WEEK: 4 MODULE 9: NERVOUS SYSTEM AND SPECIAL SENSES

1.

All the following are mechanism action of general anesthetic agents except? A. Increasing the effect of inhibitory neurotransmitter B. Open the chloride channel in neuronal membrane C. Neuronal hyperpolarization D. Open the sodium channel in neuronal membrane

2.

Which of the following drug is not in form of volatile liquids of inhalation anesthetic? A. Halothane B. Enflurane C. Nitrous oxide

D. Sevoflurane

3.

All the following are pharmacological action of inhalational anesthetic A. Skeletal muscle paralysis B. Lowering blood pressure C. Complete anesthesia with nitrous oxide D. Vagomimetic effect

4.

Which of the following is not the pharmacokinetic properties of IV agents? A. Rapid distribution to CNS B. Patients generally awakens 4-5 hours C. Clearance by metabolism and excretion D. Pharmacological effect depends on redistribution to other tissues mainly skeletal muscle

5.

All the following are the clinical use of IV anesthetic agents except? A. For maintaining the general state as long as the surgical procedure is going on B. For induction of general anesthesia C. For Dissociative anesthesia D. For Neuroleptic analgesia

6.

Which of the following is NOT present on the frontal lobe? A. Primary motor & Premotor area B. Supplementary area C. Broca's area D. Somatosensory area I and II

7.

Choose the CORRECT statements regarding primary motor area (area 4) I II III IV Body presented in inverted manner Hand & muscle of speech larger than the area of trunk & legs Area with low excitability Contain many Betz cells

A. I, II and III B. I, II, and IV C. I, III and IV D. All of the above

8.

Choose the right arrangement regarding the specialized area of premotor area ( from upward to downward) A. Broca's area > eye movement area > head rotation area > Supplementary area > Exners area B. Eye movement area > Broca's area > Head rotation area > Exner's area > Supplementary area C. Supplementary area > Area of hand skills area > Head rotation area > Eye movement area > Broca's area D. Head rotation area > Supplementary area > Exner's area > Eye movement area > Broca's area

9.

Which of the following is False regarding the area on the cerebral cortex and its function? A. Premotor area and Prefrontal association area shares similarities in planning of voluntary movement B. The excitability of the primary area is more than the premotor area C. Premotor area facilitate spinal reflex while the primary motor area against that D. Body representation on supplementary motor area is bilateral and horizontal

10.

Which is False regarding area for integrative function A. B. It receive & analyse signal from both motor and sensory cortex Consist of prefrontal association area, parieto-occipital-temporal association area and Limbic association area C. Wernick's area & area 39 in Angular gyrus are important in speech

D. Limbic association area concern mainly in planning of voluntary movement

11.

What is the name of the structure that divides the pons into tectum and cerebral peduncle? A. B. C. D. Middle cerebellar peduncle Mammillary body Aqueduct of sylvius Tegmentum

12.

Which of the following is not part of the cerebral peduncle? A. B. C. D. Tegmentum Substantianigra Basis pedunculi Interpeduncular fossa

13.

All of the following structure will cross the crus cerebri except A. B. C. D. Basilar artery Basal vein Posterior cerebral artery Optic tract

14.

Which of the following structure will give exit to rootlets of hypoglossal nerve? A. B. C. D. Anteromedian fissure Anterolateral sulcus Posteromedian sulcus Posterior perforated substance

15.

The posterolateral sulcus will give exit to rootlets of all of the following nerves except A. B. C. D. Cranial accessory nerve Vagus nerve Glossopharyngeal nerve Optic nerve

16.

At the mid brain, the corticospinal pathway descends in the A. Ventral portion B. Dorsal portion C. Lateral portion

17.

At which level the 80% of corticospinal fibers continue as lateral corticospinal tract? A. Upper medulla B.Lower medulla C. Upper pons D. Lower pons

18.

The ipsilateral fibers supply all of the following muscles: I. Muscles of abdominal wall II. Muscles of respiration III. Muscles of the distal part of upper limb IV. Muscles of the upper face A. I, II and III B. I, II and IV C. I, III and IV D. I, II, III and IV

19.

Muscles of head and neck are supplied by A. Corticolspinal tract B. Vestibulospinal tract C. Rubrospinal tract D. Corticobulbar tract

20.

Which of the following extrapyramidal tracts are crossed tract? I. Medial reticulospinal tract II. Medial tectospinal tract III. Lateral tectospinal tract IV. Lateral reticulospinal tract A. I, II and III B. I, III and IV C. II, III and IV D. I, II, III and IV

21.

All the following composed in grey matter EXCEPT: A. B. C. D. A complex of nerve cell bodies Unmyelinated nerve fibers Network of nerve ganglia Few blood capillaries

22.

What is function of substantiagelatinosa of Rolandi in dorsal horn? A. Associated with many sensory pathways for touch in ventral spinothalamic tracts B. Important cell station for impulses of pain and temperature carried by lateral spinothalamic tracts. C. Associated with proprioceptive sensation D. None of above

23.

Which are the tracts present in dorsal white column? I. II. III. IV. A. B. C. D. Septomarginal tract Gracile&cuneate tract Sulcomarginal tract Rubrospinal tract I AND II II AND III I AND IV III AND IV

24.

All the statements below are true, EXCEPT: A. B. C. D. Lateral and medial reticulo-spinal tracts are descending tracts The comma shaped tract lies between the two long tract of dorsal column The fasciculi Proprii is long tracts Pyramidal tracts in motor tracts consists of direct and indirect

25.

Match the following : a. b. c. d. Small in size and quadrilateral ( ) Thin and divergent dorsal horn ( ) Absent of olivospinal tracts ( ) Central canal is central in position () i. Cervical level ii. Thoracic level iii. Lumbar level iv. Sacral level

26.

Which of the following are true about general properties of reflexes? A. Increase the extent of the response resulting from decrease the intensity of the stimulus explains irradiation property. B. Occlusion is happened due to overlap of the discharge zones of near efferent zone C. Reciprocal innervations happen through presence of interneurons which release an excitatory transmitter at its junction with the AHC supplying the antagonistic muscle D. The tensions developed by the simultaneous stimulation of 2 afferents is greater than the sum of tensions developed by stimulation of each the 2 afferent separately is called subliminal fringe

27. I. II. III. IV. A. B. C. D.

Spinal cord reflexes can be classified into Superficial reflexes Muscle reflexes Deep reflexes Visceral reflexes I and III II and III I, II and IV I, III and IV

28. All of the following are correct about reflex EXCEPT A. Reflex is the involuntary response of an organ to stimulus B. Reflex delay caused by time needed for conduction along the afferent and efferent fibers, and across the synapse C. Reverberation of the signal for prolonged periods leading to repetitive inhibition of its efferent neurons D. Neurons in the subliminal fringe zones do not discharge but facilitated E. Muscle tension rises gradually due to recruitment of the motor neurons 29. Deep reflexes include I. Stepping reflex II. Crossed extensor reflex which is a supportive reflex III. Stretch reflex IV. Cremastertic reflex A. B. C. D. I and III II and IV I, III and IV All of the above

30. All of following are false about superficial reflexes EXCEPT A. Plantar reflex, upper and lower abdominal reflex, cremastertic reflex and crossed extensor reflex B. Center of upper abdominal reflexes is T7-T10 and for lower abdominal reflexes is T10-T12 C. Flexor withdrawal reflex is a rapid monosynaptic reflex D. Center for plantar reflex are L1, L2, S1, and S2

31.

The flexor withdrawal reflex: A. B. C. D. Does not occur if the spinal cord is separated from the higher centre Is monosynaptic & anti-gravitational (support the body against gravity) Is more rapid than the myotatic (stretch) reflex and shows no sign of fatigue Shows a characteristically long after discharge

32.

The secondary receptor in the muscle spindle (flower spray endings): A. Original signals related to changes that occuring in the muscle tendons B. Are phasic receptor that responsible for the dynamic response of muscle spindle reflex(MSR) C. Discharge impulses in the thickest nerve fiber found in the dorsal roots D. Discharge before the primary receptor E. Inform the CNS about the extent of the elongation of the muscle

33.

About the stretch reflex, all of the following are true, EXCEPT: A. B. C. D. E. It is the only monosynaptic reflex in the body It shows no after discharge and rapidly fatigue It receptor relaxes when the muscle contract Its afferent limb originate from the alpha motor neuron Stimulation of the afferent limb causes relaxation of the antagonistic muscle

34.

About the inverse stretch reflex, it is true to say that: A. B. C. D. Requires the stimulation of the inhibitory interneuron It activate the alpha motor neuron supplying the the contracting muscle It inhibit the antagonist muscle It ensure continuous contraction of the muscle fiber

35.

All of the following are the inhibitory centres of stretch reflex: A. B. C. D. Paleocerebellum Inhibitory reticular formation centre Basal ganglia Primary motor area cortex

36.

Which of the following is false regarding functional classification of cranial nerve fibers and nuclei? A. B. C. D. Special visceral efferent is supplies skeletal muscle from branchial arches General somatic afferent receives taste and olfaction sensation General somatic efferent supplies skeletal muscles from somites Special somatic afferent receives vision, hearing and equilibrium sensation

37.

Somatic efferent column includes the following nuclei except: A. B. C. D. Troclear nucleus Hypoglossal nucleus Superior salivary nucleus Abducent nucleus

38.

Motor nucleus of trigeminal nerve supplies the following skeletal muscles except: A. B. C. D. Anterior belly of digastrics Mylohyoid Tensor tympani Platysma

39.

Choose the true statement regarding general visceral efferent column: A. B. C. D. Supplies the muscles of the second branchial arch Receives general sensation from the viscera Supplies intrinsic muscles of the larynx Is called parasympathetic column as it forms the cranial outflow

40.

The following statement is true regarding special somatic efferent column except: A. Receives special types of sensation from the head B. One of the nuclei is the mesencephalic nucleus which carries proprioceptive sensation C. Vestibular nuclei receives vestibular impulses from the utricle,saccule and semicircular canal D. Cochlear nuclei receive auditory impulses from the cochlea

41.

The following are true about upper motor neuron lesion (UMNL) EXCEPT A. B. C. D. One of the site of lesion is motor nuclei of cranial nerve The muscle affected is paralysed and rigid There is intact stretch reflex Distribution of paralysis is widespread for e.g. paraplegia or hemiplegia

42.

The following are false about the site of lower motor neuron lesion (LMNL) EXCEPT A. B. C. D. Internal capsule Spinal cord Nerve supply of muscle Medulla

43.

The following are true EXCEPT I. II. III. IV. A. B. C. D. Muscle atrophy may be present in chronic cases of UMNL Positive Habinskis sign is seen in lesion at anterior horn cell The most common lesion of UMN is caused by vascular disorders In UMNL, cremastric reflex are exaggerated I and II II and IV II and III III and IV

44.

The following are false EXCEPT LMNL is caused mainly by poliomyelitis or trauma to central nerves In LMNL, hypotonia occurs due to increase discharge of facilitatory reticular formation Muscle fasciculation and fibrillation occur in LMNL Superficial reflex are lost in affected segment and paralysis always occur on the same side in LMNL A. I and II B. II and IV C. II and III D. III and IV 45. The following are true EXCEPT A. UMNL causes increased (exaggerated) all deep and superficial reflexes B. Muscle atrophy is significant in LMNL C. Motor cells of cerebral cortex and their axon which terminate at brain stem and spinal cord is called UMN D. Facilitatory reticular formation discharges spontaneously in normal condition 46. Skeletal muscle depressant is classified into two main categories. What are they? A. B. C. D. Competitive Neuromuscular blocking agents and antispasticity agents Depolarizing NMBs and central muscle relaxant NMBs and antispasticity agents Direct muscle relaxant and central muscle relaxant I. II. III. IV.

47.

Neuromuscular blocking agents are .. I II III IV A. B. C. D. Polar and inactive when administered by IV Cannot cross CNS Doesnt affect consciousness Polar and inactive when administered orally I , II, III II, III, IV I, III, IV All of the above

48.

Competitive ( non depolarizing) blockers like Curare Alkaloids : d-tubocurarine may cause hypotension due to certain effects by rapid IV injection. These certain effects are : A. B. C. D. Central vasodilation due to histamine release Sympathetic ganglionic blockade Diminished arterioles return due to loss of smooth muscle tone CNS depression

TRUE (A) or FALSE (B) 49. Tubocurarine is use in patients with liver malignancy 50. Succinylcholine is rapidly hydrolyse by pseudocholinesterase 51. Phase II block is mainly related to therapeutic uses 52. Benzodiazepines like diazepam is one of antispasticity agents use in medical practice

ANSWERS 1 2 3 4 5 6 7 8 9 D 133 C 133 C 134 B 136 A 136 D 179 B 180 C 180 C 180 11 C 230 12 D 230-1 13 A 231 14 B 229 15 D 229 16 A 200 17 B 18 B 19 D 20 C 201 21 D 22 B 23 A 24 C 25 IV, I, II, III 26 D 205-6 27 D 205 28 C 20-6 29 A 208 30 B 207 31 32 33 34 35 36 37 38 39 40 D 207 E 212 D 213 A 215 D B 234 C 236 D 236 D 236 B 238 41 42 43 44 45 46 47 48 49 50 A 221-3 C B D A C 216-7 B 217 B 217 B 218 A 218 51 52 B 219 A 220

10 D 183-4

Knowing is not enough, we must apply, Willing is not enough, we must do.
Johann Wolfgang von Goethe.

Our doubts are traitors, and make us lose the good we oft might win, by fearing to attempt
William Shakespeare