Lundy-Ekman: Neuroscience: Fundamentals for Rehabilitation, 4th Edition

Chapter 1: Introduction to Neuroscience

Test Bank

1. Which one of the following studies is an example of systems level neuroscience?
	A. A study investigating the action of the neurotransmitter dopamine in the temporal lobes of rodents
	B. A study investigating the effect of impaired memory on walking performance
	C. A study investigating how autonomic nerves influences baroreceptors in the vasculature
	D. A study investigating the differential effects of vestibular and proprioceptive impairments on balance in those who have had a stroke

ANS: C
Rationale: Systems level neuroscience is concerned with groups of cells in the nervous system that perform a common function and how these cells interact with other body systems. Other levels of neuroscience include the molecular level, which investigates the chemistry and physics involved in neural function; the cellular level, which examines the distinctions among different types of cells in the nervous system and how they function and communicate among themselves and among non-neural cells; the behavioral level, which examines the interactions among systems that influence behavior; and the cognitive level, which explores complex neurologic functions such as thinking, language, and memory. 

2. Which of the following three systems extend into all regions of the nervous system?
	A. Somatic motor, autonomic, and basal ganglia
	B. Autonomic, somatosensory, and cognitive
	C. Limbic, autonomic, and somatosensory
	D. Somatic, somatosensory, and autonomic

ANS: D
Rationale: The three systems extend throughout the entire nervous system. are the somatosensory system, conveying information from the skin and musculoskeletal system to the brain; the autonomic system, providing communication between the brain and smooth muscles, cardiac muscle, and glands; and the somatic motor system, transmitting information from the brain to the skeletal muscles. The basal ganglia, cognitive, and limbic systems are located entirely within the brain, and thus do not extend into the spinal and peripheral regions.

3. The peripheral nervous system includes which of the following?
	A. Brainstem and spinal nerves
	B. Nerves, sensory receptors, and autonomic ganglia
	C. Groups of myelinated axons called capsules or tracts
	D. Only afferent neurons that convey information to the central nervous system

ANS: B
Rationale: The peripheral nervous system consists of all nervous system structures outside of the skull and spinal column. Myelinated axons, the white matter of the peripheral nervous system, are grouped together in nerves. Peripheral nerves convey both afferent and efferent information to and from the central nervous system. Collections of autonomic cell bodies, or gray matter, located in the periphery are termed ganglia. 

4. The brainstem and cerebellum receive most of their blood supply from which of the following arterial branches?
	A. Internal carotid and posterior cerebral
	B. Vertebral and middle cerebral
	C. Vertebral and basilar
	D. Internal carotid and basilar

ANS: C
Rationale: Branches of the vertebral and basilar arteries provide blood supply to the brainstem and cerebellum. These branches include the anterior and posterior spinal arteries (medulla), posterior cerebral arteries (midbrain), posterior inferior cerebellar arteries (medulla and cerebellum), and anterior inferior and superior cerebellar arteries (pons and cerebellum).

5. The purpose of a neurologic evaluation is to:
	A. Establish a definitive diagnosis.
	B. Determine an appropriate plan of care.
	C. Determine the probable cause of the problem.
	D. Determine the probable cause of the problem and the appropriate plan of care.

ANS: D
Rationale: The purpose of a neurologic evaluation is to determine the likely cause of the problem and the appropriate course of action so that treatment can be provided. In many instances the evaluation will reveal a definitive diagnosis; however, this is not always the case.

6. A patient reports that she has recently had pain and a loss of coordination in her left leg. These symptoms initially began 5 days earlier, gradually worsened for 3 days, but then did not worsen or improve since that time. The speed of onset and nature of these complaints is most likely which one of the following?
	A. Acute vascular problem
	B. Subacute degenerative disorder 
	C. Chronic inflammatory process
	D. Subacute inflammatory process

ANS: D
Rationale: The speed of onset of a neurologic complaint can be classified as acute, subacute, or chronic. Acute problems achieve maximal signs and symptoms in minutes to hours and often indicate a vascular problem, whereas subacute problems arise over several days and may indicate an inflammatory process. Chronic problems gradually worsen over a period weeks, months, or years and may suggest either a tumor or degenerative disorder. 

7. An individual is admitted to the hospital to investigate a recently discovered abdominal mass. To determine the metabolic rate of the mass, an imaging study is ordered, during which a radioisotope is injected into the patient’s bloodstream. This study is an example of which one of the following?
	A. Computed tomographic (CT) scan
	B. Functional magnetic resonance image (fMRI) 
	C. Diffusion tensor image (DTI) 
	D. PET scan

ANS: D
Rationale: A PET scan is a nuclear imaging study in which emissions from a radioactive compound are examined to assess blood flow, oxygenation, glucose metabolism, and/or receptor location. Techniques such as CT, DTI, and fMRI rely on the use of x-ray images, radio waves, or magnetic fields. 

8. An individual suffers a cerebrovascular accident (CVA) or stroke, which disrupts the blood supply to the medial area of the frontal lobe. This disruption is most likely due to blockage of which one of the following?
	A. Anterior communicating artery
	B. Anterior cerebral artery
	C. Middle cerebral artery
	D. Posterior cerebral artery 

ANS: B
Rationale: The anterior cerebral arteries provide blood flow to the medial aspects of the frontal and parietal lobes. The anterior communicating artery joins these arteries. In addition, the middle cerebral artery supplies much of the lateral hemispheres, and the posterior cerebral artery supplies the occipital lobe and medial and inferior temporal lobe. 

9. A patient visits the emergency department after a motor vehicle accident. He has suffered multiple blunt force head traumas. This patient’s injury would be described as:
	A. Focal.
	B. Multifocal.
	C. Diffuse.
	D. Both B and C

ANS: B
Rationale: Damage or injuries to the central nervous system are categorized as being focal, multifocal, or diffuse lesions. Focal lesions are limited to a single location, multifocal lesions are limited to several nonsymmetric locations, and diffuse lesions affect bilateral structures symmetrically but do not cross the midline as a single lesion.

10. The incidence of a disease is:
	A. The proportion of the population that develops a new case of the disorder in a defined period.
	B. The current proportion of the population with the condition.
	C. The cumulative sum of past years’ prevalence rates.
	D. Typically reported as being per 1000 people.

ANS: A
Rationale: The incidence of a disease refers to the proportion of the population that develops a new case of the disorder in a defined period. The prevalence of a disease is the current proportion of the population with the condition, including both old and new cases. Thus the prevalence of a disease is the cumulative sum of past years’ incidence rates. Disease incidence is typically reported as per 100,000 people, whereas prevalence is typically reported per 1000 people.

11. Blood supply to the deep structures of the brain is provided by which of the following?
	A. Deep branches of the posterior cerebral arteries
	B. Anterior choroidal arteries
	C. Posterior choroidal arteries
	D. Both B and C
	E. A, B, and C

ANS: E
Rationale: The deep branches of each of the major cerebral arteries (e.g., anterior, middle, posterior) provide the blood supply to the deep structures of the brain. The anterior and posterior choroidal arteries provide additional blood flow to the deep structures of the brain.

12. The middle cerebral arteries arise from the ________ and supply the _________.
	A. Basilar artery; medial surfaces of the frontal and parietal lobes
	B. Internal carotid arteries; lateral cerebral hemispheres
	C. Anterior communicating artery; lateral cerebral hemispheres
	D. Internal carotid arteries; internal capsule, putamen, and caudate nucleus
	E. Internal carotid arteries; lateral cerebral hemispheres and internal capsule, putamen, and caudate nucleus 

ANS: E
Rationale: The middle cerebral arteries arise as branches from the internal carotid arteries and provide blood supply to a majority of the lateral cerebral hemispheres, as well as to the internal capsule, globus pallidus, putamen, and caudate nucleus. 

13. Which of the following arteries are part of the circle of Willis?
	A. Internal carotid and vertebral arteries
	B. Anterior and lateral cerebral arteries
	C. Anterior and posterior cerebral arteries
	D. Medial and lateral communicating arteries

ANS: C
Rationale: The circle of Willis is a ring of nine anastomotic arteries: the left and right anterior cerebral arteries, the left and right internal carotid arteries, the left and right posterior cerebral arteries, posterior communicating arteries (left and right), and the anterior communicating artery. The basilar artery and middle cerebral arteries are sometimes also included in the circle.

14. The function of the meninges includes which one of the following?
	A. Regulation of extracellular fluid content
	B. Protection of the brain and spinal cord
	C. Circulation of cerebrospinal fluid
	D. All of the above

ANS: D
Rationale: The cerebrospinal fluid system consists of both the cerebrospinal fluid and the meninges. The meninges contain spaces called dural sinuses, which contribute to the return of blood and cerebrospinal fluid to the venous blood system. The meninges also provide buoyancy and protection to the brain and spinal cord, as well as regulate extracellular fluid content.

15. Cerebrospinal fluid is secreted by the _______ and reabsorbed into the ________.
	A. Choroid plexus; lymphatic system
	B. Lymphatic system; choroid plexus
	C. Venous system; lymphatic system
	D. Choroid plexus; venous system

ANS: D
Rationale: Cerebrospinal fluid, a modified plasma filtrate, is secreted by the choroid plexus in the ventricles of the central nervous system and is reabsorbed into the venous blood system.
 
16. Which of the following correctly pairs a cerebral structure with its function?
	A. Corpus striatum; memory formation 
	B. Internal capsule; cortical and subcortical communication
	C. Amygdala; somatosensory integration and processing 
	D. Epithalamus; regulation of metabolic rate

ANS: B
Rationale: Composed of the caudate nucleus and putamen, the corpus striatum is an important structure in the basal ganglia circuit, which is critical to the control of movement. The internal capsule consists of projections between the cerebral cortex and subcortical structures, thus facilitating communication between these areas. The amygdale, a component of the limbic system, plays an important role in emotion and some aspects of memory formation. The epithalamus consists primarily of the pineal gland and influences secretion of the endocrine glands.
 
17. The cerebral hemispheres are:
	A. Divided by the central sulcus.
	B. Subdivided into four lobes per hemisphere.
	C. Composed primarily of gray matter, with an outer layer of white matter.
	D. Connected by the corpus callosum and anterior commissure.

ANS: D
Rationale: The longitudinal fissure divides the two cerebral hemispheres, and each hemisphere can be subdivided into a total of six lobes: frontal, parietal, temporal, occipital, limbic, and insular. The surface of the cerebrum is composed of gray matter, with underlying white matter deep to this. The corpus callosum connects the majority of the left and right cerebral hemispheres, with the anterior commissure connecting the left and right temporal cortices.

18. Each cranial nerve:
	A. Emerges from the spinal cord.
	B. Is numbered according to its place of attachment.
	C. Innervates the head, neck, and face.
	D. Carries motor and sensory information.

ANS: B
Rationale: The cranial nerves are a series of 12 nerve pairs that emerge from the surface of the brain and are numbered according to their sites of attachment to the brain, from anterior to posterior. Cranial nerves I, II, and VIII carry only sensory information, whereas nerves III, IV, VI, X, and XII carry primarily motor information. The remaining cranial nerves (V, VII, IX, and XI) are mixed, carrying both motor and sensory signals. Although most cranial nerves innervate structures of the head, neck, and face, the vagus nerve (X) also innervates abdominal and thoracic structures. 

19. Which one of the following functions is regulated by the structures of the diencephalon?
	A. Processing of emotion and memory information
	B. Integration of information for equilibrium 
	C. Coordination of movement
	D. Orientation to visual and auditory stimuli

ANS: A
Rationale: The diencephalon consists of the thalamus, hypothalamus, epithalamus, and subthalamus. These structures process emotion and some forms of memory. They also regulate consciousness and attention; maintain body temperature, metabolic rate, and chemical composition of the tissues; regulate eating, defensive, and reproductive behavior; and influence the secretion of endocrine glands. 
 
20. Which one of the following statements about the nervous system is incorrect?
	A. Areas of white matter of the spinal cord are divided into anterior, lateral, and dorsal areas and are called columns.
	B. The two primary functions of the spinal cord are to process information and to mediate reflex pathways.
	C. The pyramidal decussation is a prominent feature on the anterior surface of the pons.
	D. Both A and B 
	E. All of the above 

ANS: C
Rationale: A cross-section of the spinal cord reveals a centrally located area of gray matter shaped similar to the letter H. Surrounding this area of gray matter are areas of white matter, which can be divided into the anterior, lateral, and dorsal columns, or funiculi. The two primary functions of the spinal cord are to convey information between the periphery and the brain and to process information. The medulla is continuous with the spinal cord as it enters the skull. This area of the brain contains the pyramidal decussation, a prominent feature on the anterior medulla, composed of crossing axons traveling from the cerebral cortex into the spinal cord.