1. What is the body's largest sensory organ?

A. The eyes.
B. The olfactory system.
C. The skin.
D. The tongue.

2. Which of the following is not monitored by the somatosensory system?

A. Balance and equilibrium.

B. Bodily position.
C. Pain.
D. Temperature.

3. Which fibers are responsible for the transmission of the first pain response?

A. A beta.
B. A delta.
C. C.
D. II a.

4. A hereditary mutation in the SCN9A gene causes what disorder?

A. Congenital analgesia.
B. Epilepsia.
C. Hyperalgesia.
D. Marie-Charcot-Tooth syndrome.

5. Which of the following fibers mediate the sensation of innocuous touch?

A. A delta.
B. A gamma.
C. A beta.
D. C.

6. Which of the ascending pain pathways ends in the somatosensory cortex?

A. Periacueductal grey (PAG) pathway.

B. Spinoparabrachial tract.
C. Spinothalamic tracts.
D. Spino-olivary tract.
7. The descending pain pathways emerge from what regions of the brain? 1. Raphe nucleus 2.
Caudate putamen 3. Periaqueductal grey 4. Nigrostriatal pathway

A. 1 and 2.
B. 1 and 3.
C. 1, 3, and 4.
D. 2 and 4.

8. The dorsal horn is divided into layers, or laminae. Into which layers do nociceptors pass?

A. Layers I and II.

B. Layer I and IV.
C. Layers II and IV.
D. Layers III and IV.

9. Which of the ascending pain pathways results in the "emotional" response to pain?

A. Spinoreticular pathway.
B. Spinobrachial tract.
C. Anterolateral spinothalamic tract.
D. Dorsal column-medial lemniscal system.

10. Context induced analgesia is created by hyper-stimulation of which pathway?

A. Spinocerebellar pathway.
B. Spinothalamic tract.
C. Periaqueductal grey.
D. Superior cullicular pathway.

11. An area of skin that is innervated by a particular region of the spinal cord is called what?
A. Dorsal root ganglion.
B. Receptor field.
C. Ectodome.
D. Dermatome.

12. Proprioceptors are involved in detecting:

A. Pain.
B. Blood pressure.
C. Changes in tension in muscles and tendons.
D. Changes in temperature in skin.
12. Which of these somatic receptors is involved in detecting heavy pressure and vibration?

A. Free nerve endings.

B. Golgi tendon organs.
C. Meisner´s corpuscules.
D. Pacinian corpuscules.

13. The two main kinds of stretch receptors or proprioceptors that transmit information to the
spinal cord and brain about muscle tension and length are:

A. Meissner's corpuscles and Pacinian corpuscles.

B. Meissner's corpuscles and Golgi tendon organs.
C. Muscle spindles and Golgi tendon organs.
D. Pacinian corpuscles and Golgi tendon organs.

14. Which of these receptors detects an increase in tension in a muscle?

A. Golgi tendon organ.

B. Meissner's corpuscle.
C. Muscle spindle.
D. Nociceptor.

15. Which of these receptors detects lengthening or stretching of a muscle?

A. Golgi tendon organ

B. Meissner's corpuscle.
C. Muscle spindle.
D. Nociceptor.

16. Extero-receptors provide information about:

A. Body position, movement and the extent of stretch or force of muscular contraction.
B. The body's chemical composition, blood pH and blood pressure.
C. The body's internal environment.
D. The body's external environment.
17. The neuron of the spinothalamic system that ascends within the spinal cord and carries
sensory information from a dorsal horn to the thalamus is designated a:

A. Primary neuron.
B. Secondary neuron.
C. Tertiary neuron.
D. Quaternary neuron.

18. In which of the following ascending pathways or tracts do the secondary neurons decussate
within the spinal cord?

A. Fasciculus cuneatus.
B. Dorsal-column spinocerebellar tracts.
C. Fasciculus gracilis.
D. Anterolateral spinothalamic tracts.

19. Decussation of ascending spinal pathways occurs mainly within the:

A. Midbrain and medulla oblongata.

B. Pons and medulla oblongata.
C. Spinal cord and medulla oblongata.
D. Spinal cord only.

20. The fasciculus gracilis and the fasciculus cuneatus are both tracts of which pathway?

A. Dorsal-column/medial-lemniscal system.
B. Spinocerebellar.
C. Spinalthalamic.
D. Spinoreticular.

21. The posterior spinocerebellar tract in each half of the spinal cord is located in the:

A. Dorsal-column.
B. Lateral column.
C. Posterior horn.
D. Ventral column.
22. Ascending tracts of the spinal cord occur in the:

A. Columns.
B. Gray commissure.
C. Horns.
D. Roots.

23. Which of the following spinal cord ascending tracts conveys sensory information about which
we become consciously aware?

A. Spinocerebellar.
B. Spino-olivary.
C. Spinoreticular.
D. Spinothalamic.

24. The primary somatic sensory cortex is located in the:

A. Angular gyrus.
B. Cingulated gyrus.
C. Precentral gyrus.
D. Postcentral gyrus.

25. If the anterolateral spinothalamic tract is cut, which of the following sensations would be
absent on the opposite side below the incision?

A. Light touch and pressure.

B. Light touch and itch.
C. Pain and temperature.
D. Pressure and itch.

26. Which of the following tracts conducts sensory impulses for pain and temperature from
various levels of the spinal cord to the thalamus?

A. Dorsal column-medial lemniscal spinothalamic tract.

B. Fasciculus cuneatus.
C. Fasciculus gracilis.
D. Anterolateral spinothalamic tracts.
27. Each of the following are correctly paired “EXCEPT”…….

A. Spinocerebellar tract - proprioception.

B. Spinoolivary tract - balance.
C. Spinotectal tract - visual orientation reflexes.
D. Dorsal column-medial lemniscal spinothalamic tract - two-point discrimination.

28. The sensory areas for vision are located in the:

A. Frontal lobes.
B. Occipital lobes.
C. Parietal lobes.
D. Temporal lobes.

29. Incoming visual information is compared with past visual experience in which of the following
areas?

A. Broca's area.
B. Visual association area.
C. Visual cortex.
D. Wernicke's area.

30. In which of the following areas does word recognition occur?

A. Auditory association area.

B. Broca's area.
C. Primary auditory cortex.
D. Wernicke's area.

31. Decussation of ascending spinal pathways occurs mainly within the:

A. Midbrain and Medulla Oblongata.

B. Pons and Medulla Oblongata.
C. Spinal cord and Medulla Oblongata.
D. Spinal cord only.
32. Which of the following tracts carry motor impulses to trunk and upper and lower limb muscles
to maintain posture?

A. Corticospinal tracts.
B. Reticulospinal tracts.
C. Spinocerebellar tracts.
D. Spinothalamic tracts.

33. Which of the following descending tracts of the spinal cord is “NOT” an indirect pathway?

A. Anterior reticulospinal tracts.

B. Lateral corticospinal tracts.
C. Medial reticulospinal tracts.
D. Rubrospinal tracts.

34. Which of the following is ”NOT” true about the indirect pathways of the voluntary motor
system?

A. They constitute the extrapyramidal system.

B. They constitute one of the two groups of upper motor neurons.
C. They are largely involved in controlling movements in the head and neck.
D. Upper motor neurons synapse on intermediate neurons rather than directly with lower
motor neurons.

35. A pen is placed in your left hand behind your back. Which of the following tracts would NOT be
involved in your ability to state what is in your hand?

A. Association.
B. Commissural.
C. Corticobulbar.
D. Corticospinal.

36. The primary motor area is located in the __________ gyrus of each __________ lobe.

A. Precentral; frontal.
B. Precentral, parietal.
C. Postcentral; frontal.
D. Postcentral; parietal.
37. In addition to planning and initiating movements, the prefrontal areas of the frontal lobes also
functions to:

A. Help interpret sensory information and aid in understanding speech.

B. Analyze visual patterns and combine visual images with other sensory experiences.
C. Perform higher intellectual processes such as concentrating, planning and complex
problem solving.
D. Recognize words and arrange them to express a thought.

38. The motivation and foresight to plan and initiate movements is located in which of the
following areas?

A. Prefrontal area.
B. Premotor area.
C. Primary motor cortex.
D. Wernicke's area.

39. Which of the following tracts carry motor impulses that control posture adjustment?

A. Corticospinal tracts.
B. Reticulospinal tracts.
C. Spinocerebellar tracts.
D. Spinothalamic tracts.

40. Because of injuries received in an automobile accident, a young man remains hospitalized in a
coma. It is likely the injuries affected him is:

A. Amygdala.
B. Hippocampus.
C. Limbic system.
D. Reticular formation.

41. The condition resulting from a lesion in the premotor area that causes impairment of a
musician's ability to play the piano is called:

A. Aphasia.
B. Apraxia.
C. Athethosis.
D. Amorphosynthesis.
42. Which of the following cranial nerves does not have axons that pass through the brainstem or
nuclei in the brainstem?

A. Facial (VII) nerve.

B. Glossopharyngeal (IX) nerve.
C. Olfactory (I) nerve.
D. Optic (II) nerve.

43. The Broca's area:

A. Controls voluntary movements of the eyes and eyelids.

B. Controls motor functions that maintain balance and posture.
C. Coordinates complex muscular actions that make speech possible.
D. Controls the muscular movements of the hands and fingers that make skills such as writing
possible.

44. Which cranial nerve does not innervate external eye muscles?

A. III.
B. Throclear.
C. Abducens.
D. II.

45. The area of the brain that integrates proprioceptor data is the:

A. Cerebrum.
B. Hypothalamus.
C. Cerebellum.
D. Medulla Oblongata.

46. Why do odors sometimes alter our moods?

A. Because sensory input from olfaction is routed through the limbic system.
B. Because odors act as neurotransmitters and alter brain chemistry.
C. Because odors are satisfying to our sense of hunger.
D. Odors do not alter mood.
47. Which of the following is true regarding the neural pathways of transmitting visual
information?

A. The majority of fibers from the optic tract project to the superior colliculus.
B. The Geniculostriate system is primarily involved in coordinating eye and body movements.
C. The Tectal system is primarily involved in visual perception.
D. The Lateral Geniculate nucleus relays information to the striate cortex.

48. The vestibulospinal tracts:

A. Controls voluntary movements of the eyes and eyelids.

B. Controls motor functions that maintain balance and posture.
C. Coordinates complex muscular actions that make speech possible.
D. Controls the muscular movements of the hands and fingers that make skills such as writing
possible.

49. Retinal cells that generate nerve impulses toward the optic nerve are:

A. Bipolar cells.
B. Ganglion cells.
C. Amacrine cells.
D. Horizontal cells.

50. The Geniculo Calcarine tract is also known as:

A. Optic radiation.
B. Optic tract.
C. Tectospinal tract.
D. Spinocerebellar tract.

51. Primary visual cortex is also known as:

A. Insular cortex.
B. Broca´s area.
C. Temporal cortex.
D. Striate cortex.
52. A lesion of the right occipital cortex results in a field defect in ________ eye(s):

A. Right.
B. Left.
C. Both.
D. None. Just the vision for colors is affected.

53. Primary sensory neuron bodies of taste are located in:

A. Gustatory papillae.
B. Dielencephalon.
C. Ganglia of cranial VII, IX, and X nerves.
D. Trigeminal ganglion.

54. Second sensory neurons axons carrying out taste information are located in:

A. Solitary tract.
B. Pontine nuclei.
C. Mesencephalon.
D. Reticular formation.

55. Solitary nucleus axons synapse in the Parabrachial nucleus en route to:

A. Gustatory cortex.
B. Ventral Posteriomedial nucleus of the Thalamus.
C. Medial Geniculated nucleus.
D. Inferior nucleus of the Oliva.

56. Primary sensory neurons of the auditory pathways are located in:
A. Spiral (Cochlear) ganglion.
B. Vestibular nuclei.
C. Medulla oblongata.
D. Cochlea.

57. Primary auditory axons terminate in:

A. Superior Olivary nuclei.

B. Cochlear nuclei.
C. Lateral geniculate nucleus.
D. Vestibular nuclei.
58. Cochlear nuclei synapse bilaterally in several nuclei, i.e., the:

A. Superior Olivary nuclei.

B. Cochlear nuclei.
C. Lateral Geniculate nucleus.
D. Superior Olivary nuclei.

59. Axons from the Superior Olivary nuclei form a tract called the:

A. Spinothalamic tract.
B. Solitary tract.
C. Tectospinal tract.
D. Lateral Lemniscus.

60. In the midbrain, auditory pathways rely in the:

A. Inferior Culliculus.
B. Lateral geniculate nuclei.
C. Anterior thalamus.
D. Periacueductal grey.

61. Auditory thalamocortical fibers terminate in:

A. Temporal precentral cortex.

B. Prefrontal cortex.
C. Transverse temporal gyrus.
D. Anterior temporal lobe.

62. Following a motor bike accident, a 22-year old man presents with paraplegia (immobility of the
half-lower part of his body). Name (i) the tract affected; (ii) the site of injury, and (iii) the type of
lesion:

A. Corticobulbar tract, genu of internal capsula, bilateral.

B. Corticospinal tract, thoracic, bilateral.
C. Spinothalamic, thoracic, unilateral.
D. Corticospinal tract, posterior limb, unilateral.
63. A 34-year old man is rushed to the emergency room from the site of a car accident. A MRI reveals
a lesion at the level of the midbrain. His upper limbs and lower limbs are extended. Name. (i) type
of rigidity and (ii) the tract(s) involved in the extension of the limbs:

A. Decorticate, Rubrospinal tract.

B. Decorticate; Rubrospinal and Lateral Vestibulospinal tract.
C. Decerebrate, Medial Reticulospinal and Lateral Vestibulospinal tracts.
D. Decerebrate, Rubrospinal tract.

64. A 54-year-old morbidly obese and hypertensive man is brought to the emergency department
after experiencing sudden onset of weakness of his left upper and lower extremities. CT shows an
infarcted area in the medulla. Damage to which of the following tracts or fiber bundles of the
medulla would most likely explain this deficit?

A. Anterolateral system.
B. Corticospinal fibers.
C. Medial lemniscus.
D. Rubrospinal tract.

66. A 23-year-old man is brought to the emergency room from the site of an accident collision. The
neurological examination reveals weakness of the right lower extremity and loss of pain and thermal
sensations of the left side beginning at the level of umbilicus. CT (Computerized Tomography) shows
a fracture of the vertebral column with displacement of bone fragments into the vertebral canal.
Damage to which of the following tracts would correlate with the weakness of the lower extremity
in this man?

A. Right lateral corticospinal tract.

B. Left lateral corticospinal tract.
C. Reticulospinal fibers on the right.
D. Right rubrospinal tract.

67. Which of the following is NOT one of the four regions into which the spinal cord is divided?

A. Coccygeal.
B. Lumbar.
C. Thoracic.
D. Sacral.
68. The spinal cord is contiguous superiorly with the:
A. Cerebellum.
B. Medulla oblongata.
C. Midbrain.
D. Pons.

69. The white matter in each half of the spinal cord is organized into three columns. Which of the
following is NOT one of the columns?

A. Ventral.
B. Lateral.
C. Inferior.
D. Dorsal.

70. The lateral horns of the gray matter in the thoracic region of the spinal cord contain the cell
bodies of:

A. The Medulla Oblongata.

B. All motor neurons of that body segment.
C. Autonomic neurons.
D. Sensory.

71. Ascending and descending tracts of the spinal cord occur in the:

A. Columns.
B. Grey Commissure.
C. Roots.
D. Horns.

72. The knee-jerk reflex involves which of the following:

A. Sensory and motor neurons.

B. Sensory, association, and motor neurons.
C. Sensory, motor, and interneurons.
D. Sensory and association neurons.
73. Which of the following reflexes inhibits skeletal muscle contraction?

A. Knee-jerk reflex.
B. Golgi tendon reflex.
C. Stretching reflex.
D. Patellar reflex.

74. You are walking barefoot and step on a tack with your right foot. All of the following will occur
EXCEPT

A. Flexor muscles in your right thigh and leg contract to remove your foot.
B. Reciprocal innervation inhibits extensor muscles in the same limb.
C. Collaterals of sensory neurons stimulate alpha motor neurons that cause extension in the
opposite limb.
D. Collaterals of interneurons stimulate a crossed extensor reflex.

75. Which of the following statements about the spinal cord is NOT correct?
A. It has two enlargements.
B. It extends to the level of lumbar vertebra three in an adult.
C. It gives rise to 31 pairs of spinal nerves.
D. It has a central canal that is continuous with the fourth ventricle of the brain.

76. The nerves that supply the lower limbs enter or exit from this area of the spinal cord.
A. Brachial plexuses.
B. Cervical enlargement.
C. Cervical plexuses.
D. Lumbar enlargement.

77. Excitatory interneurons are involved in which of the following spinal reflexes?
A. Golgi tendon reflex.
B. Knee jerk reflex
C. Stretch (myotatic) reflex.
D. Withdrawal reflex.
78. The gray matter on either side of the spinal cord is subdivided into anterior, lateral and posterior.
A. Columns.
B. Horns
C. Funiculli
D. Fasciculli.

79. All of the following are true about spinal nerves EXCEPT
A. They are all mixed.
B. There are 31 pairs.
C. Spinal nerves may contain nerve fibers of both the somatic and autonomic nervous systems.
D. All motor nerve fibers in spinal nerves extend uninterrupted from the spinal cord to an
effector.

80. The main function of the cerebellum is ___________.

A. Consciousness.
B. Muscle coordination.
C. Homeostasis.
D. Sense reception.

THEME 5:

1. Which of the following tracts carry motor impulses to trunk and upper and lower limb muscles
to maintain posture?

E. Corticospinal tracts.
F. Reticulospinal tracts.
G. Spinocerebellar tracts.
H. Spinothalamic tracts.

2. Which of the following descending tracts of the spinal cord is “NOT” an indirect pathway?

E. Anterior reticulospinal tracts.

F. Lateral corticospinal tracts.
G. Medial reticulospinal tracts.
H. Rubrospinal tracts.
3. Which of the following is ”NOT” true about the indirect pathways of the voluntary motor
system?

E. They constitute the extrapyramidal system.

F. The constitute one of the two groups of upper motor neurons.
G. They are largely involved in controlling movements in the head and neck.
H. Upper motor neurons synapse on intermediate neurons rather than directly with lower
motor neurons.

4. A pen is placed in your left hand behind your back. Which of the following tracts would NOT be
involved in your ability to state what is in your hand?

E. Association.
F. Commissural.
G. Corticobulbar.
H. Corticospinal.

5. The primary motor area is located in the __________ gyrus of each __________ lobe.

E. Precentral; frontal.
F. Precentral, parietal.
G. Postcentral; frontal.
H. Postcentral; parietal.

6. In addition to planning and initiating movements, the prefrontal areas of the frontal lobes also
functions to:

E. Help interpret sensory information and aid in understanding speech.

F. Analyze visual patterns and combine visual images with other sensory experiences.
G. Perform higher intellectual processes such as concentrating, planning and complex
problem solving.
H. Recognize words and arrange them to express a thought.

7. The motivation and foresight to plan and initiate movements is located in which of the following
areas?

E. Prefrontal area.
F. Premotor area.
G. Primary motor cortex.
H. Wernicke's area.
8. Which of the following tracts carry motor impulses that control posture adjustment?

E. Corticospinal tracts.
F. Reticulospinal tracts.
G. Spinocerebellar tracts.
H. Spinothalamic tracts.

9. Because of injuries received in an automobile accident, a young man remains hospitalized in a

coma. It is likely the injuries affected him is:

E. Amygdala.
F. Hippocampus.
G. Limbic system.
H. Reticular formation.

10. The condition resulting from a lesion in the premotor area that causes impairment of a
musician's ability to play the piano is called:

E. Aphasia.
F. Apraxia.
G. Athethosis.
H. Amorphosynthesis.

11. Which of the following cranial nerves does not have axons that pass through the brainstem or
nuclei in the brainstem?

E. Facial (VII) nerve.

F. Glossopharyngeal (IX) nerve.
G. Olfactory (I) nerve.
H. Optic (II) nerve.

12. The Broca's area:

E. Controls voluntary movements of the eyes and eyelids.

F. Controls motor functions that maintain balance and posture.
G. Coordinates complex muscular actions that make speech possible.
H. Controls the muscular movements of the hands and fingers that make skills such as writing
possible.

13. The vestibulospinal tracts:

E. Controls voluntary movements of the eyes and eyelids.
F. Controls motor functions that maintain balance and posture.
G. Coordinates complex muscular actions that make speech possible.
H. Controls the muscular movements of the hands and fingers that make skills such as writing
possible.

14. A 34-year old man is rushed to the emergency room from the site of a car accident. A MRI reveals
a lesion at the level of the midbrain. His upper limbs and lower limbs are extended. Name. (i) type
of rigidity and (ii) the tract(s) involved in the extension of the limbs:

E. Decorticate, Rubrospinal tract.

F. Decorticate; Medial Reticulospinal and Lateral Vestibulospinal tracts.
G. Decerebrate, Rubrospinal and Lateral Vestibulospinal tract.
H. Decerebrate, Rubrospinal tract.

SHORT QUESTIONS BANK:

What clinically differentiates the Upper Motor neuron Syndrome from the Lower Motor Neuron
Syndrome? Explain briefly your answer

Using a drawing describe the “Pain-Withdrawal Flexor” reflex.

What is the Placebo effect? And the Nocebo effect?

What is Referred Pain?

What the four basic eye movements are? What are their roles?