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1. A 41 year old woman complains to her family physician about recurring episodes
of sharp pain that seem to originate from around her mouth and check. The pain is
so intense that she is unable to eat, brush her teeth or apply make-up. Where is the
lesion most likely located? (select all that apply)
a. Primary motor cortex: Facial region
b. Internal capsule: posterior limb
c. Internal capsule: anterior limb
d. Midbrain
2. Which of the following portions of the ventricular system does not contain
choroid plexus? (select all that apply)
a. Cerebral aqueduct
b. Fourth ventricle
c. Lateral ventricle
d. Interventricular foramen
e. Third ventricle
3. Which of the following represents the most common cause of blood in the
subarachnoid space (subarachnoid hemorrhage)?
a. Bleeding from an arteriovenous malformation
b. Bleeding from a meningioma
c. Bleeding from an aneurysm
d. Trauma to the brain
4. A 76 year old man presents with a resting tremor, bradykinesia, and stooped
posture. These observations suggest loss of a prominent population of cells in the
brain. Which of the following structures is most likely affected in this patient?
a. Lateral cerebellar nucleus
b. Locus ceruleus
c. Red nucleus
d. Substantia nigra
e. Subthalamic nucleus
5. A 78 year old man presents with deficits suggesting an occlusion of the posterior
spinal artery at spinal cord levels C4-T2. Which of the following structures are in
the territory served by this vessel at these levels?
a. Anterolaterla system
b. Cuneate fasciculus
c. Gracile nucleus
d. Lateral corticospinal tract
e. Medial longitudinal fasciculus
6. Which of the following symptoms is located within the territory served by
branches of the PICA by clinicians?
a. Weakness in UE & LE
b. Deviation in the tongue movement
c. Impairment of vibration and touch-pressure sensation
d. Difficulty with alleviating pain
e. Impaired taste, gag reflex, aortic reflex, and cough reflex
b.
c.
d.
e.
c. Dysmetria
d. Intention tremor
e. Resting tremor
16. Which of the following terms specifically designates this mans inability to touch
his nose with his index finger?
a. Dysmetria
b. Intention tremor
c. Rebound phenomenon
d. Resting tremor
e. Static tremor
17. The MRI of this man shows an infarcted area in the brain. Based on the deficits
this man is experiencing, which of the following represents the most likely
location of the lesion?
a. Basal nuclei of the left side
b. Basal nuclei of the right side
c. Cerebellar cortex and nuclei on the left side
d. Cerebellar cortex and nuclei on the right side
e. Midbrain on the right side
18. Assuming the lesion to the result of the occlusion of an artery, which of the
following is the most likely candidate?
a. Left anterior inferior cerebellar artery
b. Left superior cerebellar artery
c. Lenticulostriate arteries on the left
d. Right anterior inferior cerebellar artery
e. Right superior cerebellar artery
For questions 19 & 20:
A 41-year old trumpet player for the LA Philharmonic Orchestra was reprimanded by his
conductor for playing out of tune. The musician had been having difficulty reading his
music and had also been having more problems than usual playing his horn; he went to
his physician. On his way to the doctors office, he had to pull his car off the freeway
because he was violently sick and his head was spinning. Upon reaching the
physicians office, the physician conducted a brief neurological exam and noted that the
man was totally deaf in his right ear and his eye showed prominent left-beating
nystagmus. The musician also had a flaccid right lower lip and a flattened right
nasolabial fold. His right eye was red and dry and had no corneal reflex. Sensations in
his body and face were normal, as were deep tendon reflexes in his entire body.
19. Where was the lesion?
a. Midbrain
b. Pons
c. Medulla
d. Pontomedullary junction
20. What systems were involved? (Select all that apply)
a.
b.
c.
d.
e.
True/ False section: If false, please write below what changes are necessary for it to be
true.
21. Bells palsy is a result of a central lesion that results in an irreversible change in
the motor supply to the contralateral face.
22. A lesion to the corticobulbar tract between the Trigemminal Nucleus & Abducens
Nucleus would result in the uvula deviating to the same side.
23. Signs of UMN syndrome are: positive Babinski, hypertonicity, weakness, atrophy,
fasciculations, loss of fractionation and clonus.
24. Disinhibition of the globus pallidus internus is what mediates the freezing
symptoms in individuals with Parkinsons Disease.
25. Flexion withdrawal reflex is a polysynaptic reflex.
26.
Within the internal structures of a muscle, the presence of spasticity occurs
as a result of the loss of disinhibition via the lateral reticulospinal tract.