front 1 Which list correctly names the 3 anatomical lobes of the
cerebellum? | back 1 A. Anterior, posterior, flocculonodular |
front 2 A patient has severe truncal ataxia and vestibular-type imbalance
after a cerebellar lesion. Which lobe is most likely involved? | back 2 C. Flocculonodular lobe |
front 3 A midline cerebellar lesion causes poor control of neck, shoulders,
and hips during stance. Which region is most affected? | back 3 B. Vermis |
front 4 Dyscoordination is most prominent in the hands, fingers, feet, and
toes after a cerebellar hemispheric lesion. Which zone is
involved? | back 4 D. Intermediate zone |
front 5 A pianist can generate force normally but cannot smoothly organize
multistep finger sequences. Which cerebellar region is most
implicated? | back 5 C. Lateral zone |
front 6 Each individual cerebellar fold is called a: | back 6 C. Folium |
front 7 A pontine lesion interrupts cortical input to the contralateral
lateral cerebellar hemisphere. Which pathway is disrupted? | back 7 C. Corticopontocerebellar pathway |
front 8 Which cortical regions give rise to the corticopontocerebellar
pathway? | back 8 A. Motor, premotor, somatosensory cortices |
front 9 Fibers from the right cerebral motor cortex reach which cerebellar
target via the corticopontocerebellar system? | back 9 B. Left lateral hemisphere |
front 10 Which tract arises from the inferior olive and is driven by motor
cortex, basal ganglia, reticular formation, and spinal cord
inputs? | back 10 D. Olivocerebellar tract |
front 11 Vestibulocerebellar fibers terminate primarily in which
combination? | back 11 B. Flocculonodular lobe and fastigial |
front 12 Fibers from the brainstem reticular formation project mainly to which
cerebellar region? | back 12 A. Vermis |
front 13 The dorsal spinocerebellar tract enters the cerebellum through
the: | back 13 C. Inferior cerebellar peduncle |
front 14 The ventral spinocerebellar tract enters the cerebellum through
the: | back 14 B. Superior cerebellar peduncle |
front 15 Dorsal spinocerebellar fibers terminate mainly in the: | back 15 C. Ipsilateral vermis and intermediate |
front 16 Ventral spinocerebellar fibers terminate: | back 16 B. In both cerebellar sides |
front 17 Selective loss of muscle spindle input would most directly diminish
signaling in which pathway? | back 17 C. Dorsal spinocerebellar |
front 18 The dorsal spinocerebellar tract chiefly informs the cerebellum
about: | back 18 D. Contraction, tension, proprioceptive status |
front 19 Which source most strongly excites the ventral spinocerebellar
tract? | back 19 A. Anterior horn motor signals |
front 20 The ventral spinocerebellar tract best conveys which kind of
information? | back 20 B. Efferent copy motor drive |
front 21 Spinoreticular and spino-olivary pathways relay through which
structures before reaching the cerebellum? | back 21 B. Reticular formation and inferior olive |
front 22 Cerebellar afferent signals project to which two locations within the
cerebellum? | back 22 C. Deep nuclei and overlying cortex |
front 23 All cerebellar inputs ultimately terminate in the: | back 23 A. Deep cerebellar nuclei |
front 24 Which deep cerebellar nucleus corresponds to the lateral
zone? | back 24 C. Dentate |
front 25 Which deep nuclei together constitute the interposed nucleus? | back 25 B. Emboliform and globose |
front 26 The vermis is most closely associated with which deep cerebellar
nucleus? | back 26 D. Fastigial |
front 27 The functional unit of cerebellar cortex is best described
as: | back 27 B. Purkinje cell and deep nucleus |
front 28 Which sequence correctly lists the cerebellar cortical layers from
superficial to deep? | back 28 C. Molecular, Purkinje, granule |
front 29 Which fibers provide the two major afferent inputs to the cerebellum,
and what is their net effect? | back 29 A. Climbing and mossy; excitatory |
front 30 All climbing fibers entering the cerebellum originate from
the: | back 30 C. Inferior olive |
front 31 After entering the cerebellum, a climbing fiber continues from the
deep nuclear region toward the: | back 31 B. Outer cerebellar cortex |
front 32 A climbing fiber discharge in a Purkinje cell classically produces
which pattern? | back 32 B. Single prolonged complex spike |
front 33 Climbing fibers synapse directly on which cells? | back 33 B. Purkinje cells |
front 34 Mossy fibers synapse directly on which cells? | back 34 C. Granule cells |
front 35 Both mossy and climbing fibers send excitatory collaterals to
the: | back 35 A. Deep cerebellar nuclei |
front 36 Mossy fibers enter the cerebellum from: | back 36 B. Multiple CNS sources |
front 37 Granule-cell axons ascend to which cerebellar cortical layer? | back 37 D. Molecular layer |
front 38 In the molecular layer, granule-cell axons split and run as: | back 38 B. Parallel fibers |
front 39 Which fibers have far more total synaptic contacts with Purkinje
cells? | back 39 B. Parallel fibers |
front 40 Which cell population is far more numerous in the cerebellum? | back 40 C. Granule cells |
front 41 Mossy-fiber influence on Purkinje cells is best described as: | back 41 B. Weak and indirect |
front 42 Why must many mossy fibers be activated together to influence a
Purkinje cell? | back 42 C. Their effect is individually weak |
front 43 The typical Purkinje-cell response associated with mossy-fiber
activation is a: | back 43 D. Simple spike |
front 44 Purkinje-cell output to the deep cerebellar nuclei
is: | back 44 C. Inhibitory |
front 45 Under quiet resting conditions, the balance of cerebellar nuclear
input is normally: | back 45 C. Slightly excitatory |
front 46 Which statement about direct Purkinje connections is correct? | back 46 D. Climbing direct, mossy indirect |
front 47 Which are the 2 major inhibitory interneurons of the
cerebellar cortex? | back 47 C. Basket and stellate |
front 48 Basket and stellate cells are located in the: | back 48 B. Molecular layer |
front 49 Basket and stellate cells are activated primarily by: | back 49 D. Parallel fibers |
front 50 Basket and stellate cells sharpen cerebellar signaling by
producing: | back 50 B. Lateral inhibition |
front 51 The flocculonodular lobe and adjacent vermis are components of
the: | back 51 C. Vestibulocerebellum |
front 52 The vestibulocerebellum is most important for controlling: | back 52 B. Equilibrium and posture |
front 53 Damage to the flocculonodular lobe most classically causes: | back 53 B. Equilibrium disturbance |
front 54 The vestibulocerebellum helps maintain balance by providing: | back 54 B. Anticipatory correction |
front 55 Most of the vermis plus intermediate zones form the: | back 55 A. Spinocerebellum |
front 56 The spinocerebellum is especially important for coordination
of: | back 56 B. Distal limb movements |
front 57 During movement, the spinocerebellum receives intended motor plan
information from: | back 57 A. Cerebral cortex and red nucleus |
front 58 The actual movement feedback compared against intent in
spinocerebellum comes especially from: | back 58 B. Distal limb proprioceptors |
front 59 After comparing intended with actual movement, the intermediate zone
sends corrective output through the interposed nucleus to the: | back 59 B. Cortex via thalamus |
front 60 The interposed nucleus also projects to the magnocellular red
nucleus, which gives rise to the: | back 60 C. Rubrospinal tract |
front 61 The large lateral cerebellar zones constitute the: | back 61 C. Cerebrocerebellum |
front 62 The cerebrocerebellum primarily functions to: | back 62 B. Plan and time movement |
front 63 Destruction of the lateral cerebellar zones and dentate nuclei causes
marked incoordination of: | back 63 A. Complex hand-foot-speech tasks |
front 64 A patient overshoots a target and the arm oscillates around it
several times before stopping. This reflects failure of
cerebellar: | back 64 B. Damping |
front 65 The tremor produced by overshoot during a voluntary movement is
called: | back 65 C. Intention tremor |
front 66 Movements performed too rapidly for peripheral feedback correction
are called: | back 66 B. Ballistic movements |
front 67 Without an intact cerebellum, ballistic movements are
typically: | back 67 B. Weak and delayed |
front 68 Cerebellar impairment of the normal progression of speech is
called: | back 68 B. Dysarthria |
front 69 A patient trying to gaze to one side develops oscillation of the eyes
because cerebellar damping failed. This is: | back 69 B. Cerebellar nystagmus |
front 70 Cerebellar nystagmus is especially associated with damage to
the: | back 70 C. Flocculonodular lobes |
front 71 A patient with cerebellar damage has decreased resistance to passive
movement and a “floppy” limb. Loss of which structure best explains
this? | back 71 B. Deep cerebellar nuclei |
front 72 Which set correctly lists the 5 major basal ganglia structures from
your notes? | back 72 A. Caudate, putamen, pallidum, nigra, subthalamic |
front 73 Almost all major motor and sensory fibers pass through which
structure between the large basal ganglia masses? | back 73 C. Internal capsule |
front 74 The principal role of the basal ganglia in motor control is best
described as: | back 74 D. Complex motor patterning |
front 75 Which is the best example of the motor function most associated with
basal ganglia processing? | back 75 C. Writing a signature |
front 76 The putamen primarily receives input from: | back 76 B. Adjacent motor association areas |
front 77 A patient develops continuous writhing movements of the hand and face
after a focal lesion. Which structure is most likely damaged? | back 77 A. Globus pallidus |
front 78 Sudden violent flinging of the right arm and leg most strongly
suggests a lesion of the left: | back 78 C. Subthalamic nucleus |
front 79 Chorea develops, what is the probelm? | back 79 D. Putamen |
front 80 A patient has rigidity, akinesia, and tremor after degeneration of a
basal ganglia structure. Which structure is most likely
involved? | back 80 D. Substantia nigra |
front 81 The caudate circuit is most important for: | back 81 B. Cognitive motor control |
front 82 The caudate nucleus has major connections extending to: | back 82 C. All cerebral lobes |
front 83 Which type of cortical regions provides especially large input to the
caudate nucleus? | back 83 C. Association areas |
front 84 Output from the caudate circuit returns mainly to: | back 84 B. Accessory motor regions |
front 85 Dopaminergic basal ganglia fibers originate in the: | back 85 D. Substantia nigra |
front 86 Dopamine from the substantia nigra projects primarily to the: | back 86 A. Caudate and putamen |
front 87 In the basal ganglia circuitry from your notes, dopamine acts mainly
as a(n): | back 87 B. Inhibitory transmitter |
front 88 GABAergic pathways in the basal ganglia project from the: | back 88 C. Caudate/putamen to GP/nigra |
front 89 The principal effect of GABA in the basal ganglia is: | back 89 B. Inhibitory |
front 90 Cholinergic pathways in these notes project from the: | back 90 A. Cortex to caudate/putamen |
front 91 Which neurotransmitter provides much of the major excitatory balance
within basal ganglia circuits? | back 91 D. Glutamate |
front 92 Which pair represents the 2 major clinical syndromes emphasized for
basal ganglia damage? | back 92 A. Parkinson disease and Huntington disease |
front 93 Parkinson disease in your notes results from degeneration of the
substantia nigra neurons that normally: | back 93 B. Release dopamine to striatum |
front 94 The striatal target structures of the degenerating substantia nigra
neurons in Parkinson disease are the: | back 94 B. Caudate and putamen |
front 95 Which clinical combination is most typical of Parkinson
disease? | back 95 C. Tremor, rigidity, akinesia |
front 96 Postural instability in Parkinson disease is attributed mainly to
impaired: | back 96 B. Postural reflexes |
front 97 Dysphagia, speech difficulty, gait disturbance, and fatigue in
Parkinson disease are best categorized as: | back 97 C. Associated motor symptoms |
front 98 Loss of dopaminergic substantia nigra neurons causes rigidity because
it leads to: | back 98 B. Putaminal overactivity |
front 99 In Parkinson disease, excessive excitatory drive ultimately reaches
which descending control system? | back 99 C. Corticospinal control system |
front 100 Why is dopamine itself not given effectively as primary replacement
therapy for Parkinson disease? | back 100 C. It cannot cross BBB |
front 101 Which drug is given because it can cross the blood-brain barrier and
serve as a dopamine precursor? | back 101 B. L-dopa |
front 102 L-dopa improves Parkinson symptoms mainly by: | back 102 B. Restoring inhibitory-excitatory balance |
front 103 Which Parkinson symptom is especially improved by L-dopa according to
your notes? | back 103 B. Rigidity and akinesia |
front 104 L-deprenyl is useful in Parkinson disease because it: | back 104 C. Inhibits monoamine oxidase |
front 105 By inhibiting monoamine oxidase, L-deprenyl helps: | back 105 A. Increase dopamine availability |
front 106 Huntington disease is inherited in which pattern? | back 106 C. Autosomal dominant |
front 107 The major early motor manifestation of Huntington disease is: | back 107 A. Chorea |
front 108 Dementia in Huntington disease typically appears: | back 108 B. Later in course |
front 109 Huntington disease is caused by loss of GABA-secreting neurons
primarily in the: | back 109 D. Caudate and putamen |
front 110 Loss of which neuronal population is most associated with dementia in
Huntington disease? | back 110 C. Cholinergic neurons |
front 111 In Huntington disease, loss of GABA inhibition leads to spontaneous
outbursts of activity in the: | back 111 A. Globus pallidus and nigra |
front 112 A patient with progressive chorea and later dementia has a mutation
involving: | back 112 B. Expanded CCG repeats |
front 113 The mutant huntingtin gene contains excess repeats encoding: | back 113 D. Glutamine residues |
front 114 The corticopontocerebellar pathway projects mainly to which
cerebellar region? | back 114 D. Lateral hemisphere |
front 115 Corticopontocerebellar fibers ultimately reach the cerebellum on
the: | back 115 B. Opposite side |
front 116 Which set includes the 3 major brainstem-origin cerebellar afferents
from your notes? | back 116 C. Olivo, vestibulo, reticulo |
front 117 Which spinocerebellar tract enters through the inferior cerebellar
peduncle? | back 117 B. Dorsal |
front 118 The dorsal spinocerebellar tract terminates mainly in the: | back 118 C. Vermis and intermediate |
front 119 The dorsal spinocerebellar tract terminates on the: | back 119 B. Same side |
front 120 Which tract enters through the superior cerebellar peduncle and
terminates bilaterally? | back 120 D. Ventral spinocerebellar |
front 121 Signals in the dorsal spinocerebellar tract come mainly from: | back 121 B. Muscle spindles |
front 122 The ventral spinocerebellar pathway provides what type of motor
feedback? | back 122 C. Efference copy |
front 123 All deep cerebellar nuclei receive input from the cerebellar cortex
and: | back 123 A. Deep afferent tracts |
front 124 One characteristic of both Purkinje cells and deep nuclear cells is
that they normally fire: | back 124 C. Continuously |
front 125 After a movement begins, cerebellar circuitry helps prevent overshoot
by generating: | back 125 B. Negative feedback |
front 126 Basket and stellate cells are best described as: | back 126 B. Inhibitory short-axon cells |
front 127 Which cerebellar functional division consists of the flocculonodular
lobes and adjacent vermis and is most responsible for
equilibrium? | back 127 C. Vestibulocerebellum |
front 128 Which cerebellar division includes most of the vermis plus the
adjacent intermediate zones and coordinates mainly distal limb
movement? | back 128 B. Spinocerebellum |
front 129 Which cerebellar division is formed by the large lateral hemispheric
zones and helps plan sequential voluntary movements in
advance? | back 129 D. Cerebrocerebellum |
front 130 The cerebrocerebellum receives virtually all of its input from
the: | back 130 A. Cerebral motor-related cortex |
front 131 The cerebrocerebellum sends output back upward to the brain mainly
to: | back 131 B. Plan movement sequences |
front 132 Advance planning of movement by the cerebrocerebellum is
called: | back 132 C. Motor imagery |
front 133 In vestibulocerebellar dysfunction, equilibrium is especially
impaired during: | back 133 B. Rapid directional movements |
front 134 The vestibulocerebellum helps maintain balance by calculating in
advance: | back 134 B. Future body position |
front 135 In cerebellar destruction, when overshoot occurs, the cerebrum
eventually initiates a corrective movement in the: | back 135 C. Reverse direction |
front 136 Which term describes a movement that is fully preplanned to travel a
set distance and then stop? | back 136 A. Ballistic |
front 137 Cerebellar nystagmus occurs especially with damage to the: | back 137 B. Flocculonodular lobes |
front 138 Loss of which deep cerebellar nuclei particularly causes decreased
tone on the side of the lesion? | back 138 B. Dentate and interposed |
front 139 A lesion affecting the basal ganglia circuit that receives input
mainly from areas adjacent to primary motor cortex most directly
involves the: | back 139 B. Putamen |
front 140 Lesions of the globus pallidus classically produce spontaneous
continuous writhing movements called: | back 140 C. Athetosis |
front 141 A lesion of the subthalamus most classically causes: | back 141 A. Hemiballismus |
front 142 Multiple small lesions in the putamen produce flicking movements of
the face and hands called: | back 142 C. Chorea |
front 143 Which basal ganglia structure plays a major role in the cognitive
control of motor activity? | back 143 B. Caudate nucleus |
front 144 In the caudate motor-control loop, signals from the caudate nucleus
next pass primarily to the: | back 144 A. Internal globus pallidus |
front 145 After the internal globus pallidus, caudate-circuit output relays
through which thalamic nuclei? | back 145 C. Ventroanterior and ventrolateral |
front 146 Caudate-circuit output returns mainly to which cortical
regions? | back 146 B. Prefrontal, premotor, supplementary motor |
front 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? | back 147 C. Posterior parietal cortex |
front 148 Inability to accurately perceive objects through otherwise normal
sensory mechanisms is called: | back 148 B. Agnosia |
front 149 Severe damage to the right posterior parietal cortex most classically
causes: | back 149 A. Neglect syndrome |
front 150 GABA neurons in cortical-basal ganglia-cortical loops make these
loops function mainly as: | back 150 B. Negative feedback loops |
front 151 The main effect of these GABA-mediated negative feedback loops is
to: | back 151 C. Lend motor stability |
front 152 By inhibiting monoamine oxidase, L-deprenyl helps reduce destruction
of: | back 152 B. Dopamine |
front 153 The earliest motor abnormality in Huntington disease is
classically: | back 153 A. Flicking movements |
front 154 As Huntington disease progresses, patients develop severe body
distortional movements and: | back 154 B. Dementia |
front 155 The abnormal movements of Huntington disease are believed to result
primarily from loss of GABA-secreting neurons in the: | back 155 B. Caudate and putamen |
front 156 Huntington disease also involves loss of which other neuronal type in
many parts of the brain? | back 156 C. Acetylcholine-secreting neurons |
front 157 At the brainstem level, which structure smooths rapid postural
movements and prevents abnormal oscillations? | back 157 C. Cerebellum |
front 158 The cerebellum functions mainly when what type of muscle movements
are required? | back 158 B. Rapid |
front 159 One major function of the basal ganglia is to help the cortex execute
subconscious but: | back 159 B. Learned |
front 160 Another major function of the basal ganglia is to help plan multiple
parallel and sequential movement: | back 160 A. Patterns |