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1. A right inferior homonymous quadrantanopsia can be caused by a lesion to which of the following structures (areas)?
   a. left temporal (Meyer’s) loop of the optic radiations
   b.  left optic radiations passing through the parietal lobe
   c.  left lingual gyrus
   d. left cuneus
   e. only a and c are correct
   f.  only b and d are correct
   
   
2. Which of the following statements concerning Parinaud’s syndrome are true?
   a. Signs include conjugate upgaze paresis and convergence-retraction nystagmus.
   b. Pupillary reflexes show impaired light reflexes with relatively intact accommodation.
   c.  Common causes include pineal tumors or hydrocephalus compressing the tectum of the midbrain.
   d. all of the above are correct
   e. only a and c are correct


3. In the oculosympathetic pathway mediating the signs and symptoms of the Horner’s syndrome (ptosis, miosis, and facial anhidrosis):
   a. the 3rd order (postganglionic) neuron cell bodies are located in the superior cervical sympathetic ganglion and send their axons onto the external carotid artery (for innervation of sweat glands of the face, except for a small area in the supraorbital region) and onto the internal carotid artery (for innervation of the dilator pupillae muscle, smooth muscle portion of the levator palpebrae superioris, and the sweat glands in the supraorbital region)
   b.  the 2nd order (preganglionic) neuron cell bodies are located in the lateral horn of the upper 1 to 3 thoracic spinal cord segments and send their axons upward through the cervical sympathetic chain to synapse with the postganglionic cell bodies in the superior cervical sympathetic ganglion on the anterolateral surface of the upper cervical vertebral column
   c.  the 1st order (central) neuron cell bodies are located in the ipsilateral hypothalamus and send their axons down through the lateral brain stem fields (in a multisynaptic fashion)
   d. all of the above are correct
   e. only a and c are correct


4. Which of the following represents a unimodal sensory association cortex?
   a. inferior parietal lobule (areas 39, 40)
   b. areas 18 and 19
   c.  prefrontal cortex (areas 9, 10, 11)
   d. superior temporal gyrus (area 22)
   e. transverse temporal gyri (areas 41, 42)
   f.  all of the above are correct
   g.  only a and c are correct
   h.  only b and d are correct
   i.   only a, c, and e are correct


5. Which of the following represents a unimodal sensory association cortex?
   a. the parts of the cuneus and lingual gyrus on the banks of the calcarine sulcus (area 17)
   b. inferior parietal lobule (areas 39 and 40)
   c.  transverse temporal gyri (areas 41 and 42)
   d. postcentral gyrus (areas 3, 1, 2)
   e. none of the above are correct


6. Which of the following statements concerning commissural fibers is (are) true?
   a. They are bundles of fibers interconnecting areas of cortex to homologous areas of the contralateral side of the brain.
   b. One example is the uncinate fasciculus.
   c.  The neuron cell bodies of origin are small pyramidal cells in layer 3 of the cortex.
   d. all of the above are correct
   e. only a and c are correct


7. Damage to the right frontal eye field (areas 8, 6) results in which of the following?
   a. Both eyes are deviated horizontally to the left at rest.
   b. Both eyes are deviated downward at rest.
   c.  The patient cannot voluntarily look to the right.
   d. The patient cannot voluntarily look to the left.
   e. The patient cannot voluntarily look upward.


8. In the cerebral neocortex:
   a. neurons are arranged in both columns and in layers
   b. the internal granular layer (layer 4) is well developed in motor areas of the cortex
   c.  the large pyramidal cells in layer 5 of the precentral gyrus contribute to the corpus callosum
   d. the arcuate fasciculus consists of axons whose cell bodies are located in layer 4 of the superior temporal gyrus
   e. the molecular layer (layer 1) consists mainly of neuronal cell bodies


9. Which of the following fiber bundles (tracts, pathways, etc.) is an example of
   association fibers?
   a. corticopontine fibers
   b. uncinate fasciculus
   c.   corpus callosum
   d. corticospinal tract
   e. medial lemniscus


10. Which of the following statements concerning the archicortex is true?
    a. It contains a variable number of layers (3-5).
    b.   The hippocampus and dentate gyrus are a part of it.
    c.    The cingulate gyrus is a part of it.
    d.  It is the most recent area of the cerebral cortex to appear in evolution.
    e. Neurons in it are arranged in both columns and layers.
    
    
    
11. Which of the following represents a polymodal (heteromodal) sensory association cortex?
    a. inferior parietal lobule (areas 39, 40)
    b. superior parietal lobule (areas 5 and 7)
    c.   postcentral gyrus (areas 3, 1, 2)
    d.  superior temporal gyrus (area 22)
    e. the parts of the cuneus and lingual gyrus on the banks of the calcarine sulcus (area 17)


12. Which of the following statements concerning the hippocampus is (are) true?
    a. The main afferent pathway into the hippocampus is the “perforant path,” which arises from the entorhinal cortex (area 28) and synapses with dentate gyrus granule cells and CA1 hippocampal pyramidal cells.
    b. One of the main efferent pathways out of the hippocampus is the “fimbria-fornix” system, which ends primarily in the medial dorsal (dorsomedial, mediodorsal) nucleus of the thalamus.
    c.    Damage to both hippocampi produces an amnestic state in which no new declarative memories can be formed.
    d. all of the above are correct
    e.  only a and c are correct


13. The “thalamic pain syndrome” (central pain syndrome):
    a. is usually preceded by weeks to months of a contralateral hemianesthesia
    b. is characterized by a spontaneous disagreeable, often burning, pain, which may be accentuated by any stimulus to the affected region
    c.  is usually due to a lesion involving the ventral posterolateral (VPL) nucleus of the thalamus and surrounding area
    d.  can follow an infarct in the territory of the posterolateral (thalamogeniculate) group of central (perforating) arteries of the posterior cerebral artery
    e. all of the above are correct
    
    
14. A patient presents with an inability to identify a common object (eg, key) placed in his right hand with his eyes closed (stereoagnosia).  He also has difficulty determining the static position of the fingers of his right hand with his eyes closed (statoagnosia).  Where was the lesion producing these signs located?
a. left inferior parietal lobule (areas 39, 40)
b. left cuneus (areas 18, 19)
c.  left supramarginal gyrus (area 40)
d.  left superior parietal lobule (areas 5, 7)
e.   right nucleus gracilis


15. Which adult structures are derived from the embryonic telencephalon?
    a. cerebellum
    b. medulla oblongata
    c.  pons
    d. thalamus
    e. cerebral hemispheres
    
    
16. A conduction aphasia is characterized by:
    a.  intact comprehension of speech
    b. intact verbal output of speech
    c.    a lesion in the arcuate fasciculus
    d.  intact repetition
    e. the patient being intensely frustrated
    f.  all of the above are correct
    g. only a, b, and c are correct
    h. only a, b, c, and d are correct


17. Gerstmann’s syndrome:
    a. sometimes may be accompanied by an anomic (amnestic) aphasia
    b. is characterized by agraphia, finger agnosia, left-right disorientation, and acalculia
    c.  is usually due to a lesion involving the dominant (usually left) inferior parietal lobule (angular and supramarginal gyri, areas 39, 40)
    d. all of the above are correct
    e. only a and c are correct

Extended Matching Set - For each of the 7 questions below, indicate the letter of the most closely related item from the list. Each option may be correct for more than one question.


18. Interconnects the two olfactory bulbs as well as homologous regions of the temporal lobes (middle and inferior temporal gyri).
    a. Medial forebrain bundle
    b. Ansa lenticularis and lenticular fasciculus
    c.  Anterior commissure
    d. Crus cerebri
    e. Posterior commissure
    f.  Dentatorubrothalamic tract
    g. Lateral olfactory stria
    h. Uncinate fasciculus
    i.  Subthalamic fasciculus
    j.  Basal nucleus (Meynert)
    k.  Lesion of the optic chiasma
    l.   Left homonymous superior quadrantanopsia
    m. Right homonymous hemianopsia
    n.  Left homonymous inferior quadrantanopsia
    o.  Left homonymous hemianopsia
    p.  Left monocular blindness


19. Efferent pathways from the globus pallidus to the thalamus.
    a. Medial forebrain bundle
    b. Ansa lenticularis and lenticular fasciculus
    c.  Anterior commissure
    d. Crus cerebri
    e. Posterior commissure
    f.  Dentatorubrothalamic tract
    g. Lateral olfactory stria
    h. Uncinate fasciculus
    i.  Subthalamic fasciculus
    j.  Basal nucleus (Meynert)
    k.  Lesion of the optic chiasma
    l.   Left homonymous superior quadrantanopsia
    m. Right homonymous hemianopsia
    n.  Left homonymous inferior quadrantanopsia
    o.  Left homonymous hemianopsia
    p.  Left monocular blindness


20. Arises in the olfactory bulb and projects to the ipsilateral amygdala, uncus, anterior perforated substance (olfactory tubercle), and anterior parahippocampal gyrus (pyriform cortex).
    a. Medial forebrain bundle
    b. Ansa lenticularis and lenticular fasciculus
    c.  Anterior commissure
    d. Crus cerebri
    e. Posterior commissure
    f.  Dentatorubrothalamic tract
    g. Lateral olfactory stria
    h. Uncinate fasciculus
    i.  Subthalamic fasciculus
    j.  Basal nucleus (Meynert)
    k.  Lesion of the optic chiasma
    l.   Left homonymous superior quadrantanopsia
    m. Right homonymous hemianopsia
    n.  Left homonymous inferior quadrantanopsia
    o.  Left homonymous hemianopsia
    p.  Left monocular blindness


21. Arises in the septal region, basal olfactory, and periamygdaloid regions and projects to the hypothalamus and the midbrain tegmentum.
    a. Medial forebrain bundle
    b. Ansa lenticularis and lenticular fasciculus
    c.  Anterior commissure
    d. Crus cerebri
    e. Posterior commissure
    f.  Dentatorubrothalamic tract
    g. Lateral olfactory stria
    h. Uncinate fasciculus
    i.  Subthalamic fasciculus
    j.  Basal nucleus (Meynert)
    k.  Lesion of the optic chiasma
    l.   Left homonymous superior quadrantanopsia
    m. Right homonymous hemianopsia
    n.  Left homonymous inferior quadrantanopsia
    o.  Left homonymous hemianopsia
    p.  Left monocular blindness


22. Located on the anterior surface of the midbrain and contains the corticospinal, corticonuclear (corticobulbar), and corticopontine tracts.
    a. Medial forebrain bundle
    b. Ansa lenticularis and lenticular fasciculus
    c.  Anterior commissure
    d. Crus cerebri
    e. Posterior commissure
    f.  Dentatorubrothalamic tract
    g. Lateral olfactory stria
    h. Uncinate fasciculus
    i.  Subthalamic fasciculus
    j.  Basal nucleus (Meynert)
    k.  Lesion of the optic chiasma
    l.   Left homonymous superior quadrantanopsia
    m. Right homonymous hemianopsia
    n.  Left homonymous inferior quadrantanopsia
    o.  Left homonymous hemianopsia
    p.  Left monocular blindness


23. Located in the substantia innominata of the basal forebrain and contains large cholinergic neurons that have widespread projections to the cortex and amygdala.
    a. Medial forebrain bundle
    b. Ansa lenticularis and lenticular fasciculus
    c.  Anterior commissure
    d. Crus cerebri
    e. Posterior commissure
    f.  Dentatorubrothalamic tract
    g. Lateral olfactory stria
    h. Uncinate fasciculus
    i.  Subthalamic fasciculus
    j.  Basal nucleus (Meynert)
    k.  Lesion of the optic chiasma
    l.   Left homonymous superior quadrantanopsia
    m. Right homonymous hemianopsia
    n.  Left homonymous inferior quadrantanopsia
    o.  Left homonymous hemianopsia
    p.  Left monocular blindness


24. Visual deficit due to an occlusion of the right posterior cerebral artery.
    a. Medial forebrain bundle
    b. Ansa lenticularis and lenticular fasciculus
    c.  Anterior commissure
    d. Crus cerebri
    e. Posterior commissure
    f.  Dentatorubrothalamic tract
    g. Lateral olfactory stria
    h. Uncinate fasciculus
    i.  Subthalamic fasciculus
    j.  Basal nucleus (Meynert)
    k.  Lesion of the optic chiasma
    l.   Left homonymous superior quadrantanopsia
    m. Right homonymous hemianopsia
    n.  Left homonymous inferior quadrantanopsia
    o.  Left homonymous hemianopsia
    p.  Left monocular blindness

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