Week 3 NSF

Which ganglion is associated with fibers innervating the parotid gland?

Which of the following brainstem nuclei play an important role in the gag reflex?

Which symptom would be most likely associated with a peripheral facial palsy (Bell's palsy)?

Which trigeminal nucleus facilitates our awareness of our mouth hanging open?

You are practicing your cranial nerve exam during your neurosurgery preceptorship. You report to your preceptor that you believe the patient has a left hemifacial sensory loss to light touch and cold temperature, an asymmetric smile (higher on the right), horizontal diplopia, and new-onset vertigo. Where does this patient most likely have a problem?

A 33 year old woman has subacute onset of weakness. A week ago, she felt tired, but starting 3 days ago, she had difficulty
climbing stairs, and today she can't walk around her apartment. Her motor examination is notable for 2/5 strength in proximal legs
and 0/5 strength in distal legs, with absent reflexes at the patella and Achilles. Which test would help you confirm your clinical suspicion of the diagnosis?

What class of drug is a possible treatment for a woman with intermittent ptosis and dysphagia that seems to get worse the more she uses those muscles?

Amyotrophic lateral sclerosis is unique because it may clinically present with both upper motor neuron and lower motor neuron findings. Which pairing of structures are pathologically affected to account for this?

A 3 year old boy is playing on the floor of the exam room. His mother brought him in for a well-child check-up. When he stands up,
he walks his hands along the floor until they are closer to his feet and then he walks his hands up his legs until he reaches a
standing position. His mother thinks he had slower gross motor milestones than his sister, but doesn't recall specifics. You sent off a creatine kinase level, which comes back at 11,000 (normal 26-192). Where in the motor system does this child have a problem?

An eight year old boy is slowly developing new lower extremity spasticity and both urinary and fecal incontinence. Which of the following radiographic features would be consistent with these clinical findings?

A 22 year-old cyclist is involved in a collision with an oncoming automobile and is transported to a nearby hospital. During her
initial assessment, she is noted to be awake, talking appropriately, and moving her arms purposefully. She is unable to move her
legs at all and does not flinch or respond to painful stimulation of either lower extremity. While further tests are being arranged, her
blood pressure and heart rate begin to decrease. On further exam, she is noted to be less responsive with flushed skin. Which of
the following is most likely to explain the underlying cause of her symptoms?

In which distribution would a person have facial weakness if there is a supranuclear lesion (upper motor neuron, e.g. primary motor cortex)?

A 75-year-old woman is brought to the clinic with report of a bilateral ³pins and needles´sensation in her lower extremities. Her
exam reveals bilateral weakness of the proximal and distal muscles of the lower extremities, impaired proprioception and vibration, extensor plantor reflex, and symmetric increased patellar reflexes. Her gait is ataxic. She is diagnosed with subacute combined
degeneration of the spinal cord. This is a result of:

A 23 year-old mother is with her 1 day old term son in the Neonatal Intensive Care Unit. The child has a central cleft lip and palate
and narrow-set eyes (hypotelorism). When you introduce yourself to the mother, you notice that she has a single central incisor. Which of the following structures in the infant is most likely to have an abnormality?

A 19 weeks gestational age fetus is diagnosed with spina bifida cystica on a routine prenatal ultrasound. Counseling about the
prognosis and possible treatment plans depends in part on whether this spina bifida is a meningocele or myelomeningocele. Which tissue component will be involved in myelomeningocele, but not meningocele?

A 56-year old woman with rheumatoid arthritis is on multiple immunosuppressive drugs. She develops multifocal lesions in her brain that on biopsy are diagnosed as demyelinating lesions characteristic of a viral disease called progressive multifocal leukoencephalopathy. Which cell type in the brain is most likely to be infected in this disease?

A 56-year old man with a history of coronary artery disease suddenly collapses at home. When the paramedics arrive, he is found to be pulseless and has been down for about 12 minutes. Which cell population in the brain is particularly vulnerable to global ischemic brain injury?

A 70-year-old woman experienced a first time seizure. She reports having increasing headaches over the last 5 weeks. Based on the time course of her illness, what is her most likely diagnosis?

A 49-year-old man with a long history of Hepatitis C and cirrhosis is now encephalopathic. Which reaction pattern is likely to be present in his astrocytes?

Testing for the patellar tendon reflex is standard component of a neurological exam. The neural circuit underlying the
monosynaptic reflex includes which of the following?

The right lateral corticospinal tract in the spinal cord contains axons that can ALSO be found in which other part of the neuroaxis?

There is somatic organization of fibers in the corticospinal tract. A lesion in the genu of the internal capsule would most likely result in a deficit in which part of the body?

Descending motor pathways are divided into anterior and lateral systems. Which motor neurons are innervated by the anterior motor system?

A patient was found to have a hyper-reflexive response to the patellar tendon reflex. Where is the most logical site of the lesion?

Which of the following motor tracts project over the entire length of the spinal cord?

A 14-year-old girl presents with an acute CNS demyelinating process after a viral illness. Which of the following physiological processes is likely occurring at the sites of demyelination?

You train your dog to roll over in response to a hand signal. As the result of learning this new behavior, which neuronal component
has likely changed?

A 25-year-old college student presented with progressive distal muscle weakness and sensory loss. His family history revealed
others with similar symptoms and he was found to have duplication of the PMP22 gene. Why does his disease only affect peripheral nerves (PNS) and not the central nervous system (CNS)?

Use the image attached to answer the following question. This electron micrograph is a cross section through a node of Ranvier. The processes surrounding the axon (2 are indicated by red arrows) belong to which cell type?