MCQ Sem 2 Block 5 Week 1 Neuro - Cranial Nerves & Myotatic Reflexes
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 nerveExplanation
The correct answer is the Ophthalmic division of the trigeminal nerve. The ophthalmic division of the trigeminal nerve supplies sensory innervation to the skin on the tip of the nose. The other options mentioned are branches of different nerves and do not innervate the specific area mentioned in the question.Rate this question:
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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 nucleiExplanation
If the mesencephalon fails to develop, it would result in the loss of the oculomotor nuclei. The oculomotor nuclei are located in the midbrain, which is part of the mesencephalon. These nuclei are responsible for controlling the movement of the eye muscles, including the muscles that control pupil constriction and accommodation. Therefore, if the mesencephalon fails to develop, the oculomotor nuclei would be affected, leading to a loss of control over eye movements.Rate this question:
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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 nerveExplanation
The oculomotor nerve is responsible for controlling the movement of most of the eye muscles. Damage to this nerve can result in ptosis, dilation of the pupil, and a downwardly abducted eye, which are the symptoms observed in the patient. Therefore, the patient's symptoms are consistent with damage to the oculomotor nerve.Rate this question:
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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 mouthExplanation
Dry mouth, also known as xerostomia, is expected in this patient due to the involvement of the glossopharyngeal nerve (CN IX) and the vagus nerve (CN X) on the left side. These nerves are responsible for innervating the salivary glands, and their dysfunction can lead to decreased saliva production and subsequently dry mouth. The other clinical signs mentioned in the question are consistent with the involvement of the accessory nerve (CN XI) and hypoglossal nerve (CN XII) on the left side.Rate this question:
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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 VU, CN IX, CN X
- D.
CN H, CN X, CN XI
- E.
CN V, CN X, CN VII
Correct Answer
C. CN VU, CN IX, CN XExplanation
The correct answer is CN VU, CN IX, CN X. This is because SVA (Special Visceral Afferent) axons are found in cranial nerves that are responsible for carrying sensory information related to taste and smell. CN VU (Cranial Nerve VU) is the abbreviation for the Visceral branch of the Trigeminal nerve, which carries taste sensation from the anterior two-thirds of the tongue. CN IX (Cranial Nerve IX) is the Glossopharyngeal nerve, which carries taste sensation from the posterior one-third of the tongue. CN X (Cranial Nerve X) is the Vagus nerve, which carries taste sensation from the epiglottis and the lower pharynx.Rate this question:
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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 VExplanation
Cranial nerve V, also known as the trigeminal nerve, does not have a parasympathetic central connection with the brain. This nerve is primarily responsible for the sensory innervation of the face and motor control of the muscles involved in chewing. It does not have a direct connection to the parasympathetic nervous system, which is responsible for regulating involuntary bodily functions.Rate this question:
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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 VT
- C.
CN III, CN VII, CN IX, CN X
- D.
CN V, CN VII, CN X
- E.
CN E, CN IX, CN X
Correct Answer
C. CN III, CN VII, CN IX, CN XExplanation
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 carrying parasympathetic fibers that control various functions in the head and neck region, including pupillary constriction (CN III), lacrimation and salivation (CN VII), swallowing and parotid gland secretion (CN IX), and digestion and heart rate regulation (CN X).Rate this question:
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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 VExplanation
The principal sensory nucleus of V is involved in relaying touch and proprioceptive information to the somatosensory cortex from the face. This nucleus receives input from the trigeminal ganglion and sends projections to the thalamus, which then relays the information to the somatosensory cortex. The other options listed, such as the nucleus gracilis, motor nucleus of V, nucleus cuneatus, and ventral horn neurons, are not specifically involved in relaying touch and proprioceptive information from the face to the somatosensory cortex.Rate this question:
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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 tractExplanation
The correct answer is CN V; Left Trigemino-Thalamic tract. The patient's loss of pain sensation on the right side of the face suggests a lesion affecting the trigeminal nerve (CN V). The trigeminal nerve carries sensory information from the face to the brain. The deficit exhibited in this case indicates that the lesion is on the left side, affecting the left Trigemino-Thalamic tract. The Trigemino-Thalamic tract is responsible for transmitting sensory information, including pain, from the face to the thalamus in the brain.Rate this question:
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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 IXExplanation
The correct answer is GVE: CN IX. The parotid gland is innervated by the glossopharyngeal nerve (CN IX) via general visceral efferent (GVE) axons.Rate this question:
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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 XIIExplanation
The patient's symptoms of hoarseness of voice, inability to swallow, and restricted movement of the tongue indicate dysfunction of multiple cranial nerves. The glossopharyngeal nerve (IX) is responsible for the sensation and movement of the pharynx, including swallowing. The vagus nerve (X) controls the muscles of the larynx and pharynx, including vocal cord movement and swallowing. The hypoglossal nerve (XII) innervates the muscles of the tongue, which explains the restricted tongue movement. Therefore, the involvement of cranial nerves IX, X, and XII would explain the patient's symptoms.Rate this question:
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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 nucleiExplanation
The oculomotor and Edinger-Westphal nuclei are most likely affected in this young man because the symptoms described, including the depression and exotropia of the left eye and the dilation of the pupil, are consistent with damage to the oculomotor nerve. The oculomotor nerve innervates the muscles responsible for eye movement and also controls the constriction of the pupil. The Edinger-Westphal nucleus is a part of the oculomotor nerve pathway that controls the pupillary constriction. Therefore, damage to both of these nuclei would explain the observed symptoms.Rate this question:
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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 leftExplanation
The patient's tongue deviating towards the left upon protrusion indicates damage to the left hypoglossal nerve. The hypoglossal nerve innervates the muscles of the tongue and controls its movement. Damage to this nerve can result in weakness or paralysis of the muscles on the affected side of the tongue, causing it to deviate towards the side of the damage.Rate this question:
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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 ambiguousExplanation
The correct answer is Nucleus ambiguous. The nucleus ambiguous is associated with both CN IX (glossopharyngeal nerve) and CN X (vagus nerve). It is responsible for providing innervation to the voluntary muscles of the larynx, pharynx, and palate. The other options listed are not associated with both CN IX and CN X or do not play a role in innervating the voluntary muscles mentioned.Rate this question:
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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 muscleExplanation
The correct answer is Hypo-reflexia - Left Biceps Brachii muscle. The injury to the mixed spinal nerves at levels C5 and C6, along with impingement and inflammation, would result in damage to the peripheral nervous portions of these nerves. This damage would lead to a decrease in the deep tendon reflexes, also known as the myotatic reflexes. Since the injury is on the left side, the reflexes on the left side of the body would be affected, including the left Biceps Brachii muscle, resulting in hypo-reflexia.Rate this question:
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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 signExplanation
A lesion at the level of the cerebral peduncle would affect the descending fibers of the corticospinal tract. The corticospinal tract is responsible for voluntary motor control, and when it is disrupted, it can lead to an abnormal reflex known as the Babinski sign. The Babinski sign is characterized by the upward movement of the big toe and fanning out of the other toes when the sole of the foot is stimulated. This response is normally seen in infants but should be absent in adults. However, if there is damage to the corticospinal tract, as in the case of a lesion at the cerebral peduncle, the Babinski sign becomes positive, indicating an abnormal response.Rate this question:
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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. HyporeflexiaExplanation
Hyporeflexia is characteristic of lower motor neuron damage. Lower motor neuron damage refers to damage or dysfunction of the motor neurons in the spinal cord or peripheral nerves that directly innervate muscles. Hyporeflexia refers to a decrease or absence of reflexes, which is commonly observed in lower motor neuron damage. This is because the motor neurons responsible for initiating reflexes are damaged or not functioning properly. The other options, such as hyperreflexia, increased tone, spastic paralysis, and increased muscle mass, are more indicative of upper motor neuron damage.Rate this question:
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Mar 20, 2023Quiz Edited by
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Jan 15, 2012Quiz Created by
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