Neuroscience Fundamentals Rehabilitation 4th Edition Lundy Ekman – Test Bank A+

$35.00
Neuroscience Fundamentals Rehabilitation 4th Edition Lundy Ekman – Test Bank A+

Neuroscience Fundamentals Rehabilitation 4th Edition Lundy Ekman – Test Bank A+

$35.00
Neuroscience Fundamentals Rehabilitation 4th Edition Lundy Ekman – Test Bank A+
  1. Spinal axons conveying a signal for conscious somatosensation from the upper limb ascend in which of the following?
  2. Ventral horn
  3. Fasciculus gracilis
  4. Fasciculus cuneatus
  5. Internal arcuate fibers
  6. Medial lemniscus

ANS: C

Rationale: Conscious somatosensory information from peripheral receptors is conveyed to the dorsal root and ascends through the ipsilateral dorsal column. Axons from the lower limb ascend in the medial dorsal column, called the fasciculus gracilis. Axons from the upper extremity ascend in the lateral dorsal column, called the fasciculus cuneatus.

  1. Cell bodies of second-order neurons conveying a signal for conscious proprioceptive information from the lower limb are located in which of the following?
  2. Dorsal root ganglion
  3. Fasciculus cuneatus
  4. Somatosensory cerebral cortex
  5. Nucleus gracilis
  6. Medial lemniscus

ANS: D

Rationale: First-order neurons conveying conscious proprioceptive input enter the dorsal root, with cell bodies located in the dorsal root ganglion. First-order neurons from the lower limb synapse with second-order neurons whose cell bodies are located in the nucleus gracilis of the medulla.

  1. The ventral posterolateral (VPL) nucleus of the thalamus is the site of synapse for:
  2. First-order neurons of the dorsal column/medial lemniscus system.
  3. Second-order neurons with their cell bodies in the nucleus cuneatus and/or nucleus gracilis.
  4. Third-order neurons with their cell bodies in the spinal nucleus of the trigeminal cranial nerve.
  5. Second-order neurons with their cell bodies in the nucleus dorsalis (Clarke’s nucleus).
  6. Third-order neuron with their cell body the lateral cuneate nucleus.

ANS: B

Rationale: Second-order neurons, with their cell bodies located in the nucleus gracilis or nucleus cuneatus, cross the midline as the internal arcuate fibers and ascend to the thalamus as the medial lemniscus. These fibers then synapse with third-order neurons in the VPL nucleus of the thalamus.

  1. Rapidly turning the eyes and head toward a painful stimulus is a function of which one of the following tracts?
  2. Trigeminoreticulolimbic
  3. Spinoreticular
  4. Spinomesencephalic
  5. Trigeminospinothalamic
  6. Dorsal column medial lemniscus

ANS: C

Rationale: The spinomesencephalic tract carries nociceptive information to the superior colliculus and periaqueductal gray matter, producing a rapid turning of the eyes and head toward the source of the noxious input.

  1. Which of the following statements is true about the homunculus for the somatosensory cortex?
  2. The homunculus was developed by experimentally recording electrical potentials from cells in the somatosensory cortex during stimulation of various parts of the body.
  3. The area of the homunculus that represents the foot is adjacent to the area for the hand.
  4. The proportions of the homunculus are the same as the proportions of the physical body.
  5. Somatotopic organization is only found in cellular organization of the somatosensory cortex.
  6. The area of the homunculus that represents the torso is adjacent to the area for the face.

ANS: A

Rationale: The homunculus represents the size of the area of primary sensory cortex devoted to specific parts of the body. This sensory map was developed by recording the electrical potentials of neurons in the sensory cortex when stimulating various areas of the body. Increased cortical representation corresponds to a higher degree of receptors and fine-motor control required by the body area. This somatotopic organization is maintained throughout the second- and third-order neurons.

  1. Which of the following is a function of the primary somatosensory cortex?
  2. Discrimination of the texture of an object
  3. Discrimination of the shape of an object
  4. Stereognosis
  5. Both A and B
  6. A, B, and C

ANS: D

Rationale: The primary somatosensory cortex allows for the discrimination of the size, texture, and shape of objects, whereas the thalamus provides stereognosis and memory of the tactile and spatial environment.

  1. A lesion to which one of the following regions would result in crossed analgesia?
  2. Dorsal horn of the spinal cord
  3. Peripheral nerves
  4. Medulla or lower pons
  5. Thalamus
  6. Cortex

ANS: C

Rationale: A lesion of the lower pons and medulla can produce crossed analgesia because axons conveying fast pain information from the face descend ipsilaterally near the spinothalamic tract, which carries pain information from the contralateral side of the body.

  1. Which of the following pathways brings sensory information to the brain?
  2. Conscious relay
  3. Divergent
  4. Unconscious relay
  5. All of the above

ANS: D

Rationale: Three types of pathways bring sensory information to the brain: (1) conscious relay pathways, (2) divergent pathways, and (3) unconscious relay pathways.

  1. Which of the following is the general name for a bundle of axons with the same origin and a common termination?
  2. Tract
  3. Pathway
  4. Linea
  5. Lamina

ANS: A

Rationale: In the CNS, a bundle of axons with the same origin and a common termination is called a tract. A pathway is a series of neurons. Somatosensory pathways are often named for the origin and termination of the tract that contains the second neuron in the series.

  1. What are the four types of somatosensations?
  2. Movement, touch, temperature, and pain
  3. Speed, pressure, touch, and temperature
  4. Pressure, pain, touch, and temperature
  5. Pain, proprioception, touch, and temperature

ANS: D

Rationale: All four types of somatosensations reach conscious awareness: pain, proprioception, touch, and temperature.

  1. Which one of the following is the difference between discriminative touch and conscious proprioception?
  2. Discriminative touch allows for the localization of touch; conscious proprioception involves the awareness of movement of body parts.
  3. Conscious proprioception allows for localization of touch; discriminative touch involves the awareness of movement of body parts.
  4. No difference exists; these terms are synonymous.
  5. None of the above

ANS: A

Rationale: Discriminative touch involves the localization of touch and vibration and the ability to discriminate between two closely spaced points touching the skin. Conscious proprioception is the awareness of movement and the relative position of body parts in space.

  1. The pathways for discriminative touch and conscious proprioception use a three-neuron relay. Which one of the following describes the role of the secondary neuron?
  2. Conveys information from the receptors to the medulla.
  3. Conveys information from the thalamus to the cerebral cortex.
  4. Conveys information from the thalamus to the medulla.
  5. Conveys information from the medulla to the thalamus.

ANS: D

Rationale: The pathway for discriminative touch and conscious proprioception uses a three-neuron relay: (1) the primary neuron conveys information from the receptors to the medulla; (2) the secondary neuron conveys information from the medulla to the thalamus; and (3) the tertiary neuron conveys information from the thalamus to the cerebral cortex.

  1. Stimulation of a peripheral receptor is conveyed to the cell body of a primary neuron located in which one of the following?
  2. Nucleus gracilis
  3. Nucleus cuneatus
  4. Dorsal root ganglion
  5. Fasciculus gracilis
  6. Fasciculus cuneatus

ANS: C

Rationale: Stimulation of a receptor at the distal end of a primary peripheral neuron is conveyed to the cell body in the dorsal root ganglion. The proximal axon then ascends in the ipsilateral dorsal columns of the spinal cord in either the fasciculus gracilis or fasciculus cuneatus, synapsing with second-order neurons in the nucleus gracilis or cuneatus of the medulla.

  1. Spinothalamic pain is:
  2. Fast.
  3. Throbbing.
  4. Well-localized.
  5. Both A and C
  6. All of the above

ANS: D

Rationale: A common patient report of back pain secondary to lifting a heavy object consists of an initial immediate sharp sensation that indicates the location of the injury; this is called fast or spinothalamic pain. Fast pain is often followed by a dull, throbbing ache that is not well-localized. Well-localized pain is called slow or spinolimbic pain.

  1. Fast pain occurs before slow pain because fast pain impulses travel on which of the following?
  2. Larger, unmyelinated axons
  3. Smaller, unmyelinated axons
  4. Larger, myelinated axons
  5. Smaller, myelinated axons

ANS: C

Rationale: When fast pain information reaches the somatosensory cortex, an individual is consciously aware of a sharp pain in a specific location. If tissue damage has occurred, the fast pain is followed by slow, aching pain. The onset of slow pain occurs later than fast pain because slow pain impulses travel on smaller, unmyelinated axons, whereas fast pain travels on larger, myelinated axons.

  1. Activity of the medial pain system elicits which of the following types of responses?
  2. Affective
  3. Arousal
  4. Autonomic
  5. All of the above

ANS: D

Rationale: Many responses to nociception depend on a divergent ascending network of neurons called the medial pain system. Activity of the medial pain system elicits affective, motivational, withdrawal, arousal, and autonomic responses. Most of the medial pain system projection neurons synapse in medial locations in the CNS.

  1. Which one of the following are ascending tracts by which neurons reach the midbrain, reticular formation, and limbic areas?
  2. Spinoreticular
  3. Spinomesencephalic
  4. Spinothalamic
  5. All of the above

ANS: D

Rationale: The axons of ascending projection neurons reach the midbrain, reticular formation, and limbic areas via three parallel tracts in the anterolateral spinal cord: (1) spinomesencephalic, (2) spinoreticular, and (3) spinolimbic.

  1. Which one of the following pathways relay high-fidelity, somatotopically arranged information to the cerebellar cortex?
  2. Posterior spinocerebellar pathway
  3. Anterior spinocerebellar tract
  4. Cuneocerebellar pathway
  5. Rostral spinocerebellar tract
  6. Both A and C

ANS: E

Rationale: Two pathways relay high-fidelity, somatotopically arranged information to the cerebellar cortex: the (1) posterior spinocerebellar and (2) cuneocerebellar pathways. The anterior spinocerebellar and rostral spinocerebellar tracts monitor spinal interneuron activity and descending motor signals from the cerebral cortex and brainstem.

  1. The anterior spinocerebellar tract transmits information from which of the following?
  2. Arms and upper half of the body
  3. Legs and the lower half of the body
  4. Cervical spinal cord
  5. Thoracolumbar spinal cord

ANS: D

Rationale: The anterior spinocerebellar tract transmits information from the thoracolumbar spinal cord. The tract begins with cell bodies in the lateral and ventral horns, in the area of the spinal cord containing the most interneurons. The rostral spinocerebellar tract transmits information from the cervical spinal cord to the ipsilateral cerebellum via the inferior and superior cerebellar peduncles.

  1. Temperature information is transmitted via pathways to the:
  2. Reticular formation
  3. Hypothalamus
  4. Subcortical nuclei
  5. All of the above

ANS: D

Rationale: Temperature information is transmitted in phylogenetically older pathways to the reticular formation, nonspecific nuclei of the thalamus, subcortical nuclei, and hypothalamus. This temperature information does not reach conscious awareness, contributes to arousal, provides gross localization, and contributes to autonomic regulation.

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

Chapter 7: Somatosensation: Clinical Application

Test Bank

  1. Sensory extinction is the:
  2. Inability to recognize any sensations consciously.
  3. Loss of conscious proprioception.
  4. Same as astereognosis.
  5. Awareness of stimuli on only one side of the body when both sides of the body are simultaneously stimulated.
  6. Inability to localize a pinprick on one side of the body.

ANS: D

Rationale: In cases of sensory extinction (also called sensory inattention), the loss of sensation is only evident when symmetrical body parts are tested bilaterally.

  1. The role of enkephalins in the spinal cord is:
  2. To decrease release of substance P from the primary afferent.
  3. To hyperpolarize spinal interneurons in the pain pathway.
  4. To stimulate non-nociceptive interneurons of the dorsal horn.
  5. A and B
  6. A, B, and C

ANS: D

Rationale: Enkephalins bind with receptor sites on both the primary afferents and interneurons of the pain system. Enkephalin binding depresses the release of substance P and hyperpolarizes the interneurons, thus inhibiting the transmission of nociceptive signals.

  1. When the raphespinal tract is active, which neurotransmitter is released at the axon terminal in the dorsal horn of the spinal cord?
  2. Norepinephrine
  3. Gamma-aminobutyric acid (GABA)
  4. Dopamine
  5. Substance P
  6. Serotonin

ANS: E

Rationale: When the rostral ventromedial medulla is electrically stimulated, the raphespinal tracts (i.e., the axons projecting to the spinal cord) release the neurotransmitter, serotonin, in the dorsal horn, inhibiting the tract neurons via enkephalin interneurons and thus interfering with the transmission of nociceptive messages.

  1. Which of the following is(are) part of the fast-descending neuronal system for pain inhibition?
  2. Rostral ventromedial medulla
  3. Periaqueductal gray
  4. Locus coeruleus
  5. A, B, and C
  6. None of the above

ANS: D

Rationale: The brainstem areas that provide intrinsic antinociception form a neuronal descending system, arising in the following: rostral ventromedial medulla, periaqueductal gray (PAG) in the midbrain, and locus coeruleus in the pons.

  1. The locus coeruleus is located in which one of the following?
  2. Spinal cord dorsal horn
  3. Medulla
  4. Pons
  5. Midbrain
  6. Cerebral cortex

ANS: C

Rationale: The locus coeruleus is located in the pons.

  1. The periaqueductal gray is located in which one of the following?
  2. Spinal cord dorsal horn
  3. Medulla
  4. Pons
  5. Midbrain
  6. Cerebral cortex

ANS: D

Rationale: The periaqueductal gray is located in the midbrain.

  1. Which of the following guidelines will improve the reliability of sensory testing?
  2. Explain the purpose of the testing.
  3. Administer the test in a loud environment.
  4. Apply stimuli near the center of the dermatomes being tested.
  5. A and C

ANS: D

Rationale: The following guidelines serve to improve the reliability of sensory testing: (1) administer the tests in a quiet, distraction-free setting; (2) position the patient seated or lying and supported by a firm, stable surface to avoid challenging balance during the test; (3) explain the purpose of the test; (4) demonstrate each test before administering it; during the demonstration, allow the patient to see the stimulus; (5) during testing, block the patient’s vision by having the patient close the eyes or wear a blindfold or by placing a barrier between the part being tested and the patient’s eyes; and (6) apply stimuli near the center of the dermatomes being tested.

  1. Which of the following is not measured during a complete sensory evaluation?
  2. Proprioceptive thresholds
  3. Conscious touch sensitivity
  4. Thresholds for stimulation
  5. All of the above

ANS: A

Rationale: A complete sensory evaluation includes measuring sensitivity and thresholds for stimulation of each conscious sensation, except proprioceptive thresholds, which are not measured. For example, a measure of conscious touch sensitivity is the ability to distinguish between two closely applied points on the skin; threshold is the lowest intensity of a stimulus that can be perceived, similar to when the person barely perceives being touched.

  1. If only one sensory root is severed, does a complete loss of sensation result in that area?
  2. Yes. Sensation does not depend on multiple dermatomes.
  3. No. Overlapping dermatomes ensure not all sensation is lost.
  4. No. Multiple sensory roots must be severed for complete sensory loss to occur.
  5. Yes. Overlapping dermatomes will not prevent complete sensation loss.

ANS: B

Rationale: The results of somatosensory testing procedures can be used to map a person’s pattern of sensory loss. The resulting map can be compared with standardized maps of peripheral nerve distribution and of dermatome distributions to determine whether the person’s pattern of sensory loss is consistent with a peripheral nerve or a spinal region pattern. Because every individual is unique and adjacent dermatomes overlap one another, the maps presented represent common but not definitive nerve distributions. The overlap of adjacent dermatomes also ensures that if only one sensory root is severed, then a complete loss of sensation does not occur in any area.

  1. What numerical value(s) is (are) involved in determining whether the results of a nerve conduction study are normal?
  2. Conduction velocity
  3. Distal latency
  4. Amplitude of the evoked potential
  5. All of the above

ANS: D

Rationale: To determine whether a nerve conduction study is normal, three numerical values are compared: (1) distal latency, (2) amplitude of the evoked potential, and (3) conduction velocity.

  1. If sitting with the legs crossed, sensory loss will eventually occur. (Part of the limb will “fall asleep.”) In what order will this loss occur? (Hint: compression of a nerve affects function in order according to axon diameter and myelination; largest diameter myelinated axons are affected first)
  2. 1. Slow pain; 2. heat; 3. fast pain; 4. cold; 5. conscious proprioception and discriminative touch
  3. 1. Conscious proprioception and discriminative touch; 2. heat; 3. fast pain; 4. cold; 5. slow pain
  4. 1. Conscious proprioception and discriminative touch; 2. cold; 3. fast pain; 4. heat; 5. slow pain
  5. 1. Slow pain; 2. cold; 3. fast pain; 4. heat; 5. conscious proprioception and discriminative touch

ANS: C

Rationale: When a person stands up after prolonged sitting with the legs crossed, occasionally, the person finds that part of the limb has “fallen asleep.” The sensory loss proceeds in the following order: 1. conscious proprioception and discriminative touch; 2. cold; 3. fast pain; 4. heat; and 5. slow pain.

  1. Loss of pain and temperature information from the left lower limb below the L4 dermatome, complete loss of discriminative touch and conscious proprioception information from the right lower limb below the L2 dermatome, and loss of voluntary control of the right lower limb below the L2 dermatome indicates which one of the following?
  2. Brown-Séquard syndrome produced by a hemisection of the cord at L4 on the right side
  3. Brown-Séquard syndrome produced by a hemisection of the cord at L4 on the left side
  4. Brown-Séquard syndrome produced by a complete transection of the cord
  5. Brown-Séquard syndrome produced by a hemisection of the cord at L2 on the right side
  6. Brown-Séquard syndrome produced by a hemisection of the cord at L2 on the left side

ANS: D

Rationale: A hemisection (i.e., damage to the right or left half of the cord) interrupts pain and temperature sensation from the contralateral body because the axons transmitting nociceptive and temperature information cross to the opposite side of the cord soon after entering the cord. As a result of collateral branching of nociceptive axons in the dorsolateral tract, the complete loss of pain sensation occurs two to three dermatomes below the level of the lesion. Because discriminative touch and conscious proprioception information ascends on the same side of the cord as it entered, these sensations are lost ipsilateral to the lesion. Paralysis also occurs ipsilaterally. The pattern of loss is called Brown-Séquard syndrome.

  1. Lesions in what location(s) will result in decreased or lost sensation from the contralateral body or face?
  2. Ventral posterolateral (VPL) nucleus of the thalamus
  3. Ventral posteromedial (VPM) nucleus of the thalamus
  4. A and B
  5. None of the above

ANS: C

Rationale: Lesions in the VPL or VPM nucleus of the thalamus result in decreased or lost sensation from the contralateral body or face because all somatosensory information has crossed the midline before reaching the thalamus. Rarely, people who have strokes that affect the VPL or VPM nucleus have severe pain in the contralateral body or face.

  1. Which of the following is(are) part of the pain matrix?
  2. Amygdala
  3. Thalamus
  4. Hypothalamus
  5. All of the above

ANS: D

Rationale: The pain matrix includes parts of the brainstem, amygdala, hypothalamus, thalamus, and cerebral cortex.

  1. What does the counterirritant theory hypothesizes a mechanism affecting:
  2. Pain transmission
  3. Pain treatment
  4. Pain amplification
  5. None of the above

ANS: A

Rationale: A theory that has incorporated findings from research stimulated by the gate theory is the counterirritant theory. According to the counterirritant theory, inhibition of nociceptive signals by stimulation of non-nociceptive receptors occurs in the dorsal horn of the spinal cord.

  1. Which of the following are not endorphins?
  2. Dynorphins
  3. b-Endorphins
  4. Enkephalins
  5. All of the above are types of endorphins.

ANS: D

Rationale: Antinociception is the suppression of pain in response to stimulation that would normally be painful. The endogenous or natural-occurring substances that activate antinociceptive mechanisms are called endorphins. Endorphins include enkephalins, dynorphins, and b-endorphins.

  1. Which of the following is a site in the nervous system where the transmission of nociceptive information can be altered?
  2. Hormonal system
  3. Dorsal horn
  4. Cortical level
  5. All of the above

ANS: D

Rationale: The transmission of nociceptive information can be altered at several locations in the nervous system. The phenomenon of antinociception is summarized with a five-level model: Level 1 occurs in the periphery; level II occurs in the dorsal horn; level III is the fast-acting neuronal descending system; level IV is the hormonal system; and level V is the cortical level.

  1. Which of the following are NOT characteristics of acute pain?
  2. Threat of or actual tissue damage
  3. Dysfunction of endogenous pain control systems
  4. Clear description of the location of the pain
  5. Excessive autonomic activity

ANS: B

Rationale: See Table 7-4.

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