Functional
The motor cortex mainly controls which side of the body?
A. Ipsilateral
B. Bilateral
C. Contralateral
C. Contralateral
Which if the following symptoms is not typically related to cerebellar dysfunction?
A. Resting tremor
B. Intention tremor
C. Ataxia
D. Nystagmus
A. Resting tremor
In the basal ganglia, which structures collectively form the neostriatum?
A. Caudate nucleus and subthalamic nucleus
B. Substantia nigra and subthalamic nucleus
C. Putamen and globus pallidus
D. Putamen and caudate nucleus
D. Putamen and caudate nucleus
Damage to the cerebellum most characteristically leads to which of the following motor signs?
A. Resting tremor
B. Rigidity
C. Intention tremor and ataxia
D. Spasticity
C. Intention tremor and ataxia
A cerebellar lesion typically produces motor deficits on which side of the body?
A. Contralateral side
B. Ipsilateral side
C. Bilateral
D. Dependent on descending pathway...
B. Ipsilateral side
Cerebellar output pathways "double-cross", so net-effect is ipsilateral.
During examination, a patient with cerebellar pathology shows a negative Romberg test. What does this indicate?
A. Dorsal Column (DC) dysfunction
B. Vestibular dysfunction
C. Cerebellar dysfunction alone
C. Cerebellar dysfunction alone
Romberg's sign test for proprioception.
Which structure separates the caudate nucleus from the putamen?
A. Lateral ventricle
B. Internal capsule
C. Globus pallidus
D. Claustrum
B. Internal capsule
56/F is brought to the ED with acute paralysis of her right upper limb. She has a history of hypertension and ischaemic stroke but has not been able to receive anticoagulation therapy over the past month due to a perforated peptic ulcer. She is lucid and has no identifiable sensory deficits. CT angiography shows an occluded branch of one of her middle cerebral arteries.
Which cerebral hemisphere structure has most likely been affected?
A. Corpus callosum
B. Left postcentral gyrus
C. Left precentral gyrus
D. Right postcentral gyrus
E. Right precentral gyrus
C. Left precentral gyrus
In Parkinson’s disease, loss of dopamine has which effect on basal ganglia output?
A. Increased cortical excitation via thalamus
B. Reduced inhibition from GPi to thalamus
C. Over-inhibition of thalamus by GPi
D. Increased direct pathway activity
C. Over-inhibition of thalamus by GPi
Dopamine loss, reduced direct/ increased direct pathways, GPi overactivity, XS thalamic inhibition.
Which basal ganglia circuit is primarily overactive in Parkinson’s disease due to loss of dopaminergic input?
A. Direct pathway
B. Indirect pathway
C. Corticopontine pathway
B. Indirect pathway
81/M is brought to the ED with involuntarily twitching movements of his right upper limb. He has a longstanding history of hypertension and diabetes mellitus. The movements started last night and are repetitive. He wildly flings his right arm away from his side while he is being examined.
Which subcortical structure is most likely affected in this case?
A. Caudate nucleus
B. Globus pallidus
C. Putamen
D. Substantia nigra
E. Subthalamic nucleus
E. Subthalamic nucleus
"hemiballismus" (strong, flinging limb movements) occur due to dysfunction of the ONLY excitatory structure of the indirect pathway, the STN.
A 55-year-old man shows high-stepping gait, reliance on visual input, and difficulty walking in the dark. What is the MOST likely cause?
A. Cerebellar dysfunction
B. Vestibular neuritis
C. Dorsal Column degeneration
D. Parkinson's disease
C. Dorsal Column degeneration
Above describes a loss of proprioception, DC degen., potentially from B12 deficiency.
Which of the following non-motor features is MOST strongly associated with Parkinson’s disease?
A. Diplopia
B. Fasciculations
C. REM sleep behaviour disorder
D. Vertical gaze palsy
C. REM sleep behaviour disorder
Strongly linked to alpha-synuclein misfolding
Note: Vertical gaze palsy -> Progressive Supranuclear Palsy
Fasciculations -> MND
Diplopia -> brainstem/CN lesion.
When considering embryonic development of the CNS, which is the embryonic origin of the cerebellum?
A. Myelencephalon
B. Metencephalon
C. Telencephalon
D. Diencephalon
B. Metencephalon
>> Hindbrain subsequently divides into the metencephalon (superior) and the myelencephalon (inferior). The cerebellum develops from the metencephalon division.
A 40-year-old patient presents with irritability, memory decline, and involuntary writhing movements.
MRI shows caudate nucleus atrophy. What is the MOST likely neurotransmitter change?
A. Increased dopamine
B. Decreased dopamine
C. Increased ACh
D. Loss of GABAergic neurons
D. Loss of GABAergic neurons
Chorea symptoms, caudate nucleus atrophy, Huntington's
A 56-year-old woman presents with difficulty initiating self-directed movements, although she performs externally cued movements normally. She struggles to perform a sequence of motor actions she plans internally, but improves when asked to mimic the examiner.
Which cortical region is MOST likely affected?
A. Primary motor cortex
B. Premotor cortex
C. Supplementary motor area
D. Posterior parietal cortex
E. Cerebellar hemisphere
C. Supp. Motor Area
A 45-year-old man presents with impaired coordination of multi-joint movements. He overshoots targets, and his trajectory corrections are delayed and dysmetric.
Damage to which cerebellar output pathway BEST explains these findings?
A. Inferior cerebellar peduncle -> vestibular nuclei
B. Superior cerebellar peduncle -> red nucleus and thalamus
C. Middle cerebellar peduncle -> pontine nuclei
D. Inferior olive -> cerebellar cortex
B. Superior cerebellar peduncle -> red nucleus and thalamus
A researcher observes that neurons in a particular cortical area fire before a voluntary movement begins. The activity occurs even if the movement is ultimately not performed.
Which region MOST likely contains these neurons?
A. Primary motor cortex
B. Premotor cortex
C. Supplementary motor area
D. Prefrontal cortex
C. Supplementary motor area
SMA fires when movement is planned (not necessarily executed).
Premotor responds to external cues.