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Neuroscience > 04: Overview Of The Spinal Cord, Brainstem, And Cranial Nerves > Flashcards

04: Overview Of The Spinal Cord, Brainstem, And Cranial Nerves Flashcards

1
Q

Which of the following describes an essential function of the spinal cord? Select all that apply.

  • Receives and integrates sensory information
  • Sends motor communication to target tissue
  • Process visual information
  • Carries tracts that convey info to/from brain
  • Mediates spinal-level reflexes
  • Processes auditory info
A
  • Receives and integrates sensory information
  • Sends motor communication to target tissue
  • Carries tracts that convey info to/from brain
  • Mediates spinal level reflexes
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2
Q

True or false: The spinal cord extends to the level of S5 vertebra.

A

False

It extends to about L1.

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3
Q

True or false: The spinal cord is segmentally organized giving rise to 31 pairs of spinal nerves, and each will form Ipsilateral dermatomes and myotomes.

A

True

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4
Q

The dural sac surrounds the spinal cord and is attached to the vertebral column via which of the following structures?

A. Filum terminale externum
B. Filum terminale internum
C. Denticulate ligaments

A

A

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5
Q

True or false: The gray matter of the spinal cord consists of cell bodies of neurons and is arranged in three columns that include dorsal, lateral, and ventral horns.

A

True

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6
Q

Which laminae make up the ventral horn?

A. Laminae I-VI
B. Laminae VII-VIII
C. Laminae VIII-IX

A

C

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7
Q

The internal structure of each spinal cord segment looks the same with respect to the ratio of gray and white matter.

A

False

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8
Q

The ventral horn of the spinal cord is somatotopically organized. Which of the following statements best reflects this organization?

A. Motor neurons that innervate axial muscles are located laterally and those that innervate appendicular muscles are located medially.
B. Motor neurons that innervate axial muscles are located medially and those that innervate appendicular muscles are located laterally.
C. Motor neurons that innervate axial and appendicular muscles are equally distributed between the medial and lateral aspects of the ventral horn.

A

B

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9
Q

Which of the following funiculi is located between the dorsal and ventral roots of each spinal cord segment?

A. Posterior
B. Anterior
C. Lateral

A

C

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10
Q

Which funiculus contains only ascending (sensory) tracts?

A. Posterior
B. Anterior
C. Lateral

A

A

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11
Q

Which funiculus contains the lateral corticospinal tract?

A. Anterior
B. Posterior
C. Lateral

A

C

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12
Q

True or false: Medially located fibers of the corticospinal tract will influence the activity of motor neurons that innervate muscles of the upper limb.

A

True

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13
Q

True or false: The left anterolateral system will carry pain and temperature from the left side of the body.

A

False

The left anterolateral system will carry pain and temperature from the RIGHT side of the body (contralateral).

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14
Q

True or false: The posterior columns will relay touch and proprioception information from the body.

A

True

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15
Q

True or false: A complete spinal cord injury at the level of C5 results in tetraplegia.

A

True

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16
Q

Which of the following spinal cord injuries would result in Ipsilateral hemiplegia, contralateral loss of pain and temperature sensation, and Ipsilateral touch, pressure, vibration, and proprioception sensations below the level of the injury?

A. Anterior cord syndrome
B. Posterior cord syndrome
C. Brown Sequard syndrome

A

C

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17
Q

What anchors the spinal cord to the dural sac?

A. Denticulate ligaments
B. Filum terminale externum
C. Filum terminale internum
D. A and C
E. B and C

A

D

Denticulate ligaments: laterally anchors spinal cord to dural sac
Filum terminale externum: Anchors dural sac to vertebral column
Filum terminale internum: anchors terminal end of spinal cord to dural sac

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18
Q

Does the ventral horn contain motor or sensory neurons?

A

Motor

Dorsal horn is sensory neurons

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19
Q

Which laminae of the gray matter contain sensory neurons?

A. Laminae I - VI
B. Laminae VIII - X
C. Laminae VII

A

A

Laminae I-IV: process exteroceptive information
Laminae V-VI: process visceral and proprioceptive information

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20
Q

Which funiculus contains only ascending tracts?

A. Posterior funiculus
B. Anterior funiculus
C. Lateral funiculus

A

A

Anterior funiculus: Descending only
Lateral funiculus: both ascending AND descending

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21
Q

What does somatotopic organization mean?

A
  • Motor neurons of the axial skeleton are located medially (like the axial skeleton).
  • Motor neurons of the appendicular skeleton are located laterally (like the limbs).
  • Progression goes from proximal to distal
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22
Q

What are the components of a typical spinal nerve?

A

Motor components
* Somatic motor neurons
* Visceral motor neurons

Sensory components
* Somatic sensory neurons
* Visceral sensory neurons

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23
Q

What arteries supply the spinal cord with blood?

A
  • Anterior spinal artery
  • Posterior spinal arteries
  • Segmental arteries (spinal medullary, radicular)
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24
Q

What motor and sensory deficits are seen in an incomplete spinal cord injury?

A

Some motor or sensory function is spared below the site of injury.

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25
Q

What are the key functions of the spinal cord?

A
  • Receives sensory information and begins to integrate it
  • Sends motor commands
  • Carries ascending and descending tracts
  • Coordinates spinal reflexes
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26
Q

Which of the following is considered a key function of the brain stem? Select all that apply.

  • Mediating levels of arousal
  • Motor and sensory functions of the head and neck
  • Pain modulation
  • Regulating homeostatic functions
  • Maintaining postural control and balance
A

All of the above!

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27
Q

Which of the following structures is an important landmark of the midbrain?

A. Tectum
B. Olive
C. Pyramid

A

A

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28
Q

Which structure would you locate to find the exit points of cranial nerve IX, X, XI, and XII?

A. Pyramids
B. Colliculi
C. Olive

A

C

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29
Q

Which structure contains the corticospinal tract? Select all that apply.

  • Pyramids
  • Olive
  • Basilar pons
  • Crus cerebri
  • Superior colliculi
A

Pyramids
Basilar pons
Crus cerebri
Superior colliculi

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30
Q

Which of the following tracts crosses in the medulla? Select all that apply.

  • Corticospinal tract
  • Posterior columns-medial lamiscus
  • Anterolateral system
A
  • Corticospinal tract
  • Posterior columns-medial lamiscus
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31
Q

True or false: An injury to the corticospinal tract above the level of the motor decussation (crossing of fibers) will result in motor impairments ipsilaterally.

A

False

Injury ABOVE the motor decussation would result in contralateral deficits, while injury BELOW would result in ipsilateral deficits.

32
Q

Which of the following nuclei will process pain and temperature information from the face?

A. Principle sensory
B. Spinal trigeminal
C. Vestibular
D. Solitary

A

B

33
Q

Which of the following is a sensory nucleus? Select all that apply.

  • Spinal trigeminal
  • Nucleus ambiguus
  • Edinger-Westphal
  • Solitary
  • Cochlear
A
  • Spinal trigeminal
  • Solitary
  • Cochlear
34
Q

Which of the following nuclei are associated with the facial nerve? Select all that apply.

  • Superior salivatory
  • Inferior salivatory
  • Facial motor
  • Nucleus ambiguus
  • Solitary
A
  • Superior salivatory
  • Facial motor
  • Solitary
35
Q

Which cranial nerves exit the pons-medullary junction?

A. CN III and IV
B. CN VI, VII, and VIII
C. CN IX, X, and XI

A

B

36
Q

What are the three divisions of the brain stem?

A

Midbrain, pons, medulla

37
Q

What is contained in the medullary pyramids?

A

Cortical spinal tract

38
Q

What are the major ascending and descending tracts that travel through the brainstem?

A

Ascending tracts
* Anterolateral system: pain and temperature sensations
* Posterior columns: touch, pressure, proprioceptive sensation

Descending tracts
* Corticospinal tract: motor
* Corticonuclear tract
* Corticopontine tract
* Corticoreticular tract

39
Q

In what area of the brainstem do the sensory and motor decussation take place?

A

Medulla

40
Q

Where are the somatic cranial nerve motor nuclei located?

A

In the brainstem

  • Oculomotor nucleus (CN III) - in midbrain
  • Trochlear nucleus (CN IV) - in Pons
  • Abducens nucleus (CN VI) - in pons
  • Spinal accessory nucleus (CN XI) - in medulla
  • Hypoglossal nucleus (CN XII) - in medulla
  • Trigeminal motor nucleus (CN V) - in the pons
  • Facial motor nucleus (CN VII) - in the pons
  • Nucleus ambiguus (CNs IX, X, Xi) - in the medulla
41
Q

Which cranial nerves exit the pons medullary junction?

A

CN VI: Abducens nerve
CN VII: Facial nerve
CN VIII: Vestibulocochlear nerve

42
Q

True or false: The spinal cord sends sensory information and receives motor commands.

A

False

The opposite

43
Q

Where does CSF sit within the spinal cord?

A. white matter
B. central canal
C. Grey matter

A

B

44
Q

True or false: Pain and temperature information from the LEFT side of the body is conveyed through the RIGHT anterolateral system.

A

True

45
Q

Which of the following is NOT a source of blood supply to the spinal cord?

A. Anterior spinal artery
B. Posterior spinal artery
C. Spinal medullary arteries
D. Brown-sequard artery

A

D

46
Q

Which of the following ganglia are motor ganglia? Select all that apply.

  • Ciliary
  • Geniculate
  • Submandibular
  • Otic
  • Intramural
  • Semilunar
A
  • Ciliary
  • Submandibular
  • Otic
  • Intramural
47
Q

Which of the following ganglia are associated with the facial nerve? Select all that apply.

  • Pterygopalantine
  • Otic
  • Geniculate
  • Submandibular
  • Superior
  • Ciliary
A
  • Pterygopalantine
  • Geniculate
  • Submandibular
48
Q

Which of the following cranial nerves have ONLY motor components? Select all that apply.

  • CN III: Oculomotor
  • CN VII: Facial
  • CN VIII: Vestibulocochlear
  • CNI XI: Spinal Accessory
  • CN XII: Hypoglossal
A
  • CN III: Oculomotor
  • CNI XI: Spinal Accessory
  • CN XII: Hypoglossal
49
Q

Which of the following cranial nerves is a nerve of the parasympathetic division of the autonomic nervous system?

A. CN XII
B. CN I
C. CN V
D. CN X

A

D

50
Q

Damage to which special sensory cranial nerve will result in anosima?

A. CN I
B. CN II
C. CN VIII

A

A

CN I, the olfactory nerve, is responsible for smell. Anosima is the loss of smell.

51
Q

Which of the following tests can be used to test the cochlear division of the CN VIII?

A. Visual tracking
B. Weber test
C. Presenting the patient with the scent of vanilla

A

B

Visual tracking is used for vision related deficits.

The Weber Test is a test used to establish diagnosis in patients with unilateral hearing loss.

Vanilla (and scent tests) are used to test CN I, the olfactory nerve.

52
Q

Which of the following cranial nerves are assessed by evaluating ocular range of motion? Select all that apply.

  • CN III
  • CN IV
  • CN VI
  • CN XI
  • CN XII
A

CN III, IV, and VI

53
Q

Damage to which cranial nerve would result in the inability to abduct the eye?

A. CN III
B. CN VI
C. CN IV

A

B

The trochlear nerve controls the lateral rectus of the eye.

54
Q

Which of the following cranial nerves is being assessed when you test the sensation of your patient’s face?

A. Trigeminal
B. Facial
C. Vagus

A

A

55
Q

Which of the following nerves is being tested if you assess your patient’s taste sensation?

A. Facial
B. Glossopharyngeal
C. Trigeminal

A

B

56
Q

True or false: The corneal reflex tests the sensory division of the trigeminal nerve.

A

True

57
Q

If you are unable to elicit the jaw jerk reflex in your patient and their jaw muscles are weak, this may indicate damage to which of the following cranial nerves?

A. Facial
B. Trigeminal
C. Vagus

A

B

58
Q

Which cranial nerves are considered pure motor nerves?

A

CN III
CN IV
CN VI
CN XI
CN XII

59
Q

Which cranial nerves are considered pure sensory nerves?

A

CN I
CN II
CN VIII

60
Q

Which nerves are considered mixed motor and sensory nerves?

A

CN V
CN VII
CN IX
CN X

61
Q

Which nerves are considered a part of the parasympathetic nervous system?

A

CN III
CN VII
CN IX
CN X

62
Q

How do you test the functioning of the extraocular muscles?

A

ROM of the eyes and pupillary reflex

63
Q

How do you test the functioning of the trigeminal nerve?

A
  • Testing facial sensation
  • Test muscles of mastication
  • Test jaw jerk reflex
64
Q

How do you test the functioning of CN IX and X?

A
  • Gag reflex
  • Voice quality
65
Q

A patient has sustained a spinal cord injury at the level of C6 and was diagnosed with Brown Sequard syndrome. Indicate YES or NO next to the symptoms below if they would (or would not) be present in this condition.

  1. Damage to the posterior column resulting in bilateral loss of touch, pressure, vibration, and proprioception sensation
  2. Ipsilateral weakness in postural control and balance
  3. Ipsilateral hemiplegia
  4. Loss of ipsilateral shoulder abduction
  5. Retain the ability to use the thumb and index finger
  6. Contralateral loss of motor function below the level of injury
  7. Sensations of pain, temperature and crude touch are preserved below the elbow
A
  1. No (This describes a complete spinal cord injury)
  2. Yes
  3. Yes
  4. No (Would remain intact)
  5. Yes
  6. No (Would KEEP contralateral motor function)
  7. No (would LOSE these sensations)
66
Q

A patient has sustained a spinal cord injury at the level of C7 and was diagnosed with posterior cord syndrome. Indicate YES or NO next to the symptoms below if they would (or would not) be present in this condition.

  1. Contralateral motor impairment below the level of injury
  2. Loss of touch, pressure, vibration, and proprioception sensation below the level of injury
  3. Able to walk but may experience some clumsiness due to loss of proprioceptive sensation
  4. Motor function is completely spared
  5. Pain and temperature sensation is completely spared
  6. Variable motor deficits in the lower extremities
  7. Touch, pressure, and proprioception sensation preserved above the level of injury
A
  1. No (ALL motor functioning would be spared)
  2. Yes
  3. Yes
  4. Yes
  5. Yes
  6. No (This presents in cauda equina syndrome)
  7. Yes
67
Q

A patient has sustained a spinal cord injury at the level of C5 and was diagnosed with anterior cord syndrome. Indicate YES or NO next to the symptoms below if they would (or would not) be present in this condition.

  1. Variable paralysis below the level of injury
  2. Bilateral loss of temperature and pain
  3. Ipsilateral loss of touch, pressure, vibration, and proprioception sensation below the level of injury
  4. Loss of bladder control
  5. Ipsilateral hemiparesis
  6. Contralateral loss of temperature and pain
  7. Tetraplegia
A
  1. Yes
  2. Yes
  3. No (Preserved on BOTH sides)
  4. No (Present in cauda equina syndrome)
  5. No (Motor deficits would be variable below level of injury)
  6. No (These sensations would be affected bilaterally)
  7. No (Would be present in a complete spinal cord injury at or above C5)
68
Q

A patient has sustained a spinal cord injury at the level of the cauda equina and was diagnosed with cauda equina syndrome. Indicate YES or NO next to the symptoms below if they would (or would not) be present in this condition.

  1. Motor function is completely spared
  2. Incontinence and bladder control issues
  3. Loss of touch, pressure, vibration, and proprioception sensation below the level of injury
  4. Variable motor deficits in the lower extremities
  5. Variable sensory deficits in the lower extremities
  6. Loss of sexual sensation/sexual dysfunction
  7. Touch, pressure, and proprioception sensation preserved above the level of injury
A
  1. No (Motor function is variable in LE)
  2. Yes
  3. No (Variable motor and sensory loss below the level of injury would be present)
  4. Yes
  5. Yes
  6. Yes
  7. Yes
69
Q

A patient has sustained a complete spinal cord injury at the level of C5. Indicate YES or NO next to the symptoms below if they would (or would not) be present in this condition.

  1. Tetraplegia
  2. Paraplegia
  3. Fine motor deficits
  4. Loss of touch, pressure, vibration, and proprioception sensation below the level of injury
  5. Preservation of pain and temperature sensation below the level of injury
  6. Loss of touch, pressure, vibration, and proprioception sensation below the level of injury
  7. Impaired motor ability in upper extremity
A
  1. Yes
  2. No (Would be tetraplegic)
  3. Yes
  4. Yes
  5. No (This would also be lost)
  6. Yes
  7. No (Would be tetraplegic)
70
Q

Which of the following tracts relays touch, pressure, and proprioceptive sensations to the brain?

A. Anterolateral system
B. Anterior corticospinal tract
C. Lateral corticospinal tract
D. Posterior columns

BONUS: Is this an ascending or descending tract?

A

D

BONUS: Ascending

71
Q

Which of the following tracts relays pain and temperature sensations to the brain?

A. Anterolateral system
B. Anterior corticospinal tract
C. Lateral corticospinal tract
D. Posterior columns

BONUS: Is this an ascending or descending tract?

A

A

BONUS: Ascending

72
Q

Which of the following tracts is responsible for postural control and balance?

A. Anterolateral system
B. Anterior corticospinal tract
C. Lateral corticospinal tract
D. Posterior columns

BONUS: Is this an ascending or descending tract?

A

B

BONUS: Descending

73
Q

An injury to the anterolateral system above the spinal cord would present as ________________ in
pain and temperature sensation relay to the brain.

A. Bilateral deficits
B. Contralateral deficits
C. Ipsilateral deficits
D. Preservation

BONUS: If the injury were BELOW the decussation, would there be a difference?

A

B

BONUS: Deficits would be seen ipsilaterally

74
Q

An injury to the posterior columns above the decussation would present as ________________ in
pain and temperature sensation relay to the brain.

A. Bilateral deficits
B. Contralateral deficits
C. Ipsilateral deficits
D. Preservation

BONUS: If the injury were BELOW the decussation, would there be a difference?

A

B

BONUS: Deficits would be seen ipsilaterally

75
Q

An injury to the corticospinal tract above the decussation would present as ________________ in
limb movement, posture and balance commands from the brain.

A. Bilateral deficits
B. Contralateral deficits
C. Ipsilateral deficits
D. Preservation

BONUS: If the injury were BELOW the decussation, would there be a difference?

A

B

BONUS: Deficits would be seen ipsilaterally; the type of injury would depend on whether the lateral (voluntary movement) or anterior (posture/balance)corticospinal tract was injured.

Neuroscience (14 decks)

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