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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