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Clinical Neurology > Special senses > Flashcards

Special senses Flashcards

1
Q

Which of the following structures contributes to the production of the mucus that helps bind odorant molecules within the olfactory epithelium?

A. Olfactory stria
B. Olfactory bulb
C. Bowman’s glands
D. Olfactory receptors

A

C

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2
Q

Which of the following tests are linked to ion-gated channels?

A. Bitter
B. Sour
C. Sweet
D. Umami

A

B

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3
Q

Which of the following structures would most likely contain cells with olfactory and taste receptors?

A. Superior meatus
B. Oropharynx
C. Larynx
D. Esophagus

A

B

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4
Q

Where is the primary visual cortex?

A. Occiptal lobe
B. Temporal lobe
C. Parietal lobe
D. Frontal lobe

A

A

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5
Q

The retinal pigment epithelium help photoreceptors to perform their function by:

A. Blocking light from exiting the eyeball
B. Help with the detection of the darker wavelengths of light
C. Assists with the rods at night by increasing their sensitivity to photons
D. Important in the restoration of photopigments after light activation

A

D

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6
Q

Receptive fields (both on- and off-center) help with the formation of visual information pathways by organizing information that is related to:

A. Color
B. Brightness
C. Contrast
D. Binocular vision

A

C

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7
Q

Outer hair cells in the organ of Corti receive efferent stimulus that originate from which part of the auditory pathway?

A. Superior olivary complex
B. Lateral lemniscus
C. Inner hair cells
D. Primary auditory cortical center

A

A

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8
Q

The tonotopic arrangement of frequency detection within the organ of Corti is determined by which of the following mechanisms:

A. Movement of sections of the basilar membrane in response to frequency

B. Differences in the frequency pick-up between the left and right organs of Corti

C. Movement of the perilymph as opposed to the endolymph

D. Distance of the displacement of the stereocilia toward the kinocilium of the hair cells

A

A

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9
Q

The induced nystagmus during vestibular function testing causes nausea because of what mechanism?

A. The use of cold water instead of warm water
B. The degree of the head tilt during the testing
C. The amount of cerumen in the patient’s testedear
D. The disparity between visual image, spinal muscle proprioception, and vestibular information

A

D

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10
Q

Theoretically, when you do a cartwheel with your head facing forward constantly, which of the following vestibular structures are firing the most?

A. All 3 semicircular canals
B. The lateral SCC and the saccule
C. The posterior and superior SCCs and the saccule
D. The saccule and utricle and the superior SCC

A

C

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11
Q

TRUE about examining the cochlear nerve

A. If there is a conductive hearing deficit, bone conduction (BC) will be greater than or equal to air conduction (AC) in the affected ear when doing the Webber’s test

B. If there is a sensorineural hearing deficit, AC will be greater than BC in the affected ear when doing the Webber’s test

C. If there is a conductive hearing deficit, the Rinne’s test will lateralize to the affected ear

D. AOTA

E. NOTA

A

E

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12
Q

TRUE about technique for examining the eye using the opthalmoscope

A. If patient is wearing glasses, ask the patient to remove the glasses

B. The examiner uses the left hand to hold the opthalmoscope to examine the patient’s left eye

C. If the examiner is wearing glasses, the examiner should remove his glasses

D. AOTA

E. A & B only

A

D

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13
Q

TRUE about testing for visual acuity

A. The distance of the vision card to the patient’s eye should be 12 inches away

B. The examiner will hold the vision card

C. The examiner will cover the other eye of the patient that is not being tested

D. The examiner should put his hand on the top of the patient’s head to prevent it from moving

E. A & B only

A

E

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14
Q

TRUE about color blindness

A. Ishihara plates are used for checking color blindness

B. Most common type of color blindness is red-green blindness present in 8-12% of males

C. Testing for color blindness should be routinely done during a neurological exam

D. AOTA

E. A & B only

A

E

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15
Q

Before reporting that a patient is neurologically blind, the patient should NOT be able to do this:

A. Appreciate light perception
B. Appreciate hand movement
C. Appreciate light projection
D. Appreciate finger counting

A

A

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16
Q

The proper sequence of doing optic nerve examination to determine if a patient is blind

A. Counting fingers, hand movement, light projection, light perception

B. Hand movement, counting fingers, light projection, light perception

C. Hand movement, counting fingers, light perception, light projection

D. Counting fingers, hand movement, light perception, light projection

A

A

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17
Q

Pure optic nerve (CN II) examination includes:

A. Visual acuity using modified Snellen vision chart
B. Visual field testing through visual confrontation
C. Pupillary examination
D. AOTA
E. A & B only

A

A

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18
Q

The stimuli recommended for CN I examination

A. Coffee
B. Cigarette
C. Garlic 
D. A, B, & C 
E. A & B only
A

D

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19
Q

Each frontal eye field directs the gaze to the (ipsilateral/ contralateral) side.

A

Contralateral

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20
Q

The frontal eye field is located at the junction of which structures?

A

Precentral sulcus and superior frontal gyrus

21
Q

Color recognition and identification in the visual pathway:

A. cones

B. optic chiasm

C. superior colliculus

D. secondary visual pathway

A

A

22
Q

Edinger Westphal nucleus is for

A. blinking

B. lateral gaze

C. pupil constriction

A

C

23
Q

In contrast to the rod receptors in the visual

systems, cones:

A. Have a lower threshold for light waves

B. Provides achromatic vision

C. Are responsible for visual acuity

D. Are scattered throughout the retina

A

C

24
Q

Which visual modality is subserved by the

magnocellular pathway?

A. Perception of movement

B. Color

C. Shape

D. Orientation of the object

A

A

25
Q

Which of the following semicircular canals are

correctly paired?

A. Left horizontal canal- right horizontal

canal

B. Left horizontal canal- right posterior canal

C. Left horizontal canal- right superior canal

A

A

26
Q

The following statement/s is/are true of the

vestibulo-ocular reflex.

A. It is initiated by the stimulation of the

photoreceptors

B. The reflex can be elicited even under

dark illumination

C. The eye movement that it produces serves

as feedback to the vestibular apparatus

A

B

27
Q

Which of the following systems must be tested if

a patient complains of a ‘feeling of imbalance’?

A. Cerebellum

B. Dorsal column

C. Visual and vestibular

D. All of the above

A

D

28
Q

As you read this question, your eyes

accommodate to provide clear vision for reading.

During accommodation all of the following occur

EXCEPT:

A. Contraction of the cilliary muscles

B. Pupillary constriction

C. Flattening of the lens

D. Ocular convergence

A

C

29
Q

Which of the following taste sensations is

exclusively transduced via G-protein coupled

receptors?

A. Sour

B. Bitter

C. Sweet

D. Umami

A

C

30
Q

The impedance-matching problem between the

middle and inner ears is corrected by which of the

following mechanisms?

A. The ossicular chain decreases the

amplitude of vibration while increasing

the force of vibration through the middle

and inner ear

B. The total pressure acting on the smaller oval

window is increased because of high aerial

ration between the tympanic membrane and

oval window

C. The effective force that travels through the

middles is greatly increased

D. All of the above

A

A

31
Q

An individual whose branch of the facial nerve

that innervates the stapedius muscle is severed,

he/she will hear sound that is_______.

A. Louder than usual

B. Softer than usual

C. Normal

A

A

32
Q

Which of the following statement/s is true about

the Organ of Corti?

A. Glutamate is the neurotransmitter of the hair

cells

B. Most of the auditory information from the

periphery is carried by the inner hair cells

C. The basal portion of the Organ of Corti

transduces high frequency sound waves

D. All of the above are true

A

D

33
Q

Which of the following statements is/are true

about the olfactory sense?

A. The discrimination threshold of the sense of

smell is lower than taste sensation

B. The odorant-binding proteins facilitate the

transport of the odorants from cell surface to

the receptors

C. The presence of the different transduction

signals and 2nd messengers ensure that the

olfactory signals are amplified

D. All of the above statements are true

A

D

34
Q

Which of the following show functional

deterioration as one ages?

A. Accommodative power of the eyes

B. Rate of mental calculation

C. Sleep latency

D. All of the above

A

D

35
Q

The flavour of chicken is best distinguished in

which structure/area?

A. Tip of the tongue

B. Sides of the tongue

C. Back of the tongue

D. None of the above

A

A

36
Q

Which of the following visual components are

mostly transmitted via M fibers?

A. Motion

B. Form

C. Color

D. None of the above

A

A

37
Q

Retinotopic arrangements of fibers are insured

by specific layering of this structure:

A. Retina

B. Optic chiasm

C. Superior colliculus

D. Lateral geniculate nucleus

A

D

38
Q

If you see an object disappear from your lateral

field of vision, which structures in the eye are the

light rays from the object falling on?

A. Macula

B. Retinal artery arcade

C. Optic disc

D. Foveola

A

B

39
Q

Reading a patient’s chart prior to your

preceptorials, you read that the patient has: (+)

Marcus Gunn pupil, OS. Which of the following near

exam findings will you expect?

A. Paralysis of the EOM’s of the L eye

B. (-) consensual reflex of the R pupil (light

on the L eye)

C. (-) constriction of the R pupil, swinging

flashlight from L to R

D. (+) increased constriction of the R pupil,

swinging flashlight from L to R

A

B

40
Q

TRUE in testing for the olfactory nerve (CN I)

EXCEPT:

A. This is rarely tested in clinical practice

B. Examination is usually performed to

investigate a specific complaint rather than

as a screening test

C. To make sure that the stimulus is

adequate, use ammonia

D. The olfactory nerve is a special afferent

cranial nerve composed of sensory fibers

only

A

C

41
Q

Steps in testing visual acuity EXCEPT:

A. Make sure patient removes their

prescription glasses as you are

interested in their uncorrected vision

B. Hold a Rosenbaum (near vision) pocket card

at a 14 inch ‘reading’ distance

C. Have the patient cover one eye at a time

with a card

D. Ask the patient to read progressively smaller

letters until they can go no further

A

A

42
Q

Steps in examining the visual acuity, you would

A. Confront the patient by stationing yourself

directly in front. Start with your left eye

directly in line with the patient’s right eye at

a distance of about 1 meter. The patient

covers the left eye with the left hand

B. Hold up your left finger just outside your own

peripheral field, the inferior temporal

quadrant. Hold the finger equidistant

between your eye and the patient’s

C. Ideally the finger should extend beyond the

perimeter of the field. Wiggle the finger

slowly and it very slowly toward the central

field

D. None of the above

A

D

43
Q

TRUE regarding results of visual field testing:

A. A defect in visual field limited to one eye

suggests lesion of the optic nerve anterior to

the optic chiasm

B. A bitemporal hemianopsia suggests a lesion

in the optic chiasm

C. A homonymous field defect suggests a

lesion behind the optic chiasm

D. A, B and C

E. A and B only

A

D

44
Q

TRUE about a patient with left homonomous

hemianopsia EXCEPT:

A. Has a lesion in the left optic nerve

B. Does not have a brainstem lesion

C. Has a lesion after the optic chiasm

D. Has a lesion in the right hemisphere

A

A

45
Q

Approach to a patient with suspected conductive

hearing loss:

A. First determine by history and crude acuity

testing which ear has the hearing problem

B. IN doing the Rinne’s test, bone conduction

(BC) will be greater than air conduction (AC)

in the affected ear

C. In doing the Weber’s test, the sound will

lateralize to the affected ear

D. A, B and C

E. A and B only

A

D

46
Q

Approach to a patient with suspected

sensorineural hearing loss:

A. First determine by history and crude acuity

testing which ear has the hearing problem

B. In doing the Rinne’s test, air conduction will

be greater than bone conduction in the

affected ear

C. In doing the Weber’s test, the sound will

lateralize to the affected ear

D. A, B and C

E. A and B only

A

E

47
Q

True about testing CN 5 or Trigeminal nerve:

A. There are three separate division of CN 5

that the examiner should check individually

B. The trigeminal nerve innervates the scalp to

the vertex not just to the hairline

C. The angle of the jaw is not supplied by CN 5

but by the greater auricular nerve, a branch

of CN 7

D. A and B only

A

D

48
Q

In testing for the motor function of CN 5:

A. Look at the side of the face and check for

atrophy of the masseter and temporalis

muscles

B. Ask the patient to clench his teeth and feel

the masseter and temporalis muscles

C. Ask the patient to open the mouth against

your resisting hand placed under the chin

D. A, B and C

E. A and B only

A

D

Clinical Neurology (10 decks)

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