Arciaga, Frances Geline R.

MD1 – Section 1 Neuroanatomy

Multiple Choice Questions

I. Consciousness System

1. Which level of consciousness is not correctly associated with its specific

signs and symptoms?

a. Obtunded – patient is mildy alert and when aroused, shows slow

response to any stimuli
b. Somnolent – patient easily arousable but tends to drifts to sleep
state when left alone.
c. Stupor – patient has little amount of spontaneous movement, but
when aroused, is able to give lengthy and long-winded responses to
questions
d. Coma – state of extended unconsciousness, unarousable, little or no
response to pain or noxious stimuli

Answer: C. A stupored patient will speak only if stimulated by painful stimuli.

A moderate amount of spontaneous movements can only occur, and when
aroused, can only give brief responses to questions or simple commands.

2. Which signs or symptoms are manifested in a patient suffering from a

persistent vegetative state?

a. An intact reticular formation with a well-functioning cerebral cortex.

b. Experiences sleep-wake cycles thus, can be easily woken up by the
cry of a child
c. During sleep, can respond to stimuli such as pain or simple
commands.
d. Awake with eyes open and moving but without awareness
Answer: D. Persistent Vegetative State is a condition usually seen following
severe head injuries or anoxic cerebral insult. The person can still have an
intact reticular formation but his/her cerebral cortex is dysfunctional. The
cerebral cortex is necessary for the state of awareness, in which a person
can respond and interact with the environment. In this condition, the lay
observer may think that the patient is conscious due to the person being able
to open his / her eyes and move them around and experience sleep-wake
cycles. However, the person has no awareness and therefore, cannot respond
to stimuli such as verbal commands or pain.

II. Brainstem & Reticular Formation

1. Which of the following statements is CORRECT regarding the reticular

formation?

a. Pain sensations can sometimes increase the activity of the reticular

formation and excite the cerebral cortex.
b. The reticular formation is able to regulate muscle tone and reflex
activity.
c. The reticular formation can influence the synthesis or release of
releasing or release-inhibiting factors directly through the hypothalamic
nuclei, controlling the activity of the hypophysis cerebri.
d. Higher control of the ANS, from the cerebral cortex, hypothalamus,
and other subcortical nuclei, can be exerted by the reticulospinal tract only,
which descend to the sympathetic outflow and the parasympathetic
craniosacral outflow.

Answer: B. The reticular formation is capable of influencing  and  motor

activity through the reticulobulbar and reticulospinal tracts, enabling the
reticular formation to control skeletal muscle function by regulating muscle
tone and reflex activity.
2. What condition will show symptoms of paralysis and contralateral
hemianesthesia due to lesions in the tegmentum of the medulla?

a. Wallenberg Syndrome
b. Jackson Syndrome
c. Locked-In Syndrome
d. Avellis Syndrome

Answer: D. Avellis Syndrome, which results from a lesion involving the

tegmentum of the medulla and the spinothalamic tract, includes dysfunction
of the tenth cranial nerve and shows paralysis on the soft palate and vocal
cords.