1. A 72-year-old man is brought to the emergency department with left-sided weakness and impaired touch sensation on the left side of the body. Which of the following statements best describes the location of the brain damage producing these neurological signs?

A. Stroke in the left cerebral cortex
B. Stroke in the right cerebral cortex
C. Stroke affecting the right side of the spinal cord
D. Damage to peripheral nerves on the left side of the body

Comment: Because most pathways decussate in the brain; left body, right brain. Peripheral nerve damage on the left side could produce somatic sensory and motor disturbances, but it is unlikely that this damage would be so extensive, to affect the entire left side. If he had a systemic disease that affected nerve function, it would be likely that there would be some bilateral impairment or not symmetrical sensory and motor involvement.

2. A person was in a car accident and injured the lateral white matter of the spinal cord and became partly paralyzed. Which of the following choices best explains why the person became paralyzed as a consequence of the injury?

A. The injury produced extensive damage to neuronal cell bodies within the white matter.
B. The injury produced extensive damage to astrocytes in the white matter.
C. The injury destroyed the component of the ventricular system that is located in the spinal cord.
D. The injury extensively damaged axons within the white matter.

Comment: Whereas the injury could have damaged astrocytes and the central canal of the ventricular system, this would not necessarily produce paralysis. The injury would certainly have extensively damaged axons within the lateral white matter. This would cause a loss of connections between the brain and the spinal cord.

3. A patient has Alzheimer disease, which, among other impairments, is associated with a loss of acetylcholine in the forebrain. Which of the following is a major forebrain source of acetylcholine?

A. Basal nucleus
B. Ventral tegmental area
C. Locus ceruleus
D. Raphe nuclei

4. Which of the following is a major source of noradrenaline in the brain?

A. Medial septal nucleus
B. Substantia nigra compacta
C. Locus ceruleus
D. Raphe nuclei

5. Many of the neurological signs of Parkinson disease are produced by a loss of brain dopamine. Which of the following is a major source of dopamine?

A. Basal nucleus
B. Ventral tegmental area and substantia nigra compacta
C. Locus ceruleus and reticular formation
D. Raphe nuclei

6. Which of the following is a major source of serotonin (5-HT)?

A. Basal nucleus
B. Dorsal column nuclei
C. Locus ceruleus
D. Raphe nuclei

7. Damage to the dorsal columns and dorsal horn, such as what might occur after a traumatic spinal cord injury, would result primarily in disrupting which of the following functions?

A. Somatic sensation
B. Somatic motor function
C. Visceral motor function
D. All of the above choices

8. Which of the following choices lists correctly the rostro-caudal order of the brain stem divisions?

A. Medulla, midbrain, pons
B. Midbrain, pons, medulla
C. Midbrain, medulla, pons
D. Pons, midbrain, medulla

9. A patient has a cerebellar stroke. The major motor sign that the person presents with is termed ataxia, a characteristic incoordination after cerebellar damage. Which of the following statements accurately describes the location of the stroke in the brain?

A. Caudal to the tentorium and dorsal to the pons
B. Rostral to the tentorium and dorsal to the pons
C. Caudal to the tentorium and ventral to the pons
D. Rostral to the tentorium and ventral to the pons

10. A person is shot in the head. The bullet entered the skull above the right ear. In sequence, which of the following choices best describes the brain structures the bullet would encounter, from lateral to medial?

A. Parietal cortex, insular cortex, putamen, globus pallidus, anterior limb of the internal capsule, thalamus
B. Parietal cortex, insular cortex, putamen, globus pallidus, posterior limb of the internal capsule, thalamus
C. Insular cortex, putamen, posterior limb of the internal capsule, globus pallidus, thalamus
D. Insular cortex, putamen, globus pallidus, anterior limb of the internal capsule, thalamus

Comment: Parietal cortex is on the surface; the insular cortex is beneath the surface cortex. Choice A is not correct because it places the anterior limb of the internal capsule lateral to the thalamus; it should be the posterior limb.