Lundy-Ekman: Neuroscience: Fundamentals for Rehabilitation, 4th Edition

Chapter 1: ntroduction to Neuroscience !est "ank 1. Which one of the following studies is an example of systems level neuroscience? A. A study investigating the action of the neurotransmitter dopamine in the temporal lobes of rodents B. A study investigating the effect of impaired memory on walking performance C. A study investigating how autonomic nerves influences baroreceptors in the vasculature . A study investigating the differential effects of vestibular and proprioceptive impairments on balance in those who have had a stroke A!"# C $ationale# "ystems level neuroscience is concerned with groups of cells in the nervous system that perform a common function and how these cells interact with other body systems. %ther levels of neuroscience include the molecular level& which investigates the chemistry and physics involved in neural function' the cellular level& which examines the distinctions among different types of cells in the nervous system and how they function and communicate among themselves and among non(neural cells' the behavioral level& which examines the interactions among systems that influence behavior' and the cognitive level& which explores complex neurologic functions such as thinking& language& and memory. ). Which of the following three systems extend into all regions of the nervous system? A. "omatic motor& autonomic& and basal ganglia B. Autonomic& somatosensory& and cognitive C. *imbic& autonomic& and somatosensory . "omatic& somatosensory& and autonomic A!"# $ationale# +he three systems extend throughout the entire nervous system. are the somatosensory system& conveying information from the skin and musculoskeletal system to the brain' the autonomic system& providing communication between the brain and smooth muscles& cardiac muscle& and glands' and the somatic motor system& transmitting information from the brain to the skeletal muscles. +he basal ganglia& cognitive& and limbic systems are located entirely within the brain& and thus do not extend into the spinal and peripheral regions. ,. +he peripheral nervous system includes which of the following? A. Brainstem and spinal nerves B. !erves& sensory receptors& and autonomic ganglia C. -roups of myelinated axons called capsules or tracts . %nly afferent neurons that convey information to the central nervous system A!"# B $ationale# +he peripheral nervous system consists of all nervous system structures outside of the skull and spinal column. .yelinated axons& the white matter of the peripheral nervous
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system& are grouped together in nerves. 3eripheral nerves convey both afferent and efferent information to and from the central nervous system. Collections of autonomic cell bodies& or gray matter& located in the periphery are termed ganglia. 4. +he brainstem and cerebellum receive most of their blood supply from which of the following arterial branches? A. 2nternal carotid and posterior cerebral B. 5ertebral and middle cerebral C. 5ertebral and basilar . 2nternal carotid and basilar A!"# C $ationale# Branches of the vertebral and basilar arteries provide blood supply to the brainstem and cerebellum. +hese branches include the anterior and posterior spinal arteries 6medulla7& posterior cerebral arteries 6midbrain7& posterior inferior cerebellar arteries 6medulla and cerebellum7& and anterior inferior and superior cerebellar arteries 6pons and cerebellum7. 8. +he purpose of a neurologic evaluation is to# A. 1stablish a definitive diagnosis. B. etermine an appropriate plan of care. C. etermine the probable cause of the problem. . etermine the probable cause of the problem and the appropriate plan of care. A!"# $ationale# +he purpose of a neurologic evaluation is to determine the likely cause of the problem and the appropriate course of action so that treatment can be provided. 2n many instances the evaluation will reveal a definitive diagnosis' however& this is not always the case. 9. A patient reports that she has recently had pain and a loss of coordination in her left leg. +hese symptoms initially began 8 days earlier& gradually worsened for , days& but then did not worsen or improve since that time. +he speed of onset and nature of these complaints is most likely which one of the following? A. Acute vascular problem B. "ubacute degenerative disorder C. Chronic inflammatory process . "ubacute inflammatory process A!"# $ationale# +he speed of onset of a neurologic complaint can be classified as acute& subacute& or chronic. Acute problems achieve maximal signs and symptoms in minutes to hours and often indicate a vascular problem& whereas subacute problems arise over several days and may indicate an inflammatory process. Chronic problems gradually worsen over a period weeks& months& or years and may suggest either a tumor or degenerative disorder.

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:. An individual is admitted to the hospital to investigate a recently discovered abdominal mass. +o determine the metabolic rate of the mass& an imaging study is ordered& during which a radioisotope is in;ected into the patient<s bloodstream. +his study is an example of which one of the following? A. Computed tomographic 6C+7 scan B. =unctional magnetic resonance image 6f.$27 C. iffusion tensor image 6 +27 . 31+ scan A!"# $ationale# A 31+ scan is a nuclear imaging study in which emissions from a radioactive compound are examined to assess blood flow& oxygenation& glucose metabolism& and>or receptor location. +echni?ues such as C+& +2& and f.$2 rely on the use of x(ray images& radio waves& or magnetic fields. @. An individual suffers a cerebrovascular accident 6C5A7 or stroke& which disrupts the blood supply to the medial area of the frontal lobe. +his disruption is most likely due to blockage of which one of the following? A. Anterior communicating artery B. Anterior cerebral artery C. .iddle cerebral artery . 3osterior cerebral artery A!"# B $ationale# +he anterior cerebral arteries provide blood flow to the medial aspects of the frontal and parietal lobes. +he anterior communicating artery ;oins these arteries. 2n addition& the middle cerebral artery supplies much of the lateral hemispheres& and the posterior cerebral artery supplies the occipital lobe and medial and inferior temporal lobe. A. A patient visits the emergency department after a motor vehicle accident. Be has suffered multiple blunt force head traumas. +his patient<s in;ury would be described as# A. =ocal. B. .ultifocal. C. iffuse. . Both B and C A!"# B $ationale# amage or in;uries to the central nervous system are categoriCed as being focal& multifocal& or diffuse lesions. =ocal lesions are limited to a single location& multifocal lesions are limited to several nonsymmetric locations& and diffuse lesions affect bilateral structures symmetrically but do not cross the midline as a single lesion. 10. +he incidence of a disease is# A. +he proportion of the population that develops a new case of the disorder in a defined period. B. +he current proportion of the population with the condition.

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+est bank C. +he cumulative sum of past years< prevalence rates. . +ypically reported as being per 1000 people.

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A!"# A $ationale# +he incidence of a disease refers to the proportion of the population that develops a new case of the disorder in a defined period. +he prevalence of a disease is the current proportion of the population with the condition& including both old and new cases. +hus the prevalence of a disease is the cumulative sum of past years< incidence rates. isease incidence is typically reported as per 100&000 people& whereas prevalence is typically reported per 1000 people. 11. Blood supply to the deep structures of the brain is provided by which of the following? A. eep branches of the posterior cerebral arteries B. Anterior choroidal arteries C. 3osterior choroidal arteries . Both B and C 1. A& B& and C A!"# 1 $ationale# +he deep branches of each of the ma;or cerebral arteries 6e.g.& anterior& middle& posterior7 provide the blood supply to the deep structures of the brain. +he anterior and posterior choroidal arteries provide additional blood flow to the deep structures of the brain. 1). +he middle cerebral arteries arise from the DDDDDDDD and supply the DDDDDDDDD. A. Basilar artery' medial surfaces of the frontal and parietal lobes B. 2nternal carotid arteries' lateral cerebral hemispheres C. Anterior communicating artery' lateral cerebral hemispheres . 2nternal carotid arteries' internal capsule& putamen& and caudate nucleus 1. 2nternal carotid arteries' lateral cerebral hemispheres and internal capsule& putamen& and caudate nucleus A!"# 1 $ationale# +he middle cerebral arteries arise as branches from the internal carotid arteries and provide blood supply to a ma;ority of the lateral cerebral hemispheres& as well as to the internal capsule& globus pallidus& putamen& and caudate nucleus. 1,. Which of the following arteries are part of the circle of Willis? A. 2nternal carotid and vertebral arteries B. Anterior and lateral cerebral arteries C. Anterior and posterior cerebral arteries . .edial and lateral communicating arteries A!"# C $ationale# +he circle of Willis is a ring of nine anastomotic arteries# the left and right anterior cerebral arteries& the left and right internal carotid arteries& the left and right posterior cerebral arteries& posterior communicating arteries 6left and right7& and the anterior communicating

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artery. +he basilar artery and middle cerebral arteries are sometimes also included in the circle. 14. +he function of the meninges includes which one of the following? A. $egulation of extracellular fluid content B. 3rotection of the brain and spinal cord C. Circulation of cerebrospinal fluid . All of the above A!"# $ationale# +he cerebrospinal fluid system consists of both the cerebrospinal fluid and the meninges. +he meninges contain spaces called dural sinuses& which contribute to the return of blood and cerebrospinal fluid to the venous blood system. +he meninges also provide buoyancy and protection to the brain and spinal cord& as well as regulate extracellular fluid content. 18. Cerebrospinal fluid is secreted by the DDDDDDD and reabsorbed into the DDDDDDDD. A. Choroid plexus' lymphatic system B. *ymphatic system' choroid plexus C. 5enous system' lymphatic system . Choroid plexus' venous system A!"# $ationale# Cerebrospinal fluid& a modified plasma filtrate& is secreted by the choroid plexus in the ventricles of the central nervous system and is reabsorbed into the venous blood system. 19. Which of the following correctly pairs a cerebral structure with its function? A. Corpus striatum' memory formation B. 2nternal capsule' cortical and subcortical communication C. Amygdala' somatosensory integration and processing . 1pithalamus' regulation of metabolic rate A!"# B $ationale# Composed of the caudate nucleus and putamen& the corpus striatum is an important structure in the basal ganglia circuit& which is critical to the control of movement. +he internal capsule consists of pro;ections between the cerebral cortex and subcortical structures& thus facilitating communication between these areas. +he amygdale& a component of the limbic system& plays an important role in emotion and some aspects of memory formation. +he epithalamus consists primarily of the pineal gland and influences secretion of the endocrine glands. 1:. +he cerebral hemispheres are# A. ivided by the central sulcus. B. "ubdivided into four lobes per hemisphere. C. Composed primarily of gray matter& with an outer layer of white matter. . Connected by the corpus callosum and anterior commissure.

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A!"# $ationale# +he longitudinal fissure divides the two cerebral hemispheres& and each hemisphere can be subdivided into a total of six lobes# frontal& parietal& temporal& occipital& limbic& and insular. +he surface of the cerebrum is composed of gray matter& with underlying white matter deep to this. +he corpus callosum connects the ma;ority of the left and right cerebral hemispheres& with the anterior commissure connecting the left and right temporal cortices. 1@. 1ach cranial nerve# A. 1merges from the spinal cord. B. 2s numbered according to its place of attachment. C. 2nnervates the head& neck& and face. . Carries motor and sensory information. A!"# B $ationale# +he cranial nerves are a series of 1) nerve pairs that emerge from the surface of the brain and are numbered according to their sites of attachment to the brain& from anterior to posterior. Cranial nerves 2& 22& and 5222 carry only sensory information& whereas nerves 222& 25& 52& E& and E22 carry primarily motor information. +he remaining cranial nerves 65& 522& 2E& and E27 are mixed& carrying both motor and sensory signals. Although most cranial nerves innervate structures of the head& neck& and face& the vagus nerve 6E7 also innervates abdominal and thoracic structures. 1A. Which one of the following functions is regulated by the structures of the diencephalon? A. 3rocessing of emotion and memory information B. 2ntegration of information for e?uilibrium C. Coordination of movement . %rientation to visual and auditory stimuli A!"# A $ationale# +he diencephalon consists of the thalamus& hypothalamus& epithalamus& and subthalamus. +hese structures process emotion and some forms of memory. +hey also regulate consciousness and attention' maintain body temperature& metabolic rate& and chemical composition of the tissues' regulate eating& defensive& and reproductive behavior' and influence the secretion of endocrine glands. )0. Which one of the following statements about the nervous system is incorrect? A. Areas of white matter of the spinal cord are divided into anterior& lateral& and dorsal areas and are called columns. B. +he two primary functions of the spinal cord are to process information and to mediate reflex pathways. C. +he pyramidal decussation is a prominent feature on the anterior surface of the pons. . Both A and B 1. All of the above A!"# C

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$ationale# A cross(section of the spinal cord reveals a centrally located area of gray matter shaped similar to the letter H. "urrounding this area of gray matter are areas of white matter& which can be divided into the anterior& lateral& and dorsal columns& or funiculi. +he two primary functions of the spinal cord are to convey information between the periphery and the brain and to process information. +he medulla is continuous with the spinal cord as it enters the skull. +his area of the brain contains the pyramidal decussation& a prominent feature on the anterior medulla& composed of crossing axons traveling from the cerebral cortex into the spinal cord.

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