Term
| 1. What sensations do protopathic pathways transmit? |
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Definition
| Pain, crude touch, temperature |
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Term
| 2. Where is the first synapse of the spinothalamic tract? |
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Definition
| Ipsilateral dorsal horn (cell bodies in dorsal root ganglia) |
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Term
| 3. T or F The second order axons of the spinothalamic tract travel ipsilaterally through the spinal cord |
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Definition
| False, axons cross midline at same level of entry to travel contralaterally in anterolateral funiculus |
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Term
| 4. How are axons added to anterolateral funiculus as you move up the spinal cord? |
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Definition
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Term
| 5. Where do the second order axons of the spinothalamic tract synapse? |
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Definition
| Ventral posteriolateral thalamus |
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Term
| 6. T or F The axons carrying protopathic information from the periphery are small and slowly conducting. |
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Definition
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Term
| 7. Axons carrying position sense for the right big toe can be found in the |
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Definition
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Term
| 8. T or F Epicritic pathways first synapse in the dorsal horn much like the protopathic |
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Definition
| F, first order axons do not synapse until reaching the caudal medulla |
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Term
| 9. First order axons carrying information about the shape of an object in your left hand synapse in the |
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Definition
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Term
| 10. T or F Axons traveling in the medial lemniscus are running contralaterally to the dorsal root they entered. |
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Definition
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Term
| 11. Are those axons first or second order? |
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Definition
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Term
| 12. T or F, All second order axons carrying epicritic & protopathic information synapse in the Ventral posteriolateral thalamus |
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Definition
| False, second order axons supplying the face (trigeminal spinal nucleus) synapse in the ventral posteromedial thalamus. All others do however synapse in the ventral posteriolateral thalamus |
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Term
| 13. Lower motor neurons receive the majority of their synaptic input from the |
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Definition
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Term
| 14. A motor unit consists of |
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Definition
| All the muscle fibers a single lower motor neuron innervates |
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Term
| 15. An isolated lower motor neuron cell body for flexor digitorum superficialis could be distinguished from one for the biceps because the one supplying the fingers would be |
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Definition
| Smaller, increased size reflects gross movement versus fine movement |
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Term
| 16. T or F You would expect muscle fibers of the gastrocnemius (important for quick jumping) to have plentiful myoglobin & capillary beds. |
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Definition
| F, the gasctrocnemius is important for quick strong movements associated with fast fatigable fibers which are low in myoglobin. |
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Term
| 17. What type of injury would you worry about in a patient who strangely lacked golgi tendon organs? |
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Definition
| Excessive stress on muscle and tendons. Possible muscle or tendon tears |
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Term
| 18. What neuron must fire along with the lower motor neuron to ensure the muscle retains the ability to sense fiber length appropriately? |
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Definition
| Gamma motor (adjusts muscle spindle) |
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Term
| 19. Fibers carrying information from the motor cortex bound for the face are called |
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Definition
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Term
| 20. T or F All fibers carrying information from the motor cortex run contralaterally down the spinal cord |
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Definition
| F, trunk fibers can continue ipsilaterally known as the anterior corticospinal tract |
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Term
| 21. T or F Axons traveling in the lateral corticospinal tract synapse mainly on short distance local circuit neurons |
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Definition
| T, anterior corticospinal tract will synapse on long distance |
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Term
| 22. T or F Short distance local circuit neurons synapse bilaterally |
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Definition
| F, long distance local circuit neurons synapse bilaterally |
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Term
| 23. Lower motor neurons supplying the trunk receive the majority of their synaptic input from the _____ while those supplying the limbs receive the majority from _____ |
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Definition
| Long distance local circuit, short distance local circuit |
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Term
| 24. A strange lesion causes only the long distant local circuit neurons on the left side to be affected. Would expect a noticeable motor defect? |
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Definition
| In most instances, no. Due to the bilateral synapses of the long distance circuit, the trunk muscles are dually innervated. |
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Term
| 25. A growing lesion starting in most lateral portion of the ventral horn of C7 and progressing medially in the ventral horn would manifest what symptoms? |
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Definition
| Starts with difficulty extending fingers progressing to difficulty extending the forearm. (distal to proximal muscles paralysis) |
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Term
| 26. Purkinje fibers do not receive direct innervations from |
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Definition
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Term
| 27. Name excitatory cells in the cerebellar cortex |
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Definition
| Mossy fibers, climbing fibers, granule cells |
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Term
| 28. A patient with a lesion of the interposed nuclei would be expected to have difficulty |
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Definition
| Coordinating proximal and distal limb movements |
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Term
| 29. A patient with a lesion of the dentate nuclei would be expected to have difficulty |
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Definition
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Term
| 30. T or F Much like motor lesions of upper motor neurons, lesions of the cerebellar nuclei manifest contralaterally |
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Definition
| F, the cerebellum is responsible for control of the ipsilateral side of the body |
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Term
| 31. Name the inhibitory cells of the cerebellum |
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Definition
| Purkinje, stellate, basket & golgi |
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Term
| 32. A patient comes into your office stumbling as if intoxicated, void of any scent of alcohol you begin suspect a lesion involving the |
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Definition
| Medial cerebellum (cerebellar vermis) |
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Term
| 33. You ask the patient touch their finger to yours and then to their nose. They are unable to complete the task or exhibit appendicular ataxia, you now know the lesion also involves the |
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Definition
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Term
| 34. Which eye muscles are supplied by a contralateral nucleus? |
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Definition
| Superior rectus, Superior Oblique |
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Term
| 35. What deficits would you expect in a patient with a lesion of the Edinger-Westphal nucleus? |
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Definition
| Dilated pupil and loss of accomodation. |
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Term
| 36. Upon shining a light in a patient’s right eye, the left pupil constricts but the right does not. Where is the lesion? |
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Definition
| Right CN III nucleus involving right parasympathetics |
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Term
| 37. In a patient with a EW lesion, besides dilated pupil you would also expect the patient to have difficulty |
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Definition
| Focusing on near objects (accommodation) |
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Term
| 38. A lesion involving the left parietal-occipito-temporal area would cause |
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Definition
| Difficulty tracking objects to the left |
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Term
| 39. A patient comes in with paralysis of their left side, you are able to localize the lesion by simply noticing that their eyes are stuck looking left. The lesion is |
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Definition
| Involving the right pons. If the eyes were looking right you would suspect right frontal cortex |
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Term
| 40. During a neuro exam, you notice that your patient has a strong rightward gaze. Upon asking the patient to look left, you notice the right eye will not look left while the left eye looks left with nystagmus. Localize the lesion. |
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Definition
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Term
| 41. Would you expect this patient to have difficulty with accommodation? |
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Definition
| No, the accommodation reflex occurs independent of the MLF pathway. |
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Term
| 42. During a neuro exam, a patient cannot look right and when asked to look left, the right eye stays midline while the left looks left with nystagmus. Localize the lesion. |
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Definition
| Right MLF & Right abducens nucleus. |
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Term
| 43. A loss of the left frontal eye field would most likely result in what deficit? |
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Definition
| The ability of the eyes to look right in response to a stimulus |
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Term
| 44. Which cerebellar nuclei is involved in eye movement? |
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Definition
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Term
| 45. The majority of cerebellar output travels through the |
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Definition
| Superior cerebellar peduncle |
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Term
| 46. A patient exhibiting the Babinski sign has a lesion involving |
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Definition
| Upper motor neurons or coticospinal tract |
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Term
| 47. This patient would also have ____ relfexes |
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Definition
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Term
| 48. In a patient exhibiting increased jaw jerk reflex on the right side, you would expect a lesion of the |
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Definition
| Left upper motor neuron supplying CN V |
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Term
| 49. A patient comes in with complaints of the right side of their face is “drooping” as well as their right eye being itchy and dry. You can then isolate the lesion to |
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Definition
| Cranial nerve VII (not the motor nucleus because parasympathetic innveration is also involved) |
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Term
| 50. During a neuro exam, you ask the patient to stick out their tongue and notice it deviates to the right. Where are the possible lesions? |
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Definition
| L motor cortex or R Hypoglossal nerve/nucleus |
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Term
| 51. You decide it is a lesion of the Right hypoglossal nerve. What other signs likely lead you to that conclusion? |
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Definition
| Fasciculations, atrophy of the right tongue muscles |
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Term
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Definition
| Condition including the loss of sense of smell |
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Term
| 53. Loss of the rostral portion of the nucleus solitaries would result in |
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Definition
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Term
| 54. The caudal portion of that nucleus plays an important role in |
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Definition
| Chemo & baro reception as well as somatic sensation |
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Term
| 55. T or F Axons from the mesencephalic nucleus of V travel to the Ventral Posteriomedial thalamus |
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Definition
| F, These axons project bilaterally to the motor nucleus of V |
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Term
| 56. A patient comes in complaining of a loss sensation to the right side of their face. Using the pin test you find the patient has no pain sensation on their face extending back to the ear including the pinna. Where is the lesion? |
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Definition
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Term
| 57. The afferents of what cranial nerves will be affected? |
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Definition
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Term
| 58. Cell bodies carrying pain sensation around the external auditory meatus can be found in the |
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Definition
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Term
| 59. Which nuclei of CN VIII contribute to the medial longitudinal fasciculus? |
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Definition
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Term
| 60. Receptors carrying audition or hearing are found in the |
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Definition
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Term
| 61. Name the circumventricular organs |
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Definition
| Organum vasculosum, median eminence, pineal gland, subcommisural organ, area posterma, neurohypophysis, subfornical organ |
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Term
| 62. These organs tend to be located |
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Definition
| Lining the ventricular system |
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Term
| 63. T or F the majority of CSF enters the subarachnoid space and circulates around the spinal cord |
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Definition
| F, The majority moves up through the tentorium cerebella |
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Term
| 64. T or F the major role of ependymal cells is to secrete CSF |
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Definition
| F, these cells are found outside of the choroid plexus and line the central canal |
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Term
| 65. The sinus in direct communication with the Internal Jugular vein is the |
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Definition
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Term
| 66. A lesion of the paracentral lobule could potentially affect |
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Definition
| Both sensation & motor control of the lower limb |
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Term
| Which dorsal root would the axons illustrated in red have entered? |
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Definition
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Term
| Which dorsal root would the axons in green have entered? |
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Definition
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Term
| Where will the axons in blue exit the cord? |
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Definition
| Trick question, they will synapse on local circuit mainly |
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Term
| Where did the axons in blue originate? |
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Definition
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Term
| What is the medial lemniscus? |
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Definition
| It is a group of axons that run from the gracile and cunate nuclei to the VPL thalamus. |
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