Chapter 4: Functional Neuroanatomy and Essential Neuropharm

Question 1

You are looking at a slice of a brain scan that is oriented so that it depicts one hemisphere with the frontal lobe on the left of the scan and the occipital lobe on the right. You are looking at a ______.

(A) coronal slice
(B) sagittal slice
(C) horizontal slice
(D) vertical slice

Answer 1

(B) – sagittal slice – The scan is described such that you are looking at the brain from the side. As described, the cut must be sagittal, perpendicular to the ground and running in a rostral-caudal (anterior-posterior) plane.

Question 2

The parietal lobe is ___ to the temporal lobe.

(A) lateral
(B) ventral
(C) caudal
(D) dorsal

Answer 2

D - dorsal
Dorsal means “toward the back” in the spinal cord but above the brain stem the neuraxis undergoes a 90-degree bend such that terms change to be “superior” or “upper”

Question 3

A lesion of the ventral occipitotemporal area is most likely to affect ____.

(A) auditory comprehension
(B) visuospatial skills
(C) face recognition
(D) writing ability

Answer 3

C - face recognition

this area refers to that region of cortex at the border between visual association area and posterior temporal lobe.
This area is associated with the ventral pathway which is important for object, face, or form/shape recognition

Question 4

A patient with amnesia has a large lesion affecting many brain structures. In each item below, a pair of structures is listed. Damage to which of these pairs is most likely to produce dense amnesia?

(A) mammillary bodies; dorsomedial thalamus
(B) amygdala, dorsomedial thalamus
(C) hippocampus; cingulate gyrus
(D) mammilothalamic tract; anterior thalamus

Answer 4

A - mammillary bodies

The two-system theory of amnesia states that amnesia results from damage to some element of the medial and lateral limbic circuit.

Question 5

Which of the following structures is not part of the diencephalon?

(A) hypothalamus
(B) epithalamus
(C) extended amygdala
(D) subthalamus

Answer 5

C - extended amygdala

All structures within the diencephalon end with “-mus.”

Question 6

Which of the following is a CORTICAL region directly implicated in episodic memory processing?

(A) hippocampus
(B) perirhinal cortex
(C) preoptic area
(D) lateral tegmental area

Answer 6

B - perirhinal cortex

The perirhinal cortex is on the basolateral temporal lobe surface and is one of the neocortical regions that projects to the hippocampal memory system.

It is implicated in memory Hippocampus is not a CORTICAL structure

Question 7

Lesions to the basal forebrain produce amnesia because ____.

(A) cholinergic input to the hippocampus and amygdala is disrupted
(B) pathways of the medial and lateral limbic circuits may be spared
(C) the basal forebrain contains dopaminergic neurons involved in memory retrieval
(D) the basal forebrain is a key site of memory storage

Answer 7

A - cholinergic input to the hippocampus and amygdala is disrupted

The basal forebrain provides cholinergic innervations of the hippocampus and amygdala systems thus a lesion here can disrupt these systems.

Question 8

The classic interpretation of conduction aphasia is that it involves damage to the ____, thus disconnecting Broca’s and Wernicke’s areas.

(A) arcuate fasciculus
(B) supramarginal gyrus
(C) cortical watershed areas
(D) the medial frontal lobe, including the supplementary motor area

Answer 8

A - arcuate fasciculus

conduction aphasia involves a disruption of repetition with relatively spared comprehension and fluency

Question 9

Regions that appear important for mapping sounds to meaning in language include:

(A) the inferior temporoparietal region and hippocampus
(B) the supramarginal and angular gyri
(C) Heschel’s gyrus and anterior temporal pole
(D) the supplementary motor area and dorsolateral prefrontal cortex

Answer 9

B - supramarginal and angular gyri

These cortical regions provide an interface between Wernicke’s area and polymodal cortical areas that process meaning/semantics

Question 10

Pure word deafness results from ____.

(A) destruction of primary auditory cortex
(B) damage to auditory radiations within the acoustic nerve
(C) bilateral disconnection of auditory receptive areas from Wernicke’s area
(D) disconnection of Wernicke’s area from semantic regions of the anterior temporal lobe

Answer 10

C - bilateral disconnection of auditory receptive areas from Wernicke’s area

This lesion prevents speech signal from undergoing phonologic decoding in Wernicke’s area but leaves intact sound decoding of nonspeech sounds

Question 11

In the classic cortico-striatal-pallidal-thalamo-cortical loop, the “input” to the basal ganglia is to the ____ and the “output” is via the ____.

(A) globus pallidus; caudate neucleus
(B) striatum; globus pallidus
(C) globus pallidus; neucleus accumbens
(D) striatum; nucleus accumbens

Answer 11

B - striatum; globus pallidus

The striatum (caudate and putamen) receive cortical input and project to the globus pallidus, which provides basal ganglia output to the thalamus.

Each loop differs with respect to the specific striatal or pallidal region involved, but the basic architecture is the same

Question 12

Dysfunction of the mesolimbic dopamine pathway has been associated with ____.

(A) negative symptoms of schizophrenia
(B) bradykinesia
(C) impaired reward functioning
(D) non-fluent aphasia

Answer 12

C - impaired reward functioning

Mesolimbic dopamine depletion has been associated with impaired reward functioning

Question 13

Damage to the medial frontal cortex is primarily associated with ____.

(A) intentional disorders
(B) disinhibition of emotion and personality
(C) executive dysfunction
(D) ADHD

Answer 13

A - intentional disorders

Damage to the medial frontal cortex results in syndromes such as akinesia, bradykinesia, apathy, and in the most severe cases from, akinetic mutism.

Question 14

Which of the following statements about glutamate is false?

(A) It is the most abundant excitatory neurotransmitter in the brain
(B) It inhibits the formation of new memories
(C) Too much glutamate can cause excitotoxicity and cell death
(D) Glutamate has been implicated in stroke and Alzheimer’s dz

Answer 14

B - it inhibits the formation of new memories

Glutamatergic activity stimulates, rather than inhibits, new memory formation

Question 15

Dysfunction of the mesostriatal pathway has been associated with ____.

(A) negative symptoms of schizophrenia
(B) bradykinesia
(C) impaired reward functioning
(D) non-fluent aphasia

Answer 15

B - Bradykinesia

Question 16

Overactivation of the mesolimbic dopamine pathway has been associated with ____.

(A) positive symptoms of schizophrenia
(B) bradykinesia
(C) impaired reward functioning
(D) negative symptoms of schizophrenia

Answer 16

A - positive symptoms of schizophrenia

overactivation is associated with POSITIVE sxs in schizophrenia

Question 17

DEFINITION:
A neurologic condition resulting from bilateral medial frontal lobe injury in which the patient does not move or speak but remains aware of ongoing events. It can be seen in stroke syndromes, tumors of the olfactory grovee, and in the final stage of certain neurodegenerative disease

Answer 17

Akinetic Mutism

Question 18

DEFINITION:
The experimental or clinical method of establishing direct associations between anatomic damage to the brain and sensory, motor, emotional, or cognitive impairments.

Answer 18

Anatomico-clinical correlation

The core knowledge base of clinical neuropsychology depends in part on precise anatomic-clinical correlations

Question 19

DEFINITION (anatomy):

A group of structures located in the vicinity of the ventromedial frontal lobe, anterior to the caudate and putamen.

Answer 19

Basal Forebrain (BF)

Question 20

DEFINITION (anatomy):
Comprised of the nucleus basalis, diagonal band of Broca, substantia innominanta, and medial spetal nuclei, it is the major source of cholinergic input throughout the brain.

Answer 20

Basal Forebrain (BF)

Question 21

Damage to this brain area is associated with profound memory loss with confabulation, the latter of which is likely associated with neighboring frontal lobe damage.

Answer 21

Basal Forebrain (BF)

Question 22

DEFINITION:
A region of cortex defined by its cytoarchitectonics.

Classification divides the cortex into approximately 52 areas, numbered sequentially, although some regions have been subsequently subdivided and other are only present in non-human primates

Answer 22

Brodmann areas

Question 23

DEFINITION:
A prominent anatomico-clinical theory in neuropsychology that describes certain neurobehavioral syndroms as the result of damage to white matter connections as opposed to cortical processors.

Resulting syndromes occur because

Answer 23

Disconnection Theory

Question 24

Frequently studied _______ syndromes include:
Alexia without agraphia, optic aphasia, conduction aphasia, ideomotor apraxia, locked in syndrome, and impaired naming of objects in the left hand due to callosal severing which prevents communication from the left and the right hemispheres
**These result from lesions to associational or commissural nerve fibres

Answer 24

Disconnection Syndromes

Question 25

DEFINITION:
A pathological process by which nerve cells are damaged or destroyed by excessive stimulation by neurotransmitters such as Glutamate.

**Thought to be a key factor in CNS response to spinal cord injury, TBI, and neurodegenerative disorders

Answer 25

Excitotoxicity

Question 26

NAME THAT CIRCUIT:

Hippocampus –> mammillary bodies (via fornix) –> anterior thalamic nucleus (via the mammillothalamic tract) –> cingulate gyrus –> hippocampus (via cingulum and parahippocampal)

Answer 26

Medial limbic circuit (Papez circuit)

Question 27

DEFINITION:
The contemporary viewpoint that argues that the necessary and sufficient lesion producing human amnesia involves damage to two limbic circuits

Answer 27

Two-system theory of amnesia

System 1 (Medial)
involves hippocampus

System 2 (Lateral)
involves amygdala