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Somatosensory/motor system, LMN/UMN, Spinal Cord Syndromes

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Welcome to your Neurology: somatosensory/motor system, spinal cord syndromes Quiz. This quiz has 50 multiple choice questions. Make sure to mark an answer for every question! Good luck!
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Which number in the picture above refers to dendrites?
- 1
- 4 & 6
- 7
- 8
Axons in the central nervous system are insulated by:
- astrocytes
- Schwann cells
- microglial cells
- oligodendrocytes
In synapses, the signals are transmitted to the postsynaptic neuron by means of:
- varicosities
- action potentials
- neurotransmitters
- neurotropic factors
"P" in the picture below refers to which lobe?
- frontal lobe
- parietal lobe
- occipital lobe
- temporal lobe
Which part of the central nervous system is located in the brainstem?
- the limbic system
- the hypothalamus
- the reticular formation
- the neurons innervating the respiratory muscles

The mesencephalon is indicated by which number in the picture below?
- 2
- 4
- 5
- 9
Consider the following cellular elements: I. muscle spindle II. muscle spindle afferent III. interneuron IV. alpha motor neuron V. axon of alpha motor neuron VI. muscle fibers innervated by axon ramifications of alpha motor neuron Which of these elements constitute the "motor unit"?
- I, II, III, IV, V, VI
- II, III, IV, V
- IV, V, VI
- VI
The Achilles tendon reflex ("Ankle Jerk"), elicited by tapping the triceps surae tendon with a reflex hammer:
- is a phasic stretch reflex
- starts with the stimulation of Golgi tendon organs
- leads to simultaneous contraction of ankle dorsiflexors
- is supported by a reflex arc that contains one or two interneurons
Which part of the central nervous system has NO direct connections with the spinal cord?
- basal ganglia
- premotor cortex
- vestibular nuclei
- reticular formation
Which statement regarding the pyramidal tract is correct?
- it is also known as corticobulbar tract
- the main origin is the secondary motor cortex
- its fibers convey motor commands especially for trunk muscles
- the majority of its fibers cross the midline in the lowermost part of the medulla oblongata

Specialized, encapsulated cutaneous receptors:
- occur only in hairless skin
- have a nociceptive function
- are able to detect temperature changes
- are connected to relatively large-diameter fibers
Which statement regarding the spinothalamic tract is correct?
- it is necessary for pain sense
- it consists of small diameter fibers
- it conveys information from the contralateral body half
- all statements are correct
The phenomenon of "somatotopy":
- is often visualized through a "homonculus"
- occurs only in the primary somatosensory cortex
- is the result of an intergration of proprioceptive, tactual, and nociceptive information
- implies a cortical representation of the body surface in such a way that the head is located at the upper side, and the leg at the lower side of the somatosensory cortical strip
In this transverse section of the spinal cord, which letter indicates a somatosensory tract?
- P
- Q
- both
- neither
Which statement regarding the parasympathetic autonomic nervous system is NOT correct?
- the system is active during periods of ‘rest and digest’
- the neurotransmitter released in the end organs is acetylcholine
- parasympathetic fibers reach all extremities via peripheral nerves
- the cells of origin are located in the brainstem and in sacral spinal segments

Autonomic dysreflexia in spinal cord injured patients is especially to be expected...
- in partial injuries
- in diabetic patients
- in lesions of the conus medullaris
- in the postacute phase of the injury
Which part of the CNS is located in the diencephalon?
- basal ganglia
- reticular formation
- cerebral hemispheres
- thalamus
The following structures are part the CNS, except:
- cerebellum
- brainstem
- cranial nerves
- spinal nerves
Which statement is correct? The action potential ______________ .
- results from temporal and spatial summation
- has a duration of about 100 milliseconds
- is synonymous with synaptic function
- has a higher voltage as the neuron is more excited
Axons in the peripheral nervous system are insulated by:
- fibrocytes
- oligodendrocytes
- Schwann cells
- nodes of Ranvier

The patella tendon reflex elicited by a reflex hammer:
- is a tonic stretch reflex
- starts with a stimulation of nuclear chain fibers in a muscle spindle
- leads to a simultaneous inhibition of the hamstrings
- is supported by a reflex arc that contains only one interneuron
A barefoot walking person accidentally steps on a sharp piece of glass with their left foot. Reflexively, they withdraw their left leg. The right leg shows a reflex reaction as well - namely:
- autogenic inhibition
- crossed extension reflex
- reciprocal inhibition
- righting reflex
In Parkinson's disease, frequent falls can be attributed to:
- bradykinesia
- rigidity
- impaired postural reflexes
- all of the above
The gait of a cerebellar patient has the following characteristics, except:
- shuffling short steps
- wide based
- postural instability
- irregular length of steps
A patient has a partial lesio of the thoracic spinal cord, interrupting the left spinothalamic tract and the left dorsal column. They experience sensory loss in their lower body half. What do you expect?
- analgesia in the right leg, loss of discriminative touch in the right leg
- analgesia in the right leg, loss of discriminative touch in the left leg
- analgesia in the left leg, loss of discriminative touch in the right leg
- analgesia in the left leg, loss of discriminative touch in the left leg

When a patient gets a tetraplegia as a consequence of a spinal cord injury, the lesion must be in which part of the spinal cord?
- between C4 and Th3
- between Th4 and Th10
- between Th11 and L5
- between S1 and S5
A spinal cord injury affecting the conus medullaris has approx. the same effects as:
- Brown-Séquard syndrome
- central cord injury
- posterior cord injury
- cauda equina lesion
Autonomic dysreflexia is associated with the following signs, except:
- hypertension
- sweating
- bradycardia
- facial pallor
A Glasgow coma scale score of 14 is to be expected in:
- an awake, neurologically intact patient
- a normal person during REM sleep
- an awake patient with posttraumatic amnesia
- patients in persistent vegetative state
Cardinal symptoms of a lower motor neuron lesion are:
- paresis or paralysis
- muscle atrophy
- hyporeflexia or areflexia
- all of the above

Which statement is NOT correct? Spinal cord injury …
- can have a non-traumatic aetiology
- affects males more frequently than females
- leads, if complete, always to disturbances in bladder function
- is in the majority of cases caused by violence like criminal assaults or suicide attempts
Which part of the spinal cord is spared in a Brown-Séquard syndrome?
- the dorsal part
- the white matter
- all but the sacral segments
- the right half or the left half
Which statement regarding bowel function in spinal cord injured patients is correct?
- in the acute phase, ileus and gastric distension may compromise breathing
- constipation is a major problem in the acute phase but not in the chronic phase
- in the chronic phase, patients usually suffer from constipation but not from incontinence
- in the management of bowel problems, surgical and pharmacological interventions are useless
What is a ‘scotoma’?
- a swollen optic disc
- an abnormal blind spot
- a circular restriction of the visual field
- a medical instrument to inspect the retina
A left-sided homonymous hemianopia may be caused by a lesion of:
- the left optic nerve
- the right optic nerve
- the left optic radiation
- the right optic radiation

The picture above shows a shaded cortical area, containing the numbers 10, 12, 13, 21, 22, and 23. This area is part of the....
- visual system
- limbic system
- somatosensory system
- extrapyramidal motor system
The hippocampus is important for memory functions, especially:
- motor memory
- working memory
- long term memory
- all of the above
Consider four patients, each with a neurological condition since two years, leading to memory problems. Which of them displays ‘temporally graded retrograde amnesia’?
- Patient A, who recalls nothing from his infancy but has good remembrance of his high school years
- Patient B, who remembers the names of his children but forgot the names of his teenaged grandchildren
- Patient C, who can reproduce the names of those who visited him today but forgot all visits of the preceding days
- Patient D, who forgot which clothes she wore yesterday but is able to describe the minutest details of her wedding dress
Which problem is NOT to be expected in patients with a frontal syndrome?
- impulsiveness
- mental inflexibility
- increased speed of information processing
- defective insight into own strengths and weaknesses
John Johnson went to his garden shed to chop some wood for the fireplace. Ten minutes later his wife came in and saw the log being transformed into thousands of splinters. What is the best term to describe this behavior?
- confabulation
- perseveration
- dysexecutive syndrome
- Witzelsucht (inappropriate jocularity)

A patient frequently bumps into objects on his left, forgets to shave the left side of his face, leaves his left leg often in uncomfortable positions and when asked to draw a person, sketches only half a man. What is the most adequate term to describe this condition?
- unilateral neglect
- body scheme disorder
- dysexecutive syndrome
- homonymous hemianopia
How would you call the unawareness of illness, displayed by some patients with focal brain lesions?
- inattention
- anosognosia
- hemiasomatognosia
- figure-ground discrimination disorder
Broca’s aphasia:
- is an example of ‘fluent aphasia’
- is caused by lesions in the temporal lobe
- is often accompanied by right-sided hemiplegia
- is characterized by a severe disturbance of auditory language comprehension
Interviewed a few months after his stroke, a patient declares: "I talk with difficulty. I worked easily in the old days for the work that I worked, the... very well the... English – the... to work in the... and thus, now, I do not talk of anything. Absolutely of that: nothing, nothing, nothing, nothing! I worked because I worked in the old days..." What would be an appropriate description of this language disturbance?
- dysphonia
- empty speech
- global aphasia
- retrograde amnesia
Which of the following patients shows signs of ideomotor apraxia?
- patient A, who when dressing attempts to insert his leg in the sleeve of his shirt
- patient B, who bangs his fist on the table when trying to demonstrate the use of a hammer
- patient C, who is unable to copy a drawing even if the model drawing is right in front of him
- patient D, who lays down a slice of cheese on the sandwich he’s preparing, and subsequently butters the cheese with the slicer

Which kind of apraxia causes problems especially in sequencing the component parts of a complex motor act and in the use of objects?
- ideational apraxia
- buccofacial apraxia
- melokinetic apraxia
- constructional apraxia
What is the most adequate characterization of the cause of multiple sclerosis?
- a viral infection
- an auto-immune disturbance
- a recessively inherited gene defect
- a primary degeneration of oligodendrocytes
Symptoms that are especially prominent in the late phase of MS include:
- spasticity and cognitive deficits
- fatigue and diffuse muscle pains
- paresthesias and Lhermitte’s sign
- nystagmus and bilateral bulbar paresis
Which statement regarding ‘primary progressive MS’ is correct?
- it is the mildest type of MS
- it is the most frequent type of MS
- it is most often seen in males with late onset of the disease
- it is initially characterized by a gradual progression but after some years takes a relapsing- remitting course
Which type of drug is often successfully employed to relieve and shorten the acute exacerbations (relapses) of MS?
- antidepressants
- spasmolytic drugs
- non-steroidal anti-inflammatory drugs
- corticosteroids like methylprednisolone

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