Neuro Cranial Nerves & Myotactic Rflx MCQ's

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Neuro Cranial Nerves & Myotactic Rflx MCQs - Quiz

Some cranial nerves are involved in the special senses such as seeing, hearing, and taste and others control muscles in the face or regulate glands. Mytotatic reflax is a contraction in response to stretching within a muscle. The neuro cranial nerves & myotactic rflx mcq's below is designed to test how much you know. Give it a try!


Questions and Answers
  • 1. 

    When testing the sensory innervation of the face, it is important to remember that the skin on the tip of the nose is supplied by which nerve?

    • A.

      Zygomatic branch of the facial nerve

    • B.

      Maxillary division of the trigeminal nerve

    • C.

      Ophthalmic division of the trigeminal nerve

    • D.

      Buccal branch of the mandibular nerve

    • E.

      Buccal branch of the facial nerve

    Correct Answer
    C. Ophthalmic division of the trigeminal nerve
    Explanation
    The skin on the tip of the nose is supplied by the ophthalmic division of the trigeminal nerve. The trigeminal nerve is responsible for sensory innervation of the face, and it has three main divisions: ophthalmic, maxillary, and mandibular. The ophthalmic division supplies sensation to the forehead, upper eyelid, and tip of the nose. Therefore, when testing the sensory innervation of the face, it is important to remember that the skin on the tip of the nose is supplied by the ophthalmic division of the trigeminal nerve.

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  • 2. 

    A developmental disorder resulting in the failure of the mesencephalon to develop would result in the loss of which of the following structures?

    • A.

      Facial nuclei

    • B.

      Spinal trigeminal nuclei

    • C.

      Oculomotor nuclei

    • D.

      Hypoglossal nuclei

    • E.

      Dorsal motor nuclei of X

    Correct Answer
    C. Oculomotor nuclei
    Explanation
    If the mesencephalon fails to develop, it would result in the loss of the oculomotor nuclei. The oculomotor nuclei are responsible for controlling the movement of the eye muscles, including the muscles that control eye movement in different directions and the muscles that control the size of the pupil. Without the development of the mesencephalon, which is a part of the midbrain, the oculomotor nuclei would not form properly, leading to a loss of their function in controlling eye movements.

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  • 3. 

    As a 4th year medical student, you are examining a patient with ptosis (drooping of the eyelid), dilation of the pupil and a downwardly abducted eye. You conclude that the patient has sustained damage to which of the following?

    • A.

      Abducens nerve

    • B.

      Oculomotor nerve

    • C.

      Trochlear nerve

    • D.

      Principal sensory nucleus of V

    • E.

      Facial nerve - Dell's palsy

    Correct Answer
    B. Oculomotor nerve
    Explanation
    The patient's symptoms of ptosis (drooping of the eyelid), dilation of the pupil, and a downwardly abducted eye are indicative of damage to the oculomotor nerve. The oculomotor nerve is responsible for controlling the movement of the eyelid and pupil, as well as the movement of the eye in an upward and inward direction. Damage to this nerve can result in the characteristic symptoms observed in the patient. The other options listed do not match the patient's symptoms and are therefore not the correct answer.

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  • 4. 

    An 18-year-old male presented to the Emergency Room bleeding profusely from a deep cut in the left occipital triangle of his neck and undergoes emergency surgery to repair his internal jugular vein. He survives his injury but he is found on neurological examination to have left-sided weakness in shrugging his shoulder, cannot turn his head to the left against resistance, has a flat left soft palatal arch, and lacks a gag reflex on the left side. What additional clinical sign would be expected in this patient?

    • A.

      Ptosis on the left side that disappears on upward gaze

    • B.

      Profound ptosis on the left side

    • C.

      Dry eye on the left side

    • D.

      Gustatory sweating over the left parotid gland

    • E.

      Dry mouth

    Correct Answer
    E. Dry mouth
    Explanation
    Dry mouth, also known as xerostomia, is a common clinical manifestation of damage to the glossopharyngeal nerve (CN IX) and/or the vagus nerve (CN X). In this case, the patient's injury likely resulted in damage to these nerves, leading to the loss of the gag reflex on the left side and the flat left soft palatal arch. Dry mouth can occur due to decreased salivary gland function, which is controlled by these cranial nerves. Therefore, it would be expected as an additional clinical sign in this patient.

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  • 5. 

    SVA axons are contained in which of the following cranial nerves?

    • A.

      CN III, CN VII, CN IX

    • B.

      CN V, CN VIII, CN IX

    • C.

      CN VII, CN IX, CN X

    • D.

      CN II, CN X, CN XI

    • E.

      CN V, CN X, CN VII

    Correct Answer
    C. CN VII, CN IX, CN X
    Explanation
    SVA axons are contained in cranial nerves CN VII, CN IX, and CN X.

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  • 6. 

    Which of the following cranial nerves does not have a parasympathetic central connection with the brain?

    • A.

      CN III

    • B.

      CN V

    • C.

      CN VII

    • D.

      CN IX

    • E.

      CN X

    Correct Answer
    B. CN V
    Explanation
    CN V, also known as the trigeminal nerve, does not have a parasympathetic central connection with the brain. The trigeminal nerve is primarily responsible for sensory information from the face and motor control of the muscles involved in chewing. It does not have a direct role in parasympathetic functions such as regulating heart rate, digestion, or glandular secretion.

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  • 7. 

    The cell bodies of parasympathetic (GVE) axons are found in which of the following cranial nerves?

    • A.

      CN I, CN II, CN VIII

    • B.

      CN II, CN III, CN IV, CN VI

    • C.

      CN III, CN VII, CN IX, CN X

    • D.

      CN V, CN VII, CN X

    • E.

      CN II, CN IX, CN X

    Correct Answer
    C. CN III, CN VII, CN IX, CN X
    Explanation
    The cell bodies of parasympathetic (GVE) axons are found in cranial nerves CN III, CN VII, CN IX, and CN X. These cranial nerves are responsible for controlling various parasympathetic functions in the body, such as pupillary constriction (CN III), salivation and lacrimation (CN VII), swallowing and secretion (CN IX), and digestion and cardiac function (CN X).

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  • 8. 

    Which 2nd order neurons are involved with relaying touch & proprioceptive information to the somatosensory cortex from the face?

    • A.

      Principal (main) sensory nucleus of V

    • B.

      Nucleus gracilis

    • C.

      Motor nucleus of V

    • D.

      Nucleus cuneatus

    • E.

      Ventral horn neurons

    Correct Answer
    A. Principal (main) sensory nucleus of V
    Explanation
    The principal (main) sensory nucleus of V is involved in relaying touch and proprioceptive information to the somatosensory cortex from the face. This nucleus is located in the trigeminal nerve, which is responsible for transmitting sensory information from the face to the brain. Therefore, it plays a crucial role in processing touch and proprioceptive sensations from the face and relaying them to the somatosensory cortex for further interpretation and perception.

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  • 9. 

    A patient exhibits a loss of pain sensation on the right side of his face. What cranial nerve is affected and a lesion to which of the following tracts would result in the deficit exhibited in this case?

    • A.

      CN V; Left Trigemino-Thalamic tract

    • B.

      CN VII; Left spinal tract of V

    • C.

      CN V; Right Trigemino-Thalamic tract

    • D.

      CN V, Left spiral tract of V

    • E.

      CN VII; Right tractus solitarius

    Correct Answer
    A. CN V; Left Trigemino-Thalamic tract
    Explanation
    The correct answer is CN V; Left Trigemino-Thalamic tract. The patient's loss of pain sensation on the right side of his face suggests a lesion in the trigemino-thalamic tract, which is responsible for transmitting sensory information, including pain, from the face to the brain. The involvement of CN V (trigeminal nerve) indicates that the deficit is related to the sensory innervation of the face. The mention of "left" suggests that the lesion is on the left side of the brain, affecting the left trigemino-thalamic tract.

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  • 10. 

    A 42-year-old man comes to the emergency department with an abscess of the parotid gland that is subsequently excised and drained. The physician who performs this procedure knows that innervation to the parotid gland is provided by what type of axons and which cranial nerve?

    • A.

      SVA; CN X

    • B.

      SVA; CN IX

    • C.

      GVE; CN X

    • D.

      GVE: CN IX

    • E.

      GVE; CN VII

    Correct Answer
    D. GVE: CN IX
    Explanation
    The correct answer is GVE: CN IX. The parotid gland is innervated by the glossopharyngeal nerve (CN IX), which carries general visceral efferent (GVE) fibers. These fibers are responsible for providing parasympathetic innervation to the gland, controlling its secretory function.

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  • 11. 

    A 32-year-old man developed hoarseness of voice, inability to swallow and restricted movement of the tongue after open heart surgery. Peripheral injury of cranial nerves was suspected, and it was thought that the duration of the surgery together with the endotracheal tube cuff and trans-esophageal echocardiography probe pressure, as well as the head and neck position might have been the causes of this complication. Which cranial nerves were involved?

    • A.

      IX and X

    • B.

      IX, X and XII

    • C.

      VII and XII

    • D.

      V/3 and IX, X

    • E.

      V/3 and XII

    Correct Answer
    B. IX, X and XII
    Explanation
    The patient's symptoms of hoarseness of voice, inability to swallow, and restricted movement of the tongue suggest involvement of multiple cranial nerves. The glossopharyngeal nerve (IX) innervates the throat muscles and is responsible for swallowing. The vagus nerve (X) innervates the vocal cords and is responsible for voice production. The hypoglossal nerve (XII) innervates the tongue muscles and is responsible for tongue movement. Therefore, the involvement of cranial nerves IX, X, and XII can explain the patient's symptoms.

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  • 12. 

    You are examining a 20-year old male who has suffered a severe concussion after playing in the neighborhood hockey game. You notice that his left eye is depressed and exhibits exotropia and the pupil is dilated. What two nuclei are most likely affected in this young man?

    • A.

      Trochlear and salivatory nuclei

    • B.

      Trochlear and Edinger-Westphal nuclei

    • C.

      Oculomotor and Edinger-Westphal nuclei

    • D.

      Abducens and Edinger-Westphal nuclei

    • E.

      Oculomotor and salivatory nuclei

    Correct Answer
    C. Oculomotor and Edinger-Westphal nuclei
    Explanation
    The correct answer is Oculomotor and Edinger-Westphal nuclei. The symptoms described, including exotropia (outward deviation of the eye) and dilated pupil, suggest dysfunction of the oculomotor nerve (cranial nerve III). The oculomotor nucleus controls the movement of the eye muscles, including the medial rectus muscle responsible for inward movement of the eye. The Edinger-Westphal nucleus, which is located within the oculomotor nucleus, controls the constriction of the pupil. Damage to both nuclei can result in the observed symptoms.

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  • 13. 

    You are on your emergency medicine rotation and are assisting in the examination of a patient who has been in a vehicular accident. You noticed when testing the cranial nerves, the patient's tongue deviates towards the left upon protrusion. Which cranial nerve is damaged in this case?

    • A.

      The facial nerve on the left

    • B.

      The facial nerve on the right

    • C.

      The mandibular division of trigeminal (V3) on the right

    • D.

      The hypoglossal nerve on the right

    • E.

      The hypoglossal nerve on the left

    Correct Answer
    E. The hypoglossal nerve on the left
    Explanation
    The patient's tongue deviating towards the left upon protrusion suggests damage to the left hypoglossal nerve. The hypoglossal nerve is responsible for controlling the movement of the tongue. Damage to this nerve can result in weakness or paralysis of the muscles of the tongue on the affected side, causing the tongue to deviate towards the damaged side.

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  • 14. 

    Which of the following nuclei is associated with both CN IX and CN X and is important in providing innervation to the voluntary muscles of the larynx, pharynx and palate?

    • A.

      Rostral nucleus solitaries

    • B.

      Edinger-Westphal nucleus

    • C.

      Dorsal motor nucleus of X

    • D.

      Nucleus ambiguous

    • E.

      Facial nuclei

    Correct Answer
    D. Nucleus ambiguous
    Explanation
    The correct answer is Nucleus ambiguous. The nucleus ambiguous is associated with both CN IX (glossopharyngeal nerve) and CN X (vagus nerve) and is responsible for providing innervation to the voluntary muscles of the larynx, pharynx, and palate. It plays a crucial role in controlling functions such as swallowing, speech, and vocalization.

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  • 15. 

    A 22 year old truck driver suffers a crush injury to the 'left arm after a road accident. The mixed spinal nerves leaving the spinal cord at levels C5 and C6 are affected, with impingement and major inflammation. The damage is limited to the peripheral nervous portions of these nerves only. Which below is the most likely finding in this patient with regard to his Deep Tendon (Myotatic) Reflexes?

    • A.

      Areflexia (no reflex) - Left Biceps Brachii muscle

    • B.

      Hypo-reflexia (diminished reflex) - Right Biceps Brachii muscle

    • C.

      Hyper-reflexia (overactive reflex) - Left Biceps Brachii muscle

    • D.

      Hyper-reflexia - Right Biceps Brachii muscle

    • E.

      Hypo-reflexia - Left Biceps Brachii muscle

    Correct Answer
    E. Hypo-reflexia - Left Biceps Brachii muscle
    Explanation
    The injury to the mixed spinal nerves at levels C5 and C6, along with the impingement and inflammation, would affect the transmission of nerve signals to the left Biceps Brachii muscle. This would result in a diminished reflex response in the left arm, leading to hypo-reflexia.

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  • 16. 

    A lesion at the level of the cerebral peduncle would affect descending fibers of the corticospinal tract. Disruption of these axons would result in which of the following?

    • A.

      Flaccid paralysis

    • B.

      Areflexia

    • C.

      Hypotonicity

    • D.

      Positive Babinski sign

    • E.

      Absent Babinski sign

    Correct Answer
    D. Positive Babinski sign
    Explanation
    A lesion at the level of the cerebral peduncle would affect descending fibers of the corticospinal tract. The corticospinal tract is responsible for voluntary motor control. When this tract is disrupted, it can lead to an abnormal response known as the Babinski sign. The Babinski sign is characterized by the extension of the big toe and fanning of the other toes when the sole of the foot is stroked. In a normal response, the toes would flex instead. Therefore, a lesion at the level of the cerebral peduncle would result in a positive Babinski sign.

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  • 17. 

    A 79-year old man is experiencing peripheral nerve damage of his lower right limb. Which of the following is characteristic of lower motor neuron damage?

    • A.

      Hyperreflexia

    • B.

      Increased tone

    • C.

      Hyporeflexia

    • D.

      Spastic paralysis

    • E.

      Increased muscle mass

    Correct Answer
    C. Hyporeflexia
    Explanation
    Hyporeflexia is characteristic of lower motor neuron damage. Lower motor neurons are responsible for transmitting signals from the spinal cord to the muscles, and damage to these neurons can result in decreased reflexes or hyporeflexia. This is because the communication between the spinal cord and the muscles is disrupted, leading to a decrease in the normal reflex responses. The other options, such as hyperreflexia, increased tone, spastic paralysis, and increased muscle mass, are more commonly associated with upper motor neuron damage.

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  • Aug 19, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Jan 15, 2012
    Quiz Created by
    Chachelly
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