Question 1

While visiting his 79-year-old mother, her son noticed that she had developed a wide-based and unsteady gait. In which of the following structures is a lesion most likely located?&#10;A) Intermediate cerebellar hemisphere&#10;B) Posterior lobe&#10;C) Lateral cerebellar hemisphere&#10;D) Vermis&#10;E) Anterior lobe

Accepted Answer

The wide-based and unsteady gait described is characteristic of a midline (vermal) cerebellar lesion. The cerebellar vermis controls axial and proximal limb coordination, affecting gait and stance.

Question 2

The vestibular system connects to the cerebellum through fibers that primarily travel in which of the following?&#10;A) Middle cerebellar peduncle&#10;B) Inferior cerebellar peduncle&#10;C) Superior cerebellar peduncle&#10;D) Basilar pons&#10;E) Superior medullary vellum

Accepted Answer

The vestibular system connects to the cerebellum primarily through the inferior cerebellar peduncle. This connection is crucial for balance and coordination, as it allows for the transmission of vestibular information to the cerebellum, which helps in maintaining equilibrium and controlling eye movements.

Question 3

A magnetic resonance image of a 36-year-old woman involved in a motor vehicle collision indicates a lesion in the flocculonodular lobe. Which of the following deficits is this patient likely to exhibit?

A) Dysrhythmia
B) Appendicular ataxia
C) Wide-based gait
D) Loss of position sense
E) Eye movement abnormalities

E

Accepted Answer

The flocculonodular lobe, part of the cerebellum, is primarily involved in the control and coordination of eye movements and balance. Lesions in this area often result in eye movement abnormalities, such as nystagmus, rather than the other deficits listed, which are associated with different parts of the nervous system.

Question 4

A physician orders a computed tomographic scan for a 42-year-old man after he is admitted to the emergency department with nausea, vomiting, and a headache that has progressively worsened throughout the day. A hemorrhagic lesion is revealed in the superior half of the cerebellum. Which of the following blood vessels primarily supplies this area of the cerebellum?

A) Posterior inferior cerebellar artery
B) Short circumferential branches of the basilar artery
C) Superior cerebellar artery
D) Vertebral artery
E) Anterior inferior cerebellar artery

Accepted Answer

The superior cerebellar artery primarily supplies the superior half of the cerebellum, which is the area affected in the scenario described.

Question 5

A 59-year-old retired Air Force captain with a history of alcohol abuse is examined by a neurologist after waking up with nausea, vomiting, and a feeling of unsteadiness. During the examination the man exhibits dysmetria in heel-to-shin and finger-to-nose testing on the right and falls to the right as he attempts to stand. Which of the following most specifically describes the patient's dysmetria during the finger-to-nose and heel-to-shin maneuvers?

A) Titubation
B) Dysdiadochokinesia
C) Appendicular ataxia
D) Dysphagia
E) Truncal ataxia

Accepted Answer

Appendicular ataxia is characterized by a lack of coordination in limb movements, which is what the patient exhibits during the finger-to-nose and heel-to-shin testing. This condition is often associated with cerebellar dysfunction, which can affect precise, coordinated movements of the extremities.

Question 6

In which of the following is a lesion most likely located?&#10;A) Right cerebellar hemisphere&#10;B) Left and right superior cerebellar peduncle&#10;C) Flocculonodular lobe&#10;D) Left cerebellar hemisphere&#10;E) Right and left inferior cerebellar peduncle

Accepted Answer

The answer of In which of the following is a...

Question 7

The deep cerebellar nuclei primarily receive their input from which of the following?&#10;A) Stellate cells&#10;B) Basket cells&#10;C) Purkinje cells&#10;D) Climbing fibers&#10;E) Parallel fibers

Accepted Answer

The deep cerebellar nuclei primarily receive their input from Purkinje cells. Purkinje cells are the primary output neurons of the cerebellar cortex, and they send inhibitory signals to the deep cerebellar nuclei.

Question 8

A 39-year-old woman has difficulty rapidly supinating and pronating her hand. This deficit most characteristically describes which of the following?&#10;A) Dysmetria&#10;B) Dysdiadochokinesia&#10;C) Hypotonia&#10;D) Truncal ataxia&#10;E) Titubation

Accepted Answer

Dysdiadochokinesia is the inability to perform rapid, alternating movements, such as rapidly supinating and pronating the hand, and is often a sign of cerebellar dysfunction.

Deck 4: Meningeal Coverings of the Brain and Spinal Cord