Exam 2
The ___________ ___________ is a pathway in the brainstem that carries sensory information from the gracile and cuneate nuclei to the thalamus. a. Medial lemniscus b. Reticular formation c. Ponto-medullary junction d. Corpus Quadragemina
a. Medial lemniscus
Decussation in the corticospinal tracts occurs in the _____________ of the _________________________. a. Pyramids: Medulla b. Colliculi: Mid-brain c. Basis: Pons d. Olives: Medulla
a. Pyramids: Medulla
The main function of the ____________ nuclei (circuit) is to release __________ to the rest of the brain to regulate the release of enkephalins to delay pain. a. Raphe: Serotonin b. UMN: Glutamate c. Papez: Ach d. LMN: Dopamine
a. Raphe: Serotonin
Nerves that are characterized as GSA are a. Somatic sensory nerves b. Somatic motor nerves c. Visceral motor nerves d. Visceral afferent nerves
a. Somatic sensory nerves
A lesion of CN-XII would result in deviation of the tongue ___________ the place of the lesion. a. Towards b. Away
a. Towards
CN-VII communicates directly with cranial nerves __________ (CHOOSE ALL THAT APPLY) a. V b. VI c. VIII d. IX e. X f. XI g. XII
a. V c. VIII e. X
The ______________ ______________ is the neural pathway connecting Wernicke's Area to Broca's Area. a. Planum temporal b. Arcuate fasciculus c. Angular gyrus d. Corpus callosum
b. Arcuate fasciculus
Which one of the dorsal column nuclei is responsible for carrying fine touch and proprioception above 'T6'? a. Gracile fasciculus b. Cuneate fasciculus c. Cruz cerebri d. Spinothalamic Fasciculus
b. Cuneate fasciculus
Which one of the dorsal column nuclei is responsible for carrying fine touch and proprioception above 'T6'? a. Gracile nucleus b. Cuneate nucleus c. Cruz cerebri d. Spinothalamic
b. Cuneate nucleus
The ________________ is a sensory pathway of the central nervous system that conveys localized sensations of fine touch, vibration, two-point discrimination, and proprioception (position sense) from the skin and joints. It transmits information from the body to the postcentral gyrus of the cerebral cortex. a. ALS b. DCML c. Analgesic system d. Corticobulbar tract
b. DCML
The anterior regions of the cerebrum receive main blood supply from _________ ________ circulation, while the posterior parts of the brain are supplied by the ____________ system directly from the heart. a. External carotid: venous b. Internal carotid: vertebral-basilar c. External vertebral: Internal Carotid d. Dural venous: cerebral
b. Internal carotid: vertebral-basilar
_________________ is the unconscious perception of movement and spatial orientation arising from stimuli within the body itself. In humans, these stimuli are detected by nerves within the body itself, as well as by the semicircular canals of the inner ear.
b. Proprioception
The right Vagus nerve (CN-X) gives rise to the right (inferior) ___________ ____________ nerve that supplies motor function and sensation to the ____________ except the cricothyroid muscle. a. Superior laryngeal: Larynx b. Recurrent laryngeal: Larynx c. Inferior cardiac: Pharynx d. Recurrent laryngeal: Pharynx
b. Recurrent laryngeal: Larynx
This is a motor nucleus that sends a descending tract to the lower motor neurons. a. Tegmentum b. Red nucleus c. Tectum d. Corpus Quadrigemina
b. Red nucleus
What are the two (2) branches of CN-VIII? a. Vestibular & Mandibular b. Vestibular & Cochlear c. Maxillary & Mandibular d. Mandibular & Cochlear
b. Vestibular & Cochlear
Which two cranial nerves nuclei are located at the cerebellopontine angle (CPA)? a. CN III & CN IV b. CN IV & CN X c. CN VII & CN VIII d. CN IX & CN X
c. CN VII & CN VIII
The ___________is a circulatory anastomosis that supplies blood and creates redundancies or collaterals in brain circulation. a. Communicating arteries b. Basilar artery c. Circle of Willis d. Vertebral-Basilar system
c. Circle of Willis
The __________________________ fiber pathway is a projection path. a. Corpus callosum b. Arcuate fasciculus c. External capsule d. None of the above
c. External capsule
A lesion of which pathway would likely result in muscle weakness on the same side of the lesion. a. Direct activation pathway b. Indirect activation pathway c. Final common pathway d. Cortex
c. Final common pathway
The ________ supplies the most inferior surface of the cerebellum. a. SCA b. AICA c. PICA d. PCA
c. PICA
Extrapyramidal tracts are chiefly found in the ______________ ________________ of the pons and medulla, and target neurons in the spinal cord involved in reflexes, locomotion, complex movements, and postural control. These tracts are in turn modulated by various parts of the central nervous system, including starting at the striatum and progressing through the subthalamic nucleus of the basal ganglia, the cerebellum, the vestibular nuclei, and different sensory areas of the cerebral cortex. a. Tegmentum tecta b. Pontine junction c. Reticular formation d. Red nucleus
c. Reticular formation
The _____________ ____________ runs the entire length of the brainstem and is a gray matter area that is involved in fine-tuning complex behaviors such as chewing, coma, and swallowing. a. Inferior colliculus b. Tegmental baseline c. Reticular formation d. Medial lemniscus
c. Reticular formation
The _________________________ runs the entire length of the brainstem and is a gray matter area that is involved in mediating consciousness. a. Inferior colliculus b. Tegmental baseline c. Reticular formation d. Medial lemniscus
c. Reticular formation
The dorsal column medial lemniscus (DCML) is a pathway that carries _____________ information from the cuneate and gracile nuclei to the thalamus. a. Motor b. Olfactory c. Sensory d. Sub-cortical
c. Sensory
Which cranial nerve branch innervates the cricothyroid muscle? a. Vestibular branch of CN-VIII b. Recurrent laryngeal nerve c. Superior laryngeal nerve d. Stapedial nerve
c. Superior laryngeal nerve
What are the major blood supplies to the brainstem? a. AICA, PICA, SCA b. SCA, PCA, Anterior communicating arteries c. Vertebral arteries, basilar artery, PCAs d. Internal carotid arteries, vertebral arteries, basilar artery
c. Vertebral arteries, basilar artery, PCAs
Muscles of the face, head, and neck are controlled by the _____________ tract signals, which terminate on _________ nuclei within the brainstem.
corticobulbar, cranial nerve
Locked-in syndrome (LIS) is a condition in which a patient is aware but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except for the eyes. This is usually the result of a stroke in what part of the brain? a. Cortex (UMN) b. Thalamus c. Amygdala d. Brainstem e. CN-VIII f. CN-XI g. Diencephalon h. Cerebellum
d. Brainstem
Where is the olfactory bulb and CN-I located in the skull? a. Sella Turcica b. Cavernous sinus c. Petrous bone d. Cribriform plate of ethmoid
d. Cribriform plate of ethmoid
Where does the mandibular branch of the Trigeminal nerve [CN-V3] exit the skull? a. Optic Canal b. Superior Orbital Fissure c. Longitudinal Fissure d. Foramen Ovale e. Foramen Spinosum f. Foramen Rotundum
d. Foramen Ovale
A general decrease in blood flow to the brain that deprives the brain of oxygen is called _________ a. Intracerebral hypoperfusion b. Cortical asphyxia c. Anyeurism d. Hypoxia
d. Hypoxia
The _________ ___________ is an area of white matter that separates the caudate nucleus and thalamus from the lenticular nucleus. It consists of axonal fibers that run between the cerebral cortex and the pyramids of the medulla. a. Globus pallidus b. Putamen c. Caudate nucleus d. Internal capsule
d. Internal capsule
Ultimately, the dural venous sinus receives blood from internal and external veins as well as CSF from the sub-arachnoid space that empties into the _________________________. a. Dura mater b. Venous magnus c. Fourth ventricle d. Jugular vein
d. Jugular vein
A CVA involving which artery is most likely to result in damage to the parietal area of the brain? a. ACA b. AICA c. PCA d. MCA
d. MCA
A CVA involving which artery is mot likely to result in the patient having aphasia? a. ACA b. AICA c. PCA d. MCA
d. MCA
Motor functions of the corticospinal tract decussate in __________ a. Gracile or cuneate nuclei depending on body level b. Reticular formation c. Thalamus d. Pyramids of medulla
d. Pyramids of medulla
An organ or cell that is able to respond to light, heat, or other external stimulus and transmit a signal to a sensory nerve is a _______________. a. Nucleus b. Ganglia c. Affector d. Receptor
d. Receptor
_____________, hyperactive stretch reflexes, and clonus (an oscillatory motor response to muscle stretching) are implicated as symptom of UMN loss. a. Paralysis b. Amputation c. Vertigo d. Spasticity
d. Spasticity
The ___________________ is an ancient and general area within the brainstem, located between the ventricular system and distinctive basal or ventral structures at each level. a. Tectum b. Tentorium c. Tractus d. Tegmentum
d. Tegmentum
Tic Douloureux
Also known as "trigeminal neuralgia" Severe stabbing to ONE SIDE of the face Pain often felt in jaw, cheek, or lip Pain is so intense that it causes a person to wince involuntarily (A.K.A. "tic") Stems from CN-V
BP is measured at a person's upper arm at the _____ artery.
Branchial
Direct activation pathway of the speech motor system consists of fibers of which cranial nerves?
CN-V CN-VII CN-IX CN-X CN-XI CN-XII
The Corticobulbar tract DIRECTLY innervates cranial nerve nuclei for which cranial nerves?
CN-V TRIGEMINAL CN-VII FACIAL CN- XI ACCESSORY CN-XII HYPOGLOSSAL
The direct activation pathway of the speech motor system consists of fibers of which cranial nerves
CN-V, CN-VII, CN-IX, CN-X, CN-XI, CN-XII
nerves involved in the gag reflex?
CN-V—Trigeminal CN-IX—Glossopharyngeal CN-X—Vagus
Vein
Carries oxygen-poor blood back from the body to the heart.
Muscles of the face, head, and neck are controlled by the _________________ tract, which decussates at the ____________________________ within the brainstem.
Corticobulbar, pyramids of medulla
A professional baseball player was hit by a fastball to the right side of the face just under his right eye. Upon admittance to the ER he had complete anesthesia of one side of his face and X-ray showed a fractured orbit. The most likely cranial nerve that was damaged would be....... A. CN-VII B. CN-IX C. CN-V1 D. CN-V2 E. CN-V3
D. CN-V2
While executing a powerful backhand volley during a tennis game, a 55 -year-old man collapsed onto the court. After a short lapse of consciousness, he got up but sounded a bit incoherent. At the Emergency Department, the resident determined that the man had lost pain sensation on the right side of his face and the left side of his body (limbs and trunk). The physician concluded that there was an occlusion (blockage- as in thrombotic ischemic stroke) of the ______________________________________ affecting the brainstem. A. basilar artery. B. right posterior spinal artery. C. left internal carotid. D. right posterior inferior cerebellar artery (PICA).
D. right posterior inferior cerebellar artery (PICA).
The ____________________is a sensory pathway of the central nervous system that conveys localized sensations of fine touch, vibration, two-point discrimination, and proprioception from the skin and joints. It transmits information from the body to the _______________________ of the cerebral cortex.
DCML, POST CENTRAL GYRUS
Name the four components of the motor system.
Direct Activation Pathway Indirect Activation Pathway Control Circuits Final Common Pathway
DCML comprised of
Dorsal columns of the spinal cord Medial lemniscus in the brainstem
True/False The left hemisphere is mainly responsible for processing the pitch and formant frequencies of speech sounds
False
Glossopharyngeal passes through what foramen?
Jugular
Vagus passes through what foramen?
Jugular
The cranial nerve nuclei in the brainstem are arranged longitudinally such that ____ nuclei are located medially and ____ nuclei are arranged laterally.
Motor, Sensory
Blood flow to the parenchyma of the brain is accomplished by___________
Perfusion
Aneurysm
The ballooning or bulging of an artery
Embolism
The blocking of an artery by either blood or air
Direct Activation Pathway functions
-Skilled, discrete, rapid VOLUNTARY motor activity -Primarily generated by cognitive activity and may involved complex planning (speech)
Artery
Carries oxygenated blood from the heart to the body.
DCML involved in
Fine touch Vibration Proprioception
A ten-year old boy presents with right arm and leg ataxia and hoarseness. Imaging shows a paretic (not fully paralyzed) right vocal cord. The lesion site is most likely _________________ a. Right motor nucleus of CN-X b. Dorsolateral Medulla c. Dorsolateral Pons d. Internal Capsule
b. Dorsolateral Medulla
Which neuron actually causes a muscle to contract? a. UMN b. LMN
b. LMN
The __________ fasciculus carries input from the lower half of the body and the __________ fasciculus carries input from the upper half of the body. a. Pyramidal: Brachial b. Cuneate: Gracile c. Gracile: Cuneate d. DCML: ALS
c. Gracile: Cuneate
Hemorrhage
A ruptured blood vessel causing bleeding in the brain
TRUE / FALSE Diseases of the brainstem can result in abnormalities in the function of cranial nerves that may lead to visual disturbances, pupil abnormalities, changes in sensation, muscle weakness, hearing problems, vertigo, swallowing and speech difficulty, voice change, and co-ordination problems.
True
TRUE / FALSE The corticobulbar tract innervates cranial motor nuclei bilaterally with the exception of the lower facial nuclei which are innervated only unilaterally (below the eyes) and cranial nerve XII which is innervated unilaterally as well.
True
TRUE / FALSE Upper motor neurons originate in the motor region of the brain stem. ... On the other hand, lower motor neurons receive impulses from the upper motor neurons and connect the spinal cord and brain stem to the muscle fibers.
True
TRUE / FALSE Lower motor neurons (LMNs) are the motor neurons connecting the brainstem and spinal cord to muscle fibers, bringing the nerve impulses from the upper motor neurons out to the muscles. A lower motor neuron terminates on an effector (muscle).
True
True/False Lower motor neurons (LMNs) (Alpha and Gamma neurons)are motor neurons located in either the ventral horn of the spinal cord and anterior nerve roots (spinal lower motor neurons) or the cranial nerve nuclei of the brainstem and cranial nerves with motor function (cranial nerve lower motor neurons). All voluntary movement relies on spinal lower motor neurons, which innervate skeletal muscle fibers and act as a link between upper motor neurons and muscles. Cranial nerve lower motor neurons control movements of the eyes and tongue, and contribute to chewing, swallowing and vocalization.
True
The three divisions of the trigeminal nerve pass through what foramen?
V1 (Opthalmic) Superior orbital fissure V2 (Maxillary) Foramen rotundum V3 (Mandibular) Foramen ovale
The Gracile and Cuneate fasciculi are located on the _________ side of the medulla while the pyramids are located on the ___________ side of medulla.
Ventral, Dorsal
Bell's Palsy
Weakness in the muscles on one half of the face. Facial "droop." Caused by trauma to CN-VII.
The three (3) main arterial blood supplies to the cerebellum and brainstem are_______. a. AICA, PICA, SCA b. AICA, PICA, PCA c. SCA, PCA, PICA
a. AICA, PICA, SCA
The vertebral (posterior) arterial system astomoses (converges) at the __________. a. Basilar artery b. Medulla oblongata c. Circle of Willis d. Communicating arteries
a. Basilar artery
Which of the following cranial nerves are involved with the "Gag Reflex" [CHOOSE ALL THAT APPLY]? a. CN-V TRIGEMINAL NERVE b. CN-VII FACIAL NERVE c. CN-IX GLOSSOPHARYNGEAL NERVE d. CN-X VAGUS NERVE e. CN-XII HYPOGLOSSAL NERVE
a. CN-V, Trigeminal b. CN_IX, Glossopharyngeal c. CN-X, Vagus
The brainstem has nerve functions, homeostatic, and integrative functions. Six (6) out twelve (12) cranial nerves emanate from the brainstem. CN-VII and CN-VIII emanate from the ________ a. CPA b. Medulla c. Pons d. Midbrain
a. CPA
The internal carotid artery enters the base of the skull at the __________ ___________ and travels through the cavernous sinus before entering the cranial cavity where it divides, thus supplying the anterior system. a. Carotid canal b. Cerebral canal c. Foramen magnum d. Jugular foramen
a. Carotid canal
A unilateral upper motor neuron lesion results in what type of weakness? a. Contralateral b. Ipsilateral c. Bilateral d. It would not result in weakness
a. Contralateral
The Vagus nerve [CN-X] controls a few skeletal muscles, including
a. Cricothyroid muscle b. Levator veli palatini muscle c. Salpingopharyngeus muscle d. Palatoglossus muscle e. Palatopharyngeus muscle f. Superior, middle and inferior pharyngeal constrictors g. Muscles of the larynx (speech)
The ______________________ is a pathway in the brainstem that carries sensory information from the gracile and cuneate nuclei to the thalamus. a. Dorsal Column Medial lemniscus b. Reticular formation c. Ponto-medullary junction d. Corticobulbar
a. Dorsal Column Medial lemniscus
Second-order neurons of the DCML reside at the ____________. a. Gracile and Cuneate Fasciculi b. Dorsal root ganglia c. Thalamus d. Cortex
a. Gracile and Cuneate Fasciculi
The two hemispheres of the brain are thought to contribute to the processing and understanding of language. The left hemisphere processes the ______________ while the right hemisphere processes ____________. a. Linguistic meaning: prosody b. Rhythm: emotional state c. Syllable length: pitch d. Emotions conveyed: grammatical elements
a. Linguistic meaning: prosody
