Block 5 Neuro, Spinal Cord And DPS, MCQ's

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Block 5 Neuro, Spinal Cord And DPS, MCQs - Quiz

The brain stem connects the brain with the spinal cord. The spinal cord is charges with connecting a large part of the peripheral nervous system to the brain through sensory neurons. Take the Block 5 Neuro, spinal cord and dps, MCQ's and see how much you know of this connection. All the best!


Questions and Answers
  • 1. 

    A 19 year old gang member presented in the ER with a stab wound of the neck. Neurological examination revealed left hemiparesis with complete loss of vibratory and joint position sense below C6 on the same side as the weakness. Loss of pain and temperature sensation was elicited on the left at C6 only and on the right below C6. An MRI of the cervical spinal cord will reveal which of these findings?

    • A.

      Hemisection of the left spinal cord

    • B.

      Lesion of the dorsal column only on the left spinal cord

    • C.

      Complete transection of the spinal cord

    • D.

      Lesion of the left anterolateral white mater only of the spinal cord

    • E.

      Damage to the cervical dorsal roots at C6 on the left side only

    Correct Answer
    A. Hemisection of the left spinal cord
    Explanation
    The given answer, "Hemisection of the left spinal cord," is the correct explanation for the findings described in the question. The patient's symptoms indicate a lesion on the left side of the spinal cord, affecting both motor and sensory pathways. The left hemiparesis suggests damage to the corticospinal tract on the left side, while the loss of vibratory and joint position sense below C6 on the left side indicates damage to the dorsal column on the left side. The loss of pain and temperature sensation on the left at C6 and on the right below C6 suggests damage to the spinothalamic tract, which crosses over at the level of entry into the spinal cord. These findings are consistent with a hemisection of the left spinal cord.

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  • 2. 

    During a play-off game, a college hockey player is struck hard on the back of his neck with a hockey stick. A CT scan reveals a bone fragment lodged into the medial aspect of his dorsal columns in the cervical spinal cord. Which of the following functions will most likely be affected given this patient's presentation?

    • A.

      Touch, pressure, vibratory sense from ipsilateral leg

    • B.

      Pain and temperature sense from contralateral leg

    • C.

      Pain from ipsilateral face

    • D.

      Pain and temperature sense from contralateral arm

    • E.

      Touch, pressure, vibration of ipsilateral arm

    Correct Answer
    A. Touch, pressure, vibratory sense from ipsilateral leg
    Explanation
    The bone fragment lodged into the medial aspect of the dorsal columns in the cervical spinal cord suggests damage to the sensory pathways in the spinal cord. The dorsal columns are responsible for transmitting touch, pressure, and vibratory sense information from the body to the brain. Since the bone fragment is located in the cervical spinal cord, it is likely to affect the sensory input from the ipsilateral (same side) leg. Therefore, the most likely function to be affected in this patient's presentation is touch, pressure, and vibratory sense from the ipsilateral leg.

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  • 3. 

    A pain researcher wants to make a lesion to the Spinothalamic tract so that his subjects feel no pain and temperature sensation from the right leg, but leaves pain and temperature sensation rostral to the arm. Where would you advise this researcher to make his lesion?

    • A.

      Lesion the right spinal tract of V

    • B.

      Lesion the most lateral aspect of the left spinothalamic tract

    • C.

      Lesion the most medial aspect of the left spinothalamic tract

    • D.

      Lesion the most lateral aspect of the right spinothalamic tract

    • E.

      Lesion the most medial aspect of the right spinothalamic tract

    Correct Answer
    B. Lesion the most lateral aspect of the left spinothalamic tract
    Explanation
    The researcher should make the lesion in the most lateral aspect of the left spinothalamic tract. By doing so, the researcher will specifically target the pathway responsible for transmitting pain and temperature sensation from the right leg. This will result in the subjects feeling no pain and temperature sensation from the right leg, while leaving the pathway for pain and temperature sensation rostral to the arm intact.

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  • 4. 

    In which of the following funiculi would you find the dorsal columns?

    • A.

      Lateral Funiculus

    • B.

      Posterior Funiculus

    • C.

      Anterior Funiculus

    • D.

      Medial Funiculus

    • E.

      Cuneate Funiculus

    Correct Answer
    B. Posterior Funiculus
    Explanation
    The dorsal columns are found in the posterior funiculus. Funiculus refers to a bundle of nerve fibers within the spinal cord that carries specific types of information. The dorsal columns, also known as the posterior columns, are responsible for carrying sensory information related to touch, vibration, and proprioception (awareness of body position) from the body to the brain. Therefore, the correct answer is the posterior funiculus.

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  • 5. 

    A patient has an injury that results in damage to the lower motor neurons. Which of the following would you expect to see in the patient?

    • A.

      Spastic paralysis

    • B.

      Hyperreflexia

    • C.

      Increased muscle tone

    • D.

      Positive Babinski sign

    • E.

      Flaccid paralysis

    Correct Answer
    E. Flaccid paralysis
    Explanation
    Damage to the lower motor neurons would result in flaccid paralysis. Flaccid paralysis is characterized by the loss of muscle tone, decreased reflexes, and weakness in the affected muscles. It is caused by the disruption of the communication between the lower motor neurons and the muscles they innervate. This can lead to muscle atrophy and a loss of voluntary movement in the affected area.

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  • 6. 

    Which of the following tracts is affected with syringomyelia?

    • A.

      Lateral Corticospinal

    • B.

      Dorsal Column fibers

    • C.

      Anterior Corticospinal

    • D.

      Spinothalamic Tract

    • E.

      Dorsal Spinocerebellar fibers

    Correct Answer
    D. Spinothalamic Tract
    Explanation
    Syringomyelia is a condition characterized by the presence of a fluid-filled cyst or syrinx within the spinal cord. This cyst typically affects the central canal of the spinal cord and can expand over time, causing damage to nearby structures. The spinothalamic tract, which is responsible for transmitting pain and temperature sensations from the body to the brain, is commonly affected in syringomyelia. This can result in a loss of pain and temperature sensation in the affected areas of the body.

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  • 7. 

    Which of the following would you find in the dorsal horn of the spinal cord?

    • A.

      Alpha motor neuron

    • B.

      Gamma motor neuron

    • C.

      Substantia gelatinosa

    • D.

      Sympathetic cell bodies

    • E.

      Clarke's nucleus

    Correct Answer
    C. Substantia gelatinosa
    Explanation
    The dorsal horn of the spinal cord is responsible for receiving sensory information from the body. The substantia gelatinosa is a specific region within the dorsal horn that plays a role in processing and modulating pain signals. It contains interneurons that receive input from sensory neurons and transmit signals to other parts of the spinal cord. Therefore, the substantia gelatinosa is the correct answer as it is a structure found in the dorsal horn of the spinal cord.

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  • 8. 

    During a college football game, a player is "sacked" and carried off the field. A CT scan reveals a bone fragment lodged into the medial aspect of his dorsal columns in the cervical spinal cord on the left side. Which of the following functions will most likely be affected given this patient's presentation?

    • A.

      Motor control of left leg

    • B.

      Proprioception of right leg

    • C.

      Pain from left face

    • D.

      Touch, pressure, vibration of right arm

    • E.

      Touch, pressure, vibration of left leg

    Correct Answer
    E. Touch, pressure, vibration of left leg
    Explanation
    The bone fragment lodged into the medial aspect of the dorsal columns in the cervical spinal cord on the left side will most likely affect the touch, pressure, and vibration sensations of the left leg. The dorsal columns are responsible for transmitting sensory information related to touch, pressure, and vibration from the body to the brain. Since the injury is specifically on the left side, it will affect the sensory input from the left leg.

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  • 9. 

    Which of the following 2nd order neurons is involved with relaying pain and temperature information to the VPM from the face?

    • A.

      Principal (main) sensory nucleus of V

    • B.

      Spinal nucleus of V

    • C.

      Motor nucleus of V

    • D.

      Nucleus cuneatus

    • E.

      Ventral horn neurons

    Correct Answer
    B. Spinal nucleus of V
    Explanation
    The correct answer is the Spinal nucleus of V. The Spinal nucleus of V is a second order neuron that is involved in relaying pain and temperature information from the face to the VPM (ventroposteromedial nucleus) of the thalamus. It receives input from the trigeminal nerve and sends the information to the thalamus for further processing and perception of pain and temperature sensations. The other options listed are not specifically involved in relaying pain and temperature information from the face.

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  • 10. 

    45 year painter was rushed to the ER after he fell from a high building and fractured his cervical vertebra and damaged his spinal cord. During examination of his reflexes immediately after the accident, which of the following are most likely to be seen?

    • A.

      Increased reflexes

    • B.

      Decreased reflexes

    • C.

      Clonus

    • D.

      Rigidity

    • E.

      Fasiculations

    Correct Answer
    B. Decreased reflexes
    Explanation
    In cases of a spinal cord injury, especially in the cervical region, there is often a loss or decrease in reflexes below the level of the injury. This is due to the disruption of the neural pathways that transmit sensory information and reflex responses. In some cases, reflexes may return over time with rehabilitation, but immediately after the injury, decreased reflexes are commonly observed. The other options (increased reflexes, clonus, rigidity, and fasciculations) are not typically associated with spinal cord injuries and may be indicative of other neurological conditions or issues.

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  • 11. 

    Which of the following would you primarily find in the lateral funiculus of the spina cord?

    • A.

      Alpha motor neurons

    • B.

      Anterior Corticospinal tract

    • C.

      Fasciculus cuneatus

    • D.

      Medial Lemniscus

    • E.

      Lateral Corticospinal tract

    Correct Answer
    E. Lateral Corticospinal tract
    Explanation
    The lateral funiculus of the spinal cord primarily contains the Lateral Corticospinal tract. This tract is responsible for carrying motor signals from the cerebral cortex to the spinal cord, controlling voluntary movements of the limbs. The other options mentioned, such as alpha motor neurons, anterior corticospinal tract, fasciculus cuneatus, and medial lemniscus, are not primarily found in the lateral funiculus.

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  • 12. 

    As a principal investigator in a spinal cord regeneration laboratory, you decide to prepare a feline subject with a Brown-Sequard syndrome to illustrate the deficits to your graduate students and technicians. Which of the following would this subject exhibit with a Brown­Sequard syndrome on the left side?

    • A.

      A loss of voluntary motor function on the right side below the level of the lesion

    • B.

      A loss of pain and temperature sense on the left side below the level of the lesion

    • C.

      A loss of touch and pressure sense on the left side below the level of the lesion

    • D.

      A loss of touch and pressure sense on the right side below the level of the lesion

    • E.

      A loss of pain and temperature sense on the right side of the face.

    Correct Answer
    C. A loss of touch and pressure sense on the left side below the level of the lesion
    Explanation
    A subject with Brown-Sequard syndrome on the left side would exhibit a loss of touch and pressure sense on the left side below the level of the lesion. Brown-Sequard syndrome is a neurological condition characterized by damage to one side of the spinal cord. In this case, the left side of the spinal cord is affected, leading to sensory deficits on the same side of the body below the level of the lesion. This means that the subject would experience a loss of touch and pressure sensation on the left side of their body below the level of the spinal cord damage.

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  • 13. 

    A 22-year old athlete is complaining of a loss of 'touch and pressure sense from his left lower limb. You know that axons carrying this type of information are found in which of the following spinal cord regions?

    • A.

      Dorsal funiculus of the spinal cord

    • B.

      Ventral horn of the spinal cord

    • C.

      Lateral funiculus of the spinal cord

    • D.

      Dorsal horn of the spinal cord

    • E.

      Anterior funiculus of the spinal cord

    Correct Answer
    A. Dorsal funiculus of the spinal cord
    Explanation
    The loss of touch and pressure sense in the left lower limb suggests a sensory deficit. Sensory information from the body is carried by axons located in the dorsal funiculus of the spinal cord. The dorsal funiculus is responsible for transmitting sensory information from the body to the brain. Therefore, the loss of touch and pressure sense indicates an issue in the dorsal funiculus of the spinal cord.

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  • 14. 

    As a principal investigator, you are researching the morphology and functionality of alpha motor neurons in the spinal cord. Today you are ready to examine alpha motor neurons located very medially at the lumbar spinal cord level. You know that these neurons provide voluntary motor innervation to which of the following?

    • A.

      Hard

    • B.

      Trunk

    • C.

      Knee

    • D.

      Thigh

    • E.

      Foot

    Correct Answer
    D. Thigh
    Explanation
    The alpha motor neurons located very medially at the lumbar spinal cord level provide voluntary motor innervation to the thigh.

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  • 15. 

    Your great-aunt has pernicious anemia because of a vitamin B12 deficiency. She exhibits spastic paralysis and a loss of touch and pressure perception in both lower limbs, Because of your medical background, which problem do you suspect?

    • A.

      Subacute combined degeneration

    • B.

      Brown-Sequard syndrome

    • C.

      Syringomyelia

    • D.

      Amyotrophic lateral sclerosis (ALS)

    • E.

      Tabes Dorsalis

    Correct Answer
    A. Subacute combined degeneration
    Explanation
    Based on the symptoms described, the most likely problem is subacute combined degeneration. This condition is commonly caused by a vitamin B12 deficiency, which can lead to damage to the spinal cord and peripheral nerves. The symptoms of spastic paralysis and loss of touch and pressure perception in both lower limbs align with the characteristic features of subacute combined degeneration.

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  • 16. 

    A patient has an injury that results in damage to the ventral horn of the spinal cord. Which of the following would you expect to see in this patient?

    • A.

      Flaccid paralysis

    • B.

      Spastic paralysis

    • C.

      Hyperreflexia

    • D.

      Increased muscle tone

    • E.

      Positive Babinski sign

    Correct Answer
    A. Flaccid paralysis
    Explanation
    Damage to the ventral horn of the spinal cord would result in flaccid paralysis. The ventral horn is responsible for transmitting motor signals from the brain to the muscles, so damage to this area would disrupt the communication and lead to a loss of muscle tone and voluntary movement. Flaccid paralysis is characterized by weak and floppy muscles, as opposed to spastic paralysis which is characterized by stiff and rigid muscles. Hyperreflexia, increased muscle tone, and a positive Babinski sign are all associated with upper motor neuron lesions, not damage to the ventral horn.

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  • 17. 

    An occlusion of the anterior spinal artery at the T10 spinal cord level would result in which of the following?

    • A.

      Ipsilateral loss of touch and pressure sense below the level of occlusion

    • B.

      Ipsilateral loss of pain and temperature sense below the level of occlusion

    • C.

      Loss of voluntary motor function to muscles of the tongue

    • D.

      Ipsilateral loss of voluntary motor function below the level of occlusion

    • E.

      Bilateral loss of voluntary motor function below the level of occlusion

    Correct Answer
    E. Bilateral loss of voluntary motor function below the level of occlusion
  • 18. 

    A 28-year old man presents with (I) loss of joint position and vibration of his right lower limb, (II) loss of pain and temperature on his left lower limb and (III) upper motor neuron weakness of his right lower limb. Name the tracts that are damaged [in order from (I) to (III)] and the side of the spinal cord the lesion was sustained.

    • A.

      The corticospinal tract, the spinothalamic tract, the fasciculus gracilis, right side

    • B.

      The fasciculus gracilis, the spinothalamic tract, the corticospinal tract, left side.

    • C.

      The spinothalamic tract, fasciculus gracilis, the corticospinal tract, left side

    • D.

      The fasciculus gracilis, the corticospinal tract, the spinothalamic tract, right side

    • E.

      None of the above

    Correct Answer
    E. None of the above
  • 19. 

    A 36 year old male is observed to have difficulty in walking during a clinic visit. Testing indicates that his joint position sense is intact. However, his reflexes in his lower limbs are diminished. Based on the findings in this patient, which of the following pathways most likely have been damaged?

    • A.

      Lateral spinothalamic

    • B.

      Ventral spinothalamic

    • C.

      Dorsal spinocerebellar

    • D.

      Cuneocerebellar

    • E.

      Dorsal column

    Correct Answer
    C. Dorsal spinocerebellar
    Explanation
    The patient's intact joint position sense suggests that the dorsal column pathway, which is responsible for relaying proprioceptive information, is not damaged. The diminished reflexes in the lower limbs indicate damage to the dorsal spinocerebellar pathway. This pathway carries information from muscle spindles and Golgi tendon organs to the cerebellum, allowing for coordination and fine-tuning of motor movements.

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  • 20. 

    A 25 year old female accidentally drops of a suitcase that she did not realize was too heavy. Which of the following pathways are most likely to be directly responsible for transmitting unconscious proprioception?

    • A.

      Neospinothalamic

    • B.

      Spinoreticular

    • C.

      Spinocerebellar

    • D.

      Dorsal column-medial Lemniscus

    • E.

      Spinomesencephalic

    Correct Answer
    C. Spinocerebellar
    Explanation
    The spinocerebellar pathway is responsible for transmitting unconscious proprioception. This pathway carries information from the muscles, tendons, and joints to the cerebellum, which helps coordinate and regulate movement. In this scenario, when the female accidentally drops the heavy suitcase, the spinocerebellar pathway would be activated to provide feedback to the cerebellum about the position and movement of her limbs. This information allows the cerebellum to make adjustments and maintain balance and coordination.

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  • 21. 

    A patient was brought to the ER after "blacking out and falling down in the kitchen. A CT scan revealed damage to the brainstem. During neurological testing the patient displayed no obvious cranial nerve signs. Sensory testing, pinprick sensitivity and vibration testing was normal. Motor testing revealed no problems with gait and the patient was able to rise from a chair easily - however, when asked to pick up a pencil and write the patient's hand appeared clumsy. Such distal weakness is associated most commonly with?

    • A.

      Vestibulospinal tract lesions

    • B.

      Lower motor neuron lesions

    • C.

      Guillain barre syndrome

    • D.

      Corticospinal tract lesions

    • E.

      Flaccid paralysis

    • F.

      Anterior corticospinal tract lesions

    Correct Answer
    D. Corticospinal tract lesions
    Explanation
    The patient's ability to walk without difficulty and perform gross motor tasks suggests that the motor pathways involved in these functions are intact. However, the clumsiness observed in the patient's hand while attempting fine motor tasks, such as writing, indicates a problem with the corticospinal tract. The corticospinal tract is responsible for controlling voluntary movements, particularly those involving fine motor skills. Lesions in this pathway can result in distal weakness and impaired fine motor control, which is consistent with the patient's symptoms.

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  • 22. 

    A 70 year old male presents to his family physician for a regular checkup. The patient has a history of untreated syphilis when he was 25 years old. He now presents with an unsteady gait, problems with his memory and urinary incontinence. You perform a complete neurological examination which includes the Romberg's test. His Romberg is positive. Which specific task in this test indicates that the patient has suffered posterior column damage?

    • A.

      Loss of balance with his eyes closed

    • B.

      Inability to understand commands

    • C.

      Patient has lost the ability to discriminate two sensations

    • D.

      Pupils do not react to light

    • E.

      Areflexia

    Correct Answer
    A. Loss of balance with his eyes closed
    Explanation
    The Romberg's test is used to assess proprioception and the functioning of the posterior columns of the spinal cord. In a positive Romberg's test, the patient loses balance when their eyes are closed but can maintain balance when their eyes are open. This indicates that the patient is relying on visual cues for balance and is unable to compensate for the loss of proprioception caused by damage to the posterior columns. Therefore, the specific task in the test that indicates posterior column damage is the loss of balance with eyes closed.

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  • 23. 

    A 24-year-old graduate student suffers a fall from a ladder and was left paralyzed from his waist down. After initial medical management was unsuccessful for recovery of function of his legs, he was admitted to a spinal cord injury rehabilitation center. There he worked diligently at the exercises and techniques, aimed at recovery. After six weeks of intensive work he has shown no improvement in his motor function. He tearfully tells his trainer that he feels that it is not worth the effort anymore and that he would like to have a motorized chair so that he could get out of the place and get back with his studies. The behavior shown by the patient at this time suggests he is in what phase of the grief process?

    • A.

      Denial

    • B.

      Acceptance

    • C.

      Anger

    • D.

      Bargaining

    • E.

      Depression

    Correct Answer
    B. Acceptance
    Explanation
    The behavior shown by the patient, expressing his desire for a motorized chair and wanting to get back to his studies, suggests that he has accepted his condition and is ready to adapt to his new circumstances. This indicates that he has moved past denial, anger, bargaining, and depression, and has reached the acceptance phase of the grief process.

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  • 24. 

    The gait in a patient with established neuro syphilis with damage to the spinal cord is which of the following?

    • A.

      Staggering

    • B.

      Shuffling

    • C.

      Drags one feet

    • D.

      High stepping

    • E.

      Scissors like

    Correct Answer
    D. High stepping
    Explanation
    In a patient with established neuro syphilis and damage to the spinal cord, the gait is characterized by high stepping. This refers to a gait pattern where the patient lifts their legs higher than normal while walking. This abnormal gait is caused by the damage to the spinal cord, which can result in weakness or paralysis of the lower limbs. The high stepping gait is a compensatory mechanism used by the patient to clear their feet off the ground and prevent tripping or dragging.

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  • 25. 

    Which of the following would be an iatrogenic cause for a spinal cord injury?

    • A.

      Neurosyphilis

    • B.

      Meningitis

    • C.

      Motor vehicle accident

    • D.

      Osteoporosis

    • E.

      Lumbar puncture

    Correct Answer
    E. Lumbar puncture
    Explanation
    A lumbar puncture can be an iatrogenic cause for a spinal cord injury. During a lumbar puncture, a needle is inserted into the spinal canal to collect cerebrospinal fluid for diagnostic purposes. If the needle is inserted incorrectly or if there is a complication during the procedure, it can lead to damage or injury to the spinal cord. This injury can result in neurological deficits and spinal cord dysfunction.

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  • 26. 

    The incidence of spinal cord injuries in the USA is

    • A.

      10% of the population

    • B.

      Approximately 250,00 cases at any point in time in the population

    • C.

      About 12,000 new cases per year

    • D.

      Prevalent among young males

    • E.

      Mostly caused by motor vehicle accidents

    Correct Answer
    C. About 12,000 new cases per year
    Explanation
    The correct answer is "About 12,000 new cases per year." This answer is supported by the information provided in the question, which states that there are approximately 12,000 new cases of spinal cord injuries per year in the USA. The other statements in the question provide additional information about the incidence and causes of spinal cord injuries, but the specific number of new cases per year is what is being asked for in the answer.

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