Pain Review Questions Flashcards
1
Q
- Structures of the rhinencephalon include the:
a. olfactory receptor cells
b. olfactory epithelium
c. olfactory bulbs
d. olfactory tracts and areas
e. all of the above
A
- E
2
Q
- Which of the following structures is not a cranial nerve?
a. trigeminal
b. olfactory
c. obturator
d. vagus
e. spinal accessory
A
- C
3
Q
- Which of the following statements regarding the optic
nerve are true?
a. It is the second cranial nerve.
b. It contains special afferent sensory fibers.
c. Fibers from each optic nerve cross the midline to exit
the chiasm together at the opposite optic tract.
d. Via the optic tract and optic radiations, visual information
carried by the optic nerve is projected onto
the occipital lobes.
e. all of the above
A
- E
4
Q
4. Systemic diseases that can cause visual impairment include: a. diabetes mellitus b. hypertension c. vitamin A deficiency d. vitamin B12 deficiency e. all of the above
A
- E
5
Q
5. Diseases that may affect the oculomotor (cranial nerve III) are: a. brain tumors b. aneurysms c. increased intracranial pressure d. low cerebrospinal fluid pressure e. all of the above
A
- E
6
Q
- Clinical symptoms associated with disorders of the oculomotor
nerve include:
a. severe facial pain
b. inactive pupil
c. palsy of the medial rectus muscle with weak adduction
d. b and c
e. all of the above
A
- D
7
Q
- Cranial nerve IV is the:
a. spinal accessory nerve
b. trochlear nerve
c. trigeminal nerve
d. glossopharyngeal nerve
e. supraorbital nerve
A
- B
8
Q
8. Palsy of the trochlear nerve will present clinically as the: a. inability to look downward b. inability to look upward c. inability to look inward d. b and c e. a and c
A
- E
9
Q
9. The most common disorder affecting the trigeminal nerve is: a. peripheral neuropathy b. wallerian degeneration c. moya moya disease d. trigeminal neuralgia e. none of the above
A
- D
10
Q
- Trigeminal neuralgia is:
a. characterized by paroxysms of shocklike pain
b. characterized by an association with multiple sclerosis
in 2% to 3% of patients
c. often caused by tortuous cranial blood vessels
d. severe in intensity
e. all of the above
A
- E
11
Q
- The most common cause of isolated abducens
(cranial nerve VI) palsy is:
a. microvascular disease associated with diabetes
b. Rift Valley fever
c. open-angle glaucoma
d. closed-angle glaucoma
e. none of the above
A
- A
12
Q
12. The patient suffering from abducens (cranial nerve VI) palsy will be unable to: a. abduct the eye on the affected side b. smell strong odors c. constrict the pupil d. elevate the scapula e. none of the above
A
- A
13
Q
- The facial nerve is made up of the following types
of nerve fibers:
a. branchial motor special visceral efferent fibers
b. visceral motor general visceral efferent fibers
c. special sensory special afferent fibers
d. general sensory general somatic afferent
e. all of the above
A
- E
14
Q
14. The most common disorder affecting the facial nerve is: a. trigeminal neuralgia b. Dercum’s disease c. Ramsay Hunt syndrome d. Bell’s palsy e. none of the above
A
- D
15
Q
- Abnormalities of the vestibulocochlear nerve can manifest
themselves clinically as:
a. pain in the posterior third of the tongue
b. vertigo
c. hearing loss
d. b and c
e. none of the above
A
- D
16
Q
16. The most common disorder affecting the glossopharyngeal nerve is: a. trigeminal neuralgia b. glossopharyngeal neuralgia c. Ramsay Hunt syndrome d. Bell’s palsy e. none of the above
A
- B
17
Q
- Functions related to the glossopharyngeal nerve include:
a. the ‘‘dry mouth’’ associated with fear
b. the salivation reflex associated with the smell of food
c. taste on the posterior two-thirds of the tongue
d. sensation of the external ear
e. all of the above
A
- E
18
Q
- The vagus nerve provides innervation to:
a. the posterior skin of the ear, the external surface of
the tympanic membrane, the pharynx, and the external
auditory meatus
b. sensory information from the larynx, esophagus, trachea,
and abdominal and thoracic viscera
c. information from the stretch receptors of the aortic
arch and chemoreceptors of the aortic bodies
d. innervation to the intrinsic muscles of the larynx
e. all of the above
A
- E
19
Q
19. Clinical findings suggestive of compromise of the vagus nerve include: a. hoarseness b. anisocoria c. difficulty swallowing d. a and b e. a and c
A
- E
20
Q
- Disorders of the spinal accessory nerve will present clinically
as:
a. weakness of the sternocleidomastoid muscle on the
affected side
b. weakness of the intercostal muscles on the affected
side
c. weakness of the trapezius muscle on the affected side
d. a and c
e. a and b
A
- D
21
Q
- Which of the following is not a clinical sign of damage to
the hypoglossal nerve?
a. weakness of the intrinsic muscles of the tongue
b. deviation of the extended tongue to the
affected side.
c. atrophy of the intrinsic muscles of the tongue on the
affected side when the compromise of the hypoglossal
nerve has been of long-standing
d. weakness of elevation of the contralateral shoulder
e. all of the above
A
- D
22
Q
- The greater occipital nerve:
a. is a peripheral branch of the second and third cervical
nerves
b. supplies the medial portion of the posterior scalp as
far anterior as the vertex
c. has been implicated as one of the nerves subserving
the pain of occipital neuralgia
d. all of the above
e. none of the above
A
- D
23
Q
- The sphenopalatine ganglion sends major branches to the:
a. gasserian ganglion and trigeminal nerves
b. carotid plexus
c. facial nerve
d. superior cervical ganglion
e. all of the above
A
- E
24
Q
- The superficial cervical plexus:
a. controls closure of the true vocal cords
b. arises from fibers of the primary ventral rami of
the first, second, third, and fourth cervical nerves
c. provides only motor innervation
d. provides innervation of the exocrine pancreas
e. all of the above
A
- B
25
Q
- The deep cervical plexus:
a. controls closure of the true vocal cords
b. arises from fibers of the primary ventral rami of the
first, second, third, and fourth cervical nerves
c. provides only motor innervation
d. contributes fibers to the phrenic nerve
e. b and d
A
- E
26
Q
- The stellate ganglion is:
a. located in the retrocrural space
b. made up primarily of special efferent motor fibers
c. formed by the fusion of the inferior cervical and the
first thoracic ganglion as they meet anterior to the
vertebral body of C7
d. inferior to the celiac plexus
e. all of the above
A
- C
27
Q
27. The following structures are anterior to the stellate ganglion: a. skin b. subcutaneous tissue c. sternocleidomastoid muscle d. carotid sheath e. all of the above
A
- E
28
Q
- The following are true statements about the structure and
function of the cervical vertebrae:
a. There are seven cervical vertebrae.
b. The first cervical vertebra is called atlas.
c. The second cervical vertebra is called axis.
d. The transverse foramen protects and allows passage
of the vertebral artery and vein.
e. all of the above
A
- E
29
Q
- Rudimentary structures found on the seventh cervical
vertebra in a small number of patients are called:
a. chorionic villi
b. cervical ribs
c. Schmorl’s nodes
d. sesamoid bones
e. none of the above
A
- B
30
Q
- Which of the following statements are true about the
cervical intervertebral disc?
a. It serves as the major shock absorbing structure of the
cervical spine.
b. It prevents impingement of the adjacent neural
structures.
c. It helps facilitate the synchronized movement of the
cervical spine.
d. It prevents impingement of the vasculature that traverse
the cervical spine.
e. all of the above
A
- E
31
Q
31. The top and bottom of the cervical intervertebral discs are called the: a. syndesmotic junction b. nucleus pulposus c. end plates d. vomer e. none of the above
A
- C
32
Q
32. The outside of the cervical intervertebral disc is made up of a woven crisscrossing matrix of fibroelastic fibers called the: a. annulus b. nucleus pulposus c. end plates d. vomer e. none of the above
A
- A
33
Q
33. The center of the disc is the water-containing mucopolysaccharide gel-like substance called the: a. annulus b. nucleus pulposus c. end plates d. vomer e. none of the above
A
- B
34
Q
- The meninges are made up of three layers that include the:
a. pia mater
b. arachnoid mater
c. dura mater
d. tunica alba
e. a, b, and c
A
- E
35
Q
- The cerebrospinal fluid is absorbed by the:
a. tunica alba
b. pineal gland
c. arachnoid granulations
d. lacrimal glands
e. all of the above
A
- C
36
Q
- The cervical epidural space is bounded by the:
a. fusion of the periosteal and spinal layers of dura at the
foramen magnum superiorly
b. posterior longitudinal ligament anteriorly
c. vertebral laminae and the ligamentum flavum
posteriorly
d. vertebral pedicles and intervertebral foramina laterally
e. all of the above
A
- E
37
Q
- The cervical epidural space contains:
a. fat
b. veins and arteries
c. lymphatics
d. connective tissue
e. all of the above
A
- E
38
Q
- Which of the following statements regarding the cervical
facet joints is false?
a. The lower cervical facet joints receive innervation
from one vertebral level.
b. The atlanto-occipital and atlantoaxial joints are
unique relative to the other cervical facet joints.
c. The lower cervical facet joints receive innervation
from two vertebral levels.
d. The lower cervical facet joints are true joints as they
are lined with synovium.
e. All of the statements are false.
A
- A
39
Q
39. Which of the following structures aid in stabilizing the cervical spine? a. ligamentum nuchae b. interspinous ligament c. supraspinous ligament d. ligamentum flavum e. all of the above
A
- E
40
Q
40. The smaller upper four thoracic vertebrae share characteristics in common with the: a. cervical vertebrae b. thoracic vertebrae c. lumbar vertebrae d. sacrum e. none of the above
A
- A
41
Q
41. The larger lower four thoracic vertebrae share characteristics in common with the: a. cervical vertebrae b. thoracic vertebrae c. lumbar vertebrae d. sacrum e. none of the above
A
- C
42
Q
42. A distinguishing characteristic of the first 10 thoracic vertebrae is the presence of: a. intervertebral foramen b. articular facets for the ribs c. arachnoid granulations d. no end plates e. all of the above
A
- B
43
Q
43. The following structure is found at the T4 dermatome in most patients: a. nipple b. jugular notch c. stellate ganglion d. umbilicus e. none of the above
A
- A
44
Q
44. The following structure is found at the T10 dermatome in most patients: a. nipple b. jugular notch c. stellate ganglion d. umbilicus e. none of the above
A
- D
45
Q
45. The following structure is found at the L4 dermatome in most patients: a. nipple b. jugular notch c. iliac crest d. umbilicus e. none of the above
A
- C
46
Q
46. The brachial plexus is formed by the fusion of the anterior (ventral) rami of the: a. C5 spinal nerve b. C6 spinal nerve c. C7 spinal nerve d. C8 and T1 spinal nerves e. all of the above
A
- E
47
Q
47. The brachial plexus occasionally receives contributions from the anterior (ventral) rami of the: a. C2 spinal nerve b. C4 spinal nerve c. T2 spinal nerve d. b and c e. all of the above
A
- D
48
Q
- The brachial plexus is subdivided into:
a. roots
b. trunks
c. divisions and cords
d. terminal branches
e. all of the above
A
- E
49
Q
- Injuries that are isolated to the musculocutaneous nerve
present clinically as:
a. painless weakness of elbow flexion
b. painless weakness of elbow supination
c. localized sensory deficit on the radial side of the forearm
d. all of the above
e. none of the above
A
- D
50
Q
- The musculocutaneous nerve arises from the:
a. lateral cord of the brachial plexus
b. posterior cord of the brachial plexus
c. medial cord of the brachial plexus
d. all of the above
e. none of the above
A
- A
51
Q
- The ulnar nerve provides sensory innervation to the:
a. ulnar aspect of the dorsum of the hand
b. dorsal aspect of the little finger and the ulnar half
of the ring
c. palmar aspect of the little finger and the ulnar half
of the ring finger.
d. all of the above
e. none of the above
A
- D
52
Q
- The ulnar nerve:
a. arises from the medial cord of the brachial plexus
b. is made up of fibers from C8-T1 spinal roots
c. lies medial and inferior to the axillary artery
d. all of the above
e. none of the above
A
- D
53
Q
- The median nerve provides sensory innervation to:
a. a portion of the palmar surface of the hand
b. the palmar surface of the thumb, index and middle
fingers, and the radial portion of the ring finger
c. distal dorsal surface of the index and middle fingers
and the radial portion of the ring finger
d. all of the above
e. none of the above
A
- D
54
Q
- The median nerve:
a. arises from the medial and lateral cords of the brachial
plexus
b. is made up of fibers from C5-T1 spinal roots
c. lies anterior and superior to the axillary artery
d. all of the above
e. none of the above
A
- D
55
Q
- Entrapment of the median nerve:
a. occurs most commonly at the wrist
b. occurs most commonly at the elbow
c. is known as carpal tunnel syndrome
d. all of the above
e. a and c
A
- E
56
Q
- The radial nerve:
a. arises from the posterior cord of the brachial plexus
b. is made up of fibers from C5-T1 spinal roots
c. lies posterior and inferior to the axillary artery
d. all of the above
e. none of the above
A
- D
57
Q
- Damage to the radial nerve as it winds around the shaft
of the humerus is characterized by:
a. palsy or paralysis of all extensors of the wrist and digits
b. palsy or paralysis of the forearm supinators
c. numbness over the dorsoradial aspect of the hand and
the dorsal aspect of the radial 31=2 digits
d. all of the above
e. none of the above
A
- D
58
Q
- Which of the following statements is true regarding the
glenohumeral joint?
a. The humeral head articulates with the glenoid fossa.
b. It is a true joint.
c. It is the most commonly dislocated joint in humans.
d. all of the above
e. none of the above
A
- D
59
Q
- The acromioclavicular joint is formed by the:
a. distal end of the clavicle and the anterior and medial
aspect of the acromion
b. head of the humerus and the glenoid fossa
c. sternoclavicular space
d. articulation of the first rib and the vertebra
e. none of the above
A
- A
60
Q
- The subdeltoid bursa lies primarily under the:
a. acromion extending laterally between the deltoid
muscle and joint capsule
b. scapula
c. suprascapular notch
d. all of the above
e. none of the above
A
- A
61
Q
- The biceps muscle:
a. supinates the forearm
b. flexes the elbow joint
c. is innervated by the musculocutaneous nerve
d. has a long and a short head
e. all of the above
A
- E
62
Q
- The muscles that comprise the rotator cuff include the:
a. supraspinatus muscle
b. infraspinatus muscle
c. teres minor muscle
d. subscapularis muscle
e. all of the above
A
- E
63
Q
- The muscles and their associated fascia and tendons of
the rotator cuff:
a. work in concert to maintain the stability of the shoulder
joint throughout a wide and varied range of
motion
b. assist in deglutition
c. are subject to tears from overuse or misuse
d. a and c
e. none of the above
A
- D
64
Q
- The supraspinatus muscle:
a. is the most important muscle of the rotator cuff
b. provides shoulder joint stability
c. along with the deltoid muscle abducts the arm at the
shoulder by fixing the head of the humerus firmly
against the glenoid fossa.
d. is innervated by the suprascapular nerve
e. all of the above
A
- E
65
Q
- The infraspinatus muscle:
a. provides shoulder joint stability
b. along with the teres minor muscle externally rotates
the arm at the shoulder
c. is innervated by the suprascapular nerve
d. all of the above
e. none of the above
A
- D
66
Q
- The subcoracoid bursa lies:
a. between the joint capsule and the coracoid process
b. just inferior to the jugular notch
c. at the costosternal junction
d. at the costovertebral angle
e. none of the above
A
- A
67
Q
- The intercostal nerves arise from the:
a. stellate ganglion
b. anterior division of the thoracic paravertebral nerves
c. celiac plexus
d. all of the above
e. none of the above
A
- B
68
Q
- The four branches of a typical intercostal nerve include the:
a. unmyelinated postganglionic fibers of the gray rami
communicantes
b. posterior cutaneous branch
c. lateral cutaneous division
d. anterior cutaneous branch
e. all of the above
A
- E
69
Q
- The 12th intercostal nerve is commonly known as the:
a. subcostal nerve
b. posterior cutaneous branch
c. lateral cutaneous division
d. anterior cutaneous branch
e. all of the above
A
- A
70
Q
70. The first thoracic ganglion is fused with the lower cervical ganglion to help make up the: a. gasserian ganglion b. ganglion of Impar c. stellate ganglion d. all of the above e. none of the above
A
- C
71
Q
71. The major preganglionic contribution to the celiac plexus is provided by the: a. greater splanchnic nerves b. lesser splanchnic nerves c. least splanchnic nerves d. all of the above e. none of the above
A
- D
72
Q
- The ganglia usually lie approximately at the level of:
a. the fifth intercostal vein
b. T6
c. the first lumbar vertebra
d. the third lumbar vertebra
e. none of the above
A
- C
73
Q
- The celiac plexus is:
a. anterior to the crus of the diaphragm
b. posterior to the crus of the diaphragm
c. superior to the crus of the diaphragm
d. intrathoracic
e. none of the above
A
- A
74
Q
- The superior hypogastric plexus lies in front of:
a. L1
b. L4
c. T12
d. the greater curvature of the stomach
e. none of the above
A
- B
75
Q
75. The hypogastric nerves provide sympathetic innervation to the: a. pelvic viscera b. esophagus c. pelvic viscera d. a and c e. b and c
A
- C
76
Q
- The lumbar sympathetic chain and ganglia lie:
a. at the anterolateral margin of the lumbar vertebral
bodies
b. in the peritoneal cavity
c. within the spinal canal
d. within the corresponding spinal nerve roots
e. none of the above
A
- A
77
Q
- The peritoneal cavity lies lateral and anterior to the:
a. small intestine
b. lumbar sympathetic chain
c. colon
d. all of the above
e. none of the above
A
- B
78
Q
- The greater splanchnic nerve has its origin from the:
a. T5-10 spinal roots
b. C7-T2 spinal roots
c. stellate ganglion
d. all of the above
e. none of the above
A
- A
79
Q
- The lesser splanchnic nerve arises from the:
a. T10-11 roots
b. C7-T2 spinal roots
c. stellate ganglion
d. all of the above
e. none of the above
A
- A
80
Q
- The least splanchnic nerve has its origin from the:
a. T11-12 spinal roots
b. C7-T2 spinal roots
c. stellate ganglion
d. all of the above
e. none of the above
A
- A
81
Q
- The elbow joint is composed of the following bones:
a. humerus
b. ulna
c. radius
d. all of the above
e. none of the above
A
- D
82
Q
82. The bursae most commonly inflamed by overuse or misuse of the elbow include the: a. olecranon bursa b. cubital bursa c. pes anserine bursa d. b and c e. a and b
A
- E
83
Q
- The olecranon bursa lies:
a. in the posterior aspect of the elbow joint between the
olecranon process of the ulna and the overlying skin
b. in the antecubital fossa lateral to the artery
c. in the antecubital fossa medial to the artery
d. under the biceps brachii muscle
e. none of the above
A
- A
84
Q
- The cubital bursa:
a. lies in the anterior aspect of the elbow
b. is subject to inflammation from overuse or misuse of
the elbow
c. may become infected
d. may become calcified if the inflammation becomes
chronic
e. all of the above
A
- E
85
Q
- The radial nerve at the elbow lies between the:
a. lateral epicondyle of the humerus and the musculospiral
groove
b. the fascia of the triceps muscle and the muscle
substance
c. fascia of the biceps muscle and the muscle substance
d. none of the above
e. all of the above
A
- A
86
Q
- The cubital tunnel:
a. contains the axillary artery and nerve
b. is made up of the olecranon process and medial epicondyle
of the humerus
c. contains the radial artery and nerve
d. a and b
e. b and c
A
- B
87
Q
- The anterior interosseous nerve:
a. provides motor innervation to the flexor muscles of
the forearm
b. is susceptible to nerve entrapment by aberrant ligaments,
muscle hypertrophy, and direct trauma
c. is a branch of the median nerve
d. all of the above
e. none of the above
A
- D
88
Q
- The lateral antebrachial cutaneous nerve:
a. is a continuation of the musculocutaneous nerve
b. is susceptible to entrapment as the nerve passes lateral
to the fascia of the biceps tendon
c. passes behind the cephalic vein, where it divides into a
volar branch that continues along the radial border of
the forearm
d. provides sensory innervation to the skin over the lateral
half of the volar surface of the forearm
e. all of the above
A
- E
89
Q
- The wrist allows which of the following movements?
a. flexion/extension
b. radial/ulnar deviation
c. pronation/supination
d. all of the above
e. none of the above
A
- D
90
Q
- The wrist is made up of the following joints:
a. distal radioulnar joint
b. radiocarpal joint and the ulnar carpal joint
c. proximal carpal joints
d. midcarpal joints
e. all of the above
A
- E
91
Q
- The triangular fibroelastic cartilage:
a. is located primarily between the distal ulna and the
lunate and triquetrum
b. is made up of very strong fibroelastic fibers
c. acts like an intervertebral disc in that it serves as the
primary shock absorber of the wrist and acts like a
ligament in that it serves as the primarily stabilizer for
the distal radioulnar joint
d. has a poor vascular supply and heals poorly
e. all of the above
A
- E
92
Q
- The ulnar tunnel is:
a. the space between the pisiform and hamate bones of
the wrist through which the ulnar nerve and artery
pass
b. also known as the cubital tunnel
c. also known as Guyon’s canal
d. a and b
e. a and c
A
- E
93
Q
- The carpal tunnel:
a. is bounded on three sides by the carpal bones and is
covered by the transverse carpal ligament
b. contains the radial nerve
c. contains the median nerve
d. a and b
e. a and c
A
- E
94
Q
94. In addition to the median nerve, the carpal tunnel also contains: a. a number of flexor tendon sheaths b. blood vessels c. lymphatics d. all of the above e. none of the above
A
- D
95
Q
- The carpometacarpal joint:
a. is a synovial, saddle-shaped joint
b. is a synovial hinge type joint
c. serves as the articulation between the trapezium and
the base of the first metacarpal
d. a and b
e. a and c
A
- E
96
Q
- The carpometacarpal joints of the fingers:
a. are synovial plane joints that serve as the articulation
between the carpals and the metacarpals
b. also allow articulation of the bases of the metacarpal
bones with one another
c. is a synovial hinge-type joint
d. a and b
e. a and c
A
- D
97
Q
- The metacarpophalangeal joint:
a. is a synovial, ellipsoid-shaped joint
b. serves as the articulation between the base of the
proximal phalanges and the head of its respective
metacarpal
c. is a synovial hinge-type joint
d. a and b
e. a and c
A
- D
98
Q
- The interphalangeal joints:
a. are synovial hinge-shaped joints
b. are synovial plane joints
c. serve as the articulation between the phalanges
d. a and b
e. a and c
A
- E
99
Q
- The sciatic nerve:
a. innervates the distal lower extremity and foot
with the exception of the medial aspect of the
calf and foot, which are subserved by the saphenous
nerve
b. is the largest nerve in the body
c. is derived from the L4, L5, and S1-3 nerve roots
d. all of the above
e. none of the above
A
- D
100
Q
- Branches of the sciatic nerve include the:
a. tibial
b. common peroneal nerves
c. ganglion of Impar
d. a and b
e. a and c
A
- D
101
Q
- The lumbar plexus:
a. lies within the substance of the psoas muscle
b. is made up of the ventral roots of the first four
lumbar nerves and, in some patients, a contribution
from the 12th thoracic nerve
c. consists of nerves that lie in front of the transverse
processes of their respective vertebrae as they course
inferolaterally
d. consists of nerves that divide into a number of
peripheral nerves
e. all of the above
A
- E
102
Q
- The femoral nerve:
a. innervates the anterior portion of the thigh and
medial calf
b. is derived from the posterior branches of the L2, L3,
and L4 nerve roots
c. roots fuse together in the psoas muscle and descend
laterally between the psoas and iliacus muscles to
enter the iliac fossa
d. gives off motor fibers to the iliac, sartorius, quadriceps
femoris, and pectineus muscles
e. all of the above
A
- E
103
Q
- The femoral nerve:
a. passes beneath the inguinal ligament to enter the
thigh
b. is just lateral to the femoral artery as it passes
beneath the inguinal ligament
c. is enclosed with the femoral artery and vein within
the femoral sheath
d. provides sensory fibers to the knee joint as well as
the skin overlying the anterior thigh
e. all of the above
A
- E
104
Q
- The lateral femoral cutaneous nerve:
a. is formed from the posterior divisions of the L2 and
L3 nerves
b. leaves the psoas muscle and courses laterally
and inferiorly to pass just beneath the ilioinguinal
nerve at the level of the anterior superior iliac
spine and then divides into an anterior and a posterior
branch
c. provides limited cutaneous sensory innervation over
the anterolateral thigh through its anterior branch
d. provides cutaneous sensory innervation to the lateral
thigh from just above the greater trochanter to the
knee through its posterior branch
e. all of the above
A
- E
105
Q
105. Entrapment of the lateral femoral cutaneous nerve is known as: a. meralgia paresthetica b. ilioinguinal neuralgia c. genitofemoral neuralgia d. femoral neuralgia e. none of the above
A
- A
106
Q
- The ilioinguinal nerve:
a. is a branch of the L1 nerve root with a contribution
from T12 in some patients
b. follows a curvilinear course that takes it from its
origin of the L1 and occasionally T12 somatic
nerves to inside the concavity of the ilium
c. continues anteriorly to perforate the transverse
abdominal muscle at the level of the anterior superior
iliac spine.
d. may interconnect with the iliohypogastric nerve as
it continues to pass along its course medially
and inferiorly, where it accompanies the spermatic
cord through the inguinal ring and into the inguinal
canal
e. all of the above
A
- E
107
Q
- Entrapment of the ilioinguinal nerve is known as:
a. meralgia paresthetica
b. ilioinguinal neuralgia
c. genitofemoral neuralgia
d. femoral neuralgia
e. none of the above
A
- B
108
Q
- Entrapment of the iliohypogastric nerve is known as:
a. meralgia paresthetica
b. iliohypogastric neuralgia
c. genitofemoral neuralgia
d. femoral neuralgia
e. none of the above
A
- B
109
Q
- Entrapment of the genitofemoral nerve is known as:
a. meralgia paresthetica
b. ilioinguinal neuralgia
c. genitofemoral neuralgia
d. femoral neuralgia
e. none of the above
A
- C
110
Q
- The iliohypogastric nerve:
a. is a branch of the L1 nerve root with a contribution
from T12 in some patients
b. follows a curvilinear course that takes it from its
origin of the L1 and occasionally T12 somatic
nerves to inside the concavity of the ilium
c. continues anteriorly to perforate the transverse
abdominal muscle to lie between it and the external
oblique muscle where it divides into an anterior and
a lateral branch
d. all of the above
e. none of the above
A
- D
111
Q
- The ilioinguinal nerve:
a. provides cutaneous sensory innervation to the posterolateral
gluteal region via its lateral branch
b. pierces the external oblique muscle just beyond the
anterior superior iliac spine to provide cutaneous
sensory innervation to the abdominal skin above
the pubis via its anterior branch
c. may interconnect with the ilioinguinal nerve along
its course, resulting in variation of the distribution of the sensory innervation of the iliohypogastric and
ilioinguinal nerves
d. all of the above
e. none of the above
A
- D
112
Q
- The genitofemoral nerve:
a. is a branch of the L1 nerve root with a contribution
from T12 in some patients
b. follows a curvilinear course that takes it from its
origin of the L1 and occasionally T12 and L2 somatic
nerves to inside the concavity of the ilium
c. descends obliquely in an anterior course through the
psoas major muscle to emerge on the abdominal
surface opposite L3 or L4
d. all of the above
e. none of the above
A
- D
113
Q
- The genitofemoral nerve:
a. divides into a genital and femoral branch just above
the inguinal ligament
b. in males, the genital branch travels through the
inguinal canal passing inside the deep inguinal ring
to innervate the cremaster muscle and skin of the
scrotum
c. in females, the genital branch follows the course of
the round ligament and provides innervation to the
ipsilateral mons pubis and labia majora
d. in males and females, the femoral branch
descends lateral to the external iliac artery to pass
behind the inguinal ligament to enter the femoral
sheath lateral to the femoral artery to
innervate the skin of the anterior superior femoral
triangle
e. all of the above
A
- E
114
Q
- The obturator nerve:
a. provides the majority of innervation to the hip joint
b. is derived from the posterior divisions of the L2, L3,
and L4 nerves
c. leaves the medial border psoas muscle and courses
inferiorly to pass the pelvis, where it joins the obturator
vessels to travel via the obturator canal to enter
the thigh where it then divides into an anterior and
posterior branch
d. all of the above
e. none of the above
A
- D
115
Q
- The anterior branch of the obturator nerve supplies:
a. an articular branch to provide sensory innervation to
the hip joint
b. motor branches to the superficial hip adductors
c. a cutaneous branch to the medial aspect of the distal
thigh
d. all of the above
e. none of the above
A
- D
116
Q
- The posterior branch of the obturator nerve provides:
a. motor innervation to the deep hip adductors
b. an articular branch to the posterior knee joint.
c. motor innervation to the superficial hip abductors
d. a and b
e. a and c
A
- D
117
Q
- The ganglion of Impar:
a. lies in front of the coccyx just below the sacrococcygeal
junction
b. is the terminal coalescence of the sympathetic chains
c. receives fibers from the lumbar and sacral portions
of the sympathetic and parasympathetic nervous
system
d. all of the above
e. none of the above
A
- E
118
Q
- The tibial nerve:
a. is one of the two major continuations of the sciatic
nerve
b. provides sensory innervation to the posterior
portion of the calf, the heel, and the medial plantar
surface
c. splits from the sciatic nerve at the superior margin of
the popliteal fossa and descends in a slightly medial
course through the popliteal fossa
d. continues its downward course, running between the
two heads of the gastrocnemius muscle, passing deep
to the soleus muscle
e. all of the above
A
- E
119
Q
- The tibial nerve:
a. courses medially between the Achilles tendon and
the medial malleolus, where it divides into the
medial and lateral plantar nerves
b. provides sensory innervation to the heel and medial
plantar surface
c. provides motor innervation to the extensor hallucis
longus
d. a and b
e. a and c
A
- D
120
Q
120. Entrapment of the tibial nerve as it courses medially between the Achilles tendon and the medial malleolus is known as: a. anterior tarsal tunnel syndrome b. posterior tarsal tunnel syndrome c. hallux rigidus d. meralgia paresthetica e. none of the above
A
- B
121
Q
- The common peroneal nerve:
a. is one of the two major continuations of the sciatic
nerve
b. provides sensory innervation to the inferior portion
of the knee joint and the posterior and lateral skin of
the upper calf
c. is derived from the posterior branches of the L4, the
L5, and the S1 and S2 nerve roots
d. splits from the sciatic nerve at the superior margin of
the popliteal fossa and descends laterally behind the
head of the fibula
e. all of the above
A
- E
122
Q
- The ischial bursa:
a. lies between the gluteus maximus muscle and the
ischial tuberosity
b. lies between the inguinal ligament and the
acetabulum
c. lies between the tensor fascia lata and the greater
trochanter
d. all of the above
e. none of the above
A
- A
123
Q
- The hip:
a. is a ball-and-socket type joint
b. is composed of the femoral head and the cup-shaped
acetabulum
c. has a femoral head that is completely covered with
hyaline cartilage except for a central area called
the fovea, which is the point of attachment for the
ligamentum teres
d. all of the above
e. none of the above
A
- E
124
Q
- The gluteal bursae:
a. lie between the gluteal maximus, medius, and minimus
muscles as well as between these muscles and
the underlying bone
b. lie between the inguinal ligament and the
acetabulum
c. lie between the tensor fascia lata and the greater
trochanter
d. all of the above
e. none of the above
A
- A
125
Q
- The trochanteric bursa:
a. lies between the greater trochanter and the tendon
of the gluteus medius and the iliotibial tract
b. lies between the inguinal ligament and the
acetabulum
c. lies between the tensor fascia lata and the greater
trochanter
d. all of the above
e. none of the above
A
- A
126
Q
- The SI joint:
a. is a synovial (diarthrodial) joint
b. is more mobile in youth than later in life
c. becomes more fibrotic in adulthood in the upper
two-thirds of the joint
d. of the female pelvis is also more mobile to accommodate
pregnancy and parturition
e. all of the above
A
- E
127
Q
- The SI joint:
a. is densely innervated by several levels of spinal
nerves (L3-S1)
b. may produce lumbar disc–like symptoms when
stimulated
c. has muscle insertions near the joint such as the gluteus
maximus and hamstrings, which may refer pain
to the hip and ischial area, respectively, when
stressed
d. all of the above
e. none of the above
A
- D
128
Q
- The femoral-tibial joint:
a. is made up of the articulation of the femur and the
tibia
b. is a synarthrodial joint
c. is not a true joint
d. all of the above
e. none of the above
A
- A
129
Q
- The main extensor of the knee is:
a. the extensor hallucis longus
b. the quadriceps muscle that attaches to the patella via
the quadriceps tendon
c. the extensor hallucis brevis
d. all of the above
e. none of the above
A
- B
130
Q
- The main flexors of the knee joint are the:
a. hamstrings
b. gastrocnemius
c. sartorius
d. gracilis
e. all of the above
A
- E
131
Q
- The prepatellar bursa:
a. lies between the subcutaneous tissues and the patella
b. lies deep to the inguinal ligament
c. is superficial to the inguinal ligament
d. is deep to the pes anserine bursa
e. none of the above
A
- A
132
Q
- The suprapatellar bursa:
a. extends superiorly from beneath the patella under
the quadriceps femoris muscle and its tendon.
b. lies deep to the inguinal ligament
c. is superficial to the inguinal ligament
d. is deep to the pes anserine bursa
e. none of the above
A
- A
133
Q
- The deep infrapatellar bursa:
a. lies between the ligamentum patellae and the tibia
b. lies deep to the inguinal ligament
c. is superficial to the inguinal ligament
d. is deep to the infrapatellar fossa
e. none of the above
A
- A
134
Q
- The superficial infrapatellar bursa:
a. lies between the subcutaneous tissues and the ligamentum
patellae
b. lies deep to the inguinal ligament
c. is superficial to the inguinal ligament
d. is deep to the infrapatellar fossa
e. none of the above
A
- A
135
Q
- The pes anserine bursa:
a. lies between the combined tendinous insertion of the
sartorius, gracilis, and semitendinosus muscles and
the medial tibia
b. lies deep to the inguinal ligament
c. is superficial to the inguinal ligament
d. is deep to the infrapatellar fossa
e. none of the above
A
- A
136
Q
- The iliotibial band bursa:
a. lies between the iliotibial band and the lateral condyle
of the femur
b. lies deep to the inguinal ligament
c. is superficial to the inguinal ligament
d. is deep to the infrapatellar fossa
e. none of the above
A
- A
137
Q
- The iliotibial band:
a. is an extension of the fascia lata that inserts at the
lateral condyle of the tibia
b. can rub backward and forward over the lateral
epicondyle of the femur
c. can irritate the iliotibial bursa beneath it
d. all of the above
e. none of the above
A
- D
138
Q
- The distal joint between the tibia and fibula:
a. allows very little movement with the hinge joint
formed by the distal ends of the tibia and fibula
and the talus providing dorsiflexion and plantar flexion
needed for ambulation
b. is stabilized by the medial and lateral malleoli, which
extend along the sides of the talus to form a mortise
and prevents ankle rotation
c. is further strengthened by the deltoid ligament medially
and the anterior talofibular, posterior talofibular,
and calcaneofibular ligaments laterally
d. all of the above
e. none of the above
A
- D
139
Q
- The talocalcaneal joint:
a. lies between the talus and calcaneus
b. allows for additional range of motion of the ankle
joint and makes up for the limitations of motions
placed on the joint by the mortise structure of the
talus and medial and lateral malleoli
c. permits approximately 30 degrees of foot inversion
d. permits 15 to 20 degrees of foot eversion, which
allows walking on uneven surfaces
e. all of the above
A
- E
140
Q
- The deltoid ligament:
a. has two layers
b. attaches above to the medial malleolus
c. has a deep layer that attaches below to the medial
body of the talus
d. superficial fibers attach to the medial talus and the
sustentaculum tali of the calcaneus and the navicular
tuberosity
e. all of the above
A
- E
141
Q
- The anterior talofibular ligament:
a. runs from the anterior border of the lateral malleolus
to the lateral surface of the talus
b. attaches above to the medial malleolus
c. has a deep layer that attaches below to the medial
body of the talus
d. superficial fibers attach to the medial talus and the
sustentaculum tali of the calcaneus and the navicular
tuberosity
e. all of the above
A
- A
142
Q
- The posterior tarsal tunnel:
a. is made up of the flexor retinaculum, the bones of
the ankle, and the lacunate ligament
b. is the site of compression of the tibial nerve
c. contains the posterior tibial artery and a number of
flexor tendons
d. all of the above
e. none of the above
A
- D
143
Q
- The deep branch of the peroneal nerve:
a. continues down the leg in conjunction with the tibial
artery and vein to provide sensory innervation to the
web space of the first and second toes and adjacent
dorsum of the foot
b. provides motor innervation to all of the toe
extensors
c. passes beneath the dense superficial fascia of the
ankle where it is subject to entrapment called anterior
tarsal tunnel syndrome
d. all of the above
e. none of the above
A
- D
144
Q
- The Achilles tendon:
a. is the thickest and strongest tendon in the body,
yet also very susceptible to rupture
b. is the common tendon of the gastrocnemius muscle
c. begins at mid-calf and continues downward to attach
to the posterior calcaneus, where it may become
inflamed
d. narrows during its downward course, becoming
most narrow approximately 5 cm above its calcaneal
insertion
e. all of the above
A
- E
145
Q
- The Achilles bursa:
a. lies between the Achilles tendon and the base of the
tibia and the posterior calcaneus
b. is rarely inflamed
c. lies superficial to the Achilles tendon and the base of
the tibia and the posterior calcaneus
d. all of the above
e. none of the above
A
- A
146
Q
- The Achilles bursa:
a. may become inflamed with overuse or misuse
b. is located in the anterior tarsal tunnel
c. may become inflamed in association with Achilles
tendonitis
d. a and b
e. a and c
A
- E
147
Q
- The shallow longitudinal indentation along the length of
the dorsal surface of the spinal cord is called the:
a. anterior median fissure
b. posterior median sulcus
c. central canal
d. filum terminale
e. none of the above
A
- B
148
Q
148. The deep longitudinal indentation along the ventral surface of the spinal cord is called the: a. anterior median fissure b. posterior median sulcus c. central canal d. filum terminale e. none of the above
A
- A
149
Q
- The cervical enlargement:
a. contains interneurons for the nerves that supply the
upper extremities and pectoral girdle as well as
fibers from regions inferior to the cervical region,
e.g., thoracic, lumbar, and sacral
b. contains the geniculate ganglion
c. contains the ganglion of Gasser
d. all of the above
e. none of the above
A
- A
150
Q
- The lumbar enlargement contains:
a. interneurons for the nerves that supply the lower
extremities and pelvis as well as fibers from the
more inferior sacral region
b. the geniculate ganglion
c. the ganglion of Gasser
d. all of the above
e. none of the above
A
- A
151
Q
151. The end of the spinal cord tapers to a point that is called the: a. cervical enlargement b. lumbar enlargement c. hypogastric plexus d. conus medullaris
A
- D
152
Q
- The conus medullaris is at the:
a. third segment of the sacrum
b. sacral hiatus
c. level of the first lumbar vertebra
d. foramen ovale
e. none of the above
A
- C
153
Q
- The distal spinal cord is tethered distally by the:
a. filum terminale
b. sacral hiatus
c. first lumbar vertebra
d. foramen ovale
e. none of the above
A
- A
154
Q
- The dorsal root ganglia:
a. contain the nerve cell bodies of the corresponding
sensory neurons
b. contain the nerve cell bodies of the corresponding
motor neurons
c. contain the origins of the ganglion of Gasser
d. all of the above
e. none of the above
A
- A
155
Q
- The ventral nerve root carries primarily:
a. sensory neurons
b. motor neurons
c. parasympathetic ganglia
d. all of the above
e. none of the above
A
- B
156
Q
- The spinal nerve root:
a. is a mixed nerve that carries both motor and sensory
information
b. is formed from the coalescence of the dorsal and
ventral nerve roots
c. exits via the intervertebral foramen
d. all of the above
e. none of the above
A
- D
157
Q
- In the center of the spinal cord is an H-shaped structure
made up primarily of:
a. gray matter consisting of nerve cell bodies and glial
cells
b. white matter consisting of nerve cell bodies and glial
cells
c. connective tissue
d. veins and lymphatics
e. all of the above
A
- A
158
Q
158. The concept that dorsal roots carry sensory information and the ventral roots carry motor information is known as the: a. Herring-Brewer law b. Mason-Dixon law c. Bell-Magendie law d. Marbury-Madison law e. none of the above
A
- C
159
Q
- The first pair of spinal nerves is designated C1 and they:
a. exit between the skull and the first cervical
vertebra
b. exit between the first and second cervical vertebrae
c. exit via the jugular foramen
d. exit via the foramen magnum
e. none of the above
A
- A
160
Q
160. The last pair of cervical nerves exit between the seventh cervical vertebra and the first thoracic vertebra and are designated: a. C7 b. C8 c. the cervical plexus d. the stellate ganglion e. none of the above
A
- B
161
Q
- The first thoracic spinal nerve T1 exits:
a. just beneath the seventh cervical vertebra
b. just beneath the first thoracic vertebra
c. via the jugular foramen
d. via the foramen magnum
e. none of the above
A
- B
162
Q
162. Each spinal nerve is invested with three layers of connective tissue, which include the: a. outermost epineurium b. central perineurium c. innermost endoneurium d. all of the above e. none of the above
A
- D
163
Q
*163. The white ramus:
a. carries visceral motor fibers to the nearby
autonomic ganglia associated with the sympathetic
chain
b. carries special sensory fibers
c. is made up of myelinated fibers
d. a and c
e. b and c
A
- D
164
Q
- Reflexes:
a. are immediate involuntary motor responses to a specific
stimulus that are designed to help maintain
homeostasis across a wide range of conditions
b. can be modulated at the spinal cord level
c. can be modulated by the brain
d. all of the above
e. none of the above
A
- D
165
Q
- The posterior column pathway carries:
a. fine touch information
b. pressure information
c. vibratory information
d. proprioceptive information
e. all of the above
A
- E
166
Q
- First-order neurons carrying fine touch, pressure, vibratory,
and proprioceptive information from the upper
extremities enter the central nervous system via the
dorsal roots and ascend via the:
a. stellate ganglion
b. fasciculus cuneatus
c. ganglion of Gasser
d. fasciculus gracilis
e. none of the above
A
- B
167
Q
- First-order neurons carrying fine touch, pressure, vibratory,
and proprioceptive information from the lower
extremities enter the central nervous system via the
dorsal roots and ascend via the:
a. stellate ganglion
b. fasciculus cuneatus
c. ganglion of Gasser
d. fasciculus gracilis
e. none of the above
A
- D
168
Q
*168. Second-order neurons of the posterior column pathway
leave the medulla oblongata and immediately cross to
the opposite side of the brainstem to relay transmitted
information via the:
a. ribbon-like medial lemniscus
b. ribbon-like lateral lemniscus
c. stellate ganglion
d. trigeminal nucleus
e. none of the above
A
- A
169
Q
169. Fine touch information that comes from stimulus of the left great toe is projected onto the: a. ipsilateral primary sensory cortex b. contralateral primary sensory cortex c. ipsilateral frontal lobe d. contralateral frontal lobe e. none of the above
A
- B
170
Q
*170. The tract cells of the spinothalamic pathway:
a. decussate at the brainstem level to the contralateral
thalamus via the anterior white tract
b. decussate to the opposite side of the spinal cord via
the anterior white commissure to the contralateral
anterolateral spinal cord
c. travel up the ipsilateral side of the spinal cord in the
ventral region of the spinal cord
d. travel up the ipsilateral side of the spinal cord in the
dorsal region of the spinal cord
e. none of the above
A
- B
171
Q
- The anterior spinothalamic tract carries:
a. pain and temperature information
b. vibratory information
c. crude touch
d. proprioception
e. none of the above
A
- C
172
Q
- The lateral spinothalamic tract carries:
a. pain and temperature information
b. vibratory information
c. crude touch
d. proprioception
e. none of the above
A
- A
173
Q
- The pyramidal system is made up of the:
a. corticobulbar tracts
b. lateral corticospinal tracts
c. anterior corticospinal tracts
d. all of the above
e. none of the above
A
- D
174
Q
*174. Approximately 85% of these primary motor axons decussate at the level of the medulla to cross to the contralateral spinal cord to enter the: a. lateral corticospinal tracts b. anterior corticospinal tracts c. medial lemniscal tract d. anterior lemniscal tract e. none of the above
A
- A
175
Q
*175. Approximately 15% of these primary motor axons do
not decussate at the level of the medulla to remain on
the ipsilateral side of the spinal cord to enter the:
a. lateral corticospinal tracts
b. anterior corticospinal tracts
c. medial lemniscal tract
d. anterior lemniscal tract
e. none of the above
A
- B
176
Q
- The extrapyramidal system is the name used to describe
a number of centers and their associated tracts whose
primary function is to coordinate and process:
a. motor commands performed at a subconscious level
b. sudomotor responses
c. vasomotor responses
d. all of the above
e. none of the above
A
- A
177
Q
- The extrapyramidal processing centers produce output
to a variety of targets including:
a. the primary motor cortex to modulate the activities
of the pyramidal system
b. the cranial nerve nuclei to coordinate reflex
activities in response to visual, auditory, and equilibrium
input
c. descending pathways into the spinal cord including
the vestibulospinal tracts, the tectospinal tracts, the
rubrospinal tracts, and the reticulospinal tracts
d. all of the above
e. none of the above
A
- D
178
Q
- Functions of the cerebellum include the:
a. processing and integration of the functioning of the
pyramidal and extrapyramidal systems
b. maintenance of motor tone for the muscles of
posture
c. processing of proprioceptive information
d. all of the above
e. none of the above
A
- D
179
Q
- The sympathetic chain ganglia:
a. are responsible for the sympathetic activity of the
thoracic cavity, chest and abdominal wall, the head,
neck, and the extremities
b. are located on each side of the vertebral columns
c. on each side average 3 cervical, 11 or 12 thoracic, 3
to 5 lumbar, and 4 or 5 sacral ganglia
d. of the coccyx from each sympathetic chain are fused
to form a single terminal ganglion known as the ganglion
of Impar
e. all of the above
A
- E
180
Q
- The myelinated sympathetic fibers from the spinal nerve
roots:
a. may synapse within the sympathetic chain ganglion
at the same level at which the fibers entered the
ganglion
b. may ascend or descend within the sympathetic chain
and then synapse with a sympathetic ganglion at a
level different from the level of fiber entry
c. may simply pass through the sympathetic chain
without synapsing with any sympathetic chain ganglion
to ultimately synapse with a collateral ganglion
or the adrenal medulla
d. all of the above
e. none of the above
A
- D
181
Q
*181. The sympathetic division of the autonomic nervous
system is best characterized by the concept of:
a. convergence
b. divergence
c. reverberating circuitry
d. ultra-short axons
e. none of the above
A
- B
182
Q
- The sympathetic collateral ganglia:
a. most often lie anterolateral to the descending aorta
b. include the celiac ganglion
c. include the superior and inferior mesenteric ganglia
d. give off postganglionic fibers that provide sympathetic
innervation to the abdominopelvic viscera
e. all of the above
A
- E
183
Q
- The sympathetic nerves located in the center of the
adrenal medulla:
a. release epinephrine and norepinephrine into the
capillary bed of the adrenal medulla
b. allow tissues not innervated by postganglionic
sympathetic fibers to receive stimulation by the sympathetic nervous system providing they have
receptors sensitive to epinephrine and norepinephrine
c. are stimulated by preganglionic sympathetic nerves
that do not synapse in the ganglia of the sympathetic
chain
d. all of the above
e. none of the above
A
- D
184
Q
- The parasympathetic division of the autonomic nervous
system has:
a. preganglionic neurons and nuclei that are located in
the brain, mesencephalon, pons, and medulla
oblongata
b. autonomic nuclei that reside in the lateral gray horns
of spinal segments S2-4
c. preganglionic fibers that travel within cranial nerves
III, VII, IX, and X to synapse at the ciliary, sphenopalatine,
otic, and submandibular ganglia
d. short postganglion fibers that carry parasympathetic
commands to their respective target organs
e. all of the above
A
- E
185
Q
- Stimulation of these parasympathetic nerves results in:
a. the release of acetylcholine by all preganglionic parasympathetic
neurons, which causes stimulation of all
nicotinic receptors
b. stimulation of muscarinic receptors
c. inhibition of muscarinic receptors
d. all of the above
e. none of the above
A
- D
186
Q
- The autonomic nervous system is characterized by:
a. one nerve–one fiber innervation
b. discrete innervation
c. an antagonistic dual innervation system
d. an all-sort axon configuration
e. all of the above
A
- C
187
Q
- Nociceptors are freely distributed in the:
a. outer layers of the skin
b. walls of blood vessels
c. periosteum of bone
d. joint capsules
e. all of the above
A
- E
188
Q
- When nociceptors are initially stimulated, the first
response is the firing of the receptors to produce an
immediate message to the central nervous system that
results in the perception known as:
a. dull pain
b. slow pain
c. fast pain
d. internuncial pain
e. none of the above
A
- C
189
Q
- Fast pain information is carried by:
a. C fibers
b. A delta fibers
c. the white communicantes
d. the gray communicantes
e. all of the above
A
- B
190
Q
- Slow pain information is carried by:
a. C fibers
b. A delta fibers
c. the white communicantes
d. the gray communicantes
e. all of the above
A
- A
191
Q
- C fibers are:
a. heavily myelinated
b. pure sympathetic fibers
c. unmyelinated
d. only found in the pelvis
e. none of the above
A
- C
192
Q
192. Pain and temperature impulses are carried to the central nervous system via the: a. lateral spinothalamic tract b. anterior spinothalamic tract c. Meissner corpuscles d. all of the above e. none of the above
A
- A
193
Q
- Mechanoreceptors include:
a. tactile receptors
b. baroreceptors
c. proprioceptors
d. all of the above
e. none of the above
A
- D
194
Q
- Baroreceptors are commonly found in the:
a. aorta and carotid arteries
b. urinary bladder and ureters
c. respiratory system
d. digestive system
e. all of the above
A
- E
195
Q
- Encapsulated tactile receptors include:
a. Meissner’s corpuscles
b. Pacinian corpuscles
c. Ruffinian corpuscles
d. all of the above
e. none of the above
A
- D
196
Q
- Unencapsulated receptors include:
a. Merkel’s discs
b. free nerve endings
c. root hair plexuses
d. the digestive system
e. all of the above
A
- E
197
Q
- Proprioceptors are located in:
a. muscle spindles
b. the Golgi tendon apparatus
c. joint capsules
d. ligaments
e. all of the above
A
- E
198
Q
- Examples of specialized proprioceptors include:
a. the muscle spindle apparatus
b. Meissner’s corpuscles
c. the Golgi tendon apparatus
d. a and b
e. a and c
A
- E
199
Q
- The major chemoreceptors are located in the:
a. medulla oblongata
b. carotid bodies
c. aortic bodies
d. all of the above
e. none of the above
A
- D
200
Q
- Chemoreceptors located in the medulla oblongata
respond to changes in the:
a. hydrogen ion concentrations in the cerebrospinal
fluid
b. protein concentration in the cerebrospinal fluid
c. carbon dioxide concentrations in the cerebrospinal
fluid
d. a and b
e. a and c
A
- E
201
Q
- The phenomenon of wind-up:
a. is modulated in large part by modulatory
neurotransmitter peptides
b. is an example of how modulatory neurotransmitter
peptides can result in increased transmission of
nociceptive information
c. occurs primarily at the spinal cord level
d. often results in increased perception of pain
e. all of the above
A
- E
202
Q
202. Examples of modulatory neurotransmitter peptides include: a. substance P b. somatostatin c. vasoactive intestinal polypeptide d. calcitonin gene–related peptide e. all of the above
A
- E
203
Q
- The two cerebral hemispheres are divided by the:
a. medial longitudinal fissure
b. Sylvian fissure
c. postcentral gyrus
d. precentral gyrus
e. putamen
A
- A
204
Q
204. The primary area for afferent sensory processing of the cerebrum is: a. medial longitudinal fissure b. Sylvian fissure c. postcentral gyrus d. precentral gyrus e. putamen
A
- C
205
Q
205. The primary area for efferent motor processing of the cerebrum is: a. medial longitudinal fissure b. Sylvian fissure c. postcentral gyrus d. precentral gyrus e. putamen
A
- D
206
Q
- The central white matter is made up of:
a. unmyelinated fibers
b. myelinated fibers
c. ganglionic cell bodies
d. small-diameter sympathetic fibers
e. all of the above
A
- B
207
Q
- Efferent motor impulses originating in the precentral
gyrus of the left cerebral hemisphere control the:
a. right side of the body
b. left side of the body
c. both sides of the body
d. all of the above
e. none of the above
A
- A
208
Q
- The functions of the limbic system are complex and
include:
a. the establishment of baseline emotional states
b. behavior drives
c. facilitation of storage and retrieval of memories
d. the coordination and linkage of the complex conscious
functions of the cerebral cortex with the
unconscious and autonomic functions
e. all of the above
A
- E
209
Q
- Afferent sensory impulses originating on the left side of
the body are perceived by the:
a. right postcentral gyrus
b. left postcentral gyrus
c. postcentral gyri of both cerebral hemispheres
d. all of the above
e. none of the above
A
- A
210
Q
210. Inhibition of pain impulses may also occur by stimulation of: a. periaqueductal gray matter that surrounds the third ventricle and cerebral aqueduct b. trigone of the bladder c. pulmonary vasculature d. all of the above e. none of the above
A
- A
211
Q
- The ventral posterior portion of the ventral nuclei of the thalamus is the primary relay station for the transmission of:
a. fine touch
b. pain
c. temperature
d. pressure and proprioception
e. all of the above
A
- E
212
Q
- The posterior nuclei is made up of the:
a. pulvinar
b. lateral geniculate nuclei
c. medial geniculate nuclei
d. all of the above
e. none of the above
A
- D
213
Q
- The thalamic nuclei include the:
a. lateral nuclei and medial nuclei
b. anterior nuclei
c. ventral nuclei
d. posterior nuclei
e. all of the above
A
- E
214
Q
- The thalamus is located in the:
a. rhinencephalon
b. norencephalon
c. mesencephalon
d. diencephalons
e. none of the above
A
- D
215
Q
- Functions of the hypothalamus include:
a. raising or lowering of body temperature
b. causing the release of antidiuretic hormone to signal
the kidneys to restrict water loss
c. causing the release of oxytocin to stimulate contractions
of the uterus and prostate as well as the myoepithelial
cells of the breasts
d. coordination of circadian rhythms
e. all of the above
A
- E
216
Q
- Functions of the hypothalamus include the:
a. coordination and modulation of autonomic functions
including blood pressure, heart rate, blood
pressure, and respiration
b. coordination and modulation of involuntary somatic
motor activities associated with pain, pleasure, rage,
and sexual arousal
c. coordination of the complex interactions between
the neuroendocrine system and the pituitary gland
d. coordination and modulation of voluntary and involuntary
behavioral patterns including thirst and
hunger
e. all of the above
A
- E
217
Q
- Structures of the mesencephalon include the:
a. red nuclei
b. substantia nigra
c. superior and inferior colliculus
d. reticular activating system
e. all of the above
A
- E
218
Q
- The pons contains the following structures:
a. the apneustic center and the pneumotaxic centers
b. the sensory and motor nuclei of cranial nerves V, VI,
VII, and VIII
c. the nuclei that process and relay afferent information
from the cerebellum that arrives in the pons via
the middle cerebral peduncles
d. tracts of ascending, descending, and transverse fibers
that carry information from the spinal cord to the
brain and from the brain to the spinal cord and the
information from opposite cerebral hemispheres
e. all of the above
A
- E
219
Q
219. The apneustic center and the pneumotaxic centers control: a. voluntary respiration b. involuntary respiration c. heart rate d. all of the above e. none of the above
A
- B
220
Q
- Important nuclei and centers that sort, relay, and modulate
a variety of activities necessary for the maintenance
of homeostasis which are located in the medulla
oblongata include the:
a. respiratory rhythmicity center
b. cardiovascular center
c. olivary nuclei
d. nucleus gracilis and cuneatus
e. all of the above
A
- E
221
Q
- Clinical characteristics include:
a. bilateral or occasionally unilateral pain involving
the frontal, temporal, and occipital regions
b. bandlike nonpulsatile ache or tightness
c. associated neck symptomatology
d. pain that evolves over a period of hours or days and
then tends to remain constant without progressive
symptomatology
e. all of the above
A
- E
222
Q
- The following statements are true about tension-type
headache.
a. There is no aura associated with tension-type
headache.
b. Significant sleep disturbance is usually present.
c. It affects females more than males.
d. all of the above
e. none of the above
A
- D
223
Q
- Effective treatments for tension-type headache include:
a. tricyclic antidepressants
b. cervical steroid epidural nerve blocks
c. biofeedback
d. all of the above
e. none of the above
A
- D
224
Q
224. Effective prophylactic treatments for migraine headaches include: a. beta-blockers b. calcium channel blockers c. nonsteroidal anti-inflammatory agents d. valproic acid e. all of the above
A
- E
225
Q
225. The main risk of the use of abortive therapies in the treatment of migraine headache includes: a. analgesic rebound headache b. peripheral vascular ischemia c. coronary artery ischemia d. all of the above e. none of the above
A
- D
226
Q
226. Clinical signs and symptoms of migraine headache include: a. unilateral pounding headache b. nausea and vomiting c. pallor d. photophobia and sonophobia e. all of the above
A
- E
227
Q
227. The painless neurologic phenomenon associated with migraine with aura includes: a. Braxton-Hicks contractions b. Cullen’s sign c. aura d. all of the above e. none of the above
A
- C
228
Q
- Clinical signs and symptoms of cluster headache
include:
a. severe retro-orbital and temporal headache
b. deep, boring quality
c. unilateral
d. Horner’s syndrome and rhinorrhea
e. all of the above
A
- E
229
Q
- Effective treatments for cluster headaches include:
a. prednisone
b. sphenopalatine ganglion blocks
c. lithium carbonate
d. methysergide
e. all of the above
A
- E
230
Q
230. In contradistinction to migraine and tension-type headache, cluster headache is unique in its: a. female predominance b. association with sickle cell disease c. male predominance d. long onset-to-peak e. none of the above
A
- C
231
Q
- The headache with the shortest onset-to-peak is:
a. migraine headache
b. cluster headache
c. tension-type headache
d. analgesic rebound headache
e. none of the above
A
- B
232
Q
- The diagnostic criteria for pseudotumor cerebri include:
a. signs and symptoms suggestive of increased intracranial
pressure including papilledema
b. normal magnetic resonance imaging (MRI) or computed
tomography (CT) of the brain performed with
and without contrast media
c. increased cerebrospinal fluid pressure documented
by lumbar puncture
d. normal cerebrospinal fluid chemistry, cultures, and
cytology
e. all of the above
A
- E
233
Q
- The typical patient suffering from papilledema is:
a. female
b. obese
c. between 20 and 45 years old
d. complaining of headache
e. all of the above
A
- E
234
Q
234. Drugs implicated in the evolution of pseudotumor cerebri include: a. vitamin A b. tetracyclines c. nalidixic acid d. corticosteroids e. all of the above
A
- E
235
Q
235. Clinical disorders associated with pseudotumor cerebri include: a. anemias b. endocrinopathies c. blood dyscrasias d. chronic respiratory insufficiency e. all of the above
A
- E
236
Q
- Common causes of ocular pain include:
a. conjunctivitis
b. corneal abrasions
c. glaucoma
d. uveitis
e. all of the above
A
- E
237
Q
- The sine qua non of post-dural puncture headache is:
a. postural headache
b. fever
c. unilateral nature
d. all of the above
e. none of the above
A
- A
238
Q
- Causes of trigeminal neuralgia include:
a. acoustic neuromas
b. cholesteatomas and bony abnormalities
c. aneurysms and angiomas
d. compression by aberrant or tortuous blood vessels
e. all of the above
A
- E
239
Q
239. Medication treatment options for trigeminal neuralgia include: a. carbamazepine b. baclofen c. gabapentin d. all of the above e. none of the above
A
- D
240
Q
- Surgical treatment options for trigeminal neuralgia
include:
a. trigeminal nerve block
b. retrogasserian injection of glycerol
c. radiofrequency lesioning of the gasserian ganglion
d. microvascular decompression of the trigeminal
root
e. all of the above
A
- E
241
Q
241. The following symptom is pathognomonic for temporal arteritis: a. tinnitus b. papilledema c. jaw claudication d. areflexia e. none of the above
A
- C
242
Q
- Temporal arteritis is a:
a. disease of the sixth decade
b. disease associated with polymyalgia rheumatica in
approximately 50% of patients
c. disease that affects females three times more often
than males
d. disease that affects almost exclusively whites
e. all of the above
A
- E
243
Q
243. Over 90% of patients with temporal arteritis have a significantly elevated: a. hemoglobin b. erythrocyte sedimentation rate c. uric acid d. all of the above e. none of the above
A
- B
244
Q
- Common causes of otalgia include:
a. cellulitis and/or abscess of the auricle
b. otitis externa
c. otitis media
d. meningitis
e. all of the above
A
- E
245
Q
- Herpes zoster infection involving the geniculate ganglion
and external auditory canal and auricle is called:
a. Boerhaave’s syndrome
b. zoster sine herpes
c. zoster ophthalmicus dura
d. zoster polio juvenalis
e. none of the above
A
- E
246
Q
- The ear receives innervation from the:
a. facial nerve
b. glossopharyngeal nerve
c. auriculotemporal branch of the mandibular nerve
d. superficial petrosal nerve
e. all of the above
A
- E
247
Q
- Nose pain is commonly caused by:
a. infections including folliculitis
b. foreign bodies
c. malignancies
d. all of the above
e. none of the above
A
- D
248
Q
- Midface pain may be caused by:
a. sinusitis
b. osteomyelitis of the facial bones
c. squamous cell carcinomas
d. nasopharyngiomas
e. all of the above
A
- E
249
Q
249. Referred pain to the ear, midface, and throat can be caused by: a. tumors of the nasopharynx b. deep infections of the pharynx including retropharyngeal abscess c. dental infections d. Eagle’s syndrome e. all of the above
A
- E
250
Q
- The greater occipital nerve:
a. arises from fibers of the dorsal primary ramus of the
second cervical nerve
b. arises, to a lesser extent, from fibers from the third
cervical nerve
c. pierces the fascia just below the superior nuchal
ridge along with the occipital artery
d. supplies the medial portion of the posterior scalp as
far anterior as the vertex
e. all of the above
A
- E
251
Q
- The lesser occipital nerve:
a. arises from the ventral primary rami of the second
and third cervical nerves
b. passes superiorly along the posterior border of the
sternocleidomastoid muscle, dividing into cutaneous branches that innervate the lateral portion of the
posterior scalp and the cranial surface of the pinna
of the ear
c. is relatively easy to block with local anesthetic and
steroid
d. all of the above
e. none of the above
A
- D
252
Q
- Cervical radiculopathy is best treated with a multimodality
approach including:
a. physical therapy including heat modalities and deep
sedative massage
b. nonsteroidal anti-inflammatory agents
c. skeletal muscle relaxants
d. cervical steroid epidural nerve blocks with local
anesthetic and steroid
e. all of the above
A
- E
253
Q
- Pain syndromes that may mimic cervical radiculopathy
include:
a. cervicalgia
b. cervical bursitis and cervical fibromyositis
c. inflammatory arthritis
d. disorders of the cervical spinal cord, roots, plexus,
and nerves
e. all of the above
A
- E
254
Q
- The causes of cervical radiculopathy include:
a. herniated disc
b. foraminal stenosis and osteophyte formation
c. tumor
d. infection
e. all of the above
A
- E
255
Q
255. The patient suffering from cervical radiculopathy may experience: a. pain in a dermatomal distribution b. numbness c. weakness d. loss of reflexes e. all of the above
A
- E
256
Q
- Patients will commonly place the hand of the affected
extremity on the top of the head in order to obtain relief
when suffering from compromise of which of the
following cervical nerve roots?
a. C5
b. C6
c. C7
d. C8
e. none of the above
A
- C
257
Q
- The clinical hallmark of cervical strain is:
a. neck pain
b. pain in a dermatomal distribution
c. myelopathy
d. all of the above
e. none of the above
A
- A
258
Q
- The pain of cervical strain:
a. often begins in the occipital region
b. radiates in a nondermatomal pattern into the
shoulders and intrascapular region
c. is often exacerbated by movement of the cervical
spine and shoulders
d. is often accompanied by headaches and sleep
disturbance
e. all of the above
A
- E
259
Q
- Physical examination results of the patient suffering
from cervical strain may include:
a. tenderness on palpation of the paraspinous musculature
and trapezius
b. spasm of the paraspinous musculature and trapezius
c. decreased range of motion of the cervical spine
d. normal neurologic examination of the upper
extremities
e. all of the above
A
- E
260
Q
- Cervical strain is best treated with a multimodality
approach including:
a. physical therapy with heat modalities and deep sedative
massage
b. nonsteroidal anti-inflammatory agents
c. skeletal muscle relaxants
d. cervical facet blocks with local anesthetic and steroid
e. all of the above
A
- E
261
Q
- The patient suffering from cervicothoracic bursitis will
present with:
a. the complaint of dull, poorly localized pain in the
lower cervical and upper thoracic region
b. nonradicular pain that spreads from the midline to
the adjacent paraspinous area
c. the patient holding the cervical spine rigid with the
head thrust forward to splint the affected ligament
and bursae
d. pain that is exacerbated by flexion and extension of
the lower cervical spine and upper thoracic spine
e. all of the above
A
- E
262
Q
- The pathognomonic lesion of fibromyalgia pain is the:
a. goblet cell
b. trigger point
c. delta cell
d. beta cell
e. none of the above
A
- B
263
Q
- Cervicothoracic bursitis is best treated with a multimodality
approach including:
a. physical therapy with heat modalities and deep sedative
massage
b. nonsteroidal anti-inflammatory agents
c. skeletal muscle relaxants
d. injection of the cervicothoracic bursae with local
anesthetic and steroid
e. all of the above
A
- E
264
Q
- Fibromyalgia of the cervical spine is best treated with a
multimodality approach including:
a. techniques that will help eliminate the trigger point
b. tricyclic antidepressant compounds
c. trigger point injections
d. all of the above
e. none of the above
A
- D
265
Q
- Each facet joint receives fibers from the:
a. dorsal ramus at the same level as the vertebra
b. ventral ramus at the same level as the vertebra
c. dorsal ramus of the vertebra above
d. a and b
e. a and c
A
- E
266
Q
- Cervical facet syndrome is a constellation of symptoms
consisting of:
a. neck, head, shoulder, and proximal upper extremity
pain that radiates in a nondermatomal pattern
b. pain that is dull and ill defined in character
c. pain that may be unilateral or bilateral
d. pain that is exacerbated by flexion, extension, and
lateral bending of the cervical spine
e. all of the above
A
- E
267
Q
267. Cervical facet syndrome is best treated with a multimodality approach including: a. physical therapy with heat modalities b. nonsteroidal anti-inflammatory agents c. skeletal muscle relaxants d. injection of the cervical facet joints with local anesthetic and steroid e. all of the above
A
- E
268
Q
- Common causes of thoracic radiculopathy include:
a. herniated disc
b. foraminal stenosis and osteophyte formation
c. tumor and infection
d. vertebral compression fractures
e. all of the above
A
- E
269
Q
- The patient suffering from thoracic radiculopathy may
experience:
a. pain in a dermatomal distribution
b. numbness and paresthesias
c. weakness
d. loss of superficial abdominal reflexes
e. all of the above
A
- E
270
Q
- Thoracic myelopathy is most commonly due to:
a. midline herniated thoracic disc
b. spinal stenosis
c. demyelinating disease
d. tumor or, rarely, infection
e. all of the above
A
- E
271
Q
271. Intercostal neuralgia is best treated with a multimodality approach including: a. tricyclic antidepressant compounds b. nonsteroidal anti-inflammatory agents c. gabapentin d. injection of the intercostal nerves with local anesthetic and steroid e. all of the above
A
- E
272
Q
*272. Physical examination of the patient suffering from costosternal
syndrome will reveal that:
a. the patient will vigorously attempt to splint the joints
by keeping the shoulders stiffly in neutral position
b. pain is reproduced with active protraction or retraction
of the shoulder, deep inspiration, as well as full
elevation of the arm
c. the costosternal joints and adjacent intercostal
muscles may be tender to palpation
d. the patient may also complain of a clicking sensation
with movement of the joint
e. all of the above
A
- E
273
Q
*273. Physical examination of the patient suffering from
manubriosternal joint syndrome will reveal that:
a. the patient will vigorously attempt to splint the
joints by keeping the shoulders stiffly in neutral
position
b. pain is reproduced with active protraction or retraction
of the shoulder, deep inspiration, and full
elevation of the arm
c. the manubriosternal joint may feel hot and inflamed
d. shrugging of the shoulder may also reproduce the
pain
e. all of the above
A
- E
274
Q
- Symptoms associated with compression fractures of the
thoracic vertebra include:
a. pain that is aggravated by deep inspiration, coughing,
and any movement of the dorsal spine
b. pain and spasm of the paraspinous muscles elicited
by palpation of the affected vertebra
c. hematoma and ecchymosis overlying the fracture
site if trauma has occurred
d. abdominal ileus and severe pain with resulting
splinting of the paraspinous muscles of the dorsal
spine further compromising the patient’s ability to
walk and their pulmonary status
e. all of the above
A
- E
275
Q
- Initial treatment of pain secondary to compression
fracture of the thoracic spine should include:
a. combination of simple analgesics and the nonsteroidal
anti-inflammatory drugs or opioids if the pain is
uncontrolled
b. the local application of heat and cold, which may
also be beneficial to provide symptomatic relief of
the pain of vertebral compression fracture
c. the use of an orthotic, such as the CASH brace
d. thoracic epidural block using local anesthetic and
steroid
e. all of the above
A
- E
276
Q
- The patient suffering from lumbar radiculopathy will
complain of:
a. pain, numbness, tingling, and paresthesias in the
distribution of the affected nerve root or roots
b. weakness and lack of coordination in the affected
extremity
c. muscle spasms and back pain as well as pain referred
into the buttocks
d. reflex changes are demonstrated on physical examination
and a reflex shifting of the trunk to one side
called a list
e. all of the above
A
- E
277
Q
- Lumbar radiculopathy is best treated with a multimodality
approach including:
a. physical therapy with heat modalities
b. nonsteroidal anti-inflammatory agents
c. skeletal muscle relaxants
d. lumbar epidural or caudal injection of the affected
nerve roots with local anesthetic and steroid
e. all of the above
A
- E
278
Q
- Lumbar myelopathy is most commonly due to:
a. midline herniated lumbar disc
b. spinal stenosis
c. tumor or, rarely, infection
d. all of the above
e. none of the above
A
- D
279
Q
- Patients suffering from lumbar myelopathy or cauda
equina syndrome will experience:
a. varying degrees of lower extremity weakness
b. bowel symptomatology
c. bladder symptomatology
d. all of the above
e. none of the above
A
- D
280
Q
- The patient suffering from coccydynia will exhibit:
a. point tenderness over the coccyx with the pain being
increased with movement of the coccyx
b. movement of the coccyx may cause sharp paresthesias
into the rectum
c. on rectal exam, the levator ani, piriformis, and
coccygeus muscles may feel indurated and palpation
of these muscles may induce severe spasm
d. sitting may exacerbate the pain of coccydynia, and
the patient may attempt to sit on one buttock to
avoid pressure on the coccyx
e. all of the above
A
- E
281
Q
- The following pathologic conditions may mimic the
pain of coccydynia:
a. primary pathology of the rectum and anus
b. primary tumors or metastatic lesions of the sacrum
and/or coccyx
c. proctalgia fugax
d. insufficiency fractures of the pelvis and sacrum
e. all of the above
A
- E
282
Q
- Proctalgia fugax can be distinguished from coccydynia
in that patients suffering from proctalgia fugax will
exhibit:
a. no increase in pain with movement of the coccyx
b. an increase in pain with movement of the coccyx
c. blood in stool
d. a and c
e. none of the above
A
- A
283
Q
- Reflex sympathetic dystrophy is characterized by:
a. burning facial pain
b. sudomotor changes
c. vasomotor changes
d. trophic skin changes
e. all of the above
A
- E
284
Q
- The clinical symptomatology of reflex sympathetic
dystrophy of the face may often be confused with:
a. pain of dental origin
b. pain of sinus origin
c. atypical facial pain
d. trigeminal neuralgia
e. all of the above
A
- E
285
Q
- Characteristic symptoms of a typical post-dural
puncture headache include:
a. rapid onset of headache when the patient moves
from the horizontal to the upright position
b. constant holocranial headache when the patient is
supine
c. headache that abates when the patient resumes a
horizontal position
d. a and b
e. a and c
A
- E
286
Q
286. Untreated post-dural puncture headache may result in: a. glossopharyngeal neuralgia b. persistent cranial nerve palsies c. increased serum potassium d. increased serum sodium e. none of the above
A
- B
287
Q
287. Medication treatment options for glossopharyngeal neuralgia include: a. carbamazepine b. baclofen c. gabapentin d. all of the above e. none of the above
A
- D
288
Q
- Surgical treatment options for glossopharyngeal neuralgia
include:
a. glossopharyngeal nerve block
b. radiofrequency lesioning of the glossopharyngeal
nerve
c. microvascular decompression of the trigeminal
root
d. all of the above
e. none of the above
A
- D
289
Q
- Varieties of spasmodic torticollis include:
a. tonic spasmodic torticollis
b. clonic spasmodic torticollis
c. tonic/clonic spasmodic torticollis
d. all of the above
e. none of the above
A
- D
290
Q
- Patients suffering from brachial plexopathy will complain
of:
a. pain radiating to the supraclavicular region and
upper extremity
b. neuritic pain that may take on a deep, boring quality
with invasion of the plexus by tumor
c. movement of the neck and shoulder that exacerbates
the pain
d. all of the above
e. none of the above
A
- D
291
Q
- Common causes of brachial plexopathy include:
a. compression of the plexus by cervical ribs or abnormal
muscles
b. invasion of the plexus by tumor, e.g., Pancoast’s
syndrome
c. direct trauma to the plexus, e.g., stretch injuries and
avulsions
d. inflammatory causes, e.g., Parsonage-Turner syndrome
and postradiation plexopathy
e. all of the above
A
- E
292
Q
- Adson’s maneuver is helpful in the diagnosis of thoracic
outlet syndrome and is performed by:
a. palpating the radial pulse on the affected side with
the patient’s neck extended and the head turned
toward the affected side
b. occluding both the ulnar and radial arteries at the
wrist
c. forcibly flexing the cervical spine
d. active pronation of the affected extremity
e. none of the above
A
- A
293
Q
- Signs and symptoms of thoracic outlet syndrome include:
a. paresthesias of the upper extremity radiating into the
distribution of the ulnar nerve
b. aching and incoordination of the affected extremity
c. edema or discoloration of the arm
d. in rare instances venous or arterial thrombosis
e. all of the above
A
- E
294
Q
294. Provocation of the symptoms of thoracic outlet syndrome may be elicited by a variety of maneuvers including the: a. Adson test b. elevated arm stress test c. Allen test d. a and b e. a and c
A
- D
295
Q
- Invasive treatments useful in the palliation of the pain
associated with Pancoast’s tumor include:
a. brachial plexus block
b. dorsal root entry zone lesioning
c. radiofrequency lesioning of the brachial plexus
d. cordotomy
e. all of the above
A
- E
296
Q
- Pharmacologic treatment useful in the palliation of the
pain associated with Pancoast’s tumor includes:
a. gabapentin
b. carbamazepine
c. baclofen
d. opioid analgesics
e. all of the above
A
- E
297
Q
- Patients suffering from Pancoast’s tumor syndrome will
complain of:
a. neuritic pain radiating to the supraclavicular region
and upper extremity.
b. initial pain in the upper thoracic and lower cervical
dermatomes as the lower portion of the brachial
plexus is involved as the tumor grows from below
c. exacerbation of pain with movement of the neck and
shoulder
d. Horner’s syndrome in some patients
e. all of the above
A
- E
298
Q
- Pancoast’s tumor syndrome:
a. is the result of local growth of tumor from the apex
of the lung directly into the brachial plexus
b. usually involves the first and second thoracic nerves
as well as the eighth cervical nerve producing a
classic clinical syndrome consisting of severe arm
pain and, in some patients, Horner’s syndrome
c. often results in destruction of the first and second
ribs
d. all of the above
e. none of the above
A
- D
299
Q
- Tennis elbow is also known as:
a. medial epicondylitis
b. lateral epicondylitis
c. radial tunnel syndrome
d. pronator syndrome
e. none of the above
A
- B
300
Q
300. Which of the following painful conditions may be misdiagnosed as tennis elbow? a. radial tunnel syndrome b. pronator syndrome c. C6-7 radiculopathy d. a and b e. a and c
A
- E
301
Q
301. Treatments effective in the management of tennis elbow include: a. nonsteroidal anti-inflammatory agents b. local application of heat and cold c. physical therapy d. injection of the lateral epicondyle with local anesthetic and steroid e. all of the above
A
- E
302
Q
- Patients suffering from tennis elbow will complain of:
a. pain that is localized to the region of the lateral
epicondyle
b. pain that is constant and is made worse with active
contraction of the wrist
c. the inability to hold a coffee cup or hammer with
weakened grip strength
d. pain when undergoing a tennis elbow test
e. all of the above
A
- E
303
Q
- Golfer’s elbow is also known as:
a. medial epicondylitis
b. lateral epicondylitis
c. radial tunnel syndrome
d. pronator syndrome
e. none of the above
A
- A
304
Q
304. Which of the following painful conditions can be misdiagnosed as golfer’s elbow? a. radial tunnel syndrome b. gout, arthritis, and bursitis c. C6-7 radiculopathy d. a and b e. b and c
A
- E
305
Q
305. Treatments effective in the management of golfer’s elbow include: a. nonsteroidal anti-inflammatory agents b. local application of heat and cold c. physical therapy d. injection of the medial epicondyle with local anesthetic and steroid e. all of the above
A
- E
306
Q
- Patients suffering from golfer’s elbow will complain of:
a. pain that is localized to the region of the medial
epicondyle
b. pain that is constant and is made worse with active
contraction of the wrist
c. the inability to hold a coffee cup or hammer with
weakened grip strength
d. pain when undergoing a Golfer’s elbow test
e. all of the above
A
- E
