Neuroscience – Part 2 14Mar2009

Neuro #1 – Physiology: Motor Systems (Chapter 9)

1) Which of the following is associated with the extrapyramidal motor pathways?
a) Corticospinal tract
b) Corticobulbar tract
c) Basal ganglia
2.1) What muscles are controlled by the medial motor pathway?
a) Postural
b) Hands and fine movement
c) Breathing and cardiac
d) Visceral
e) Trapezius and sternocleidomastoid
2.2) Which of the following is a tract of the lateral motor system?
a) Tectospinal tract
b) Vestibulospinal tract
c) Pontine reticulospinal tract
d) Pontine medullary tract
e) Rubrospinal tract
3) Which of the following describes the release phenomenon?
a) When inhibition is removed and actions cease to take place
b) When inhibition is removed and actions are allowed to take place
c) When inhibition occurs and actions cease to take place
d) When inhibition occurs and actions are allowed to take place
4) Which of the following would be seen in spinal shock after a spinal cord injury (SCI),
such as a transection, at the level of T6?
a) Permanent loss of motor function below the level of T6
b) Temporary loss of motor function below the level of T6
c) Permanent loss of motor function involving all of the spinal cord
d) Temporary loss of motor function involving all of the spinal cord
e) Permanent loss of motor function above the level of T6
f) Temporary loss of motor function above the level of T6
5) Which of the following would most likely occur as a mass reflex with loss of
descending spinal inhibition or spinal cord rearrangement?
a) Multiple muscle clonus, especially in the feet
b) Hyperactive extension of the arms
c) Hyperactive flexion of the arms
d) Hyperactive extension of the arms with bowel evacuation
e) Hyperactive flexion of the arms with bowel evacuation
6) A positive Babinski sign, with upward movement of the big toe and fanning downward
of the other toes, is a sign that a lesion occurred in what tract?
a) Anterior corticospinal tract
b) Lateral corticospinal tract
c) Corticobulbar tract
d) Rubrospinal tract
e) Vestibulospinal tract
7) Many biological oscillators, such as those controlling breathing, operate on the basis of
reciprocal ____ of circuits called half-centers that control ____ muscles.

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a) Excitation; Synergistic
b) Excitation; Antagonistic
c) Inhibition; Synergistic
d) Inhibition; Antagonistic
8.1) A trauma patient presents to the Emergency Room in decorticate position. A tonsilar
brain herniation is found. Shortly after, the patient progresses to decerebrate rigidity, and
thus appears with:
a) Head arched back, arms extended by the sides, legs extended
b) Elbows, wrists and fingers flexed, legs flexed and rotated outward
c) Head flexed forward, arms extended by the sides, legs flexed
d) Elbows, wrists and fingers flexed, legs extended and rotated inward
8.2) Which of the following is thought to be important in the rigidity seen in decerebrate
positioning?
a) Alpha motor neurons
b) Gamma motor neurons
c) Type Ia sensory fibers
d) Type II sensory fibers
e) Golgi tendon organs
9) In the normal vestibulo-ocular reflex, turning the head to one side results in ipsilateral
rotation of the eyes. In patients with nystagmus, which of the following is seen?
a) Slow motion away from a target then saccade toward the target
b) Slow motion toward a target then saccade to neutral
c) Saccade away from a target then slow motion toward the target
d) Saccade toward a target then slow motion to neutral
10) Which of the following is controlled by the corticobulbar tract and not the lateral
corticospinal tract?
a) Tongue
b) Lower face
c) Postural muscles
d) Distal extremities
11) Which of the following connected areas receives sensory information from the post-
central gyrus and visual information from the occipital cortex?
a) Pre-motor cortex
b) Posterior parietal lobe
c) Supplementary motor cortex
12) Neglect syndrome occurs with a lesion in the non-dominant hemisphere for language
(usually right), and has what affect?
a) Inability to recognize objects placed in the contralateral hand and inability to
recognize 3D objects
b) Inability to recognize objects placed in the ipsilateral hand and inability to
recognize 3D objects
c) Inability to recognize objects placed in the contralateral hand and inability to
draw 3D objects accurately
d) Inability to recognize objects placed in the ipsilateral hand and inability to
draw 3D objects accurately
13) Which of the following best describes the role of the cerebellum in movement?

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a) Coordinated motion of the extremities

b) Gross motion before and during their progress
c) Fine-tuned motion before and during their progress
d) Reciprocally inhibited motion of contralateral muscles
e) Directly inhibited motion of ipsilateral muscles
Match the cerebellum division with the functional description:
14.1) Regulates movement and muscle tone a) Archicerebellum
14.2) Modulates the output of the motor cortex b) Paleocerebellum
14.3) Controls balance, coordinates head/eye movements c) Neocerebellum
15) Which of the following signs of neocerebellum damage is seen as irregular
performance of pronation and supination of the forearm?
a) Ataxia
b) Asynergy
c) Dysmetria
d) Intention tremor
e) Dysdiadochokineia
f) Pendular phasic stretch reflexes
g) Dysarhria
16) Which of the following components of the basal ganglia does NOT have fiber
striations (striatum) connecting their nucleus?
a) Caudate nucleus
b) Putamen
c) Globus pallidus
17) What two brainstem nuclei are associated with the basal ganglia?
a) Putamen and nucleus accumbens
b) Nucleus accumbens and substantia nigra
c) Substantia nigra and caudate nucleus
d) Caudate nucleus and subthalamic nucleus
e) Subthalamic nucleus and substantia nigra
18) A patient presents with tremor, rigidity, and bradykinesia. An MRI of the frontal lobe
shows an abnormal substantia nigra. Which of the following neurotransmitters (neuron
types) would most likely be involved in this patient’s disease?
a) Nicotine
b) Muscarine
c) Dopamine
d) Epinephrine
e) Norepinephrine

Neuro #2 – Physiology: Higher Functions Of The Nervous System (Chapter 11)

1.1) In mature individuals at rest with the eyes closed, the EEG recorded from the
posterior region of the brain shows a(n) ____ rhythm, whereas that recorded from the
anterior part of the brain has a(n) ____ rhythm.
a) Alpha (8-13 Hz); Beta (>13 Hz)
b) Beta (>13 Hz); Alpha (8-13 Hz)
c) Theta (4-7 Hz); Delta (<4 Hz)
d) Delta (<4 Hz); Theta (4-7 Hz)

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1.2) Which of the following are associated with deep levels of sleep?
a) Alpha (8-13 Hz) and Beta (>13 Hz)
b) Beta (>13 Hz) and Delta (<4 Hz)
c) Delta (<4 Hz) and Theta (4-7 Hz)
d) Theta (4-7 Hz) and Alpha (8-13 Hz)
e) Alpha (8-13 Hz) and Delta (<4 Hz)
2.1) What stage of sleep is the deepest?
a) Stage 1 (7-10 Hz)
b) Stage 2 (3-7 Hz with 12-14 Hz bursts)
c) Stage 3 (1-2 Hz higher voltage)
d) Stage 4 (1-2 Hz)
e) Rapid eye movement (REM)
2.2) Which of the following is NOT characteristic of REM sleep?
a) Occurs after 90 minutes of sleep
b) Is a deepening of sleep and has a higher voltage
c) Muscle tone disappears and reflexes are inhibited
d) Reduced blood pressure interrupted by hypertension
e) Dreaming and penile erections
3) Which of the following is usually preceded by an aura, involves loss of consciousness,
and tonic/clonic contractions of muscles on both sides of the body?
a) Partial seizure
b) Generalized seizure
c) Grand mal seizure
d) Petite mal seizure
4) Damage to what region of the brain affects recent memory, which is the process in
which short-term memory is converted to long-term memory?
a) Pons
b) Medulla
c) Substantia nigra
d) Hypothalamus
e) Hippocampus
5) Which of the following types of learning is considered associative learning?
a) Habituation
b) Sensitization
c) Classic conditioning
6.1) Damage to which of the following would result in a diminished ability to speak and
write, with nonfluent speech and vocabulary that is often reduced to expletives?
a) Supramarginal gyri of the temporal lobe
b) Angular gyri of the temporal lobe
c) Posterior part of the superior temporal gyrus
d) Inferior frontal gyrus just anterior to the face
e) A, B, or C
6.2) Damage to which of the following would result in fluent but meaningless speech
with frequent paraphasias and neologisms (words with personal meaning)?
a) Supramarginal gyri of the temporal lobe
b) Angular gyri of the temporal lobe

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c) Posterior part of the superior temporal gyrus

d) Inferior frontal gyrus just anterior to the face
e) A, B, or C

Neuro #3 – Motor Systems I (Chapter 24)

1.1) The medial vestibulospinal tract has axons originating in the medial and inferior
vestibular nuclei that descend ____ and influence motor neurons controlling ____
musculature.
a) Ipsilaterally; Neck
b) Contralaterally; Neck
c) Bilaterally; Neck
d) Ipsilaterally; Leg extensors
e) Contralaterally; Leg extensors
f) Bilaterally; Leg extensors
1.2) The lateral vestibulospinal tract has axons that descend ____ and influence motor
neurons controlling ____ musculature.
a) Ipsilaterally; Neck
b) Contralaterally; Neck
c) Bilaterally; Neck
d) Ipsilaterally; Leg extensors
e) Contralaterally; Leg extensors
f) Bilaterally; Leg extensors
1.3) Damage to the superior colliculus causes decerebrate rigidity due to the ____, which
is rostral to the superior colliculus and is responsible for flexor muscles.
a) Medial vestibulospinal tract
b) Lateral vestibulospinal tract
c) Medial reticulospinal tract
d) Lateral reticulospinal tract
e) Rubrospinal tract
1.4) Fibers of which of the following arise in the red nucleus, crossing at the tegmental
decussation?
a) Medial vestibulospinal tract
b) Lateral vestibulospinal tract
c) Medial reticulospinal tract
d) Lateral reticulospinal tract
e) Rubrospinal tract
1.5) Which of the following muscles are innervated by the rubrospinal tract?
a) Neck and head
b) Arm flexors
c) Arm extensors
d) Leg flexors
e) Leg extensors
2.1) A lesion eliminating cortical input to the red nucleus would result in decorticate
positioning, as which of the following tracts can still get excitation as projections from
the cerebellar nuclei are unaffected by the lesion?
a) Medial vestibulospinal tract

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b) Lateral vestibulospinal tract

c) Medial reticulospinal tract
d) Lateral reticulospinal tract
e) Rubrospinal tract
2.2) A patient presents comatose with pupils fixed and dilated, no eye movement, lower
extremities extended, toes pointed inward, upper extremities extended, fingers flexed,
forearms pronated, and neck extended. Which of the following would be the least likely
to lead to this presentation?
a) Central herniation
b) Uncal herniation
c) Cerebellar herniation
d) Tosillar herniation
e) Cingulate herniation

Neuro #4 – Motor Systems II (Chapter 25)

1) The cell bodies of upper motor neurons are located in the ____ and the cell bodies of
lower motor neurons are located in the ____.
a) Brainstem or spinal cord; Cerebral cortex
b) Cerebral cortex; Brainstem or spinal cord
c) Spinal cord; Brainstem or cerebral cortex
d) Brainstem or cerebral cortex; Spinal cord
e) Brainstem; Cerebral cortex or spinal cord
2) Which of the following signs is associated with lower motor neuron lesions (non-
pyramidal tract sign)?
a) Positive Babinski sign
b) Hyper-reflexia or clonus
c) Hyper-tonia
d) Flaccid with eventual spastic muscles
e) Fibrillations or fasciculations
3) Strychnine acts on Renshaw cells, affecting their ability to control alpha motor neuron
firing by binding to the glycine receptors on the motor neuron. What affect would this
have on the diaphragm?
a) Repeated contractions (hiccups)
b) Slightly increased contractions (tachypnea)
c) Slightly decreased contractions (bradypnea)
d) Tetanus contractions (clonus)
e) Flaccid paralysis
4.1) The corticospinal tract originates in what layer of the cerebral cortex?
a) Molecular layer I
b) External granular layer II
c) External pyramidal layer III
d) Internal granular layer IV
e) Internal pyramidal layer V
f) Multiform layer VI
4.2) Which of the following is NOT a location where the corticonuclear and corticospinal
tracts originate?

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a) Primary motor cortex (Area 4)

b) Premotor cortex (Area 6) and supplementary motor cortex
c) Primary somatosensory cortex (Areas 1, 2, and 3)
d) Dorsolateral prefrontal cortex
e) Posterior parietal cortex
4.3) The corticonuclear and corticospinal tracts terminate in the red nucleus (ipsilateral),
reticular formation (bilateral), and the motor nuclei of all cranial nerves bilaterally
including:
a) Facial
b) Nucleus ambiguus
c) Hypoglossal
d) Spinal accessory
e) Trigeminal
4.4) At their level of termination, corticospinal fibers synapse primarily on:
a) Interneurons in laminae V to VII
b) The intermediate zone and anterior horn (laminae VII to IX)
c) The base of the posterior horn (laminae IV to VI)
5) Which of the following would be seen with a midbrain lesion of the corticonuclear
(corticobulbar) tract?
a) Contralateral lower face paralysis
b) Ipsilateral lower face paralysis
c) Contralateral paralysis of mastication muscles
d) Ipsilateral paralysis of mastication muscles
e) Bilateral clonus reflex of the ankles
6.1) Loss of the corticospinal tract may result in partial compensation by what tract,
playing a role in increased flexor tone of the upper limbs seen in decorticate posturing?
a) Corticonuclear
b) Corticorubral
c) Corticoreticular
d) Corticopontine
e) Vestribulospinal
6.2) Where does the corticoreticular (reticulospinal) tract originate?
a) Areas 4 and 6
b) Areas 5 and 7
c) Premotor cortex
d) Somatosensory cortex
e) Nearly all areas of the cortex
6.3) Where does the corticopontine system originate?
a) Areas 4 and 6
b) Areas 5 and 7
c) Premotor cortex
d) Somatosensory cortex
e) Nearly all areas of the cortex
7) In voluntary movement, what is the role of the supplementary motor cortex (and
premotor cortex)?
a) Hand-eye coordination

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b) Motor movement with decreased neuron firing as muscle load increase

c) Motor movement with increased neuron firing as muscle load increase
d) Planning and rehearsing movement
e) Adjusting fine movements while gross movements are taking place
8) Which of the following would NOT be seen in Brown-Séquard syndrome at the level
of L4 on the left, post-spinal shock?
a) Spastic paralysis on the left
b) Loss of vibratory sense on the left
c) Loss of temperature sense on the right
d) Loss of proprioception on the right
e) Loss of pain sensation on the right

Neuro #5 – Basal Nuclei (Chapter 26)

1.1) The neostriatum includes:
a) Caudate
b) Putamen
c) Dorsal basal nuclei
d) A & B
e) A, B, & C
1.2) Which of the following is NOT a component of the dorsal basal nuclei?
a) Substantia nigra
b) Subthalamic nucleus
c) Parabrachial pontine reticular formation
d) Pedunculopontine tegmental nucleus
e) Nucleus basalis of Meynert
1.3) Which of the following is a component of the paleostriatum?
a) Substantia innominata
b) Substantia nigra
c) Nucleus accumbens
d) Nucleus basalis of Meynert
e) Olfactory tubercle
2.1) Which of the following is a component of the pallidal complex, not the striatal
complex?
a) Substantia innominata
b) Nucleus accumbens
c) Putamen
d) Olfactory tubercle
e) Caudate nucleus
2.2) Which of the following does NOT specifically supply the telencephalic region?
a) Medial striate artery
b) Lenticulostriate branches of M1
c) Posteriomedial branches of P1
d) Anterior choroidal artery
2.3) Where are striosomes (ACHesterase-poor regions) the most prominent?
a) Substantia innominata
b) Nucleus accumbens

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c) Putamen
d) Olfactory tubercle
e) Caudate nucleus
2.4) Where would primarily GABAergic neurons with high rates of spontaneous activity
be found?
a) Globus pallidus
b) Nucleus accumbens
c) Putamen
d) Substantia innominata
e) Caudate nucleus
2.5) The substantia nigra is divided into the pars compacta, which produces ____, and the
pars reticulate, which has ____-ergic neurons.
a) GABA; Dopamine
b) Dopamine; GABA
c) GABA; Acetylcholine
d) Acetylcholine; GABA
2.6) The direct pathways for basal nuclei ____ flow through the thalamus and has fibers
that use ____ and substance P.
a) Inhibits; Dopamine
b) Inhibits; GAB A
c) Facilitates; Dopamine
d) Facilitates; GABA
e) Facilitates; Enkephalin
2.7) The indirect pathways for basal nuclei includes a loop through the subthalamic
nucleus and the:
a) Globus pallidus
b) Nucleus accumbens
c) Putamen
d) Substantia innominata
e) Caudate nucleus
3.1) Which of the following is centered on the ventral striatum, plays a role in
maintenance of memory, and may be involved in schizophrenia?
a) Motor loop
b) Oculomotor loop
c) Dorsolateral Prefrontal loop
d) Lateral orbitofrontal loop
e) Limbic loop
3.2) Where is the motor loop (basal ganglia modality) centered?
a) Globus pallidus
b) Supplementary motor area (SMA)
c) Putamen
d) Primary motor cortex (MC)
e) Premotor cortex (PMC)
4.1) Which of the following is commonly seen in those with vascular lesions localized to
the contralateral subthalamic nucleus?
a) Akinesia: impaired ability to initiate voluntary movements

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b) Bradykinesia: the reduction in velocity and amplitude of movements

c) Ballismus: consistent, uncontrolled flinging movements of the extremities
d) Choreiform: generalized dance-like movements of the limbs
e) Athetoid: continuous writhing of distal portions of the extremities
4.2) Which of the following is present in Huntington disease and less commonly
Parkinson disease?
a) Akinesia
b) Bradykinesia
c) Ballismus
d) Choreiform
e) Athetoid
4.3) Which of the following is due to disruption of the balance between outflows of the
direct and indirect pathways to the thalamus, increasing the activation of antagonist
muscles?
a) Akinesia
b) Bradykinesia
c) Ballismus
d) Choreiform
e) Athetoid
4.4) Huntington disease causes degeneration to which of the following areas?
a) Globus pallidus
b) Nucleus accumbens
c) Neostriatum
d) Substantia innominata
e) Substantia nigra
4.5) What drug would be given to patients with Parkinson disease to replace the
dopamine missing in the nigral complex?
a) Dopamine
b) Carbidopa
c) Tyrosinase
d) L-DOPA
e) GABA
4.6) A patient presents with wing-beating tremor (asterixis). An MRI shows bilateral
cavitation of the lenticular nuclei. Which of the following is the most likely?
a) Huntington disease
b) Parkinson disease
c) Sydenham chorea
d) Tardive dyskinesia
e) Wilson disease
4.7) Which of the following causes rapid, irregular, aimless movements and is associated
with group A beta-hemolytic streptococci?
a) Huntington disease
b) Parkinson disease
c) Sydenham chorea
d) Tardive dyskinesia
e) Wilson disease

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Neuro #6 – Cerebellum (Chapter 27)

1.1) Which of the following is descriptive of the middle cerebral peduncle?
a) Composed of a restiform body
b) Composed of a juxtarestiform body on the wall of the 4th ventricle
c) Conveys afferent fibers from the nuclei of the basilar pons
d) Contains cerebellar efferent fibers from cerebellar nuclei
e) Distributes to the diencephalon and brainstem
1.2) Which of the following are contained in the flocculonodular lobe of the cerebellum?
a) Lobules I and HII
b) Lobules V and HV
c) Lobules VI and HVI
d) Lobules IX and HIX
e) Lobules X and HX
1.3) Which of the following cerebellar nuclei is considered lateral?
a) Fastigial nucleus
b) Globose nucleus
c) Emboliform nucleus
d) Dentate nucleus
1.4) Which of the following nuclei exit the cerebellum via the juxtarestiform bodies
(inferior peduncle) instead of the superior cerebellar peduncle?
a) Fastigial nucleus
b) Globose nucleus
c) Emboliform nucleus
d) Dentate nucleus
1.5) Which of the following arteries does NOT feed the cerebellum?
a) PICA
b) AICA
c) Superior cerebellar artery
d) Lenticulostriate artery
1.6) Which of the following are the only excitatory neurons of the cerebellar cortex?
a) Purkinje cells
b) Granular cells
c) Golgi cells
d) Stellate cells
e) Basket cells
1.7) Which of the following are the only efferent neurons of the cerebellar cortex?
a) Purkinje cells
b) Granular cells
c) Golgi cells
d) Stellate cells
e) Basket cells
1.8) Where do climbing fibers originate?
a) Locus ceruleus
b) Superior olive
c) Inferior olive

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d) Medulla nuclei
e) Pons nuclei
2.1) The vestibulocerebellar module is made of the vestibulocerebellum and the:
a) Fastigial nucleus
b) Globose nucleus
c) Emboliform nucleus
d) Dentate nucleus
2.2) Which of the following cerebellar functional divisions contains the vermis?
a) Vestibulocerebellum (Archicerebellum)
b) Spinocerebellum (Paleocerebellum)
c) Cerebrocerebellum (Neocerebellum)
2.3) The spinocerebellum is able to elaborate proprioceptive input in order to anticipate
the future position of a body part during the course of a movement, in a "feed forward"
manner.
a) True
b) False, that is the role of the vestibulocerebellum/flocculocerebellum
c) False, that is the role of the cerebrocerebellum/pontocerebellum
2.4) The vestibulocerebellum is involved in planning movement that is about to occur and
has purely cognitive functions as well.
a) True
b) False, that is the role of the spinocerebellum
c) False, that is the role of the cerebrocerebellum/pontocerebellum
3) Which of the following would occur with a lesion of the cerebellum?
a) Impaired performance of some previously learned motor behaviors
b) Impaired learning of some new motor behaviors
c) Impaired timing of motor behaviors/movements
d) All of the above
e) None of the above
4.1) Which of the following refers to lesions of the lateral cerebellum resulting in
deterioration of coordinated movement?
a) Dyssynergia
b) Ataxia
c) Dysmetria
d) Intention tremor
e) Dysdiadochokinesia
f) Dysarthria
4.2) Which of the following is shows accentuated movement near a target such as when a
patient is asked to touch their nose with their finger tip and is seen in lesions of the
cerebrocerebellum?
a) Dyssynergia
b) Ataxia
c) Dysmetria
d) Intention tremor
e) Dysdiadochokinesia
f) Dysarthria
4.3) Which of the following would be seen in a vestibulocerebellar lesion?

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a) Dyssynergia
b) Dysdiadochokinesia
c) Dysmetria and decomposition
d) Contralateral ataxia
e) Ipsilateral ataxia
4.4) A patient presents with palatal myoclonus (PM) due to damage to the Triangle of
Guillain-Mollaret. Which of the following is NOT a part of this triangle?
a) Red nucleus
b) Dentate nucleus
c) Globus pallidus
d) Inferior olivary nucleus

Neuro #7 – Visual Motor System (Chapter 28)

1.1) During extraocular motion testing of the cardinal positions of gaze, the patient looks
up and to their left. What muscles are being tested?
a) Right superior oblique; Left superior rectus
b) Right superior rectus; Left superior oblique
c) Right inferior oblique; Left superior rectus
d) Right superior rectus; Left inferior oblique
e) Right superior rectus; Left superior rectus
1.2) If a patient is looks down and to the right, what muscles are being used?
a) Right superior oblique; Left inferior rectus
b) Right inferior rectus; Left superior oblique
c) Right inferior oblique; Left inferior rectus
d) Right inferior rectus; Left inferior oblique
e) Right inferior rectus; Left inferior rectus
1.3) What eye muscle is innervated by the trochlear nerve (CN IV)?
a) Superior rectus
b) Inferior rectus
c) Lateral rectus
d) Medial rectus
e) Superior oblique
f) Inferior oblique
1.4) What eye muscle is innervated by the abducens nerve (CN VI)?
a) Superior rectus
b) Inferior rectus
c) Lateral rectus
d) Medial rectus
e) Superior oblique
f) Inferior oblique
1.5) Which of the following intraocular muscles changes the curvature of the lens?
a) Ciliary muscle
b) Sphincter pupillae muscle
c) Dilator pupillae muscle
d) B & C
2.1) Which of the following is located in the facial colliculus?

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a) Oculomotor nucleus
b) Edinger-Westphal nucleus
c) Trochlear nucleus
d) Abducens nucleus
e) Medial longitudinal fasciculus (MLF)
2.2) Which of the following contains the cholinergic, preganglionic parasympathetic
motor neurons that control lens accommodation and pupillary constriction?
a) Oculomotor nucleus
b) Edinger-Westphal nucleus
c) Trochlear nucleus
d) Abducens nucleus
e) Medial longitudinal fasciculus (MLF)
2.3) While examining a patient, eye convergence is intact. When the patient looks to the
left, the left eye goes left but the right eye stays at neutral. Which of the following is the
most likely?
a) CN IV on the right
b) CN VI on the left
c) MLF on the right
d) MLF on the left
e) MLF bilaterally
2.4) Damage to the pontine tegmentum (unilateral lesion of the paramedian pontine
reticular formation) would most likely cause what extraocular movement signs?
a) Bilateral MLF lesion
b) CN VI lesion with MLF ipsilaterally
c) CN VI lesion with MLF contralaterally
d) MLF on the ipsilateral side
e) MLF on the contralateral side
2.5) If a patient is asked to look to the left and then down, and both eyes look left but
only the left eye looks down, what nerve is damaged?
a) CN III on the right
b) CN III on the left
c) CN IV on the right
d) CN IV on the left
e) CN VI on the right
f) CN VI on the left
3) Damage to one side of the sympathetic trunk leads to Horner syndrome, which would
have which of the following signs seen in a patient sitting under a heat lamp?
a) Ipsilateral ptosis; Ipsilateral miosis; Ipsilateral diaphoresis
b) Ipsilateral ptosis; Ipsilateral miosis; Contrlateral diaphoresis
c) Ipsilateral ptosis; Ipsilateral mydriasis; Ipsilateral diaphoresis
d) Ipsilateral ptosis; Ipsilateral mydriasis; Contralateral diaphoresis
e) Contralateral ptosis; Contralateral miosis; Ipsilateral diaphoresis
f) Contralateral ptosis; Contralateral mydriasis; Contralateral diaphoresis
4.1) The horizontal gaze center is found in the pons, surrounding which of the following?
a) Oculomotor nucleus
b) Edinger-Westphal nucleus

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c) Trochlear nucleus
d) Abducens nucleus
e) Medial longitudinal fasciculus (MLF)
4.2) The vertical gaze center, found in the midbrain, would be affected by what kind of
tumor?
a) Pineal tumor
b) Pituitary tumor
c) Choroidal tumor
d) Medulla tumor
e) Sellar tumor
4.3) What is the role of the nucleus prepositus hypoglossi?
a) Tongue movement
b) Maintaining neural eye position
c) Sending excitatory burst signals for eye movement
d) Sending inhibitory burst signals for eye movement
e) Sending a hold signal for maintaining non-neutral eye position
4.4) Damage to neurons located in the supraoculomotor area would lead to what deficit?
a) No response to light
b) Loss of accommodation reflex
c) Loss of saccades movement
d) Loss of smooth pursuit movement
e) Movement of both eyes into a down and out position
4.5) Lesion of the superior colliculus, which can localize a stimulus, would lead to what
deficit (usually with full recovery)?
a) No response to light
b) Loss of accommodation reflex
c) Loss of saccades movement
d) Loss of smooth pursuit movement
e) Movement of both eyes into a down and out position
4.6) During a caloric ear test, cold water is injected into the external auditory canal.
Which of the following will be seen in relation to the ear being tested?
a) Slow movement ipsilaterally with fast saccade (beat) contralaterally
b) Slow movement contralaterally with fast saccade (beat) ipsilaterally
c) Fast saccade (beat) ipsilaterally with slow movement contralaterally
d) Fast saccade (beat) contralaterally with slow movement ipsilaterally
5.1) You are sitting in a car at a stoplight. The car next to you begins to move and you get
the feeling that you are moving (optokinetic reflex). Which of the following is NOT
required for the reflex circuit?
a) Retinal ganglion cells
b) Accessory nuclei
c) Pontine nuclei
d) Cerebellum
e) Vestibular nuclei
f) Superior olivary complex
5.2) The convergence triad of ocular events requires constriction of the pupils, a ciliary
body (lens movement) and which extraocular muscle?

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a) Superior rectus
b) Inferior rectus
c) Lateral rectus
d) Medial rectus
e) Superior oblique
f) Inferior oblique
5.3) In the pupillary light reflex, the afferent limb is the ____ nerve and the efferent limb
is the ____ nerve.
a) Optic; Oculomotor
b) Oculomotor; Optic
c) Optic; Abducens
d) Abducens; Optic
e) Trochlear; Oculomotor
5.4) In the blink reflex, the afferent limb is the ____ nerve and the efferent limb is the
____ nerve.
a) Trigeminal; Oculomotor
b) Optic; Oculomotor
c) Trigeminal; Facial
d) Facial; Trigeminal

Neuro #8 – Visceral Motor Pathways (Chapter 29)

1.1) Which of the following cranial nerves is NOT associated with the parasympathetic
(craniosacral) nervous system?
a) CN III
b) CN V
c) CN VII
d) CN IX
e) CN X
1.2) Which of the following is a location for sympathetic postganglionic cell bodies?
a) Celiac ganglia
b) Ciliary ganglia
c) Submandibular ganglia
d) Pterygopalatine ganglia
e) Otic ganglia
1.3) What is the primary neurotransmitter of postganglionic, sympathetic sweat glands?
a) Acetylcholine
b) Dopamine
c) Norepinepherine
d) Serotonin
e) GABA
1.4) Which of the following targets blood vessels of the face, scalp, and neck as well as
salivary glands, nasal glands, lacrimal glands, and eye structures?
a) Celiac ganglion
b) Aorticorenal ganglion
c) Superior mesenteric ganglion
d) Inferior mesenteric ganglion

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e) Superior cervical ganglion

1.5) What is the location of postganglionic cell bodies for the glossopharyngeal (CN IX)
nerve?
a) Terminal ganglia in/on wall of target organ
b) Ciliary ganglion
c) Pterygopalatine ganglion
d) Otic ganglion
e) Submandibular ganglion
1.6) Which of the following parasympathetic nerves targets reproductive tissues?
a) Oculomotor
b) Facial
c) Glossopharyngeal
d) Vagus
e) Sacral splancnics
1.7) Which of the following involves nicotinic, not muscarinic receptors?
a) Smooth muscle
b) Cardiac muscle
c) Skeletal muscle
d) Glandular cells
2.1) Which of the following is NOT involved in integration or coordination of autonomic
functions?
a) Hypothalamus
b) Hippocampus
c) Reticular formation
d) Solitary nucleus
2.2) The chemoreceptor reflex is activated by:
a) Increased pO2
b) Decreased pO2
c) Increased pCO2
d) Decreased pCO2
2.3) Micturition is brought about by the contraction of the detrusor muscle and relaxation
of the external urethral sphincter, which is supplied by ____ motor neurons in spinal
segments ____.
a) Alpha; S1-S2
b) Gamma; S1-S2
c) Alpha; S3-S4
d) Gamma; S3-S4

Neuro #9 – Hypothalamus (Chapter 30)

1) Which of the following is located anterior and caudal to the hypothalamus?
a) Cerebellum
b) Pineal body
c) Cingulate gyrus
d) Nucleus accumbens
e) Pituitary gland

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2.1) Which of the following divisions of the hypothalamus contains the sexual dimorphic
nucleus involved in the release of gonadotropin releasing hormone (GnRH)?
a) Preoptic area
b) Lateral zone
c) Medial zone
d) Periventricular zone
2.2) Which of the following nuclei is NOT found in the supraoptic (chiasmatic) region of
the medial hypothalamic zone?
a) Supraoptic
b) Preoptic
c) Paraventricular
d) Suprachiasmatic
e) Anterior
2.3) Which of the following divisions of the hypothalamus contains a feeding center,
which responds to changes in blood glucose?
a) Preoptic area
b) Lateral zone
c) Medial zone
d) Peraventricular zone
2.4) Which of the following hypothalamic areas plays a role in male vocalization, male
sexual mounting, and female sexual lordosis behavior?
a) Arcuate nucleus
b) Ventromedial nucleus
c) Dorsomedial hypothalamic nucleus
d) Pituitary gland
e) Posterior nucleus
2.5) Korsakoff syndrome (amnesic-confabulatory syndrome) is a brain disorder of the
medial hypothalamus caused by a lack of thiamine, which is seen in which of the
following groups of patients?
a) Diabetics
b) Epileptics
c) Stroke patients
d) Chronic alcoholics
e) Cocaine users
2.6) Which of the following hypothalamic nuclei is involved in thermoregulation such as
sweating?
a) Medial preoptic nucleus
b) Supraoptic nucleus
c) Paraventricular nucleus
d) Anterior hypothalamic nucleus
e) Suprachiasmatic nucleus
2.7) Which of the following hypothalamic nuclei are involved in release of oxytocin and
vasopressin?
a) Anterior hypothalamic nucleus and medial preoptic nucleus
b) Supraoptic nucleus and paraventricular nucleus
c) Suprachiasmatic nucleus and lateral preoptic nucleus

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d) Dosomedial hypothalamic nucleus and arcuate nucleus

e) Ventromedial nucleus and lateral nucleus
3.1) Which of the following is an exclusively efferent connection of the hypothalamus?
a) Mamillothalamic tract
b) Fornix
c) Stria terminalis
d) Ventral amygdalofugal tract
e) Medial forebrain bundle
3.2) Which of the following is an exclusively afferent connection of the hypothalamus?
a) Retinohypothalamic tract
b) Dorsal longitudinal fasciculus (of Schültz)
c) Medial forebrain bundle
d) Ventral amygdalofugal tract
e) Stria terminalis
4) What is the affect of disrupting hypothalamospinal fibers at the level of C6?
a) Ipsilateral loss of sympathetic flow to the face and body
b) Contralateral loss of sympathetic flow to the face and body
c) Ipsilateral loss of parasympathetic flow to the face and body
d) Contralateral loss of parasympathetic flow to the face and body
5) Which of the following hormones regulated by the hypothalamus causes the anterior
pituitary to inhibit secretion of growth hormone?
a) Corticotropin-releasing hormone
b) Gonadotropin-releasing hormone
c) Growth hormone-releasing hormone
d) Thyrotropin-releasing hormone
e) Somatostatin
6.1) Overproduction of which of the following leads to hyperadrenalism and thus
Cushing disease?
a) Prolactin
b) Thyrotropin
c) Growth hormone
d) Gonadotropin
e) Corticotropin
6.2) Damage to which of the following areas would lead to loss of episodic memory?
a) Anterior hypothalamus
b) Posterior hypothalamus
c) Infundibulum
d) Mamillary bodies
e) Arcuate nucleus
7.1) Which of the following nuclei is involved in the baroreceptor reflex?
a) Arcuate nucleus
b) Ventromedial nucleus
c) Solitary nucleus
d) Posterior nucleus
e) Dorsomedial hypothalamic nucleus
7.2) What part of the hypothalamus is involved in regulating heat dissipation?

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a) Caudal/Posterior
b) Rostral/Anterior
c) Lateral
d) Medial
7.3) The supraoptic and paraventricular nuclei are involved in the water reflex, which can
lead to diabetes insipidus with inappropriate secretion of what hormone?
a) Vasopressin (ADH)
b) Prolactin
c) Leutinizing hormone (LH)
d) Growth hormone
e) FSH & TSH
7.4) Damage to which of the following areas will likely lead to endocrine imbalance?
a) Paraventricular nuclei
b) Supraoptic nuclei
c) Mamillary process
d) Infundibulum
e) Posterior hypothalamus
7.5) A patient presents with anosmia and gonad digenesis (sterility) due to Kallman
syndrome. Cells secreting which of the following did not develop for this patient during
embryonic stages?
a) Corticotropin-releasing hormone
b) Gonadotropin-releasing hormone
c) Growth hormone-releasing hormone
d) Thyrotropin-releasing hormone
e) Leutinizing hormone-releasing hormone
7.6) A lesion to the anterior hypothalamus will most likely lead to what temperature
regulation affect?
a) Hyperthermia
b) Hypothermia
c) Poikilothermia
d) No affect
7.7) A lesion to the posterior hypothalamus will most likely lead to what temperature
regulation affect?
a) Hyperthermia
b) Hypothermia
c) Poikilothermia
d) No affect
7.8) Which of the following areas of the hypothalamus is most involved in appetite?
a) Paraventricular nuclei
b) Ventromedial nuclei
c) Lateral hypothalamic nucleus
d) Dorsomedial hypothalamic nucleus
e) Suprachiasmic nucleus
7.9) Which of the following areas of the hypothalamus is most involved in circadian
rhythms (sleep)?
a) Paraventricular nuclei

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b) Ventromedial nuclei
c) Lateral hypothalamic nucleus
d) Dorsomedial hypothalamic nucleus
e) Suprachiasmic nucleus
7.10) Damage to which of the following hypothalamic areas would most lead to extreme
aggressivity (unprovoked attacks)?
a) Paraventricular nuclei
b) Ventromedial nuclei
c) Lateral hypothalamic nucleus
d) Dorsomedial hypothalamic nucleus
e) Suprachiasmic nucleus

Neuro #10 – Limbic System (Chapter 31)

1.1) Which of the following is a component of the second level (limbic lobe and
subcortical nuclei) of the limbic system?
a) Uncus
b) Cingulate gyrus
c) Amygdaloid complex
d) Subcallosal area
e) Parahippocampal gyrus
1.2) Which of the following is NOT involved in an efferent fiber bundle connection of
the limbic system?
a) Subiculum
b) Hippocampus
c) Amygdala
d) Mamillary body
e) Periaquaductal gray
2.1) The hippocampus is critical in what type of memory?
a) Working memory
b) Declarative memory
c) Procedural memory
2.2) Which of the following is NOT a part of the circuit of Papez?
a) Anterior thalamus
b) Hippocampus
c) Hypothalamus
d) Cingulate cortex
e) Amygdala
2.3) A chronic alcoholic presents with confabulation of events that never occurred,
thiamine deficiency, and ataxia due to cerebellar damage. Which of the following would
best describe this patient?
a) Akinetic mutism
b) Korsakoff syndrome
c) Wernicke-Korsakoff syndrome
d) Klüver-Bucy syndrome
e) Alzheimer disease
f) Anterograde amnesia

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2.4) A patient presents with diminished emotional response, immobility, inability to talk,
and unresponsiveness (akinetic mutism). Which of the following parts of the cingulated
gyrus was affected?
a) One side of the anterior portion
b) Both sides of the anterior portion
c) One side of the posterior portion
d) Both sides of the posterior portion
2.5) A patient presents with suspected memory loss. A clinician tells the patient three
words to remember and begins an examination. Thirty seconds later, the clinician asks
the patient about the words and the patient cannot even recall being asked to remember
any words (anterograde amnesia). Which structure is likely damaged?
a) Hypothalamus
b) Thalamus
c) Hippocampus
d) Amygdala
e) Nucleus accumbens
2.6) A patient presents with intracellular neurofibrillary tangles and extracellular amyloid
deposits in the subiculum and entorhinal cortex. Which of the following is the most
likely?
a) Akinetic mutism
b) Korsakoff syndrome
c) Wernicke-Korsakoff syndrome
d) Klüver-Bucy syndrome
e) Alzheimer disease
f) Anterograde amnesia
3.1) The amygdala is located directly anterior (rostral) to which of the following?
a) Hypothalamus
b) Thalamus
c) Hippocampus
d) Olfactory bulb
e) Prefrontal cortex
3.2) Which of the following areas are involved in combining uncontrolled olfactory input,
such as pheromones or certain scents, with memories when a person suddenly is able to
bring back “forgotten” memories when they smell certain scents?
a) Thalamus and hypothalamus
b) Hippocampus and amygdala
c) Nucleus accumbens and septal nuclei
d) Prefrontal cortex and olfactory bulb
e) Broca area and Wernicke area
3.3) Which of the following symptoms is NOT associated with an amygdala lesion
causing Klüver-Bucy syndrome?
a) Hyperorality
b) Hypermetamorphosis
c) Hyperphagia
d) Hypersexuality
e) Hypervigilance

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3.4) Which of the following would give you an impending sense of danger if you saw a
big person wearing a ski mask and holding a knife in a dark alley?
a) Hypothalamus
b) Thalamus
c) Hippocampus
d) Amygdala
e) Olfactory bulb
4) Which of the following are proposed roles of the nucleus accumbens?
a) Laughter, pleasure, fear, addiction
b) Hunger, satiety, thirst, hunting behaviors
c) Feelings of warmth, cold, shivering
d) Circadian rhythms, sleep, crying
e) Anger, rage, vocalization, sorrow
5) Which of the following is NOT considered a role of the limbic system?
a) Memory
b) Pleasure
c) Fear
d) Sorrow
e) Appetite

Neuro #11 – Cerebral Cortex (Chapter 32)

1.1) What cerebral cortex layer is thicker in motor areas?
a) II
b) III
c) IV
d) V
e) VI
1.2) Which of the following consists mainly of output layers or the cerebral cortex
(pyramidal neurons)?
a) Allocortex
b) Mesocortex
c) Corticoid region
d) Granular cortex
e) Agranular cortex
1.3) Which of the following cerebral cortex layers is NOT matched correctly?
a) II is input
b) III is output
c) IV is input
d) V is output
e) VI is output
2.1) Which of the following thalamic nuclei is inhibitory and thus is different from the
rest of the thalamus in its connections?
a) Anterior nuclei
b) Medial nuclei
c) Intralaminar nuclei
d) Reticular nuclei

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e) Lateral nuclei
2.2) Which of the following thalamic nuclei functions with the limbic system in emotion
and memory?
a) Anterior nuclei
b) Medial nuclei
c) Intralaminar nuclei
d) Reticular nuclei
e) Lateral nuclei
2.3) Which of the following thalamic nuclei connects with the frontal lobe and
hypothalamus to integrate sensory information?
a) Anterior nuclei
b) Medial nuclei
c) Intralaminar nuclei
d) Reticular nuclei
e) Lateral nuclei
2.4) The thalamus acts as a state-dependent gate in that it is a ____ fidelity delay when
someone is in the ____ state.
a) Low; Awake
b) High; Awake
c) Low; Sleep
d) High; Sleep
3.1) A patient presents with lack of concentration, apathy, lack of insight, lack of
cleanliness, loss of social graces, and disinhibition (inappropriate behaviors). Which of
the following is most likely?
a) Wernicke aphasia
b) Broca aphasia
c) Contralateral neglect
d) Damage to prefrontal cortex
e) Damage to corpus callosum
3.2) A lesion to what Brodmann area would result in ageusia (loss of taste sensation)?
a) BA 1, 2, 3
b) BA 6, 8, 9
c) BA 5
d) BA 41, 42
e) BA 43
3.3) Alexia without agraphia, seen in damage to the corpus callosum splenium or even
the occipital lobe (visual agnosia), nearly always involves what artery?
a) Left middle cerebral artery
b) Right middle cerebral artery
c) Left posterior cerebral artery
d) Right posterior cerebral artery
3.4) A patient is asked to raise her right arm and she does so correctly. The patient is able
to speak fluently on her own, but when asked their name the patient responds with, “the
kangaroo ate my toothbrush.” Which of the following is the most likely problem?
a) Wernicke aphasia
b) Broca aphasia

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c) Conduction aphasia
d) Damage to prefrontal cortex
e) Damage to corpus callosum
f) Global aphasia
3.5) A patient presents with damage to the middle cerebral artery. They have great
difficulty recognizing any form of language, including environmental sounds. They make
several attempts at speaking, but the words come out in a random, contextually
inappropriate mix. Which of the following is the most likely problem?
a) Wernicke aphasia
b) Broca aphasia
c) Conduction aphasia
d) Global aphasia
e) Damage to splenium of the corpus callosum
3.6) A patient presents with occlusion to the frontal M4 branches of the middle cerebral
artery. The patient is asked to describe how they came to the hospital for cardiovascular
surgery and responds slowly with, “Yea… uh… Monday… er… Dad… Wednesday…
hospital… ah… nine o’clock… blood… doctors… heart.” Which of the following is the
most likely problem?
a) Wernicke aphasia
b) Broca aphasia
c) Conduction aphasia
d) Global aphasia
e) Damage to splenium of the corpus callosum
3.7) A patient presents with asomatognosia, left-sided astereognosia, alexia, and
agraphia. To test for neglect syndrome, the clinician closes the patient’s right eye and
holds a finger up. The clinician asks if the patient sees the finger and the patient cannot.
The clinician then wiggles the finger and the patient can now see it. Which of the
following areas is most likely damaged?
a) Left temporal lobe
b) Right temporal lobe
c) Left parietal lobe
d) Right parietal lobe
3.8) Damage to which of the following areas would lead to transcortical (ideokinetic)
apraxia, where a patient would be able to move their right arm, when asked to move their
left arm they cannot physically make it happen, but can recognize objects placed in their
left hand (no astereognosia)?
a) Hippocampus
b) Amygdala
c) Pituitary gland
d) Corpus callosum
3.9) Which of the following would NOT be likely seen with damage to the parietal lobe?
a) Receptive aphasia
b) Alexia with agraphia
c) Conduction aphasia
d) Transcortical apraxia
e) Visual aphasia

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3.10) Global aphasia usually involves a “left side blowout” injury affecting which of the
following?
a) Broca area
b) Wernicke area
c) Arcuate fasciculus
d) All of the above
3.11) Conduction aphasia usually involves an injury affecting which of the following?
a) Broca area
b) Wernicke area
c) Arcuate fasciculus
d) All of the above

Neuro #12 – A Survey Of The Cerebrovascular System (Chapter 8)

1) Which of the following common causes of vascular compromise frequently occurs at
carotid artery branch points?
a) Meningeal hemorrhage
b) Intraventricular hemorrhage
c) Parenchymatous hemorrhage
d) Aneurysm
e) Cerebral embolism
f) Thrombus
g) Transient ischemic attack (TIA)
h) Arteriovenous malformation (AVM)
2.1) Which of the following is the largest branch of the internal carotid artery?
a) Opthalmic artery
b) Posterior communicating artery
c) Middle cerebral artery
d) Anterior communicating artery
e) Anterior cerebral artery
2.2) Which of the following structures is NOT supplied by the anterior choroidal artery?
a) Optic chiasm and tract
b) Internal capsule
c) Globus pallidus
d) Hippocampus
e) Hypothalamus
f) Amygdala
g) Substantia nigra and red nucleus
3) Which of the following is NOT a branch of the basilar artery?
a) Superior cerebellar artery
b) Posterior inferior cerebellar artery (PICA)
c) Anterior inferior cerebellar artery (AICA)
d) Labyrinthine artery
e) Circumferential pontine artery
4) Watershed infarcts are commonly caused by ____, which affect the ____ zones of the
involved artery or arteries.
a) Hypotension; Border

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b) Hypotension; Central
c) Hypertension; Border
d) Hypertension; Central
5.1) What cranial nerve arises between the posterior cerebral artery and the
quadrigeminal artery?
a) CN II
b) CN III
c) CN IV
d) CN V
e) CN VI
5.2) What cranial nerve arises at the branch point of the pontine and vertebral artery from
the basilar artery?
a) CN II
b) CN III
c) CN IV
d) CN V
e) CN VI
5.3) Which of the following cranial nerves is NOT directly adjacent to the posterior
inferior cerebellar artery (PICA)?
a) CN V
b) CN VII
c) CN VIII
d) CN IX
e) CN X
f) CN XI
6.1) Which of the following arteries does NOT supply the medulla?
a) Anterior spinal artery (ASA)
b) Posterior spinal artery (PSA)
c) Anterior inferior cerebellar artery (AICA)
d) Posterior inferior cerebellar artery (PICA)
e) Quadrigeminal artery (QA)
6.2)Which of the following arteries supplying the pons is the most lateral?
a) Paramedian artery
b) Short circumferential artery
c) Long circumferential artery
d) Basilar artery
6.3) Most of the direct branches supplying the midbrain arise from what artery?
a) Superior cerebellar artery (SCA)
b) Posterior cerebral artery P1
c) Posterior cerebral artery P2
d) Posterior communicating artery
e) Basilar artery
6.4) Which of the following arteries of the deep forebrain (diencephalon) feeds the
putamen, globus pallidus, internal capsule, and basal ganglia?
a) Medial striate artery
b) Lenticulostriate artery

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c) Thalamoperforating artery
d) Medial posterior choroidal artery
e) Thalamogeniculate artery
6.5) Which of the following areas is NOT supplied by the middle cerebral artery?
a) Motor and premotor cortex
b) Somatosensory cortex
c) Auditory cortex
d) Broca and Wernicke areas
e) Association areas
f) Visual cortex
7) Which of the following would NOT be drained by the deep cerebral veins (internal
cerebral vein, basal vein, great cerebral vein)?
a) Basal ganglia
b) Internal capsule
c) Diencephalon
d) Pons
8) Which spinal cord artery feeds most of the grey matter?
a) Anterior spinal artery
b) Posterior spinal artery
c) Supplemental artery
d) Radicular artery
e) Artery of Adamkiewicz
9) A patient is given morphine in an ambulance and nearly immediately vomits on the
paramedic. Which of the following circumventricular organs, which have incomplete
blood-brain barriers, is associated with this reflex?
a) Pineal gland
b) Choroid plexus
c) Median eminence
d) Area postrema
e) Posterior pituitary
f) Subcommisural organ
g) Subfornical organ
10.1) What is the most likely neurological defect seen in thrombosis of the anterior spinal
artery (Beck syndrome) in the cervical level?
a) Loss of pain and temperature sensation below the lesion with flaccid paralysis
of the arms
b) Loss of pain and temperature sensation below the lesion with flaccid paralysis
of the arms, trunk, and legs
c) Loss of pain and temperature sensation above the lesion with spastic paralysis
of the arms
d) Loss of pain and temperature sensation above the lesion with spastic paralysis
of the arms, trunk, and legs
10.2) A patient presents with a clot in the anterior spinal artery, leading to medial
medullary syndrome (Dejerine syndrome). Which of the following clinical symptoms
will be ipsilateral?
a) Babinski sign

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b) Loss of discriminative touch

c) Weakness of the legs
d) Weakness of the arms
e) Deviation of the tongue
10.3) What artery is most commonly involved in lateral medullary syndrome (Wallenberg
syndrome)?
a) Anterior cerebral artery (ACA)
b) Middle cerebral artery (MCA)
c) Posterior cerebral artery (PCA)
d) Anterior inferior cerebellar artery (AICA)
e) Posterior inferior cerebellar artery (PICA)
10.4) Which of the following effects is NOT correct or NOT present in a patient with
lateral medullary syndrome?
a) Contralateral loss of pain and temperature sensation from the body
b) Ipsilateral loss of pain and temperature sensation from the face
c) Contralateral Horner syndrome
d) Vertigo, diplopia, nystagmus, vomiting
e) Dysphagia, hoarseness, diminished gag reflex, hiccups
f) Ipsilateral ataxia
10.5) A 48-year-old man suffered a sudden weakness of his left arm and leg which
caused him to fall while shaving. He was helped to his feet but his left arm and leg felt
stiff. In addition, he complained of seeing "double.” A neurologist found that the patient
was alert with normal mental status. There was no evidence of increased intracranial
pressure though his blood pressure was 200/95. There was a spastic paresis with a
positive Babinski sign in the left extremities and loss of vibratory and positional sense on
the left. The patient walked with an ataxic gait. Pain and temperature sensations were
normal. There was diplopia when the patient looked toward the right side. At rest the
right eye deviated toward the nose (internal strabismus or squint) while the left eye
looked straight ahead. There was a paralysis of conjugate gaze toward the right. Ocular
convergence was normal. Which of the following is the most likely?
a) Medial medullary syndrome
b) Lateral medullary syndrome
c) Medial pontine syndrome
d) Lateral pontine syndrome
e) Medial midbrain syndrome
10.6) Which of the following would be seen only in lateral pontine syndrome and NOT in
lateral medullary syndrome?
a) Contralateral loss of pain and temperature sensation from the body
b) Ipsilateral loss of pain and temperature sensation from the face
c) Ipsilateral Horner syndrome
d) Vestibulocochlear defects
e) Ipsilateral bite weakness
10.7) Which of the following would present with ophthalmoplegia and contralateral
hemiplegia of the body?
a) Medial midbrain syndrome
b) Medial medullary syndrome

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c) Medial pontine syndrome

d) Lateral medullary syndrome
e) Lateral pontine syndrome
10.8) Which of the following is NOT an effect of occluding the lentriculostriate artery,
which is so commonly ruptured it has been termed by Charcot the “artery of cerebral
hemorrhage”?
a) Inability to wink contralaterally
b) Inability to smile contralaterally
c) Contralateral body motor deficits
d) Contralateral body sensation deficits
11.1) A man presents with the inability to turn his right eye down and out, upper motor
neuron lesion on the left side and loss of discriminative touch on the left side. Where is
the lesion?
a) Medulla
b) Basilar pons
c) Caudal midbrain
d) Rostral midbrain
e) Telencephalon
11.2) Which of the following would NOT be seen in a middle cerebral artery stroke, the
most commonly affected artery by cerebrovascular accidents (CVAs)?
a) Ipsilateral inferior quadrantanopia
b) Eye deviated toward the side of the infarct
c) Contralateral hemiplegia
d) Contralateral hemianesthesia
e) Wernicke aphasia
11.3) Which of the following nerves is the least likely to be compressed by an aneurysm
at the branch point of the internal carotid artery from the circle of Willis?
a) CN III
b) CN IV
c) CN V1
d) CN V2
e) CN V3
f) CN VI
11.4) A patient presents with a stroke involving the posterior cerebral artery. Although
their visual field is severely affected, they have macular sparing due to macular profusion
from what artery?
a) Anterior cerebral artery
b) Middle cerebral artery
c) Anterior inferior cerebellar artery
d) Posterior inferior cerebellar artery
e) Lenticulostriate artery

James Lamberg

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Neuroscience – Part 2 14Mar2009

AnswerKey Neuro #4 2.2) B Neuro #9 2.1) D

Neuro #1 1) B 2.3) A 1) E 2.2) A
1) C 2) E 2.4) C 2.1) A 2.3) B
2.1) A 3) D 3) D 2.2) B 2.4) B
2.2) E 4.1) E 4.1) A 2.3) B 3.1) D
3) B 4.2) D 4.2) D 2.4) B 3.2) E
4) B 4.3) E 4.3) E 2.5) D 3.3) C
5) E 4.4) A 4.4) C 2.6) D 3.4) C
6) B 5) A 2.7) B 3.5) A
7) D 6.1) B Neuro #7 3.1) A 3.6) B
8.1) A 6.2) C 1.1) C 3.2) A 3.7) D
8.2) B 6.3) E 1.2) B 4) A 3.8) D
9) B 7) D 1.3) E 5) E 3.9) E
10) C 8) D 1.4) C 6.1) E 3.10) D
11) B 1.5) A 6.2) D 3.11) B
12) C Neuro #5 2.1) D 7.1) C
13) C 1.1) D 2.2) B 7.2) B Neuro #12
14.1) B 1.2) E 2.3) C 7.3) A 1) D
14.2) C 1.3) B 2.4) C 7.4) D 2.1) C
14.3) A 2.1) A 2.5) C 7.5) E 2.2) E
15) E 2.2) C 3) B 7.6) A 3) B
16) C 2.3) E 4.1) D 7.7) C 4) A
17) E 2.4) A 4.2) A 7.8) C 5.1) B
18) C 2.5) B 4.3) E 7.9) E 5.2) E
2.6) D 4.4) B 7.10) B 5.3) A
Neuro #2 2.7) A 4.5) C 6.1) E
1.1) B 3.1) E 4.6) A Neuro #10 6.2) C
1.2) C 3.2) C 5.1) F 1.1) C 6.3) B
2.1) D 4.1) C 5.2) D 1.2) E 6.4) B
2.2) B 4.2) D 5.3) A 2.1) B 6.5) F
3) C 4.3) B 5.4) C 2.2) E 7) D
4) E 4.4) C 2.3) C 8) A
5) C 4.5) D Neuro #8 2.4) B 9) D
6.1) D 4.6) E 1.1) B 2.5) C 10.1) A
6.2) E 4.7) C 1.2) A 2.6) E 10.2) E
1.3) A 3.1) C 10.3) E
Neuro #3 Neuro #6 1.4) E 3.2) B 10.4) C
1.1) C 1.1) C 1.5) D 3.3) E 10.5) C
1.2) D 1.2) E 1.6) E 3.4) D 10.6) E
1.3) D 1.3) D 1.7) C 4) A 10.7) A
1.4) E 1.4) A 2.1) B 5) E 10.8) A
1.5) B 1.5) D 2.2) B 11.1) C
2.1) E 1.6) B 2.3) C Neuro #11 11.2) A
2.2) E 1.7) A 1.1) D 11.3) E
1.8) C 1.2) E 11.4) B
2.1) A 1.3) B

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