February month Discussion QUESTIONS

1.A 30-year-old man suffering from herpetic

meningoencephalitis survives with severe bilateral
damage to his temporal lobes. He is now unable to
recognize objects presented to him although he does
appear to see. He is restrained to his bed because he
attempts to put everything into his mouth. His appetite
is insatiable, and he is hypersexual. He has an
unusually low aggression level. Bilateral lesions to
which limbic system structure is likely present?

1.​Amygdala
2.Hippocampus
3.Ventral tegmental area
4.Nucleus accumbens

This patient displayed the classic symptoms of

Kluver-Bucy syndrome: amnesia, docility,
hyperphagia, hyperorality, hypersexuality, and
visual agnosia.
Visual agnosia is impairment in recognition of
visually presented objects. It is different than
cortical blindness, which is from lesions to the
visual cortex.
Kluver-Bucy syndrome results from bilateral
lesions to the amygdala.
While Kluver-Bucy syndrome is incredibly rare, it
has, in humans who have severe lesions to their
temporal lobes

2.The brain’s ability to change in response to

experience or damage is called:
a. lateralization
b. lesioning
c. ​neuroplasticity
d. functionality

3.Damage to the hippocampus is most likely to impair:

a. ​memory
b. balance
c. sleep
d. breathing
4.Which part of the limbic system is involved in an
individual's feeling of hunger?
a. thalamus
b. pons
c. ​hippocampus
d. hypothalamus

5.Which part of the limbic system helps to prevent

unwanted muscle movements?

Amygdala

Thalamus

Basal ganglia

Hippocampus

6.Scientists working on lab rats are interested in further

researching the development of the thalamus. They
would like to look for molecular markers as early in
development as possible. Which derivative of the
neural tube should they look for molecular markers on?
1.Mesencephalon
2.Telencephalon
3.Rhombencephalon
4.​Diencephalon

7.A 70-year old man with a history of hypertension went

to work and had a sudden onset of nausea and
vomiting. He was taken to ER, where his exam was
notable for slurred speech, dysmetria on finger-to-nose
testing on the left side. His gait was normal. Where is
the lesion?
A.Cerebellar vermis
B.Right cerebellar hemisphere
C.Left cerebellar hemisphere
D.Fastigial nucleus
E.Vestibular nuclei

8.A 45-year-old man was admitted to the hospital with a

cerebellar hemorrhage. The patient exhibited an
unsteady "drunk like" gait and the physician noted that
he swayed while entering the examination room. Which
region of the cerebellum was most likely affected by the
bleed?
A.Hemispheres of the anterior lobe
B. Hemisphere of the posterior lobe
C. Interposed nuclei
D. Dentate nucleus ​E.Flocculonodular lobe

9.cerebellum originates from the dorsal aspect of the

brain stem and overlies the ______ ventricle.
A.Lateral ventricle
B.Midline ventricle
C.Third ventricle
D.Fourth ventricle

10.A patient with cancer of the lower rectum complains

of pain down the lateral side of the leg and foot. What
nerve is involved?
1.​Sciatic nerve
2.Posterior femoral cutaneous nerve
3.Obturator nerve
4.Femoral nerve
11.A patient with cancer of the lower rectum complains
of pain down the lateral side of the leg and foot. What
nerve is involved?
1.​Sciatic nerve
2.Posterior femoral cutaneous nerve
3.Obturator nerve
4.Femoral nerve

12.A patient with a history of hypertension and

hypercholesterolemia, who complains of sudden loss of
vision in the right eye which lasts for a few minutes ,
the symptom may be ..
a) agnosia..
b) apraxia.
c) homonymous hemianopia. d) ​amaurosis fugax

13.The Amaurosis fugax is ..

a) darkening of vision permanently..
b) inability to move the body parts EXCEPT eye.
c) Sudden brightness of vision..
d) temporary darkening of vision

14.The Common causes of Amaurosis fugax is.

a) lesion in opthalmic artery..
b) lesion in temporal artery..
c) lesion in internal carotid artery..
d) all the above

15. Amaurosis fugax is a painful permanent loss of

vision in one or both eyes —-
True or false
False

16.The Most common cause of amaurosis fugax is

a)headache
b) meningitis
c)insufficient blood supply to eye(ischemia)
d) Occipital lobe infarction

17. Amaurosis fugax commonly occurs in ..

a)TIA..
b) stroke…
c) multiple sclerosis ..
d) all the above

18.Amaurosis fugax also called ​monocular​..vision

19.Amaurosis fugax occurs due to the following causes
except…
a) occlusion in the int and ext carotid artery..
b) occlusion in ophthalmic
​c) deep temporal artery…
d) superficial temporal artery

20.Amaurosis fugax caused by ..

a) ischemia ,
b)hemorrhage
c) arteritis..
d) all the above

21.In Medical terminology, Darkening means ..

Amaurosis​​.....and lasting for a short time means
fugax…

22. Which of the following is not a symptom of akinetic

mutism
a)motor paralysis
b)lack of motor function
c)lack of speech
d) slowness
23.Apathetic akinetic mutism is not related to
a) mesencephalic akinetic mutism
b) ​frontal akinetic mutism
c)somnolent akinetic mutism
d) damage of midbrain

24.In akinetic mutism, patients can move after repeated

commands .true/false.
False

25.The state of Patient unable to move is called .

Akinetic​.....and unable to ....​speak​.....is called mute.

26.The common causes of Amaurosis fugax is ..

a) anterior cerebral artery..
b) posterior cerebral artery..
c) middle Cerebral artery..
d) posterior inferior Cerebellar artery

27.The most common cause of Akinetic mutism is ..

a) frontal lobe infarction..
b) temporal lobe infarction..
c) bifrontal lobe infarction..
d) occipital lobe infarction
28.The common causes of Akinetic mutism is ..
a) anterior cerebral artery..
b) posterior cerebral artery..
c) middle Cerebral artery.
.d) posterior inferior Cerebellar artery

29.Thalamic pain syndrome is a condition developed

after a thalamic stroke, a stroke causing damage to
Thalamus..
a) central pain syndrome..
b) Dejerine–Roussy syndrome....
c) non-noxious pain syndrome..
d​) all the above

30.The common cause Thalamic pain syndrome or

Thalamic stroke mainly due to the occlusion in the ..
a) aca…
b) mca..
c) int carotid artery..
d) ​pca

31.Thalamus is the integration center for..

Sensation​......and ..​ Sleep​... except ...​smell​...sense
32. ​Allodynia​...... refers to central pain sensitization
(increased response of neurons) following normally
non-painful, often repetitive, stimulation. ​Allodynia​ can
lead to the triggering of a pain response from stimuli
which do not normally provoke pain.

33: aesthesis," which means..

a) ​sensation​.
b) pain..
c) cold..
d)temp

34...​ Dysasthesia​...... is defined as an unpleasant,

abnormal sense of touch. It often presents as pain but
may also present as an inappropriate, but not
discomforting, sensation.

35. Allodynia is a noxious pain sensation ...true or false

False

36. What is the difference between Hyperpathia and

Hyperesthesia
Hyperpathia is a clinical symptom of certain
neurological disorders wherein nociceptive stimuli
evoke exaggerated levels of pain. This should not
be confused with allodynia, where normally
non-painful stimuli evoke pain.
Dysesthesia(abnormal sensation). It is defined as
an unpleasant, abnormal sense of touch. It often
presents as pain but may also present as an
inappropriate, but not discomforting, sensation
37.The following Clinical feature of Thalamic pain
syndrome is except ..
a) allodynia..
b) hyperpathia and dysesthesia..
c) ​hyperacusis​..
d) hyperalgesia

38: Damage to the potion of Thalamus leads to …

a) risk of coma..
b) sensory disturbance of the body parts..
c) movement disorder( chorea and hemiballismus..
d) all the above​ ..
e) a & b
39.Allodynia is
A. Pain elicited by thermal stimuli
B.pain elicited by deep pressure
C. Pain elicited at night
D​. Pain elicited by non noxious stimuli

40.Post central stroke syndrome can be treated by

general analgesics. True or false

1. All the sensory information passes and integrates in the

THALAMUS except ..
a) vision..
b) auditory.
.c) taste.
.d) smell. ( HAAD exam)

2.The Limbic system consists of ..

a) thalamus & hypothalamus
; b) Hippocampus.;
c) Amydyla..
d) all the above
3.The main function of Limbic system is ..
a) memory & emotional..
.b) sexual arousal.
.c) controlling autonomic nervous system..
d) all the above

4.The function of Hippocampus....

a) sextual..
b) emotions..
c) memory…
d) hunger

5. The shape of Hippocampus is..

a) hippopotamus..
b) sea horse..
c) camel..
d) elephant

6.This is responsible for the perception of emotions such as anger,

fear, and sadness, as well as the controlling of aggression.
.a) THALAMUS ..
b) hypothalamus.
.c) Hippocampus ..
d) amygdala

7.The ..........is an almond-shaped section of nervous tissue located in

the ......... lobe of the brain.

8. The predominant function of Amygdala is ..

a) role of sex..
b) role of memory…
c) role of feeding..
d) role of fear

9.Which part of the Limbic system is called as "startle circuit "of the
brain..
a) THALAMUS..
b) hypothalamus..
c) Amygdala..
d) Hippocampus

10.The ________ is to feel fear as the ________ is to feel pleasure.

a. pons/medulla
b. amygdala/hypothalamus
c. thalamus/hypothalamus
d. cerebellum/amygdala

11. Which part of the limbic system is involved in an individual's

feeling of hunger?
a. thalamus
b. pons
c. hippocampus
d. hypothalamus

12.The limbic system includes the:

a. amygdala, hypothalamus, hippocampus
b. hypothalamus, medulla, hippocampus
c. hippocampus, pons, thalamus
d. cerebellum, pons, hypothalamus
13. What is Amygdala?
a) Fear and Anger station..
b)Relay station..
c) memory station.
d) Thinking station.

14.Which of the following structures does not belong to the limbic

system?
A.Striatum
B.Amygdala
C.Hypothalamus
D.Hippocampus

15.The function of Hippocampus..

a)It helps us remember.

b)it turns our long term memory to short term memory.

c)it turns our short term memory to long term memory.

d) fear memory

16.The hippocampus is involved in the formation of ..

a) old memories..
b) new memories.
.c) intermediate memories…
d. all the above

17.Hippocampus is a brain structure embedded deep in the …

a) frontal lobe..
b) Parietal lobe..
c) occipital lobe..
d) temporal lobe

18.All of the following statements about this thalamic nucleus are true
EXCEPT:
A. It is part of the limbic system.
B. It projects to cingulate cortex.
C. It receives input from the hypothalamus.
D. It projects to motor and premotor cortex.
E. It is a specific relay nucleus

19.The person can experience a loss of memory and a loss of the

ability to make new, long-term memories..
.a) due to damage to hypothalamus..
b) due to damage from THALAMUS .
c) due to damage to the amygdala..
d) due to damage of Hippocampus

20.The Hippocampus lesion results in ..

a) Alzheimer's disease…
b) transient global Amnesia..
c) epilepsy..
d) all the above

21.This is responsible for learning and memory..

a) THALAMUS..
b) hypothalamus.
.c) amygdala.
.d) Hippocampus

22.This controls body temperature, hunger, important aspects of

parenting and attachment behaviours, thirst, fatigue, sleep, and
circadian rhythm..
a) THALAMUS..
.b) hypothalamus..
c) amygdala..
d) Hippocampus

23: Anterograde amnesia means..........and retrograde amnesia means

.......these occur due to damage of ..........

24.This is the ability to maintain a relatively stable internal state that

persists despite changes in the world outside....
a) osmosis....
b) hematemesis.
.c) heterostasis..
.d) homeostasis

25.Hyperactivity of Limbic system leads to

A.stroke
B.schizophrenia
C.anterograde amnesia
D.chorea

26.The Amygdala is ..
a) pea shaped..
b) lunar shaped..
.c)walnut shaped .
.d) almond shaped

27.The Hippocampus is responsible for the perception of emotions

such as anger, fear, and sadness, as well as the controlling of
aggression. True or false

28.: The thalamus in humans also plays a role in

sexual activity and libido, or sex drive. True or false

29.The principal structure of the Limbic system are linked by a loop of

series connect called ........... circuit ( MRB TN 2019)

30 Apart from the major part of the Limbic system ( THALAMUS..

hypothalamus.. Amygdala..and Hippocampus) the other parts also
involved minorities are.
.a) cingulate gyrus & prefrontal cortex..
b) basal ganglia..
.c) Olfactory cortex & fornix.
.d) all the above ( Delhi mrb)

31.What is the function of the Reticular Activating system??

32. What is the reticular activating system?? Where it is present

33. Loss of function of Reticular Activating system leads to coma..true

or false

34.The glasgow coma scale(gcs),,the maximum points is

..a)13..b)24..c)14..d)15
35. The Patient is said to be in a coma when the GCS scale .
a)0..
b)less than 5..
c) less than 8…
d) less than 3

36.The GCS scale consists of

.a) eye opening..
b) motor ..
c) verbal.
.d) all the above

37: The minimal score of unresponsive Patient is ..a)8..

b) 0..
c)1..
d)3

38.What is the difference between comatose and unresponsive

Patient..is unresponsive Patient can be said coma ??

39.Death is the permanent cessation of all biological functions that

sustain a living organism. True or False

40.What criteria determine death?

41.What is cardiopulmonary death

42.What is brain death

43: What is the criteria for brain death

44.The total number of spinal vertebrae in human ..
a) 24..
b) 31..
c)33..
d)27

45.The spinal nerve of the cervical ..

a) 7.
.b) 6..
c)9..
d)8

46.The total number of spinal nerves ..

a) 33pair..
b) 31pair..
c) 26 pairs.
d) none of the above

47.The spinal nerve of coccyx..

a) 1..
b)2
..c)3.
.d)4

48: In the spinal column,,,,Lordosis present in ........and ........ region

and kyphosis present in ...... region

49.The first vertebra name is Axis and the second is Altas...true or

false
50.The spinal cord ends at ..
a) C1..
b) L5…
c)S5....
d) L1 &L2

51. Spinal cord present in Lumbar and sacral canal..true or false

52.The nerve fibres pass through the lumbar and sacral canal is
called as..
a) conus medullaris..
.b)spinal cord tract..
.c) sympathetic and parasympathetic
..d) cauda equina

53. .................. is a delicate strand of fibrous tissue, about 20 cm in

length, proceeding downward from the apex of the conus medullaris. It
is one of the modifications of pia mater.

54: Filum terminale is a ....

Continuation of spinal cord ..
b) Continuation of nerve fibres..
c) continuation of meninges…
d) all the above

55. The tapering end of spinal cord is….

55.Shortness of which muscle causes restrictions of

shoulder abduction and lateral rotation?
A) pectoralis major
B)teres major
C) subscapularis
D)serratus anterior

56. The shoulder abduction..

a)180deg ..
b)60deg.
c)120deg.
d)90deg

57.The shoulder girdle or complex actions..

a) elevation & depression.
.b) forward & backward rotation..
c) protraction and retraction..
d) all the above

58.The shoulder joint action is .

.a) Fle & extension..
b) abd. & Add…
c) med & lat rotation..
d) all the above

59. The elevation of the shoulder ( overhead abduction) is

same as abduction of the shoulder ...true or false
60.180 degree shoulder abduction happens in ... shoulder
abduction..
b) shoulder elevation..
c)shoulder joint rotation..
d) shoulder joint adduction

61.The shoulder joint is otherwise called ........

The shoulder complex or girdle is the combination of many

joints but shoulder joint or glenohumeral joint is the
combination of single joint

62.The shoulder joint is not a single entity. In any patient

with shoulder pathology the degree of glenohumeral
movement must be ascertained. The normal range of
abduction at the glenohumeral joint is:

1.30 to 45 degrees
2.50 to 70 degrees
3.90 to 110 degrees
4.130 to 155 degrees
The normal range of abduction of the glenohumeral joint is
approximately 90 to 110 degrees.
Some texts may limit this range to as small as 90 to 95
degrees of abduction.
Further abduction of the arm above 90 degrees is
accomplished through upward rotation of the scapula,
which raises the humerus above the shoulders to point
straight upwards.
This motion, however, is independent of glenohumeral
joint.

63.The collective structure is called brainstem except..

a) Midbrain..
b) cerebellum..
c) pons ..
d) medulla oblongata.

64.The number of Cranial nerves present in the brainstem.

.a) 12..
b )10..
c)8..
d) 11

65.The medulla oblongata responsible for ..

a) respiratory and cardiac center..
b final four Cranial nerves( 9,10,11,12)..
c) pyramidal tract decussation..
d) all the above

66.The final 4 Cranial nerve is trigeminal nerve abducens

nerve facial nerve, vestibulocochlear nerve ... true or false

67.The pons means "bri.... is part of the brainstem, and in

humans and other bipeds lies ......... to the midbrain, s......
to the medulla oblongata and a......... to the cerebellum.
The pons is also called the pons Va........

68. The middle four cranial nerves originate from the pons
are
trigeminal nerve (CN V)
abducens nerve (CN VI)
facial nerve (CN VII)
vestibulocochlear nerve (CN VIII)...true or false

69.Oculomotor and trochlear nerve origin from..

a) medulla..
b) pons..
c) Midbrain....
cerebellum

70.The part of brainstem also involved in the control of

sleep cycles and the regulation of deep sleep
..a) Midbrain..
b) pons..
c) medulla oblongata .
.d) preoccipital cortex

71.The part of the brainstem serves important functions in

motor movements eyes…
a) Midbrain …
b)pons..
c) medulla oblongata UI..
d) cerebellum

72.The .........nucleus present in Midbrain that responsible

for motor coordinations

73.1)Which cranial nerve is responsible for all eye

movements??,,2)what are the 2 cranial nerve present in
Midbrain??,,3)what are the Cranial nerve present in the
pons.??.4) name the nerve present in the
medulla.???..5)where the first 2 cranial nerves are
located.??
1)Which cranial nerve is responsible for all eye
movements??,,

3rd,4th and 6 th cranial nerves

2)what are the 2 cranial nerve present in Midbrain??,

Oculomotor nerve
TROCHLEAR nerve

,3)what are the Cranial nerves present in the pons.??

Trigeminal nerve
Abducens nerve
FACIAL nerve
Vestibulocochlear nerve

.4) name the nerve present in the medulla.???.

Glossopharyngeal nerve
Vagus nerve
Accessory nerve
Hypoglossal nerve

.5)where the first 2 cranial nerves are located.??

Olfactory nerve nucleus - in olfactory bulb

From olfactory Mucosa to frontal lobe and temporal lobe .

Optic nerve nucleus - lateral​geniculate Nucleus and
pretectal Nucleus

From retina (rods and cones) to visual cortex in Occipital

lobe

74. Patient cannot raise hand in abduction or maintain in

abduction due to?
A)adhesive capsulitis
B)supraspinatus tear
C)rotator cuff tear

75.The Muscles of shoulder abduction…

1) supraspinatus & infraspinatus..
c) Teres Minor…
d) deltoid

76.The Muscle of the rotator cuff except..

1) supraspinatus & infraspinatus.
.2) subscapularis
3)Teres Minor…
d) deltoid

77.What is drop arm test,, in which pathology ,the test is

positive
Because in the question two points emphasized,, unable
to raise the hand(. Supraspinatus- initiation of
abduction..)and unable to maintain ( supraspinatus :
stabilization)

78.What is empty can test

79.What is painful arc syndrome..in which pathology ,this

test is positive

80.From 60 to 120 degree abduction, is the shoulder

moved medially or laterally??

81. During 6o to 120 degree of abduction, Gr....... Moves

medially which impinge the subacromial structure , where
subacromial bursa or supraspinatus tendon compressed
by gr......tr....

82: The subacromial impingement syndrome test …

a) Neer's test..
b) Hawkins Kennedy​ test…
c) painful arc test..
d) all the above

83. the structure presents in the subacromial space ..

a) subacromial bursa..
b) supraspinatus tendon..
c) long head of biceps tendon..
d) all the above

In neer and Hawkins test , the , the particular position of

abduction ( reduce the space between superior humeral
head and acromion) and internal rotation ( where the
greater tubercle moves medially ) , this both the humeral
head and greater tubercle compress the inured structure
,which provokes the pain, thus indicates the impingement
syndrome

84.The subacromial impingement syndrome test …

a) Neer test..
b) hawkins kennedy test…
c) painful arc test..
d) all the above

85. In the Neer impingement test, the movement which

provokes the pain symptoms..
a) flexion.
.b) extension.
.c) internal rotation..
.d) external rotation
86. In the Hawkins impingement test, the movement which
provokes the pain symptoms..
a) flexion..
b) extension..
c) internal rotation..
.d. external rotation

In neer test, elevation of the arm( 180 degree flexion) ,

generally provokes pain.. It can also be done by long arm
flexion with internal rotation ( by probation) or external
rotation ( by supination).

87.The Patient age is 20, who doesn't have any history of

trauma or soft tissue injury, but all impingement tests are
positive.. true or false

Three type of Neer test,,

1) long lever flexion ( 180) ..
2) long lever flexion with internal rotation..
3) long lever flexion with external rotation

88.The function of pons ..

a). Relay sensory information to the cerebellum..
b) control sleep cycles and breathing.
c) house of 5,6,7,8 Cranial nerve..
.c) all the above...
89. The pons present in the…
a) prosencephalon..
b) mesencephalon..
c) Rhombencephalon.
.d) none of the above

90.This Syndrome is characterized by the Ipsilateral

paralysis of 6 ( loss of abduction) and 7 ( paralysis of
facial Muscles) Cranial nerve combined with contralateral
hemiplegia due to lesion of the pyramidal fibres.
.a) locked in Syndrome..
b) Raymond Syndrome..
.c) Millard gubler syndrome…
d) benedikt syndrome

91.This Syndrome is characterized by the Ipsilateral

paralysis of 6th ( loss of abduction) Cranial nerve
combined with contralateral hemiplegia due to lesion of
the pyramidal fibres without involvement of 7th Cranial
nerve.
a) locked in Syndrome..
b) Raymond Syndrome…
c) Millard gubler syndrome…
d) benedikt syndrome
92.This Syndrome is characterized by complete paralysis
of nearly all voluntary muscles in the body except for
vertical eye movements and blinking. The Patient is aware
of the surroundings but couldn't communicate verbally as
well..
a) locked in Syndrome..
b) Raymond Syndrome…
c) Millard gubler syndrome…
d) benedikt syndrome

93. The locked in Syndrome generally occurs due to the

lesion in the..
a) Midbrain…
b) pons..
c) medulla oblongata…
d)all the above

94.Ascending tract is ..
a) sensory..
b) motor..
c) afferent..
d) a & c

95.The major ascending tract are ..

a) lemniscal system..
b) anterolateral system..
c) spinocerebellar system..
d) all the above

96.For the neurological disease the most common tract

affected…
a) lemniscal system..
b) anterolateral system..
c) spinocerebellar system..
d) all the above

97.For orthopedic disease the most common tract

affected…
a) lemniscal system..
b) anterolateral system..
c) spinocerebellar system..
d) all the above

98. The anterolateral system consists of

1) A...... tract , which function is carry ...... and. L.......tract
which function is carry p.....and T.....

99. The main role of the lemniscal system is

f.....,v....,p.....tw.......and p......

100.The predominant role of spinocerebellar tract is ..

a) pain..
b) temperature..
c) conscious sensation of Joint, Muscle and skin
movements..
d)nonconscious sensation of Joint, Muscle and skin
movements.

101: The conscious sensation of Joint, Muscle and skin

movements carried by ......tract.

102.The fine touch receptor is known as M.......

103.The temperature receptor is known as .....

104.The receptor present in Muscle, tendon, joints, skin

known as........
.
105.What is the meaning of crude touch ?

106.What is the difference between crude touch and fine

touch

107.The Rhomberg test is used for the lesion in the ..

.a) anterior spinothalamic tract…
b) spinocerebellar tract.
.c) lemniscal tract..
d) b & c
108.The lemniscal system otherwise called D ...... tract

109.The free nerve ending receptor is responsible for

carrying p......t......c......

110.Rhomberg test positive in which tract lesion??

111.What is the Rhomberg sign?

112.The nonconscious sensation of joints and Muscles

carried by.....tract

113.The conscious sensation of joints and Muscles carried

by.....tract

114.Dorsal column tract Otherwise called as ........

115.In neuro ,the most common symptom except …

a)balance...
b) pain..
c) altered sensation..
d) incoordination

116.In Ortho ,the most common symptom …

a)balance...
b) pain..
c) altered sensation..
d) incoordination

Rhomberg test:
Ask the patient to stand with their feet together (touching
each other). Then ask the patient to close their eyes.
Remain close at hand in case the patient begins to sway
or fall.
What is Being Tested?
With the eyes open, three sensory systems provide input
to the cerebellum to maintain truncal stability. These are
vision, proprioception, and vestibular sense. If there is a
mild lesion in the vestibular or proprioception systems, the
patient is usually able to compensate with the eyes open.
When the patient closes their eyes, however, visual input
is removed and instability can be brought out. If there is a
more severe proprioceptive or vestibular lesion, or if there
is a midline cerebellar lesion causing truncal instability, the
patient will be unable to maintain this position even with
their eyes open. Note that instability can also be seen with
lesions in other parts of the nervous system such as the
upper or lower motor neurons or the basal ganglia, so
these should be tested separately in other parts of the
exam.
Introduction
The Romberg test is an appropriate tool to diagnose
sensory ataxia, a gait disturbance caused by abnormal
proprioception involving information about the location of
the joints. It is also proven to be sensitive and accurate
means of measuring the degree of disequilibrium caused
by central vertigo, peripheral vertigo and head trauma. It
has been used in clinic for 150 years
The Romberg test is used to demonstrate the effects of
posterior column disease upon human upright postural
control. Posterior column disease involves selective
damaging of the posterior column, known as tabes
dorsalis neurosyphilis. The Romberg test is used for the
clinical assessment of patients with disequilibrium or
ataxia from sensory and motor disorders.

Equilibrium is defined as any condition in which all acting

forces are cancelled by each other resulting in a stable
balanced system. It is maintained through the sensory
information from vestibular, somatosensory and visual
systems. A patient who has a problem with Proprioception
(Somatosensory) can still maintain balance by
compensating with vestibular function and vision. In the
Romberg test, the patient stands upright and asked to
close his eyes. A loss of balance is interpreted as a
positive Romberg sign.
The Romberg test was first described in 1846 and was
originally described for the condition tabes dorsalis. Before
performing the Romberg test, it is necessary to test other
aspects of the patient's balance when potential issues with
ataxia or disequilibrium are present. Often, proprioceptive
challenges are not the first problems faced by this
population. Sometimes, it is more simple. It is important to
first assess other aspects of balance impairment in order
to rule out confounding factors that could lead to a false
positive test

117.The sensory system controls the trunk stability is. .

a) vision..
b) vestibular system..
c) proprioception..
d) all the above

118. The Rhomberg test timing.....

a) 10 sec..
b) 25 sec..
c) 60 sec .
d) 30 sec

119.The nerve tract from the spinal cord to medulla

oblongata is named as medial lemniscus and the nerve
tract from Medulla to brain is called as posterior column
tract..true or false

120: Inner H shaped inner part of Spinal cord is

......matter and outer surface is ......matter. the reason is
this color is .......

121. The postero medial part of dorsal column tract is

called as cuneatus fasciculus and posterolateral part of
tract is called as ......

122.The medial gracilis carries the sensation from the ..

a) foot..
b) upper limb , upper trunk and neck..
c) face…
d) lower limb and lower trunk

123.The lateral cuneatus carries the sensation from the ..

a) foot..
b) upper limb , upper trunk and neck..
c) face…
d) lower limb and lower trunk

124.Basal ganglia is........mater

Cerebral cortex is .......mater
The white matter of the brain is made up primarily of axon
tracts, the long, spindly appendages of some brain cells.
These tracts transmit the electrical signals that the brain
cells, called neurons, use to communicate. They're
wrapped in a fatty layer called myelin, which insulates the
axons and allows them to conduct signals quickly, much
like rubber insulation does for electrical wires. The type of
fat in myelin makes it look white, so myelin-dense white
matter takes on a white hue as well.
In contrast, gray matter is mostly neuron cell bodies and
non-neuron brain cells called glial cells. These glial cells
provide nutrients and energy to neurons. They help
transport glucose into the brain, clean the brain of excess
chemicals and may even affect the intensity of the
neurons' communications.
Because these cells are not surrounded by white myelin,
they take on the natural grayish color of the neurons and
glial cells. In a living person, it actually looks
pinkish-brown, because it has so many tiny blood vessels
called capillaries.
White matter is buried deep in the brain, while gray matter
is mostly found on the brain's surface, or cortex. The
spinal cord, which transmits nerve impulses to and from
the rest of the body, has the opposite arrangement: gray
matter at its core with insulating white matter on the
outside.
125.Based on structure , the receptor is classified into
e.......and n.........

126.The receptor which is sensitive by deformation ..

a) thermoreceptors..
b) chemoreceptors..
c) baroreceptor..
d) mechanoreceptor

127.The encapsulated receptor is..

a) meissner's corpuscles..
b) pacinian corpuscles..
c)Ruffni ending..
d) all the above

128.The nonencapsulated receptor except.

a) free nerve endings.
b) merkel's disc..
c) hair follicle ending.
d) pacinian corpuscles

129.The pain and temperature carried by..

a) pacinian corpuscles..
b) meissner's corpuscles..
c) merkel's disc..
d) free nerve endings

130.The receptor responds for low intensity touch..

a) Meissner's corpuscles..
b) pacinian corpuscles…
c) Ruffni ending..
d) merkel's disc

131.The receptor responds for light touch and low intensity

vibration..
a) Meissner's corpuscles..
b) pacinian corpuscles…
c) Ruffini ending..
d) merkel's disc

132.The receptor respond for deep pressure and high

intensity vibration..
a) Meissner's corpuscles..
b) pacinian corpuscles…
c) Ruffini ending..
d) merkel's disc

133.The receptor respond for touch , pressure and

stretch..
a) Meissner's corpuscles..
b) pacinian corpuscles…
c) Ruffini ending..
d) merkel's disc

134: The receptor looks like onion shape .

a) Meissner's corpuscles..
b) pacinian corpuscles…
c) Ruffini ending..
d) merkel's disc

135.The proprioceptor cristae and maculae present in …

a) joint..
b) muscle…
c) tendon..
d) vestibular apparatus

136. The proprioceptor present in …

a) skin..
b) muscle & tendon..
c) vestibular apparatus..
d) all the above

137: .Chemoreceptors that monitor blood glucose levels

are also A.interoceptors.
B. proprioceptors.
C. special senses.
D. exteroceptors.
138.What pathway conveys fine touch information from
the body to the somatosensory cortex?
a) Dorsal-column medial-lemniscus pathway.
b) lateral Spinothalamic tract..
c)corticobulbar tract ..
d) spinocerebellar tract

139.What pathway conveys crude touch information from

the body to the somatosensory cortex?
a) Dorsal-column medial-lemniscus pathway.
b) anterior Spinothalamic tract..
c)corticobulbar tract ..
d) spinocerebellar tract

140.What is the most common type of cutaneous receptor

found in the skin?

Merkel discs
Krause's end-bulbs
Free nerve endings
Meissner corpuscles

141.Cutaneous receptors respond to stimuli that are

outside the body and are therefore also
A. proprioceptors.
B. interoceptors.
C.exteroceptors.
D. special senses

142.Which of the following is NOT a cutaneous receptor?

A.muscle spindle
B. touch receptor
C. heat receptor
D. pain receptor

143.Damage to cutaneous receptors would limit the ability

to detect all of the following except
A. pain
.B. thermal sensations.
C.body position
.D. touch.

144.individuals would normally perceive pain when the

chemoreceptors are stimulated.
True
FALSE

145.These detect environmental changes and trigger

nerve impulses that travel on sensory pathways into the
CNS.
A.sensory receptors
B.the five senses
C.somatic senses
D.special senses

146.Simple sensory receptors (or somatic senses)

contain:
A.touch, pressure, temperature, pain
B.smell, taste, hearing, equilibrium, vision

147. Complex sensory receptors (or special senses)

contain:
A.touch, pressure, temperature, pain
B.smell, taste, hearing, equilibrium, vision

148.Pain receptors are stimulated by...

A.temperature change
B.tissue damage
C.light energy
D.pressure or movement

149.The ability to ignore unimportant stimuli is called...

A.sensory receptors
B.perception
C.sensations
D.sensory adaptation

150.You smell something delicious baking. What kind of

sensory receptors receive that information?
A.Photoreceptors B.Mechanoreceptors
C.Thermoreceptors
D. Olfactory receptors

151.The special sense organs include ________ .

A) taste buds
B) nose
C) eye
D) ear
E) all of the above

152.What type of sensory receptors process pressure and

touch information?
A.Chemoreceptors
B.Olfactory receptors
C. Mechanoreceptors
D. Photoreceptors

153.The sense of knowing the position of the limbs is

called ______.
A) proprioception
 B) adaptation
C) reflex
D) isolation
E) stasis

154.The sense Normal human being is..

a) 8..
b)5.
c)7…
d)6

155.The pain and temperature carried by..

a) lateral Spinothalamic tract..
b) anterior Spinothalamic tract..
c) medial lemniscal tract..
d) spinocerebellar tract

156.The Spinothalamic tract decussation ..

a) at the medulla oblongata..
b) above the corresponding spinal cord..
c)at the level spinal cord ..
d) pons

157.The crude touch is carried by…

a) lateral Spinothalamic tract..
b) anterior Spinothalamic tract..
c) medial lemniscal tract..
d) spinocerebellar tract

158.The ascending tract reach the thalamus at ..

a) ventral part..
b) lateral part..
c) posterior part.
d) ventral posterolateral ( VPL) part

160.The ascending tract end at the Cerebral cortex of..

a) somatosensory area I ( 3,1,2)..
b) somatosensory area II( 5, 7)..
c ) posterior parietal lobe..
d) all the above

161: During pain and temperature , the Patient is alert and

sleep disappear because din the brainstem, the lateral
Spinothalamic tract synapse with the R.......... system

162.The spinothalamic tract is composed of two adjacent

pathways: anterior and lateral. The anterior spinothalamic
tract carries sensory input about c.......and p....... The
lateral spinothalamic tract carries information about
p......and t...........
163.Which is the movement seen in shoulder during
swimming
A) abd /forward flex/iR
B)abd/forward flex/Er
C)abduction/extension/ir
D) abd/extension/external rotation

163.Types of sensory fibers are associated with the

spinothalamic tract....
a)type III fibers.
b) unmyelinated c-fibers, c)myelinated A-delta fibers.
d) all the above

164.The first order neuron pain and temperature synapse

in the spinal cord at ..
a) Clarke's nucleus..
b) Raphe nucleus..
c) fastigial and dentate nucleus..
d) substantia gelatinosa rolando

165.The pain and temperature carried by ..

a) Anterior Spinothalamic tract..
b) lateral Spinothalamic tract..
c) spinocerebellar tract ..
d) all the above
166.The opioid receptor present in the spinal cord is
............ which prevent the pain when administer the opioid
drugs( like morphine)

Type A fibers:
These fibers are the thickest and fastest conducting.
They are myelinated.
They have a diameter of 1.5-20 micron
Their speed of conduction is 4-120 m/sec, which shows
that they have a really fast conduction of impulse.
Examples of type A fibers are skeletomotor fibers,
fusimotor fibers and afferent fibers to skin.
Type B fibers:
These fibers are medium in size, i.e. they are smaller than
type A fibers but larger than type C.
They are myelinated.
They have a diameter of 1.5-3.5 microns.
Their speed of conduction is 3-15 m/sec, which shows that
they are slower than type A fibers.
Examples of type B fibers are preganglionic autonomic
efferents
Type C fibers:
These fibers are the smallest and thinnest.
They are non-myelinated.
They have a diameter of 0.1-2 microns.
Their speed of conduction is 0.5-4 m/sec, which shows
that they have the slowest conduction.
Examples of type C fibers are postganglionic autonomic
efferents and afferent fibers to skin.

167.Type of nerve fibre ..

a) 2 ..
b) 3 ..
c) 4 .
d) all the above

168.Delta fibres are L.........., m.........and f.........

169.C fibres are s......u.......s.....

170.Nociceptive means..
a) sensation of cold..
b) sensation of touch..
c) sensation of texture..
d) sensation of pain

171.The pain fibres …

a) A Beta fibers..
b) A Delta fibres..
c) C fibers..
d) b and c
172.Touch and proprioception carried by ..
a) A beta fibers..
b) A Delta fibres..
c) C fibers..
d) b and c

173.Neuropathic pain is other than nerve lesion and

nociceptive pain due to nerve lesion ..true or false

174.Brachialgia and diabetes mellitus is .......pain and joint

and Muscle injury is .......pain

175.The Patient is suffering pain,, soft tissue

MANIPULATION and electrotherapy activates the fibres
that close the pain gate in the spinal cord ..
a) A Beta fibers..
b) A Delta fibres..
c) C fibers..
d) b and c

176.The spinocerebellar tract carries the non conscious

proprioceptive sensation from..
a) Muscles..
b) joints..
c) skin..
d) all the above

177.The first order neuron of the spinocerebellar tract

synapse in the spinal cord at..
a) substantia gelatinosa ..
b) Clarke's column..
c) gracilis nucleus..
d) cuneatus nucleus

178.Clarke's column presents in which lamina or layer of

Spinal cord..
a) V..
b)VI..
c)VII.
d)II

179.The spinocerebellar tract consists of..

a) anterior spinocerebellar tract..
b) posterior spinocerebellar tract..
c) cuneo spinocerebellar tract..
d) all the above

180.The cuneo spinocerebellar tract carries the

proprioceptive information from..
a) lower limb..
b) thorax..
c) upper limb ..
d) upper limb and neck

181.Dorsal spinocerebellar tract otherwise called ..

a) olivary tract..
b) growers tract..
c) Fleshings tract..
d) tract of goll and burdach

182.Ventral spinocerebellar tract otherwise called ..

a) olivary tract..
b) growers tract..
c) Fleschigs tract..
d) tract of goll and burdack

183.Tract of goll and burdack is the traditional name of ..

a) lemniscal system..
b) anterolateral system..
c) spinocerebellar tract..
.d) all the above

184. The dorsal spinocerebellar tract carries the from the

spinal segment of ..
a) below L2..
b) C1 to C8..
c) T 1 to L2
185.The ventral spinocerebellar tract carries the form of
the spinal segment of .
.a) below L2..
b) C1 to C8.
.c) T 1 to L2..
d) none of the above

186.The cuneo spinocerebellar tract carries the from the

spinal segment of ..
a) below L2.
.b) C1 to C8.
.c) T 1 to L2..
d) none of the above

187. In the Spinal cord, the first order neuron of dorsal

spinocerebellar tract synapse at ..a) substantia gelatinosa
..
.b) olivary nucleus
..c) Clarke's nucleus..
d) accessory cuneate nucleus

188.In the Medulla, the cuneo spinocerebellar tract

synapse at ..
a) substantia gelatinosa …
b) olivary nucleus..
c) Clarke's nucleus..
d) accessory cuneate

189.The conscious proprioception sense carried by

m.........and nonconscious proprioception sense carried by
s.........

190.The touch and pressure receptor .....

a) Meissner's corpuscles.
.b) Ruffini corpuscles
.c) pacinian corpuscles..
d) all the above

191.The most important part of the brainstem is .

a) Midbrain..
b) pons..
c) cerebellum..
d) medulla oblongata

192.The medulla oblongata Otherwise called…

a) pyramid..
b) bridge.
.c) pea.
.d) bulbar

193.The medulla oblongata gives the houses for the Cranial nerve
nuclei of..
a) 1 n 2..
b) 3 n 4..
c) 5,6,7,8..
d) 9,10,11,12

194.In the autonomic nervous system , the parasympathetic part of

the cranial nerve is ..
a) 1,2,3,10.
.b) 3,7,9,11.
.c) 3, 7, 9,12.
.d) 3,7,9,10

195. The sympathetic outflow Otherwise called T.............and

parasympathetic outflow otherwise called C............

196. The role of medulla oblongata is .

.a) heart rate, breathing rate and blood pressure..
b) vomiting , sneezing reflex & sleep cycle..
c) vasomotor center..
d) all the above

197.Muscles supplied by glossopharyngeal nerve (9th Cranial nerve

198.Muscles supplied by vagus (10th Cranial nerve).

199.Muscles supplied by accessory nerve

200.Muscles supplied by HYPOGLOSSAL nerves......

201.The corticobulbar tract is a part of pyramidal tract...the
corticobulbar tract terminates at the motor nuclei of Cranial nerve in
the brainstem.true or false

202.The corticobulbar tract Otherwise called lower motor NEURON of

the Cranial nerve ..true or false

203. The sympathetic outflow Otherwise called T.............and

parasympathetic outflow otherwise called C............

204.In autonomic nervous system , the parasympathetic part of cranial

nerve is ..
a) 1,2,3,10..
b) 3,7,9,11..
c) 3, 7, 9,12..
d) 3,7,9,10

205.In the medulla oblongata , 15% pyramidal tract fibres decussate

contralateral ,and 85% goes Ipsilateral ..true or false

206.Medulla Oblongata end at inferior part of atlas(C1)...true or false

207. The predominant function of Thalamus..

a) sleep…
b) memory.
..c) emotional…
d) sensory integration

208.Damage to the medulla oblongata can result in: Difficulty

swallowing. Loss of gag and cough reflex.. true or false.... Rationale
209.1)Amygdala…
2) Hippocampus
3)Medulla Oblongata. 1)Plays aPlays a significant role in the
formation of long-term memories.
2) centers for the control of vital processes such as heart rate,
respiration, blood pressure, and swallowing…
3)Limbic structure involved in many brain functions, including emotion,
learning and memory. ARRANGE IN CORRECT ORDER

1. Amygdala-limbic structure involved in emotion, learning, memory

2. hippocampus-formation of long term memory
3.MO- center for control of vital
process such as HR, BP, Respiration

210. O........ present in the superior part of medulla. It act as a relay

for the proprioceptive from the spinal cord to cerebellum

211.Cell body of the Neurons called as area of white matter and

axons (nerve fibres) called as area of grey matter ...true or false

212.Medial Medullary Syndrome Otherwise called Dejerine Syndrome

and Lateral Medullary Syndrome otherwise called Wallenberg
syndrome....true or false

213.The paralysis of tongue Muscle , loss of kinesthetic sensation with

contralateral hemiplegia.
.a) Weber syndrome…
b lateral Medullary Syndrome ( Wallenberg).
.c) medial Medullary Syndrome (Dejerine).
.c) locked in Syndrome

214. The loss of pain and temperature with contralateral hemiplegia..

a) Weber syndrome…
b lateral Medullary Syndrome(Wallenberg)
c) medial Medullary Syndrome Dejerine
d) locked in Syndrome

215.Where are the vital centres located in the brainstem?

a) midbrain

b) pons

c) medulla oblongata

d) cerebellum