Semester 2 Neuro, Quiz 1 - Somatosensory System And Pain

21 Questions | By BLACKMD | Updated: Mar 22, 2022 | Attempts: 1619

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1.

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-Sequard
- C.
  
  Claude
- D.
  
  Wallenberg
- E.
  
  Weber
2.

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. (i) 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
3.

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. (ii) 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
4.

Damage to which of the following fiber bundles or tracts would most likely explain the loss of vibratory sensation of the left lower limb?
- A.
  
  Anterolateral system on the right
- B.
  
  Cuneate fasciculus on the left
- C.
  
  Cuneate fasciculus on the right
- D.
  
  Gracile fasciculus on the left
- E.
  
  Gracile fasciculus on the right
5.

An 88-year-old man is brought to the emergency department by his daughter. She indicates that he complained of weakness of his "arm" and "leg" (upper and lower extremities) on the right side and of "seeing two of everything" (double vision-diplopia). CT shows an infarcted area in the medial area of the pons at the pons-medulla junction. The infarcted area is consistent with the vascular territory served by paramedian branches of the basilar artery. (i) Weakness of the extremities on the right can be explained by damage to which of the following structures?
- A.
  
  Corticospinal fibers on the left
- B.
  
  Corticospinal fibers on the right
- C.
  
  Middle cerebellar peduncle on the left
- D.
  
  Rubrospinal fibers on the left
- E.
  
  Rubrospinal fibers on the right
6.

An 88-year-old man is brought to the emergency department by his daughter. She indicates that he complained of weakness of his "arm" and "leg" (upper and lower extremities) on the right side and of "seeing two of everything" (double vision-diplopia). CT shows an infarcted area in the medial area of the pons at the pons-medulla junction. The infarcted area is consistent with the vascular territory served by paramedian branches of the basilar artery. (ii) Injury to which of the following structures in this man is most specifically related to the loss of pain and thermal sensations on the body below the neck?
- A.
  
  Anterolateral system
- B.
  
  Cuneate fasciculus
- C.
  
  Gracile fasciculus
- D.
  
  Medial lemniscus
- E.
  
  Spinal trigeminal tract
7.

An 88-year-old man is brought to the emergency department by his daughter. She indicates that he complained of weakness of his "arm" and "leg" (upper and lower extremities) on the right side and of "seeing two of everything" (double vision-diplopia). CT shows an infarcted area in the medial area of the pons at the pons-medulla junction. The infarcted area is consistent with the vascular territory served by paramedian branches of the basilar artery. (iii) Damage to which of the following structures would most specifically explain the loss of pain and thermal sensations on the man's face?
- A.
  
  Anterolateral system
- B.
  
  Medial lemniscus
- C.
  
  Medial longitudinal fasciculus
- D.
  
  Solitary tract
- E.
  
  Spinal trigeminal tract
8.

A 79-year-old woman is brought to the emergency department after a fall in her home from which she was unable to get up. The examination reveals a deviation of the tongue to the left on protrusion, a pronounced weakness of the right upper and lower extremities, and a loss of position and vibratory sense and discriminative touch on the right side of the body below the neck. CT shows an infarcted area in the medulla . (i) Which of the following represents the best localizing sign in this patient?
- A.
  
  Deviation of the tongue
- B.
  
  Motor loss on lower extremity
- C.
  
  Motor loss on upper extremity
- D.
  
  Sensory loss on lower extremity
- E.
  
  Sensory loss on upper extremity
9.

A 79-year-old woman is brought to the emergency department after a fall in her home from which she was unable to get up. The examination reveals a deviation of the tongue to the left on protrusion, a pronounced weakness of the right upper and lower extremities, and a loss of position and vibratory sense and discriminative touch on the right side of the body below the neck. CT shows an infarcted area in the medulla . (ii) Damage to which of the following tracts or fiber bundles would most likely give rise to the sensory deficits experienced by this patient?
- A.
  
  Anterolateral system
- B.
  
  Medial lemniscus
- C.
  
  MediaIlongitudinaIfascicuIus
- D.
  
  Solitary tract
- E.
  
  SpinaI trigeminaI tract
10.

A 15-year-old boy is brought to the emergency department after an accident on his father's farm. The examination reveals weakness of the left lower extremity, but no frank paralysis. There is a loss of pinprick sensation on the right side beginning at the T8 dermatome (about half way between the nipple and umbilicus), and dorsiflexion of the great toe in response to plantar stimulation. Based on this examination, which of the following represents the most likely approximate location of this lesion?
- A.
  
  T6 on the left side
- B.
  
  T6 on the right side
- C.
  
  T8 on the left side
- D.
  
  T8 on the right side
- E.
  
  Tl0 on the left side
11.

An 80-year-old woman is brought to the emergency department from an assisted care facility. The woman, who is in a wheelchair, complains of not feeling well, numbness on her face, and being hoarse, although she claims not to have a cold. The examination reveals a loss of pain and thermal sensations on the right side of her face and the left side of her body. CT shows an infarcted area in the lateral portion of the medulla. A lesion of which of the following structures in this woman would explain the loss of pain and thermal sensations on her body excluding the head?
- A.
  
  Anterolateral system on the left
- B.
  
  Anterolateral system on the right
- C.
  
  Medial lemniscus on the left
- D.
  
  Spinal trigeminal nucleus on the left
- E.
  
  Spinal trigeminal tract on the left
12.

In the course of a neurological examination of a 23-year-old man, the physician places her index finger on the midline of the mandible and taps it with a percussion hammer stimulating the afferent limb of the jaw (jaw-jerk) reflex. Collateral fibers from which of the following brain stem nuclei enterthetrigeminaI motarnueleusto initiate the motor response?
- A.
  
  Hypoglossal
- B.
  
  Mesencephalic
- C.
  
  Principal sensory
- D.
  
  Spinal trigeminal, pars caudalis
- E.
  
  Spinal trigeminal, pars interpolaris
13.

The facial sensory deficits experienced by this woman are explained by a lesion to the axons of cell bodies located in which of the following structures?
- A.
  
  Anterior trigeminothalamic fibers on the left
- B.
  
  Left trigeminal ganglion
- C.
  
  Principal sensory nucleus on the left
- D.
  
  Right trigeminal ganglion
- E.
  
  Spinal trigeminal nucleus on the right
14.

The loss of pain and thermal sensations experienced by this woman on the right side of her body (excluding the face) is most likely the result of damage to which of the following structures?
- A.
  
  Anterolateral system fibers on the left
- B.
  
  Anterolateral system fibers on the right
- C.
  
  Anterior trigeminothalamic fibers on the left
- D.
  
  Medial lemniscus on the left
- E.
  
  Medial lemniscus on the right
15.

An ll-year-old girl is brought to the family physician by her mother. The mother explains that the girl has been complaining that her hands and arms "feel runny." In fact, the mother states that the girl cut her little finger, but did not resize it until she saw blood. The examination reveals a bilateral loss of pain and thermal sensation on the upper extremities and shoulder. Which of the following is the most likely cause of this deficit in this girl?
- A.
  
  Brawn-Sequard syndrome
- B.
  
  Posterior inferior cerebellar artery syndrome
- C.
  
  Tabes dorsalis
- D.
  
  Syringobulbia
- E.
  
  Syringomyelia
16.

You touch the edge of a coin with your right index finger. This tactile information is sent to cortex by a tract that crosses the neuroaxis at which point in the nervous system?
- A.
  
  Anterior white commissure
- B.
  
  Upper cervical cord
- C.
  
  Fvlid-pons
- D.
  
  All levels of the spinal cord
- E.
  
  Caudal medulla
17.

During a neurological examination a 49-year old woman's Romberg's test is positive. Which of the following is the major structure that has been affected?
- A.
  
  Spinal nucleus of V
- B.
  
  Ventral commissure of spinal cord
- C.
  
  Ventral horn of spinal cord
- D.
  
  Dorsal columns
- E.
  
  Red nucleus
18.

A 26-year old woman is in an automobile accident. A neurological exam reveals loss of touch, vibration and proprioception in her lower right limb. What is the adaptation rate and receptive field size of Meissner's corpuscles in response to touch under normal conditions?
- A.
  
  Adapt rapidly to stimuli and have a small receptive field
- B.
  
  Adapt rapidly to stimuli and have a large receptive field
- C.
  
  Adapt slowly to stimuli and have a large receptive field
- D.
  
  Adapt slowly to stimuli and have a small receptive field
- E.
  
  None of the above
19.

A patient presents with weakness in the limbs on the left side of the body as well as loss of pain and temperature sensitivity on the left side of the body. Damage to which fibers types could elicit such pain/temperature symptoms?
- A.
  
  Type Ap fibers
- B.
  
  Type C fibers
- C.
  
  Type 1a fibers
- D.
  
  Type lb fibers
- E.
  
  Type Ay fibers
20.

Following a series of strokes a 76~year old woman complains of Hypogeusia . In the pathway that is affected where are the cell bodies of the third order sensory neurons located?
- A.
  
  Insula
- B.
  
  Solitary nucleus
- C.
  
  VPM (Ventral posteromedial nucleus; of the thalamus)
- D.
  
  Cranial nerve ganglia
- E.
  
  Taste buds
21.

A 26-year footballer collides with a member of the opposition during a soccer match. A couple of days later he meets with his physician and complains of hyposmia. Which of the following statements is correct in relation to normal olfaction?
- A.
  
  Primary olfactory neurons are multipolar
- B.
  
  The main output cell of the olfactory bulb is the mitral cell
- C.
  
  Primary olfactory neurons synapse in specific glomeruli within the olfactory epithelium
- D.
  
  Sustentacular cells are also known as Basal cells
- E.
  
  Olfactory epithelium is located in the inferior nasal cavity