DIENCEPHALON

1. The posterior thalamic radiation carries __________ information from thalamus.

Motor
Visual*
Sensory
Auditory

2. The motor informations from Basal Ganglia and Cerebellum relays in the ______ nucleus of
Thalamus.
VPL
VPM
AN
VA & VL*

3. The VPM nucleus in thalamus receives inputs via ____________.

Medial lemniscus
Trigeminal lemniscus*
Spinal lemniscus
Lateral Lemniscus

4. The Medial geniculate body receives inputs via ____________.

Medial lemniscus
Trigeminal lemniscus
Spinal lemniscus
Lateral Lemniscus*

5. The supra optic nucleus in hypothalamus secretes _________ hormone and transmit it into the
Posterior pituitary gland.
Oestrogen
Progesterone
Oxytoxin*
Antidiuretic

6. The Somesthetic, Visual & Auditory informations are integrated in ____________ nucleus of
Thalamus.
VPL
VPM
Pulvinar*
VA & VL

7. The anterior pituitary glands secretions are controlled by __________ nucleus of Hypothalamus.
Preoptic
Supraoptic
Arcuate*
Paraventricular

8. The most likely symptoms due to the lesion in the subthalamic nuclei is ____________.
Chorea
Athetosis
Hemiballismus*
Tremor

9. Amenorrhea or Impotence symptoms are due to most likely lesion in the ____________ nucleus in
Hypothalamus.
Supraoptic
Preoptic*
Venteromedial
Lateral Hypothalamic zone
10. The Paraventricular nucleus in hypothalamus secretes _________ hormone and transmit it into the
Posterior pituitary gland.
Oestrogen
Progesterone
Oxytoxin
Antidiuretic*

11. An infarct in a 65 year-old woman destroyed the VPL completely on the right side. Which of the
following deficits would be associated with is lesion:
Inability to feel tactile on the left side of the body
Inability to feel tactile on the left side of the face
Inability to feel pain on the left side of the body*
Inability to feel pain on the left side of the face

12. The presence of hemianesthesia, hemianopia & sensory hemi ataxia suggests damage to the
following:
Internal capsule
Thalamus opticus*
Spinal cord
Black substance

13. The following symptoms may develop with damage in hypothalamus , EXCEPT:
Panic attacks
Sweating disorder
Hemianalgesia
Blood pressure disturbance

14. The Paraventricular nucleus in hypothalamus secretes _________ hormone and transmit it into the
Posterior pituitary gland.
Oestrogen
Progesterone
Oxytoxin
Antidiuretic*

15. Which of the following thalamic nuclei projects to the posterior paracentral gyrus?
Dorsomedial
Lateral geniculate
Ventral lateral
Ventral posterolateral*
Ventral posteromedial

16. Which of the following vessels is the principal blood supply to the pulvinar nucleus of the dorsal
thalamus?
Lenticulostriate
Medial striate
Quadrigeminal
Thalamogeniculate*
Thalamoperforating

17. A 34-year-old man presents with confusion and persistent headache. MRI reveals an enlarged
lateral ventricle on the left side, presumably resulting from a dime-sized tumor located in the left
interventricular foramen. Based on the location of this tumor, which of the following diencephalic
structures is most directly impinged upon?
Anterior nucleus*
Centromedian nucleus
Dorsomedial nucleus
Ventral anterior nucleus
Ventrallateral nucleus
18. A 58-year-old man presents with the complaint of difficulty seeing. The history reveals that the
man has hypertension and that he is largely noncompliant regarding his medications. The
examination reveals that he has a right homonymous hemianopia, and an MRI shows a lesion of the
primary visual cortex. Which of the following relays vital input to this damaged area of cortex?
(A) Lateral dorsal nucleus
(B) Lateral geniculate nucleus
(C) Medial geniculate nucleus
(D) Pulvinar nucleus
(E) Ventral lateral nucleus

19. A 59-year-old morbidly obese man is brought to the Emergency Department following an episode
at his home. The history reveals that the man has uncontrolled diabetes and hypertension. The
precipitating factor for this visit was the sudden onset of involuntary fl ailing movements of his right
upper extremity, which occur intermittently without warning. MRI reveals a well-localized infarct in
the diencephalon. This lesion is most likely located in which of the following nuclei of the
diencephalon?
Anterior
Centromedian
Subthalamic*
Ventral lateral
Ventral posteromedial

20. Which of the following thalamic nuclei is located within the internal medullary lamina and,
therefore, is commonly referred to as one of the intralaminar nuclei?
Anterior
Dorsomedial
Centromedian*
Lateral dorsal
Thalamic reticular

21. A 71-year-old man is brought to the Emergency Department after his wife discovered that she had
significant difficulty awakening him in the morning. The history reveals that the man has suffered from
hypertension for several years. MRI reveals an infarct involving the following thalamic nuclei:
anterior, rostral part of the dorsomedial, and ventral anterior. Which of the following vascular
territories is most likely represented by this lesion?
Anterior choroidal artery
Medial striate artery
Quadrigeminal artery
Thalamogeniculate artery*
Thalamoperforating artery

22. Which of the following thalamic nuclei is primarily responsible for conveying pain, thermal, and
discriminative touch sensations for the face to the appropriate part of the primary somatosensory
cortex?
Centromedian
Pulvinar
Ventral lateral
Ventral posterolateral
Ventral posteromedial*

23. A 57-year-old woman presents to her ophthalmologist with the complaint of not being able to see
things to my left, I think Im going blind. The examination revealed the following. First, the physician
noticed that the woman, when in a resting attitude, tended to keep her head rotated to her right.
Second, the woman ignored objects that entered her left visual fields: when the physicians nurse
stepped into the womans left visual space, the woman did not see her until the physician told her to
look to her left. Third, when tested carefully, the woman was not blind in either her right or her left
visual fields. MRI revealed a localized hemorrhagic lesion in the right thalamus. An infarct in which of
the following would most likely account for this womans deficit?
Centromedian
Dorsomedial
Lateral geniculate
Pulvinar*
Ventral lateral

24. An association nucleus of the thalamus is one that receives input from several different sources
and projects to widespread cortical regions that are not specifically motor or sensory in function.
Which of the following nuclei fits these criteria?
Anterior
Dorsomedial*
Lateral geniculate
Ventral lateral
Ventral posterolateral

25. Which of the following thalamic nuclei is an essential synaptic station in those circuits relayed
through the dorsal thalamus (such as the Papez circuit) that are related to functions of the limbic
system?
Anterior
Centromedian
Dorsomedial
Ventral lateral
Ventral posteromedial

26. A relay nucleus of the thalamus is one that receives input from a specific source and projects to a
specific cortical region that may have a motor or sensory function as broadly defined. Which of the
following nuclei fits these criteria?
Centromedian
Dorsomedial
Lateral dorsal
Lateral posterior
Ventral lateral*

27. A 59-year-old man complains to his family of facial numbness. The history taken at the Emergency
Department reveals that the man is diabetic. The examination confirms facial numbness over much of
the left side of his face and reveals that the man is not compliant with his medication regimen. MRI
reveals a focal lesion in the thalamus. Recognizing the deficits experienced by this man, this lesion is
most likely located mainly in which of the following nuclei?
Dorsomedial
Ventral anterior
Ventral lateral
Ventral posterolateral
Ventral posteromedial*

28. A 27-year-old woman visits her family physician. The history and examination reveal the
following: the woman had been quite athletic all of her life; over the last year, she has eaten
excessively and gained a significant amount of weight, and she is no longer able to participate in
sports. Enhanced MRI reveals well-localized bilateral hypothalamic lesions. Bilateral damage to
which of the following would most likely be the cause of this womans clinical course?
Dorsomedial hypothalamic nucleus
Lateral hypothalamic nucleus/area
Mammillary nucleus
Suprachiasmatic nucleus
Ventromedial hypothalamic nucleus*

29. Which of the following thalamic nuclei receives important projections from the internal segment of
the globus pallidus and from the contralateral cerebellar nuclei?
Anterior nucleus*
Lateral dorsal nucleus
Ventral lateral nucleus
Ventral posterolateral nucleus
Ventral posteromedial nucleus

30. A 74-year-old man is brought to the Emergency Department by his wife who explained that he
had a sudden spell. The examination reveals that the man has a left homonymous hemianopia and
has some difficulty localizing sound in space, but he is not deaf. The man has no somatomotor or
somatosensory deficits, and he has no trouble walking. MRI reveals a small infarct in his thalamus.
Based on his deficits, this lesion is most likely in which of the following vascular territories?
Anterior choroidal artery
Lateral posterior choroidal artery
Lenticulostriate artery
Thalamogeniculate artery*
Thalamoperforating artery

31. Which of the following herniation syndromes may have diabetes insipidus as one of its
complicating factors?
Cingulate
Transtentorial*
Tonsillar
Uncal
Upward cerebellar

32. The mother of a 16-year-old girl brings her daughter to the gynecologist concerned that the girl
may be pregnant. The history reveals that the mother noticed that her daughters bras were wet
and the daughter acknowledged that she had fluid coming out of her breasts. The examination
reveals a healthy, normally proportioned, non pregnant girl, with a white discharge coming from her
breasts; the gynecologist assures the mother that her daughter is still a virgin. Which of the following
would most likely explain this condition in this girl?
ACTH secreting tumor
Growth hormone secreting tumor
Pinealoma
Pituitary apoplexy
Prolactinoma*

33. A 43-year-old man is brought to the Emergency Department (ED). The history, provided by the
family, is known to the ED staff; the man is a serious alcoholic who suffers deficits characteristic of his
problem. In addition, he has been diagnosed with diabetes insipidus. Based on the diagnosis of his
diabetes, this man would most likely experience which of the following?
Polycythemia
Polydipsia*
Polyneuralgia
Polymyoclonus
Polyphagia

34. A 61-year-old woman presents with a complaint of persistently seeing two of everything. The
examination reveals a dilated left pupil and an inability to look up, down, or medially with that eye.
MRI reveals an aneurysm of the basilar bifurcation. During surgery to clip this aneurysm, the small
perforating branches of P1 are inadvertently occluded by the clip. Which of the following structures
would be most adversely affected by this disruption of blood supply?
Anterior hypothalamic nucleus
Mammillary nuclei*
Medial preoptic nuclei
Paraventricular nucleus
Tuberal region nuclei

35. A 7-year-old boy is brought to the family physician by his mother. The history reveals that the boy
had a minor bicycle accident 6 weeks earlier, hit his head, but was examined and had no lesions or
deficits. The mother notes that the boy has no appetite, and has not eaten normally for several weeks.
The examination reveals a skinny, almost emaciated, and lethargic boy. Cranial nerves, motor and
sensory systems, and reflexes are normal, considering the boys weakened state. MRI reveals a small
localized defect. Which of the following represents the most likely location of this lesion?
Anterior hypothalamic nucleus
Lateral hypothalamic nucleus*
Mammillary nuclei
Suprachiasmatic nucleus
Ventromedial hypothalamic nucleus
36. Which of the following fiber bundles contains bidirectional connections between the septal nuclei,
lateral hypothalamic nucleus, tuberal nuclei, and brainstem areas such as the Periaqueductal gray
and the tegmental nuclei?
Mammillotegmental tract
Mammillothalamic tract
Medial forebrain bundle
Stria terminalis
Stria medullaris thalami

37. Which of the following hypothalamic nuclei is described as being sexually dimorphic, that is
being larger in males than in females?
Lateral hypothalamic nucleus
Medial preoptic nucleus*
Paraventricular nucleus
Posterior hypothalamic nucleus
Suprachiasmatic nucleus

38.A 48-year-old woman visits her family physician with the complaint of frequent urination. The
history reveals that this symptom appeared about 3 months ago; at that time the woman remembers
that she had a sudden headache that responded to OTC medications. The woman also says that she
is thirsty all the time and has trouble sleeping because of her frequent trips to the bathroom at
night. Laboratory tests reveal normal glucose levels; MRI shows a small lesion within her
hypothalamus. This lesion is most likely located in which of the following hypothalamic nuclei?
Arcuate
Mammillary
Suprachiasmatic
Suparoptic*
Ventromedial

39. A 13-year-old boy is brought to the family physician by his mother. The examination reveals that
the boy is 6 ft tall, weighs 145 lb, and appears muscular, although when tested for muscle strength he
is weak. His mother indicates that since he was a baby he has been big for his age. The boys
fasting levels of growth hormone are 11 to 27 ng/mL. This boy is most likely suffering from which of
the following?
Acromegaly
Cushing disease
Gigantism*
Precocious puberty
Wernicke syndrome

40. A 51-year-old man is brought to the Emergency Department by the local police who state that the
man was disruptive in a public place. The examination reveals an unkempt, emaciated, and
intoxicated man who is somewhat uncooperative. He can recall events of past years but only states
that he has been living on the streets for sometime when asked about more recent activities. He
seems confused as to where he is, and clearly makes up answers to most questions. In addition to a
nutritious diet and a restriction of alcohol intake, therapeutic doses of which of the following would
most likely contribute to an improvement of this mans condition?
Levodopa
Penicillamine
Thiamin*
Vitamin A
Vitamin D

41. A 35-year-old man visits his family physician. He explains that over the past year or so he has
experienced a progressive loss of interest in sex (decreased libido), and when aroused, he has great
difficulty achieving and maintaining an erection ( impotence). The examination reveals a normal
looking slender man of average height. The ophthalmological examination showed a partial loss of
vision in both eyes, but not blindness; the man stated that he did not realize that this was happening.
MRI reveals a pituitary tumor extending through the diaphragma sella, into the suprasellar cistern,
and impinging on the hypothalamus. This man is most likely suffering from which of the following?
Excessive follicle-stimulating hormone
Excessive growth-stimulating hormone
Excessive oxytocin production
Excessive prolactin production*
Excessive thyrotropin production

42. A 7-year-old boy is brought to the pediatrician by his mother. The mother explains that her son
fell off a jungle gym about a week ago; he was examined by a physician and did not appear to have
any injuries. Since this event the mother indicates that her son seems subdued, has lost his appetite,
and complains constantly about being cold. His temperature may drop to several degrees below
normal, and he wears layers of clothes in an attempt to keep warm. Bilateral lesions in which of the
following areas would most likely explain the symptoms in this boy?

Anterior hypothalamic area

Lateral hypothalamic nucleus
Posterior hypothalamic area*
Ventromedial nucleus
Suprachiasmatic nucleus

43. Which of the following fiber bundles contains axons that arise in the arcuate nucleus and pass to
the median eminence and the base of the pituitary stem?
Medial forebrain bundle
Postcommissural fornix
Stria medullaris thalami
Supraopticohypophysial tract
Tuberoinfundibular tract*