QUESTION BANK – NERVE & MUSCLE PHYSIOLOGY
Essay Questions:
1. Explain the excitation-contraction coupling mechanism in skeletal muscle. Write brief
note on Rigor mortis. (7+3)
2. Explain with illustration events occurring in the transmission of impulse across
the neuromuscular junction. Add a note on Myasthenia gravis. (7+3)
Basic concept & Applied type questions:
1. Describe the sarco-tubular system in skeletal muscle and its role in muscle contraction
(3+2)
2. Classify nerve fibers based on Erlanger & Gasser’s parameters. Mention the fiber type
most susceptible to injury by pressure. (4+1)
3. Explain Wallerian degeneration and regeneration of nerve fibers. (2.5+2.5).
4. Explain the rachet theory of muscle contraction. (5)
5. Explain the mechanism of impulse transmission across neuro-muscular junction. (5).
6. List and explain the characteristics of skeletal muscle contraction. (5)
7. Describe the energy source and metabolism in skeletal muscle during exercise. (2.5+2.5).
8. Define Myasthenia gravis. Explain its clinical features and tests for its diagnosis. (1+4)
9. Explain excitation-contraction coupling in skeletal muscles.
10. Classify and mention the differences between types of skeletal muscle fibers. (1+4)
11. Mention the effect each of the following has at the neuromuscular junction: (1x5)
(a) Myasthenia gravis
(b) Neostigmine
(c) Botulimum toxin
(d) Curare
(e) Lambert Eaton syndrome
12. List the differences between isotonic and isometric contractions.
Reasoning type questions:
1. Draw a strength-duration curve and mention its significance. (2+1)
2. Compare and contrast red and white muscle fibers. (3)
3. Compare and contrast skeletal and smooth muscle contractions. (3)
4. Define saltatory conduction and mention its significance. (1+2)
5. Name the types of muscle contraction and give an example for each.
6. Name any two neuro-muscular blocking agents with their mechanism of action.
(1.5+1.5)
7. Define rigor mortis. Mention its physiological basis. (1+2)
8. State and explain Frank-Starling’s law of muscle contraction.
9. Define a motor unit. Mention the types of motor units. (1+2)
10. Mention three sources of energy for muscle contraction. (1x3)
11. Define saltatory conduction in nerves and mention its advantages. (1+2)
12. Mention three sources of energy for muscle contraction. (1x3)
13. List the differences between skeletal and smooth muscles.
14. Explain the length tension relation in skeletal muscles.
15. What is refractory period in an excitable tissue & its ionic basis? (1+2)
16. How does administration of neostigmine improve the symptoms of myasthenia
gravis?
17. Give reason for stiffening of muscles after death of an individual.
18. Illustrate the nerve action potential graph and mention its ionic basis.
Case scenario-based questions:
Case based question – 1
1. Hanumanthappa, 62 year old presents with a 6 month history of generalized fatigue
and weakness. He initially noted difficulty in ascending stairs & raising his arms
above his head. Examination reveals a cachectic man with poorly reactive, dilated
pupils and mild bifacial weakness. Prominent weakness in the pelvic and shoulder
girdles with mild distal leg weakness is noted. Reflexes are initially absent although
these are obtainable after a brief period of exercise.
a. What is the probable cause for the above clinical features?
b. What is the physiological basis & its treatment?
c. Name any two diseases with the same physiological basis.
Case based question – 2
2. Deepak accidentally injured his right forearm with a sharp object. On examination he was
found to have damaged his ulnar nerve. (1+3+1)
a) What are the types of nerve injuries?
b) What are the steps involved in its healing process?
c) What is the use of strength-duration curve in this case?
Case based question – 3
2. Srinivas finding no response to his call to awaken his mother, attempted to move her
limbs which he found were stiff and could not make any passive movements. He calls
his family doctor, who on examining confirms her death which has occurred a few
hours ago. (1+1+1)
a) Mention the reason for stiffness of the limbs in this case
b) What is the physiological basis for the above?
c) Mention the source of calcium for skeletal muscle contraction?
Case based question – 4
4. Chitra aged 25 years presents with recurrent slurring of speech that worsens when she
continues to talk and has trouble during swallowing which deteriorates when she continues
to eat and has double vision that gets worse when reading or watching TV. She has
intermittent weakness in her legs and arms. She reports a feeling of generalized fatigue and
is occasionally short of breath.
a. What is the probable diagnosis? (1)
b. What is the physiological basis for the above symptoms? (2)
c. Mention any two clinical conditions with a similar etiology. (2)
Multiple choice questions:
