Neuroanatomy Test II Quiz I Motor Tracts

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Quiz on Neuroanatomy Test II Quiz I Motor Tracts, created by espiri4604 on 09/04/2015.
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Quiz by espiri4604, updated more than 1 year ago
espiri4604
Created by espiri4604 about 9 years ago
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Question 1

Question
A 47-year-old welder presents at the Emergency Department with sudden onset of difficulty speaking. The examination reveals slurred speech, deviation of the tongue to the right on attempted protrusion, and weakness of the lower facial muscles also on the right. CT shows a well-localized hemorrhagic lesion that is most likely located in which of the following?
Answer
  • (A) Anterior limb of the internal capsule on the left
  • (D) Posterior limb of the internal capsule on the left
  • (E) Posterior limb of the internal capsule on the right

Question 2

Question
Which of the following is the receptor for the afferent limb of the patellar tendon reflex or the jaw jerk reflex?
Answer
  • (A) Golgi tendon organ
  • (B) Merkel cell ending
  • (C) Muscle spindle
  • (D) Pacinian corpuscle
  • (E) Ruffini ending

Question 3

Question
Which of the following is a sign that would most likely be seen in a patient with a lower motor neuron lesion?
Answer
  • (A) Hyperreflexia
  • (B) Hypertonia
  • (C) Muscle fasciculations
  • (D) Muscle groups affected
  • (E) Muscle spasticity

Question 4

Question
The MRI of a 71-year-old man suggests a small vascular lesion affecting the structure indicated by the arrow in the image below. Which of the following would you most likely expect to see in this patient?
Answer
  • (A) Left internuclear ophthalmoplegia
  • (B) Paralysis of lateral rectus on gaze to the left
  • (C) Paralysis of lateral rectus on gaze to the right
  • (D) Tongue deviates to the left on protrusion
  • (E) Tongue deviates to the right on protrusion

Question 5

Question
The MRI of a 56-year-old man presents with a sudden loss of motor function of his right hand. The MRI reveals a circumscribed cortical lesion, most likely hemorrhagic in origin. Which of the following represents the most likely location of this lesion?
Answer
  • (A) Anterior paracentral gyrus
  • (B) Lateral third of the precentral gyrus
  • (C) Medial third of the precentral gyrus
  • (D) Middle third of the precentral gyrus
  • (E) Middle third of the postcentral gyrus

Question 6

Question
A Neurologist sees three patients in her clinic. These are a 23-year-old man with a Brown- Séquard syndrome resulting from trauma at C3-5, a 69-year-old woman with a Wallenberg syndrome, and a 79-year-old man with a hemorrhagic stroke in the lateral portions of the pontine tegmentum. In addition to the expected deficits, a careful examination would also reveal which of the following in all three patients?
Answer
  • (A) A loss of discriminative touch on the forehead
  • (B) A loss of pain and thermal sensation on one side of the face
  • (C) Constriction of the pupil (miosis) on the side of the lesion
  • (D) Deviation of the tongue and uvula on attempted phonation
  • (E) Weakness of the digits on the side opposite the lesion

Question 7

Question
Which of the following encodes the rate of change in muscle length during contraction of a skeletal muscle?
Answer
  • (A) Dynamic nuclear bag fibers
  • (B) Golgi tendon organ
  • (C) Merkel cell ending
  • (D) Nuclear chain fibers
  • (E) Static nuclear bag fiber

Question 8

Question
A 37-year-old woman presents to her family physician with intermittent physical problems. She is referred to a neurologist and, after a thorough examination, a tentative diagnosis of multiple sclerosis is made. MRI shows an area of demyelination in the region indicated by the arrow in the image below. Which of the following deficits would correlate most specifically with the location of this lesion?
Answer
  • (A) Tongue deviates to the left, weak left upper and lower extremities
  • (B) Tongue deviates to the left, weak left lower extremity
  • (C) Tongue deviates to the right, weak left upper and lower extremities
  • (D) Tongue deviates to the right, weak left lower extremity
  • (E) Tongue deviates to the right, weak left upper extremity

Question 9

Question
A 67-year-old man presents at the Emergency Department with a medial medullary (Dejerine) syndrome. He has a right-sided weakness of the UE and LE, a right-sided loss of vibratory sense and discriminative touch, and a deviation of the tongue to the left on attempted protrusion. Weakness of which of the following muscles would explain the asymmetrical tongue movement in this man?
Answer
  • (A) Chondroglossus
  • (B) Genioglossus
  • (C) Hyoglossus
  • (D) Palatoglossus
  • (E) Styloglossus

Question 10

Question
A 47-year-old man is brought to the Emergency Department from the site of a motor vehicle collision. The examination reveals facial injuries with a probable broken nose, a compound fracture of the left humerus, and large bruises/contusions on his left thigh. CT confirms these observations and shows a skull fracture in the left frontal region, extensive intracranial hemorrhage, a fracture through the left orbit, and a fractured pelvis. The man is unconscious and within 6 hours exhibits decorticate posturing. Excessive action in which of the following tracts/systems would explain the flexion of the upper extremities in this man?
Answer
  • (A) Anterolateral
  • (B) Corticospinal
  • (C) Reticulospinal
  • (D) Rubrospinal
  • (E) Vestibulospinal

Question 11

Question
A 71-year-old woman presents to her family physician with difficulty swallowing and some numbness on her face. The history reveals that this was a sudden onset (2 days ago), and that the woman not only had difficulty swallowing but also complained that she got food “down the wrong tube.” The examination revealed a loss of sensation on the right side of the face, some moderate sensory loss on the left side of her body, and a weak right vocal fold (endoscopic observation). MRI showed a lesion in the territory of the posterior inferior cerebellar artery (PICA). Damage to which of the following structures would explain this motor deficit in this patient?
Answer
  • (A) Hypoglossal nucleus
  • (B) Nucleus ambiguus
  • (C) Restiform body
  • (D) Solitary nucleus
  • (E) Spinal trigeminal nucleus

Question 12

Question
A 51-year-old woman awakens in the morning and has some difficulty talking. Her daughter takes her to the Emergency Department. The history reveals that the woman takes medication for diabetes and for elevated blood pressure, and is significantly overweight. The results of the examination suggest the probability of a small stroke; MRI shows a lesion localized to the area indicated by the arrow in the image below. Which of the following deficits would most likely be seen in this patient based on the location and extent of the damage?
Answer
  • (A) Deviation of the tongue to the left on attempted protrusion
  • (B) Deviation of the uvula to the right on phonation
  • (C) Difficulty elevating the right shoulder against resistance
  • (D) Weakness of facial muscles on the lower right side of the face
  • (E) Weakness of masticatory muscles of the left
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