neuroanatomy 3rd Comprehensive Examination 121 - 144

Question 1

Questions 121-125
The response options for items 121-125 are the
same. You will be required to select one answer
for each item in the set.
(A) Caudate nucleus
(B) Globus pallidus
(C) Centromedian nucleus
(D) Substantia nigra
(E) Subthalamic nucleus
Match each description with the most appro-
priate nucleus.
121. Destruction causes contralateral hemibal-
lism

Answer 1

121-E. Hemiballism results from circumscript lesions of the subthalamic nucleus.

Question 2

Questions 121-125
The response options for items 121-125 are the
same. You will be required to select one answer
for each item in the set.
(A) Caudate nucleus
(B) Globus pallidus
(C) Centromedian nucleus
(D) Substantia nigra
(E) Subthalamic nucleus
Match each description with the most appro-
priate nucleus.
122. Receives dopaminergic input from the
midbrain

Answer 2

122-A. The caudate nucleus and the putamen (caudatoputamen) receive dopaminergic input
from the pars compacta of the substantia nigra, the nigrostriatal tract.

Question 3

Questions 121-125
The response options for items 121-125 are the
same. You will be required to select one answer
for each item in the set.
(A) Caudate nucleus
(B) Globus pallidus
(C) Centromedian nucleus
(D) Substantia nigra
(E) Subthalamic nucleus
Match each description with the most appro-
priate nucleus.
123. Gives rise to the ansa lenticularis and the
lenticular fasciculus

Answer 3

123-B. Neurons of the globus pallidus give rise to the ansa lenticularis and the lenticular fascicuius, two pathways that project to the ventral anterior, ventral lateral, and centromedian nu-
clei of the thalamus.

Question 4

Questions 121-125
The response options for items 121-125 are the
same. You will be required to select one answer
for each item in the set.
(A) Caudate nucleus
(B) Globus pallidus
(C) Centromedian nucleus
(D) Substantia nigra
(E) Subthalamic nucleus
Match each description with the most appro-
priate nucleus.
124. Destruction causes hypokinetic-rigid
syndrome

Answer 4

124-D. Destruction or degeneration of the substantia nigra results in parkinsonism (hypoki-
netic—rigid syndrome).

Question 5

Questions 121-125
The response options for items 121-125 are the
same. You will be required to select one answer
for each item in the set.
(A) Caudate nucleus
(B) Globus pallidus
(C) Centromedian nucleus
(D) Substantia nigra
(E) Subthalamic nucleus
Match each description with the most appro-
priate nucleus.

125. A loss of cells in this griseum causes
     greatly dilated lateral ventricles

Answer 5

125-A. In Huntington chorea, there is a loss of neurons in the striatum. Cell loss in the head of
the caudate nucleus causes dilation of the frontal horn of the lateral ventricle (hydrocephalus ex
vacuo), which is visible on computed tomography (CT) and magnetic resonance imaging (MRI)
studies.

Question 6

Questions 126-132
The response options for items 126-132 are the
same. You will be required to select one answer
for each item in the set.
(A)	Acetylcholine (Ach)
(B)	Dopamine
(C)	Gamma-aminobutyric acid (GABA)
(D)	Norepinephrine
(E)	Serotonin
Match each of the following nuclei or cells with
the appropriate neurotransmitter.
126.	Raphe nuclei

Answer 6

126-E. Serotonin (5-HT) is produced by neurons located in the raphe nuclei. This paramidline
column of cells extends from the caudal medulla to the rostral midbrain.

Question 7

Questions 126-132
The response options for items 126-132 are the
same. You will be required to select one answer
for each item in the set.
(A)	Acetylcholine (Ach)
(B)	Dopamine
(C)	Gamma-aminobutyric acid (GABA)
(D)	Norepinephrine
(E)	Serotonin
Match each of the following nuclei or cells with
the appropriate neurotransmitter.
127.	Purkinje cells

Answer 7

127-C. Purkinje neurons are GABA-ergic. GABA-ergic neurons are also found in the striatum,
globus pallidus, and in the pars reticularis of the substantia nigra

Question 8

Questions 126-132
The response options for items 126-132 are the
same. You will be required to select one answer
for each item in the set.
(A)	Acetylcholine (Ach)
(B)	Dopamine
(C)	Gamma-aminobutyric acid (GABA)
(D)	Norepinephrine
(E)	Serotonin
Match each of the following nuclei or cells with
the appropriate neurotransmitter.
128.	Nucleus basalis of Meynert

Answer 8

128-A. The nucleus basalis of Meynert contains cholinergic neurons, which project to the entire
neocortex. This griseum is a ventral forebrain nucleus found embedded in the substantia in-
nominata (located ventral to the globus pallidus). This nucleus degenerates in Alzheimer disease.

Question 9

Questions 126-132
The response options for items 126-132 are the
same. You will be required to select one answer
for each item in the set.
(A)	Acetylcholine (Ach)
(B)	Dopamine
(C)	Gamma-aminobutyric acid (GABA)
(D)	Norepinephrine
(E)	Serotonin
Match each of the following nuclei or cells with
the appropriate neurotransmitter.
129.	Motor cranial nerve nuclei

Answer 9

129-A. Acetylcholine (ACh) is the neurotransmitter of motor cranial nerves [general somatic ef-
ferent (GSE), special visceral efferent (SVE), and general visceral efferent (GVE)] and anterior
horn cells of the spinal cord.

Question 10

Questions 126-132
The response options for items 126-132 are the
same. You will be required to select one answer
for each item in the set.
(A) Acetylcholine (Ach)
(B) Dopamine
(C) Gamma-aminobutyric acid (GABA)
(D) Norepinephrine
(E) Serotonin
Match each of the following nuclei or cells with
the appropriate neurotransmitter.
130. Pars compacta of the substantia nigra

Answer 10

130-B. Neurons of the pars compacta of the substantia nigra contain dopamine. Dopamine also
is present in the ventral tegmental area of the midbrain, the superior colliculus, and the arcuate
nucleus of the hypothalamus.

Question 11

Questions 126-132
The response options for items 126-132 are the
same. You will be required to select one answer
for each item in the set.
(A)	Acetylcholine (Ach)
(B)	Dopamine
(C)	Gamma-aminobutyric acid (GABA)
(D)	Norepinephrine
(E)	Serotonin
Match each of the following nuclei or cells with
the appropriate neurotransmitter.
131.	Locus ceruleus

Answer 11

131-D. The locus ceruleus is the largest assemblage of noradrenergic (norepinephrinergic) neu-
rons in the entire brain. It is located in the lateral pontine and midbrain tegmenta. Locus
ceruleus neurons project to the entire neocortex and cerebellar cortex.

Question 12

Questions 126-132
The response options for items 126-132 are the
same. You will be required to select one answer
for each item in the set.
(A)	Acetylcholine (Ach)
(B)	Dopamine
(C)	Gamma-aminobutyric acid (GABA)
(D)	Norepinephrine
(E)	Serotonin
Match each of the following nuclei or cells with
the appropriate neurotransmitter
132.	Globus pallidus

Answer 12

132-C. The globus pallidus contains gamma-aminobutyric acid GABA-ergic neurons that pro-
ject to the thalamus and subthalamic nucleus.

Question 13

Questions 133-137
The response options for items 133-137 are the
same. You will be required to select one answer
for each item in the set.
(A) Glutamate
(B) Glycine
(C) p-Endorphin
(D) Enkephalin
(E) Substance P
Match each description below with the appro-
priate neurotransmitter.
133. Neurotransmitter of afferent pain fibers

Answer 13

133-E. Substance P is contained in dorsal root ganglion cells and is the neurotransmitter of af-
ferent pain fibers. Substance P also is produced by striatal neurons, which project to the globus
pallidus and substantia nigra.

Question 14

Questions 133-137
The response options for items 133-137 are the
same. You will be required to select one answer
for each item in the set.
(A) Glutamate
(B) Glycine
(C) p-Endorphin
(D) Enkephalin
(E) Substance P
Match each description below with the appro-
priate neurotransmitter.
134. Major inhibitory neurotransmitter of the
spinal cord

Answer 14

134-B. Glycine is the major inhibitory neurotransmitter of the spinal cord. The Renshaw in-
terneurons of the spinal cord are glycinergic.

Question 15

Questions 133-137
The response options for items 133-137 are the
same. You will be required to select one answer
for each item in the set.
(A) Glutamate
(B) Glycine
(C) p-Endorphin
(D) Enkephalin
(E) Substance P
Match each description below with the appro-
priate neurotransmitter
135. Major neurotransmitter of the cortico-
spinal pathway

Answer 15

135-A. Glutamate is the major excitatory neurotransmitter of the brain; neocortical gluta-
matergic neurons project to the caudate nucleus and the putamen (striatum).

Question 16

Questions 133-137
The response options for items 133-137 are the
same. You will be required to select one answer
for each item in the set.
(A) Glutamate
(B) Glycine
(C) p-Endorphin
(D) Enkephalin
(E) Substance P
Match each description below with the appro-
priate neurotransmitter
136. Located almost exclusively in the hypo-
thalamus

Answer 16

136-C. P-Endorphinergic neurons are located almost exclusively in the hypothalamus (arcuate
and premamillary nuclei).

Question 17

Questions 133-137
The response options for items 133-137 are the
same. You will be required to select one answer
for each item in the set.
(A) Glutamate
(B) Glycine
(C) p-Endorphin
(D) Enkephalin
(E) Substance P
Match each description below with the appro-
priate neurotransmitter
137. Helps inhibit input from afferent pain
fibers

Answer 17

137-D. Enkephalinergic neurons in the dorsal horn of the spinal cord presynaptically inhibit the
dorsal root ganglion cells that mediate pain impulses.

Question 18

Questions 138-144
The response options for items 138-144 are the
same. You will be required to select one answer
for each item in the set.
(A) Left frontal lobe
(B) Left parietal lobe
(C) Right partial lobe
(D) Left temporal lobe
(E) Right occipital lobe
Match each of the following neurologic deficits
with the most likely lesion site.

138. Left upper quadrantanopia

Answer 18

138-E. A lesion of the lingual gyrus of the right occipital lobe can cause a left upper homony-
mous quadrantanopia. Lower retinal quadrants are represented in the lower banks of the cal-
carine sulcus.

Question 19

Questions 138-144
The response options for items 138-144 are the
same. You will be required to select one answer
for each item in the set.
(A) Left frontal lobe
(B) Left parietal lobe
(C) Right partial lobe
(D) Left temporal lobe
(E) Right occipital lobe
Match each of the following neurologic deficits
with the most likely lesion site.
139. Muscle weakness and clumsiness in the
right hand; slow effortful speech

Answer 19

139-A. A lesion of the Broca speech area (areas 44 and 45) and the adjacent motor cortex of the
precentral gyrus (area 4) can cause Broca expressive aphasia and an upper motor neuron (UMN)
lesion involving the hand area of the motor strip. This territory is supplied by the superior divi-
sion of the middle cerebral artery (prerolandic and rolandic arteries).

Question 20

Questions 138-144
The response options for items 138-144 are the
same. You will be required to select one answer
for each item in the set.
(A) Left frontal lobe
(B) Left parietal lobe
(C) Right partial lobe
(D) Left temporal lobe
(E) Right occipital lobe
Match each of the following neurologic deficits
with the most likely lesion site.
140. Inability to identify a key placed in the
left hand with the eyes closed

Answer 20

140-C. A parietal lesion in the left postcentral gyrus (areas 3, 1, and 2) or in the left superior pari-
etal lobule (areas 5 and 7) can cause astereognosis, the deficit in which a patient with eyes closed
cannot identify a familiar object placed in the right hand. This territory is supplied by the superior
division of the middle cerebral artery (the rolandic and anterior parietal arteries). The dorsal aspect
of the superior parietal lobule on the convex surface is also supplied by the anterior cerebral artery.

Question 21

Questions 138-144
The response options for items 138-144 are the
same. You will be required to select one answer
for each item in the set.
(A) Left frontal lobe
(B) Left parietal lobe
(C) Right partial lobe
(D) Left temporal lobe
(E) Right occipital lobe
Match each of the following neurologic deficits
with the most likely lesion site.
141. Denial of hemiparesis; patient ignores
stimuli from one side of the body

Answer 21

141-C. Characteristic signs of damage to the nondominant hemisphere include hemineglect, topo-
graphic memory loss, denial of deficit (anosognosia), and construction and dressing apraxia. A le-
sion in the right inferior parietal lobule could account for these deficits. This territory is supplied
by the inferior division of the middle cerebral artery (posterior parietal and angular arteries).

Question 22

Questions 138-144
The response options for items 138-144 are the
same. You will be required to select one answer
for each item in the set.
(A) Left frontal lobe
(B) Left parietal lobe
(C) Right partial lobe
(D) Left temporal lobe
(E) Right occipital lobe
Match each of the following neurologic deficits
with the most likely lesion site.
143. Patient is unable to identify fingers
touched by examiner when eyes are closed; is
unable to perform simple calculations

Answer 22

143-B. Gerstmann syndrome includes left-right confusion, finger agnosia, dysgraphia, and
dyscalculia. This syndrome results from a lesion of the left angular gyrus of the inferior parietal
lobule. This territory is supplied by branches from the inferior division of the middle cerebral
artery (angular and posterior parietal arteries).

Question 23

Questions 138-144
The response options for items 138-144 are the
same. You will be required to select one answer
for each item in the set.
(A)	Left frontal lobe
(B)	Left parietal lobe
(C)	Right partial lobe
(D)	Left temporal lobe
(E)	Right occipital lobe
Match each of the following neurologic deficits
with the most likely lesion site.
144.	Babinski sign and ankle clonus

Answer 23

144-A. A lesion of the anterior paracentral lobule results in an upper motor neuron (UMN) le-
sion (spastic paresis) involving the contralateral foot. Ankle clonus, exaggerated muscle stretch
reflexes, and the Babinski sign are common.

Question 24

Questions 138-144
The response options for items 138-144 are the
same. You will be required to select one answer
for each item in the set.
(A) Left frontal lobe
(B) Left parietal lobe
(C) Right partial lobe
(D) Left temporal lobe
(E) Right occipital lobe
Match each of the following neurologic deficits
with the most likely lesion site.
142. Poor comprehension of speech; patient is
unaware of the deficit

Answer 24

142-D. Wernicke receptive aphasia is characterized by poor comprehension of speech, unaware-
ness of the deficit, and difficulty finding the correct words to express a thought. The Wernicke
speech area is found in the posterior part of the left superior temporal gyrus (area 22). This terri-
tory is supplied by the inferior division of the middle cerebral artery (posterior temporal branches).