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Transcript
Examination #2
Dental Neuroscience (NSci 6110)
Thursday, March 6, 2008
Instructions: Complete the name and identification block of the answer sheet. Choose the
single best answer for each of the 36 questions listed below and mark the answer sheet
accordingly. If you dispute the validity of a question, or wish to otherwise qualify your answer,
do so in writing on the sheet provided (the last page of these questions (page 7)). We will take
into account such qualifications prior to establishing the final version of the "Key". In order for
your written qualifications to be considered, they must be turned in with your answer sheet,
and you must identify yourself by printing your name and ID number on the qualification sheet.
1.
Which of the following statements concerning the sympathetic division of the autonomic
nervous system is TRUE?
a.
The neurotransmitter released by postganglionic sympathetic neurons is
acetylcholine.
Acetylcholine activates nicotinic receptors on postganglionic neurons.
Activation of sympathetic nerves inhibits adrenal secretion of epinephrine.
Cell bodies of preganglionic sympathetic neurons are found in the brainstem.
Preganglionic sympathetic neurons are located in the adrenal medulla.
*
b.
c.
d.
e.
2.
Activation of the parasympathetic nervous system most likely would
*
a.
b.
c.
d.
e.
increase contraction of the bladder (evacuation of the bladder).
increase heart rate.
increase pupillary diameter.
increase glycogenolysis (conversion of glycogen to glucose).
increase lens thickness to promote far vision.
3.
Beta-1-adrenergic receptor blockers are used in the treatment of high blood pressure,
because these agents
*
a.
b.
c.
d.
e.
reduce vasodilation in skeletal muscle.
reduce heart rate.
reduce cardiac contractility.
b and c only
a, b and c
1
4.
The baroreceptor reflex operates to maintain arterial pressure within a normal
physiological range. Based on your understanding of how the parasympathetic system
operates during this reflex, increases in carotid sinus pressure would result in
*
a.
b.
c.
d.
e.
decreased activity in the carotid sinus nerve.
increased efferent vagal activity.
decreased parasympathetic activity.
increased heart rate.
none of the above.
5.
In peripheral nerves, afferent fibers
*
a.
b.
c.
d.
e.
6.
What type of receptor is involved in the sensation of fullness?
*
a.
b.
c.
d.
e.
7.
Receptors that have to do with bodily sensations are called
*
a.
b.
c.
d.
e.
8.
Which of the following is an example of a phasic receptor?
*
a.
b.
c.
d.
e.
carry information to the central nervous system.
carry sensory information from the central nervous system.
carry information from sensory receptors.
a and b.
a and c.
chemical receptors
photoreceptors
mechanoreceptors
nociceptors
All of the above.
nociceptors.
proprioceptors.
somatic receptors.
photoreceptors.
None of the above.
nociceptor
mechanoreceptor
proprioceptor
a and b
a and c.
2
9.
Which of the following are TRUE regarding the Meissner corpuscle mechanoreceptor?
*
a.
b.
c.
d.
e.
10.
Where do axons in the dorsal column pathway cross the midline?
*
a.
b.
c.
d.
e.
It is found in hairy skin and is slowly adapting
It is found in glabrous skin and is slowly adapting
It is found in glabrous skin and is rapidly adapting
It is found in hairy skin and is rapidly adapting
It is associated with hair follicles.
After they synapse in the dorsal column nuclei.
In the thalamus.
In the spinal cord.
Before they synapse in the dorsal column nuclei.
Just prior to entering the cortex.
11.
A lesion in the right dorsal column pathway just before the dorsal column nuclei will
cause sensory deficits
*
12.
a.
b.
c.
d.
e.
on the left side of the body.
on the right side of the body.
on both sides of the body.
only on the midline.
All of the above.
The distorted representation of the body on the primary sensory cortex is due to
a.
*
13.
*
the number of neurons in the thalamus that get input from different body
regions.
b.
the number of neurons in the dorsal column nuclei.
c.
the amount of tactile stimulation that the body part receives.
d.
differences in the number of mechanoreceptors and nociceptors in various body
regions.
e.
None of the above.
Which of the following best describes hyperalgesia?
a.
b.
c.
d.
e.
Decrease in the pain threshold.
Increased pain to stimuli that are normally painful.
Neuronal sensitization.
a and b
b and c
3
14.
The physiological correlate of hyperalgesia is
*
a.
b.
c.
d.
e.
15.
Which is TRUE regarding the medial spinothalamic tract?
*
a.
b.
c.
d.
e.
desensitization.
the spinothalamic tract.
sensitization.
hyperactivity in thalamus.
reorganization of the cortex.
It is involved in the sensory aspects of pain.
It is involved in emotional reactions to pain.
It projects to the primary somatosensory cortex.
It includes the ventral posteriorlateral nucleus.
None of the above.
16.
A lesion of the spinothalamic tract at the level of the cervical spinal cord will causes
deficits in pain sensation
*
*
*
*
**
a.
b.
c.
d.
e.
on the ipsilateral side of the body.
along the midline.
in the orofacial region.
on both sides of the body.
None of the above.
Credit given for all answers, since side of lesion not specified.
17.
Which type of peripheral nerve fiber is most sensitive to ischemia (the first type of fiber
to lose function) and which is the least sensitive to ischemia (last type of fiber to lose
function)?
*
a.
b.
c.
d.
e.
18.
Referred pain is best described by
*
a.
b.
c.
d.
e.
A-delta, C
C, A-beta
A-beta, C
A-beta, A-delta
A-delta, A-beta
injury to nerves.
convergence.
sensitization of nociceptors.
sensitization of spinal neurons.
None of the above.
4
19.
*
The ischemic nerve block showed that
a.
b.
c.
d.
e.
C-fibers are excited by cold.
A-beta fibers are mechanoreceptors.
A-delta fibers mediate the sensation of cold.
All of the above.
None of the above.
20.
What causes burning pain to cold stimuli?
*
a.
b.
c.
d.
e.
Excitation of C nociceptors.
Excitation of A-delta nociceptors.
Excitation of mechanoreceptors.
Loss of C fiber function.
None of the above.
21.
The primary nucleus within the trigeminal system that receives information from
mechanoreceptive afferent fibers is the
*
22.
*
**
a.
b.
c.
d.
e.
spinal nucleus.
main sensory nucleus.
motor nucleus.
mesencephalic nucleus.
dorsal column nucleus.
Which nucleus in the trigeminal system is involved in proprioception?
a.
b.
c.
d.
e.
Spinal nucleus.
Main sensory nucleus.
Motor nucleus.
Mesencephalic nucleus.
None of the above.
23.
A lesion to the main sensory nucleus on the right side of the brain will cause sensory
deficits
a.
on the left side of the face.
*
b.
on the right side of the face..
c.
on top of the head
d.
the entire body below the head.
e.
None of the above.
5
24.
The only bilateral projection to VPM arises from
*
*
a.
b.
c.
d.
e.
25.
The trigeminal nerve innervates which of the following craniofacial tissues?
*
a.
b.
c.
d.
e.
the intraoral cavity.
the masseter muscles.
the main sensory nucleus.
a and b
a and c.
Taste papillae
Nasal mucosa
Cornea
b and c
All of the above
26.
The trigeminal ganglion shares which of the following features with spinal dorsal root
ganglia?
*
a.
b.
c.
d.
e.
Somatotopic organization
Origin of sensory nerve fibers for peripheral tissues
Origin of motor nerve fibers to glandular tissues
b and c
All of the above
27.
Representation of craniofacial tissues in the trigeminal brain stem complex is
*
a.
b.
c.
d.
e.
28.
The sensory innervation of teeth
*
a.
b.
c.
d,
in an inverted face arrangement.
only at the principal sensory nucleus and spinal subnucleus caudalis.
at all levels of the trigeminal brain stem complex.
a and b
a and c
is restricted to the odontoblast layer.
supplies the dental pulp and dentinal tubules.
is comprised exclusively of C-fibers.
a and c
6
29.
*
e.
b and c
In the section of the pons shown below, the arrow points to which nucleus?
a.
b.
c.
d.
e.
ventral posteriolateral nucleus
main or chief sensory nucleus of the trigeminal nerve
spinal nucleus of the trigeminal nerve
ventral posteriomedial nucleus
motor nucleus of the trigeminal nerve
30.
In the section of the cervical spinal cord shown, the arrow points to the
*
a.
b.
c.
d.
e.
gracile nucleus.
gracile fasciculus.
medial lemniscus.
cuneate nucleus.
cuneate fasciculus.
7
31.
In the section of the medulla shown, the curved white line represents the axon of a 2ndorder neuron projecting to the thalamus. This neuron could transmit information concerning
*
a.
b.
c.
d.
e.
pain and temperature sensation from the head
pain and temperature sensation from the arm
the sensation of touch from the arm
pain and temperature sensation from the leg
the sensation of touch from the leg
32.
If a lesion occurred in the caudal medulla at the site marked by the white "Xs", which of
the following modalities would be affected?
*
a.
b.
c.
d.
e.
Proprioception from the ipsilateral lower body
Pain from the ipsilateral side of the face
Light touch from the ipsilateral upper body
b and c
all of the above
8
33.
Which of the following is not a key characteristic of myofascial pain and TMJ arthralgia?
a.
*
b.
c.
d.
e.
The patient’s pain is brought on, or if pain is already present, is increased with
palpation, range of motion of the jaw or other provocation tests
The clinical exam duplicates the patient’s pain complaint
The patient reports that their pain is decreased with jaw movement, function and
parafunction
All of the above
None of the above
34.
Which of the following characteristics are commonly associated with TMJ disk
displacement with reduction?
*
a.
b.
c.
d.
e.
TMJ pain (i.e. arthralgia) is not typically present
Normal range of motion of the jaw
Clicking, popping or snapping noises
All of the above
None of the above
35.
Which of the following characteristics is not associated with acute TMJ disk
displacement without reduction?
*
a.
b.
c.
d.
e.
Maximum opening of the mouth is limited
TMJ CT shows concurrent degenerative joint disease (i.e. osteophyte)
Deviation of the mouth on opening to the affected side
All of the above
None of the above
36.
Which of the following characteristics are associated with trigeminal neuralgia?
*
a.
b.
c.
d.
e.
Pain is provoked only with firm palpation pressure
Mild to moderate paroxysmal stabbing shock-like pain
Nerve blocks to the trigger area do NOT eliminate their pain
All of the above
None of the above
9