中国医学科学院北京协和医学院解剖与组胚学系

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Quiz

提示: 测试时间为16分钟，系统自动计时，时间到后自动提交。

1 . A 67-year-old man is evaluated for persistent shooting pains, lower limb ataxia, and bladder dysfunction. Physical examination demonstrates small irregular pupils that constrict with accommodation but not in response to light. A VDRL test is positive. A CT scan of the spinal cord would most likely demonstrate atrophy of which of the following structures?
    A. Dorsal column
    B. Dorsal horn
    C.  Lateral column
    D. Ventral column
    E. Ventral horn

2 . A patient presents with complaints of chronic headaches. After a complete physical examination including a neurological examination, a cerebral arteriogram is ordered. The arteriogram reveals a large aneurysm of the right superior cerebellar artery immediately distal to its origin from the basilar artery. Which of the following clinical findings is most likely to be seen as a result of compression of a cranial nerve by this aneurysm?
    A.  Loss of abduction of the right eye
    B. Loss of adduction of the right eye
    C. Loss of depression of the right eye from the adducted position
    D. Loss of sensation on the right side of the face
    E. Loss of visual field of the right eye

3 . A 69-year-old man presents with unilateral hearing loss. A lesion in which of the following structures could be responsible for this loss?
    A. Inferior colliculus
    B. Lateral lemniscus
    C. Medial geniculate body
    D. Medial lemniscus
    E. Organ of Corti
    F. Superior olivary nucleus

4 . A 15-year-old boy presents to his pediatrician complaining of headaches. Physical examination is remarkable for paralysis of upward gaze, bilateral papilledema, and pupils that react to accommodation, but not to light. The physician orders a CT scan of the head, which demonstrates a pineal tumor. Damage to which of the following structures probably accounts for the patient's upward gaze defect?
    A. Mamillary body
    B. Optic chiasm
    C.  Pons
    D. Superior cerebellar peduncle
    E. Superior colliculus

5 . A 65-year-old male presents with a history of headache and difficulty walking. He felt well the previous night, but woke up with a severe headache and was unable to move his right leg. Clinical examination reveals no higher cortical function deficit. The optic discs are sharp, and the pupils are equal and reactive. The direct and consensual light reflexes are normal, and testing of the cranial nerves reveal no deficits. The right leg is hypotonic, and the man is unable to move it. Deep tendon reflexes are absent and Babinski's sign cannot be elicited. The most likely cause for this problem is loss of blood flow in the
    A. left anterior cerebral artery
    B. left middle cerebral artery
    C. left posterior cerebral artery
    D. right anterior cerebral artery
    E. right middle cerebral artery
    F. right posterior cerebral artery

6 . A 35-year-old man sustains a knife wound to the neck that completely destroys the left C6 dorsal root ganglion. Two months later, the axons, dendrites, and nerve cell bodies of this damaged structure have completely degenerated. What changes in the spinal cord can be predicted from this injury?
    A. Axonal loss in the contralateral spinothalamic tract
    B. Axonal loss in the ipsilateral dorsal columns
    C. Axonal loss in the ipsilateral lateral corticospinal tract
    D. Nerve cell body loss in the contralateral ventral horn
    E. Nerve cell body loss in the ipsilateral dorsal horn

7 . A 35-year-old man sustains a knife wound to the neck that completely destroys the left C6 dorsal root ganglion. Two months later, the axons, dendrites, and nerve cell bodies of this damaged structure have completely degenerated. What changes in the spinal cord can be predicted from this injury?
    A. Axonal loss in the contralateral spinothalamic tract
    B. Axonal loss in the ipsilateral dorsal columns
    C. Axonal loss in the ipsilateral lateral corticospinal tract
    D. Nerve cell body loss in the contralateral ventral horn
    E. Nerve cell body loss in the ipsilateral dorsal horn

8 . A 63-year-old man complains of trouble swallowing and hoarseness. On physical exam, he is noted to have ptosis and a constricted pupil on the left, and a diminished gag reflex. Neurological examination shows decreased pain and temperature sensation on the left side of his face and on the right side of his body. Which of the following vessels is most likely occluded?
    A. Anterior inferior cerebellar artery (AICA)
    B. Anterior spinal artery
    C. Middle cerebral artery (MCA)
    D.  Posterior cerebral artery (PCA)
    E. Posterior inferior cerebellar artery (PICA)