and then abruptly releases the wrist D. The student reported the presence of absence of overshooting

TRUE about doing meningeal examination A. To check for Kernig’s sign, the examiner places his hand beneath the patient’s occiput and passively flexes the neck forward until the patient’s chin touches the chest B. To test for Brudzinski’s sign, the examiner asks the patient to lie supine and flex one of the patient’s legs at both the hip and the knee at 90 degrees C. A & B are correct D. A & B are incorrect

``` Motor tests to be done while the patient is in the erect position EXCEPT: A. Romberg test B. Gait testing C. Walking on toes and heels D. Tandem walk ```

``` . Before reporting that a patient is neurologically blind, the patient should NOT be able to do this: A. Appreciate light perception B. Appreciate hand movement C. Appreciate light projection D. Appreciate finger counting ```

``` A monocular field defect suggests: A. Lesion in the optic nerve B. Lesion in the optic chiasm C. Lesion in the optic radiation D. Lesion at the occipital lobe ```

TRUE about technique for examining the eye using the opthalmoscope A. If patient is wearing glasses, ask the patient to remove the glasses B. The examiner uses the left hand to hold the opthalmoscope to examine the patient’s left eye C. If the examiner is wearing glasses, the examiner should remove his glasses D. AOTA E. A & B only

TRUE about examining the cochlear nerve A. If there is a conductive hearing deficit, bone conduction (BC) will be greater than or equal to air conduction (AC) in the affected ear when doing the Webber’s test B. If there is a sensorineural hearing deficit, AC will be greater than BC in the affected ear when doing the Webber’s test C. If there is a conductive hearing deficit, the Rinne’s test will lateralize to the affected ear D. AOTA E. NOTA

``` Neurological testing for meningeal irritation A. Testing for Brudzinski’s sign B. Testing for Kernig’s sign C. Straight leg raising test D. AOTA E. A & B only ```

True statements on what you can test while patient is standing EXCEPT A. Romberg test for cerebellar testing B. Check for wide based gait for cerebellar lesion C. Check for spastic gait suggestive of corticospinal tract lesion D. Check for arm swing which is poor in Parkinson’s disease and corticospinal lesion E. Unterberger and Fukuda testing for vestibular dysfunction

``` The first thing that you would do in somatomotor examination A. Check for pronator drift B. Check for atrophy and asymmetry C. Check for spasticity D. Check for motor strength E. Check for rigidity ```

TRUE about motor strength testing in a seemingly normal patient A. Start with asking the patient to abduct both arms as the examiner pushes them down B. Start with doing the pronator drift test C. If a patient can move the muscle being tested against gravity, his MRS is at least 2/5 D. Finger abduction and adduction are innervated by C8 E. Thigh flexors are innervated by L2-L4

``` The reflex grading of a patient with hyperactive reflexes accompanied by unsustained clonus A. +2 B. +3 C. +4 D. +5 ```

TRUE regarding tone during motor examination A. Myotonia is due to contraction of both agonist and antagonist muscles B. Dystonia is the slow relaxation of muscle C. Percussion myotonia is when a muscle dimples following percussion with a hammer D. AOTA E. A & B only

``` Signs of lower motor neuron lesion EXCEPT A. Presence of fasciculation B. Reflexes are decreased C. Mild atrophy due to disuse D. Presence of weakness ```

TRUE about a finding of weakness in neurologic examination A. In general, proximal weakness is suggestive of myopathy or diseases of muscles B. In general, distal weakness is suggestive of neuropathy or disease involving nerves C. The muscles are strongest when acting from their shortest position and have relatively little strength when acting from the longest position D. AOTA E. A & B only

. TRUE about technique on using the opthalmoscope to examine the patient’s right eye A. Examiner uses the left hand to hold the opthalmoscope B. Examiner uses the left eye to examine the patient’s eye C. Examiner uses the right eye to examine the patient’s eye D. Examiner uses the right hand to hold the opthalmoscope and uses the left eye

``` Which of the following structures contributes to the production of the mucus that helps bind odorant molecules within the olfactory epithelium? A. Olfactory stria B. Olfactory bulb C. Bowman’s glands D. Olfactory receptors ```

``` Which of the following tests are linked to ion-gated channels? A. Bitter B. Sour C. Sweet D. Umami ```

``` Which of the following structures would most likely contain cells with olfactory and taste receptors? A. Superior meatus B. Oropharynx C. Larynx D. Esophagus ```

``` Where is the primary visual cortex? A. Occiptal lobe B. Temporal lobe C. Parietal lobe D. Frontal lobe ```

The retinal pigment epithelium help photoreceptors to perform their function by: A. Blocking light from exiting the eyeball B. Help with the detection of the darker wavelengths of light C. Assists with the rods at night by increasing their sensitivity to photons D. Important in the restoration of photopigments after light activation

``` Receptive fields (both on- and off-center) help with the formation of visual information pathways by organizing information that is related to: A. Color B. Brightness C. Contrast D. Binocular vision ```

``` Outer hair cells in the organ of Corti receive efferent stimulus that originate from which part of the auditory pathway? A. Superior olivary complex B. Lateral lemniscus C. Inner hair cells D. Primary auditory cortical center ```

The tonotopic arrangement of frequency detection within the organ of Corti is determined by which of the following mechanisms: A. Movement of sections of the basilar membrane in response to frequency B. Differences in the frequency pick-up between the left and right organs of Corti C. Movement of the perilymph as opposed to the endolymph D. Distance of the displacement of the stereocilia toward the kinocilium of the hair cells

The induced nystagmus during vestibular function testing causes nausea because of what mechanism? A. The use of cold water instead of warm water B. The degree of the head tilt during the testing C. The amount of cerumen in the patient’s testedear D. The disparity between visual image, spinal muscle proprioception, and vestibular information

Theoretically, when you do a cartwheel with your head facing forward constantly, which of the following vestibular structures are firing the most? A. All 3 semicircular canals B. The lateral SCC and the saccule C. The posterior and superior SCCs and the saccule D. The saccule and utricle and the superior SCC

The Mental Status Examination describes the sum total of the examiner’s observations and impressions of the psychiatric patient: A. During the past month B. Over the past 2 weeks C. At the time of the examination D. From the patient’s last visit up to the present

The patient’s Mental Status Examination: A. Can change from hour to hour B. Should remain the same from one examination to the next C. Is stable if the patient is incoherent D. Is expected to be the same if the patient has not yet undergone treatment

``` The level of rapport established with the patient may be recorded in this part of the Mental Status Examination A. Overt behavior B. Appearance C. Attitude toward examiner D. Affect ```

``` Statements about the patient’s mood should include: A. Fluctuations B. Intensity C. Duration D. AOTA ```

``` A patient would only ride jeepneys with plate numbers adding up to an even number. This would be reported in which part of the Mental Status Examination? A. Perception B. Thought content C. Thought process D. Orientation ```

Which of the following structures is NOT part of a sensory unit? A. Dorsal horn neuron B. Neuron in the dorsal root ganglion C. Afferent nerve fiber D. Receptors in the peripheral terminals

``` Which of the following statements about generator or receptor potentials is true? A. They are depolarizing potentials B. They are graded potentials C. They are ligand gated D. They are propagated potentials ```

``` A three year old child while playing fell on a piece of stone, hitting his left knee and crying because of the pain. The initial, acute pain is due to the stimulation of which nerve fiber? A. A gamma B. A beta C. A delta D. C fiber ```

``` What transmitters are predominantly secreted by somatic nociceptive afferent fibers? A. Serotonin and CGRP B. CGRP and histamine C. Substance P and glutamate D. Bradykinin and substance P ```

Unlike somatic pain, visceral pain is perceived to be diffuse and poorly localized because: A. There are more C afferent pain fibers than A delta fibers B. There is significant overlapping of visceral sensory receptive fields C. Afferent pain fibers from the visceral organs are poorly represented in the cortex D. AOTA

``` Damage to DNA causing phenotypic changes in aging due to radiation is explained by which theory of aging? A. Error Catastrophic Theory B. Somatic Mutation Theory C. Antagonistic Pleitropy D. Free Radical Theory ```

The following are features of normal aging EXCEPT A. Decline in the ability to learn new information B. Decreased performance on timed tasks C. Impaired semantic memory D. Decreased efficiency in performing complex tasks

``` Which neurotransmitter in the CNS is found to be decreased in aging and associated with significant clinical signs and symptoms in the aged? A. GABA B. Dopamine C. Serotonin D. Glutamate ```

``` An apparently 80 year old male consulted you for general check up. Neurologic examination in this patient would most likely reveal a decreased which tendon reflex? A. Jaw reflex B. Brachioradialis C. Triceps D. AOTA ```

In your routine neurologic examination, you find that a 75 year old woman could not identify the smell of coffee. What would be your conclusion? A. The inability to smell coffee is due to diminished sensitivity of the olfactory epithelium with aging B. The olfactory bulb could have been impaired due to a history of trauma to the frontal bone C. The patient may have some form of memory impairment D. Any of the above