Block 5 Neuro, Spinal Cord And DPS, MCQ's
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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!
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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.
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
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