Phys 57 Flashcards


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1

Which list correctly names the 3 anatomical lobes of the cerebellum?
A. Anterior, posterior, flocculonodular
B. Vermis, intermediate, lateral
C. Dentate, interposed, fastigial
D. Molecular, Purkinje, granule

A. Anterior, posterior, flocculonodular

2

A patient has severe truncal ataxia and vestibular-type imbalance after a cerebellar lesion. Which lobe is most likely involved?
A. Anterior lobe
B. Posterior lobe
C. Flocculonodular lobe
D. Intermediate zone

C. Flocculonodular lobe

3

A midline cerebellar lesion causes poor control of neck, shoulders, and hips during stance. Which region is most affected?
A. Dentate nucleus
B. Vermis
C. Lateral zone
D. Interposed nucleus

B. Vermis

4

Dyscoordination is most prominent in the hands, fingers, feet, and toes after a cerebellar hemispheric lesion. Which zone is involved?
A. Vermis
B. Flocculus
C. Lateral zone
D. Intermediate zone

D. Intermediate zone

5

A pianist can generate force normally but cannot smoothly organize multistep finger sequences. Which cerebellar region is most implicated?
A. Vermis
B. Fastigial nucleus
C. Lateral zone
D. Intermediate zone

C. Lateral zone

6

Each individual cerebellar fold is called a:
A. Sulcus
B. Gyrus
C. Folium
D. Fissure

C. Folium

7

A pontine lesion interrupts cortical input to the contralateral lateral cerebellar hemisphere. Which pathway is disrupted?
A. Olivocerebellar tract
B. Reticulocerebellar fibers
C. Corticopontocerebellar pathway
D. Vestibulocerebellar fibers

C. Corticopontocerebellar pathway

8

Which cortical regions give rise to the corticopontocerebellar pathway?
A. Motor, premotor, somatosensory cortices
B. Visual, auditory, limbic cortices
C. Broca, Wernicke, insular cortices
D. Cingulate, hippocampal, olfactory cortices

A. Motor, premotor, somatosensory cortices

9

Fibers from the right cerebral motor cortex reach which cerebellar target via the corticopontocerebellar system?
A. Right vermis
B. Left lateral hemisphere
C. Right lateral hemisphere
D. Left fastigial nucleus

B. Left lateral hemisphere

10

Which tract arises from the inferior olive and is driven by motor cortex, basal ganglia, reticular formation, and spinal cord inputs?
A. Vestibulocerebellar tract
B. Reticulocerebellar tract
C. Corticopontocerebellar tract
D. Olivocerebellar tract

D. Olivocerebellar tract

11

Vestibulocerebellar fibers terminate primarily in which combination?
A. Vermis and dentate
B. Flocculonodular lobe and fastigial
C. Intermediate zone and interposed
D. Lateral hemisphere and dentate

B. Flocculonodular lobe and fastigial

12

Fibers from the brainstem reticular formation project mainly to which cerebellar region?
A. Vermis
B. Dentate
C. Flocculus
D. Lateral zone

A. Vermis

13

The dorsal spinocerebellar tract enters the cerebellum through the:
A. Middle cerebellar peduncle
B. Superior cerebellar peduncle
C. Inferior cerebellar peduncle
D. Cerebral peduncle

C. Inferior cerebellar peduncle

14

The ventral spinocerebellar tract enters the cerebellum through the:
A. Inferior cerebellar peduncle
B. Superior cerebellar peduncle
C. Middle cerebellar peduncle
D. Restiform body only

B. Superior cerebellar peduncle

15

Dorsal spinocerebellar fibers terminate mainly in the:
A. Bilateral lateral hemispheres
B. Contralateral dentate nucleus
C. Ipsilateral vermis and intermediate
D. Flocculonodular lobe only

C. Ipsilateral vermis and intermediate

16

Ventral spinocerebellar fibers terminate:
A. Ipsilateral vermis only
B. In both cerebellar sides
C. Only in dentate nuclei
D. Only in flocculonodular lobe

B. In both cerebellar sides

17

Selective loss of muscle spindle input would most directly diminish signaling in which pathway?
A. Ventral spinocerebellar
B. Reticulocerebellar
C. Dorsal spinocerebellar
D. Olivocerebellar

C. Dorsal spinocerebellar

18

The dorsal spinocerebellar tract chiefly informs the cerebellum about:
A. Visual target motion
B. Planned speech output
C. Retinal error signals
D. Contraction, tension, proprioceptive status

D. Contraction, tension, proprioceptive status

19

Which source most strongly excites the ventral spinocerebellar tract?
A. Anterior horn motor signals
B. Primary visual cortex discharge
C. Cochlear nuclear output
D. Thalamocortical sensory relay

A. Anterior horn motor signals

20

The ventral spinocerebellar tract best conveys which kind of information?
A. Nociceptive limb afference
B. Efferent copy motor drive
C. Vestibular hair-cell activity
D. Olfactory contextual input

B. Efferent copy motor drive

21

Spinoreticular and spino-olivary pathways relay through which structures before reaching the cerebellum?
A. Red nucleus and thalamus
B. Reticular formation and inferior olive
C. Pontine nuclei and tectum
D. Basal ganglia and hypothalamus

B. Reticular formation and inferior olive

22

Cerebellar afferent signals project to which two locations within the cerebellum?
A. Cortex and thalamus
B. Vermis and flocculus
C. Deep nuclei and overlying cortex
D. White matter and peduncles

C. Deep nuclei and overlying cortex

23

All cerebellar inputs ultimately terminate in the:
A. Deep cerebellar nuclei
B. Purkinje layer
C. Molecular layer
D. Inferior olive

A. Deep cerebellar nuclei

24

Which deep cerebellar nucleus corresponds to the lateral zone?
A. Fastigial
B. Interposed
C. Dentate
D. Globose

C. Dentate

25

Which deep nuclei together constitute the interposed nucleus?
A. Dentate and fastigial
B. Emboliform and globose
C. Fastigial and globose
D. Dentate and emboliform

B. Emboliform and globose

26

The vermis is most closely associated with which deep cerebellar nucleus?
A. Dentate
B. Interposed
C. Emboliform
D. Fastigial

D. Fastigial

27

The functional unit of cerebellar cortex is best described as:
A. Granule cell and basket cell
B. Purkinje cell and deep nucleus
C. Mossy fiber and Golgi cell
D. Climbing fiber and stellate cell

B. Purkinje cell and deep nucleus

28

Which sequence correctly lists the cerebellar cortical layers from superficial to deep?
A. Purkinje, molecular, granule
B. Granule, molecular, Purkinje
C. Molecular, Purkinje, granule
D. Molecular, granule, Purkinje

C. Molecular, Purkinje, granule

29

Which fibers provide the two major afferent inputs to the cerebellum, and what is their net effect?
A. Climbing and mossy; excitatory
B. Climbing and basket; inhibitory
C. Mossy and Purkinje; inhibitory
D. Golgi and stellate; excitatory

A. Climbing and mossy; excitatory

30

All climbing fibers entering the cerebellum originate from the:
A. Red nucleus
B. Pontine nuclei
C. Inferior olive
D. Vestibular nuclei

C. Inferior olive

31

After entering the cerebellum, a climbing fiber continues from the deep nuclear region toward the:
A. Cerebellar peduncle
B. Outer cerebellar cortex
C. Fastigial nucleus
D. Inferior medulla

B. Outer cerebellar cortex

32

A climbing fiber discharge in a Purkinje cell classically produces which pattern?
A. Brief repetitive simple spike
B. Single prolonged complex spike
C. Silent hyperpolarizing pause
D. Tetanic basket-cell burst

B. Single prolonged complex spike

33

Climbing fibers synapse directly on which cells?
A. Granule cells
B. Purkinje cells
C. Basket cells
D. Stellate cells

B. Purkinje cells

34

Mossy fibers synapse directly on which cells?
A. Purkinje cells
B. Basket cells
C. Granule cells
D. Golgi cells

C. Granule cells

35

Both mossy and climbing fibers send excitatory collaterals to the:
A. Deep cerebellar nuclei
B. Purkinje layer only
C. Molecular layer only
D. Inferior olive only

A. Deep cerebellar nuclei

36

Mossy fibers enter the cerebellum from:
A. Inferior olive
B. Multiple CNS sources
C. Vestibular nerve
D. Thalamus

B. Multiple CNS sources

37

Granule-cell axons ascend to which cerebellar cortical layer?
A. Granule layer
B. Purkinje layer
C. White matter
D. Molecular layer

D. Molecular layer

38

In the molecular layer, granule-cell axons split and run as:
A. Climbing fibers
B. Parallel fibers
C. Basket fibers
D. Olivary fibers

B. Parallel fibers

39

Which fibers have far more total synaptic contacts with Purkinje cells?
A. Climbing fibers
B. Parallel fibers
C. Reticulocerebellar fibers
D. Rubrospinal fibers

B. Parallel fibers

40

Which cell population is far more numerous in the cerebellum?
A. Purkinje cells
B. Basket cells
C. Granule cells
D. Stellate cells

C. Granule cells

41

Mossy-fiber influence on Purkinje cells is best described as:
A. Strong and direct
B. Weak and indirect
C. Strong and inhibitory
D. Direct and prolonged

B. Weak and indirect

42

Why must many mossy fibers be activated together to influence a Purkinje cell?
A. Purkinje cells lack dendrites
B. Mossy synapses are inhibitory
C. Their effect is individually weak
D. They bypass granule cells

C. Their effect is individually weak

43

The typical Purkinje-cell response associated with mossy-fiber activation is a:
A. Complex spike
B. Plateau potential
C. Afterdischarge burst
D. Simple spike

D. Simple spike

44

Purkinje-cell output to the deep cerebellar nuclei is:
A. Excitatory
B. Modulatory only
C. Inhibitory
D. Electrical coupling

C. Inhibitory

45

Under quiet resting conditions, the balance of cerebellar nuclear input is normally:
A. Slightly inhibitory
B. Exactly neutral
C. Slightly excitatory
D. Entirely Purkinje-driven

C. Slightly excitatory

46

Which statement about direct Purkinje connections is correct?
A. Mossy direct, climbing indirect
B. Both direct to Purkinje
C. Both indirect to Purkinje
D. Climbing direct, mossy indirect

D. Climbing direct, mossy indirect

47

Which are the 2 major inhibitory interneurons of the cerebellar cortex?
A. Granule and Golgi
B. Purkinje and granule
C. Basket and stellate
D. Climbing and mossy

C. Basket and stellate

48

Basket and stellate cells are located in the:
A. Purkinje layer
B. Molecular layer
C. Granule layer
D. White matter

B. Molecular layer

49

Basket and stellate cells are activated primarily by:
A. Climbing fibers
B. Purkinje axons
C. Vestibular fibers
D. Parallel fibers

D. Parallel fibers

50

Basket and stellate cells sharpen cerebellar signaling by producing:
A. Feedforward excitation
B. Lateral inhibition
C. Recurrent facilitation
D. Long-loop activation

B. Lateral inhibition

51

The flocculonodular lobe and adjacent vermis are components of the:
A. Spinocerebellum
B. Cerebrocerebellum
C. Vestibulocerebellum
D. Olivocerebellum

C. Vestibulocerebellum

52

The vestibulocerebellum is most important for controlling:
A. Speech initiation
B. Equilibrium and posture
C. Distal fine movement
D. Pain localization

B. Equilibrium and posture

53

Damage to the flocculonodular lobe most classically causes:
A. Aphasia and neglect
B. Equilibrium disturbance
C. Resting tremor
D. Spastic hemiparesis

B. Equilibrium disturbance

54

The vestibulocerebellum helps maintain balance by providing:
A. Segmental reflex gain
B. Anticipatory correction
C. Pain suppression
D. Motor initiation

B. Anticipatory correction

55

Most of the vermis plus intermediate zones form the:
A. Spinocerebellum
B. Vestibulocerebellum
C. Cerebrocerebellum
D. Archicerebellum only

A. Spinocerebellum

56

The spinocerebellum is especially important for coordination of:
A. Eye convergence only
B. Distal limb movements
C. Olfactory tracking
D. Emotional expression

B. Distal limb movements

57

During movement, the spinocerebellum receives intended motor plan information from:
A. Cerebral cortex and red nucleus
B. Vestibular nuclei and thalamus
C. Inferior olive and pons
D. Basal ganglia and tectum

A. Cerebral cortex and red nucleus

58

The actual movement feedback compared against intent in spinocerebellum comes especially from:
A. Auditory receptors
B. Distal limb proprioceptors
C. Retinal ganglion cells
D. Visceral afferents

B. Distal limb proprioceptors

59

After comparing intended with actual movement, the intermediate zone sends corrective output through the interposed nucleus to the:
A. Hypothalamus and pons
B. Cortex via thalamus
C. Basal ganglia directly
D. Vestibular ganglion only

B. Cortex via thalamus

60

The interposed nucleus also projects to the magnocellular red nucleus, which gives rise to the:
A. Tectospinal tract
B. Vestibulospinal tract
C. Rubrospinal tract
D. Reticulospinal tract

C. Rubrospinal tract

61

The large lateral cerebellar zones constitute the:
A. Spinocerebellum
B. Vestibulocerebellum
C. Cerebrocerebellum
D. Paleocerebellum

C. Cerebrocerebellum

62

The cerebrocerebellum primarily functions to:
A. Detect body pain
B. Plan and time movement
C. Regulate wakefulness
D. Control pupillary reflexes

B. Plan and time movement

63

Destruction of the lateral cerebellar zones and dentate nuclei causes marked incoordination of:
A. Complex hand-foot-speech tasks
B. Reflex withdrawal only
C. Visual fixation only
D. Breathing rhythm only

A. Complex hand-foot-speech tasks

64

A patient overshoots a target and the arm oscillates around it several times before stopping. This reflects failure of cerebellar:
A. Facilitation
B. Damping
C. Crossed extension
D. Sensory gating

B. Damping

65

The tremor produced by overshoot during a voluntary movement is called:
A. Resting tremor
B. Asterixis
C. Intention tremor
D. Fasciculation

C. Intention tremor

66

Movements performed too rapidly for peripheral feedback correction are called:
A. Ataxic movements
B. Ballistic movements
C. Choreiform movements
D. Spastic movements

B. Ballistic movements

67

Without an intact cerebellum, ballistic movements are typically:
A. Fast and excessive
B. Weak and delayed
C. Hypermetric only
D. Rigid and fixed

B. Weak and delayed

68

Cerebellar impairment of the normal progression of speech is called:
A. Aphonia
B. Dysarthria
C. Dysphasia
D. Apraxia

B. Dysarthria

69

A patient trying to gaze to one side develops oscillation of the eyes because cerebellar damping failed. This is:
A. Ophthalmoplegia
B. Cerebellar nystagmus
C. Ocular bobbing
D. Internuclear palsy

B. Cerebellar nystagmus

70

Cerebellar nystagmus is especially associated with damage to the:
A. Dentate nuclei
B. Lateral hemispheres
C. Flocculonodular lobes
D. Interposed nuclei

C. Flocculonodular lobes

71

A patient with cerebellar damage has decreased resistance to passive movement and a “floppy” limb. Loss of which structure best explains this?
A. Dentate nucleus
B. Deep cerebellar nuclei
C. Inferior olive
D. Red nucleus

B. Deep cerebellar nuclei

72

Which set correctly lists the 5 major basal ganglia structures from your notes?
A. Caudate, putamen, pallidum, nigra, subthalamic
B. Caudate, thalamus, pallidum, nigra, pons
C. Putamen, claustrum, pallidum, olive, amygdala
D. Caudate, putamen, dentate, nigra, thalamus

A. Caudate, putamen, pallidum, nigra, subthalamic

73

Almost all major motor and sensory fibers pass through which structure between the large basal ganglia masses?
A. External capsule
B. Corpus callosum
C. Internal capsule
D. Cerebral peduncle

C. Internal capsule

74

The principal role of the basal ganglia in motor control is best described as:
A. Primary force generation
B. Visual motion processing
C. Spinal reflex inhibition
D. Complex motor patterning

D. Complex motor patterning

75

Which is the best example of the motor function most associated with basal ganglia processing?
A. Detecting joint vibration
B. Initiating stretch reflex
C. Writing a signature
D. Sensing limb position

C. Writing a signature

76

The putamen primarily receives input from:
A. Primary motor cortex only
B. Adjacent motor association areas
C. Primary visual cortex only
D. Vestibular cortex only

B. Adjacent motor association areas

77

A patient develops continuous writhing movements of the hand and face after a focal lesion. Which structure is most likely damaged?
A. Globus pallidus
B. Putamen
C. Subthalamic nucleus
D. Substantia nigra

A. Globus pallidus

78

Sudden violent flinging of the right arm and leg most strongly suggests a lesion of the left:
A. Globus pallidus
B. Caudate nucleus
C. Subthalamic nucleus
D. Putamen

C. Subthalamic nucleus

79

Chorea develops, what is the probelm?
A. Globus pallidus
B. Caudate nucleus
C. Subthalamic nucleus
D. Putamen

D. Putamen

80

A patient has rigidity, akinesia, and tremor after degeneration of a basal ganglia structure. Which structure is most likely involved?
A. Putamen
B. Globus pallidus
C. Subthalamic nucleus
D. Substantia nigra

D. Substantia nigra

81

The caudate circuit is most important for:
A. Vestibular balance control
B. Cognitive motor control
C. Pain discrimination
D. Auditory localization

B. Cognitive motor control

82

The caudate nucleus has major connections extending to:
A. Brainstem nuclei only
B. Frontal lobe only
C. All cerebral lobes
D. Cerebellar hemispheres only

C. All cerebral lobes

83

Which type of cortical regions provides especially large input to the caudate nucleus?
A. Primary sensory areas
B. Visual relay nuclei
C. Association areas
D. Olfactory bulbs

C. Association areas

84

Output from the caudate circuit returns mainly to:
A. Primary motor cortex
B. Accessory motor regions
C. Spinal anterior horn
D. Cerebellar cortex

B. Accessory motor regions

85

Dopaminergic basal ganglia fibers originate in the:
A. Subthalamic nucleus
B. Putamen
C. Globus pallidus
D. Substantia nigra

D. Substantia nigra

86

Dopamine from the substantia nigra projects primarily to the:
A. Caudate and putamen
B. Globus pallidus only
C. Thalamus and cortex
D. Subthalamic nucleus only

A. Caudate and putamen

87

In the basal ganglia circuitry from your notes, dopamine acts mainly as a(n):
A. Excitatory transmitter
B. Inhibitory transmitter
C. Modulator without effect
D. Peripheral neurotransmitter

B. Inhibitory transmitter

88

GABAergic pathways in the basal ganglia project from the:
A. Cortex to putamen
B. Nigra to thalamus
C. Caudate/putamen to GP/nigra
D. Thalamus to caudate

C. Caudate/putamen to GP/nigra

89

The principal effect of GABA in the basal ganglia is:
A. Excitatory
B. Inhibitory
C. Neuromuscular
D. Hormonal

B. Inhibitory

90

Cholinergic pathways in these notes project from the:
A. Cortex to caudate/putamen
B. Nigra to caudate/putamen
C. Pons to pallidum
D. Thalamus to cortex

A. Cortex to caudate/putamen

91

Which neurotransmitter provides much of the major excitatory balance within basal ganglia circuits?
A. Serotonin
B. GABA
C. Dopamine
D. Glutamate

D. Glutamate

92

Which pair represents the 2 major clinical syndromes emphasized for basal ganglia damage?
A. Parkinson disease and Huntington disease
B. Myasthenia and ALS
C. Wilson disease and dystonia
D. Ataxia and dysmetria

A. Parkinson disease and Huntington disease

93

Parkinson disease in your notes results from degeneration of the substantia nigra neurons that normally:
A. Release GABA to cortex
B. Release dopamine to striatum
C. Release acetylcholine to thalamus
D. Release glutamate to pallidum

B. Release dopamine to striatum

94

The striatal target structures of the degenerating substantia nigra neurons in Parkinson disease are the:
A. Dentate and fastigial
B. Caudate and putamen
C. Globus pallidus and thalamus
D. Red nucleus and pons

B. Caudate and putamen

95

Which clinical combination is most typical of Parkinson disease?
A. Chorea, aphasia, neglect
B. Ballismus, weakness, sensory loss
C. Tremor, rigidity, akinesia
D. Athetosis, nystagmus, dysmetria

C. Tremor, rigidity, akinesia

96

Postural instability in Parkinson disease is attributed mainly to impaired:
A. Visual acuity
B. Postural reflexes
C. Cortical language output
D. Peripheral nerve conduction

B. Postural reflexes

97

Dysphagia, speech difficulty, gait disturbance, and fatigue in Parkinson disease are best categorized as:
A. Pure sensory deficits
B. Nonmotor endocrine signs
C. Associated motor symptoms
D. Cerebellar reflex losses

C. Associated motor symptoms

98

Loss of dopaminergic substantia nigra neurons causes rigidity because it leads to:
A. Striatal underactivity
B. Putaminal overactivity
C. Pallidal silence
D. Cerebellar denervation

B. Putaminal overactivity

99

In Parkinson disease, excessive excitatory drive ultimately reaches which descending control system?
A. Spinocerebellar system
B. Vestibulo-ocular system
C. Corticospinal control system
D. Dorsal column system

C. Corticospinal control system

100

Why is dopamine itself not given effectively as primary replacement therapy for Parkinson disease?
A. It is rapidly nephrotoxic
B. It triggers hemiballismus
C. It cannot cross BBB
D. It blocks acetylcholine release

C. It cannot cross BBB

101

Which drug is given because it can cross the blood-brain barrier and serve as a dopamine precursor?
A. Haloperidol
B. L-dopa
C. GABA
D. Bromocriptine

B. L-dopa

102

L-dopa improves Parkinson symptoms mainly by:
A. Blocking glutamate release
B. Restoring inhibitory-excitatory balance
C. Destroying overactive putamen
D. Inhibiting motor cortex directly

B. Restoring inhibitory-excitatory balance

103

Which Parkinson symptom is especially improved by L-dopa according to your notes?
A. Aphasia and neglect
B. Rigidity and akinesia
C. Ballismus and chorea
D. Vision loss and ataxia

B. Rigidity and akinesia

104

L-deprenyl is useful in Parkinson disease because it:
A. Stimulates acetylcholine release
B. Blocks GABA receptors
C. Inhibits monoamine oxidase
D. Replaces dopamine directly

C. Inhibits monoamine oxidase

105

By inhibiting monoamine oxidase, L-deprenyl helps:
A. Increase dopamine availability
B. Block thalamic output
C. Decrease acetylcholine synthesis
D. Enhance cerebellar damping

A. Increase dopamine availability

106

Huntington disease is inherited in which pattern?
A. Autosomal recessive
B. X-linked dominant
C. Autosomal dominant
D. Mitochondrial

C. Autosomal dominant

107

The major early motor manifestation of Huntington disease is:
A. Chorea
B. Rigidity
C. Ataxia
D. Athetosis

A. Chorea

108

Dementia in Huntington disease typically appears:
A. Before birth
B. Later in course
C. Only in children
D. Only with treatment

B. Later in course

109

Huntington disease is caused by loss of GABA-secreting neurons primarily in the:
A. Thalamus and cortex
B. Globus pallidus and nigra
C. Red nucleus and pons
D. Caudate and putamen

D. Caudate and putamen

110

Loss of which neuronal population is most associated with dementia in Huntington disease?
A. Dopaminergic neurons
B. Serotonergic neurons
C. Cholinergic neurons
D. Glutamatergic neurons

C. Cholinergic neurons

111

In Huntington disease, loss of GABA inhibition leads to spontaneous outbursts of activity in the:
A. Globus pallidus and nigra
B. Caudate and putamen
C. Thalamus and cortex
D. Cerebellum and pons

A. Globus pallidus and nigra

112

A patient with progressive chorea and later dementia has a mutation involving:
A. Expanded CTG repeats
B. Expanded CCG repeats
C. Expanded CAG repeats
D. Expanded CGG repeats

B. Expanded CCG repeats

113

The mutant huntingtin gene contains excess repeats encoding:
A. Glycine residues
B. Alanine residues
C. Lysine residues
D. Glutamine residues

D. Glutamine residues

114

The corticopontocerebellar pathway projects mainly to which cerebellar region?
A. Vermis
B. Fastigial nucleus
C. Intermediate zone
D. Lateral hemisphere

D. Lateral hemisphere

115

Corticopontocerebellar fibers ultimately reach the cerebellum on the:
A. Same side
B. Opposite side
C. Midline
D. Inferior surface

B. Opposite side

116

Which set includes the 3 major brainstem-origin cerebellar afferents from your notes?
A. Rubro, tecto, spinothalamic
B. Dorsal, ventral, corticospinal
C. Olivo, vestibulo, reticulo
D. Pallido, striato, nigral

C. Olivo, vestibulo, reticulo

117

Which spinocerebellar tract enters through the inferior cerebellar peduncle?
A. Ventral
B. Dorsal
C. Rostral
D. Anterior

B. Dorsal

118

The dorsal spinocerebellar tract terminates mainly in the:
A. Contralateral lateral zone
B. Bilateral dentate nuclei
C. Vermis and intermediate
D. Flocculonodular lobe only

C. Vermis and intermediate

119

The dorsal spinocerebellar tract terminates on the:
A. Opposite side
B. Same side
C. Midline only
D. Superior surface only

B. Same side

120

Which tract enters through the superior cerebellar peduncle and terminates bilaterally?
A. Dorsal spinocerebellar
B. Olivocerebellar
C. Reticulocerebellar
D. Ventral spinocerebellar

D. Ventral spinocerebellar

121

Signals in the dorsal spinocerebellar tract come mainly from:
A. Golgi tendon organs
B. Muscle spindles
C. Basal ganglia
D. Visual cortex

B. Muscle spindles

122

The ventral spinocerebellar pathway provides what type of motor feedback?
A. Rebound discharge
B. Lateral inhibition
C. Efference copy
D. Reciprocal inhibition

C. Efference copy

123

All deep cerebellar nuclei receive input from the cerebellar cortex and:
A. Deep afferent tracts
B. Basal ganglia loops
C. Corticospinal collaterals
D. Vestibular ganglia only

A. Deep afferent tracts

124

One characteristic of both Purkinje cells and deep nuclear cells is that they normally fire:
A. Intermittently
B. Phasically
C. Continuously
D. Randomly

C. Continuously

125

After a movement begins, cerebellar circuitry helps prevent overshoot by generating:
A. Positive feedback
B. Negative feedback
C. Feedforward silence
D. Tonic facilitation

B. Negative feedback

126

Basket and stellate cells are best described as:
A. Excitatory long-axon cells
B. Inhibitory short-axon cells
C. Dopaminergic projection cells
D. Cholinergic relay cells

B. Inhibitory short-axon cells

127

Which cerebellar functional division consists of the flocculonodular lobes and adjacent vermis and is most responsible for equilibrium?
A. Spinocerebellum
B. Cerebrocerebellum
C. Vestibulocerebellum
D. Neocerebellum

C. Vestibulocerebellum

128

Which cerebellar division includes most of the vermis plus the adjacent intermediate zones and coordinates mainly distal limb movement?
A. Vestibulocerebellum
B. Spinocerebellum
C. Cerebrocerebellum
D. Flocculocerebellum

B. Spinocerebellum

129

Which cerebellar division is formed by the large lateral hemispheric zones and helps plan sequential voluntary movements in advance?
A. Spinocerebellum
B. Vestibulocerebellum
C. Archicerebellum
D. Cerebrocerebellum

D. Cerebrocerebellum

130

The cerebrocerebellum receives virtually all of its input from the:
A. Cerebral motor-related cortex
B. Vestibular ganglia only
C. Inferior olivary nucleus
D. Spinal dorsal horn

A. Cerebral motor-related cortex

131

The cerebrocerebellum sends output back upward to the brain mainly to:
A. Generate reflexes
B. Plan movement sequences
C. Maintain consciousness
D. Detect pain location

B. Plan movement sequences

132

Advance planning of movement by the cerebrocerebellum is called:
A. Efference copy
B. Lateral inhibition
C. Motor imagery
D. Reciprocal innervation

C. Motor imagery

133

In vestibulocerebellar dysfunction, equilibrium is especially impaired during:
A. Sleep
B. Rapid directional movements
C. Quiet standing only
D. Slow repetitive tapping

B. Rapid directional movements

134

The vestibulocerebellum helps maintain balance by calculating in advance:
A. Muscle ATP stores
B. Future body position
C. Visual cortex output
D. Basal ganglia firing

B. Future body position

135

In cerebellar destruction, when overshoot occurs, the cerebrum eventually initiates a corrective movement in the:
A. Same direction
B. Upward direction
C. Reverse direction
D. Ipsilateral limb only

C. Reverse direction

136

Which term describes a movement that is fully preplanned to travel a set distance and then stop?
A. Ballistic
B. Ataxic
C. Dysmetric
D. Choreiform

A. Ballistic

137

Cerebellar nystagmus occurs especially with damage to the:
A. Dentate nucleus
B. Flocculonodular lobes
C. Globus pallidus
D. Caudate nucleus

B. Flocculonodular lobes

138

Loss of which deep cerebellar nuclei particularly causes decreased tone on the side of the lesion?
A. Fastigial and vestibular
B. Dentate and interposed
C. Red and olivary
D. Caudate and putamen

B. Dentate and interposed

139

A lesion affecting the basal ganglia circuit that receives input mainly from areas adjacent to primary motor cortex most directly involves the:
A. Caudate
B. Putamen
C. Thalamus
D. Substantia nigra

B. Putamen

140

Lesions of the globus pallidus classically produce spontaneous continuous writhing movements called:
A. Chorea
B. Tremor
C. Athetosis
D. Ballismus

C. Athetosis

141

A lesion of the subthalamus most classically causes:
A. Hemiballismus
B. Dysarthria
C. Dysmetria
D. Rigidity

A. Hemiballismus

142

Multiple small lesions in the putamen produce flicking movements of the face and hands called:
A. Athetosis
B. Intention tremor
C. Chorea
D. Dystonia

C. Chorea

143

Which basal ganglia structure plays a major role in the cognitive control of motor activity?
A. Putamen
B. Caudate nucleus
C. Subthalamic nucleus
D. Globus pallidus

B. Caudate nucleus

144

In the caudate motor-control loop, signals from the caudate nucleus next pass primarily to the:
A. Internal globus pallidus
B. Dentate nucleus
C. Red nucleus
D. Subthalamus only

A. Internal globus pallidus

145

After the internal globus pallidus, caudate-circuit output relays through which thalamic nuclei?
A. Anterior and medial
B. Geniculate nuclei
C. Ventroanterior and ventrolateral
D. Pulvinar and intralaminar

C. Ventroanterior and ventrolateral

146

Caudate-circuit output returns mainly to which cortical regions?
A. Primary sensory cortex only
B. Prefrontal, premotor, supplementary motor
C. Visual, auditory, olfactory
D. Primary motor cortex only

B. Prefrontal, premotor, supplementary motor

147

A patient can feel an object in the hand but cannot identify it despite intact sensation. A lesion of which cortex best explains this?
A. Primary motor cortex
B. Occipital association cortex
C. Posterior parietal cortex
D. Prefrontal cortex

C. Posterior parietal cortex

148

Inability to accurately perceive objects through otherwise normal sensory mechanisms is called:
A. Apraxia
B. Agnosia
C. Ataxia
D. Aphasia

B. Agnosia

149

Severe damage to the right posterior parietal cortex most classically causes:
A. Neglect syndrome
B. Broca aphasia
C. Hemiballismus
D. Resting tremor

A. Neglect syndrome

150

GABA neurons in cortical-basal ganglia-cortical loops make these loops function mainly as:
A. Positive feedback loops
B. Negative feedback loops
C. Feedforward loops
D. Vestibular loops

B. Negative feedback loops

151

The main effect of these GABA-mediated negative feedback loops is to:
A. Increase oscillation
B. Destabilize posture
C. Lend motor stability
D. Trigger ballistic output

C. Lend motor stability

152

By inhibiting monoamine oxidase, L-deprenyl helps reduce destruction of:
A. Acetylcholine
B. Dopamine
C. GABA
D. Glutamate

B. Dopamine

153

The earliest motor abnormality in Huntington disease is classically:
A. Flicking movements
B. Cogwheel rigidity
C. Resting tremor
D. Decerebrate posturing

A. Flicking movements

154

As Huntington disease progresses, patients develop severe body distortional movements and:
A. Hemianopia
B. Dementia
C. Hemiballismus
D. Dysarthria only

B. Dementia

155

The abnormal movements of Huntington disease are believed to result primarily from loss of GABA-secreting neurons in the:
A. Red nucleus and pons
B. Caudate and putamen
C. Cerebellum and olive
D. Pallidum and thalamus

B. Caudate and putamen

156

Huntington disease also involves loss of which other neuronal type in many parts of the brain?
A. Dopamine-secreting neurons
B. Serotonin-secreting neurons
C. Acetylcholine-secreting neurons
D. Norepinephrine-secreting neurons

C. Acetylcholine-secreting neurons

157

At the brainstem level, which structure smooths rapid postural movements and prevents abnormal oscillations?
A. Basal ganglia
B. Thalamus
C. Cerebellum
D. Hippocampus

C. Cerebellum

158

The cerebellum functions mainly when what type of muscle movements are required?
A. Painful
B. Rapid
C. Passive
D. Isometric only

B. Rapid

159

One major function of the basal ganglia is to help the cortex execute subconscious but:
A. Random
B. Learned
C. Reflexive
D. Sensory

B. Learned

160

Another major function of the basal ganglia is to help plan multiple parallel and sequential movement:
A. Patterns
B. Reflexes
C. Lesions
D. Peduncles

A. Patterns