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1. A right superior 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
   
   CASE STUDY (Questions 2 and 3 below)
   A patient presents with the recent onset of ptosis and miosis of the left eye, without any other signs or symptoms.  Examination showed the left pupil to be 3 mm and the right pupil to be 5 mm.  There was a 2 mm ptosis of the left eyelid.
   
   
2. Which of the following locations and/or structures could be involved by the pathological process?
   a. descending sympathetic fibers in the left lateral tegmentum of the pons or medulla (central Horner’s syndrome, 1st order neuron)
   b. left apex of the lung (preganglionic Horner’s syndrome, 2nd order neuron)
   c.  left internal carotid artery pericarotid sympathetic plexus (postganglionic oculosympathetic paresis, 3rd order neuron)
   d. all of the above are correct


3. Oculosympathetic pupillary testing was performed.  When 4% cocaine eye drops were placed in each eye, the left pupil did not dilate (3 mm), but the right pupil dilated (8 mm).  After full recovery, 1% hydroxyamphetamine eye drops were placed in each eye.  The left pupil remained at 3 mm, but the right pupil again dilated (7 mm).  Given these data, which of the following pathological processes caused this patient’s findings?
   a. occlusion of the left posterior inferior cerebellar artery (PICA)
   b.  left apical lung carcinoma
   c.  dissection of the left internal carotid artery in the cavernous sinus
   d. all of the above are correct
   e. none of the above are correct


4. 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. superior parietal lobule (areas 5 and 7)
   c.  transverse temporal gyri (areas 41 and 42)
   d. postcentral gyrus (areas 3, 1, 2)
   e. only b and d are correct


5. 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 to the right at rest
   c.  the patient cannot voluntarily look to the right
   d. the patient cannot voluntarily look to the left
   e. only b and d are correct


6. The anterior commissure:
   a. is an example of an association bundle
   b. connects the inferior frontal lobe to the anterior temporal lobe
   c.  connects the left motor speech center (Broca’s area, areas 44, 45) with the left superior temporal gyrus (Wernicke’s area, area 22)
   d. connects the middle and inferior temporal gyri of one side to the other
   e. only a and c are correct


7. Which of the following statements concerning association 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. The neuron cell bodies of origin are small pyramidal cells in layer 5 of the cortex.
   c.  One example is the corpus callosum.
   d. One example is the corticospinal tract.
   e. none of the above is correct


8. Which of the following represents a polymodal (heteromodal) sensory association cortex?
   a. superior parietal lobule (areas 5 and 7)
   b. lateral occipital cortex (areas 18 and 19)
   c.  postcentral gyrus (areas 3, 1, 2)
   d. all of the above are correct
   e. none of the above is correct



9. Which of the following statements concerning the archicortex is (are) true?
   a. It contains three layers.
   b. The hippocampus is a part of it.
   c.   The dentate gyrus is a part of it.
   d.  It is the most primitive area of the cerebral cortex.
   e.  all of the above are correct



10. Which of the following fiber bundles (tracts, pathways, etc.) is  an example of
    projection fibers?
    a. corticostriate fibers
    b.   uncinate fasciculus
    c.    corpus callosum
    d.  arcuate fasciculus
    e. superior longitudinal fasciculus
    
    


11. Which diencephalic structure is the dominant circadian pacemaker of the brain?
    a.  pineal body
    b.  neurohypophysis
    c.   suprachiasmatic nucleus of the hypothalamus
    d.  supraoptic nucleus of the hypothalamus
    e.  paraventricular nucleus of the hypothalamus


12. Which language component is mediated by the nondominant (dorsolateral) frontal lobe?
    a. comprehension
    b. naming
    c.    repetition
    d. prosody
    e.  writing


13. The orbitofrontal cortex is most heavily involved in which of the following cortical functions?
    a. impulse control and personality behaviors
    b. memory consolidation
    c.  language comprehension
    d.  complex motor programming
    e. visual-spatial orientation


14. Which adult structures are derived from the embryonic diencephalon?
a. hypothalamus
b. pineal body
c.  thalamus
d.  medial geniculate body
e.   all of the above are correct
f.  only a and c are correct
g. only b and d are correct


15. Layer 4 of the cerebral cortex, the internal granular layer, contains a dense band of nerve fibers.  Which of the following statements concerning this structure is (are) true?
    a. This band of fibers is called the external (outer) line (or band) of Baillarger.
    b. This band of fibers contains the terminal ramifications of the thalamocortical projections from the specific thalamic relay nuclei.
    c.  This band of fibers is especially prominent in the primary visual cortex (area 17), where it is known as the line of Gennari.
    d.  Layer 4 of the cortex is particularly well-developed in sensory areas of the cortex.
    e. all of the above are correct
    f.  only a and b are correct
    
    
16. Which of the following statements concerning hippocampal circuitry 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 projection from the subiculum back to the entorhinal cortex, which has connections with cortical association areas.
    c.    The dentate granule cells project to the CA3 pyramidal cells via the mossy fiber pathway.
    d.  The CA3 pyramidal cells give off recurrent (Schaffer) collaterals that synapse with CA1 pyramidal cells. These CA1 neurons have collaterals that synapse with neurons of the subiculum.
    e. all of the above are correct
    f.   only a and c are correct
    g. only b and d are correct


17. 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. impaired repetition
    e. all of the above are correct
    f.  only a, b, 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. 73-year-old with fluent, but incomprehensible, speech and inability to follow commands.
    a. Inferior parietal lobule (areas 39, 40)
    b. Prefrontal cortex (areas 9, 10, 11)
    c.  Limbic cortex
    d. Supplementary motor area
    e. Brodmann's areas 8, 6 (frontal eye field)
    f.  Wernicke's aphasia
    g. Broca's aphasia
    h. Superior parietal lobule (areas 5, 7)
    i.  Uncus
    j.  Lesion of the optic chiasma
    k.  Left homonymous superior quadrantanopsia
    l.   Right homonymous hemianopsia
    m.  Left homonymous inferior quadrantanopsia
    n.  Left homonymous hemianopsia
    o.  Left monocular blindness
    
    
19. Controls voluntary (saccadic) eye movements.
    a. Inferior parietal lobule (areas 39, 40)
    b. Prefrontal cortex (areas 9, 10, 11)
    c.  Limbic cortex
    d. Supplementary motor area
    e. Brodmann's areas 8, 6 (frontal eye field)
    f.  Wernicke's aphasia
    g. Broca's aphasia
    h. Superior parietal lobule (areas 5, 7)
    i.  Uncus
    j.  Lesion of the optic chiasma
    k.  Left homonymous superior quadrantanopsia
    l.   Right homonymous hemianopsia
    m. Left homonymous inferior quadrantanopsia
    n.  Left homonymous hemianopsia
    o.  Left monocular blindness
    
    
20. Unimodal sensory association cortex.
    a. Inferior parietal lobule (areas 39, 40)
    b. Prefrontal cortex (areas 9, 10, 11)
    c.  Limbic cortex
    d. Supplementary motor area
    e. Brodmann's areas 8, 6 (frontal eye field)
    f.  Wernicke's aphasia
    g. Broca's aphasia
    h. Superior parietal lobule (areas 5, 7)
    i.  Uncus
    j.  Lesion of the optic chiasma
    k.  Left homonymous superior quadrantanopsia
    l.   Right homonymous hemianopsia
    m. Left homonymous inferior quadrantanopsia
    n.  Left homonymous hemianopsia
    o.  Left monocular blindness
    
    
21. Parahippocampal and cingulate gyri.
    a. Inferior parietal lobule (areas 39, 40)
    b. Prefrontal cortex (areas 9, 10, 11)
    c.  Limbic cortex
    d. Supplementary motor area
    e. Brodmann's areas 8, 6 (frontal eye field)
    f.  Wernicke's aphasia
    g. Broca's aphasia
    h. Superior parietal lobule (areas 5, 7)
    i.  Uncus
    j.  Lesion of the optic chiasma
    k.  Left homonymous superior quadrantanopsia
    l.   Right homonymous hemianopsia
    m. Left homonymous inferior quadrantanopsia
    n.  Left homonymous hemianopsia
    o.  Left monocular blindness


22. 37-year-old with a sudden perception of an unpleasant odor, followed by a seizure.
    a. Inferior parietal lobule (areas 39, 40)
    b. Prefrontal cortex (areas 9, 10, 11)
    c.  Limbic cortex
    d. Supplementary motor area
    e. Brodmann's areas 8, 6 (frontal eye field)
    f.  Wernicke's aphasia
    g. Broca's aphasia
    h. Superior parietal lobule (areas 5, 7)
    i.  Uncus
    j.  Lesion of the optic chiasma
    k.  Left homonymous superior quadrantanopsia
    l.   Right homonymous hemianopsia
    m. Left homonymous inferior quadrantanopsia
    n.  Left homonymous hemianopsia
    o.  Left monocular blindness
    
    
23. 65-year-old with a left homonymous inferior quadrantanopsia.  He fails to dress the left side of his body and denies that "anything is wrong with him."
    a. Inferior parietal lobule (areas 39, 40)
    b. Prefrontal cortex (areas 9, 10, 11)
    c.  Limbic cortex
    d. Supplementary motor area
    e. Brodmann's areas 8, 6 (frontal eye field)
    f.  Wernicke's aphasia
    g. Broca's aphasia
    h. Superior parietal lobule (areas 5, 7)
    i.  Uncus
    j.  Lesion of the optic chiasma
    k.  Left homonymous superior quadrantanopsia
    l.   Right homonymous hemianopsia
    m. Left homonymous inferior quadrantanopsia
    n.  Left homonymous hemianopsia
    o.  Left monocular blindness


24. Bitemporal hemianopsia.
    a. Inferior parietal lobule (areas 39, 40)
    b. Prefrontal cortex (areas 9, 10, 11)
    c.  Limbic cortex
    d. Supplementary motor area
    e. Brodmann's areas 8, 6 (frontal eye field)
    f.  Wernicke's aphasia
    g. Broca's aphasia
    h. Superior parietal lobule (areas 5, 7)
    i.  Uncus
    j.  Lesion of the optic chiasma
    k.  Left homonymous superior quadrantanopsia
    l.   Right homonymous hemianopsia
    m. Left homonymous inferior quadrantanopsia
    n.  Left homonymous hemianopsia
    o.  Left monocular blindness
    
    

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