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Worksheetsneurophysio -2nd year mbbs
Total questions: 80
Worksheet time: 40mins
A 35-year-old woman is unable to feel the texture of a fabric or distinguish between two close points on her skin. Which pathway is most likely damaged?
Lateral Spinothalamic Tract
Ventral Spinothalamic Tract
Dorsal Column-Medial Lemniscal System
Anterior Corticospinal Tract
Which of the following sensory receptors is responsible for detecting high-frequency vibration (30–800 Hz)?
Meissner’s corpuscles
Pacinian corpuscles
Merkel’s discs
Ruffini’s endings
First-order neurons of the Dorsal Column System for the lower limbs (below T6) ascend in which of the following?
Fasciculus Cuneatus
Fasciculus Gracilis
Dorsal Spinocerebellar Tract
Lissauer’s Tract
Where do the second-order neurons of the Neospinothalamic tract decussate?
Lower Medulla
Upper Medulla
At the level of entry in the spinal cord (Anterior Commissure)
Thalamus
A patient presents with "Analgesia" but preserved touch sensation. This "dissociated sensory loss" is characteristic of a lesion in:
The Dorsal Root Ganglion
The Thalamic VPL nucleus
The Central Canal (e.g., Syringomyelia)
The Internal Capsule
Which fiber type is responsible for "Fast-Sharp" pain, typically elicited by mechanical or thermal stimuli?
Type C fibers
Type A-beta fibers
Type A-delta fibers
Type B fibers
The "Gate Control Theory" suggests that pain transmission is inhibited at the spinal cord level by the stimulation of:
C fibers
A-delta fibers
A-beta fibers (Tactile)
Pain-sensitive free nerve endings
Which substance is considered the primary neurotransmitter for "Slow-Chronic" Type C pain fibers in the dorsal horn?
Glutamate
Substance P
Glycine
Acetylcholine
Stimulation of which brain area is known to cause "Profound Analgesia" by activating the descending inhibitory system?
Primary Somatosensory Cortex
Periaqueductal Gray (PAG) area
Hypothalamus
Basal Ganglia
Referred pain from the heart is often felt in the left arm because:
The heart and arm are supplied by the same peripheral nerve
They share second-order neurons in the T1–T5 spinal segments
The arm has a larger representation in the homunculus
The heart has no pain receptors of its own
Which of the following is an example of a "Phasic" receptor (rapidly adapting)?
Muscle Spindle
Golgi Tendon Organ
Pacinian Corpuscle
Baroreceptors
The ability to identify an object by touch without visual input (Stereognosis) depends primarily on:
Somatosensory Area I
Somatosensory Area II
Somatosensory Association Area (Brodmann 5, 7)
Prefrontal Cortex
Which Thalamic nucleus is the primary relay station for sensory information from the face?
Ventral Posterolateral (VPL)
Ventral Posteromedial (VPM)
Lateral Geniculate Nucleus
Medial Geniculate Nucleus
Brown-Séquard Syndrome (hemisection of the cord) results in which of the following below the lesion?
Ipsilateral loss of pain; Contralateral loss of vibration
Ipsilateral loss of vibration; Contralateral loss of pain
Bilateral loss of all sensation
Ipsilateral loss of all sensation
"Slow pain" is transmitted to the brain via which pathway?
Neospinothalamic tract
Paleospinothalamic tract
Dorsal Columns
Corticospinal tract
The neurotransmitter released by the descending analgesic fibers of the raphe magnus nucleus is:
Norepinephrine
Serotonin
Dopamine
GABA
Tic Douloureux is a condition characterized by lancinating pain in the distribution of:
The Sciatic nerve
The Trigeminal nerve
The Vagus nerve
The Brachial plexus
Which receptor is specialized to detect skin stretch and deep pressure?
Merkel’s disc
Ruffini’s endings
Meissner’s corpuscles
Free nerve endings
The "Sensory Homunculus" represents the body parts in the cortex. Which part has the largest representation?
Trunk
Legs
Lips and Hands
Shoulders
Which chemical is a potent stimulator of pain receptors during tissue ischemia?
Sodium ions
Bradykinin
Magnesium
Glucose
A patient shows spasticity, hyperreflexia, and a positive Babinski sign. This indicates a lesion in:
The Lower Motor Neuron
The Upper Motor Neuron
The Cerebellum
The Neuromuscular Junction
Which spinal cord tract is responsible for controlling the fine, skilled movements of the fingers?
Ventral Corticospinal Tract
Lateral Corticospinal Tract
Rubrospinal Tract
Vestibulospinal Tract
The "Muscle Spindle" detects which of the following?
Muscle Tension
Muscle Length and rate of change in length
Joint angle
Blood flow to the muscle
Which motor neuron innervates the "Intrafusal fibers" of the muscle spindle?
Alpha motor neuron
Gamma motor neuron
Beta motor neuron
Delta motor neuron
The Monosynaptic Stretch Reflex (e.g., Patellar reflex) involves which afferent nerve fiber?
Type Ia
Type Ib
Type II
Type C
The Golgi Tendon Organ (GTO) is responsible for which reflex?
The Stretch Reflex
The Inverse Stretch Reflex (Autogenic Inhibition)
The Withdrawal Reflex
The Crossed Extensor Reflex
A lesion in the Basal Ganglia typically results in which of the following?
Hypotonia and Ataxia
Spastic paralysis
Involuntary movements (Chorea, Athetosis)
Loss of all reflexes
Which part of the brain is responsible for the "Plan" and "Intent" of complex motor movements?
Primary Motor Cortex
Premotor Cortex
Supplementary Motor Area
Cerebellum
Decerebrate rigidity (extension of all four limbs) occurs when there is a lesion:
Above the Red Nucleus
Between the Red Nucleus and Vestibular Nuclei
In the Spinal Cord
In the Cerebellum
The "Direct Pathway" of the Basal Ganglia has what effect on the Thalamus?
Inhibition
Disinhibition (Excitation)
No effect
Permanent damage
Parkinson's Disease is caused by the destruction of neurons in the:
Caudate Nucleus
Putamen
Substantia Nigra pars compacta
Subthalamic Nucleus
Which of the following is a classic sign of Cerebellar disease?
Resting Tremor
Intention Tremor
Lead-pipe rigidity
Hemiballismus
The "Withdrawal Reflex" (Flexor Reflex) is characterized by:
Monosynaptic pathway
Polysynaptic pathway and Divergence
Inhibition of the ipsilateral flexors
Excitation of the ipsilateral extensors
The "Crossed Extensor Reflex" serves to:
Speed up the withdrawal from pain
Support the body weight when the opposite limb is withdrawn
Maintain muscle tone during sleep
Protect the tendons from rupture
What is the function of "Renshaw Cells" in the spinal cord?
To excite alpha motor neurons
To provide lateral inhibition (Recurrent inhibition)
To transmit pain signals
To sense muscle stretch
A lesion of the Subthalamic Nucleus results in:
Parkinsonism
Hemiballismus
Huntington’s Chorea
Ataxia
The "Clasp-Knife" effect is a clinical feature of:
Cerebellar Ataxia
Lower Motor Neuron lesion
Upper Motor Neuron lesion (Spasticity)
Basal Ganglia disease
Which tract is primarily involved in maintaining equilibrium and posture?
Corticospinal
Vestibulospinal
Tectospinal
Rubrospinal
"Alpha-Gamma Co-activation" ensures that:
The muscle spindle remains sensitive even when the muscle contracts
The muscle relaxes instantly after a jump
The Golgi Tendon organ is inhibited
Fatigue is prevented
Dysdiadochokinesia is the inability to:
Speak clearly
Perform rapid alternating movements
Maintain balance with eyes closed
Sense pain
Tabes Dorsalis (Syphilis) specifically destroys the dorsal roots and dorsal columns. A patient with this would have:
Loss of pain but normal balance
Sensory Ataxia and Romberg's sign
Spastic paralysis
Loss of temperature only
Which chemical is released by the "Damaged Tissue" to sensitize nociceptors (Hyperalgesia)?
Prostaglandins
Acetylcholine
Dopamine
Epinephrine
The "Internal Capsule" is a common site for strokes. A stroke here usually causes:
Ipsilateral Hemiplegia
Contralateral Hemiplegia
Quadriplegia
Monoplegia
Which receptor is most sensitive to the "Rate of Change" of muscle length (Dynamic response)?
Nuclear Chain fiber
Nuclear Bag fiber
Golgi Tendon Organ
Ruffini ending
"Huntington's Disease" is characterized by the loss of GABAergic neurons in the:
Substantia Nigra
Striatum (Caudate and Putamen)
Red Nucleus
Thalamus
Broca’s Area is located in the:
Posterior Temporal Lobe
Frontal Lobe (Dominant Hemisphere)
Occipital Lobe
Parietal Lobe
A "Positive Romberg Sign" (swaying when eyes are closed) indicates a deficit in:
Cerebellar function
Proprioception (Dorsal Columns)
Visual system
Vestibular system only
Which fibers have the slowest conduction velocity?
Type A-alpha
Type A-gamma
Type B
Type C
The "Primary Motor Cortex" corresponds to which Brodmann area?
Area 3,1,2
Area 4
Area 6
Area 17
Spinal Shock, immediately following a traumatic cord injury, is characterized by:
Hyperreflexia
Spasticity
Loss of all reflexes and hypotonia
Increased blood pressure
Which neurotransmitter is used by the Purkinje cells of the Cerebellum?
Glutamate
GABA
Norepinephrine
Serotonin
The "Pretectal area" is involved in which reflex?
Stretch reflex
Pupillary Light Reflex
Withdrawal reflex
Corneal reflex
"Athetosis" is characterized by:
Violent flailing of limbs
Continuous, slow, writhing movements
Rhythmic tremors at rest
Loss of coordination
Which area of the cerebellum is mainly concerned with Equilibrium?
Spinocerebellum
Cerebrocerebellum
Vestibulocerebellum (Flocculonodular lobe)
Vermis
In Myasthenia Gravis, the clinical defect is at the:
Nerve Axon
Muscle Spindle
Post-synaptic Acetylcholine Receptors
Spinal Cord
A patient cannot feel pain on the left side of the body below the neck. Where is the most likely lesion?
Left Spinal Cord (Lateral Spinothalamic)
Right Spinal Cord (Lateral Spinothalamic)
Left Dorsal Columns
Right Thalamus
The "Phantom Limb" phenomenon is thought to be due to:
Regeneration of nerves in the stump
Cortical reorganization in the somatosensory cortex
Excessive use of the other limb
Psychosis
Which of the following describes "Clonus"?
A single muscle twitch
Rhythmic, oscillating muscle contractions due to hyperactive stretch reflexes
Constant muscle contraction
Flaccid paralysis
The "Middle Ear" muscles (Stapedius) reflex is a motor response to:
Acceleration
Pain
Loud Noise
Light
Which receptor is found in the "Glabrous" (hairless) skin only?
Hair end-organ
Meissner's Corpuscle
Ruffini Ending
Free Nerve Ending
What is the primary function of the "Ponto-Reticulospinal Tract"?
Excite Antigravity muscles
Inhibit Antigravity muscles
Control finger movements
Control eye movements
"Past Pointing" is a sign of:
Basal Ganglia lesion
Cerebellar lesion
UMN lesion
LMN lesion
The primary neurotransmitter for "Excitation" in the CNS motor pathways is:
GABA
Glycine
Glutamate
Dopamine
A "Lower Motor Neuron" lesion is characterized by:
Spasticity
Fasciculations and Atrophy
Hyperreflexia
Babinski positive
Which tract decussates in the "Pyramids"?
Lateral Corticospinal
Anterior Corticospinal
Vestibulospinal
Spinothalamic
The "Supplementary Motor Area" is primarily involved in:
Sensory perception
Bilateral movements and complex posture
Simple reflex arcs
Taste sensation
"Slow-adapting" receptors are also known as:
Tonic receptors
Phasic receptors
Speed receptors
Nociceptors
The "Ventral Spinocerebellar Tract" enters the cerebellum via the:
Inferior Cerebellar Peduncle
Middle Cerebellar Peduncle
Superior Cerebellar Peduncle
Thalamus
What is the effect of "Endorphins" on the brain?
Increase pain perception
Inhibit the release of Substance P
Cause muscle contraction
Increase heart rate
Which of the following is an "Effector" in a reflex arc?
Sensory neuron
Muscle or Gland
Interneuron
Receptor
"Allodynia" is defined as:
Increased response to a painful stimulus
Pain resulting from a stimulus that does not normally provoke pain
Absence of pain
Chronic numbness
The "Paleocerebellum" (Vermis and Intermediate zone) primarily controls:
Motor planning
Coordination of distal limb movements
Muscle tone and posture of the axial body
Speech
In the Direct Pathway, the Globus Pallidus Internus is
Excited
Inhibited
Bypassed
Destroyed
Damage to the Cuneate Nucleus results in loss of
Pain from the legs
Vibration sense from the arms
Motor control of the face
Temperature from the trunk
Bradykinesia means
Fast movements
Slow movements
No movements
Tremor
The Medial Lemniscus carries fibers to the
Spinal cord
Medulla
Thalamus
Cerebellum
Nociceptors are generally
Encapsulated receptors
Specialized epithelial cells
Free nerve endings
Found only in the skin
Decorticate posturing (flexion of arms) suggests a lesion
In the Medulla
Above the Midbrain (Red Nucleus intact)
In the Spinal Cord
In the Cerebellum
The Autogenic Inhibition reflex is mediated by
Muscle spindle
Golgi Tendon Organ
Joint receptors
Skin receptors
Which Brodmann area is the Somatosensory Association Area?
1, 2, 3
4
5, 7
17
