Block 5 Neuro Atlas Ch 3 W Expl

18 Questions | By Chachelly | Last updated: Mar 20, 2022 | Total Attempts: 221

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1.

A 63-year-old man has hearing loss, tinnitus (ringing or buzzing sounds in the ear),vertigo, and unsteady gait; all of these have developed over several years. MRI reveals a large tumor (3 cm in diameter) at the cerebellopontine angle, most likely a vestibular schwannoma (sometimes incorrectly called an acoustic neuroma). What additional deficit could this patient also have?
- A.
  
  Anosmia
- B.
  
  Hemianopsia
- C.
  
  Numbness on the face
- D.
  
  Visual field deficits
- E.
  
  Weakness of the tongue
2.

A 41-year-old woman complains to her family physician about recurring episodes of sharp pain that seem to originate from around her mouth and cheek. The pain is so intense that she is unable to eat, brush her teeth, or apply make-up. Which of the following cranial nerves is the most likely source of this pain?
- A.
  
  Facial (VII)
- B.
  
  Glossopharyngeal (IX)
- C.
  
  Hypoglossal (XII)
- D.
  
  Trigeminal (V)
- E.
  
  Vagus (X)
3.

A 63-year-old man has hearing loss, tinnitus (ringing or buzzing sounds in the ear),vertigo, and unsteady gait; all of these have developed over several years. MRI reveals a large tumor (3 cm in diameter) at the cerebellopontine angle, most likely a vestibular schwannoma (sometimes incorrectly called an acoustic neuroma). In addition to the vestibulocochlear nerve, which of the following structures would most likely also be affected by the tumor in this man?
- A.
  
  Anterior inferior cerebellar artery
- B.
  
  Facial nerve
- C.
  
  Glossopharyngeal nerve
- D.
  
  Posterior inferior cerebellar artery
- E.
  
  Vagus nerve
4.

A 47-year-old man presents with an intense pain on his face arising from stimulation at the corner of his mouth. This is characteristic of trigeminal neuralgia (tic douloureux).MRI shows a vessel compressing the root of the trigeminal nerve. Aberrant branches of which of the following vessels would most likely be involved?
- A.
  
  Anterior inferior cerebellar artery
- B.
  
  Basilar artery
- C.
  
  Posterior cerebral artery
- D.
  
  Posterior inferior cerebellar artery
- E.
  
  Superior cerebellar artery
5.

Which of the following cranial nerves contain the afferent and efferent limbs of the corneal reflex?
- A.
  
  II and III (optic, oculomotor)
- B.
  
  III,IV,VI (oculomotor, trochlear, abducens)
- C.
  
  V and VII (trigeminal, facial)
- D.
  
  VIII and IX (vestibulocochlear, glossopharyngeal)
- E.
  
  IX and X (glossopharyngeal, vagus)
6.

A 59-year-old man complains of persistent headache. An MRA(magnetic resonance angiography) shows an aneurysm in the interpeduncular fossa (and cistern) arising from the basilar tip. Which of the following cranial nerves would be most directly affected by this aneurysm?
- A.
  
  Abducens (VI)
- B.
  
  Oculomotor (III)
- C.
  
  Optic (II)
- D.
  
  Trigeminal,V1 (V)
- E.
  
  Trochlear (IV)
7.

Which of the following cranial nerves passes between the posterior cerebral artery and the superior cerebellar artery as it exits the brainstem?
- A.
  
  Abducens
- B.
  
  Oculomotor
- C.
  
  Optic
- D.
  
  Trigeminal
- E.
  
  Vestibulocochlear
8.

A lesion involving the root of which of the following nerves would most likely have an effect on the gag reflex?
- A.
  
  Accessory
- B.
  
  Facial
- C.
  
  Glossopharyngeal
- D.
  
  Hypoglossal
- E.
  
  Trigeminal
9.

A 67-year-old man complains of persistent throat pain. He experiences a sharp pain in his throat and at the base of his tongue when he chews and swallows. The man does not have an infected throat and the pain is not elicited by stroking the tongue, face, or walls of the oral cavity. On some occasions the pain radiates to the man’s ear. MRI/MRA reveals that there are no obviously abnormal vessels around the brainstem. This man is most likely suffering from which of the following?
- A.
  
  Geniculate neuralgia
- B.
  
  Glossopharyngeal neuralgia
- C.
  
  Occipital neuralgia
- D.
  
  Post herpetic neuralgia
- E.
  
  Trigeminal neuralgi
10.

A 43-year-old woman presents with persistent headache. She complains that her pain has waxed and waned and her discomfort has not been relieved by OTC medications. MRI reveals alarge aneurysm (3.0 cm in diameter) extending caudally from the junction of the left A1 segment and the anterior communicating artery. Based on the location and size of this aneurysm, which of the following symptoms might this patient have?
- A.
  
  A constricted pupil
- B.
  
  Diplopia
- C.
  
  Idiopathic pain on the face
- D.
  
  Partial loss of eye movement
- E.
  
  Partial loss of vision
11.

Which of the following represent the most common site of aneurysms on the vertebrobasilar system, sometimes referred to as the posterior circulation?
- A.
  
  Along the course of the vertebral artery
- B.
  
  Bifurcation of the basilar artery (basilar tip)
- C.
  
  Junction of PICA with the posterior spinal artery
- D.
  
  Junction of PICA with the vertebral artery
- E.
  
  Origin of the anterior spinal artery
12.

A 69-year-old man presents with headache. During the course of the neurological examination, the physician notices that the man’s right pupil is dilated and that his right eye deviates “down-and-out. “Which of the following represents the most likely location of this lesion?
- A.
  
  Abducens nerve in the prepontine cistern
- B.
  
  Abducens nerve in the premedullary cistern
- C.
  
  Oculomotor nerve in the ambient cistern
- D.
  
  Oculomotor nerve in the interpeduncular cistern
- E.
  
  Trochlear nerve in the interpeduncular cistern(F)Trochlear nerve in the ambient cistern
13.

A 21-year-old man is brought to the emergency department from the site of a motorcycle collision. The neurological examination reveals that he is unable to abduct his left eye, but all other eye movements are normal. The examination further reveals that motor, sensory, and reflex function is normal. Which of the following represents the most likely location of this lesion?
- A.
  
  Abducens nucleus on the left
- B.
  
  Abducens nucleus on the right
- C.
  
  Abducens root on the left
- D.
  
  Abducens root on the right
- E.
  
  Basilar pons on the left
- F.
  
  Basilar pons on the right
14.

A 27-year-old woman presents to her physician with the main complaint of double vision. The woman explains to her physician that she has had double vision on three occasions over the last several months. The examination reveals the following. When the woman looks to the right her right eye abducts and her left eye adducts. When she looks to the left her left eye abducts and her right eye does not adduct (it does not move to the right).Further evaluations suggest that this woman has MS. Recognizing the above deficits, which of the following represents the most likely location of the lesion in this woman?
- A.
  
  Abducens nucleus on the left
- B.
  
  Abducens nucleus on the left
- C.
  
  Left medial longitudinal fasciculus
- D.
  
  Left oculomotor nucleus
- E.
  
  Right medial longitudinal fasciculus
- F.
  
  Right oculomotor nucleus
15.

Which of the following brainstem syndromes would result in the greatest deficits of eye movement?
- A.
  
  Claude
- B.
  
  Déjérine
- C.
  
  Guble
- D.
  
  Raymond
- E.
  
  Wallenberg
16.

A 79-year-old man experiences a sudden difficulty in speaking and swallowing; he is transported to the emergency department by his wife. The examination reveals that the man has dysphagia and is hoarse. Recognizing these deficits, from which of the following syndromes is this man most likely suffering?
- A.
  
  Claude
- B.
  
  Gubler
- C.
  
  Raymond
- D.
  
  Wallenberg
17.

A 71-year-old woman is diagnosed with a one-and-a-half syndrome resultant to a lesion on the right side of the pons. Movement of which of the following muscles is preserved in this patient?
- A.
  
  Right medial rectus
- B.
  
  Right lateral rectus
- C.
  
  Left medial rectus
- D.
  
  Left lateral rectus
18.

A 78-year-old man presents with difficulty speaking; he can speak but his words are a bit garbled and not clear. The man also has a left-sided hemiparesis that spares the face. Which of the following represents the most likely location of this man’s lesion?
- A.
  
  Medial basilar pons on the left
- B.
  
  Medial basilar pons on the right
- C.
  
  Medial medulla on the left
- D.
  
  Medial medulla on the right
- E.
  
  Medial midbrain on the left