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تحميل الدليل التدريبي

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Questions

Neuro-physiology

Write short notes on:

1-  Functions of sensory receptors.

2-  Classifications of receptors.

3-  Types of mechano-receptors.

4-  Mechanism of receptor potential in different receptors.

5-  Properties of receptor potential.

6-   Specificity of receptors.

7-  Types of adaptation and significance of each of them.

8-  Mechanism of adaptation.

9-  Coding of sensory information.

10-                     Fine touch sensation.

11-                     Vibration sense.

12-                     Types of kinesthetic and proprioceptive sensations.

13-                     Perception of the different grades of temperatures.

14-                     Types and distribution of pain receptors.

15-                     Mechanism of stimulation of pain receptors.

16-                     Types of pain.

17-                     Cutaneous hyper-algesia.

18-                     Ischemic pain.

19-                     True visceral pain.

20-                     Examples and mechanism of Referred pain.

21-                     Intracranial headache.

22-                     Exracranial headache.

23-                     Termination of the afferent neuron.

24-                     Functions of inter-neurons.

25-                     Motor neuron unite and motor neuron pool.

26-                     Mechanism of synaptic transmission.

27-                     Properties of synaptic transmission.

28-                     Central delay and central fatigue in reflex action.

29-                     Fractionation and occlusion.

30-                     Discharge zone and area of subliminal fringe.

31-                     Reciprocal Innervation.

32-                     Recruitment and After-discharge.

33-                     Inhibition and rebound.

34-                     Successive spinal induction.

35-                     Sensory and motor innervation of muscle spindles.

36-                     Supra-spinal facilitatory centers.

37-                     Supra-spinal inhibitory centers.

38-                     Functions of stretch reflex.

39-                     Properties of stretch reflex.

40-                     Lengthening and shortening reactions of stretch reflex.

41-                     Control of muscle tone.

42-                     Functions of muscle tone.

43-                     Mechanism and clinical examples of tendon jerks.

44-                     Variation of tendon jerks and their clinical significance.

45-                     Functions of area 4.

46-                     Effects of lesion in area 4:

47-                     Functions of area 6.

48-                     Pyramidal tract lesion at different levels.

49-                     Extra-pyramidal tracts.

50-                     Functions of extra-pyramidal tracts.

51-                     Effects of UMNL.

52-                     Effects of LMNL.

53-                     Stage of shock (spinal shock).

54-                      Stage of reflex activity in spinal cord lesion.

55-                     Hemi-section of spinal cord (Brown Sequard syndrome).

56-                     Anterior and posterior Quadrant lesion of the spinal cord.

57-                     Sryngo-myelia.

58-                     Lesion of the dorsal column of the spinal cord.

59-                     Lesion of dorsal nerve roots.

60-                     Effects of unilateral lesion of the posterior limb of the internal capsule.

61-                     Mechanism of regulation and coordination of the voluntary movements.

62-                     Cerebellar ataxia.

63-                     Functions of the basal ganglia.

64-                     Parkinsonism.

65-                     Thalamic nuclei.

66-                     Functions of the thalamus.

67-                     Thalamic syndrome.

68-                     Factors affecting the activity of the RAS.

69-                     Function of the hypothalamus.

70-                     Manifestations of hypothalamic lesions.

71-                     Control of endocrinal secretion through.

72-                     Regulation of body temperature.

73-                     Regulation of body water.

74-                     Regulation of body weight.

75-                     Regulation of blood glucose level.

76-                     Functions of Prefrontal areas.

77-                     Somatic sensory area or area 3.1 . 2.

78-                     Sensory association area or area 5, 7.

79-                     Wernick's area (general interpretative area, or area 39, 40).

80-                     Memory.

81-                     Sensory and motor Speech centers.

82-                     Aphasia.

83-                     Structure, functions and mechanism of action of the macula.

84-                     Structure and mechanism of stimulation of crista.

85-                      Methods of stimulation of the S.C.Cs.

86-                     Causes and Pathway of nystagmus.

87-                      Causes of vertigo.

88-                      Local static reflexes.

89-                     Segmental static reflexes.

90-                     Stato-tonic reflexes.

91-                     Righting reflexes.

92-                     Reflexes due to linear acceleration.

93-                     Control of standing and walking.

Fill the blank:

1-    ……………..……......................................…. are present in aortic and carotid bodies.

2-    ………………….….............................................. are present in taste and smell receptors.

3-    ……………….…...................................... are not sensory receptors because they are not connected with sensory nerves.

4-    ………………..................................................….. are the start points of all body reflexes.

5-    ……………….…......................................................include touch, pressure, stretch, baro-receptors, etc.

6-    ……………..…….….................................. are stimulated by deformation and stretch of receptor membrane.

7-    ………………….…. are stimulated by combination with their specific chemical substances.

8-    ……………….…. are stimulated by tissue damage.

9-    ……………….….. are stimulated by light waves.

10-            ……………….….. are stimulated by either increase or decrease temperature.

11-            Some receptors can respond to stimuli other than the adequate stimuli, but these stimuli must be of high …………..…..............................................….….

12-            ………………..... is determined by the central connection between the receptors and the higher centers in the cerebral cortex.

13-           Weber-Fechner law states that the ……………………of action potential is directly proportional with the logarithm of the …………………....of the stimulus.

14-            …………….……..are slowly adapting receptors.

15-            …………….…..are rapidly adapting receptors.

16-           The higher centers can discriminate ………….….……..of sensation by specificity of receptors and pathway.

17-            ……………………of stimulus is determined by varying the number of stimulated receptors and the rate of discharge from each receptor.

18-            …………………… of stimulus is determined by the law of projection.

19-            Coding of sensory information means ability of the higher centers to discriminate …………..…….…, …..…………….….., and ………………...of different sensations.

 

20-     …………means one inter neuron divides into several branches to supply large number of A.H.Cs, while ……….…. means many inter neuron supply one A.H.C.

21-     ………………means continuous stimulation of AHC as a result of single stimulation of afferent nerve.

22-     ………. is composed of AHC, its axon and the number of skeletal muscle fibers supplied by it.

23-     …………….is composed of all AHC supplying a certain muscle.   

24-           ………………... is the site of contact between the axon of a neuron called (pre synaptic neuron) and the cell body of another neuron

25-           Pre-synaptic neuron gives rise to large number of pre-synaptic terminals each of them ends by a swelling known as ……………….

26-           Pre-synaptic terminals are separated from the post synaptic neuron by a narrow space known as ……………...

27-           ……………………is produced by stimulation of several numbers of pre-synaptic terminals at the same time.

28-           …………….…….. is produced by stimulation of a single pre-synaptic terminal by a several stimuli after each other within a very short time.

29-           ……….…………. stimulates synaptic transmission, while ……………inhibit synaptic transmission. Alkalosis ……….…..………….synaptic transmission, acidosis ……….……….…….synaptic transmission, while severe hypoxia (Anoxia)……………………… synaptic transmission and may lead to fainting in less than 5 seconds.

30-           …………………….. is the property by means of which strong stimulus can excite many motor neuron pools inside the spinal cord.

31-           ……………………..is the property by means of which contraction of a certain muscle is accompanied by relaxation of the antagonistic muscles to the same extent.

32-           …………………means gradual contraction of the muscle as a result of stimulation of the afferent, while ………………..means gradual relaxation of the muscle after stoppage of stimulation.

33-           ………………….is the property by means of which the stronger reflex inhibit the weaker reflexes when applied at the same time, while …………..means exaggeration of the reflex after its temporal inhibition.

34-           …………………is due to lesion of one of the supra-spinal inhibitory centers.

35-           …………………is due to lesion of one of the supra-spinal facilitatory centers.

36-           …………………is de to lesion in the reflex arc; afferent, center or in the efferent.

37-           The center of Knee jerk is present in………………….  , Ankle jerk is present in ………….………, Biceps jerk is present in  …..………….., and Triceps jerk is present in ………………….

38-            Voluntary movements are controlled by the following cortical motor areas: ......................................................................., ...............................................................,  and ...........................................................................

39-           Area 4 occupies the ............................................................ of the frontal lobe, area 6 lies .................................................................................., while supplemental area lies .........................................................................................................................

40-           In area 4 the body is represented ..................................... It supplies mainly the muscles in the .............................................. of the body through ........................... tract. The area of representation of any part of the body is related to its ...................................... So, the areas of the fingers, lips and tongue are .............................. than areas of the trunk and thigh.

41-           Functions of area 4: It ........................... voluntary, fine, discrete (isolated) movement in the opposite side of the body. It ............................. stretch reflex and muscle tone of the opposite side of the body. It also ................................. spinal reflexes and spinal centers.

42-           Effects of lesion in area 4: ........................................... of the muscles of the opposite side of the body. .............................. muscles tone is the paralyzed muscle.  .................................... of reflexes; superficial reflexes  and  deep reflexes. ............................................. which means abnormal response of planter reflex.

43-           Functions of area 6: ........................................of the complex voluntary movements initiated by area 4. ..................................... of gross movements produced by proximal muscles. .................................................... which occur in the trunk and proximal parts of the limbs to help fine voluntary movements produced by the distal parts (fingers). ........................................ e.g. swinging movements of arms during walking and facial expression which reflects the emotional state of the person. Area 6 ............................ stretch reflex and MT of the opposite side of the body. It ....................... spinal reflexes and spinal centers.

44-           Touching the palmer surface of the hand produces firm closure of the hand over the touched object. This reflex is known as ........................................, the center of this reflex is present in ..................................... it is normally inhibited by ............................ of the frontal lobe.

45-           Pre-motor area contains the following special areas: ..........................................., ................................................................., ..........................................................., and ...............................................................

46-            Broca's area (area 44 & 45): is present in the ........................... cerebral hemisphere. It is the motor center for .............................. Its lesion leads to .......................................

47-           Hand skills area (Exner's area) controls the ..................................... Its lesion leads to ..................................... and .....................................

48-           In supplemental motor area the body representation ................................... ...................................... It helps in control of the complex movements which involves .............................................. and also involves ......................................................

49-           Pyramidal tract arises from the motor areas: ............................................, ....................................., ................................................, and from the sensory areas ..................................................................., and ............................................

50-           Pyramidal tract passes from C.C to .................................. then the fibers collect together and pass in the internal capsule where the fibers occupy ....................................................................

51-           In pyramidal tract, lesion of area 4 leads to ............................................ in the opposite side because lesion affects only part of area 4. Lesion in internal capsule leads to .................................................. in the opposite side. Lesion in brain stem leads to ............................................. which means UNML in opposite side and cranial nerve lesion (LMNL) in the same side. Unilateral lesion in the spinal cord above the brachial plexus leads to ................................................ Bilateral lesion above brachial plexus leads to ............................................. Unilateral lesion below the brachial plexus and above lumbo-sacral plexus leads to ....................................... .................................... Bilateral lesion below the brachial plexus and above lumbo-sacral plexus leads to .................................................

52-           Extra pyramidal tracts are .............................................................................., ............................................................, .................................................................., ..........................................................., and ................................................................

53-           UMNL results from damage of descending motor tracts ................................................ or ......................................................................... 

54-           The most common site is ........................................... where the fibers condense together. The most common causes are ........................... or ................................ of cerebral blood vessels.

55-           In UMNL paralysis is usually ............................................ because pyramidal tract fibers condense together. Paralysis occurs usually in the ............................................. side.

56-           In UMNL no recovery occurs because of absence of .................................................

57-           Babinski's sign may be physiological e.g.: ............................................ due to lack of myelination of pyramidal tract, and in adults during ....................................., ..............................................,  and ............................................

58-           In UMNL wasting is not marked because .........................................................., and ..................................................................................

59-           In UMNL the muscles respond normally to electrical stimulation, Faradic current produces ............................................................, Galvanic current produces contractions which are not the same in magnitude, we observe that .........................  > ........................ > ............................. > ...............................

60-           LMNL results from damage of .................................. or ................................................

61-           In LMNL paralysis is usually ........................................... because AHCs are widely spread all over the spinal cord. It occurs in the .............................................. side of the lesion. Paralysis is ........................................... because it is accompanied with loss of MT.

62-           In LMNL recovery can occur because ...........................................................................

63-           In LMNL there is marked wasting of the affected muscles because........................................................... and ................................................................

64-           In LMNL there is abnormal response to electrical stimulation which is known as .................................................... in which: Faradic current produces ................................. and Galvanic current produces abnormal response in which .................. > .........................

65-            In motor nerve lesion ............................ occurs distal to the lesion and ........................... occurs proximal to it, ...................................... can occur if the cell bodies ( AHC ) are not affected.

66-            Complete transaction of the spinal cord is caused by ..........................................., ........................................, ............................................., or ............................................

67-            The duration of spinal shock in human is ...................... weeks. In spinal shock there is permanent loss of .............................................. , ............................... of all muscles below the level of the lesion and a temporal loss of .......................................................

68-            In complete transaction of spinal cord micturition reflex is ...................................... in the stage of shock, this case is known as ............................................................................., then it becomes .................................................. in stage of reflexes, lastly it returns to ................................................................... in stage of failure of reflexes.

69-            In spinal cord lesion bed sores appear in the back and gluteal region due to: .................................... , ............................... and ..................................................

70-            Spinal shock is treated by ............................................... , ....................................., ................................. and ................................................

71-           In Hemi-section of spinal cord there is ........................................................... above the level of the lesion, but at the level of the lesion there are ......................................... , ....................................., and ............................................

72-           In Hemi-section of spinal cord below the level of the lesion and at the same side there is loss of ................................................................ ,  .................................................., and ............................................................., but in the opposite side there is loss of .........................................., .......................................... and ...........................................

73-           Posterior Quadrant lesion of the spinal cord is manifested by ....................................... , ................................................., ..............................................

74-            Anterior Quadrant lesion of the spinal cord is manifested by ................................... , ................................................... , .........................................................

75-           Sryngo-myelia is manifested early by loss of ................................................ and ................................................................. at the same level on both sides. Progressive erosion leads to .................................................., ................................................, and ...........................................................

76-            Lesion of the dorsal column of the spinal cord leads to lesion of ................................... and .......................................... tracts of both sides. This leads to loss of ................................................... , ............................................................... ,  and .........................................................

77-           In ........................................................ the patient losses his equilibrium and falls down if he closes his eyes. This occurs in dorsal column lesion.

78-           In unilateral lesion of the posterior limb of the internal capsule the patient suffers from .................................... , .........................................., .............................................. and ...............................................................

79-           The cerebellum lies in the ................................. , below the .................................... It lies behind medulla and pons from which it is separated by the cavity of .........................................................

80-           Each cerebellar hemisphere is divided into 3 lobes by 2 deep fissures ................................................... and ................................................................... These lobes are ..................................................... , ........................................................ and ....................................................

81-           The cerebellum is connected to the brain stem on each side by: ...................................................... which connects the cerebellum and midbrain, ......................................................... which connects the cerebellum and pons, and ....................................................... which connects the cerebellum and medulla oblongata.                   

82-           From the functional point of view the cerebellum is divided into: .............................................. or vestibular part, ..................................................... or spinal part, and .................................................................................. or cerebral part.

83-            Archi-cerebellum is connected with ....................................... and it controls ................................ Lesion of this part of cerebellum leads to ................................. , ..................................., and ...................................

84-           Paleo-cerebellum is connected with ............................................ and it is ........................................ to muscle tone, and helps in ...................................

85-           Neo-cerebellum is connected with .............................. and it is ............................... to muscle tone, and helps in ...................................................................

86-           Lesions of Neo-cerebellum leads to ..................................... , ...................................., and .............................................

87-            Cerebellar ataxia means .........................................................................................

88-           In Dysmetria the patient is unable to .................................................................. resulting in either ......................................................where the hand shoots beyond the object, or ........................................................where the hand stops before the object. This is tested by .....................................................................

89-            In Decomposition of movements the patient is unable to .......................................... , he can do it in many steps. This is tested by ....................................................

90-           In Asynergia the patient is unable to ................................................ this is tested by asking the patient to ................................................

91-            In Adiadochokinesis the patient is unable to ............................................ , this is tested by asking the patient to ..........................................................

92-           In Rebound movements the patient ....................................................... If the patient is asked to push you while you oppose him, then you go back suddenly, the patient .....................................................

93-           Kinetic tremors means ................................................... which appear during ............................. and disappear during ....................................... while static tremors appear during ................................... and disappear during ...........................................

94-           In new-cerebellar syndrome the patient walks ..................................................., he deviates towards the diseased side, then corrects himself back to the original line, but in Parkinsonism the patient walks ...................................................

95-            In new-cerebellar syndrome the speech of the patient becomes .................................. but in Parkinsonism the speech is ..........................................

96-           Basal ganglia include the following: ............................................... , ..............................., ......................................., ............................................, and ..............................................

97-           Lesion of basal ganglia leads to ..................................., ....................................., ............................... , and ................................

98-           Rigidity in Parkinsonism is either ............................................... or .......................................... but in UMNL it is ................................

99-           In parkinsonism MT ­ in all muscles of the body. It is more marked in ................................... muscles of the limbs more than ......................................., and in ..................................................... more than ..............................................................

100-      Non specific thalamic nuclei include ..............................................................., ........................................................... , and ....................................................................

101-      Non specific thalamic nuclei receive impulses from ........................................... and discharge to ............................................................

102-       Postero-ventral nucleus (PVN) of the thalamus receives sensory impulses from ..................................................... & ....................................................... And projects to area ................................... and area ....................................................

103-      The thalamus is the higher center for ...................................................... sensations relay station for ....................................................... sensations from the opposite side of the body.

104-      Reticular activating system (RAS) receives impulses from ...................................... , ...................................... , ........................................ , and ...................................

105-       Hypothalamus contains the biological clock which regulates the diurnal variation of the following functions: .........................................., ....................................................., ........................................................... , and .........................................................

106-      Hypothalamic lesions leads to ....................................., ....................................... , ...................................... , ................................... , and ...............................................

107-      Each cerebral hemisphere contains 5 lobes; ............................ , ........................., ............................ , ................................ and ............................ lobes. Each lobe is divided by several sulci into many gyri. The central sulcus separates ............................... from ............................... lobe. The lateral sulcus separates ................................ from ................................ lobe.

108-       Primary sensory area ( somatic sensory area or area 3.1 . 2) occupies ........................................ , it receives fibers from ..................................... of the thalamus through the .......................... In this area the body is represented ................................ It receives sensations from the .................................. side of the body. The area of representation depends upon ...................................... It receives the following sensation; ................................. , ......................................, .................................... , and ...................................

109-      Secondary sensory area or area 5, 7 lies ............................................ It receives fiber from ............................................ and also from .............................................. It is concerned with ...................................................................... So the person can recognize the objects by ....................... , ................... , ................... and .......................... of the objects. Its lesion leads to .............................................

110-      Wernick's area or area 39, 40 lies at ................................................. occupying ................................. gyrus and ................................ gyrus. This area receives impulses from the following association area: ...................................................... , ................................................................... , and ...........................................................

111-      Short term memory is the ability to retain ............................................................. for .................................................................. Short term memory is due to .....................................................................  Long term memory is the storage of information which can be recalled after .......................................................... It results from ........................................ or .....................................................................

112-      Sensory speech centers are ......................................................................... and ............................................................................. , motor speech centers are ..................................................................... and .......................................................

113-      Visual aphasia is due to lesion of ................................................. In this type the patient can see, but he can't .................................................. Auditory aphasia is due to lesion of ....................................................... In this type the patient can hear, but he can't ............................................... General sensory aphasia is due to lesion in ............................................. In this type the patient fails to ...................................... and fails to ..............................................................

114-      Broca's aphasia: It is due to damage of the ......................................... The patient can't ......................................... The muscle of speech are .................................................. But Agraphia is due to damage of ............................................... The patient can't .......................................... ,  the muscles of the hand are ................................................

115-      The labyrinth is present in the ............................................................... It is formed of a bony labyrinth and membranous labyrinth. The space between the bony and membranous labyrinth is filled with ................................................. , where as the membranous labyrinth is filled with .......................................................

116-      Utricle and saccule contain ..................................... This part detects ................................... and controls equilibrium during ................................      Semicircular canals (SCCs) contain .................................... This part controls equilibrium during ...................................

117-      The macula is composed of ........................................ and .................................... The cilia of the these cells are present in a gelatinous substance known as ....................................... The later contains ...................................................... called otolith. Each hair cell has many small cilia called .................................. and a single large cilium called .................................... which is located to one side. The base and sides of the hair cells are connected with the ................................. nerve.

118-       During acceleration, the otolith membrane is displaced to the .......................................... direction of movement by ......................................... causing bending of the cilia of the hair cells. This leads to sensation of ............................................ and also produces ............................................ to maintain equilibrium. During deceleration, the otolith membrane is displaced in the .................................... direction of movement by ..................................... causing bending of the cilia of hair cells. This leads to sensation of ............................................. and also produces ........................................................ to maintain equilibrium.

119-       There are 3 SCCs on each side, they lie in ................................... at right angles to each other; ............................................ , ......................................... and .............................................. The 2 horizontal canals lie at the same plane (co-planer), they are tilted backward by ................................... Each SCC has a dilatation called .................................. which contains a sensory organ called ..........................................

120-       The crista is composed of ....................................... and ........................................ The cilia of the hair cells are present in a gelatinous substance known as .................................. Each hair cell contains small cilia ................................. and a single large cilium ..................................... which is located to one side. The base and sides of the hair cells are connected with the ................................................. nerve.

121-       In horizontal canals; The kino-cilium is located ................................................ , so bending the copula of the crista towards the utricle (by movement of endo-lymph) leads to ...................................... of the hair cells, while bending the copula away from the utricle leads to ..................................... of the hair cells. This unequal discharge reaches the CC and gives information about .................................................. and produces ................................................ to maintain equilibrium.

122-      If we rotate a person from left to right, the endo-lymph seems to rotate ................................. by ............................. , this leads to bending of Rt. copula ..................................... (stimulation) and bending of the left copula ....................................... (inhibition). This condition remains for about ........................... and are responsible for: .............................  and ................................ to maintain equilibrium during rotation.

123-      During rotation; the endo-lymph rotates in ................................... and the copula returns to ........................................ due to its elasticity. At the end of rotation the endo-lymph rotate ..................................... by ....................................... This leads to bending of the Rt. copula ................................... (inhibition) and bending of the left copula ..................................... (stimulation). This condition remains for about ................................... and leads to: ..................................... and .................................... which may disturb equilibrium.

124-       Nystagmus means ................................... which may be ..................................... , .............................................. or .................................. Types of nystagmus; ....................................; which occurs at the start of rotation, it has two components: ............................................. , in the opposite side of rotation to keep the visual fields fixed and ............................................... , in the same side of rotation to bring back the eye ball after its deviation, and ..................................... which occurs at the end of rotation, it has two components: .................................. , in the same side of rotation and ...................................... , in the opposite side of rotation.

125-       Pathway of nystagmus, Slow  component; From ............................. to vestibular nerve ® ................................. ® vestibular nerve ® ................................... ® medial longitudinal bundle (MLB) of both sides ® ................................... Rapid  component; From ................................. in the frontal lobe ® through .................................... tract ® to cranial nuclei of 3, 4, 6 nerves of the .................................. side ® to the eye.

126-       Causes of nystagmus: ........................................ , .................................................. , ............................................... , and ..............................

127-       Vertigo means ............................... which occurs ................................................. So if a person is rotated from left to right, then rotation is stopped, he feels .........................................................................................

128-      Mechanism of vertigo:   CC is accustomed to receive the movement ........................................... which is correct at the beginning of rotation, but after rotation, the endo-lymph still rotates, this gives the CC ................................................

129-      Pathway of vertigo: From ................................. to vestibular nerve ® .................................. ® vestibular nerve ® .................................. ® inferior cerebellar peduncle ® .......................... of cerebellum ® ................................... nucleus ® superior cerebellar peduncle ® ................................... ® CC (superior temporal gyrus near auditory area).

130-      Causes of vertigo: .................................... , ..................................... , ........................................... , and .................................................

131-       In Post pointing test of Barany, after rotation if we ask a person to place his finger on a certain spot when his eyes are closed, his finger deviates towards ..................... due to ................................ and also due to .............................................

132-       After rotation the patient suffers from the following autonomic changes .................................... , ............................... , .......................... , ............................... , and ................................................ all are parasympathetic except ..........................

133-       Deep pressure applied on the sole of the food (e.g. during standing) leads to reflex .................................... of the same limb, this reflex is known as .................................. This reflex arises from the ......................................... and its center lies in ...................................... of the spinal cord. This reflex does not show the property of ...................................................

134-      If a painful stimulus is applied to one lower limb, this leads to ............................................. in the same limb and ............................................ of the other limb to be able to support the body weight, this reflex is known as ....................................................................

135-       Segmental static reflexes include ..................................................... , .............................................. , ..................................... , and .........................................

136-       In Stato-tonic neck reflexes, Dorsi-flexion of the head leads to ............................................. of the fore limbs and ................................... of the hind limbs. Ventro-flexion of the head leads to ............................. of the fore limbs and ....................................... of the hind limbs. Lateral bend or rotation to one side leads to ............................. of fore and hind limbs on that side and ............................... of fore and hind limbs on opposite side.

137-       In standing position, the body weight is supported by  ........................................... , .................................................. , and ..................................................................

138-       Any change in the body position is detected by; ............................................ , .................................... , ........................................... , and ............................... This change in position leads to ............................................ so as to correct the body position and maintain equilibrium.

139-       Walking is controlled by the following centers; .................................................. , ..................................................... , and ....................................................

 

 

Choose the best answer:

1-          Fine touch:

a- is poorly localized.

b- is divided into light and deep touch.

c- not includes the fine details about the nature of the touch stimuli.

d- is sharply localized and gives information about the nature of the touch stimuli.

2-          2- Tactile localization:

a- is the ability of the person to recognize the object without using his vision.

b- is the ability of the person to perceive two stimuli applied to the skin at the same time as two separate points.

c- is the ability of the person to localize accurately the point of touch without using his vision.

d- is the ability of the person to know the type of clothes by touching them while the eyes are closed.

3-           3- Tactile discrimination:

a- is more accurate over finger tips, lips, nipple, lobule of ear, and tip of nose.

b- is more accurate over the trunk, shoulders, and thighs.

c- is less accurate when the eyes are closed.

d- is a special type of fine touch associated with mild surface stimuli such as a flee crawling on the skin.

4-          4- The following are touch receptors except:

a- Pacinian corpuscles.

b- Muscle spindle.

c- Hair follicle receptors.

d- Meissner's corpuscles.

5- The pathway of:

a- crude touch is the spino-cerebellar tract.

b- fine touch is the ventral spino-thalamic tract.

c- temperature sensation is the Gracil and Cuneate tracts.

d- fast pain is the lateral spino-thalamic tract.

5-           Gracil and Cuneate tracts carry the following sensations except:

a-  fine touch sensation.

b-  slow pain sensation.

c-  sense of position.

d-  sense of movement.

6-           Vibration sense:

a-  is detected by Ruffini's and free nerve ending.

b-  is detected by Pacinian and Meissner's corpuscles.

c-  helps the person to differentiate between weights without lifting them.

d-  plays a role in the sense of position.

7-           Kinesthetic and proprioceptive sensations include the following except:

a-  sense of position.

b-  sense of movement.

c-  sense of deep pressure.

d-  crude touch.

8-           About thermal sensation:

a-  the warm receptors are stimulated between 25OC - 45OC.

b-  the cold receptors are less than the warm receptors.

c-  only the cold receptors are stimulated between 0OC – 10OC.

d-  the warm receptors adapt more slowly than the cold receptors.

9-          As regards cutaneous pain:

a-  it is associated with referred pain .

b-  touch produces pain in area of primary hyper-algesia.

c-  is caused by ischemia of the skeletal muscles.

d- secondary hyper-algesia is localized to the injured area and the area which surrounds the site of injury.

Choose the best answer:

10-     Synaptic transmission:

(a) occurs in both directions.

(b) does not show fatigue.

(c) is  delayed for about 5.0 m. sec.

(d) is markedly affected by O2 lack.

11-     Synaptic transmission is stimulated by:

(a) Acidosis.

(b) Caffeine.

(c) O2 lack.

(d) Anesthetics.

12-     Excitatory postsynaptic potential (EPSP) is:

(a) is an all or none response.

(b) always initiates an action potential.

(d) is associated with decreased excitability.

(e) can be summated.

13-     Inhibitory postsynaptic potential (IPSP) is:

(a) produced by release of acetylcholine.

(b) produced by release of GABA or amino acid glycine.

(c) a state of depolarization.

(d) due to increased Na+ permeability in the postsynaptic membrane.

14-     After discharge is mainly due to:

(a) closed and parallel interneuron circuits.

(c) converging and diverging circuits.

(d) occlusion.

(e) resistance.

15-     Reciprocal innervation:

(a) is mediated through monosynaptic pathways.

(b) occurs during the positive supporting reflex.

(c) helps contraction of flexor and extensor of the same limb at the same time.

(d) is the property by means of which contraction  of a certain muscle is accompanied by relaxation of the antagonistic muscles..

16-     The stretch reflex:

(a) is transmitted by thin afferent nerve fibers.

(b) is a poly-synaptic reflex.

(c) is highly localized.

(d) is stimulated by Golgi tendon organ.

17-     Overstretch of skeletal muscle leads to its relaxes due to:

(a) decreased discharge from the primary and secondary endings.

(b) decreased discharge from the gamma motor neurons.

(c) increased discharge from the antagonistic muscles.

(d) increased activity of the Golgi tendon organs.

18-     In the lengthening reaction ( clasp-knife ):

(a) the contracting muscle suddenly relaxes due to over-distention of the muscle.

(b) stimulation of the Pacinian corpuscles is maximal.

(c) muscle contraction is inhibited by over-activity of muscle spindles.

(d) Golgi tendon organs stimulates alpha motor neurons.

19-     Knee jerk is exaggerated in:

(a) diseases associated with hypertonia.

(b) sleep and anesthesia.

(c) poliomyelitis.

(d) hypothyroidism.

20-     The primary ( annulo-spiral) endings in the muscle spindles are:

(a) present only at the central parts of the nuclear chain fibers.

(b) thin myelinated fibers.

(c) concerned with production of the muscle tone.

(d) concerned with the dynamic type of the stretch reflex.

21-     The property of rebound is:

(a) a condition in which a reflex can facilitate a subsequent reflex.

(b) a gradual decline of the response caused by repeated stimulation.

(c) the exaggeration of a reflex after its temporary suppression.

(e) the temporal inhibition of a week reflex by a stronger reflex.

22-     About the knee jerk all the following are true except:

(a) It is lost in LMNL.

(b) It is exaggerated in Tetany.

(c) It is decreased in neocerebellar lesions.

(d) It is exaggerated in anxiety and nervousness.

23-     Lesion in L 2,3,4 leads to:

(a) loss of ankle jerk.

(b) loss of biceps jerk.

(c) loss triceps jerk.

(d) loss of knee jerk.

24-     Ankle jerk is lost in lesion of:

(a) L 2,3,4.

(b) S 1,2.

(c) C 5,6.

(d) C 6,7.

25-     The following are supra-spinal facilitatory centers except:

(a) Motor area 4.

(b) Neo cerebellum.

(c) Vestibular nucleus.

(d) Anterior cerebellum.

26-     The following are supra-spinal inhibitory centers except:

(a) Basal ganglia.

(b) Area 4 s, 2 s, 8 s, 19 s, 24 s.

(c) Bulbo-reticular facilitatory area.

(d) Anterior cerebellum.

27-     About the muscle spindles:

(a) they contain intra-fusal muscle fibers, the central parts of which are contractile.

(b) the primary endings arise from the nuclear chain fibers only.

(c) the secondary endings are responsible for the dynamic stretch reflex.

(d) the gamma motor neurons supply the peripheral contractile parts.

28-     The gamma efferent motor neurons:

(a) are four types.

(b) stimulate the extra-fusal muscle fibers.

(c) receive inhibitory impulses from area 4 and the neo-cerebellum.

(f) are activated by basal ganglia.

29-     The annulo-spiral endings of the muscle spindles are stimulated when:

(a) The muscle is stretched.

(b) The muscle is contracted.

(c) The gamma efferent fibers are inhibited.

(d) The intra-fusal muscle fibers are relaxed.

 

 

30-       Primary motor area (area 4):

  a- occupies the post-central gyrus of the frontal lobe.

  b- inhibits spinal reflexes and spinal centers.

  c- inhibits stretch reflex and muscle tone of the opposite side of the body.

  d- supplies mainly the muscles in opposite side of the body through pyramidal tract.

31-     Effects of lesion in area 4:

  a- Paralysis of the muscles of the same side of the body.

b- ¯ Muscles tone is the paralyzed muscle (flaccid paralysis), in the opposite side of the body.

  c- loss of all sensation from the opposite side of the body.

  d- loss of visceral reflexes.

32-       Pre-motor area (area 6):

  a- lies behind the area 4.

  b- facilitates stretch reflex and MT of the opposite side of the body.

c- affects the muscles indirectly through its connection with basal ganglia, reticular formation, red nucleus and vestibular nucleus.

  d- facilitates spinal reflexes and spinal centers.

33-       Pyramidal tract:

 a- facilitates stretch reflex and MT in the same side of the body.

 b- arises from motor area 4, pre-motor area 6, and supplemental area and also from  sensory area 3,1,2 and area 5,7.

 c- inhibits spinal reflexes and spinal centers.

 d- occupies the genu and posterior 2/3 of the anterior limb.

34-       In Upper Motor Neuron lesion (UMNL):

a- paralysis occur in the same side.

b- paralysis is associated with hypotonia.

c- paralysis is localized.

d- slight wasting of the muscles occur.

35-     Cerebellum:

  a- lies in the posterior cranial fossa, above tentorium cerebelli.

  b- consists of 2 hemispheres and a vermis.

  c- lies behind the midbrain and pons.

  d- is less folded than the cerebral cortex.

36-     Archi-cerebellum:

  a- is the oldest part of cerebellum and occupies the Flocculo-nodular lobe.

  b- is connected with the spinal cord.

  c- controls voluntary movements.

  d- is largest part of the cerebellum.

37-     Paleo-cerebellum:

  a- is the newest and largest part of the cerebellum.

  b- is formed of the anterior lobe, vermal zone and paravermal zone.

  c- is connected with the cerebral cortex.

  d- is excitatory to muscle tone.

38-     Neocerebellar syndrome is manifested by the following except:

  a- Hypotonia.

  b- Paralysis of the muscles in the same side of the lesion.

  c- Ataxia.

  d- Athenia.

39-     Cerebellar ataxia is manifested by the following except:

  a- Dysmetria.

  b- Decomposition of movements.

  c- Mask face.

  d- Kinetic tremors.

40-     Dysmetria means that the patient is unable to:

  a- do delicate movements.

  b- judge the distance and force of movement.

  c- perform complex movement in one step.

  d- do two acts at the same time, one is primary and the other is synergic.

41-     Basal ganglia:

  a- are the main part of the pyramidal system.

  b- are excitatory to MT.

c- inhibit the over activity of the cortical motor areas through the feedback inhibitory circuit.

  d- are the higher motor center of voluntary movement in man.

42-     Non specific thalamic nuclei are the following except:

  a- Midline nuclei.

  b- Reticular nuclei.

c- Postero- ventral nucleus.

  d- Intra-laminar nuclei.

43-     Thalamus:

a- is the higher center for fine sensations form the opposite side of the body.

b- is a relay station for crude sensations from the opposite side of the body in their way to the sensory cortex.

c- is a relay station for olfactory sensation in their way to olfactory cortex.

  d- is a relay station for auditory sensation in their way to the auditory cortex.

44-     Factors increasing activity of the RAS:

a- Impulses from the sleep inducing center.

b- Catecholamine which explains the alert state which occurs in stress.

c- Anesthetic drugs.

  d- Serotonin.

45-     On exposure to hot the heat loss center is stimulated and causes:

a- decrease heat loss by VC of skin B.V.

b- increase MT and voluntary movements.

c- increase food intake.

  d- increase sweat secretion.

46-     Hypothalamus ↑ blood glucose in case of hypoglycemia by these mechanisms:

a- stimulation of the feeding center which stimulates hunger sensation.

b- inhibition of vagus nucleus which decrease gastric motility and decrease hunger sensation.

c- decrease secretion of adrenaline, glucocorticoids, thyroxin and GH.

  d- increase voluntary movements.

 

True or false questions:

1-     Sensory receptors have the following functions:

a-  Gives informations about the external and internal environment.

b-  The start points of all body reflexes.

c-  The informations received by them help in learning and memory.

d-  Respond to adrenaline, acetyl choline, hormones, and histamine.

2-     The following are examples of chemo-receptors:

a-  Baroreceptors present in the carotid sinus and Aortic arch.

b-  Carotid and Aortic bodies.

c-  Taste and smell receptors.

d-  Osmo-receptors and gluco-receptors in the hypothalamus.

3-     True visceral pain results from:

a- over distension of  a hollow viscous.

b- ischemia of the viscera.

c- friction between the two layers of pleura.

d- spasm of the smooth muscles present in the wall of the viscera.

4-     The pain arising from the visceral is referred to:

a-  the right shoulder in gall bladder inflammation.

b-  the left arm and left shoulder in angina pectoris.

c-  the umbilicus in appendicitis.

d-  the scrotum and testis in ureteric colic.

5-     The visceral pain is carried by:

a-  sympathetic nerves which carry pain from the viscera itself.

b-  vagus nerve which carry pain from esophagus, larynx and trachea.

c-  phrenic nerve which carry pain from diaphragm and biliary tract.

d-  thoracic and lumber spinal nerves which carry pain from parietal layer of pleura and peritoneum.

6-     Referred pain is explained by:

a-  Dorsal root branching theory.

b-  convergence projection theory.

c-  convergence facilitation theory.

d-  law of projection.

7-     Intra cranial pain sensitive structures are:

a-  cerebral and dural arteries.

b-  brain parenchyma.

c-  venous sinuses.

d-  dura matter in the floor of anterior and posterior cranial fossa.

8-     Extra cranial headache is caused by:

a-  dilatation of the intra cranial arteries.

b-  brain tumors and brain abscess.

c-  changes in the C.S.F pressure.

d-  constipation.

9-     Intra cranial headache is caused by:

a-  glaucoma due to increase intra ocular pressure.

b-  hypertension.

c-  Meningeal irritation as in case of meningitis.

d-  dilatation of intracranial vessels as in migraine headache.

10- Headache:

a- is felt in the frontal area in case of irritation of pain sensitive structures below tentorium cerebelli.

b- is felt in the occipital area in case of irritation of pain sensitive structures above tentorium cerebelli.

c-   is felt around the eye ball and in the nasal region due to extra cranial causes.

d-   may be due to chronic thoracic or abdominal diseases.

11- The primary ( annulo-spiral) endings in the muscle spindles are:

(a) present only at the central parts of the nuclear chain fibers.

(b) thick myelinated fibers.

(c) concerned with production of the muscle tone.

(d) concerned with the dynamic type of the stretch reflex.

12- The property of rebound is:

(a) a condition in which a reflex can facilitate a subsequent reflex.

(b) a gradual decline of the response caused by repeated stimulation.

(c) the exaggeration of a reflex after its temporary suppression.

(e) the temporal inhibition of a week reflex by a stronger reflex.

13- Knee jerk:

(a) is lost in LMNL.

(b) is exaggerated in Tetany.

(c) is decreased in neocerebellar lesions.

(d) is exaggerated in anxiety and nervousness.

14- Lesion in L 2,3,4 leads to:

(a) loss of ankle jerk.

(b) loss of biceps jerk.

(c) loss triceps jerk.

(d) loss of knee jerk.

15- Ankle jerk is lost in lesion of:

(a) L 2,3,4.

(b) S 1,2.

(c) C 5,6.

(d) C 6,7.

16- The following are supra-spinal facilitatory centers:

(a) Motor area 4.

(b) Basal ganglia.

(c) Vestibular nucleus.

(d) Anterior cerebellum.

17- The following are supra-spinal inhibitory centers:

(a) Basal ganglia.

(b) Area 4 s, 2 s, 8 s, 19 s, 24 s.

(c) Bulbo-reticular facilitatory area.

(d) Neo cerebellum.

18- About the muscle spindles:

(a) they contain intra-fusal muscle fibers, the peripheral parts of which are contractile.

(b) the primary endings arise from the nuclear chain fibers only.

(c) the secondary endings are responsible for the dynamic stretch reflex.

(d) the gamma motor neurons supply the peripheral contractile parts.

19- The gamma efferent motor neurons:

(a) are four types.

(b) stimulate the extra-fusal muscle fibers.

(c) receive inhibitory impulses from area 4 and the neo-cerebellum.

(f) are activated by basal ganglia.

20- The annulo-spiral endings of the muscle spindles are stimulated when:

(a) The muscle is stretched.

(b) The muscle is contracted.

(c) The dynamic gamma efferent fibers are stimulated.

(d) The intra-fusal muscle fibers are relaxed.

 

21- Pre-motor area contains the following special areas:

  a-  Broca's area of speech (area 44 & 45).

  b-  Frontal eye movement area.

  c-  Head rotation area.

  d-  Supplemental motor area.

22-Supplemental motor area:

a- lies immediately anterior and superior to pre-motor area (mainly on the edge and medial side of the cerebral hemisphere).

b- body representation in this area lies horizontal with the head posterior and the leg anterior.

c- is connected with the primary motor area and pre-motor area as well as basal ganglia and cerebellum.

d- helps in control of the complex movements which involves large group of muscles and also involves both sides of the body.

23- The following are Extra-pyramidal tracts:

  a-  Rubro-spinal tract                                                                                               

  b-  Reticulo-spinal tracts

  c-  Cortico-spinal tract.

  d-  Reticulo-spinal tracts

24-Tecto-spinal tracts:

  a-  the lateral tract is responsible for visual attack and defensive reactions.

  b-  the ventral tract is responsible for auditory attack and defensive reactions.

c- Lateral Tecto-spinal tract originates from superior colliculus in the tectum of the midbrain.

d- Ventral tecto-spinal tract originates from inferior colliculus in the tectum of the midbrain.

25-Functions of extra-pyramidal tracts:

  a- Regulation of equilibrium and maintain posture.

  b- Fixation movements.

  c- Initiation of voluntary movement.

  d- Associated movements.

26-In Lower Motor Neuron lesion (LMNL):

  a- wasting is marked in the affected muscles.

  b- response to electrical stimulation is normal.

  c- paralysis occurs in the opposite side.

  d- paralysis is associated with hypertonia.

27-In Upper Motor Neuron lesion (UMNL):

a- abdominal and cremastric reflexes are lost in the opposite side of the lesion.

b- planter reflex is changed to Babinski's sign.

c- paralysis is localized.

d- recovery can occur.

28-Upper Motor Neuron lesion (UMNL):

a-  results from lesion of AHC or motor nerve.

b- results from damage of descending motor tracts (pyramidal tract alone or together with extra-pyramidal tract).

c- usually wide spread because pyramidal tract fibers condense together.

d- usually in the opposite side because pyramidal tract fibers cross in its pathway from CC to AHC.

29-Reaction of degeneration:

  a- means abnormal response to electrical stimulation which occur in LMNL.

b- occurs between injury of the motor nerve and complete atrophy of the muscle, after that there is no response to either faradic or Galvanic currents .

  c- means response to Faradic currant and no response to Galvanic currant.

  d- occurs in UMNL.

30-Complete transaction of the spinal cord:

a- results from fracture spines, gun shots & stab wound.

b- results in temporal loss of voluntary motor activity.

  c- results in permanent loss of all reflexes below the level of the lesion.

d- causes death if the lesion is in the cervical segment above origin of phrenic nerves.

31-Spinal shock is followed by the stage of reflex activity which is characterized by:

  a- recovery of reflexes.

  b- gradually rise of ABP to normal.

  c- increase body temperature to normal.

  d- increase bed sores.

32-At the level of the lesion in hemi-section of the spinal cord there is:

  a- loss of all sensations (cutaneous, deep and visceral).

  b- UMNL.

  c- cutaneous hyperesthesia.

  d- loss of all reflexes (superficial, deep and visceral).

33-Below the level, and at the same side of hemi-section of spinal cord there is:

  a- LMNL.

  b- UMNL.

  c- loss of fine touch, proprioceptive sensations, and vibration sense.

  d- loss of pain and temperature sensations.

34-In posterior quadrant lesion of the spinal cord there is:

  a- loss of fine touch, proprioceptive sensations, and vibration sense.

  b- increase MT due to lesion of inhibitory extra-pyramidal tracts.

  c- LMNL.

  d- UMNL due to lesion of pyramidal tract.

35-Sryngo-myelia:

  a- causes hemi-section of spinal cord.

b- means dilatation of the central canal of the spinal cord due to gradual erosion of the grey matter around it.

  c- produces loss of pain and temperature at the same level on both sides.

  d- produces loss of pain and temperature below the same level on both sides.

36-Lesion of the dorsal column of the spinal cord produces:

  a- loss of all sensations (cutaneous, deep and visceral).

  b- loss of fine touch sensations.

  c- UMNL.

  d- loss of pain and temperature sensations.

37-Unilateral lesion of the posterior limb of the internal capsule produces:

a- loss of all sensations from the same side of the body.

  b- loss of vision in the opposite halves of visual fields of both eyes.

c- paralysis of the muscles present in the same side of the body.

  d- decrease hearing.

38-Neo-cerebellum:

a- is the newest and largest part of the cerebellum.

b- is formed of the lateral parts of the posterior lobe which are enlarged bilaterally to form the cerebellar hemispheres.

c- is connected with the motor areas of the cerebral cortex mainly area 4.

  d- is inhibitory to MT.

39-Neo-cerebellum regulates voluntary movement by comparing the motor information from CC, with the sensory information from the muscles through the following mechanism:

a- Servo-comparator (braking) functions.

b- Damping function.

c- Predictive function.

  d- Voluntary control.

40-Basal ganglia are:

  a- Caudate nucleus.

  b- Lentiform nucleus.

  c- Thalamus.

  d- Hypothalamus.

41-Chorea:

 a- results from lesion of new-cerebellum.

 b- results from lesion of Caudate nucleus which occurs as a complication of rheumatic fever in children.

 c- is manifested by involuntary dancing movements which occur during rest, increase with emotions and disappears during sleep.

 d- is associated with hypotonia and pendular knee jerk.

42-Parkinsonism:

a- Results from damage of substantia nigra.

b- results from lesion of paleo-cerebellum.

c- is manifested by static tremors.

d- is associated with muscle rigidity.

43-Thalamic syndrome:

a- results from thrombosis of the thalamo-geniculate artery.

b- caused by damage of the PVN and LVN of the thalamus.

c- is manifested by loss of fine sensation including fine touch, fine temp & fine pain.

d- is associated with Chorea and athetosis; due to interruption of the inhibitory circuit.

44-Reticular activating system (RAS):

a- is essential for initiation and maintenance of consciousness.

b- is a complex polysynaptic system which extends from the brain stem to the thalamus.

c- receives impulses from ascending sensory tracts.

d- sends impulses to non specific thalamic nuclei from which impulses are projected diffusely to all parts of the CC.

45-On exposure to cold the heat gain center is stimulated and causes:

a- increase heat loss by V.D of skin B.V.

b- increase MT and shivering.

c- increase adrenaline, thyroxin and glucocorticoids which increase metabolic rate and blood glucose.

d- decrease food intake.

46-Hypothalamus regulates body water by:

a- increasing water gain in case of dehydration.

b- increasing urine volume in case of hydration.

c- stimulation of thirst center in case of hydration.

d- decrease food intake.

47-Manifestations of hypothalamic lesions:

a- Diabetes mellitus.

b- Narcolepsy.

c- Frolich's syndrome.

d- Hypothalamic anorexia (anorexia nervosa).

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