Waxman Questions

A 68-year-old teacher with hypertension complained of a severe headache and was taken to the hospital. Examination revealed that he could write normally but could not read. His speech was normal. In the patient-

1. the left anterior cerebral artery was probably involved

2. there was probably a right homonymous hemianopia

3. the left middle cerebral artery was probably involved

4. the left posterior cerebral artery was probably involved

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

C. 2 and 4 are correct

Within the internal capsule, descending motor fibers for the face-

A. are located in front of fibers for the arm, in the anterior part of the anterior limb

B. are located posterior to the fibers for the leg, in the posterior half of the posterior limb

C. are located in front of the fibers for the arm, in the anterior part of the posterior limb

D. travel within the corticovestibular tract

E. synapse in the capsular nucleus

C. are located in front of the fibers for the arm, in the anterior part of the posterior limb

The dorsal nucleus (of Clarke) in the spinal cord-

A. receives contralateral input from dorsal root ganglia

B. terminates at the L2 segment

C. terminates in the midbrain

D. terminates in the ipsilateral cerebellum

E. receives fibers from the external cuneate nucleus

D. terminates in the ipsilateral cerebellum

ATP provides an essential energy source in the CNS for-

A. division of neurons

B. maintenance of ionic gradients via ATPase

C. generation of action potentials

D. EPSPs and IPSPs

B. maintenance of ionic gradients via ATPase

The equilibrium potential for K+ in neurons is ordinarily nearest-

A. the equilibrium potential for Na+

B. resting potential

C. reversal potential for the EPSP

D. the peak of the action potential

B. resting potential

Structures in the ventromedial regions of the medulla receive their blood supply from the-

A. posterior spinal and superior cerebellar arteries

B. vertebral and anterior spinal arteries

C. posterior spinal and posterior cerebral arteries

D. posterior spinal and posterior inferior cerebellar arteries

E. posterior and anterior inferior cerebellar arteries

B. vertebral and anterior spinal arteries

Examination of a patient revealed a drooping left eyelid, together with weakness of adduction and elevation of the left eye, loss of the pupillary light reflex in the left eye, and weakness of the limbs and lower facial muscles on the right side. A single lesion most likely to produce all these signs would be located in the-

A. medial region of the left pontomedullary junction

B. basomedial region of the left cerebral peduncle

C. superior region of the left mesencephalon

D. dorsolateral region of the medulla on the left side

E. periaqueductal gray matter on the left side

B. basomedial region of the left cerebral peduncle

Lesions of the cerebral cortex on one side can result in a deficit in muscles innervated by the-

1. contralateral spinal motor neurons

2. ipsilateral spinal motor neurons

3. contralateral facial (VII) nerve

4. ipsilateral facial (VII) nerve

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

The basic neuronal signaling unit is-

A. the equilibrium potential

B. the action potential

C. the resting potential

D. the supernormal period

B. the action potential

Astrocytes-

1. may function to buffer extracellular K+

2. are interconnected by gap junctions

3. can proliferate to form a scar after an injury

4. migrate to the CNS from bone marrow

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

The lateral column of the spinal cord contains the-

A. lateral corticospinal tract

B. direct corticospinal tract

C. Lissauer's tract

D. gracile tract

A. lateral corticospinal tract

Destruction of the lower cervical and upper thoracic ventral roots on the left side leads to-

1. dilated right pupil

2. constricted right pupil

3. dilated left pupil

4. constricted left pupil

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

D. only 4 is correct

Cortical area 17-

1. is also termed the striate cortex

2. is involved in the processing of auditory stimuli

3. receives input from the lateral geniculate body

4. receives input from the medial geniculate body

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

The myelin sheath is-

1. produced within the CNS by oligodendrocytes

2. produced within the peripheral nervous system by Schwann cells

3. interrupted periodically by the nodes of Ranvier

4. composed of spirally wrapped plasma membrane

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

E. all are correct

In axoplasmic transport-

1. some macromolecules move away from the cell body at rates of several centimeters per day

2. mitochondria move along the axon

3. microtubules seem to be involved

4. some types of molecules move toward the cell body at rates of up to 300 mm per day

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

E. all are correct

Within the cerebellum-

1. climbing fibers and mossy fibers carry afferent information

2. Purkinje cells provide the primary output from the cerebellar cortex

3. Purkinje cells project to the ipsilateral deep cerebellar nuclei

4. efferents from the deep cerebellar nuclei project to the contralateral red nucleus and thalamic nuclei

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

E. all are correct

The ventroposterior medial nucleus of the thalamus-

1. receives axons from neurons located in the contralateral cuneate nucleus in the medulla

2. receives axons from neurons located in area 4 on the medial surface of the ipsilateral cerebral hemisphere

3. contains neurons that respond to olfactory stimuli applied ipsilaterally

4. contains neurons whose axons project to the somatosensory cortex of the ipsilateral cerebral hemisphere

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

D. only 4 is correct

The cerebrum consists of the-

A. thalamus and basal ganglia

B. telencephalon and midbrain

C. telencephalon and diencephalon

D. brain stem and prosencephalon

E. cerebellum and prosencephalon

C. telencephalon and diencephalon

In a patient with hemiparkinsonism (unilateral Parkinson's disease) affecting the right arm, a lesion is most likely in the-

A. right subthalamic nucleus

B. left subthalamic nucleus

C. right substantia nigra

D. left substantia nigra

E. right globus pallidus

D. left substantia nigra

The dorsal column system of one side of the spinal cord-

1. is essential for normal two-point discrimination on that side

2. arises from both dorsal root ganglion cells and dorsal horn neurons

3. synapses on neurons of the ipsilateral gracile and cuneate nuclei

4. consists primarily of large, myelinated, rapidly conducting axons

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

E. all are correct

Auditory stimuli normally cause impulses to pass through the-

1. trapezoid body

2. inferior olivary nucleus

3. medial geniculate nucleus

4. medial lemniscus

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

The spinal subarachnoid space normally-

A. lies between the pachymeninx and the arachnoid

B. lies between the pia and the arachnoid

C. ends at the cauda equina

D. communicates with the peritoneal space

E. is adjacent to the vertebrae

B. lies between the pia and the arachnoid

A ganglion is defined as a-

1. part of the basal ganglia

2. group of nerve cell bodies within the hypothalamus

3. layer of similar cells in the cerebral cortex

4. group of nerve cell bodies outside the neuraxis

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

D. only 4 is correct

Neurotransmitters found in the brain stem include-

1. acetylcholine

2. norepinephrine

3. dopamine

4. serotonin

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

E. all are correct

The fibers carrying information from the spinal cord to the cerebellum-

1. can arise from Clarke's column cells (dorsal nucleus)

2. represent the contralateral body half in the dorsal spinocerebellar tract

3. can arise from cells of the external cuneate nucleus

4. are important elements in the conscious sensation of joint position

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

In a stroke affecting the territory of the middle cerebral artery-

A. weakness and sensory loss are most severe in the contralateral leg

B. weakness and sensory loss are most severe in the contralateral face and arm

C. weakness and sensory loss are most severe in the ipsilateral leg

D. weakness and sensory loss are most severe in the ipsilateral face and arm

E. akinetic mutism is often seen

B. weakness and sensory loss are most severe in the contralateral face and arm

The following are correct-

1. the diaphragm is innervated via the C3 and C4 roots

2. the deltoid and triceps are innervated via the C5 root

3. the biceps are innervated via the C5 root

4. the gastrocnemius is innervated via the L4 root

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

The hippocampal formation consists of the-

A. dentate gyrus

B. hippocampus

C. subiculum

D. all of the above

D. all of the above

The solitary nucleus-

1. serves visceral functions, none of which are consciously perceived

2. gives rise to preganglionic parasympathetic axons

3. mediates pain arising from the heart during myocardial ischemia

4. receives axons running with nerve VII

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

D. only 4 is correct

Axons in the spinothalamic tract-

1. carry information about pain and temperature (lateral spinothalamic tract) and light touch (anterior spinothalamic tract)

2. carry information about pain (lateral spinothalamic tract) and temperature (anterior spinothalamic tract)

3. decussate within the spinal cord, within one or two segments of their origin

4. synapse in the gracile and cuneate nuclei

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

The corticospinal tract passes through-

1. the internal capsule

2. the crus cerebri

3. the pyramids of the medulla

4. the lateral and anterior columns of the spinal cord

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

E. all are correct

The peripheral nervous system-

A. includes the spinal cord

B. is sheathed in fluid-filled spaces enclosed by membranes

C. includes cranial nerves

D. does not include spinal nerves

E. is surrounded by bone

C. includes cranial nerves

The efferent axons of the cerebellar cortex arise from-

A. Golgi cells

B. vestigial nucleus cells

C. granule cells

D. Purkinje cells

E. pyramidal cells

D. Purkinje cells

The homunculus in the motor cortex-

1. contains magnified representations of the face and hand

2. represents the face highest on the convexity of the hemisphere

3. is located largely within the territory of the middle cerebral artery

4. gives rise to all of the axons that descend as the corticospinal tract

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

Decussations are-

1. aggregates of tracts

2. fiber bundles in a spinal nerve

3. horizontal connections crossing within the CNS from the dominant to nondominant side

4. vertical connections crossing within the CNS from left to right or vice versa

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

D. only 4 is correct

Alzheimer's disease is characterized by-

1. neurofibrillary tangles

2. loss of neurons in the basal forebrain (Meynert) nucleus

3. senile plaques

4. severe pathology in CA1

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

E. all are correct

Brodmann's area 4 corresponds to the-

A. primary motor cortex

B. premotor cortex

C. Broca's area

D. primary sensory cortex

E. striate cortex

A. primary motor cortex

Which of the following statements about the globus pallidus is not true?

A. it is located adjacent to the internal capsule

B. it receives excitatory axons from the caudate and putamen

C. it is the major outflow nucleus of the corpus striatum

D. it sends inhibitory axons to the thalamus

B. it receives excitatory axons from the caudate and putamen

The intermediolateral gray column-

1. contains preganglionic neurons for the autonomic nervous system

2. is prominent in the thoracic region

3. is prominent in upper lumbar regions

4. is prominent in cervical regions

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

Large-diameter dorsal root axons of one side of L5 terminate in the-

1. marginal layer of the ipsilateral dorsal horn

2. ipsilateral gracile nucleus

3. ipsilateral cuneate nucleus

4. ipsilateral dorsal nucleus (of Clarke)

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

C. 2 and 4 are correct

A healthy 25-year-old man had an episode of blurred vision in the left eye that lasted 2 weeks and then resolved. Six months later he developed difficulty walking. Examination showed decreased visual acuity in the left eye, nystagmus, loss of vibratory sensation and position sense at the toes and knees bilaterally, and hyperactive deep tendon reflexes with a Babinski reflex on the right. Three years later, the man was admitted to the hospital with dysarthria, intention tremor of the left arm, and urinary incontinence. The clinical features are consistent with-

1. myasthenia gravis

2. a series of strokes

3. a cerebellar tumor

4. multiple sclerosis

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

D. only 4 is correct

The cell body of most neurons-

1. cannot divide in the adult

2. is the main site of protein synthesis in the neuron

3. is the site of the cell nucleus

4. contains synaptic vesicles

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

Glutamate-

1. is the transmitter at the neuromuscular junction

2. may be involved in excitotoxicity

3. is a major inhibitory transmitter in the CNS

4. is a major excitatory transmitter in the CNS

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

C. 2 and 4 are correct

Pain sensation-

1. is carried in large myelinated (A-alpha) axons

2. is carried by small myelinated and unmyelinated (A-delta and C) axons

3. is carried upward in the dorsal columns of the spinal cord

4. is carried upward in the spinothalamic tract and spinoreticulothalamic system

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

C. 2 and 4 are correct

Complex cells in the visual cortex have receptive fields that-

A. are smaller than the receptive fields of simple cells

B. respond to lines or edges with a specific orientation, only when presented at one location in the visual field

C. respond to lines or edges with a specific orientation, presented anywhere within the visual field

D. contain "on" or "off" centers

C. respond to lines or edges with a specific orientation, presented anywhere within the visual field

Myelin is produced by-

A. oligodendrocytes in the CNS and Schwann cells in the PNS

B. Schwann cells in the CNS and oligodendrocytes in the PNS

C. oligodendrocytes in both CNS and PNS

D. Schwann cells in both CNS and PNS

A. oligodendrocytes in the CNS and Schwann cells in the PNS

The striatum includes-

1. the caudate nucleus

2. the globus pallidus

3. the putamen

4. the substantia nigra

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

Second-order neurons in the dorsal column system-

1. convey information about pain and temperature

2. cross within the lemniscal decussation

3. cross within the pyramidal decussation

4. convey well-localized sensations of fine touch, vibration, two-point discrimination, and proprioception

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

D. only 4 is correct

In humans, the spinothalamic tract-

1. carries information from the ipsilateral side of the body

2. exhibits topographic organization

3. arises principally from neurons of the same side of the cord

4. mediates information about pain and temperature

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

C. 2 and 4 are correct

Parasympathetic fibers are carried in-

1. cranial nerves III and VII

2. cranial nerves IX and X

3. sacral roots S2-4

4. thoracic roots T8-12

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

Axons in the optic nerve originate from-

A. rods and cones

B. retinal ganglion cells

C. amacrine cells

D. all of the above

B. retinal ganglion cells

The following fiber systems in the spinal cord are ascending tracts except for the-

A. cuneate tract

B. ventral spinocerebellar tract

C. spinothalamic tract

D. spinoreticular tract

E. reticulospinal tract

E. reticulospinal tract

The principal neurotransmitter(s) released by synaptic terminals of sympathetic axons is/are-

1. epinephrine

2. norepinephrine

3. acetylcholine

4. gamma-aminobutyric acid

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

Signs of upper-motor-neuron lesions include-

1. Babinski's sign

2. hypoactive deep tendon reflexes and hyporeflexia

3. spastic paralysis

4. severe muscle atrophy

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

The brain stem includes-

1. the midbrain (mesencephalon)

2. pons

3. medulla oblongata

4. telencephalon

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

The long-term consequences of a left hemisection of the spinal cord at midthoracic level would include-

1. loss of voluntary movement of the left leg

2. loss of pain and temperature sensation in the right leg

3. diminished position and vibration sense in the left leg

4. diminished deep tendon reflexes in the left leg

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

Na, K-ATPase-

1. utilizes ATP

2. acts as an ion pump

3. maintains the gradients of Na+ and K+ ions across neuronal membranes

4. consumes more than 25% of cerebral energy production

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

E. all are correct

Norepinephrine is found in the-

1. sympathetic nervous trunk

2. locus ceruleus

3. lateral tegmentum of the midbrain

4. neuromuscular junction

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

The dorsal spinocerebellar tract-

1. arises in the dorsal nucleus of Clarke and, above C8, in the accessory cuneate nucleus

2. carries information arising in the muscle spindles, Golgi tendon organs, touch and pressure receptors

3. ascends to terminate in the cerebellar cortex

4. projects without synapses to the basal ganglia and cerebellum

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

Gamma-efferent motor neurons-

1. are located in the intermedial lateral cell column of the spinal cord

2. cause contraction of intrafusal muscle fibers

3. provide vasomotor control to blood vessels in muscles

4. are modulated by axons in the vestibulospinal tract

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

C. 2 and 4 are correct

The trigeminal nuclear complex-

1. has somatic afferent components

2. participates in certain reflex responses of cranial muscles

3. has a branchial efferent component

4. receives projections of axons coursing with nerve X

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

Meyer's loop carries optic radiation fibers representing-

A. the upper part of the contralateral visual field

B. the lower part of the contralateral visual field

C. the upper part of the ipsilateral visual field

D. the lower part of the ipsilateral visual field

A. the upper part of the contralateral visual field

A-delta and C peripheral afferent fibers-

1. terminate in laminas I and II of the dorsal horn

2. convey the sensation of pain

3. terminate in lamina V of the dorsal horn

4. convey the sensation of light touch

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

The neurotransmitter dopamine-

1. is produced by neurons that project from the substantia nigra to the caudate and putamen

2. mediates transmission at the neuromuscular junction

3. is depleted in Parkinson's disease

4. is the major excitatory transmitter in the CNS

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

Axon pathways that decussate before they terminate include the-

1. optic nerve (II) fibers from the temporal halves of the two retinas

2. gracile fasciculus

3. cuneate fasciculus

4. olivocerebellar fibers

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

D. only 4 is correct

Axons in the spinothalamic tracts decussate-

A. in the medullary decussation

B. in the medullary lemniscus

C. within the spinal cord, five to six segments above the level where they enter

D. within the spinal cord, within one to two segments of the level where they enter

E. in the medial lemniscus

D. within the spinal cord, within one to two segments of the level where they enter

A spinal motor neuron in an adult-

1. maintains its membrane potential via the active transport of sodium and potassium ions

2. synthesizes protein only in the cell body and not in the axon

3. does not synthesize DNA for mitosis

4. does not regenerate its axon following section of its peripheral portion

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

The spinal nerve roots-

1. exit below the corresponding vertebral bodies in the cervical spine

2. exit above the corresponding vertebral bodies in the cervical spine

3. exit above the corresponding vertebral bodies in the lower spine

4. exit below the corresponding vertebral bodies in the lower spine

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

C. 2 and 4 are correct

A lesion in the nucleus of cranial nerve IV would produce a deficit in the-

A. upward gaze of the ipsilateral eye

B. upward gaze of the contralateral eye

C. downward gaze of the contralateral eye

D. downward gaze of the ipsilateral eye

D. downward gaze of the ipsilateral eye

A 68-year-old teacher with hypertension complained of a severe headache and was taken to the hospital. Examination revealed that he could write normally but could not read. His speech was normal. The lesion(s) most likely involved the-

1. corpus callosum

2. Broca's area

3. left visual cortex

4. left angular gyrus

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

Fine-diameter dorsal root axons of L5 on one side terminate in the-

1. marginal layer of the ipsilateral dorsal horn

2. ipsilateral substantia gelatinosa

3. ipsilateral lamina V of the dorsal horn

4. ipsilateral dorsal nucleus (of Clarke)

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

The vagus (X) nerve contains-

1. visceral afferent fibers

2. visceral efferent fibers

3. branchial efferent fibers

4. somatic efferent fibers

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

The Klüver-Bucy syndrome-

1. is characterized by hyperorality and hypersexuality

2. is characterized by psychic blindness and personality changes

3. is seen in patients with bilateral temporal lobe lesions

4. is seen in patients with lesions of the anterior thalamus

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

Sensory input for taste is carried by-

A. the vestibulocochlear (VIII) nerve

B. the facial (VII) nerve for the entire tongue

C. the facial (VII) and glossopharyngeal (IX) nerves for the anterior two-thirds and posterior one-third of the tongue, respectively

D. the glossopharyngeal (IX) and vagus (X) nerves for the anterior two-thirds and posterior one-third of the tongue, respectively

C. the facial (VII) and glossopharyngeal (IX) nerves for the anterior two-thirds and posterior one-third of the tongue, respectively

The extrastriate cortex-

1. is Brodmann's areas 18 and 19

2. receives input from area 17

3. is the visual association cortex

4. is the primary auditory cortex

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

Inhibitory transmitters in the CNS include-

1. glutamate (presynaptic inhibition)

2. GABA (presynaptic inhibition)

3. glutamate (postsynaptic inhibition)

4. GABA (postsynaptic inhibition)

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

C. 2 and 4 are correct

Most synaptic terminals of axons that form chemical synapses in the CNS contain-

1. synaptic vesicles

2. presynaptic densities

3. neurotransmitter(s)

4. rough endoplasmic reticulum

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

A. 1, 2, and 3 are correct

A sign of an upper-motor-neuron lesion in the spinal cord is-

A. severe muscle atrophy

B. hyperactive deep tendon reflexes

C. flaccid paralysis

D. absence of pathologic reflexes

E. absence of withdrawal responses

B. hyperactive deep tendon reflexes

In central facial paralysis resulting from damage of the facial (VII) nucleus there is-

A. paralysis of all ipsilateral facial muscles

B. paralysis of all contralateral facial muscles

C. paralysis of ipsilateral facial muscles except the buccinator

D. paralysis of all contralateral muscles except the buccinator

E. paralysis of contralateral facial muscles except the frontalis and orbicularis oculi

E. paralysis of contralateral facial muscles except the frontalis and orbicularis oculi

Generation of the action potential-

A. depends on depolarization caused by the opening of K+ channels

B. depends on hyperpolarization caused by the opening of K+ channels

C. depends on depolarization caused by the opening of Na+ channels

D. depends on hyperpolarization caused by the opening of Na+ channels

E. depends on second messengers

C. depends on depolarization caused by the opening of Na+ channels

After transection of the peripheral nerve, the-

1. axons and Schwann cells distal to the cut undergo degeneration and disappear

2. sensory axons distal to the cut survive, but motor axons degenerate

3. motor neurons whose axons were cut degenerate and disappear

4. surviving axons of the proximal stump will send out new growth cones to attempt regeneration

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

D. only 4 is correct

The following rules about dermatomes are correct-

1. the C4 and T2 dermatomes are contiguous over the anterior trunk

2. the nipple is at the level of C8

3. the thumb, middle finger, and 5th digit are within the C6, C7, and C8 dermatomes, respectively

4. the umbilicus is at the level of L2

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

Hemiplegia and sensory deficit on the right side of the body may be caused by infarction in the territory of the-

A. left middle cerebral artery

B. right anterior cerebral artery

C. left posterior cerebral artery

D. left superior cerebellar artery

E. anterior communicating artery

A. left middle cerebral artery

In a motor neuron at rest, an excitatory synapse produces an EPSP of 15 mV, and an inhibitory synapse produces an IPSP of 5 mV. If both the EPSP and IPSP occur simultaneously, then the motor neuron would-

A. depolarize by about 10 mV

B. depolarize by 20 mV

C. depolarize by more than 20 mV

D. change its potential by less than 1 mV

A. depolarize by about 10 mV

A lesion of the right frontal cortex (area 8) produces-

A. double vision (diplopia)

B. impaired gaze to the right

C. impaired gaze to the left

D. dilated pupils

E. no disturbances of the ocular motor system

C. impaired gaze to the left

Wernicke's aphasia is usually caused by-

A. a lesion in the superior temporal gyrus

B. a lesion in the inferior temporal gyrus

C. a lesion in the inferior frontal gyrus of the dominant hemisphere

D. lesions in the midbrain

E. alcohol abuse

A. a lesion in the superior temporal gyrus

The optic chiasm-

1. is located close to the pineal and is often compressed by pineal tumors

2. is located close to the pituitary and is often compressed by pituitary tumors

3. contains decussating axons that arise in the temporal halves of the retinas

4. contains decussating axons that arise in the nasal halves of the retinas

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

C. 2 and 4 are correct

Which of the following is not part of the Papez circuit?

A. hippocampus

B. mamillary bodies

C. posterior thalamic nuclei

D. cingulate gyrus

E. parahippocampal gyrus

C. posterior thalamic nuclei

If the oculomotor nerve (III) is sectioned, each of the following may result except for-

A. partial ptosis

B. abduction of the eyeball

C. dilation of the pupil

D. impairment of lacrimal secretion

E. paralysis of the ciliary muscle

D. impairment of lacrimal secretion

The somatic nervous system innervates the-

A. blood vessels of the skin

B. blood vessels of the brain

C. muscles of the heart

D. muscles of the body wall

E. muscles of the viscera

D. muscles of the body wall

A 55-year-old patient presented with an 8-month history of gradually progressive incoordination in the right arm and leg. Examination revealed hypotonia and ataxia in the limbs on the right side. The most likely diagnosis is-

1. a stroke

2. a tumor

3. in the left cerebellar hemisphere

4. in the right cerebellar hemisphere

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

C. 2 and 4 are correct

Sensory nuclei of the thalamus include-

1. lateral geniculate

2. superior geniculate

3. ventral posterior, lateral

4. ventral anterior

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

Which of the following statements about the auditory system is not true?

A. the lateral lemniscus carries information from both ears

B. it has a major synaptic delay in the midbrain

C. it has a major synaptic delay in the thalamus

D. it has a major synaptic delay in the inferior olivary nucleus

E. crossing fibers pass through the trapezoid body

D. it has a major synaptic delay in the inferior olivary nucleus

The cell layer around the central canal of the spinal cord-

1. is called the ventricular zone

2. is the same as the pia

3. encloses cerebrospinal fluid

4. is called the marginal zone

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

B. 1 and 3 are correct

In adults-

1. there is very little myelin in the spinal cord

2. the dorsal columns and lateral columns are heavily myelinated

3. the spinal cord terminates at the level of the S5 vertebrae

4. the spinal cord terminates at the level of the L1 or L2 vertebra

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

C. 2 and 4 are correct

In a patient with a missile wound involving the left cerebral hemisphere, the following might be expected-

1. dense neglect of stimuli on the left side

2. hemiplegia involving the right arm and leg

3. hemiplegia involving the left arm and leg

4. aphasia

A. 1, 2, and 3 are correct

B. 1 and 3 are correct

C. 2 and 4 are correct

D. only 4 is correct

E. all are correct

C. 2 and 4 are correct

A neurologic syndrome is characterized by loss of pain and thermosensitivity on the left side of the face and on the right side of the body from the neck down; partial paralysis of the soft palate, larynx, and pharynx on the left side; ataxia on the left side; and hiccuping. This syndrome could be expected from infarction in the territory of the-

A. basilar artery

B. right posterior inferior cerebellar artery

C. left posterior inferior cerebellar artery

D. right superior cerebellar artery

E. left superior cerebellar artery

C. left posterior inferior cerebellar artery

The subclavian artery gives rise directly to the-

A. lumbar radicular artery

B. great ventral radicular artery

C. anterior spinal artery

D. vertebral artery

D. vertebral artery

A patient complains of unsteadiness. Examination shows a marked diminution of position sense, vibration sense, and stereognosis of all extremities. He is unable to stand without wavering for more than a few seconds when his eyes are closed. There are no other abnormal findings. The lesion most likely involves the-

A. lateral columns of the spinal cord, bilaterally

B. inferior cerebellar peduncles, bilaterally

C. dorsal columns of the spinal cord, bilaterally

D. spinothalamic tracts, bilaterally

E. corticospinal tracts

C. dorsal columns of the spinal cord, bilaterally

A 54-year-old accountant, who worked until the day of his illness, was found on the floor, with a right hemiparesis (arm and face more severely affected than the leg) and severe aphasia. The diagnosis is most likely-

A. a tumor involving the thalamus on the left

B. a large tumor of the left cerebral hemisphere

C. a stroke involving the right middle cerebral territory

D. a stroke involving the right anterior cerebral territory

E. a stroke involving the left middle cerebral territory

F. a stroke involving the left anterior cerebral territory

E. a stroke involving the left middle cerebral territory