NEUROLAB: 2nd Shifting Flashcards
Painful, thermal sensations, light (crude) touch, and
pressure ascend in these tracts.
A. Anterolateral Spinothalamic Tract
B. Dorsal Column Medial Lemniscus
C. Lateral Corticospinal Tract
D. Anterior Corticospinal Tract
A. Anterolateral Spinothalamic Tract
It is a major pathway for voluntary movements and is
responsible for speed and agility of movements.
A. Anterolateral Spinothalamic Tract
B. Dorsal Column Medial Lemniscus
C. Lateral Corticospinal Tract
D. Anterior Corticospinal Tract
C. Lateral Corticospinal Tract
Where does CSF normally circulate?
A. Between dura mater and arachnoid mater
B. Between dura mater and pia mater
C. Between pia mater and arachnoid mater
C. Between pia mater and arachnoid mater
In adults, at what level does the spinal cord terminate?
A. Lower border of the 1st lumbar vertebra
B. Lower border of the 3rd lumbar vertebra
C. Upper border of the 1st lumbar vertebra
D. Upper border of the 3rd lumbar vertebra
A. Lower border of the 1st lumbar vertebra
This is present throughout the length of the spinal
cord and contains the long ascending fibers from the
sacral, lumbar, and lower six thoracic spinal nerves.
A. Fasciculus cuneatus
B. Fasciculus gracilis
C. Both
D. Neither
B. Fasciculus gracilis
In children, the spinal cord ends at what vertebral
level?
A. Lower border of the 1st lumbar vertebra
B. Lower border of the 3rd lumbar vertebra
C. Upper border of the 1st lumbar vertebra
D. Upper border of the 3rd lumbar vertebra
D. Upper border of the 3rd lumbar vertebra
In the somatotopic arrangement of the corticospinal
tract, what is the most lateral spinal cord segment?
A. Cervical segment
B. Thoracic segment
C. Lumbar segment
D. Sacral segment
D. Sacral segment
The primary second-order neuron of the tract
subserves proprioceptive and kinesthetic sensations
on the upper extremities
A. Nucleus cuneatus
B. Nucleus gracilis
C. Both
D. Neither
A. Nucleus cuneatus
What is the affected spinal cord segment in a patient
with a fracture of the T12 vertebra?
A. L3
B. L4
C. L5
D. S1
C. L5
What ascending tract subserves discriminative touch?
A. Anterior Spinothalamic Tract
B. Dorsal Column Medial Lemniscus
C. Lateral Spinothalamic Tract
B. Dorsal Column Medial Lemniscus
You have a patient with a tumor on the central part of
the spinal cord. Based on the case, the patient will
experience weakness and sensory loss in what part of
the body? Upper extremity or Lower extremity?
Upper extremity
Give 1 descending tract besides corticospinal tract
Any 1 of the following
1. Rubrospinal tract
2. Vestibulospinal tract
3. Tectospinal tract
TRUE OR FALSE: The medulla becomes the spinal cord at the level of foramen magnum
True
TRUE OR FALSE: Radicular spinal arteries supply the upper ⅔ of the spinal cord
False
Which of the following cranial nerves exit from the Pons?
a. Glossopharyngeal
b. Vestibulocochlear
c. Vagus
d. Oculomotor
b. Vestibulocochlear
A 65-year-old male presents to the emergency department for dizziness. On physical exam, he has difficulty abducting the left eye and peripheral facial palsy. Head computed tomography scan is concerning for ischemic stroke. What is the site of the lesion?
a. Brainstem
b. Pons
c. Medulla
d. Spinal Cord
b. Pons
TRUE OR FALSE: The tectum consists of 4 swellings, two superior, and two inferior colliculi, that are associated with hearing and vision, respectively.
False
TRUE OR FALSE: The nucleus of the tractus solitarius is located in the pons.
False
TRUE OR FALSE: The Edinger-Westphal nucleus is located in the medulla oblongata.
False
The following statements concern the medial medullary syndrome:
a. The tongue is paralyzed on the contralateral
side
b. Ipsilateral hemiplegia is evident
c. Ipsilateral sensations of sensation and movement are impaired
d. It is commonly caused by a thrombosis of a branch of the vertebral artery to the medulla
d. It is commonly caused by a thrombosis of a branch of the vertebral artery to the medulla
The following statements concern the lateral medullary syndrome:
a. It may be caused by thrombosis of the anterior inferior cerebellar artery
b. The nucleus ambiguus of the same side may be damaged
c. Analgesia and thermoanesthesia may be evident on the contralateral side of the face
d. Contralateral trunk and extremity hyperalgesia may occur
b. The nucleus ambiguus of the same side may be damaged
TRUE or FALSE: Affectation of the midbrain can
result in to decrease in the level of consciousness.
True
Lateral Vestibular nucleus can be found on what level of the brainstem?
a. Decussation of pyramids
b. Decussation of medial lemniscal
c. Olives
d. Just inferior to pons
e. Facial colliculus
f. All of the above
g. None of the above
d. Just inferior to pons
The superior colliculus is located on what part of the
brainstem.
A. Midbrain
B. Pons
C. Medulla oblongata
A. Midbrain
Medulla comes from what primary division.
A. Prosencephalon
B. Mesencephalon
C. Rhombencephalon
C. Rhombencephalon
Main sensory nucleus of the trigeminal nerve can be
seen at what level of the pons?
A. Spinal nucleus of CN V
B. Trigeminal nucleus / nuclei
C. Mesencephalic nuclei of CN V
B. Trigeminal nucleus / nuclei
Edinger-Westphal nucleus can be found on what level of
the brainstem.
a. Decussation of pyramids
b. Decussation of medial lemniscal
c. Olives
d. Just inferior to pons
e. Facial colliculus
f. Trigeminal nuclei
g. Superior Colliculus
h. Inferior Colliculus
i. All of the above
g. Superior Colliculus
Reticular system can be found on what level of the brainstem?
a. Decussation of pyramids
b. Decussation of medial lemniscal
c. Olives
d. Just inferior to pons
e. Facial colliculus
f. All of the above
g. None of the above
f. All of the above
Abducent nucleus can be found on what level of the brainstem?
a. Decussation of pyramids
b. Decussation of medial lemniscal
c. Olives
d. Just inferior to pons
e. Facial colliculus
f. All of the above
g. None of the above
e. Facial colliculus
The spinal tract of the trigeminal nerve ends at what
level of the brainstem?
a. Decussation of pyramids
b. Decussation of medial lemniscal
c. Olives
d. Just inferior to pons
e. Facial colliculus
f. All of the above
g. None of the above
e. Facial colliculus
Pons cradles what cranial nerves? Answer the cranial nerve numbers in Hindu Arabic numeral format.
5678
This nucleus is medial to dentate
A. Fastigial nucleus
B. Globose nucleus
C. Emboliform nucleus
C. Emboliform nucleus
What is the structure that connects the cerebellum to the midbrain?
Possible answers:
1. Superior cerebellar peduncles
2. Brachium Conjunctivum
The afferent fiber of the cerebellum from the spinal cord conveys muscle joint information from the muscle spindle, tendon organs, and joints of the lower trunk and lower extremities. This afferent fiber is
called:
A. Anterior spinocerebellar fibers
B. Posterior spinocerebellar fibers
B. Posterior spinocerebellar fibers
It is an afferent fiber of the cerebellum that passes through the inferior cerebellar peduncle only to receive signals from the cerebral cortex.
A. Corticopontocerebellar
B. Cerebro-olivocerebellar
C. Cerebroreticulocerebellar
B. Cerebro-olivocerebellar
The cerebellum is supplied by cerebrospinal fluid via what cavity?
A. Lateral ventricle
B. Cerebral aqueduct
C. Third ventricle
D. Fourth ventricle
D. Fourth ventricle
It is a cerebellar pathology wherein the patient has difficulty halting forceful movement after the resistive stimulus is removed.
A. Tremors
B. Rebound phenomenon
C. Nystagmus
D. Titubation
B. Rebound phenomenon
Give at least one coordination test that can be tested in the lower extremities for the presence of dysmetria.
Possible answers:
1. Drawing circle
2. Figure eight
3. Placing feet on floor markers
4. Foot tapping
5. Heel-on-shin / Heel-to-shin
6. Toe-to-examiner’s finger test
TRUE OR FALSE: Affectation of the cerebellum is an upper motor neuron disorder, which results in ipsilateral dysmetria, nystagmus, hypertonicity, and ataxia.
False
Dysdiadochokinesia will result in damage to what functional name of the affected structure?
A. Vestibulocerebellum
B. Spinocerebellum
C. Cerebrocerebellum
C. Cerebrocerebellum
Phylogenetic name of flocculonodular.
A. Archicerebellum
B. Paleocerebellum
C. Neocerebellum
A. Archicerebellum
You have a patient who suffered from spinal cord injury 2 weeks ago due to a gunshot wound on the T7 spinal cord segment. The patient is referred for PT assessment and treatment. What is the affected vertebra of the patient based on the affected spinal cord segment?
a. T4
b. T6
c. T8
d. T10
a. T4
You have a patient who suffered from a spinal cord injury 2 weeks ago due to a gunshot wound on the T7 spinal cord segment. The patient is referred for PT assessment and treatment. What is the dermatomal landmark of the affected spinal cord segment.
a. Above nipple line
b. Costal margin
c. Umbilicus
d. Medial side of the upper arm
b. Costal margin
You have a patient who suffered from a spinal cord injury 2 weeks ago due to a gunshot wound on the T7 spinal cord segment. According to his MRI, his
spinal cord (B) posterior aspect has been severely damaged. Which of the following symptom/s would you NOT expect from a patient to manifest?
a. Bilateral loss of crude touch below the level of lesion
b. Bilateral loss of pain and temperature below the level of lesion
c. Bilateral loss of vibratory sense, proprioception, and kinesthesia below the level of lesion
d. Both A and B
e. Both B and C
d. Both A and B
You have a patient who suffered from a spinal cord injury 2 weeks ago due to a gunshot wound on the T7 spinal cord segment. The patient also has
weakness graded ⅕ on (B) lower extremities. What is the second-order neuron of the affected tract based on the symptom of the patient.
a. Dorsal root ganglion
b. Internuncial neuron
c. Lower motor neuron
d. Nucleus gracilis
e. Substantia gelatinosa
b. Internuncial neuron
You have a patient who suffered from a spinal cord injury 2 weeks ago due to a gunshot wound on the T7 spinal cord segment. The patient manifests
problems with his epicritic sensations. No problems with the pain and temperature sensations and no weakness on the (B) limbs below the level of the lesion. What is the most lateral segment of the spared or unaffected tracts based on the somatotopic arrangement of the spinal cord?
a. Cervical
b. Thoracic
c. Lumbar
d. Sacral
d. Sacral
You have a patient with ® midbrain lesion due to atherosclerosis of the artery supplying the midbrain. Which of the following symptoms would the patient manifest secondary to the affected structure EXCEPT:
a. Decrease arousal
b. Difficulty in adducting the ® eye
c. Impaired pupillary light reflex
d. Internal strabismus
e. None of the above
d. Internal strabismus
You have a patient with ® midbrain lesion due to atherosclerosis of the artery supplying the midbrain. In this MRI result, you read that there was an
affectation of the ® superior colliculus level. Based on the affected structure, which of the following symptoms would you expect the patient to manifest EXCEPT:
a. Impaired auditory reflexes
b. Impaired consensual light reflex
c. Impaired eye movement especially towards the midline
d. Impaired voluntary movement of the limbs
a. Impaired auditory reflexes
You have a patient with a tumor on the brainstem. According to her MRI, the tumor is between the pons and medulla. Before the operation, the patient is
referred to PT assessment and intervention. The medulla is one of the affected structures of the patient. One of the levels of the medulla is at the level of the inferior cerebellar peduncle. Which of the following sign/s and symptom/s would you expect if this level is affected?
a. Deviation of the uvula
b. Impaired proprioception and vibratory sense
c. Weakness of the facial muscles
d. Both A and C
e. All of the above
a. Deviation of the uvula
You have a patient with a tumor on the brainstem. According to her MRI, the tumor is between the pons and medulla. Before the operation, the patient is referred to PT assessment and intervention. Based on the affected structures, which of the following symptom/s would you NOT expect to manifest on the patient.
a. Decrease level of consciousness
b. Dilation of pupils upon pupillary light reflex
c. Impaired pain sensation in the facial area
d. Weakness of the muscle of mastication
b. Dilation of pupils upon pupillary light reflex
You have a patient with a tumor on the brainstem. According to her MRI, the tumor is between the pons and medulla. Before the operation, the patient is referred to PT assessment and intervention. Affectation of the decussation of pyramids will result in damage to the following structures EXCEPT:
a. Accessory nucleus
b. Hypoglossal nucleus
c. Spinal nucleus of the trigeminal nerve
d. Nucleus Gracilis
e. Reticular system
b. Hypoglossal nucleus
You have a patient diagnosed to have multiple sclerosis. In her MRI, demyelination is evident in some parts of the cerebellum, cerebrum, and spinal cord. One of the affected parts of the cerebellum of the patient is the lateral zone of the hemisphere. The vermis is responsible for:
a. Controlling the muscles of the limbs’ distal parts, especially the hands and feet
b. Influencing the movements of the long axis of the body such as the neck, shoulders, thorax, abdomen, and hips
c. Planning of sequential movements of the entire body
d. All of the above
b. Influencing the movements of the long axis of the body such as the neck, shoulders, thorax, abdomen, and hips
You have a patient diagnosed to have multiple sclerosis. In her MRI, demyelination is evident in some parts of the cerebellum, cerebrum, and spinal cord. Among the lobes of the cerebellum, the posterior lobe is affected. Based on the affected lobe, which of the following symptoms would you expect to manifest in the patient?
a. Hypertonicity
b. Hypometria
c. Imbalance
d. Nystagmus
b. Hypometria
You have a patient diagnosed to have multiple sclerosis. In her MRI, demyelination is evident in some parts of the cerebellum, cerebrum, and spinal cord. The patient presents with gait ataxia. Which of the following tests is the most appropriate to conduct to accurately assess for the impairment patient?
a. Finger-to-nose
b. Heel-on-shin
c. Static standing balance
d. Walking around the circle
d. Walking around the circle
You have a patient diagnosed to have multiple sclerosis. In her MRI, demyelination is evident in some parts of the cerebellum, cerebrum, and spinal cord. One of the symptoms of the patient is the presence of nystagmus. Based on the patient’s presentation, the affected cerebellar nucleus is the _________.
a. Dentate nucleus
b. Emboliform nucleus
c. Fastigial nucleus
d. Dentate nucleus
c. Fastigial nucleus
You have a patient diagnosed to have multiple sclerosis. In her MRI, demyelination is evident in some parts of the cerebellum, cerebrum, and spinal cord. Which of the following signs and symptoms would the patient manifest due to affectation of the cerebellum EXCEPT:
a. Ataxia
b. Dysdiadochokinesia
c. Hypertonicity
d. Resting Tremor
d. Resting Tremor
