Chapter 15: Structure and Function of the Neurologic System

MULTIPLE CHOICE
1. Which pathway carries sensory information toward the central nervous system (CNS)?
a. Ascending
c. Somatic
b. Descending
d. Efferent
ANS: A

Peripheral nerve pathways can be afferent (ascending) pathways that carry sensory impulses
toward the CNS. The remaining options do not carry sensory information to the CNS.
PTS: 1

REF: Page 448

2. Which type of axon transmits a nerve impulse at the highest rate?

a. Large nonmyelinated
c. Small nonmyelinated
b. Large myelinated
d. Small myelinated
ANS: B

If the myelin layer is tightly wrapped many times around the axon and is forming the nodes of
Ranvier, then conduction velocity increases and the neuron is referred to as myelinated. The
increased diameter of the myelinated axons allows for the transmission of impulses at a faster
rate. The other options do not affect nervous impulse transmission rates.
PTS: 1

REF: Pages 448-450

3. Which nerves are capable of regeneration?

a. Nerves within the brain and spinal cord
b. Peripheral nerves that are cut or severed
c. Myelinated nerves in the peripheral nervous system
d. Unmyelinated nerves of the peripheral nervous system
ANS: C

Nerve regeneration is limited to only myelinated fibers and generally occurs only in the
peripheral nervous system.
PTS: 1

REF: Pages 450-451

4. The neurotransmitter, norepinephrine, is secreted in the:

a. Somatic nervous system
c. Sympathetic postganglion
b. Parasympathetic preganglion
d. Parasympathetic postganglion
ANS: C

Most postganglionic sympathetic fibers release norepinephrine (adrenaline). The remaining

options do not reflect the correct site of norepinephrine secretion.
PTS: 1

REF: Pages 473-474

5. Both oligodendroglia and Schwann cells share the ability to:

a. Form a myelin sheath
c. Transport nutrients
b. Remove cellular debris
d. Line the ventricles

ANS: A

The function of oligodendroglia (oligodendrocytes) is to deposit myelin within the central

nervous system (CNS). Oligodendroglia are the CNS counterpart of Schwann cells. The
remaining options are not reflective of the common function of these structures.
PTS: 1

REF: Pages 449-450

6. During a synapse, what change occurs after the neurotransmitter binds to the receptor?
a. The permeability of the presynaptic neuron changes; consequently, its membrane

potential is changed as well.

b. The permeability of the postsynaptic neuron changes; consequently, its membrane

potential is changed as well.

c. The postsynaptic cell prevents any change in permeability and destroys the action

potential.
d. The presynaptic cell synthesizes and secretes additional neurotransmitters.
ANS: B

The binding of the neurotransmitter at the receptor site changes the permeability of the
postsynaptic neuron and, consequently, its membrane potential. The remaining options do not
accurately describe the occurrence.
PTS: 1

REF: Pages 452-453

7. What name is given to a large network of neurons within the brainstem that is essential for

maintaining wakefulness?
a. Midbrain
b. Reticular activating system

c. Medulla oblongata
d. Pons

ANS: B

The reticular activating system is essential for maintaining wakefulness. The remaining
options are not essential to this function.
PTS: 1

REF: Page 454

8. Thought and goal-oriented behaviors are functions of which area of the brain?
a. Cerebellum
c. Prefrontal lobe
b. Limbic system
d. Occipital lobe
ANS: C

The prefrontal area is responsible for goal-oriented behavior (i.e., ability to concentrate),
short-term or recall memory, and the elaboration of thought and inhibition on the limbic
(emotional) areas of the CNS. The remaining options are not involved in these functions.
PTS: 1

REF: Page 456

9. The region responsible for the motor aspects of speech is located in the:
a. Wernicke area in the temporal lobe
c. Wronka area in the parietal lobe
b. Broca area in the frontal lobe
d. Barlow area in the occipital lobe
ANS: B

Broca speech area is the only region responsible for the motor aspects of speech.

PTS: 1

REF: Page 457

10. Parkinson and Huntington diseases are associated with defects in which area of the brain?
a. Thalamus
c. Cerebellum
b. Medulla oblongata
d. Basal ganglia
ANS: D

Parkinson and Huntington diseases are conditions associated with defects of the basal ganglia.
No current research supports the role of any of the other options in these diseases.
PTS: 1

REF: Page 457

11. Maintenance of a constant internal environment and the implementation of behavioral patterns

are main functions of which area of the brain?

a. Thalamus
b. Epithalamus

c. Subthalamus
d. Hypothalamus

ANS: D

Hypothalamic function falls into two major areas: (1) maintenance of a constant internal
environment, and (2) implementation of behavioral patterns. The remaining options do not
address these functions.
PTS: 1

REF: Page 459

12. The ability of the eyes to track moving objects through a visual field is primarily a function of

which colliculi?
a. Inferior
b. Superior

c. Mid
d. Posterior

ANS: B

The superior colliculi are involved with voluntary and involuntary visual motor movements
(e.g., the ability of the eyes to track moving objects in the visual field). Tracking moving
objects is not the primary function of the remaining options.
PTS: 1

REF: Page 459

13. What parts of the brain mediate the expression of affect, both emotional and behavioral states?
a. Hypothalamus and subthalamus
c. Limbic system and prefrontal cortex
b. Parietal and frontal lobes
d. Basal ganglia and medulla oblongata
ANS: C

Extensive connections with the limbic system and prefrontal cortex mediate the expression of
affect, both emotional and behavioral states. The remaining options are not involved in these
expressions.
PTS: 1

REF: Page 457

14. Reflex activities concerned with heart rate, blood pressure, respirations, sneezing, swallowing,

and coughing are controlled by which area of the brain?

c. Cerebellum
d. Medulla oblongata

a. Pons
b. Midbrain
ANS: D

The medulla oblongata makes up the myelencephalon and is the lowest portion of the
brainstem. Reflex activities, such as heart rate, respiration, blood pressure, coughing,
sneezing, swallowing, and vomiting, are controlled only in this area.
PTS: 1

REF: Page 460

15. From which part of the midbrain do cranial nerves V to VIII emerge?
a. Midbrain
c. Medulla oblongata
b. Pons
d. Lateral colliculi
ANS: B

The nuclei of cranial nerves V through VIII (see Table 15-6 for discussion) are located only in
the pons.
PTS: 1

REF: Pages 459-460

16. From which part of the midbrain do cranial nerves IX to XII emerge?
a. Midbrain
c. Medulla oblongata
b. Pons
d. Lateral colliculi
ANS: C

The nuclei of cranial nerves IX through XII (see Table 15-6 for discussion) are located only in
the medulla oblongata.
PTS: 1

REF: Page 460

17. Which area of the brain assumes the responsibility for conscious and unconscious muscle

synergy and for maintaining balance and posture?

a. Cerebrum
c. Diencephalon
b. Cerebellum
d. Brainstem
ANS: B

The cerebellum is responsible for conscious and unconscious muscle synergy and for
maintaining balance and posture. This role is not assumed by any of the remaining options.
PTS: 1

REF: Page 459

18. Which statement is true regarding upper motor neurons?

a. Upper motor neurons directly influence muscles.
b. They modify spinal reflex arcs.
c. Upper motor neurons are located in the gray matter of the spinal cord.
d. They extend their dendritic processes out of the CNS.
ANS: B

Upper motor neurons (i.e., corticospinal tract) are the classification of motor pathways
completely contained within the CNS. Their primary roles include directing, influencing, and
modifying reflex arcs, lower-level control centers, and motor and some sensory neurons. The
remaining options do not accurately describe the characteristic functions of upper motor
neurons.
PTS: 1

REF: Page 462

19. The membrane that separates the brains cerebellum from its cerebrum is the:
a. Tentorium cerebelli
c. Arachnoid membrane
b. Falx cerebri
d. Falx cerebelli
ANS: A

The tentorium cerebelli is a membrane that separates the cerebellum below from the cerebral
structures above. The remaining options do not perform the function described in the stem.
PTS: 1

REF: Page 464

20. The function of arachnoid villi is to:

a. Produce cerebrospinal fluid
b. Provide nutrients to the choroid plexuses
c. Transmit impulses within the meninges
d. Absorb cerebrospinal fluid into the cerebral venous sinuses
ANS: D

CSF is reabsorbed by means of a pressure gradient between the arachnoid villi and the
cerebral venous sinuses. The remaining options do not accurately describe the function of
arachnoid villi.
PTS: 1

REF: Page 466

21. Where is the cerebrospinal fluid produced?

a. Arachnoid villi
c. Ependymal cells
b. Choroid plexuses
d. Pia mater
ANS: B

The choroid plexuses are the structures that produce CSF; they arise from the pia mater. The
remaining options do not have a role in CSF production.
PTS: 1

REF: Pages 465-466

22. Which of the meninges closely adheres to the surface of the brain and spinal cord and follows

the sulci and fissures?

a. Dura mater
b. Arachnoid

c. Pia mater
d. Inner dura

ANS: C

The delicate pia mater closely adheres to the surface of the brain and spinal cord and even
follows the sulci and fissures. The remaining options are not represented in the description
provided in the stem.
PTS: 1

REF: Pages 464-465

23. Norepinephrine produces what primary response?

a. Increased contractility of the heart
c. Vasoconstriction
b. Release of renin from the kidney
d. Pupillary dilation
ANS: C

The primary response from norepinephrine is the stimulation of the 1-adrenergic receptors
that cause vasoconstriction. The remaining options do not accurately reflect the primary
response of norepinephrine.
PTS: 1

REF: Page 474

24. What is an effect of the sympathetic nervous system?

a. Stimulation of peristalsis
c. Reduction in heart rate
b. Increased blood sugar levels
d. Pupillary constriction
ANS: B

In general, sympathetic stimulation promotes responses that are concerned with the protection
of the individual, which include increased blood sugar levels, temperature, and blood
pressure. The responses noted in the remaining options are not a result of sympathetic
stimulation.
PTS: 1

REF: Page 476

25. The brain receives approximately what percentage of the cardiac output?
a. 80%
c. 20%
b. 40%
d. 10%
ANS: C

The brain receives approximately 20% of the cardiac output, or 800 to 1000 ml of blood flow
per minute.
PTS: 1

REF: Page 454

26. The collateral blood flow to the brain is provided by the:

a. Carotid arteries
c. Circle of Willis
b. Basal artery
d. Vertebral arteries
ANS: C

The arterial circle (circle of Willis) (see Figure 15-20) is a structure credited with the ability to
compensate for reduced blood flow from any one of the major contributors (collateral blood
flow). The remaining options are not considered sources of collateral blood flow.
PTS: 1

REF: Page 467

27. The nurse recognizes that a patients diagnosis of a viral infection of the brains meningeal

layer is supported by which diagnostic laboratory result?

c. Protein <10 mg/dl
d. Glucose <40 mg/dl

a. Chloride <110 mEq/L

b. Leukocytes >10/mm3
ANS: B

Viral infections causing meningitis will produce a white blood cell (leukocyte) count greater
than 10/mm 3. The chloride level is observed in tuberculous meningitis, the protein level has
little clinical significance, and the glucose level is observed in patients with acute bacterial
meningitis.
PTS: 1

REF: Page 479 | Table 15-8

MULTIPLE RESPONSE
28. Which cranial nerves contain parasympathetic nerves? (Select all that apply.)
a. I (olfactory)
d. IX (glossopharyngeal)
b. III (oculomotor)
e. X (vagus)
c.
VII (facial)
ANS: B, C, D, E

All but cranial nerve I (olfactory) contain parasympathetic nerves.

PTS: 1

REF: Page 473

29. The sympathetic nervous system primarily serves to protect an individual by doing which of

the following? (Select all that apply.)

a. Decreasing mucous production
d. Decreasing sweat excretion
b. Increasing blood sugar levels
e. Increasing blood pressure
c.
Increasing body temperature
ANS: B, C, E

In general, sympathetic stimulation promotes responses that are concerned with the protection
of the individual, which include increasing blood sugar levels, temperature, and blood
pressure. The remaining options are not protective measures resulting from initiatives made
by the sympathetic nervous system.
PTS: 1

REF: Page 476

30. The aging process brings about what changes to human cells? (Select all that apply.)
a. Increased neurofibrillary tangles
d. Decreased myelin presence
b. Imbalance of neurotransmitters
e. Altered dendrite structure
c.
Increased neuron production
ANS: A, B, D, E

Principal cellular changes associated with aging include a decrease in the number of neurons,
decreased myelin, decreased number of dendritic processes and synaptic connections,
intracellular neurofibrillary tangles, and an imbalance in the amount and distribution of
neurotransmitters. The aging process does not bring about an increase in neuron production.
PTS: 1

REF: Page 478 | Box 15-5

31. Which statement is true regarding the blood-brain barrier (BBB)? (Select all that apply.)
a. The BBB is dependent on astrocytes.
b. It uses the meningeal layers of the brain.
c. It restricts the flow of large molecules, such as potassium.
d. Naturally occurring inflammatory mediators affect the BBB.
e. The BBB appears to play a role in slowing down the onset of degenerative brain

disease.
ANS: A, C, D, E

The BBB is a term used to describe cellular structures that selectively inhibit certain
substances in the blood from entering the interstitial spaces of the brain or CSF. This term
emphasizes the impermeability of the nervous system to large and potentially harmful
molecules. Astrocytes wrap their foot processes around the epithelial cells of brain capillaries,
thereby contributing to the formation of the BBB. Tight junctions between capillary
endothelial cells form a barrier that regulates the passage of ions (e.g., sodium, potassium)
that could interfere with nerve transmission, prevent toxins from entering the brain, and
promote transport of nutrients and the removal of metabolites. Hormones, neurotransmitters,
and inflammatory mediators can affect BBB permeability. Inhibiting these endogenous
chemicals with drug therapy may reduce brain edema and slow the onset of degenerative brain
diseases. The statement regarding the meningeal layers of the brain is incorrect.
PTS: 1

REF: Page 469 | Box 15-4

32. A nurse caring for an older adult patient would expect which functional changes to occur?
a.
b.
c.
d.
e.

(Select all that apply.)

Increased risk for falls
Increased risk for falls
Loss of muscle in the arms and legs
Decrease in the need for social interaction
Increased agitation and frustration levels

ANS: A, B, C

Functional changes with aging include skeletal muscle atrophy, progressive deficits in taste
and smell, and a decrease in neuromuscular control with changes in gait and posture. Neither
increased agitation and frustration nor a decreased need for social interaction is considered an
expected change resulting from the aging process.
PTS: 1

REF: Page 478 | Box 15-5

33. What evidence does the nurse expect to see when a patient experiences trauma to the

hypothalamus? (Select all that apply.)

Uneven expression of mood
Unstable blood glucose levels
Poor regulation of body temperature
Visual disturbances such as blurred vision
Nausea, vomiting, and symptoms of gastroesophageal reflux disease

a.
b.
c.
d.
e.

ANS: A, B, C

The hypothalamus forms the base of the diencephalon. Hypothalamic function controls
autonomic nervous system (ANS) function, regulation of body temperature, endocrine
function (e.g., unstable glucose levels), and regulation of emotional expression. Visual and
gastrointestinal symptoms would not likely be related to hypothalamus function.
PTS: 1

REF: Page 459 | Box 15-3

34. A Schwann cell: (Select all that apply.)

a. Can form the myelin sheath.
b. Is also referred to as a neurolemmocyte.
c. Affects the function of the nodes of Ranvier.
d. Is located in the peripheral nervous system.

e. Is responsible of decreasing conduction velocity.

ANS: A, B, C, D

The Schwann cell, or neurolemmocyte, is a glial cell that wraps around and covers axons in
the peripheral nervous system. Schwann cells form and maintain the myelin sheath, and the
nodes of Ranvier form the spaces on either side of the Schwann cell. If the myelin layer is
tightly wrapped many times around the axon, forming nodes of Ranvier, then it increases
conduction velocity and the neuron is referred to as myelinated.
PTS: 1

REF: Page 450

MATCHING

Match the function with the appropriate cranial nerve.

______ A. Fibers emerge from the posterior midbrain and exit from the skull to run to the
eye.
______ B. Provides motor and sensory functions to the face, mouth, nose, and eyes.
______ C. Fibers emerge from the midbrain, exit from the skull, and extend to the eye.
______ D. Controls motor functions to the pharynx and salivary glands and sensory
functions from the pharynx and tongue.
______ E. Innervates muscles that move the eye laterally.
______ F. Affects control over the motor fibers to the muscles of tongue and sensory
impulses from the tongue to the brain.
______ G. Is purely sensory and carries impulses for the sense of smell.
______ H. Is made up of parasympathetic motor fibers that supply the smooth muscles of
the abdominal organs.
______ I. Transmits impulses for the sense of hearing.
______ J. Carries sensory and motor fibers to the pharynx and larynx.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.

Glossopharyngeal nerve
Oculomotor nerve
Trochlear nerve
Abducens nerve
Trigeminal nerve
Hypoglossal nerve
Vagus nerve
Spinal accessory nerve
Olfactory nerve
Vestibulocochlear nerve

35. ANS: D
PTS: 1
REF: Page 472 | Table 15-6
MSC: The glossopharyngeal nerve affects control over the motor fibers that serve the pharynx (throat)
and salivary glands, as well as the sensory fibers that carry impulses from the pharynx, posterior
tongue (taste buds), and pressure receptors of the carotid artery.
36. ANS: C
PTS: 1
REF: Page 472 | Table 15-6
MSC: The oculomotor nerve fibers emerge from the midbrain, exit from the skull, and extend to the
eye. These fibers control: (1) the motor fibers to the inferior oblique, superior, inferior, and medial
rectus extraocular muscles that direct the eyeball; (2) the levator muscles of the eyelid; (1) the smooth
muscles of the iris and ciliary body; and (4) proprioception (sensory) to brain from the extraocular
muscles.

37. ANS: A
PTS: 1
REF: Page 472 | Table 15-6
MSC: The trochlear nerve fibers emerge from posterior midbrain and exit from skull to affect control
over the proprioceptor and motor fibers for the superior oblique muscle of eye (extraocular muscle).
38. ANS: E
PTS: 1
REF: Page 472 | Table 15-6
MSC: The abducens nerve affects control over the motor fibers to the lateral rectus muscle and the
proprioceptor fibers from the same muscle to the brain, allowing the eyes to move laterally.
39. ANS: B
PTS: 1
REF: Page 472 | Table 15-6
MSC: The trigeminal nerve affects control over both the motor and sensory functions to the face;
conducts sensory impulses from the mouth, nose, surface of eye, and dura mater; it also contains motor
fibers that stimulate the chewing muscles.
40. ANS: F
PTS: 1
REF: Page 472 | Table 15-6
MSC: The hypoglossal nerve affects control over the motor fibers to the muscles of tongue and
sensory impulses from the tongue to the brain.
41. ANS: H
PTS: 1
REF: Page 472 | Table 15-6
MSC: The vagus nerve affects control over the fibers that carry sensory and motor impulses for the
pharynx. A large part of this nerve is parasympathetic motor fibers that supply smooth muscles of the
abdominal organs and is capable of receiving sensory impulses from the viscera.
42. ANS: J
PTS: 1
REF: Page 472 | Table 15-6
MSC: The spinal accessory nerve affects control over the sensory and motor fibers for the
sternocleidomastoid and trapezius muscles and the muscles of the soft palate, pharynx, and larynx.
43. ANS: G
PTS: 0
REF: Page 472 | Table 15-6
MSC: The olfactory nerve is purely sensory and carries impulses for the sense of smell.
44. ANS: I
PTS: 0
REF: Page 472 | Table 15-6
MSC: The vestibulocochlear nerve is purely sensory; the vestibular branch transmits impulses for the
sense of equilibrium; the cochlear branch transmits impulses for the sense of hearing.