Book Review And Study Questions For Chapter 8 - Part 2 Of 3

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Book Review and Study Questions for Chapter 8 - Part 2 of 3

  
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1.  A 31-year-old woman is examined by an otolaryngologist pur-suant to her complaint of hearing difficulties.The physicianplaces a tuning fork against the woman’s mastoid bone untilshe no longer perceives sound,then moves the prongs to herexternal ear where a faint sound is again heard.This maneuveris best described as:
A.
B.
C.
D.
E.
2.  A 64-year-old man is brought to a rural health clinic by a neigh-bor.The history reveals that the man is a recluse,lives by him-self,and does not regularly visit a physician.The examinationreveals that the man has difficulty walking,chorea and dysto-nia,and is suffering dementia.The neighbor believes that theman’s father died from a similar disease.A tentative diagnosisof Huntington disease is made.Absence of which of the follow-ing structures in an MRI of this man would be consistent withthis diagnosis?
A.
B.
C.
D.
E.
3.  A 23-year-old man is brought to the emergency departmentfrom an accident at a construction site.CT shows a fracture ofthe left mastoid bone with total disruption of the stylomastoidforamen.Which of the following deficits would most likely beseen in this man?
A.
B.
C.
D.
E.
4.  Cell bodies located in which of the following ganglia of thehead supply postganglionic fibers to the parotid gland?
A.
B.
C.
D.
E.
5.  A 23-year-old man is brought to the emergency department fromthe site of an automobile collision.CT shows fractures of the facialbones and evidence of bilateral trauma to the temporal lobes(blood in the substance of the brain). As this man recovers,which of the following deficits is mostlikely to be the most obvious?
A.
B.
C.
D.
E.
6.  A 23-year-old man is brought to the emergency department fromthe site of an automobile collision.CT shows fractures of the facialbones and evidence of bilateral trauma to the temporal lobes(blood in the substance of the brain). Assuming that this man also has sustained bilateral injury tothe Meyer-Archambault loop,which of the following deficitswould he also most likely have?
A.
B.
C.
D.
E.
7.  A 59-year-old man,who is a family physician,confides in a neu-rology colleague that he believes he has early-stage Parkinsondisease.The neurological examination reveals a slight resting tremor of the left hand,slow gait,and lack of the normal rangeof facial expression.Which of the following is the most likelylocation of the degenerative changes at this stage of the physi-cian’s disease?
A.
B.
C.
D.
E.
8.  A 14-year-old boy is brought to the emergency departmentafter an accident on his BMX bicycle.The examination revealsthat the boy has severe facial injuries.Craniofacial CT showsfracture of facial bones and probable crushing of the structurestraversing the superior orbital fissure.Damage to which of thefollowing structures passing through this fissure would resultin diplopia when attempting to look down and in?
A.
B.
C.
D.
E.
9.  A 67-year-old man is brought to the emergency department by hiswife.She explains that he fell suddenly,could not get out of his bed,and complained of feeling sick.The examination revealed a left-sided weakness of the upper and lower extremities,a lack of mostmovement of the right eye,and a dilated pupil on the right.MRIshows an infarcted area in the brainstem. The weakness of this man’s extremities is explained by damageto the axons of cell bodies that are located in which of the fol-lowing regions of the brain?
A.
B.
C.
D.
E.
10.  A 67-year-old man is brought to the emergency department by hiswife.She explains that he fell suddenly,could not get out of his bed,and complained of feeling sick.The examination revealed a left-sided weakness of the upper and lower extremities,a lack of mostmovement of the right eye,and a dilated pupil on the right.MRIshows an infarcted area in the brainstem. This man’s dilated pupil is due to damage to which of the fol-lowing fiber populations?
A.
B.
C.
D.
E.
11.  A 67-year-old man is brought to the emergency department by hiswife.She explains that he fell suddenly,could not get out of his bed,and complained of feeling sick.The examination revealed a left-sided weakness of the upper and lower extremities,a lack of mostmovement of the right eye,and a dilated pupil on the right.MRIshows an infarcted area in the brainstem. Which of the following descriptive phrases best describes theconstellation of signs and symptoms seen in this man?
A.
B.
C.
D.
E.
12.  Which of the following structures contains the cell bodies oforigin for fibers conveying taste information from the anteriortwo-thirds of the tongue?
A.
B.
C.
D.
E.
13.  During a screening neurological examination of a 39-year-oldman,the physician taps the supraorbital ridge,stimulating thesupraorbital nerve,and elicits a motor response.Which of thefollowing most likely represents the motor response in thisman?
A.
B.
C.
D.
E.
14.  A 67-year-old man has a bilateral anterolateral cordotomy atT10 for intractable pelvic pain.Four months after this proce-dure the man begins to experience pain sensations.Which ofthe following would most likely explain the apparent recur-rence of pain in this man?
A.
B.
C.
D.
E.
15.  An 84-year-old woman presents to her physician with the com-plaint of difficulty walking.The examination reveals that thewoman has an unsteady gait and tends to forcibly slap her feetto the floor as she walks.She has no other deficits.The physi-cian concludes that the woman has sensory ataxia.Degenerative changes in which of the following would mostlikely explain this deficit?
A.
B.
C.
D.
E.
16.  A 70-year-old woman is brought to the emergency department byher daughter after becoming ill during a trip to the mall.Thewoman is conscious but lethargic,and she has trouble speakingand swallowing.The examination reveals a loss of pain and ther-mal sensation on the left side of the face and a hoarse gravely voice(as if the woman has a sore throat).Movements of the extremitiesare normal for the woman’s age,but she has a loss of pain and ther-mal sensations on the right side of her body.The corneal reflex isabsent on the left side.MRI shows an infarcted area in the brain-stem. The facial sensory deficits experienced by this woman areexplained by a lesion to the axons of cell bodies located inwhich of the following structures?
A.
B.
C.
D.
E.
17.  A 70-year-old woman is brought to the emergency department byher daughter after becoming ill during a trip to the mall.Thewoman is conscious but lethargic,and she has trouble speakingand swallowing.The examination reveals a loss of pain and ther-mal sensation on the left side of the face and a hoarse gravely voice(as if the woman has a sore throat).Movements of the extremitiesare normal for the woman’s age,but she has a loss of pain and ther-mal sensations on the right side of her body.The corneal reflex isabsent on the left side.MRI shows an infarcted area in the brain-stem. The loss of pain and thermal sensations experienced by thiswoman on the right side of her body (excluding the face) ismost likely the result of damage to which of the followingstructures?
A.
B.
C.
D.
E.
18.  A 70-year-old woman is brought to the emergency department byher daughter after becoming ill during a trip to the mall.Thewoman is conscious but lethargic,and she has trouble speakingand swallowing.The examination reveals a loss of pain and ther-mal sensation on the left side of the face and a hoarse gravely voice(as if the woman has a sore throat).Movements of the extremitiesare normal for the woman’s age,but she has a loss of pain and ther-mal sensations on the right side of her body.The corneal reflex isabsent on the left side.MRI shows an infarcted area in the brain-stem. Taking into account all the deficits experienced by this woman,which of the following characterizes the syndrome,and theside,in this patient?
A.
B.
C.
D.
E.
19.  A 17-year-old boy from a poor rural community is diagnosedwith hepatolenticular degeneration (Wilson disease).Which ofthe following is accumulating in certain tissues of his body andproducing health problems?
A.
B.
C.
D.
E.
20.  Which of the following represents the location of the postgan-glionic fibers that influence the dilator pupillae muscle of theiris on the ipsilateral side?
A.
B.
C.
D.
E.
21.  A 37-year-old man presents with vertigo,nystagmus,ataxia,andhearing loss in his right ear.MRI shows a tumor in the cerebel-lopontine angle.A biopsy specimen of this tumor indicates thatthis mass most likely originated from myelin-forming cells onthe root of the vestibulocochlear nerve.Which of the followingterms most correctly identifies this tumor?
A.
B.
C.
D.
E.
22.  An inherited (autosomal recessive) disorder may appear early inthe teenage years.These patients have degenerative changes inthe spinocerebellar tracts,posterior columns,corticospinal fibers,cerebellar cortex,and at select places in the brainstem.The symp-toms of these patients may include ataxia,paralysis,dysarthria,and other clinical manifestations.This constellation of deficits ismost characteristically seen in which of the following?
A.
B.
C.
D.
E.
23.  A 45-year-old man complains to his family physician that thereseems to be something wrong with his mouth.The examina-tion reveals a weakness of the masticatory muscles,a deviationof the jaw to the left on closure,and a sensory loss on the sameside of the lower jaw.MRI shows a tumor,presumably a trigem-inal schwannoma,in the foramen ovale.Compression of whichof the following structures would most likely be the cause ofthe deficits experienced by this man?
A.
B.
C.
D.
E.
24.  A 49-year-old man visits his ophthalmologist with what theman interprets as “trouble seeing.”The history reveals that theman had a sudden event a few days before in which he felt sickand was nauseated.The man said his trouble “seeing”startedafter this sudden sickness.The examination reveals a loss ofabduction and adduction of the right eye and a loss of adduc-tion of the left eye.MRI confirms an infarcted area in the cau-dal and medial pontine tegmentum.Which of the followingmost specifically identifies this man’s clinical problem?
A.
B.
C.
D.
E.
25.  Collaterals of ascending anterior (ventral) trigeminothalamicfibers that contribute to the vomiting reflex would most likelyproject into which of the following brainstem structures?
A.
B.
C.
D.
E.
26.  The topographical arrangement of fibers in the medial lemnis-cus at mid-olivary levels is such that the sensory informationbeing conveyed by those fibers located most anterior (ventral)in this bundle will eventually terminate in which of the follow-ing structures?
A.
B.
C.
D.
E.
27.  An 11-year-old girl is brought to the family physician by hermother.The mother explains that the girl has been complain-ing that her hands and arms “feel funny.”In fact,the motherstates that the girl cut her little finger,but did not realize ituntil she saw blood.The examination reveals a bilateral loss ofpain and thermal sensation on the upper extremities and shoul-der.Which of the following is the most likely cause of thisdeficit in this girl?
A.
B.
C.
D.
E.
28.  A 57-year-old obese man is brought to the emergency depart-ment by his wife.The examination reveals that cranial nervefunction is normal but the man has bilateral weakness of his lower extremities.He has no sensory deficits.MRI shows asmall infarcted area in the general region of the cervical spinalcord–medulla junction.Which of the following represents themost likely location of this lesion?
A.
B.
C.
D.
E.
29.  A 34-year-old woman presents with the complaint of seeing “two ofeverything”(diplopia).The history reveals that the woman becomestired during the work day to the point where she frequently mustleave her work place early.The woman said that her vision prob-lems appeared first,and later she noticed that,when she drank,itwould “go down the wrong pipe.”The examination reveals weak-ness of the ocular muscle,difficulty in swallowing (dysphagia),andmild weakness of the upper extremities.Sensation is normal.Further laboratory tests indicate that the woman has a neurotrans-mitter disease.   Based on the history and symptoms experienced by thiswoman,which of the following is the most likely cause of hermedical condition?
A.
B.
C.
D.
E.
30.  A 34-year-old woman presents with the complaint of seeing “two ofeverything”(diplopia).The history reveals that the woman becomestired during the work day to the point where she frequently mustleave her work place early.The woman said that her vision prob-lems appeared first,and later she noticed that,when she drank,itwould “go down the wrong pipe.”The examination reveals weak-ness of the ocular muscle,difficulty in swallowing (dysphagia),andmild weakness of the upper extremities.Sensation is normal.Further laboratory tests indicate that the woman has a neurotrans-mitter disease.   Which of the following represents the most likely location ofthe neurotransmitter dysfunction in this woman?
A.
B.
C.
D.
E.
31.  A 34-year-old woman presents with the complaint of seeing “two ofeverything”(diplopia).The history reveals that the woman becomestired during the work day to the point where she frequently mustleave her work place early.The woman said that her vision prob-lems appeared first,and later she noticed that,when she drank,itwould “go down the wrong pipe.”The examination reveals weak-ness of the ocular muscle,difficulty in swallowing (dysphagia),andmild weakness of the upper extremities.Sensation is normal.Further laboratory tests indicate that the woman has a neurotrans-mitter disease.   Which of the following represents the neurotransmitter mostlikely affected in this woman?
A.
B.
C.
D.
E.
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