Download Practice Questions for Neuro Anatomy Lectures 8,9,11,12 The

Practice Questions for Neuro Anatomy Lectures 8,9,11,12
1. The higher the cord the level, the more white matter and thus more:
a. Afferent, ascending tracts – picks up axons as goes up toward the
brain
b. Efferent, descending tracts
c. None of the above
2. What spinal cord level has well developed grey matter of dorsal horns
(afferent nerve fibers enter and terminate) and ventral horns (efferent motor
neuron cell bodies exit to innervate skeletal muscle)?
a. Cervical
b. Thoracic
c. Lumbar
d. Sacral
e. A and C, because these are where the upper and lower limbs are
f. B and D
3. The grey matter of the thoracic and upper lumbar (T1-L2/3) have _____ horns
with cell bodies of preganglionic sympathetic neurons.
a. Dorsal
b. Lateral
c. Ventral
d. all of the above
4. How many sections are in the Rexed’s laminae that are numbered from
dorsal to ventral?
a. 5
b. 10
c. 15
d. 20
5. This lamina has a low content of myelinated nerve fibers and aids in pain and
temperature sensations.
a. Lamina I
b. Lamina II = substantia gelatinosa
c. Lamina V
d. Lamina VII
e. Lamina IX
6. This lamina has intermediate grey matter.
a. Lamina I
b. Lamina II
c. Lamina V
d. Lamina VII
e. Lamina IX
7. This lamina has motor neurons in the anterior horn:
a. Lamina I
b. Lamina II
c. Lamina V
d. Lamina VII
e. Lamina IX
8. Where do the interneuron projections within the dorsal horn of the spinal
cord project to and enter at dorsal root before dividing into ascending and
descending branches?
a. Brain
b. Cerebellum
c. Visceral structures
d. A and B, the branches wil run in dorsolateral fasciculus or Lissaure’s
tract
e. All of the above
9. The afferent fibers of the dorsal horn run in the dorsolateral fasciculus or
Lissauer’s tract at the dorsal horn tip. What Rexed’s lamina is this if it aids in
the sensation of pain and temperature?
a. Lamina I
b. Lamina II
c. Lamina V
d. Lamina VII
e. Lamina IX
10. Proprioceptive and muscle afferents project and terminate in the dorsal horn
in the:
a. Superficial laminae
b. Intermedial laminae
c. Deeper laminae
d. All of the above
11. This lamina is the origin of the dorsal spinocerebellar tract (subconsiuous)
that get afferent input from muscle spindles and golgi tendons:
a. Lamina I
b. Lamina II
c. Lamina V
d. Lamina VII
e. Lamina IX
12. What is the name of the cells in lamina?
a. Clarke’s nucleus/column
b. Thoracic nucleus
c. Cervical nucleus
d. A and B
e. All of the above
13. At what level do the preganglionc sympathetic neurons of the lamina in
number 11 enter?
a. C1-C7
b. T1-L2 (in the lateral horns)
c. L1-L5
d. S2-S4
14. At what level do the preganglionc parasympathetic neurons of the lamina in
number 11 enter?
a. C1-C7
b. T1-L2
c. L1-L5
d. S2-S4
15. What type of neurons of the lamina that innervates skeletal muscle innervate
intrafusal (comprise muscle spindle) muscle fibers?
a. Alpha
b. Beta
c. Gamma
d. None of the above
16. What type of neurons of the lamina that innervates skeletal muscle innervate
extrafusal (typical) muscle fibers?
a. Alpha
b. Beta
c. Gamma
d. None of the above
17. This portion of the ventral horn has the motor neurons that innervate axial
musculature (neck and trunk):
a. Anterior
b. Medial
c. Posterior
d. Lateral
18. This portion of the ventral horn has the motor neurons that innervate the
limb muscles:
a. Anterior
b. Medial
c. Posterior
d. Lateral
19. The white matter of the spinal cord only has descending fibers.
a. True
b. False, has both ascending and descending fibers and is divided into 3
columns (funiculi) dorsal, lateral, and ventral
20. These are small bundles of nerve fibers that share common origins,
terminations, and functions:
a. Funiculi
b. Fasciculi, which are within one of the 3 columns or funiculi
c. Tracts
d. A and C
e. B and C
21. This type of nerve fibers in white fiber of the spinal cord aids in coordination
of flexor reflexes and is a narrow band peripheral to grey matter (fasciculus
proprius):
a. Long, ascending
b. Long, descending
c. Shorter intersegmental or proriospinal fibers
22. What part of the brain is where info about impulses from pain, thermal,
tactile, and muscle and joint receptors reaches a conscious level?
a. Brain stem
b. Cerebellum
c. Cerebral cortex
23. What part of the brain is where info about impulses from pain, thermal,
tactile, and muscle and joint receptors reaches a subconscious level?
a. Brain stem
b. Cerebellum
c. Cerebral cortex
24. The primary neurons of the conscious level of ascending spinal tracts are
______, synapse in _____ matter and are ________.
a. Pseudounipolar, white, contralateral
b. Unipolar, white, ipsilateral
c. Pseudounipolar, gray, ipsilateral
d. Unipolar, gray, contralateral
e. Unipolar, white, contralateral
25. The secondary neurons of the conscious level of ascending spinal tracts go to
the:
a. Medulla
b. Pons
c. Thalamus
d. Cerebral cortex
26. The tertiary neurons of the conscious level of ascending spinal tracts go from
the answer in number 25 to the:
a. Medulla
b. Pons
c. Cerebellum
d. Thalamus
e. Cerebral cortex, the conscious level of ascending spinal tracts are 3
neuron systems between the peripheral receptor and the cerebral
cortex
27. What is name of the conscious ascending spinal tract that is in dorsal
funiculi?
a. Posterior column-medial lemniscus system
b. Dorsal column system
c. Dorsal spinocerebrellar tract
d. A and B
e. B and C
28. The tract in question number 27 has 2 tracts. Fasciculus gracilis is ______ and
from ________.
a. medial, T6 and below
b. lateral, T7 and above
c. medial, T7 and below
d. lateral, T6 and above
29. The tract in question number 27 has 2 tracts. Fasciculus cuneatus is ______
and from ________.
a. medial, T6 and below
b. lateral, T7 and above
c. medial, T7 and below
d. lateral, T6 and above
30. Fill in the blanks of the following diagram of the above tract with these
words: ascend, descend, ipsilaterally, contralaterally, thalamocortical
neurons, thalamus, medulla, pons, internal arcuate fibers, external arcuate
fibers, cerebellum, anterior, posterior, ventral, medial, primary cortex,
somatosensory cortex
Fibers of both tracts ascend
ipsilaterally without
interuption to the medulla
to cell bodies where they
terminate upon secondary
neurons
tertirary neurons are
located in postcentral gyrus
on somatosensory cortex
They then terminate in
thalamus
secondary neurons
decussate in medulla as
internal arcuate fibers
they then ascend through
brain stem as medial
lemniscus
31. Fill in the blanks of the following diagram of the spinothalmic tract
(conscious ascending spinal tract) with these words: ascend, descend,
ipsilaterally, contralaterally, thalamocortical neurons, thalamus, medulla,
pons, internal arcuate fibers, external arcuate fibers, cerebellum, anterior,
posterior, ventral, medial, primary cortex, somatosensory cortex:
cell bodies ascend ipsilateral
to dorsal horn
tertiary thalamocortical
terminate in the
somatosensory cortex
terminates in thalamus
from cell bodies,
spinothalamic axons
decussate by passing through
ventral white commisure
secondary axons form
contralateral to the axons
32. The fibers of the dorsal spinocerebellar tract that originate from Clarke’s
column (_________) synapse on secondary neurons and ascend __________ and
enter cerebellum via the inferior cerebellar peduncle.
a. C1-T1, ipsilaterally
b. T1-L5, contralaterally
c. T1-L2, ipsilaterally, ascending pathways that are subconscious are 2
neuron systems
d. L1-L5, contralaterally
33. The fibers of the dorsal spinocerebellar tract that have primary afferents
from caudal to L2 ascend in fasciculus ___________ and synapse in Clarke’s
nucleus.
a. Gracilis
b. Cuneatus
c. Both
34. The fibers of the dorsal spinocerebellar tract that have primary afferents
from cervical and upper thoracic travel in fasciculus cuneatus to
lateral/external cuneate nucleus and axons travel ________ to ________
cerebellar peduncle.
a. Ipsilaterally, superior
b. Ipsilaterally, inferior
c. Contralaterally, superior
d. Contralaterally, inferior
35. The fibers of the ventral spinocerebellar tract (________) have axons that
ascend ________ to rostral pons and then turn caudally and enter cerebellum.
a. C1-T1, ipsilaterally
b. T12-L5, contralaterally
c. T1-L2, ipsilaterally
d. L1-L5, contralaterally
36. Where do the fibers of the ventral spinocerebllar tract enter the cerebellum?
a. Superior cerebellar peduncle
b. Inferior cerebellar peduncle
c. None of the above
37. The ventral spinocerebellar tract ultimately ends up on the ___________ side to
that of the origin.
a. Ipsilateral
b. Contralateral
c. All of the above
38. 75-90% of the pyramidal tract decussate at the caudal medulla and enter
____________lateral corticospinal tract.
a. Ipsilateral
b. Contralateral
c. All of the above
39. This tract receives impulses from pain and thermal:
a. Dorsal columns
b. Spinothalmic tract
c. Spinocerebellar trat
d. Corticospinal tract
40. This tract receives impulses for control of voluntary, discrete, skilled
movements:
a. Dorsal columns
b. Spinothalmic tract
c. Spinocerebellar trat
d. Corticospinal tract, neurons from this tract arise from cell bodies in
cerebral cortex and will leave cerebral hemispheres by passing
through corona radiate to enter crus cerebri of midbrain and in the
medulla they form 2 columns on ventral surface called pyramids
41. This tract receives impulses for proprioception and discriminative touch:
a. Dorsal columns
b. Spinothalmic tract
c. Spinocerebellar trat
d. Corticospinal tract
42. This tract receives impulses for control of posture and coordination of
movement:
a. Dorsal columns
b. Spinothalmic tract
c. Spinocerebellar trat
d. Corticospinal tract
43. Which of the following is the correct order of travel for the internal carotid
artery (ICA)?
a. Common carotid a., branches at neck and face, cavernous sinus,
cranium via carotid canal
b. Common carotid a., neck and face w/out branches, cranium via
carotid canal, cavernous sinus with hypophysial branches
c. Common carotid a., neck and face w/out branches, cavernous sinus,
cranium via carotid canal
d. Common carotid a., branches of neck and face, cranium via carotid
canal, cavernous sinus with hypophysial branches
44. After leaving the final order in the above question, it then terminates by
bifurcating as:
a. Anterior cerebral arteries
b. Middle cerebral arteries
c. Posterior cerebral arteries
d. A and B
e. B and C
45. This artery is branch of the ICA and passes caudally and laterally to supply
the optic tract, choroid plexus, and thalamus:
a. Ophthalmic a.
b. Anterior cerebral a.
c. Middle cerebral a.
d. Posterior communicating a.
e. Anterior choroidal a.
46. This artery is branch of the ICA and is often a direct continuation of the ICA.
It will enter the lateral fissure of Sylvius and supplies deep structures of
diencephalon and telencephalon. Distal branches of this artery supplies
lateral surface of cerebral hemisphere.
a. Ophthalmic a.
b. Anterior cerebral a.
c. Middle cerebral a.
d. Posterior communicating a.
e. Anterior choroidal a.
47. This artery is branch of the ICA is found immediately after ICA enters the
subarachnoid space and supplies the eye:
a. Ophthalmic a.
b. Anterior cerebral a.
c. Middle cerebral a.
d. Posterior communicating a.
e. Anterior choroidal a.
48. This artery is branch of the ICA and passes posteriorly and inferior to the
optic tract and anastomoses with the posterior cerebral a. The site where it
originates from the internal carotid a. is a common site for an aneurysm.
a. Ophthalmic a.
b. Anterior cerebral a.
c. Middle cerebral a.
d. Posterior communicating a.
e. Anterior choroidal a.
49. This artery is branch of the ICA and courses above the optic nerve, is joined
with it’s counterpart via the anterior communicating a. and occupies the
midline are of the cerebral hemisphere.
a. Ophthalmic a.
b. Anterior cerebral a.
c. Middle cerebral a.
d. Posterior communicating a.
e. Anterior choroidal a.
50. What is the correct sequence for the vertebral artery:
a. Transverse foramen of vertebral column, subclavian a., foramen
magnum, ventrolateral surface of medulla and unites with
counterpart to form basillary a. at pons
b. Subclavian a., Transverse foramen of vertebral column, foramen
magnum, ventrolateral surface of medulla and unites with
counterpart to form basillary a. at pons
c. Common carotid a., Transverse foramen of vertebral column, foramen
magnum, ventrolateral surface of medulla and unites with
counterpart to form basillary a. at pons
d. Transverse foramen of vertebral column, common carotid a., foramen
magnum, ventrolateral surface of medulla and unites with
counterpart to form basillary a. at pons
51. Which of the following is a branch of the vertebral artery?
a. Posterior inferior cerebellar a.
b. Anterior inferior cerebellar a. = a branch of the basilary a.
c. Posterior spinal a.
d. Anterior spinal a.
e. A, C, and D
f. All of the above
52. Which of the following is the largest branch of the vertebral artery that
supplies the posterior and inferior cerebellum, choroid plexus of 4th
ventricle, and dorsolateral medulla?
a. Posterior inferior cerebellar a.
b. Anterior inferior cerebellar a.
c. Posterior spinal a.
d. Anterior spinal a.
e. A, C, and D
f. All of the above
53. Which of the following supplies the dorsal horns and posterior funiculi and is
a branch of the vertebral artery?
a. Posterior inferior cerebellar a.
b. Anterior inferior cerebellar a.
c. Posterior spinal a.
d. Anterior spinal a.
e. A, C, and D
f. All of the above
54. Which of the following runs in the ventral median fissure to supply the
anterior 2/3 of the spinal cord, and blood flow in this artery is reinforced by
the radicular a.?
a. Posterior inferior cerebellar a.
b. Anterior inferior cerebellar a.
c. Posterior spinal a.
d. Anterior spinal a.
e. A, C, and D
f. All of the above
55. This branch of the basilar a. constitutes many small branches around the
pons:
a. Anterior inferior cerebellar a.
b. Labyrinthine a.
c. Pontine a.
d. Superior cerebellar a.
e. Posterior inferior cerebellar a.
f. Posterior cerebral a.
56. This branch of the basilar a. is the terminal branch of this artery and runs
laterally around the midbrain:
a. Anterior inferior cerebellar a.
b. Labyrinthine a.
c. Pontine a.
d. Superior cerebellar a.
e. Posterior inferior cerebellar a.
f. Posterior cerebral a.
57. This branch of the basilar a. supplies the lateral caudal pons and anterior and
inferior aspects of the cerebellum:
a. Anterior inferior cerebellar a.
b. Labyrinthine a.
c. Pontine a.
d. Superior cerebellar a.
e. Posterior inferior cerebellar a.
f. Posterior cerebral a.
58. This branch of the basilar a. supplies the latereal rostral pons and caudal
midbrain, and the superior cerebellum:
a. Anterior inferior cerebellar a.
b. Labyrinthine a.
c. Pontine a.
d. Superior cerebellar a.
e. Posterior inferior cerebellar a.
f. Posterior cerebral a.
59. This branch of the basilar a. is sometimes a branch of the anterior inferior
cerebellar a. and supplies the ear. It can sometimes cause vertigo and
ipsilateral deafness if occluded.
a. Anterior inferior cerebellar a.
b. Labyrinthine a.
c. Pontine a.
d. Superior cerebellar a.
e. Posterior inferior cerebellar a.
f. Posterior cerebral a.
60. A patient comes into the ED who was just in a MVA and has a falling BP. You
can expect that the blood flow to the watershed zones of the brain (the space
between terminal branches of adjacent a.) will have the highest likely hood of
sustaining damage.
a. True
b. False
61. This cerebral vein drains the lateral aspect of the cerebral cortex and
subcortical white matter. It drains into the superior of inferior sagittal
venous dural sinuses.
a. Deep cerebral veins
b. Superficial cerebral veins
c. Both of the above
d. None of the above
62. This cerebral vein drains the internal structures of the hemisphere such as
the choroid plexuses, basal ganglia, periventricular regions, diencephalons
and will drain into the straight dural venous sinus.
a. Deep cerebral veins
b. Superficial cerebral veins
c. Both of the above
d. None of the above
63. Disagreeable sensations produced by non-noxious stimuli:
a. Anesthesia
b. Hypesthesia
c. Hyperesthesia
d. Paresthesia
e. Dyesthesia
64. Partial loss of touch sensation:
a. Anesthesia
b. Hypesthesia
c. Hyperesthesia
d. Paresthesia
e. Dyesthesia
65. Complete loss of touch sensation:
a. Anesthesia (dorsal column)
b. Hypesthesia
c. Hyperesthesia
d. Paresthesia
e. Dyesthesia
66. Spontaneous sensations like pins and needles:
a. Anesthesia
b. Hypesthesia
c. Hyperesthesia
d. Paresthesia
e. Dyesthesia
67. Abnormal sensitivity to touch sensations:
a. Anesthesia
b. Hypesthesia
c. Hyperesthesia
d. Paresthesia
e. Dyesthesia
68. Shooting pain in dermatomal distributions:
a. Analgesia
b. Hypalgesia
c. Hyperalgesia
d. Radicular pain (spinal nerves)
e. Causalgia
69. Complete less of pain appreciation:
a. Analgesia (spinothalamic tract)
b. Hypalgesia
c. Hyperalgesia
d. Radicular pain
e. Causalgia
70. Burning pain that radiates from site of trauma:
a. Analgesia
b. Hypalgesia
c. Hyperalgesia
d. Radicular pain
e. Causalgia
71. Partial loss of pain appreciation:
a. Analgesia
b. Hypalgesia
c. Hyperalgesia
d. Radicular pain
e. Causalgia
72. Abnormal sensitivity of pain appreciation:
a. Analgesia
b. Hypalgesia
c. Hyperalgesia
d. Radicular pain
e. Causalgia
73. A patient presents to your clinic with a hemi-transection at C8 spinal cord
level. He has a loss of pain and temperature on his right and a loss of
vibration and proprioception on the _________.
a. Right
b. Left
c. Both sides
74. The above question can be associated with Brown-Sequard Syndrome and is
__________.
a. ALS System lesion
b. Dissociated sensory loss
c. DC-ML system lesions
d. Trigeminal system lesions
e. Spinal (neural shock)
75. A patient presents with a unilateral dorsal column lesion at T7. Where will
this patient have sensory loss?
a. At and below T7, ipsilaterally
b. At and below T7, contralaterally
c. At and above T7, ipsilaterally
d. At and above T7, contralaterally
76. A patient presents with a unilateral medial lemniscus lesion. What would the
type of loss?
a. Ipsilateral
b. Contralateral, by this point the DC has already decussated
77. You ask the patient the patient in the above question to close their eyes and
you put a vibrating fork on their left forearm. They were unable to accurately
tell you the kind or location of the vibration. What side of the brain did the
lesion occur at?
a. Right
b. Left
c. Both
78. You ask the above patient to then stand up and close their eyes. They
immediately start to sway. The patient then steps forward to catch himself
but still ends up falling (you were there, though, he was fine). Was this a
positive Romberg sign for ad DC-ML system lesion?
a. Yes
b. No
c. Not enough information
79. A patient presents to your clinic and you are concerned about a DC-ML
system lesion. You ask the patient to close her eyes and you place a penny in
her hand and ask her to distinguish the type of coin it is. She is unable to do
so. What does she have?
a. Agraphesthesia
b. Astereognosis
c. Extinction phenomenon
80. What type of lesion does the patient in the above question have?
a. Unilateral dorsal column lesion
b. Unilateral dorsal column nuclei lesion
c. Unilateral medial lemniscus, VPL, internal capsule, or Area 3,1,2 lesion
d. Superior parietal lobule lesion
81. Can a patient have a DC-ML system lesion even if the primary somatosensory
cortex is intact?
a. Yes
b. No
82. A patient presents with a loss of pain and temperature at the umbilicus. What
would be the spinal cord level lesion?
a. T8, ipsilateral
b. T8, contralateral
c. T12, ipsiltareal
d. T12, contralateral
83. What type of lesion is this?
a. ALS System lesion
b. Dissociated sensory loss
c. DC-ML system lesions
d. Trigeminal system lesions
e. Spinal (neural shock)
84. What type of specific lesion of the above general lesion would a patient have
initial loss of all sensations including pain, but pain sensations may recover
over time. Dyesthesias (spontaneous, burning sensations)can develop and
can be referred as thalamic pain syndrome. No touch is recovered though.
What is this lesion?
a. Unilateral spinal cord lesion
b. Unilateral brainstem lesion
c. Unilateral VPL, internal capsule or Area 3,1,2 lesion
d. Unilateral thalamic (VPL) lesion
85. The spinal (neural) shock triad is flaccid paralysis, areflexia, and hypotension
a. True
b. False