Block 5 Neuro Atlas Ch 6 W Expl Part 1
- 1.A 16-year-old boy is brought to the emergency department following a diving accident at a local quarry. The examination reveals a bilateral loss of motor and sensory function in the trunk and lower extremities. At 36 hours after the accident the boy is able to dorsiflex his toes, barely move his right lower extremity at the knee, and is able to perceive pinprick stimulation of the perianal skin (sacral sparing).Which of the following most specifically describes the spinal cord lesion in this patient?
- A.
Central cord
- B.
Complete
- C.
Hemisection
- D.
Incomplete
- E.
Large syringomyelia
- 2.A 54-year-old morbidly obese and hypertensive man is brought to the emergency department after experiencing sudden onset of weakness of his left upper and lower extremities. CT shows an infarcted area in the medulla. Damage to which of the following tracts or fiber bundles of the medulla would most likely explain this deficit?
- A.
Anterolateral system
- B.
Corticospinal fibers
- C.
Medial lemniscus
- D.
Rubrospinal tract
- E.
Vestibulospinal fibers
- 3.A 78-year-old healthy, active woman experiences a sudden weakness of her right upper extremity during an angiogram to determine the patency of her carotid bifurcation. The immediate examination reveals weakness of both extremities on the right and a partial loss of vision in both eyes (homonymoushemianopsia).These observations suggest an embolic stroke resulting in a lesion involving motor and visual structures. The infarcted area in CT points to the occlusion of one vessel. Which of the following vessels is most likely occluded?
- A.
Anterior cerebral artery
- B.
Anterior choroidal artery
- C.
Ophthalmic artery
- D.
Lateral posterior choroidal artery
- E.
Posterior cerebral artery (P3 and P4 segments)
- 4..A 69-year-old man is brought to the emergency department by his wife after complaining of a severe headache and becoming stuporous. CT shows a hemorrhage into the head of the caudate nucleus that has ruptured into the anterior horn of the lateral ventricle. This hemorrhage has most likely originated from which of the following vessels?
- A.
Anterior choroidal artery (branch of internal carotid)
- B.
Lenticulostriate branches (of M1 )
- C.
Medial posterior choroidal artery (branch of P2)
- D.
Medial striate artery (branch of proximal A2)
- E.
Thalamoperforating artery(ies)
- 5.A 23-year-old man is brought to the emergency department from the site of an automobile collision. The neurological examination reveals weakness of the right lower extremity and a loss of pain and thermal sensations on the left side beginning at the level of the umbilicus. CT shows a fracture of the vertebral column with dis-placement of bone fragments into the vertebral canal. Damage to which of the following tracts would correlate with weakness of the lower extremity in this man?
- A.
Left lateral corticospinal tract
- B.
Reticulospinal fibers on the right
- C.
Right lateral corticospinal tract
- D.
Right rubrospinal tract
- E.
Vestibulospinal fibers on the right
- 6.A 23-year-old man is brought to the emergency department from the site of an automobile collision. The neurological examination reveals weakness of the right lower extremity and a loss of pain and thermal sensations on the left side beginning at the level of the umbilicus. CT shows a fracture of the vertebral column with dis-placement of bone fragments into the vertebral canal. Which of the following represents the most likely level of dam-age to the spinal cord resulting from the fracture to the vertebral column in this man?
- A.
T6 on the left
- B.
T8 on the left
- C.
T8 on the right
- D.
T10 on the left
- E.
T10 on the right
- 7.The artery of Adamkiewicz is an especially large spinal medullary artery supplementing the arterial blood supply to the spinal cord. Which of the following represents the most consistent location of this vessel?
- A.
At C7–C8 on the left
- B.
At L5–S1 on the left
- C.
At L5–S1 on the right
- D.
At T6–T7 on the right
- E.
At T12–L1 on the left
- 8.The CT of a 73-year-old woman shows an infarcted area in the rostral portions of the dorsomedial nucleus, the anterior nucleus,and the ventral anterior nucleus. Which of the following arteries supply blood to this area of the brain?
- A.
Anterior choroidal
- B.
Lateral striate (lenticulostriate)
- C.
Medial striate
- D.
Thalamogeniculate
- E.
Thalamoperforating
- 9.Which of the following structures is insinuated between the external and extreme capsules and is functionally related to the insular cortex?
- A.
Claustrum
- B.
External medullary lamina
- C.
Lamina terminalis
- D.
Putamen
- E.
Stria terminalis
- 10.An 83-year-old man is brought to the emergency department by his daughter, who explains that her father started having “fits.” The examination reveals an alert, otherwise healthy, man who frequently has uncontrollable flailing movements of his left arm. Which of the following structures is most likely involved in this lesion?
- A.
Cerebellar cortex plus nuclei
- B.
Lenticular nucleus
- C.
Subthalamic nucleus
- D.
Ventral lateral nucleus
- E.
Ventral posterolateral nucleus
- 11.A 17-year-old girl presents with a bilateral loss of pain and thermal sensations at the base of the neck (C3 dermatome) and extending over the upper extremity and down to the level of the nipple (C4 to T4 dermatomes). MRI shows a cavitation in the spinal cord at these levels. Damage to which of the following structures would most likely explain this deficit?
- A.
Anterior white commissure
- B.
Left anterolateral system
- C.
Medial longitudinal fasciculus
- D.
Posterior columns
- E.
Right anterolateral system
- 12.Which of the following structures is located within the territory of the medulla that is served by the anterior spinal artery?
- A.
Anterolateral system
- B.
Gracile fasciculus
- C.
Medial lemniscus
- D.
Rubrospinal tract
- E.
Spinal trigeminal tract
- 13.A 59-year-old man complains to his family physician that he has trouble chewing. The examination reveals a weakness of masticatory muscles on the left side. Which of the following nuclei is specifically related to the deficit seen in this man?
- A.
Left facial motor
- B.
Left hypoglossal
- C.
Left trigeminal motor
- D.
Right facial motor
- E.
Right trigeminal motor
- 14.A 15-year-old boy with signs of increased intracranial pressure(stupor, vomiting, and headache) is referred to a neurologist. The examination reveals a paralysis of upward gaze, and MRI shows a large tumor of the pineal gland. Damage to which of the following structures would be most specifically related to the gaze deficit?
- A.
Exit of the trochlear nerve
- B.
Inferior colliculus
- C.
Occlusion of the great cerebral vein
- D.
Posterior commissur
- E.
Superior colliculus
- 15.A 61-year-old man is brought to the emergency department after a fall from his garage roof. The examination reveals a hemiplegia on the left, a loss of vibratory sense on the left, and a loss of pain and thermal sensation on the right side involving the upper and lower extremities. These deficits are characteristically seen in which of the following syndromes?
- A.
Benedikt
- B.
Brown-Séquard
- C.
Claude
- D.
Wallenberg
- E.
Weber
- 16..Based on their relative locations in the spinal cord, which of the following tracts or fiber bundles would most likely be involved in a lesion located in the immediate vicinity of the lateral corticospinal tract?
- A.
Anterolateral system
- B.
Anterior spinocerebellar tract
- C.
Gracile fasciculus
- D.
Medial longitudinal fasciculus
- E.
Rubrospinal tract
- 17.A 92-year-old woman is brought to the emergency department by her caregiver. The woman had suddenly become drowsy and confused. The examination revealed no cranial nerve deficits and age-normal motor function, but a loss of pain, thermal, vibratory, and discriminative touch sensations on one side of the body excluding the head. CT shows a small infarcted area. Which of the following structures is the most likely location of this lesion?
- A.
Anterolateral system
- B.
Medial geniculate nucleus
- C.
Subthalamic nucleus
- D.
Ventral posterolateral nucleus
- E.
Ventral posteromedial nucleus
- 18.In its location immediately internal to the anterior spinocere-bellar tract, which of the following fiber bundles would most likely be damaged in a lesion to this area of the spinal cord?
- A.
Anterolateral system
- B.
Anterior corticospinal tract
- C.
Anterior white commissure
- D.
Cuneate fasciculus
- E.
Lateral corticospinal tract
- 19.A 37-year-old man is brought to the emergency department with a severe head injury. Within a few hours he is decerebrate (upper and lower extremities extended) and comatose. The extension of his extremities indicates a dominant input to extensor motor neurons through reticulo spinal fibers/track Which of the following most specifically describes the position of these activated fibers within the spinal cord?
- A.
Anterolateral area (area of anterolateral system)
- B.
Posterolateral area (area of lateral corticospinal tract)
- C.
Posterior columns
- D.
Posterolateral (dorsolateral) tract
- E.
Intermediate zone
- 20.71-year-old woman presents to her family physician with the complaint that “food dribbles out of my mouth when I eat. “the examination reveals a unilateral weakness of muscles around the eye (palpebral fissure) and the opening of the mouth (oral fissure).She also has a loss of pain and thermal sensations on the opposite side of the body excluding the head. CT shows an infarcted area in the lateral portion of the pontine tegmentum. Damage to which of the following nuclei would most likely explain the muscle weakness experienced by this woman?
- A.
Abducens
- B.
Arcuate
- C.
Facial motor
- D.
Hypoglossal
- E.
Trigeminal motor
- 21.71-year-old woman presents to her family physician with the complaint that “food dribbles out of my mouth when I eat. “the examination reveals a unilateral weakness of muscles around the eye (palpebral fissure) and the opening of the mouth (oral fissure).She also has a loss of pain and thermal sensations on the opposite side of the body excluding the head. CT shows an infarcted area in the lateral portion of the pontine tegmentum. The loss of pain and thermal sensations experienced by this woman would most likely correlate with a lesion involving which of the following structures?
- A.
Anterior (ventral) trigeminothalamic tract
- B.
Anterolateral system
- C.
Lateral lemniscus
- D.
Medial lemniscus
- E.
Spinal trigeminal tract
- 22.A 77-year-old woman is discovered slumped on the floor in the grocery store; emergency medical personnel transport her to a local hospital. The examination reveals a drowsy somewhat stuporous woman who is difficult to arouse. CT shows a large hemorrhage within the brain medial to the internal medullary lamina. Which of the following structures is most likely involved in this lesion?
- A.
Anterior thalamic nucleus
- B.
Dorsomedial nucleus
- C.
Globus pallidus
- D.
Ventral lateral and anterior nuclei
- E.
Ventral posterolateral nucleus
- 23.A 78-year-old man presents with deficits suggesting an occlusion of the posterior spinal artery at spinal cord levels C4–T2.Which of the following structures are in the territory served by this vessel at these levels?
- A.
Anterolateral system
- B.
Cuneate fasciculus
- C.
Gracile nucleus
- D.
Lateral corticospinal tract
- E.
Medial longitudinal fasciculus
- 24.Based partially on their embryological origin from a common group of cells, which of the following combinations of structures appear to be the same shade of grey in a T1-weightedMRI?
- A.
Dorsomedial nucleus and globus pallidus
- B.
Globus pallidus and caudate
- C.
Globus pallidus and putamen
- D.
Putamen and caudate nucleus
- E.
Putamen and pulvinar
- 25.Which of the following portions of the trigeminal nuclear complex is found in lateral areas of the brainstem between the level of the obex and the spinal cord-medulla junction and is the source of trigeminothalamic fibers conveying pain and thermal information originating from the face and oral cavity?
- A.
Mesencephalic nucleus
- B.
Principal sensory nucleus
- C.
Spinal trigeminal nucleus, pars caudalis
- D.
Spinal trigeminal nucleus, pars interpolaris
- E.
Spinal trigeminal nucleus, pars oralis
Questions: 35 | Attempts: 16475 | Last updated: Mar 22, 2022
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Sample QuestionObserving patient's behavior and activities?
Questions: 26 | Attempts: 2615 | Last updated: Mar 22, 2022
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Sample QuestionA term used to describe a closed head injury in which there is brief disruption in level of conscienceness, amnesia regarding the occurance, and headache.
Questions: 15 | Attempts: 1845 | Last updated: Mar 22, 2022
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Sample QuestionA patient with daytime sleepiness is sent to a sleep lab for analysis. Just after midnight, the EEG records K complexes and sleep spindles. What stage of sleep is being recorded?
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