CNS Motor System

Test
MCQs
25.10.2022
1. A 16-year-old boy is brought to the emergency room by ambulance
after suffering a concussion during a football game. When he awoke
there was no difficulty with his speech and he was able to understand
and follow Commands, but he had difficulty understanding written
language and pictures. His condition is most likely caused by damage to
which of the following?
a. Angular gyrus in the categorical hemisphere
b. Arcuate fasciculus connecting Broca and Wernicke’s areas
c. Broca’s area in the frontal lobe
d. Hippocampus
e. Wernicke’s area at the posterior end of the superior temporal gyrus

a. Angular gyrus in the categorical hemisphere

2. 13-year-old boy has no movement in his legs after falling out of atree.
Neurological examination shows absence of both the myotatic (stretch)
and reverse myotatic reflexes in the lower extremities. Which of the
following is the most important role of the g motor neurons?

a. Detect the length of resting skeletal muscle

b. Generate activity in lb afferent fibers
c. Maintain la afferent activity during contraction of muscle
d. Prevent muscles from producing too much force
e. Stimulate skeletal muscle fibers to contract

c. Maintain la afferent activity during contraction of muscle

3. A 72 – year old man visit his physician because he finds it difficult to
hold his hand steady when painting. Examination reveals a resting tremor
and rigidity. The symptoms are relieved by a single dose of levodopa. This
patient’s neurological signs are most likely related to a lesion within
which of the following?
a. Caudate nucleus and putamen
b. Cerebellum
c. Hippocampus
d. Premotor area
e. Substantia nigra

e. Substantia nigra
4. A 72 – year old man develops selective loss of the large pyramidal cells in
the precentral gyrus and degeneration of the corticospinal and
corticobulbar projections. Other neuronal systems are spared. He is told
that the progression of the disease is variable, and that the worst prognosis
is about a 3- year survival. The precentral gyrus and corticospinal and
corticobullar tracts are essential for which of the following?
a. Auditory identification
b. Kinesthesia
c. Olfaction
d. Vision
e. Voluntary movement

e. Voluntary movement
5. A 78 – year old man is evaluated by a physiatrist after a stroke. The
patient is observed to suffer from dysmetria, ataxia, and intention tremor.
These neurological signs are most likely related to a lesion within which of
the following regions of the brain?
a. Basal ganglia
b. Cerebellum
c. Cortical motor strip
d. Eighth cranial nerve
e. Medulla

b. Cerebellum
6. A 43 – year old woman has a chief complaint muscle weakness. The
distribution of muscle weakness and the presence of hyperactive tendon reflexes
is consistent with pyramidal tract disease. Tapping the patella tendon elicits a
reflex contraction of the quadriceps muscle. Which of the following occurs
during the contraction of the quadriceps muscle?
a. The α-motor neurons innervating the extrafusal muscle fibers decrease their rate of
firing
b. The α-motor neurons to the antagonistic muscles increase their rate firing
c. The ϒ-motor neurons innervating the intrafusal muscle fibers increase their rate
firing
d. The la afferents from the muscle spindle increase their rate of firing
e. The lb afferents from the Golgi tendon organ increase their rate firing

e. The lb afferents from the Golgi tendon organ increase their rate firing
7. A 16 – year old adolescent girl with epilepsy has an EEG recording
done during a routine visit to her neurologist. The α-rhythm appearing on
an EEG has which of the following characteristics?
a. It disappears when a patient’s eyes open
b. It is associated with deep sleep
c. It is replaced by slower, larger waves during REM sleep
d. It produces 20 to 30 waves per second
e. It represents activity that is most pronounced in the frontal region of the
brain

a. It disappears when a patient’s eyes open

8. On a physical examination, stroking the plantar surface of her foot
produces a reflex extension of the large toe rather than the expected
flexion, which indicates damage to which of the following?
a. Basal ganglia
b. Brain stem
c. Cerebellum
d. Lower motoneurons
e. Upper motoneurons

e. Upper motoneurons
9. A 41-year-old man complaints to his physician about jet lag whenever
he flies long distances to meetings. Melatonin is prescribed as a way to
reset his circadian rhythm. The circadian rhythm is controlled by which
of the following nuclei?
a. Arcuate
b. Lateral
c. Paraventricular
d. Suprachiasmatic
e. Ventromedial

d. Suprachiasmatic
10. A 17 – year old boy is admitted to the hospital with a traumatic brain
injury, sustained when he fell from his motorcycle. He develops a fever of
102.2oF (39oC), which is unrelated to an infection or inflammation. The
fever is most likely due to a lesion of which of the following?
a. Anterior hypothalamus
b. Arcuate nucleus
c. Lateral hypothalamus
d. Paraventricular nucleus
e. Posterior nucleus

a. Anterior hypothalamus
11. A 62 – year old man with a history of hypertension and
hyperlipidemia is admitted to the hospital for evaluation after
demonstrating signs and symptoms of a stroke. Subsequent CT scans,
perceptual tests, and a neurological examination provide evidence for
impairment of the otolith pathways. The otolith organs (utricle and
saccule) are responsible for which of the following?
a. Detecting angular accelerating
b. Detecting the position of the head in space
c. Producing rotary nystagmus
d. Producing the stretch reflex
e. Producing the vestibular-ocular reflex

b. Detecting the position of the head in space

12. A 27-year old man with severe epilepsy, characterized by major convulsions and
lapses of consciousness every few minutes, underwent experimental neurosurgery to
help relive his seizures. The operation had a significant, beneficial effect on the
epilepsy, but led to a devastating memory deficit. He had normal procedural
memory, maintained long-term memory for events that occurred prior to surgery,
and his short-term memory was intact, but he could not commit new events to long-
term memory (loss of declarative memory). Which of the following areas of the brain
was bilaterally resected in this patient?
a. Cerebral cortex
b. Cingulate gyrus
c. Hypothalamus
d. Parietal lobe
e. Temporal lobe

e. Temporal lobe
13. A 59 –year old woman with bilateral glaucoma is treated with drops of
the parasympathetic agent pilocarpine. Cholinergic stimulation of the
pupil causes which of the following?
a. Absence of the pupillary response to light
b. Inequality of pupil size
c. Pupillary constriction (miosis)
d. Pupillary dilation (mydriasis)
e. Tonic pupil (slow redilation after exposure to light)

c. Pupillary constriction (miosis)

14. An 80-year-old farmer presented with complaints of weakness and fatigue,
aching, orthostatic hypotension, constipation, and sleep disturbances. His family
physician told him that he was just getting old, and would have to get used to it.
His bradykinesia worsened and he couldn’t pick up his feet when he walked.
When he was no longer able to plow his own fields, he got depressed, and his wife
said he would just sit at the table and rub his thumb along his fingers. She called
her son-in-law, a neurologist, and asked him if he’d come out to the country to
evaluate him. The pathophysiology of Parkinson disease can be attributed to a
paucity of which of the following neurotransmitters?
a. Acetylcholine
b. Dopamine
c. Glutamate
d. Neuropeptide Y
e. Serotonin
b. Dopamine
15. A 16-year-old, highly allergic girl who is stung by a bee gives herself a
shot of epinephrine prescribed by her physician. Because epinephrine
activates β-adrenergic receptors, it will relieve the effects of the bee sting
by decreasing which of the following?
a. Contraction of airway smooth muscles
b. Rate of depolarization in the SA node
c. Rate of glycogenolysis in the liver
d. Strength of ventricular muscle contraction
e. Transport of calcium into skeletal muscle fibers

a. Contraction of airway smooth muscles

16. An 85-year-old man is brought to his doctor by his daughter. She
reports that he has memory loss, is often confused, and has been having
increasing difficulty with routine activities that he used to do on his own,
such as paying bills and going grocery shopping. She wonders if this is
just because of old age or a more serious problem. Which of the following
would provide the definitive diagnosis of Alzheimer’s disease?
a. Cerebral cortical atrophy on CT brain or MRI
b. Improved symptoms with cholinesterase inhibitors
c. Neurotic plaques containing A-beta (Aβ) amyloid bodies
d. Nonspecific slowing of EEG
e. Presence of an apolipoprotein ԑ4 allele on chromosome 19
c. Neurotic plaques containing A-beta (Aβ) amyloid bodies
17. Which of the following statements concerning the general functional
role of the cerebellum is correct?
a. The cerebellum directly stimulates motor neurons required to make a
movement
b. The cerebellum is unable to make corrective adjustments to the movement
once it is performed
c. The cerebellum does not receive feedback from muscles that execute the
actual movement
d. The cerebellum is not involved in the planning of a movement, only its
execution
e. The cerebellum plays an active role in the coordination of the muscles
required to make a movement
e. The cerebellum plays an active role in the coordination of the
muscles required to make a movement
18. Which of the following body parts is represented most laterally and
inferiorly within the primary motor cortex?
a. Face
b. Hand
c. Neck
d. Abdomen
e. Lower limb

a. Face
19. Which of the following items is the type of neuron whose axon forms
synaptic junctions with skeletal muscle cells (intrafusal fibers) within the
muscle spindles?
a. Alpha motor neurons
b. Pyramidal neurons
c. Gamma motor neurons
d. Granule cells
e. Purkinje cells

c. Gamma motor neurons

20. Which brain structure serves as the major controller of the limbic
system?
a. Hypothalamus
b. Hippocampus
c. Amygdala
d. Mammillary body
e. Fornix

a. Hypothalamus
21. The two hemispheres of the brain are connected by which nerve fibers
or pathways?
a. Lateral lemniscus
b. Corticofugal fibers
c. Corpus callosum
d. Arcuate fasciculus
e. Medial longitudinal fasciculus

c. Corpus callosum
22. A 41-year-old woman visits the physician because of difficulties in
performing simple tasks that involve repetitive movements. The physician
asks the patient to turn one hand upward and downward at a rapid pace.
The woman quickly loses all perception of the instantaneous position of
the hand, which results in a series of stalled attempts and jumbled
movements. Which term best describes this patient’s movements?
a. Agraphesthesia
b. Astereognosis
c. Dysarthria
d. Dysdiadochokinesia
e. Hemineglect

d. Dysdiadochokinesia
23. A 32-year-old basketball player mentally rehearses free throw shots
while lying in bed. Which option best describes the area of the brain that
is involved in generating a motor image of this action in the absence of
actual movement?
a. Basal ganglia
b. Cerebellum
c. Limbic system
d. Premotor cortex
e. Primary motor cortex

d. Premotor cortex
24. Function of putamen circuit is:

A. Sequence of motor patterns

B. Patterns of motor activity
C. Timing of motor activity
D. Magnitude of motor activity
E. Intensity of motor activity

B. Patterns of motor activity

25. The precentral gyrus and corticospinal tract are involved in:
a. Vision
b. Kinesthesia
c. Olfaction
d. Voluntary movements
e. Auditory identification

d. Voluntary movements
26. A 23-year-old woman is a right-handed musician of considerable
talent. Which brain structure is most likely to have been physically larger
in the dominant hemisphere as compared with the nondominant
hemisphere at birth?
a. Anterior temporal lobe
b. Posterior temporal lobe
c. Premotor cortex
d. Primary motor cortex
e. Primary somatosensory area

b. Posterior temporal lobe

27. Which of the following best describes the cerebellar deficit in which
there is a failure to perform rapid alternating movements indicating a
failure of “progression” from one part of the movement to the next?
a. Past-pointing
b. Intention tremor
c. Dysartheria
d. Nystagmus
e. Dysdiadochokinesia

e. Dysdiadochokinesia
28. Which of the following spinal cord levels contains the entire population
of preganglionic sympathetic neurons?
A) C5-T1
B) C3-C5
C) S2-S4
D) T1-L2
E) T6-L1

D) T1-L2
29. The condition of prosopagnosia usually results from dysfunction or
damage to which area of the cerebral cortex?
A) Prefrontal area
B) Junction of parietal and temporal lobe on nondominant side of the brain
C) Frontal eye fields
D) Underside of medial occipital and temporal lobes
E) Limbic association areas of frontal and anterior temporal lobes

D) Underside of medial occipital and temporal lobes

30. The sweat glands and piloerector muscles of hairy skin are innervated
by which of the following fiber types?
A) Cholinergic postganglionic parasympathetic fibers
B) Cholinergic postganglionic sympathetic fibers
C) Adrenergic preganglionic parasympathetic fibers
D) Adrenergic postganglionic sympathetic fibers
E) Adrenergic preganglionic sympathetic fibers

B) Cholinergic postganglionic sympathetic fibers