MIDTERM
Medical Neuroscience (NSC 6-111)
February 27, 2004
1. An important feature of the leakage K+ channels that generate the resting membrane potential in neurons is that
A. they take approximately 200 msec to gate open.
* B. they have a high probability of being open at the resting membrane potential.
C. they open only when the membrane potential is depolarized to voltages more positive than 0 mV.
D. they inactivate very rapidly after they open.
2. Voltage-gated Na+ channels inactivate within 1 msec after the cell membrane potential is depolarized. RECOVERY of Na+
channels from inactivation occurs
A. after an additional 1 to 3 msec, even when the cell membrane potential remains depolarized.
*B. 1 to 3 msec after the cell membrane potential has been hyperpolarized back to near the resting membrane potential.
C. 50 to 100 msec after the cell membrane potential has been hyperpolarized back to near the resting membrane potential.
D. after Na+ ions stop flowing through the channel.
3. On the planet Endor, animals have evolved a unique nervous system. Neurons in these animals are exclusively permeable to Ba2+
at their normal resting membrane potential. In these animals, there is a 10-fold higher Ba2+ concentration outside the cell than there is
inside. The resting membrane potential of these cells will be approximately
A. –58 mV.
B. –29 mV.
C. 0 mV.
* D. +29 mV.
E. +58 mV
4. From a functional standpoint, Na+ channel inactivation is important because
A. inactivation allows a neuron to depolarize rapidly during the rising phase of the action potential.
*B. inactivation allows a neuron to repolarize rapidly once the peak of the action potential has been reached.
C. inactivation contributes to the stretch-sensitivity of Na+ channels.
D. A and B only
E. A, B, and C
5. Which of the following statements about neuronal dendrites is correct? [BOOK]
A. There are no voltage-gated channels on dendrites and action potentials never propagate through them.
B. There are some voltage-gated channels on dendrites but action potentials never propagate through them.
*C. There are some voltage-gated channels on dendrites and action potentials sometimes propagate through them.
6. In patients with multiple sclerosis, cooling the body can sometimes alleviate symptoms because at cooler temperatures
A. K+ channels have a larger conductance.
* B. Na+ channels inactivate more slowly.
C. the resting membrane potential is more negative.
D. the resting membrane potential is more positive.
E. cooling causes a placebo effect.
7. In patients with Lambert-Eaton myasthenic syndrome, Ca2+ channel function in presynaptic terminals is disrupted. If you recorded
postsynaptic miniature endplate potentials (MEPPs) in biopsy samples from these patients, the potentials
A. would have a smaller-than-normal amplitude.
* B. would have a normal amplitude.
C. would have a larger-than-normal amplitude.
8. A miniature endplate potential (MEPP) is generated by
A. one molecule of acetylcholine released into the synaptic cleft.
* B. the acetylcholine contained in one synaptic vesicle released into the synaptic cleft.
C. the acetylcholine contained in approximately 150 synaptic vesicles released into the synaptic cleft.
D. an action potential arriving at the endplate.
E. none of the above.
9. Sensory receptor cells transduce specific types of physical energy into changes in cell membrane potential. Transduction
mechanisms generating receptor potentials in different types of receptor cells include
A. the closing of Na+ channels gated by an intracellular messenger.
B. the opening of mechano-sensitive ion channels permeable to Na+ and K+.
C. the release of inhibitory neurotransmitters onto hair cells, generating cell hyperpolarization.
* D. A and B only
E. A, B and C
10. In sensory neurons that adapt to a stimulus, the phasic (dynamic) phase of the response is proportional to
A. the amplitude of the stimulus.
* B. the rate of change of the stimulus.
C. the duration of the stimulus.
D. the location of the stimulus in space.
11. Which of the following statements concerning the cerebrospinal system is TRUE?
A. Approximately 2 liters of cerebrospinal fluid are produced each day.
B. Flow of cerebrospinal fluid is random.
* C. Virchow-Robin space is filled with cerebrospinal fluid.
D. An increase in cerebrospinal pressure decreases cerebrospinal fluid reabsorption.
E. none of the above
12. Which is TRUE concerning the blood-brain barrier (BBB)?
A. It is the result of tight junctions between astrocyte foot processes surrounding capillaries.
B. A compound’s permeability is directly proportional to its water solubility.
C. Addictive compounds generally have specific transport systems.
D. All brain areas have a BBB.
* E. none of the above
13. Which is TRUE of the transporter systems that move compounds between blood and brain?
A. All transporters are energy dependent.
* B. Glucose transporter is concentration dependent.
C. Glycine moves via the large neutral amino acid transporter.
D. An increase in glucose transporters occurs in chronic hyperglycemia.
E. none of the above
14. A lesion of the gray matter of cerebral cortex at which of the areas indicated in gray at right would be most likely to cause a
reduction in tactile acuity on the right hand? ANSWER C
15. Which of the following types of primary afferent receptors would be strongly activated by an increase in skin temperature within
its receptive field from 30oC to 53oC?
A. cooling receptors
B. warming receptors
* C. A mechanoheat nociceptors
D. Slowly Adapting type I receptors
E. none of the above
16. Which of the following types of primary afferent fibers are most powerfully activated by indentation of the skin?
A. Merkel disc endings
B. Meissner’s corpuscles
C. Ruffini’s endings
* D. A and B only
E. A, B and C
17. A tumor forms on the ventral surface of the medulla and spreads dorsally. Initially, it cuts many axons within the pyramid. As it
progresses, it spreads throughout the left pyramid and into the ventral half of the medial lemniscus on the left side cutting all of the
axons within the affected region. It does not extend lateral to the medial lemniscus. A deficit in which of the following would most
likely occur?
A. two point discrimination on the right hand
* B. vibration sense on the right foot
C. proprioceptive sense for the left foot
D. two point discrimination on the left hand
E. pain and temperature sensation on the right arm
18. Which of the following statements regarding the spinal nucleus and tract of the trigeminal nerve is TRUE?
A. Within both, the somatotopic organization is such that the jaw is represented dorsally and the forehead is represented ventrally.
B. The central processes of many nociceptors descend within the spinal tract of V.
C. The axons of neurons within the spinal nucleus of V cross the midline and ascend to the thalamus.
D. A and B only
* E. A, B, and C
19. Which of the following statements regarding trigeminal neuralgia (or tic douloureux) is TRUE? (BOOK)
A. It is characterized by brief attacks of excruciating pain.
B. It’s symptoms usually appear in only one division of the trigeminal nerve.
C. It is sometimes treated by cutting the ipsilateral spinal tract of V (trigeminal tractotomy).
D. two of the above
* E. A, B, and C
20. Which of the following statements related to cordotomy is TRUE?
A. It is a surgical procedure in which the dorsal part of the lateral funiculus is cut.
* B. It is a surgical procedure in which spinothalamic tract axons cut.
C. Over time, many of the cut axons grow across the injured area causing pain to return.
D. When it is performed unilaterally, analgesia and athermia are produced on the ipsilateral body.
E. more than one of the above
21. Which of the following statements regarding stimulation-produced analgesia is TRUE?
A. Activation of neurons in the central gray inhibits nociceptive reflexes.
B. Activation of neurons in the central gray inhibits nociceptive firing of spinothalamic tract neurons.
C. Many neurons in the central gray send a large direct inhibitory projection to the spinal cord.
* D. A and B only
E. A, B, and C
22. A patient suffers from severe pain in the upper back. Disease in which of the following visceral structures would be most likely to
produce or contribute to the patient’s pain?
A. heart
B. esophagus
* C. lung
D. kidney
E. None of the above could produce the patient’s pain.
23. Which of the following statements regarding “first pain” is TRUE?
A. It is easily distinguished from second pain following noxious stimulation on the thorax or abdomen.
B. It is perceived as dull or aching.
* C. It is perceived as sharp or pricking.
D. It is the result of activation of nociceptors with unmyelinated axons.
E. more than one of the above
24. Which of the following is NOT located within the cerebral hemispheres?
A. hippocampus
B. basal ganglia
* C. hypothalamus
D. amygdala
E. post central gyrus
25. The cervical spinal cord in humans contains how many segments?
A. 12
B. 5
* C. 8
D. 10
E. 6
26. Which of the following is located within the temporal lobe and is also part of the limbic lobe?
A. primary auditory cortex
* B. hippocampus
C. cingulate gyrus
D. medial dorsal nucleus
E. Wernicke’s area
27. In which cortical layer do the axons from neurons in thalamic sensory nuclei terminate?
A. the molecular layer (layer I)
B. the external pyramidal layer (layer III)
* C. the internal granular layer (layer IV)
D. the internal pyramidal layer (layer V)
E. the fusiform layer (layer VI)
28. Which of the following statements regarding the mesencephalic tract of the trigeminal nerve is TRUE?
A. Its axons terminate in neuromuscular junctions and release Ach onto the muscles of mastication.
B. Its axons descend in the spinal tract of V
C. Its axons terminate in the contralateral ventral posterior medial nucleus of thalamus
D. Its axons terminate in the main (or chief) sensory nucleus of V
* E. Its axons carry proprioceptive information from the muscles of mastication.
29. In a patient seen by a neurologist, MRI shows syringomyelia (a hole that develops in the central spinal cord and cuts axons within
the anterior white commissure) that extends from the caudal end of spinal segment T1 to the rostral end of C3. In which of the
following dermatomes would bilateral analgesia and athermia be seen?
A. C6
B. C7
C. T1
D. two of the above
* E. A, B, and C
30. In addition to analgesia and athermia, patients who undergo bilateral cordotomy have disruptions in which of the following?
(BOOK)
A. itch
B. pressure sensations from the bladder and bowel
C. sexual sensations
D. A and C only
* E. A, B, and C
31. Which of the following ionotropic receptor types is highly permeable to sodium ions?
A. GABA-A receptor
B. nicotinic acetylcholine receptor
C. AMPA receptor
D. NMDA receptor
* E. more than one of the above
32. Glial reuptake is an important clearance mechanism in the synaptic cleft for
A. GABA.
B. glutamate.
C. acetylcholine.
* D. A and B only
E. A and C only
33. Excitotoxicity which can injure or even kill neurons is caused by (BOOK)
A. excessive acetylcholine release and muscarinic receptor activation.
B. excessive activation of voltage dependent sodium channels.
C. excessive activation of glutamate transporters.
* D. excessive calcium entry through NMDA receptors.
E. none of the above
34. Rods are most densely concentrated in which region of the retina?
A. the blind spot
B. the fovea
* C. the periphery
D. They are evenly distributed across the retina.
E. none of the above
35. Photoreceptors make direct synaptic contact with
A. amacrine and bipolar cells.
* B. horizontal and bipolar cells.
C. ganglion and amacrine cells.
D. ganglion cells.
E. both c and d are correct
36. A patient has developed left homonymous hemianopsia. Damage in which area of the primary visual pathway will most likely
cause this visual deficit? ANSWER C
37. Visual information is distributed in dorsal and ventral streams in the extrastriate cortex. Deficits in the ventral stream are more
likely to impair
A. perception of motion of objects.
* B. perception of color and detail of objects.
C. perception of objects projected in the lower half of the visual field.
D. perception of faint objects.
E. none of the above
38. Which of the following statements regarding the primary visual cortex is FALSE?
A. It has a vertical organization composed of ocular dominance columns and orientation columns.
B. It contains simple and complex cells that respond to bars of light in their receptive fields.
* C. The retinotopic organization is such that all areas of the retina occupy equal areas of cortex.
D. It receives inputs from the lateral geniculate nucleus.
E. Many cells can respond to visual stimulation from both eyes.
39. Which region of the retina is most suited for high resolution, color vision?
* A. fovea
B. optic disc
C. peripheral retina
D. none of the above
40. When we move from sunlight to darkness, which of the following occurs in rods and cones?
A. intracellular cGMP levels decrease
B. phosphodiesterases are activated
* C. cGMP gated channels open
D. the number of action potentials increases
E. none of the above
41. Which of the following stimuli within the receptive field of an OFF-center ganglion cell will be most effective to increase its firing
rate?
* A. illumination in the surrounding area and darkness in the center
B. illumination in the center area and darkness in the surrounding area
C. illumination in both center and surrounding areas
D. darkness in both center and surrounding areas
E. none of the above
42. Which of the following statements regarding the lateral geniculate nucleus is FALSE?
A. Its neurons have circular receptive fields.
B. It contains both parvocellular and magnocellular layers.
* C. Each of its layers receives inputs from both eyes.
D. It projects to the primary visual cortex.
E. It has a retinotopic organization.
43. Which pair of neurotransmitters is likely to be located in the same presynaptic terminal?
* A. acetylcholine and CGRP
B. glycine and GABA
C. glutamate and acetylcholine
D. glutamate and serotonin
E. none of the above
44. Which of the following neurotransmitters DOES NOT require the enzyme dopamine-beta-hydroxylase for its synthesis?
A. dopamine
B. epinephrine
C. serotonin
D. norepinephrine
* E. more than one of the above
45. Which of the following proteins is directly blocked by fluoxetine (Prozac)?
A. monoamine oxidase
B. aromatic amino acid decarboxylase
C. 5-HT3 receptor
* D. serotonin transporter (SERT)
E. none of the above
46. One of the functions of the middle ear is to compensate for the loss of energy that would normally occur during the transition from
an air to fluid environment. Which of the following mechanisms is thought to contribute to amplification of sound pressure waves in
the middle ear?
A. the lever action of the ossicular chain
B. the relative surface areas of the oval and round windows
C. the relative surface areas of the tympanic membrane and the oval window
* D. A and C only
E. A, B, and C
47. Electrochemical gradients for K+ ions are critical for normal transduction of sound pressure waves by cochlear hair cells. Which
of the following best describes the relative distribution of K+ ion concentration in the cochlea?
A. perilymph > hair cell cytoplasm > endolymph
* B. endolymph > hair cell cytoplasm > perilymph
C. endolymph > hair cell cytoplasm = perilymph
D. hair cell cytoplasm > endolymph > perilymph
E. endolymph > perilymph > hair cell cytoplasm
48. Which of the following statements concerning the cochlea is FALSE?
* A. Frequencies of 100 to 500 Hz are represented near the base of the cochlea.
B. Outer hair cells receive efferent innervation through axo-somatic synapses.
C. Inner hair cells receive a greater density of afferent innervation than outer hair cells.
D. Stereocilia of outer hair cells are firmly attached to the tectorial membrane.
E. The basilar membrane is wide and flexible near the apex of the cochlea.
49. Which of the following mechanisms contributes to frequency selectivity of cochlear hair cells?
A. passive frequency separation by the basilar membrane
B. active motility of outer hair cells (cochlear amplifier)
C. structural specializations of hair cells at different locations along the cochlea
D. A and B only
* E. A, B, and C
50. The so-called "core" auditory pathway provides fast, direct, and tonotopically organized information to primary auditory cortex.
Which of the following nuclei are considered to be part of this system?
A. superior olivary nucleus
B. dorsal cochlear nucleus
C. principal region of medial geniculate nucleus
* D. B and C only
E. A, B, and C
51. A subject who hears normally through bone conduction but not by air conduction is likely to have conductive hearing loss. Which
of the following can cause conductive hearing deficits? (BOOK)
A. hair cell damage from ototoxic drugs
B. abnormal ossification of bones in the middle ear
C. perforated tympanic membrane
* D. B and C only
E. A, B, and C
52. Axons of mitral cells in the olfactory bulb are distributed to four different regions of olfactory cortex. Outputs from two of these
paleo-cortical regions eventually reach the neocortex. Which of the following is the main neo-cortical area receiving olfactory
information?
* A. orbitofrontal cortex
B. insular cortex
C. transverse temporal gyrus of Heschl
D. entorhinal cortex
E. piriform cortex
53. The primary sensory innervation of gustatory receptor cells is provided by three cranial nerves whose central axons project to the
nucleus of the solitary tract. Which of the following cranial nerves innervates gustatory receptor cells?
A. facial (VII)
B. glossopharyngeal (IX)
C. vagus (X)
D. B and C only
* E. A, B, and C
54. Which of the following is the primary gustatory sensory cortex?
A. orbitofrontal cortex
* B. insular cortex
C. transverse temporal gyrus of Heschl
D. entorhinal cortex
E. piriform cortex
MIDTERM: February 26, 2003
1. Which of the following primary afferent receptors respond optimally to lateral displacement or stretching of the skin?
A. Slowly Adapting type I (Merkel discs)
* B. Slowly Adapting type II (Ruffini corpuscles)
C. Meissner's corpuscles
D. B and C, not A
E. A, B, and C
2. Which of the following statements accurately describes a property of C polymodal nociceptors?
A. The conduction velocity of their axons is between 0.5 and 2 m/sec.
B. They are activated by lowered pH in areas of injury
C. Their threshold for responding to heating of the receptive field is near 45oC.
D. A and C, not B
* E. A, B, and C
3. Which of the following statements regarding stellate neurons of the cerebral cortex is TRUE?
A. Their cell bodies are located primarily in cortical layer 5.
B. Their axons project to the thalamus.
C. Their axons project to the spinal cord.
D. A and C
* E. none of the above
4. Neuronal cell bodies in the lateral half of the ventral posterior lateral nucleus (VPL) of thalamus on the RIGHT side of the brain are
part of the pathway that underlies which of the following?
A. pain originating from the right face
B. temperature sensation on the left arm
C. 2-point discrimination on the left face
* D. joint position sense on the left leg
E. vibratory sense on the right leg
5. A spinal injury that cuts all axons on the RIGHT side of the cord (Brown-Sequard Syndrome) in spinal segment T3 will cause
which of the following symptoms?
A. analgesia on the right hand
B. two point discrimination deficit on the left foot
* C. deficit in vibratory sense on the right foot
D. athermia on the right foot
E. proprioceptive deficit of the right fingers
6. Which of the following statements regarding cordotomy (the surgical procedure in which white matter of the spinal cord is cut to
block chronic pain) is TRUE?
* A. The ventral half of the lateral funiculus is cut in a cordotomy.
B. Following a cordotomy, pain sensation returns in about six months because spinothalamic tract axons grow across the injured area
in the spinal cord.
C. Unilateral cordotomies produce analgesia on the ipsilateral side.
D. A and B, not C
E. A, B, and C
7. The following pairs indicate a visceral structure and the somatic area to which pain originating in the visceral structure is most often
referred. Which pairing is INCORRECT?
A. heart - left arm and chest
B. esophagus - chest
C. kidney - lower back
* D. lungs - arms and chest
E. cranial vessels - orbits
8. Which of the following statements accurately describes the phenomenon of second pain?
A. It is produced by activation of nociceptors with myelinated axons.
B. It is most easily distinguished from first pain on the trunk.
* C. It has an aching quality.
D. It has a sharp quality.
E. more than one of the above
9. Trigeminal tractotomy (surgical interruption of the spinal tract of V in the caudal pons) on the LEFT side causes which of the
following?
* A. athermia on the left face
B. analgesia on the right face
C. decreased vibratory sense on the left face
D. decreased 2-point discrimination thresholds on the right arm
E. decreased proprioceptive sense for the muscles of mastication
10. Which of the following statements regarding the spinal nucleus of the trigeminal nerve is FALSE?
A. It receives a prominent input from nociceptors that innervate the ipsilateral face.
B. Its axons project to the contralateral ventral posterior medial nucleus through the ventral trigeminothalamic tract.
*C. Its axons project to the ipsilateral ventral posterior medial nucleus through the dorsal trigeminothalamic tract.
D. It is located in the medulla.
E. It is located medial to the spinal tract of the trigeminal nerve.
11. The forebrain includes which of the following?
A. amygdala
B. superior colliculus
C. temporal cortex
* D. A and C, not B
E. A, B, and C
12. Which of the following statements regarding the dorsal column nuclei is TRUE?
A. The central processes of primary afferent axons with receptors in the T10 dermatome terminate in the cuneate nucleus.
B. The central processes of primary afferent axons with receptors in the T1 dermatome terminate in the gracile nucleus.
C. The axons of neurons in the gracile nucleus ascend in the ipsilateral medial lemniscus.
D. The medial lemniscus terminates primarily in the central lateral nucleus of thalamus.
* E. None of the above is TRUE.
13. A lesion of the cerebral cortex at which of the areas indicated in gray would likely cause a deficit in 2-point discrimination on the
right side of the face near the mouth? ANSWER E
14. Lesions of the ventral posterior lateral nucleus of thalamus can produce a form of "central pain" that is associated with abnormal
somatic sensations. Which of the following is an effective treatment for this form of intense pain?
A. morphine or other types of opiate agonists
B. non-steroidal anti-inflammatory agents
C. trigeminal tractotomy
* D. antiepileptic compounds
E. cordotomy
15. The pairs below indicate a dorsal root ganglion and the area of the body that it supplies with sensory receptors. Which pair is
INCORRECT?
* A. C1 - top of head
B. C7 - hand
C. L1 - inguinal area
D. L4 - foot
E. S3 - buttocks
16. The diagram at right is a schematic representation of a posterior view of T2-C3 spinal segments. The black box indicates the area
of a bilateral lesion produced by syringomyelia in which all axons have been cut. The lesion extends from caudal C8 through rostral
C5 and involves the anterior white commissure completely throughout the extent of the lesion. Which of the following symptoms
would the patient most likely present?
A. 2-point discrimination deficit on the hands
* B. analgesia on the hands
C. athermia on the abdomen
D. lack of sensation of vibration on the feet
E. a bilateral band of analgesia centered at the level of the nipples
17. Which of the following neocortical areas has poorly developed granular layers and is classified as agranular cortex?
A. primary somatic sensory cortex
* B. primary motor cortex
C. hippocampus
D. Brodmann's area 17
E. more than one of the above
18. The voltage sensor of voltage-gated ion channels is formed by
A. the P region of the channel.
B. sugar groups attached to extracellular regions of the channel.
C. phosphorylation sites on cytoplasmic regions of the channel.
* D. a positively charged trans-membrane domain of the channel.
E. a negatively charged trans-membrane domain of the channel.
19. From a functional standpoint, Na+ channel inactivation is important because
* A. it allows a neuron to hyperpolarize once the peak of the action potential has been reached.
B. it allows a neuron to depolarize rapidly during the rising phase of the action potential.
C. it contributes to the stretch-sensitivity of Na+ channels.
D. A and B, not C
E. A, B, and C
20. On the planet Klingon, neurons at rest are permeable to both K+ and Na+, due to the presence of voltage-independent (leakage)
K+ and Na+ channels. Assume the following ion concentrations: K+ inside, 100 mM; K+ outside, 10 mM; Na+ inside 10 mM; Na+
outside 100 mM. Assume that the permeability of single K+ and Na+ channels are equal. If five times as many K+ channels as Na+
channels are open, the membrane potential of Klingon neurons will be approximately
A. -58 mV.
* B. -31 mV.
C. 0 mV.
D. +31 mV.
E. +58 mV.
21. The primary factor that controls the resting membrane potential of neurons on earth is
A. Na+ channels are inactivated at rest.
B. low voltage-activated Ca2+ channels are open at rest.
* C. leakage K+ channels are open at rest.
D. Cl- channels are open at rest.
22. Which of the following statements concerning neurons is TRUE?
A. Ligand-gated receptors are located primarily on axon terminals.
B. Voltage-gated Na+ channels are located primarily on neuronal dendrites.
* C. Voltage-gated Na+ channels are located primarily on the axon.
D. AMPA-glutamate receptors are located primarily at nodes of Ranvier.
E. none of the above
23. If the number of open ion channels in a dendrite DECREASES, the membrane length constant will
A. be shorter.
B. remain the same.
* C. be longer.
24. The presence of external Ca2+ is essential for chemical synaptic transmission because
A. Ca2+ is needed to activate ligand-gated receptors on the postsynaptic membrane.
* B. Ca2+ influx into the presynaptic terminal is needed for the release of neurotransmitter.
C. Ca2+ influx is required to depolarize the presynaptic terminal.
D. A and B
E. none of the above
25. Following the arrival of an action potential at the presynaptic terminal of a fast excitatory chemical synapse, the postsynaptic
membrane (at the synapse) will depolarize after a delay of approximately
* A. 1 millisecond
B. 10 millisecond
C. 100 millisecond
D. 1 second
E. a couple of years
26. Sensory systems are more sensitive in detecting variations in stimulus intensity rather than in detecting the absolute intensity of a
stimulus. Which of the following cellular mechanisms is most responsible for this greater sensitivity to changing stimuli?
A. convergent inputs onto cortical neurons
B. the inactivation of Na+ channels in the primary afferent axons
* C. adaptation in sensory receptor cells
D. the activation of K+ channels in thalamic cells
E. release of NO onto cortical neurons
27. In patients with synesthesia
A. the relative weights of objects are sometimes confused.
b. mapping of the visual world onto the superior colliculus is disrupted.
C. sensory adaptation is poorly developed.
* D. stimuli in one sensory modality sometimes evoke perceptions in another modality.
E. sensitivity to auditory stimuli is reduced.
28. Which ionotropic receptor is highly permeable to calcium ions?
A. GABAA receptor
B. AMPA receptor
* C. NMDA receptor
D. B and C
E. none of the above
29. Tyrosine is NOT a precursor for synthesis of
A. norepinephrine.
B. dopamine.
* C. serotonin.
D. L-DOPA.
E. epinephrine.
30. Which type of neuron expresses dopamine-beta-hydroxylase?
A. serotoninergic
B. dopaminergic
C. cholinergic
D. glutamatergic
* E. none of the above
31. Which of the following is the main mechanism of inactivation of nitric oxide?
* A. spontaneous decay
B. nitric oxide synthases
C. nitric oxide transporters
D. calcium influx
E. none of the above
32. Which of the following statements regarding the NMDA receptor is FALSE?
A. The glutamate binding site is part of the receptor.
B. It has a cation selective ion pore.
C. It generates fast EPSPs in many synapses.
* D. It is blocked by calcium ions at hyperpolarized membrane potentials.
33. Which of the following is not an ionotropic receptor?
* A. GABA-B receptor
B. NMDA receptor
C. glycine receptor
D. nicotinic acetylcholine receptor
E. AMPA receptor
34. Which area of the retina is more sensitive for detection of a faint, distant star in the night sky?
A. fovea
B. optic disc
* C. peripheral retina
D. macula
E. none of the above
35. Light stimulation in rods and cones evokes graded hyperpolarization by
A. opening of potassium channels.
B. opening of chloride channels.
C. closing of potassium channels.
* D. closing of sodium channels.
E. none of the above
36. A lesion at which of the locations in the visual system (designated with a letter in the figure at right) would cause a left superior
homonymous quadrantanopsia? ANSWER D
37. A patient displays visual deficits in the entire left visual field for both eyes. Damage in which area (designated with a letter in the
figure at right) would cause these symptoms? ANSWER C
38. Which of the following statements regarding the primary visual cortex is FALSE?
A. It has a columnar organization.
B. It contains ocular dominance columns.
C. It receives inputs from the lateral geniculate nucleus.
* D. Its cells respond only to circular spots of light.
E. Its cells can respond to visual inputs from both eyes.
39. Lesions in the parvocellular layers of the lateral geniculate nucleus would impair
A. color vision.
B. visual acuity.
C. motion perception.
* D. A and B
E. B and C
40. The pigment epithelium is critical for vision because it promotes the
A. synthesis of phosphodiesterase.
* B. recycling of bleached photopigment.
C. regeneration of transducins.
D. recycling of cGMP.
E. none of the above
41. Which of the following types of neurons responds best to a moving bar of light in its receptive field?
A. ganglion cells in the fovea
B. parvocellular cells in the lateral geniculate nucleus
* C. cells in layer V and VI of the striate cortex
D. bipolar cells in the retina
E. magnocellular cells in the lateral geniculate nucleus
42. Hyperopia can be corrected by a set of (BOOK)
* A. convex lenses.
B. concave lenses.
C. biconcave lenses.
D. none of the above
43. The transduction of sound pressure changes into receptor potentials by cochlear hair cells is dependent on the distribution of
potassium ions in the cochlea. Which of the following best describes the relative concentrations of K+ in various compartments of the
cochlea?
* A. endolymph > hair cell cytoplasm > perilymph
B. hair cell cytoplasm > endolymph > perilymph
C. endolymph > perilymph > hair cell cytoplasm
D. perilymph > hair cell cytoplasm > endolymph
E. hair cell cytoplasm > perilymph > endolymph
44. Which of the following statements about the middle ear and inner ear is FALSE?
* A. Scalae containing endolymph and perilymph merge at the helicotrema.
B. The stapes contacts the oval window.
C. The round window is the interface between the middle ear and the scala tympani.
D. The oval window is the interface between the middle ear and the scala vestibuli.
E. The organ of Corti extends the entire length of the basilar membrane.
45. The structure and mechanical properties of the basilar membrane change along the length of the cochlea. Which of the following
best describes the basilar membrane?
A. narrow near base of cochlea
B. stiff near base of cochlea
C. flexible near apex of cochlea
D. two of the above
* E. A, B, and C.
46. The superior olivary nuclear complex
A. receives input from ventral cochlear nuclei on both sides of the brain.
B. is a source of cochlear efferent axons.
C. is important in sound localization.
D. A and C, not B
* E. A, B and C
47. Three major mechanisms contribute to the selective responsiveness of cochlear hair cells to different frequencies of sound
pressure. Which of the following contributes to frequency selectivity in the cochlea?
A. frequency tuning by the basilar membrane
B. morphological specializations of individual hair cells differ along the length of the cochlea
C. participation of outer hair cells in the cochlear amplifier
D. two of the above
* E. A, B, and C
48. The Rinne's test of auditory function begins with placement of a vibrating tuning fork to the mastoid process. After sound
perception subsides, the tuning fork (while it continues to vibrate) is placed in the air, near the external ear. If a subject reports
perception of sound from the mastoid placement, but not from the outer ear, a hearing disorder should be suspected. In such a
situation, hearing loss would most likely involve damage to the (BOOK)
A. cochlea.
B. auditory nerve.
* C. middle ear.
D. cochlear nuclei.
E. spiral ganglion.
49. Which of the following statements about the olfactory system is TRUE?
A. G-protein couple receptors for odorants are located on olfactory cilia.
B. Each glomerulus in the olfactory bulb contains the dendrites of many mitral cells.
C. Neo-cortical olfactory representation is in the orbitofrontal cortex.
* D. two of the above
E. A, B, and C are TRUE.
50. Which of the following statements about the gustatory system is FALSE?
* A. Gustatory receptor cells are neurons.
B. Gustatory transduction involves G-protein coupled receptors.
C. Gustatory transduction involves direct gating of ionic channels by tastants.
D. Innervation of taste buds is provided by cranial nerves VII, IX, and X.
E. Gustatory afferent fibers travel through the solitary tract.
51. Which of the following statements about chemosensation is FALSE?
A. Chemoreceptors contributing to the common chemical sense are located in the nasal cavity.
B. Neo-cortical representation of gustatory information occurs in insular cortex.
* C. Paleo-cortical representation of gustatory information occurs in entorhinnal cortex.
D. Flavor is a perception resulting from both olfaction and gustation.
E. The olfactory tract consists mostly of axons of mitral cells coming from the olfactory bulb.
52. Which is a symptom of Meniere's Disease?
A. hearing loss
B. vertigo
C. imbalance
D. two of the above
* E. A, B, and C
53. What type of information is carried by afferent fibers from the otolith organs?
A. sound frequency
B. head rotation in any plane
* C. head linear acceleration in any direction
D. constant velocity head rotation
E. none of the above
54. Where are the cell bodies of the afferents from the semicircular canal?
* A. Scarpa's ganglion
B. facial nerve
C. vestibular nucleus
D. cerebellum
E. juxtarestiform body
Quiz 2 Answers
Quiz 2:April 7, 2003
1. Your patient has wild, exaggerated involuntary movements of the left arm and leg. The lesion is most likely in which structure?
A. left globus pallidus interna
B. left dentate nucleus
C. left subthalamic nucleus
D. left substantia nigra compacta
* E. none of the above
2. Which is TRUE concerning the primary motor cortex?
*A. It projects via the corticospinal tract to the dorsal horn, intermediate gray and ventral horn of the spinal cord.
B. Lesions of it result in permanent loss of all contralateral voluntary movements.
C. It receives projections from the prefrontal and striate cortex.
D. It modulates rest tone via projections to the vestibular nucleus.
E. all of the above
3. A subject is asked to make complex movements of the fingers of the right hand that require visual guidance. You would predict
activation in which brain region?
A. left somatosensory cortex
B. left primary motor cortex
C. right cerebellar cortex
D. left posterior parietal cortex
* E. all of the above
4. Long-term depression (LTD) of Purkinje cells can be blocked by
A. metabotropic glutamate receptor antagonists
B. blocking protein kinase C
C. blocking NMDA glutamate receptors
* D. A and B, not C
E. A, B, and C
5. Consider a blindfolded patient on his or her hands and knees on a tilt table. The table is tilted so the patient's head is down. You
expect which of the following vestibulospinal and vestibulocolic reflex reactions
A. extension of legs, flexion of the arms, dorsi-flexion of neck
B. flexion of the legs, extension of the arms and ventri-flexion of the neck
C. extension of the legs, flexion of the arms and ventri-flexion of the neck
* D. flexion of the legs, extension of the arms and dorsi-flexion of the neck
E. extension of the legs, extension of the arms and dorsi-flexion of the neck
6. Which of the following statements is TRUE concerning the spinocerebellum?
A. Primary mossy fiber afferent input is from the pontine nuclei.
B. Purkinje cells in this region of the cerebellar cortex project to the dentate nucleus.
* C. Lesions results in ipsilateral action tremor and limb dysmetria.
D. Output projections are primarily via the vestibular nuclei.
E. It is involved in cognitive aspects of motor coordination.
7. Which of the following symptoms is associated with damage to the facial nerve?
A. lack of salivation (dry mouth)
B. reduced taste sensation on the ipsilateral posterior third of the tongue
* C. deficit in lacrimation in the ipsilateral eye (dry eye)
D. reduced tactile sense on the ipsilateral soft palate
E. weak, raspy voice
8. Cells of the adrenal medulla are derived from the neural crest and function as part of the sympathetic division of the autonomic
nervous system. Which of the following statements about these cells is TRUE?
A. Cells of the adrenal medulla are innervated by pre-ganglionic axons whose cell bodies reside in the interomediolateral cell column
of the spinal cord.
B. Cells of the adrenal medulla function as sympathetic post-ganglionic neurons without axons.
C. The adrenal medulla releases about 20% norepinephrine and 80% epinephrine.
D. B and C only
* E. A, B, and C
9. The detrusor muscle contains
A. many alpha adrenergic receptors.
B. many beta adrenergic receptors.
C. many muscarinic cholinergic receptors.
D. A and C only
* E. B and C only
10. The more complex types of eye movement take longer to initiate. Rank these eye movement systems as simplest (shortest latency)
< intermediate < most complex (longest latency)
A. saccades < optokinetic < VOR (vestibulo-ocular reflex)
B. smooth pursuit < saccades < VOR
* C. VOR < optokinetic < saccades
D. saccades < smooth pursuit < optokinetic
E. none of the above
11. What is the sensory receptor in the monosynaptic stretch reflex?
A. intrafusal fiber
* B. Group Ia muscle spindle
C. Group Ib tendon organ
D. Group II muscle spindle
E. none of the above
12. A physician injects amobarbitol into a left-handed patent's right carotid artery. The patient is asked to raise both arms and count
out loud. As the barbiturate takes effect, the left arm falls and the patient cannot continue to count. What does this suggest? (BOOK)
A. the patient's language specialization is in the left hemisphere
* B. the patient's language specialization is in the right hemisphere
C. the patient has no laterality in cortical specialization
D. the patient is dyslexic
E. more than one of the above
13. The mesolimbic system has been implicated in behavior associated with positive reinforcement and motivation. Which of the
following experimental treatments most likely would enhance the function of the mesolimbic system?
A. lesions in the ventral tegmental area
* B. administration of l-dopa
C. stimulation of the locus coeruleus
D. administration of a dopamine receptor antagonist
E. none of the above
14. A patient displays oral tendencies, hypersexuality and visual agnosia. A brain MRI most likely would show damage or
degeneration in the
A. hippocampus.
*B. amygdala.
C. mamillary nuclei.
D. septal nuclei.
E. prefrontal cortex.
Quiz 2-2004
1. A tumor that severs the right oculomotor nerve will cause which of the following symptoms?
A. When the patient says “aahhhh”, his/her palate and uvula will deviate to the left.
B. The right eye of the patient will be deviated medially at rest.
C. The patient’s right pupil will be constricted.
D. The patient will be unable to depress his/her right eye when it is deviated nasally.
* E. none of the above
2. Which of the following statements regarding the glossopharyngeal nerve is FALSE?
A. It carries taste information from the posterior third of the tongue.
B. It carries somatic sensory information from the palate and the posterior third of the tongue.
C. The parasympathetic component of c.n. IX controls output of the parotid gland.
*D. Information originating in the baroreceptors of the aortic arch travel in it.
E. Fibers originating in nucleus ambiguous travel to the stylopharyngeus muscle through it.
3. OMITTED
4. Tilting the head down on a tilt-board would result in which of the following?
* A. activation of vestibulospinal reflexes that produce extension of the arms
B. activation of vestibulospinal reflexes that dorsiflex the neck
C. flexion of the legs via the medial vestibulospinal tract
D. ventriflexion of the neck via the medial vestibulospinal tract
E. none of the above
5. Which of the following statements regarding the circuitry of the basal ganglia is TRUE?
A. Corticostriatal projections from the primary motor cortex terminate primarily in the caudate nucleus.
B. Aspiny neurons in the striatum project to the external segment of the globus pallidus.
C. The subthalamic nucleus projection to the internal segment of the globus pallidus is GABAergic.
* D. The main output projections from the basal ganglia are from the pars reticulata of the substantia nigra and the internal segment of the
globus pallidus.
E. none of the above
6. Which of the following occurs during Parkinson’s Disease?
A. increased firing of neurons in the external segment of the globus pallidus
* B. increased firing of neurons in the internal segment of the globus pallidus
C. increased firing of neurons in the motor thalamus
D. decreased firing of neurons in the subthalamic nucleus
E. all of the above
7. Which of the following statements regarding cerebellar circuitry and its connections is TRUE?
A. Purkinje cells are the sole output of the cerebellar cortex.
B. Parallel fibers are the axons of granule cells.
C. Mossy fiber projections arise from the spinal cord, medulla and pons.
D. The dentate nucleus projects to the ventral lateral and ventral anterior nucleus of the thalamus.
* E. all of the above
8. Concerning the major subdivisions of the cerebellum, which of the following is TRUE?
A. Purkinje cells in the spinocerebellum project to the globus and dentate nuclei.
* B. Lesions of the spinocerebellulm result in dysmetria and action tremor.
C. Lesions of the cerebrocerebellum result in involuntary movements.
D. The cerebrocerebellum receives projections from the dorsal spinocerebellar tract.
E. none of the above
9. The upper motor neuron syndrome includes
A. hypotonia, paresis and rest tremor.
B. increased tone, paresis and involuntary movements.
* C. increased tone, paresis and increased stretch reflexes.
D. dystonia, paresis and bradykinesia.
E. none of the above
10. Which of the following statements regarding motor areas of the cerebral cortex is TRUE?
A. All are in the frontal lobe.
B. All are agranular cortex.
C. All send projections to the spinal cord.
D. All receive projections from the posterior parietal cortex.
* E. all of the above
11. Which is of the following statements regarding the premotor cortex is TRUE?
* A. It plays an important role in producing movements guided by external stimuli.
B. Lesions of it result in loss of independent control of the hands.
C. Neurons within it fire primarily during movements.
D. Stimulation of it produces movements restricted to single joints.
E. all of the above
12. Which of the following will be active immediately before and during complex movements of the fingers of the right hand?
A. left primary motor cortex
B. left somatic sensory cortex
C. right supplementary motor area
D. left supplementary motor area
* E. all of the above
13. Which of the following statements related to autonomic ganglionic neurotransmission is TRUE?
A. Sympathetic pre-ganglionic neurons synthesize and release acetylcholine.
B. Parasympathetic pre-ganglionic neurons synthesize and release acetylcholine.
C. Autonomic post-ganglionic neurons contain predominantly nicotinic cholinergic receptors.
D. A and B only.
* E. A, B, and C.
14. The cell bodies of all autonomic pre-ganglionic neurons reside within the central nervous system. Which of the following areas would
NOT contain parasympathetic pre-ganglionic cell bodies?
A. Nucleus Ambiguus
* B. Intermediolateral Cell Column
C. Dorsal Motor Nucleus of Cranial Nerve X
D. Edinger-Westphal nucleus
E. Sacral Parasympathetic Nucleus
15. Atropine, a muscarinic cholinergic receptor antagonist, is the major pharmacological agent contained in extracts of the belladonna plant.
What would most likely result from application of atropine directly to the eye?
A. pupillary dilation
B. relaxation of the ciliary muscle
C. flattening of the ocular lens
D. A and B only
* E. A, B, and C
16. The internal sphincter muscle is a ring of smooth muscle within the neck of the bladder. When constricted, this sphincter contributes to
urinary bladder continence. Which of the following neurotransmitter receptors predominates in the internal sphincter muscle?
* A. alpha adrenergic receptors
B. beta adrenergic receptors
C. nicotinic cholinergic receptors
D. muscarinic cholinergic receptors
E. GABA receptors
17. What is the cupula?
A. a bed of hair cells in the canal system
B. a bed of hair cells in the otolith system
* C. a highly vascular membrane
D. a membrane containing the otoliths
E. a fluid that contains a high concentration of K+
18. Symptoms of Meniere’s Disease include
A. hearing loss.
B. vertigo.
C. imbalance.
D. nausea.
* E. all of the above.
19. What is it called when slow eye movements in one direction are periodically accompanied by very fast eye movements in the opposite
direction?
A. the vestibulo-ocular reflex
B. smooth pursuit eye movements
C. vergence
* D. nystagmus
E. none of the above
20. When your patient attempts to maintain fixation, his eyes drift upward. You suspect a lesion in the
A. frontal eye fields.
* B. midbrain.
C. pons.
D. medulla.
E. none of the above
21. Ventral roots contain
* A. the axons of motoneurons.
B. group Ia muscle spindles afferents.
C. group II muscle spindles afferents.
D. group Ib tendon organ afferents.
E. B, C, and D only
22. What is the function of the propriospinal tract? (BOOK)
A. to carry proprioceptive input to the thalamus
B. to carry proprioceptive input to nucleus gracilis and nucleus cuneatus
* C. to carry proprioceptive input from one spinal level to another
D. to carry gamma efferent axons from the spinal cord to the proprioceptors
E. more than one of the above
23. The mesolimbic system has been implicated in behavior associated with positive reinforcement or reward. Which of the following
treatments most likely would increase the function of the mesolimbic system?
A. administration of benzodiazepines
B. stimulation of the substantia nigra
C. administration of a dopamine receptor antagonist
D. stimulation of the locus coeruleus
* E. administration of amphetamines
24. The neural pathway from the hypothalamus to the brainstem and spinal cord that coordinates the activity of the autonomic nervous
system is
A. the stria terminalis
* B. the dorsal longitudinal fasciculus
C. the stria medullaris thalami
D. the fornix
E. the mammilothalamic tract
25. Which of the following is a symptom of Korsakoff's Syndrome?
* A. confabulation
B. hypersexuality
C. oral tendencies
D. A and B only
E. A, B and C
26. Based on the "monoamine hypothesis" of depression, a patient diagnosed with depression would benefit from treatment with a
A. monoamine oxidase inhibitor.
B. serotonin uptake inhibitor.
C. adrenergic receptor antagonist.
* D. A and B only
E. A, B and C
27. Trauma to the head that severs the pituitary stalk most likely would result in
A. decreased prolactin and growth hormone.
B. increased vasopressin and ACTH.
C. increased fluid retention by the kidney.
* D. loss of the milk-ejection reflex.
E. loss of balance
28. Which of the following statements concerning hypothalamic control of pituitary function is TRUE?
A. Magnocellular neurons that project to the posterior pituitary synthesize releasing factors like corticotropin-releasing hormone.
B. Parvocellular neurons that project to the median eminence control secretion of oxytocin from the posterior pituitary.
C. Blocking the hypophysial portal vessels will reduce secretion of all anterior pituitary hormones.
D. Stressful stimuli will result in increased secretion of all anterior pituitary hormones.
*E. Growth hormone is the only anterior pituitary hormone regulated by an excitatory and inhibitory releasing hormone.
Final Exam Answers
Medical Neuroscience (NSC 6-111); May 5, 2003
1. Voltage-gated Na+ channels inactivate within 1 msec after the cell membrane potential is depolarized. RECOVERY of Na+
channels from inactivation occurs
A. after an additional 1 to 3 msec, even when the cell membrane potential remains depolarized.
*B. 1 to 3 msec after the cell membrane potential has been hyperpolarized back to near the resting membrane potential.
C. 50 to 100 msec after the cell membrane potential has been hyperpolarized back to near the resting membrane potential.
D. after Na+ ions stop flowing through the channel.
2. On the planet Endive, animals have evolved a unique nervous system. Neurons in these animals are exclusively permeable to Na+ at
their normal resting membrane potential. In these animals, there is a 10-fold higher Na+ concentration outside the cell than there is
inside. The resting membrane potential of these cells will be approximately
A. -58 mV.
B. -29 mV.
C. 0 mV.
D. +29 mV.
* E. +58 mV.
3. Temporal summation of synaptic potentials in a dendrite will be reduced if
A. the membrane resistance is increased.
* B. the membrane resistance is decreased.
C. the diameter of the dendrite is increased.
D. A and C only.
E. B and C only.
4. A miniature endplate potential (MEPP) is generated by
A. one molecule of acetylcholine released into the synaptic cleft.
* B. the acetylcholine contained in one synaptic vesicle released into the synaptic cleft.
C. the acetylcholine contained in approximately 150 synaptic vesicles released into the synaptic cleft.
D. an action potential arriving at the endplate.
E. none of the above.
5. In sensory neurons that adapt to stimuli, the phasic (dynamic) phase of the response is proportional to
A. the amplitude of the stimulus.
* B. the rate of change of the stimulus.
C. the duration of the stimulus.
D. the location of the stimulus in space.
6. Which of the following responses can be evoked in glial cells when they are activated by neurotransmitters released from neurons?
A. generation of action potentials in glial cells
B. increased intracellular glial Ca2+ concentration
C. release of glutamate from glial cells
* D. B and C only
E. A, B and C
7. The two major types of macro glial cells in the CNS are
A. Schwann cells and astrocytes.
* B. oligodendrocytes and astrocytes.
C. Schwann cells and oligodendrocytes.
D. oligodendrocytes and microglial cells.
E. none of the above.
8. Astrocytes contribute to neuronal metabolism in several ways, including
A. storing glucose in the form of glycogen granules.
B. converting glucose to lactate, which is transported to neurons.
C. converting glucose to ATP, which is transported to neurons.
* D. both A and B.
E. both A and C.
9. Which of the following types of primary afferent receptors would be strongly activated by an increase in skin temperature within its
receptive field from 30oC to 49oC?
* A. C polymodal nociceptors
B. warming receptors
C. A mechanoheat nociceptors
D. Slowly Adapting type I receptors
E. none of the above
10. The patient illustrated at right has a hemiparesis on the right side affecting both the arm and leg. He also has diplopia, ptosis of the
left eyelid, his left eye is deviated down and out, and his left pupil is enlarged. Which of the following is the most likely cause of these
symptoms?
A. an obstruction of the anterior spinal artery that destroys the corticospinal tract in the right spinal cord
B. a stroke of the left middle cerebral artery affecting the precentral gyrus
C. a stroke of the right posterior cerebral artery affecting the thalamus and internal capsule
D. a stroke in the caudal pons due to a blockage in the right circumferential branches of the basilar artery.
*E. a tumor affecting the left cerebral peduncle and oculomotor nerve.
11. Which of the following symptoms would you expect to find in the same patient in the right leg and foot?
A. Babinski response
B. muscle weakness
C. increased monosynaptic stretch reflexes (e.g. patella tendon tap)
D. increased muscle tone
* E. all of the above
12 . Which of the following statements regarding the spinothalamic tract is TRUE?
A. Cell bodies at the origin of it are located in the marginal zone of the spinal cord.
B. It terminates in the ventral posterior lateral thalamic nucleus.
C. It terminates in the central lateral thalamic nucleus.
D. Its axons ascend in the ventral lateral funiculus contralateral to the cell bodies of origin.
* E. all of the above
13. Which of the following cortical layers contains the majority of cells that give rise to axons that project in the corticospinal tract?
A. external granular (layer II)
B. external pyramidal (layer II)
C. internal granular (layer IV)
* D. internal pyramidal (layer V)
E. fusiform (layer VI)
14. A lesion of the gray matter of cerebral cortex at which of the areas indicated in gray would likely cause a deficit in vibration sense
on the right leg? ANSWER A
15 . A lesion of the gray matter of cerebral cortex at which of the areas indicated in gray would likely cause an upper motor neuron
syndrome involving the right arm? ANSWER B
16. Which of the following symptoms would be seen in a patient who has Horner's Syndrome on the right side?
A. dilated right pupil, even in bright light
B. no tears formed in the right eye
* C. slight ptosis of the right eyelid
D. A and B only
E. A, B, and C
17. The drawings at right illustrate the eyes of a patient you see in the ER. The top pair illustrates her eyes as she as looking at you in
front of her. The bottom pair illustrates her eyes after you ask her to open her left eyelid, which she does fully. Her pupils are normally
reactive to light and bilaterally symmetrical. Her left eye is deviated medially and she can not move it laterally beyond the midline. A
lesion on the left side in which of the following cranial nerves would cause these symptoms?
A. II
B. III
C. IV
* D. VI
E. VII
18. Which of the following cranial nerves contain chemoreceptors and baroreceptors (General Visceral Afferent) fibers that travel in
the solitary tract and terminate in the solitary nucleus?
A. VII
B. IX
C. X
* D. B and C only
E. A, B, and C
19. Which of the following statements correctly describes neurons in the spinal nucleus of the trigeminal nerve?
A. They receive inputs from axons descending in the spinal tract of V.
B. They receive a large input from nociceptors innervating the ipsilateral face and anterior two-thirds of the tongue.
C. They receive input from nociceptors innervating the posterior third of the tongue through the glossopharnygeal nerve.
D. A and B only
* E. A, B, and C
20. There are how many thoracic spinal segments in humans?
A. 5
B. 8
C. 10
D. 11
* E. 12
21. Which of the following symptoms would be characteristic of a lesion involving lower motor neurons?
A. Babinski response
B. increased monosynaptic stretch (e.g. patella tendon) reflexes
* C. fasciculations in the affected muscles
D. increased tone
E. none of the above
22. Which of the following symptoms would you expect to see in a patient who has an afferent defect in the swinging flashlight test of
pupillary constriction?
A. reduced constriction of the pupil in the affected eye when the light is flashed in the unaffected eye
* B. reduced constriction in the unaffected eye when the light is flashed in the affected eye
C. normal constriction in the affected eye when the light is flashed in the affected eye
D. normal constriction in the unaffected eye when the light is flashed in the affected eye
E. more than one of the above
23. An obstruction at the rostral end of the basilar artery that blocks flow into both posterior cerebral arteries would be expected to
cause which of the following symptoms?
A. memory disturbances
B. sleepiness
C. visual hallucinations
D. blindness
* E. all of the above
24. Prolonged constant firing of semicircular canal afferents would produce which sensation?
A. that you are walking along a flat surface, with sparse visual cues
B. that you are moving with constant linear acceleration
C. that your head is tilted with respect to gravity
* D. that your head is spinning around and around
E. more than one of the above
25. What is nystagmus?
A. the slow phase of the vestibulo-ocular reflex
B. the fast phase of the vestibulo-ocular reflex
C. the slow phase of the optikinetic reflex
D. the fast phase of the optokinetic reflex
* E. the slow and fast phases of a back and forth eye movement
26. Regarding the motoneuronal discharge for saccades, which statement is FALSE?
A. The axons of the various motoneurons run in three different cranial nerves.
B. The phasic burst may be produced by input from premotor areas in the pons or the midbrain.
C. The sustained (tonic) activity may be produced by input from premotor areas in the pons or the midbrain.
* D. The duration of the tonic activity determines the size of the saccade.
E. Tonic activity holds the eye in the final position in the orbit.
27. Regarding the Golgi tendon organs, which statement is TRUE?
A. They contain group Ib afferents.
B. They contain group II afferents.
C. Each is in series with a small number of muscle fibers.
D. Each is in series with most of the fibers of a given muscle.
* E. more than one of the above
28. When people are not able to use proprioception at the ankle for the control of standing posture, they can instead rely on
A. auditory input.
B. vestibular input.
C. visual input.
* D. more than one of the above.
E. none of the above.
29. Language learning
A. involves grouping similar sounds into categories.
B. is implemented in developing cortex using a Hebbian learning rule.
C. has a critical period.
D. can be facilitated by playing slowed recordings of speech sounds.
* E. more than one of the above
30. A stroke patient speaks fluently but has trouble reading, understanding speech and producing meaningful written paragraphs. You
suspect a lesion in
A. Broca's area.
* B. Wernicke's area.
C. Inferior temporal cortex.
D. all of the above.
E. none of the above.
31. You neighbor calls you over to his backyard where his 10 year old is lying awake on the yard after being hit in the left side of the
face with a baseball bat. He has a left facial droop and the dad is worried he has had a brain injury. On the way to the ER what finding
would you look for that would most reassure you that the facial droop was caused by an injury in the peripheral nervous system and
not by a brain injury?
A. a dilated pupil
* B. weakness of left brow and left lower face
C. sleepiness and confusion
D. left arm and leg weakness
E. internuclear ophthalmoplegia
32. Which of the following symptoms would you expect to see in a patient with a lesion of the right hypoglossal nerve?
*A. When asked to stick the tongue straight out, the tongue deviates to the patient's right.
B. tongue atrophied on the left
C. increased tone on the right side of the tongue
D. Horner's syndrome on the right
E. fasciculations in the left side of the tongue
33. The primary causes of hydrocephalus include
A. blockage of flow.
B. increased production of CSF.
C. increased absorption of CSF.
* D. A and B only.
E. A, B and C.
34. Which of the following is FALSE concerning the blood brain barrier?
A. Glucose crosses the blood brain barrier using a concentration dependent, passive transport system.
B. Many addictive compounds are highly permeable.
* C. All areas of the CNS have a blood brain barrier.
D. Anatomical barrier is due to tight junctions between brain capillaries.
E. Tumors usually disrupt the blood brain barrier.
35. Which of the following statements is TRUE?
A. The prefrontal cortex is involved primarily with procedural memory.
* B. Patients with lesions in area 46 have difficulty monitoring events within working memory.
C. The dorsal stream is involved with object recognition.
D. Neurons in the posterior parietal cortex respond to specific faces.
E. none of the above
36. Which is TRUE concerning the inferior temporal cortex?
A. Cells have a retinotopic organization.
* B. Lesions produce visual agnosia.
C. Responses of the neurons are dependent on lighting and object size.
D. It lacks connections with limbic structures.
E. all of the above
37. Which is TRUE of the Balint syndrome?
A. It is due to lesion in the posterior parietal lobe.
B. It is associated with hemispatial neglect.
C. It is characterized by inaccuracy in reaching for visual targets.
D. It is characterized by an inability to see multiple objects simultaneously.
* E. all of the above
38. The major factor controlling permeability of a substance across the blood-brain-barrier is its
A. size.
*B. oil-water partition coefficient.
C. molecular weight.
D. none of the above
39. Long-term depression (LTD) of Purkinje cells can be prevented by
A. blocking protein kinase C.
B. blocking metabotropic glutamate receptors.
C. blocking NMDA receptors.
* D. A and B only.
E. A, B and C.
40. Long-term potentiation (LTP) of excitatory synaptic inputs to CA1 pyramidal neurons can be blocked by
A. NMDA agonists.
* B. non-NMDA antagonists.
C. drugs that depolarize CA1 pyramidal neurons.
D. blocking metabotropic GABA receptors.
E. none of the above.
41. Which of the following is TRUE concerning memory and memory systems?
A. Procedural memory is relatively long.
B. High concentrations of epinephrine interfere with memory formation.
C. Alzheimer's disease results in retrograde amnesia.
D. Opiate antagonists facilitate memory formation.
* E. all of the above
42. Which of the following is TRUE?
* A. The inferior olive receives a major projection from the red nucleus.
B. The spinocerebellum includes the lateral hemispheres.
C. Lesions of the cerebrocerebellum result in a shuffling gait.
D. The emboliform and globus nuclei project to the pontine nuclei.
E. Purkinje cells in the cerebrocerebellum project to the emboliform nucleus.
43. Which is TRUE concerning the primary motor cortex?
A. It projects via the pyramidal tract to motor cranial nerve nuclei.
B. It has a motor homunculus.
C. It projects to the spinal cord via the corticospinal tract.
D. It modulates muscle tone via projections to the pontine and medullary reticular formation.
* E. all of the above
44. Lesions of the premotor cortex produce deficits in
A. proprioception.
B. manipulations requiring both hands.
* C. visually guided reaching involving a complex trajectory.
D. muscle strength.
E. none of the above.
45. Which is TRUE concerning the ventral spinocerebellar tract?
A. It projects to the cerebellum as climbing fibers.
B. Its primary input is from alpha-motorneurons.
C. It provides primarily proprioceptive signals to the cerebellum.
* D. It provides primarily an efference copy signaling the state of the spinal cord circuitry.
E. It terminates primarily in the cerebellar cortex on the side contralateral to the cell bodies from which it originates.
46. Which is TRUE concerning the spiny neurons in the striatum?
A. They receive inputs from the cerebral cortex and globus pallidus.
B. They are the major output neuron of the striatum.
C. GABA/SP containing spiny neurons project to the globus pallidus externa.
* D. A and B only
E. A, B and C
47. Destruction of the substantia nigra, pars compacta, results in which of the following?
* A. decreased firing of neurons in the globus pallidus externa
B. increased firing of neurons in the ventral lateral thalamus
C. decreased firing of the GABA/ENK spiny neurons in the striatum
D. increased firing of the GABA/SP spiny neurons in the striatum
E. none of the above
48. Decerebrate rigidity is characterized by which of the following?
A. decreased firing in the medullary reticulospinal system
B. increased firing in the pontine reticulospinal system
C. increased firing in IA muscle spindle afferents of physiological extensors
D. A. and B only
* E. A, B and C
49. Rotating a cat about the spinal axis to its left side will produce which vestibulospinal reflex actions?
A. flexion of the left limbs
B. extension of the hind limbs
* C. rotation of the head to the right
D. A and B only
E. A, B and C
50. Your patient has an intention (action) tremor and dysmetria of the left arm and leg. The patient also has a widebased, unsteady
gait. You suspect that the lesion is in which of the following?
A. right subthalamic nucleus
B. right primary motor cortex
C. flocculonodular lobe
* D. left vermis and intermediate zones
E. right globus pallidus
51. Your patient has the following neurological signs: 1) loss of control of muscles of facial expression in the lower left face, 2)
weakness, increased muscle tone and increased stretch reflexes in the left arm, and 3) left hand/fingers are clumsy. You suspect a
lesion in which structure?
A. right posterior parietal cortex
* B. right primary motor cortex
C. left spinocerebellum
D. right neostriatum
E. none of the above are TRUE
52. Which of the following statements is FALSE concerning motor cortical areas?
A. Primary motor cortex receives input from joint receptors via the thalamus.
B. Supplementary motor area receives bilateral inputs from the primary motor cortex.
C. Premotor cortex projects to the spinal cord and red nucleus.
* D. Premotor cortex contains Betz cells.
E. Primary motor cortex is agranular cortex.
53. A lesion at which cortical area indicated in gray in the drawing would cause difficulties in repeating sentences without affecting
comprehension? ANSWER: E (also credit for C)
54. An 83-year-old, right-handed woman is brought to the emergency room because her daughter says, "I think she has had a nervous
breakdown". The patient greeted you with a smile and extended her hand when you offered yours. In response to your question about
her health, she responded: "Siggly twap after wapple. I was after exactly the wok but not the tiggle. It was glibbly serious, but not
fatarb. How are you?" Your conversation continued much in the same vein over the next few minutes. She uttered many sounds, some
of which was understandable to you as words, but you could make no sense of it. At a superficial level the patient appeared to
understand you (i.e. she appeared engaged, nodding and shaking her head enthusiastically), yet she did not follow instructions and
frequently queried "what?" She did not cooperate with your instruction to repeat a short sentence. There were no major motor or
sensory deficits, although examination was somewhat difficult because of lack of cooperation. Which of the following is TRUE?
A. The patient has suffered a psychotic break.
B. The patient is confused and a diffuse neurological process (e.g. a toxic exposure) involving the cerebral hemispheres is likely to be
responsible.
C. The behavior reflects a nonfluent aphasia.
*D. A single lesion caudal to the central sulcus on the left is likely to be responsible.
E. The patient speaks only Portuguese.
55. The neural pathway from the hypothalamus to the intermediolateral nucleus of the spinal cord is the
A. mammilo-thalamic tract.
B. fornix.
C. stria medullaris of the thalamus.
D. stria terminalis.
* E. dorsal longitudinal fasciculus.
56. Based on the "dopamine hypothesis" of schizophrenia, individuals with this disorder most likely would benefit by treatment with a
A. serotonin receptor antagonist.
B. NMDA receptor agonist.
* C. dopamine receptor antagonist.
D. dopamine reuptake inhibitor.
E. l-dopa.
57. A patient displays memory loss of information with emotional content and impaired recognition of emotion in facial expressions.
A brain MRI most likely would show damage or degeneration in the
A. mamillary nuclei.
* B. amygdala.
C. hippocampus.
D. septal nuclei.
E. prefrontal cortex.
58. A patient displays anterograde amnesia, disorientation and often responds to questioning with complete fabrication. This triad of
symptoms is associated with a disorder called
A. Kluver-Bucy Syndrome.
* B. Korsakoff's Syndrome.
C. Azheimer's Dementia.
D. Urbach-Weithe Syndrome.
E. Old Age Syndrome.
59. Stimulation of the preoptic area and anterior hypothalamus would initiate a parasympathetic response that would include (Book)
A. decreased heart rate.
B. pupillary constriction.
C. increased intestinal peristalsis.
D. A and B only.
* E. A, B, and C.
60. In order to test pituitary function, a physician injects insulin to produce a stress response consisting of pituitary secretion of
prolactin, adrenocorticotropic hormone and growth hormone. The hypothalamic signals mediating these responses would include
* A. neural secretion of corticotropin-releasing hormone.
B. neural secretion of gonadotropin-releasing hormone.
C. neural secretion of dopamine.
D. A and B only.
E. A, B, and C.
61. A hypothalamic tumor interrupts blood flow in the median eminence but does not alter the function of nerve fibers in the pituitary
stalk. As a result of the tumor, changes in pituitary function would be reflected by
A. decreased oxytocin and growth hormone.
B. increased prolactin and growth hormone.
C. decreased thyroid-stimulating hormone and prolactin.
* D. decreased luteinizing hormone and adrenocorticotropic hormone.
E. none of the above.
62. Head trauma results in complete pituitary stalk section. The symptoms observed would include
A. polydipsia.
B. polyuria.
C. galactorrhea.
D. A and B only.
* E. A, B, and C.
63. Norepinephrine is a peripheral response element that contributes to the regulation of body temperature by
A. increasing cutaneous vasodilation to promote heat loss.
B. decreasing cellular metabolism to reduce heat production.
* C. increasing the activity of uncoupling protein to generate heat.
D. increasing shivering to generate heat.
E. increasing sweating to promote heat loss.
64. Non-steroidal anti-inflammatory drugs (NSAIDS) reduce fever by acting in the anterior hypothalamus to
A. increase the thermoregulatory threshold or set point.
B. increase the firing rate of cold-sensitive neurons.
* C. increase the firing rate of warm-sensitive neurons.
D. increase prostaglandin synthesis.
E. block cytokine receptors.
65. Dehydration induced by water deprivation results in increased secretion of vasopressin and fluid intake. Which of the following
treatments most likely would block drinking after dehydration, but not affect vasopressin secretion?
A. infusion of fluid to offset increases in osmolality
B. lesions in the paraventricular nucleus
C. lesions of the median preoptic nucleus
* D. lesions of the zona incerta
E. both C and D.
66. Short-term signals that most likely would limit meal size include each of the following except
A. nutrient in the oropharyngeal cavity.
B. gastric distention.
C. cholecystokinin (CCK).
* D. nutrient in the stomach.
E. nutrient in the small intestine.
67. Obesity induced by hyperphagia (increased eating) could result from
A. reduced activity of orexin neurons in the lateral hypothalamic area.
B. reduced activity of neuropeptide Y neurons in the arcuate nucleus.
* C. reduced activity of melanocortin neurons in the arcuate nucleus.
D. increased activity of neurons in the ventromedial nucleus of the hypothalamus.
E. increased stimulation of arcuate neurons by leptin.
68. Neurons eventually develop from which of the following cell groups?
*A. ectoderm
B. endoderm
C. mesoderm
D. hypoblast
E. more than one of the above
69. Which of the following brainstem nuclei normally develop from the basal plate of the myelencephalon?
A. oculomotor nucleus
B. spinal trigeminal nucleus
C. nucleus solitarius
*D. hypoglossal nucleus
E. more than one of the above
70. If a mutation resulted in failure of the neural crest to form during early development, which of the following cell groups would you
expect to be completely absent late in development?
A. oligodendrocytes
*B. submandibular ganglion
C. trigeminal motor nucleus
D. deep cerebellar nuclei
E. more than one of the above
71. Neurotrophin activation of Trk receptors on neurons leads to
A. increased activation of certain caspases.
B. increased expression of Nogo-A.
*C. increased expression of certain bcl-2 family members.
D. increased expression of axon growth molecules (e.g. GAP43 & tubulin).
E. more than one of the above.
72. Which of the following cell types would you expect to express the protein Nogo-A?
*A. oligodendrocytes
B. astrocytes
C. dorsal root ganglion neurons
D. lower motor neurons
E. more than one of the above
73. Nerve growth factor (NGF)
A. is expressed by a neuron after its axon is cut.
B. is a neurotrophin receptor.
C. promotes division of certain neurons.
*D. promotes survival of certain neurons.
E. more than one of the above
74. Parkinson's disease is a neurodegenerative disorder produced by selective loss of dopaminergic neurons in the substantia nigra. LDOPA is commonly used to treat Parkinson's disease because
A. it selectively targets the substantia nigra.
* B. it readily crosses the blood-brain barrier.
C. it is converted to dopamine by dopamine beta-hydroxylase.
D. it is not metabolized in the blood stream.
E. none of the above
75. Which pair of items is likely to be located at the postsynaptic membrane in neuromuscular junctions?
A. GABA-A receptor and acetylcholinesterase
* B. acetylcholine receptor and voltage gated sodium channel
C. voltage gated potassium channel and muscarinic receptor
D. acetylcholinesterase and GABA transaminase
E. none of the above
76. A compound that blocks dopamine receptors would have a similar effect to one that
A. stimulates L-dopa synthesis.
B. inhibits epinephrine synthesis.
C. stimulates norepinephrine synthesis.
* D. inhibits dopamine synthesis.
E. none of the above
77. A patient has a left homonymous superior quadrantic anopsia with macular sparing. Which of the following structures is most
likely damaged?
A. right lateral geniculate nucleus
B. striate cortex in the upper bank of the right calcarine sulcus
C. optic radiations in Meyer's loop on the right side
D. optic radiations in Meyer's loop on the left side
* E. striate cortex in the lower bank of the right calcarine sulcus
78. The receptive fields of retinal ganglion cells
* A. are areas in retina where a stimulus elicits changes in a cell's membrane potential.
B. are composed of either ON and OFF areas, but never both.
C. are usually larger near the fovea than in the retinal periphery.
D. are similar to cells in the primary visual cortex.
E. none of the above
79. The greatest amount of refraction occurs when light passes through (BOOK)
A. the lens.
B. the aqueous humor.
*C. the cornea.
D. the pupil.
E. none of the above
80. Transmission of sound pressure waves from air to liquid results in a loss of greater than 90% in acoustic energy. Which of the
following contributes to compensation for this loss in energy?
A. the lever action of the ossicles in the middle ear
B. the large ratio of surface areas of tympanic membrane to oval window
C. the small ratio of surface areas of oval window to round window
* D. A and B only
E. A, B, and C
81. Sound localization is computed in the
A. spiral ganglion
B. dorsal cochlear nucleus
* C. superior olivary nucleus
D. A and C only
E. B and C only
82. Which of the following receives direct projections from mitral cells of the olfactory bulb?
A. anterior olfactory nucleus
B. entorhinal cortex
C. piriform cortex
D. B and C only
* E. A, B, and C
83. Which of the following is important in determining the response of an organ to sympathetic activation?
A. the relative numbers of nicotinic and muscarinic receptors located on the organ
B. the relative amounts of norepinephrine and epinephrine delivered to the organ
C. the relative numbers of alpha and beta receptors located on the organ
D. A and B only
* E. B and C only
84. Cell bodies of sympathetic pre-ganglionic neurons are located in
A. pre-vertebral ganglia.
B. sacral spinal cord.
* C. thoracic spinal cord.
D. para-vertebral ganglia.
E. superior salivatory nucleus.
85. Which of the following is most likely to affect the filling and continence phase of normal bladder function?
* A. interference with normal function of the lumbar spinal cord
B. damage of one or both vagus nerves
C. interference with normal function of the sacral spinal cord
D. A and C only
E. B and C only
86. Normal functioning of the eye during near vision is associated with
A. enhanced activation of parasympathetic autonomic outflow.
B. contraction of the ciliary muscles.
C. pupillary constriction.
D. A and B only
* E. A, B, and C
Final 2004
1. At nearly every level, the various components of our auditory system are specialized to preserve or optimize acoustic frequencies most
relevant to human speech. Which of the following most accurately represents the range of frequencies present in normal human speech?
A. 10 to 500 Hz
B. 200 to 1,000 Hz
* C. 500 to 5,000 Hz
D. 2,000 to 15,000 Hz
E. 10,000 to 20,000 Hz
2. Some auditory nuclei receive information from one ear, and others integrate information from both ears. Which of the following nuclei
receives exclusively monaural auditory afferent information?
A. dorsal cochlear nucleus
B. ventral cochlear nucleus
C. superior olivary nucleus
* D. A and B, not C
E. B and C, not A
3. Which of the following statements about chemosensation is TRUE?
A. Olfactory receptor cells are neurons.
B. Gustatory afferent neurons project to the nucleus of the solitary tract.
C. Olfactory cortex is paleo-cortex receives projections from mitral cells.
D. Only two of the above are TRUE.
* E. A, B, and C
4. Cell bodies of parasympathetic pre-ganglionic neurons are located in
* A. sacral spinal cord.
B. lumbar spinal cord.
C. thoracic spinal cord.
D. A and B, not C
E. B and C, not A
5. A drug that blocks muscarinic cholinergic receptors would interfere with all functions of
A. the sympathetic division of autonomic outflow
* B. the parasympathetic division of autonomic outflow
C. skeletal muscle
D. A and B, not C
E. B and C, not A
6. An extract of the belladonna (beautiful lady) plant was valued by ancient Roman women as a cosmetic agent because when delivered to
the surface of the eyeball, it produced a larger appearing eye (pupillary dilation) and a distant look (far-vision). Considering what you know
about autonomic control of pupillary diameter and lens thickness, what is the most likely mechanism of action of the belladonna extracts?
* A. muscarinic cholinergic receptor antagonist
B. alpha adrenergic receptor antagonist
C. beta adrenergic receptor antagonist
D. A and B, not C
E. B and C, not A
7. A patient suffered severe damage to several lumbar spinal nerves following a motorcycle accident. In addition to a number of sensory and
motor deficits, this person experiences problems with normal bladder function. Which of the following is most likely contributing to bladder
dysfunction?
A. disturbances in the filling phase of bladder function
B. impaired control of internal sphincter muscles
C. impaired control of external sphincter muscles
* D. A and B only
E. A, B, and C
8. From a functional standpoint, Na+ channel inactivation is important because
* A. inactivation allows a neuron to hyperpolarize once the peak of the action potential has been reached.
B. inactivation allows a neuron to depolarize rapidly during the rising phase of the action potential.
C. inactivation contributes to the stretch-sensitivity of Na+ channels.
D. A and B only
E. A, B, and C
9. The primary factor that controls the resting membrane potential of neurons is
A. Na+ channels are inactivated at rest.
B. low voltage-activated Ca2+ channels are open at rest.
* C. leakage K+ channels are open at rest.
D. Cl- channels are open at rest.
10. If the number of open ion channels in a dendrite DECREASES, the membrane length constant will
A. be shorter.
B. remain the same.
* C. be longer.
11. Following the arrival of an action potential at the presynaptic terminal of a fast excitatory chemical synapse, the postsynaptic membrane
(at the synapse) will depolarize after a delay of approximately
* A. 1 millisecond.
B. 10 millisecond.
C. 100 millisecond.
D. 1 second.
E. a couple of years.
12. In patients with synesthesia
A. the relative weights of objects are sometimes confused.
B. mapping of the visual world onto the superior colliculus is disrupted.
C. sensory adaptation is poorly developed.
* D. stimuli in one sensory modality sometimes evoke perceptions in another modality.
E. sensitivity to auditory stimuli is reduced.
13. The three major types of glial cells in the CNS are
A. oligodendrocytes, Schwann cells and astrocyctes.
B. oligodendrocytes, Schwann cells and microglial cells.
C. astrocytes, Schwann cells and microglial cells.
* D. astrocytes, oligodendrocytes and microglial cells.
E. none of the above.
14. Glial cells in the CNS express which of the following membrane proteins?
A. potassium channels
B. glutamate receptors
C. gap junction proteins
* D. A, B, and C
E. none of the above
15. The most important mechanism for removing glutamate from the synaptic cleft after it has been released during synaptic transmission is
A. re-uptake into the presynaptic terminal.
B. uptake into the post-synaptic neuron.
C. enzymatic degradation in the synaptic cleft.
D. uptake into nearby oligodendrocytes.
* E. uptake into nearby astrocyctes.
16. The cell bodies of parasympathetic preganglionic axons are found within all of the following except
A. cranial nerve III.
B. cranial nerve VII.
C. cranial nerve IX.
D. cranial nerve X.
* E. cranial nerve XI.
17. Which of the following receptors has axons that conduct action potentials between 4 and 30 m/sec?
A. slowly adapting type I
B. Ruffini’s Endings
C. Pacinian Corpuscles
* D. cooling afferent fibers
E. Meissner’s Corpuscles
18. Thalamic input to the cortex surrounding the calcarine fissure originates in which of the following?
* A. lateral geniculate nucleus
B. anterior nucleus
C. ventral lateral/ventral anterior nuclei
D. ventral posterior lateral nucleus
E. dorsal medial nucleus
19. The patient illustrated at right has a hemiparesis, hyper-reflexivity and increased tone on his right side affecting both the arm and leg. He
also has diplopia. His left eye is deviated nasally and he can’t move it lateral to the position in which the eye is looking straight forward. His
left eyelid is closed. When asked, he can open it normally. His left pupil responds normally to light. Which of the following is the most likely
cause of these symptoms?
A. an obstruction or occlusion of the anterior spinal artery that destroys the corticospinal tract in the right spinal cord
B. an infarct (stroke) of the left middle cerebral artery affecting the precentral gyrus
C. an infarct of the right posterior cerebral artery affecting the thalamus and internal capsule
*D. an infarct in the caudal pons due to a blockage in the left paramedian and short circumferential branches of the basilar artery.
E. a tumor affecting the left cerebral peduncle and oculomotor nerve.
20. The diagram at right is a representation of a patient’s spinal cord. The gray shading represents the area of a lesion produced by bone
fragments from a cervical fracture. All axons in the lateral funiculus in the left side of C4 have been cut. Which of the following symptoms
would you likely see?
* A. paresis in the left foot
B. paresis in the right hand
C. analgesia on the left foot
D. decreased tactile sense on the left hand
E. more than one of the above
21. A lesion of the spinal tract of the trigeminal nerve in the right pons will cause which of the following symptoms?
A. reduced tactile sensation on the right face
B. analgesia on the left anterior two-thirds of the tongue
C. athermia on the right face
D. reduced corneal blink reflex on the right side
* E. more than one of the above
22. The symptoms produced by damage to cranial nerve III include which of the following?
A. ptosis
B. dilated pupil
C. eye deviated laterally and ventrally
*D. A and B only (will give credit here too)
* E. A, B, and C
23. Which cranial nerve supplies the nociceptive and tactile sensory input for the posterior one-third of the tongue?
A. V
B. VII
* C. IX
D. X
E. XI
24. Which of the following symptoms would most likely be seen as a result of damage to the vagus nerve?
* A. weak, raspy voice
B. when patient says “aahhhh”, the palate deviates toward damaged side
C. inability for food to pass through gastrointestinal tract
D. dry ipsilateral eye
E. more than one of the above
25. Occlusion of the anterior spinal artery in T4 would cause which of the following symptoms?
A. paresis in both legs
B. bilateral Babinski signs
C. increased tendon reflexes in the legs
D. bilateral analgesia in the legs
* E. all of the above
26. Which of the following is a symptom of Horner’s syndrome? (BOOK)
A. miosis
B. ptosis
C. loss of sweating on the face
D. A and B only
* E. A, B, and C
27. A patient has a Wallenberg or Posterior Inferior Cerebellar Artery syndrome in the left brainstem. Which of the following symptoms
would you NOT expect to see?
A. analgesia on the right leg
B. analgesia on the left face
* C. action tremors of the right arm
D. dizziness
E. dysphagia
28. Which of the following symptoms on the face would be helpful in distinguishing damage to the left facial nerve from damage to cortical
areas on the right that give rise to corticobulbar fibers projecting to the facial nucleus (that is, distinguishing a lower from an upper motor
neuron syndrome)?
A. reduced nasal-labial fold on the left
B. inability to elevate left eyebrow
C. fasciculations in muscles of facial expression on the left
D. the corner of the left mouth does not elevate during an attempt to smile
* E. B and C
29. During a neurologic exam, you note that when you shine a light in the patient’s right eye, both pupils constrict symmetrically. When you
shine it in the left eye, neither pupil constricts. Your diagnosis is a problem with the
A. right oculomotor nerve.
B. left oculomotor nerve.
C. right optic nerve.
* D. left optic nerve.
E. none of the above
30. You see a right handed patient in the ER who has severe problems understanding spoken and written language. The patient also has a
right superior quadrantanopsia. Your diagnosis is a stroke affecting
A. the left occipital lobe.
* B. the left temporal lobe.
C. the left lateral geniculate nucleus.
D. left frontal lobe.
E. right parietal lobe.
31. Which of the following symptoms would you expect to see in a patient following occlusion at the rostral (or distal) end of the basilar
artery preventing blood flow through both posterior cerebral arteries?
A. memory disturbances
B. blindness
C. disturbances in touch sensation over the extremities and face bilaterally
D. A and B only
* E. A, B, and C
32. Where does endolymph originate?
A. endolymphatic sac
B. endolymphatic duct
* C. secretory cells in the membranous labyrinth
D. subarachnoid space of the ventricular system
E. arterioles in the bony labyrinth
33. Neurons in the vestibular nucleus
B. receive input from otolith afferents.
C. project to the contralateral vestibular nucleus.
D. project to the trochlear nucleus.
D. project to the spinal cord.
* E. all of the above
34. What is nystagmus?
A. the slow phase of a back and forth eye movement
B. the quick phase of a back and forth eye movement
* C. both phases of a back and forth eye movement
D. a smooth pursuit eye movement
E. none of the above
35. Imagine that a stimulating electrode is implanted in your right superior colliculus. Stimulation would be most likely to produce
A. a smooth pursuit movement to the right.
B. a smooth pursuit movement to the left.
C. a saccade to the right.
* D. a saccade to the left.
E. a horizontal nystagmus.
36. Which stimulus will evoke the highest frequency of action potentials in a primary (Ia) muscle spindle afferent receptor?
* A. a dynamic (transient) stretch of the muscle
B. a tonic (sustained) stretch of the muscle
C. the contraction of a single motor unit
D. the contraction of the entire muscle
37. Which of the following posture platform test results best distinguish between patients with no vestibular input and patients with BPPN
(benign paroxysmal positional nystagmus)?
A. accurate vision and accurate proprioception
B. no vision, but accurate proprioception
* C. inaccurate vision, but accurate proprioception
D. inaccurate vision and inaccurate proprioception
E. none of the above
38. Which morphological abnormality is likely to be present in the brains of dyslexic people?
A. a lack of laterality (enlargement on one side) of the planum temporale
B. abnormal lamination in Broca’s area
C. abnormal lateral geniculate neurons
* D. all of the above
E. none of the above
39. The critical period for language learning refers to which of the following phenomena?
A. Parents emphasize the differences between important vowel sounds when talking to babies.
B. Babies start to babble well before they can form native language words.
* C. Babies gradually loose the ability to distinguish foreign language phonemes from similar native language phonemes.
D. Novel morphemes (e.g., new prefixes and suffixes) are learned more readily by babies than by older children.
E. none of the above
40. A stroke patient forms individual words normally but prefers not to speak or write in full sentences. The patient’s comprehension of both
spoken and written sentences appears to be normal. You should suspect a lesion of
* A. Broca’s area
B. Wernicke’s area
C. Inferior temporal cortex
D. all of the above
E. none of the above
41. A persistent posterior neuropore at birth results in a condition known as
A. cranial agangliogenesis (failure of the cranial sensory ganglia to form).
B. Bell’s sign (facial paralysis).
* C. spina bifida.
D. anencephaly.
E. more than one of the above.
42. The cells at the lateral margin of the neural plate at the level of the future spinal cord will give rise to
A. Schwann cells.
B. neurons of sympathetic ganglia.
C. astrocyctes.
D. cortical pyramidal neurons.
* E. more than one of the above.
43. Which of the following factors are believed to be responsible for the inability of axons to regenerate in the mature central nervous system
(CNS)?
A. glial scar formation
B. axon growth inhibiting molecules associated with myelin
C. slow Wallerian degeneration
D. failure of CNS neurons to reactivate axon growth program
* E. more than one of the above
44. Mutation of a caspase gene that prevents it from functioning normally could
* A. result in an abnormal increase in the number of neurons in the nervous system.
B. allow severed axons to regenerate in the spinal cord.
C. prevent autonomic ganglia from developing.
D. result in spina bifida.
E. more than one of the above.
45. Which of the following functions has been attributed to neurotrophins?
* A. prevent neuron death in the developing nervous system
B. prevent axon regeneration in the mature central nervous system
C. prevent synaptic plasticity associated with learning in the mature nervous system
D. promote cell division in the developing nervous system
E. more than one of the above
46. A 70-year-old man presents to you with the following deficits: right hemiparesis, left facial weakness (including forehead), mildly
slurred speech without language difficulty. Using your knowledge of neuroanatomy and Occam’s razor, localize the lesion(s).
A. one lesion, left cortex
* B. one lesion, left brainstem
C. one lesion, right cortex
D. two lesions, right cortex/left brainstem
E. two lesions, left cortex/right brainstem
47. In response to your greeting (“Hello there, how are you?”), an aphasic woman replies: “Hello there, how are you?” Thereafter, she
struggles but says virtually nothing on her own, although she readily (and eventually exasperatingly) repeats what you say. What type of
aphasia does she have?
A. Broca’s area
B. global
C. Wernicke’s area
D. conduction
* E. none of the above
48. Which type of neuron DOES NOT contain dopamine-beta-hydroxylase?
A. GABAergic
B. dopaminergic
C. cholinergic
D. glutamatergic
* E. more than one above
49. Which of the following is a common way of ending the actions of dopamine in synapses?
* A. reuptake by presynaptic neuron
B. breakdown of receptor molecule
C. uptake by glial cells
D. more than one above
50. Which of the following is a property of the NMDA receptor?
A. It couples to G-proteins.
B. It contains a potassium selective ion pore.
C. It generates fast IPSPs in many synapses.
D. It is blocked by calcium ions at hyperpolarized membrane potentials.
* E. none of the above
51. Which thalamic nucleus receives visual information from the retina?
A. inferior colliculus
* B. lateral geniculate
C. medial geniculate
D. B and C
E. none of the above
52. The photoreceptors make synaptic contact with
A. amacrine and bipolar cells.
* B. horizontal and bipolar cells.
C. ganglion and amacrine cells.
D. ganglion cells directly.
E. B and C
53. Stimulation of rods and cones with light evokes graded hyperpolarization by
A. opening potassium channels.
B. opening chloride channels.
C. closing potassium channels.
* D. closing sodium channels.
E. more than one above
54. Long-term potentiation (LTP) of excitatory synaptic inputs to CA1 pyramidal neurons can be blocked by which of the following?
A. NMDA antagonists
B. non-NMDA antagonists
C. substance P receptor antagonists
* D. A and B only
E. A, B and C
55. Which of the following statements concerning memory and memory systems is FALSE?
A. The hippocampus is primarily involved with declarative memory.
B. Procedural memories tend to last longer than declarative memories.
* C. Opiate agonists augment memory formation.
D. Visual memories are stored in the visual areas of the cerebral cortex.
E. The amygdala is involved with emotive memories.
56. Below the level of the lesion, transection of the spinal cord results in
A. immediate loss of tone and reflexes.
B. immediate loss of all voluntary movement.
C. increase in alpha-motor neuron firing after 1-2 months.
D. increase in gamma-motoneuron firing after 1-2 months.
* E. all of the above
57. Decerebration results in increased stretch reflexes due to
A. hypersensitivity of receptors on alpha-motoneurons.
B. sprouting of IA afferents onto alpha-motoneurons.
* C. release of the medullary reticular formation from excitatory control by the cerebral cortex.
D. A and B only
E. A, B and C
58. The major factor controlling permeability of a substance across the blood brain barrier is its
A. size.
* B. lipid solubility.
C. charge.
D. molecular weight.
E. none of the above
59. A stroke in the right primary motor cortex will result in which of the following?
A. loss of control of muscles of facial expression in the lower right face
B. loss of control of the muscles of facial expression in the left forehead
* C. paresis, increased tone and increased stretch reflexes on the left side of the body
D. paresis, increased tone and increased stretch reflexes on the right side of the body
E. loss of the ability to plan and execute complex reach trajectories
60. Viewed from behind, rotating a cat clockwise about the spinal axis will produce which vestibulospinal reflex actions?
A. extension of the left forelimb and hindlimb
* B. extension of the right forelimb and hindlimb
C. flexion of the right forelimb and hindlimb
D. dorsi-flexion of the neck
E. none of the above
61. Which of the following statements is TRUE?
* A. Prefrontal cortex is involved primarily with working memory.
B. Patients with lesions in area 46 are unable to see multiple objects simultaneously (simultanagnosia).
C. The dorsal stream is involved with object recognition.
D. Neurons in the posterior parietal cortex respond to specific faces.
E. none of the above
62. Which is TRUE concerning the inferior temporal cortex?
A. It lack a retinotopic organization.
B. Lesions of it produce visual agnosia.
C. Responses of the neurons in it are independent of lighting and object size.
D. It has connections with limbic structures.
* E. all of the above
63. Which is TRUE concerning the ventral spinocerebellar tract?
A. projects to the cerebellum as climbing fibers
B. primary input is from alpha-motoneuron axon collaterals
* C. provides the cerebellum an efference copy signaling the state of the spinal circuitry
D. projects primarily to the contralateral cerebellar cortex
E. none of the above
64. Your patient has wild, exaggerated involuntary movements of the right arm and leg. The lesion is most likely in which structure?
A. left globus pallidus interna
B. left dentate nucleus
* C. left subthalamic nucleus
D. left substantia nigra pars compacta
E. none of the above
65. Which of the following statements is FALSE concerning the cerebro-cerebellum?
A. Primary mossy fiber afferent input is from the pontine nuclei.
B. It includes the hemispheres of the cerebellar cortex.
C. Lesions of it result in dysmetria of the finest motor movements.
* D. Its output projections are primarily from the globus and emboliform nuclei.
E. It may be involved in cognitive aspects of motor coordination.
66. Which of the following statements is FALSE concerning Huntington’s Chorea?
* A. It primarily involves the GABA/substance P group of spiny neurons in striatum.
B. The genetic abnormality that underlies it is due to trinucleotide repeats.
C. It causes cell death in both the striatum and cerebral cortex.
D. GABA replacement therapy is not successful.
E. Patients who have it develop both involuntary movements and dementia.
67. Which of the following statements is TRUE of the frontal lobe?
A. Lesions of Area 46 produce deficits in object recognition.
* B. Lesions in the dorsolateral prefrontal cortex produce deficits in monitoring events within working memory.
C. Neurons in the frontal lobe respond primarily during remapping of the visual world.
D. Lesions produce the Balint syndrome.
E. none of the above
68. Which is TRUE concerning the modulators of memory?
A. Epinephrine and norepinephrine affect memory with a sigmoid response function.
B. Opioid antagonists generally impair memory storage.
C. Urbach-Wiethe disease involves loss of procedural memory.
D. Greater levels of glucocorticoids lead to greater memory storage.
* E. none of the above
69. Which of the following statements regarding motor cortical areas is TRUE?
A. Only Area 6 has Betz cells.
* B. Primary motor, premotor and supplementary cortices all send descending projections to the spinal cord.
C. Area 4 includes both the frontal eye fields and the primary cortex.
D. Motor cortical areas are granular cortex.
E. none of the above
70. Lesions of the pyramidal tract at the lower medulla would produce which of the following?
A. Loss of opposition of thumb and index finger.
B. Loss of independent extension of a single finger.
C. Loss of reaching movements.
* D. A and B only
E. A, B, and C
71. Which is TRUE concerning the effects of increasing dopamine levels in the basal ganglia?
A. It decreases the firing of GABA/ENK spiny neurons.
B. It increases the firing of GABA/SP spiny neurons.
C. It decreases the firing of globus pallidus interna neurons.
D. A and B only
* E. A, B, and C
72. Which of the following statements concerning projections from the motor cortical areas is TRUE?
A. Most of the axons arise from Betz cells.
B. The vast majority of axons of the corticospinal tract originate from neurons in the primary motor cortex.
* C. Corticobulbar tract fibers arise from pyramidal cells located in cortical layer 5.
D. All descending axons project through the medullary pyramids.
E. none of the above
73. The neural pathway from the amygdala to the septal nucleus is the
A. mammilo-thalamic tract.
B. fornix.
C. stria medullaris of the thalamus.
* D. stria terminalis.
E. dorsal longitudinal fasciculus.
74. Based on the "monoamine hypothesis" of depression, individuals with this disorder most likely would benefit by treatment with a
* A. norepinephrine reuptake inhibitor.
B. NMDA receptor agonist.
C. dopamine receptor agonist.
D. serotonin receptor antagonist.
E. choline reuptake inhibitor.
75. A patient displays anterograde amnesia and disorientation and often responds to questioning with complete fabrication. A brain MRI
most likely would show damage or degeneration in the
A. amygdala.
* B. mamillary nuclei.
C. hippocampus.
D. septal nuclei.
E. prefrontal cortex.
76. Which of the following disorders results from altered function of the amygdala?
A. Kluver-Bucy Syndrome
B. Urbach-Wiethe Syndrome
C. Post-Traumatic Stress Disorder
D. A and B only
* E. all of the above
77. The light-dark cycle provides important cues for entrainment of circadian rhythms. Which hypothalamic nucleus receives direct retinal
projections and serves as the "master clock" for circadian rhythms? (Book)
A. supraoptic nucleus.
B. retrochiasmatic nucleus.
* C. suprachiasmatic nucleus.
D. median preoptic nucleus.
E. paraventricular nucleus.
78. To assess pituitary function, patients are injected with a mixture of hypothalamic releasing hormones that include corticotropin-releasing
hormone, gonadotropin-releasing hormone and thyrotropin-releasing hormone. A normal pituitary response would include
* A. increased vasopressin and luteinizing hormone, but not oxytocin.
B. increased growth hormone, follicle-stimulating hormone and ACTH.
C. increased ACTH, thyrotropin-stimulating hormone and oxytocin.
D. increased prolactin and vasopressin, but not thyrotropin-stimulating hormone.
E. increased luteinizing hormone, follicle-stimulating hormone and dopamine.
79. Which of the following mechanisms for increasing body temperature is mediated by both norepinephrine and thyroid hormone?
A. increasing cutaneous vasoconstriction to promote heat retention
B. increasing cellular metabolism to generate heat
C. increasing the activity of uncoupling protein to generate heat
* D. B and C only
E. all of the above
80. Inflammatory cells release cytokines like interleukin-1 that act in the hypothalamus to induce hyperthermia or fever. Cytokines induce
fever by
A. decreasing the thermoregulatory threshold or set point.
* B. increasing the firing rate of cold-sensitive neurons in the anterior hypothalamus/preoptic area.
C. increasing the firing rate of warm-sensitive neurons in the anterior hypothalamus/preoptic area.
D. decreasing prostaglandin synthesis.
E. decreasing cyclooxygenase (COX)-2 activity.
81. Dehydration induced by water deprivation results in increased plasma osmolality which stimulates secretion of vasopressin and fluid
ingestion. Which of the following treatments most likely would block vasopressin secretion after dehydration, but not affect drinking?
A. infusion of fluid to offset increases in osmolality
* B. lesions in the supraoptic nucleus
C. lesions of the median preoptic nucleus
D. lesions of the zona incerta
E. B and C
82. Studies examining the role of gastric receptors in mediating meal-induced reduction in food intake showed that
A. neither gastric distention nor nutrient were involved.
B. both gastric distention and nutrient were involved.
* C. only gastric distention was involved.
D. only gastric nutrient was involved.
E. gastric distention reduces the firing rate of vagal afferents.
83. Experimental manipulations of the hypothalamus that would result in hypophagia (decreased food intake) include
A. injecting neuropeptide Y into the paraventricular nucleus.
B. injecting leptin into the arcuate nucleus.
C. stimulating melanocortin neurons projecting from the arcuate nucleus.
* D. both B and C.
E. all of the above
84. Possible pharmacological treatments for obesity produced by hyperphagia (increased eating) would include
A. treatment with a melanocortin receptor antagonist.
* B. treatment with a ghrelin receptor antagonist.
C. treatment with a leptin receptor antagonist.
D. treatment with a neuropeptide Y receptor agonist.
E. treatment with a cholecystokinin receptor antagonist.
85. Which of the following symptoms would you expect to see in a patient who has had a long standing lesion of the left hypoglossal nerve?
A. When asked to stick the tongue straight out, the tongue deviates to the patient’s right.
*B. The tongue is atrophied on the left.
C. There is increased tone on the left side of the tongue.
*D. B and D (OOPS... typo so giving credit here too)
E. A, B, and C
86. You neighbor calls you over to his backyard where his 10 year old is lying awake on the yard after being hit in the left side of the face
with a baseball bat. He has a left facial droop and the dad is worried he has had a brain injury. On the way to the ER what finding would you
look for that would most reassure you that the facial droop was not caused by brain injury?
A. a dilated pupil
* B. weakness of left brow and left lower face
C. sleepiness and confusion
D. left arm and leg weakness
E. internuclear ophthalmoplegia