Medulla and Cerebellum Quiz

A 70-year old man with a history of hypertension went to work and had sudden onset of nausea and vomiting. He was taken to ER, where his exam was notable for slurred speech, dysmetria on finger-to-nose testing on the left side. His gait was normal. Where is the lesion?

Select one:

a. cerebellar vermis

b. left cerebellar hemisphere

c. vestibular nuclei

d. right cerebellar hemisphere

b. left cerebellar hemisphere

A 45-year-old man was admitted to the hospital with a cerebellar hemorrhage. The patient exhibited an unsteady "drunk like" gait and the physician noted that he swayed while entering the examination room. Which region of the cerebellum was most likely affected by the bleed? Select one:

a. Hemisphere of the posterior lobe

b. Interposed nuclei

c. Flocculonodular lobe

d. Hemisphere of the anterior lobe

c. Flocculonodular lobe

Dysdiadokmesia refers to which of the following?

Select one:

a. Inability to control vestibulo-ocular reflexes

b. inability to control distance, power or speed of a movement

c. Inability to perform rapid alternating movements with the hands

d. Inability to stand without swaying with eyes open

c. Inability to perform rapid alternating movements with the hands

Concerning the circuitry between mossy fibers, climbing fibers and cells of the cerebellar cortex, which of the following pairs both provide excitatory input?

Select one:

a. Climbing fibers & Basket cells

b. Purkinje cells & Golgi cells

c.Mossy fibers & Purkinje cells

d.Granule cell parallel fibers & Mossy fibers

d.

Granule cell parallel fibers & Mossy fibers

As a researcher studying the circuitry of the cerebellum, which of the following nuclei do you wish to lesion if you are focusing mainly on the flocculonodular lobe circuitry of the cerebellum?

Select one:

a. Globose nucleus

b. Fastigial nucleus

c. Dentate nucleus

d. Spinal border cells

b. Fastigial nucleus

A 27-year old patient displays ataxia when asked to walk across the examination room. You ask him to stand still with his eyes closed and note marked swaying back and forth. When he opens his eyes the swaying persists. Vibration sense is normal on all four limbs. Given the clinical picture in this case, such ataxia is likely due to damage to which of the following structures?

Select one:

a. dorsal columns

b. cerebellum

c. cerebellar peduncles

d. Ventral horns of the spinal cord

b. cerebellum

Efferent axons from the dentate nucleus terminate in what thalamic nucleus and travel through what peduncle?

Select one:

a. Ventral posterolateral nucleus of the thalamus (VPL) ---superior cerebellar peduncle

b. Ventral lateral nucleus of the thalamus (VL) ---superior cerebellar peduncle

c. Ventral anterior nucleus of the thalamus (VA) ---superior cerebellar peduncle

d. Ventral anterior nucleus of the thalamus (VA) ---middle cerebellar peduncle

b. Ventral lateral nucleus of the thalamus (VL) ---superior cerebellar peduncle

As a researcher studying the circuitry of the cerebellum, which of the following nuclei do you know to be the major output neurone of the cerebellar cortex?

Select one:

a. dentate nucleus

b. Clarke's nucleus

c. Purkinje cells

d. Fastigial nucleus

c. Purkinje cells

What types of sensory endings, other than muscle spindles, convey information to the cerebellum via spinal cord tracts?

A. Golgi tendon organs.

B. Mechanoreceptors.

C. Both.

D. Neither.

C. Both

What part of the cerebellum does this artery supply?

A. Inferior surface.

B. Superior surface.

C. Tonsils.

D. Vermis.

E. Flocculonodular lobe.

B. Superior surface.

What part of the brain stem and cerebellum is NOT supplied by this artery in the posterior fossa? This angiogram is a lateral view with the rostrum to the left. The vertebral artery was injected.

A. Lateral part of medulla.

B. Tonsillar region of cerebellum.

C. Inferior surface of posterior cerebellum.

D. Inferior cerebellar peduncle.

E. Pons.

E. Pons.

What attaches the cerebellum to the brain stem?

A. Cerebral peduncles.

B. Vermis.

C. Cerebellar peduncles.

D. Tonsil.

C. Cerebellar peduncles.

Ataxia is defined as:

A. Inability to perform rapidly alternating movements.

B. Error in the range of movement.

C. Lack of continuity in the execution of movements.

D. Error in the rate, force, and direction of movement.

E. Muscle weakness.

D. Error in the rate, force, and direction of movement

Which of the following are indications of cerebellar disturbance?

A. Hypotonia.

B. Intention tremor.

C. Pendular knee jerk.

D. Scanning speech.

E. All of the above.

E. All of the above.

What are the structural and functional relations between the cerebellar cortex and the deep, or central, nuclei?

A. Deep nuclei receive input from Purkinje cells.

B. Deep nuclei receive input from mossy fibers.

C. Deep nuclei receive input from climbing fibers.

D. All of the above

D. All of the above

Where are the cell bodies of the axons that convey sensory information from this sense organ?

A. Dorsal root ganglia.

B. Intermediolateral cell column or lateral horn.

C. Clarke's nucleus (or nucleus dorsalis of Clarke).

D. Ventral horn

A. Dorsal root ganglia.

The dorsal spinocerebellar tract is contralateral to its cell bodies.

A. True.

B. False.

B. False.

How do the olivocerebellar axons terminate in the cerebellum?

A. Mossy fibers.

B. Climbing fibers.

C. Basket cell axons.

B. Climbing fibers.

These nuclei are contralateral to the cerebellar hemisphere where their axons terminate.

A. True.

B. False.

A. True

What is the afferent supply of these nuclei?

A. All areas of ipsilateral cerebral cortex.

B. All areas of contralateral cerebral cortex.

C. Contralateral precentral gyrus.

D. Ipsilateral precentral gyrus.

E. Red nucleus

A. All areas of ipsilateral cerebral cortex.

What course do the axons follow in reaching these nuclei in the pons?

A. Cortex-->internal capsule-->cerebral peduncle.

B. Cortex-->internal capsule-->red nucleus.

C. Cortex-->thalamus-->cerebellar peduncle.

D. Thalamus-->internal capsule-->cerebellar peduncle.

A. Cortex-->internal capsule-->cerebral peduncle.

What is the vascular supply of the pons?

A. Vertebral arteries.

B. Basilar artery.

C. Superior cerebellar artery.

D. Posterior inferior cerebellar artery

B. Basilar artery.

The axons in this structure terminate as mossy fibers.

A. True.

B. False.

A. True.

What is the orientation of the Purkinje cell dendrites with respect to the granule cell axons?

A. Perpendicular.

B. Parallel.

A. Perpendicular.

To what brain stem nuclei does this structure project?

A. Vestibular nuclei.

B. Reticular nuclei.

C. Red nucleus.

D. A and B.

E. A, B, and C.

D. A and B.

What route do the thalamocortical fibers from the ventral lateral nucleus (arrow) take?

A. Internal capsule

B. External capsule

C. Extreme capsule

D. Cerebral peduncle

E. Pyramid

A. Internal capsule

The right cerebral cortex affects the function of the right cerebellar cortex.

A. True.

B. False.

B. False.

The clinical signs of cerebellar hemisphere disease generally occur on the same side as the lesion.

A. True.

B. False.

A. True.

Occlusion of PICA has compromised the lateral medulla. Which of the following will occur?

A. Ipsilateral loss of pain and temperature from the body.

B. Ipsilateral loss of pain and temperature from the face.

C. Contralateral loss of somatic position and vibratory sensation.

B. Ipsilateral loss of pain and temperature from the face.