Neuro Quiz Questions Flashcards
Your patient was sitting in your office, and you notice that he couldn’t sit still. He was constantly squirming and fidgeting. However, when you asked him to touch his nose with his finger he performed the task easily. From these observations alone you conclude that the patient’s disorder is likely
Basal ganglia
A 75 year old man comes to you and complains that he has suddenly lost hearing and is now totally deaf. He speaks in a loud voice and doesn’t react to auditory stimuli. Further, he displays hypesthesia (diminished sensation) and paresis (weakness) over the entire right side of the body from head to toe, positive Babinski sign in his right foot, and he has severe deficits in his right visual field. A year ago he suffered from a stroke that left him with no visible deficits except that now he doesn’t comb his hair on the left side, doesn’t shave the left side of his face and has trouble finding the bathroom in his home.
Two months later you examine him again in a follow-up visit and find that he now responds to auditory startle stimuli. He cannot understand what you say to him, but has no trouble following written commands. He speaks fluently and says that sounds are all mixed up; language sounds like running water. You diagnose
His previous lesion was a stroke that damaged the auditory cortex on the right side, and his current lesion was a stroke involving the posterior limb of the internal capsule on the left side.
The ventroposterolateral nucleus receives
axons whose cell bodies are in the gracile and cuneate nuclei on the opposite side.
A 45 year old bartender suddenly collapsed while working out at the gym. On arrival at the hospital she was examined by the neurosurgery resident. The resident discovered that her patient exhibited weakness and diminished sensation over the entire right half of the body from head to toe with positive Babinski of the right foot. In addition she had large defect in her right visual field. Speech and language comprehension were normal. The woman probably suffered an infarct of the: A. right middle cerebral artery B. left posterior cerebral artery C. left middle cerebral artery D. left lenticulostriate artery E. left anterior cerebral artery
D. L lenticulostriates
The 3rd ventricle is associated with what part of the brain?
Diencephalon
The family of a 77 year old woman brought their mother to the Emergency Dept. after she had collapsed onto the floor of her kitchen. On examination you find:
weakness over the left side of her body, but Babinski sign was negative.
the lower part of her face sagged a bit on the left side, but the lines on her forehead were symmetrical.
her tongue deviated to the left when asked to stick it out
homonymous scotomas in the left lower quadrants of her visual field
hypesthesia (diminished sensation) over much of the left side of her body
speech and comprehension were normal, as was hearing.
After a few days she was released with some residual weakness and hypesthesia. However, she would get lost in her house, and would go to bed without taking off her left sock and shoe, and she rarely brushed the left side of her hair. This woman probably suffered from:
a stroke involving the inferior parietal lobule & deep white matter on the right side.
A patient experiences loss of pain and temperature sensation over the left upper and lower limbs, and loss of epicritic sensation on the same side. These symptoms alone indicate that the patients problem is at least as high in the neuraxis as the…
medulla on the right side
The nucleus of the spinal trigeminal tract projects to:
the contralateral ventroposteromedial nucleus of the thalamus (VPM)
A man collapsed at the gym while lifting weights. When he awoke he exhibited diminished epicritic sensation on the left side of the body, paresis over both left extremities with positive Babinski on the left foot and his tongue deviated to the right. There are no other sensory deficits. You diagnose
a stroke of a branch of the anterior spinal artery
A lesion of what artery is most likely to result in contralateral hemineglect syndrome?
Right MCA
A woman came to her doctor complaining that she woke up in the morning, and she was blind in her right eye. Also she stated that she couldn’t read - letters seemed all jumbled up and didn’t make sense. There were no other sensory or motor deficits. You suspect that she suffered
a stroke of the left posterior cerebral artery
A patient presents with violent involuntary ballistic movements that are jerky and irregular and mainly involve the upper extremity on one side of the body.
The lesion was most likely located in the:
Subthalamic nucleus.
The _______ association cortex is involved in understanding “what an object is,” while the _______ association cortex is involved in understanding “where an object is.”
- temporal
2. parietal
A patient presents with reduced facial expression, spontaneous movements (slower than normal) that are revealed most clearly when walking, monotonous speech, an increase in muscle tone in the arms, and a rhythmic tremor (4 to 7 Hz) in the fingers, including a pill-rolling tremor.
Which of the following pharmacological treatment strategies would be most appropriate for this patient:
L-DOPA
Localized application of a GABA receptor agonist within the SNpr would most likely
result in involuntary saccadic eye movements
A middle-aged, male professor of neuroscience at a northeastern medical school began to experience intermittent episodes of uncontrollable sleep, even while giving lectures to the first-year medical class. At the request of colleagues and students, it was suggested that he see a neurologist in the university hospital. The neurologic examination revealed temporary loss of muscle tone in the trunk and extremities, and in the sleep clinic, he experienced some hallucinations and tended to remain awake at night. The neurologist concluded that the patient was suffering from:
Narcolepsy
A 63-year-old woman was experiencing difficulties in a card-sorting test (as a measure of cognitive function), and failed to accurately perceive the vertical when seated in a tilted chair. A magnetic resonance imaging scan revealed the presence of a lesion in the:
prefrontal cortex
The structure(s) that is important in the production of virtually all vocalizations is the
larynx
A 55-year-old man was recently diagnosed with Huntington’s disease. This disorder may best be understood in terms of the loss of which substance with which result?
Gamma aminobutyric acid (GABA) in the neostriatum, reduction of neostriataI inhibition on the lateral (external) pallidal segment
Slow wave sleep includes:
stage III and stage IV sleep.
he part of the cerebellum that is highly developed in humans and involved with the planning and execution of complex spatial and temporal sequences is the
cerebrocerebellum
A 72-year-old man was found unconscious in his home and was taken to the emergency room of the local hospital. After a few days, the patient remained in a coma, and the pattern on his electroencephalogram revealed mainly the presence of an alpha-like rhythm. In addition, the patient presented with normal eye movements and a variety of autonomic and somatomotor reflexes. On the basis of these observations as well as a magnetic resonance imaging scan, the neurologist concluded that the lesion was localized to the:
Pons. The disorder described in this case is referred to as “coma vigil.” It is characteristic of a pontine lesion, which includes parts of the tegmentum but spares the dorsomedial region, which is associated with the control of horizontal eye movements. Although the patient is comatose, his electroencephalographic response is characteristic of an alpha rhythm, and horizontal eye movements are clearly present.
The auditory hair-cell bodies are embedded in the
Basilar membrane
The entrainment of our body’s circadian rhythm with environmental light-dark cycles is mediated by
Specialized retinal ganglion cells
Rapid eye movement (REM) sleep is believed to originate in the:
pons
If humans were placed in a cave and deprived of all time clues, they would
begin free-running, (i.e., their internal clock would operate on a cycle in approximately a 24-hour time cycle).
A patient holding a ball in his right hand identifies it as “a ball,” but when holding it in his left hand he calls it “a round thing.” This patient most likely
a split brain patient
An older gentleman is seated in front of you eating dinner at a local bar. When he is chewing, his entire head continues to bob slightly up and down as if nodding. When he reaches out to pick up a piece of food you notice that his arm is also shaking slightly throughout the entire movement, and it continues to shake when he puts the food in his mouth. Within 20 minutes of starting his meal, you no longer notice the shaking. What is the most likely explanation?
Essential tremor
A neuroscientist wanted to design an experiment to investigate the brain mechanisms that regulate pain. This investigator discovered that, when electrical stimulation was applied to the midline of the medulla, pain sensation was attenuated. Which of the following possibilities could account for this observation?
Release of serotonin in the dorsal horn of spinal cord. Stimulation of raphe magnus neurons in the midline medulla is expected to result in the release of serotonin at their terminals in the dorsal horn and excite (not inhibit) enkephalin-containing interneurons located in the dorsal horn.
The terminals of nociceptive afferents release
Substance P. The terminals of nociceptive afferents in the spinal cord release substance P and glutamate. Enkephalins and serotonin are not the transmitters released by the terminals of nociceptive afferents. These transmitters are released at different sites in the descending pain control circuits. Gamma aminobutyric acid and acetylcholine are inhibitory and excitatory neurotransmitters, respectively, in the central nervous system, and they are not involved in nociception.
