Neurophysiology Practice Questions

Q: Which of the following substances has the same concentration in cerebrospinal fluid (CSF) and plasma?

Cl. ***Cl*** - **Chloride ions (Cl-)** have the **closest concentration** between CSF and plasma among the listed options, with a CSF-to-plasma ratio of approximately 1.1-1.15. - CSF chloride is **slightly higher** than plasma chloride (CSF: ~120-130 mEq/L; Plasma: ~100-110 mEq/L) because chloride ions freely cross the **blood-brain barrier** and help maintain **electroneutrality** in CSF due to the low protein content. - The elevated chloride compensates for the absence of negatively charged proteins in CSF, making it the **best answer** among the given options. *Glucose* - **Glucose** concentration in CSF is approximately **60-70%** of plasma glucose concentration (CSF: 50-80 mg/dL; Plasma: 70-110 mg/dL). - Transport across the **blood-brain barrier** occurs via **GLUT1 transporters**, which are tightly regulated to meet brain metabolic demands. *Ca* - **Calcium (Ca2+)** concentration in CSF is **significantly lower** than in plasma (CSF: ~2.1-2.5 mg/dL; Plasma: ~8.5-10.5 mg/dL). - Only the **ionized, unbound fraction** can cross the blood-brain barrier, as protein-bound calcium cannot pass through. *HCO3* - **Bicarbonate (HCO3-)** concentration in CSF is typically **slightly lower** than in plasma (CSF: ~20-25 mEq/L; Plasma: ~22-28 mEq/L). - Active regulation maintains **CSF pH** and CO2 buffering capacity independent of plasma bicarbonate levels.

Q: Unable to consolidate long-term memory. Which lobe of the brain is involved?

Temporal. ***Temporal*** - The **temporal lobe**, particularly the **hippocampus** within it, is critically involved in the formation and consolidation of new long-term memories [1]. - Damage to the temporal lobe can result in **anterograde amnesia**, the inability to form new memories after the injury [1]. *Frontal* - The **frontal lobe** is primarily responsible for executive functions, **planning**, decision-making, and working memory [1]. - While it contributes to memory retrieval and strategic memory processes, it is not the primary site for the consolidation of long-term memories. *Parietal* - The **parietal lobe** is involved in processing **sensory information**, spatial awareness, and navigation. - It plays a role in attention and short-term memory, but not in the consolidation of long-term memory. *Occipital* - The **occipital lobe** is dedicated to **visual processing** and interpretation of visual information. - It has no direct primary role in the consolidation of long-term memories.

Q: Lesion of globus pallidus causes

Athetosis. ***Athetosis*** - **Athetosis** is the **classic movement disorder** associated with lesions of the **globus pallidus**, often occurring with **putamen** involvement. - It is characterized by **slow, writhing, involuntary movements**, particularly affecting the **distal extremities** (hands and feet). - Commonly seen in **kernicterus** (bilirubin-induced damage to basal ganglia), **cerebral palsy**, and **status marmoratus** of the basal ganglia. - When combined with chorea, it forms **choreoathetosis**. *Chorea* - **Chorea** is predominantly associated with dysfunction of the **caudate nucleus** and **putamen**, as seen in **Huntington's disease**. - It involves brief, irregular, unpredictable, **involuntary movements** that flow from one body part to another. *Hemibalismus* - **Hemibalismus** is most commonly caused by a lesion in the **subthalamic nucleus** (nucleus of Luys), often due to a **lacunar stroke**. - It involves large-amplitude, **involuntary flinging movements** of the limbs on **one side of the body**. *Dystonia* - **Dystonia** involves sustained or repetitive muscle contractions leading to twisting movements or abnormal fixed postures. - It results from dysfunction of **multiple basal ganglia structures** including the globus pallidus internal segment, putamen, and thalamus, but is **not the classic presentation** of isolated globus pallidus lesions.

Q: Narcolepsy is due to abnormality in ?

Hypothalamus. **Hypothalamus** - Narcolepsy is primarily caused by the loss of **orexin (hypocretin)** producing neurons in the **hypothalamus**, which are crucial for maintaining wakefulness. - This deficiency leads to dysregulation of **sleep-wake cycles**, causing excessive daytime sleepiness and other narcolepsy symptoms. *Neocortex* - The neocortex is involved in higher-level cognitive functions, sensory perception, and voluntary movement, but it is not the primary site of pathology in narcolepsy. - While sleep stages involve cortical activity, the core deficit in narcolepsy does not originate here. *Cerebellum* - The cerebellum is mainly responsible for motor control, coordination, and balance. - Its dysfunction is associated with ataxic gait and coordination problems, not the sleep disturbances characteristic of narcolepsy. *Medulla oblongata* - The medulla oblongata controls vital autonomic functions like breathing, heart rate, and blood pressure. - While involved in sleep regulation pathways, it is not the primary anatomical location affected in narcolepsy.

Q: Which of the following statements is true regarding the function of the spinocerebellar tract?

Smoothens and coordinates movements. ***Smoothens and coordinates movements*** - The spinocerebellar tract provides the cerebellum with **unconscious proprioceptive information** from muscle spindles and Golgi tendon organs. - This information allows the cerebellum to compare intended movements with actual movements, thereby **smoothing and coordinating voluntary motor activity**. *Involved in planning and programming motor activities* - This function is primarily attributed to the **cerebral cortex** (e.g., premotor and supplementary motor areas) and the **basal ganglia**. - While the cerebellum is involved in motor learning and fine-tuning, the initial **planning and programming** of complex movements are cortical functions. *Involved in maintaining equilibrium* - Maintaining equilibrium and balance is primarily a function of the **vestibulocerebellum** (flocculonodular lobe), which receives input from the vestibular system. - While the spinocerebellum indirectly influences balance by coordinating limb movements, its direct role is less pronounced than that of the vestibulocerebellum. *Facilitates learning through vestibulo-ocular reflex changes* - This function is specific to the **vestibulocerebellum** and is crucial for adapting the vestibulo-ocular reflex (VOR) to maintain visual stability during head movements. - The spinocerebellar tract's primary role is proprioception for limb coordination, not VOR adaptation.

Q: Which tract is responsible for the loss of proprioception and fine touch?

Dorsal column. ***Dorsal column*** - The **dorsal column-medial lemniscus pathway** is responsible for transmitting **fine touch**, **vibration**, and **proprioception** from the body to the cerebral cortex. - Damage to this tract (e.g., in **tabes dorsalis** or **vitamin B12 deficiency**) leads to a loss of these sensations. *Anterior spinothalamic tract* - This tract primarily conveys crude touch and pressure sensations. - While it carries tactile information, it does not transmit the fine discriminative touch or proprioception associated with the dorsal columns. *Lateral spinothalamic tract* - This pathway is responsible for transmitting **pain** and **temperature** sensations. - It does not play a role in proprioception or fine touch. *Corticospinal tract* - The **corticospinal tract** is a **motor pathway** responsible for voluntary movement. - It has no role in transmitting sensory information such as proprioception or fine touch.

Q: What is the normal range for the CSF/plasma glucose ratio?

0.6 - 0.8. ***Correct: 0.6 - 0.8*** - This ratio indicates that cerebrospinal fluid (CSF) glucose concentration is typically 60-80% of plasma glucose concentration - This range is crucial for identifying metabolic or infectious pathologies affecting the central nervous system - Normal CSF glucose is approximately 50-80 mg/dL when plasma glucose is 70-120 mg/dL *Incorrect: 0.2 - 0.4* - A ratio in this range indicates significantly low CSF glucose, suggesting conditions like bacterial meningitis or hypoglycorrhachia - This is well below the normal physiological proportion of glucose in the CSF relative to plasma - Seen in bacterial/tuberculous meningitis, fungal infections, or malignancy *Incorrect: 1.0 - 1.2* - A CSF/plasma glucose ratio close to or above 1.0 would imply that CSF glucose levels are equal to or higher than plasma levels, which is physiologically impossible under normal conditions - Glucose transport into the CSF is regulated by GLUT-1 transporters and typically results in lower concentrations than in plasma - The blood-brain barrier maintains this gradient *Incorrect: 1.2 - 1.6* - This range is even more exaggerated and physiologically impossible, as CSF glucose cannot exceed plasma glucose in a healthy individual - Such a high ratio would contradict the mechanisms of glucose transport across the blood-brain barrier - Would suggest laboratory error if observed

Q: Neurotransmitter involved in nigrostriatal pathway is?

Dopamine. ***Dopamine*** - The **nigrostriatal pathway** is a major dopaminergic pathway in the brain, originating in the **substantia nigra pars compacta** and projecting to the striatum. - It is crucial for the control of voluntary movement, and its degeneration is a hallmark of **Parkinson's disease**. *Serotonin* - Serotonin (5-HT) is primarily involved in mood, sleep, appetite, and cognition, and is not the primary neurotransmitter of the **nigrostriatal pathway**. - Serotonergic pathways originate in the **raphe nuclei** and project widely throughout the brain. *Acetylcholine* - Acetylcholine is a key neurotransmitter in the periphery (neuromuscular junction, autonomic nervous system) and in the central nervous system, involved in learning and memory. - Cholinergic neurons in the **basal forebrain** project to the cortex and hippocampus, but acetylcholine is not the neurotransmitter of the **nigrostriatal pathway**. *Norepinephrine* - Norepinephrine (noradrenaline) is involved in arousal, attention, and the fight-or-flight response, with pathways originating in the **locus coeruleus**. - While it plays a role in modulating motor circuits, it is not the main neurotransmitter of the **nigrostriatal pathway**.

Q: Which part of the brain is responsible for setting posture before planned movement?

Supplementary motor cortex. ***Supplementary motor cortex*** - The **supplementary motor cortex (SMA)** is responsible for **anticipatory postural adjustments** that occur before voluntary movements - It plays a key role in **internal generation and planning of complex motor sequences** - SMA activation precedes movement, ensuring **postural stability and coordination** - Essential for **bilateral coordination** and **motor programming** *Premotor cortex* - The **premotor cortex** is primarily involved in **externally guided movements** and selection of movements based on sensory cues - While it participates in motor planning, it is more focused on **sensory-motor integration** rather than anticipatory postural control *Motor cortex* - The **primary motor cortex** executes voluntary movements by sending signals directly to spinal motor neurons - Responsible for **fine motor control** and determining the **force and direction** of muscle contractions - Functions in **movement execution** rather than preparatory postural adjustments *Frontal eye fields* - The **frontal eye fields** control **voluntary saccadic eye movements** and visual attention - Not involved in trunk or limb **postural preparation** for planned movements

Q: Which sensory modalities are most directly affected by lesions of the primary somatosensory cortex?

Localization and two-point discrimination. ***Localization and two-point discrimination*** - Lesions in the **primary somatosensory cortex** (S1) lead to profoundly impaired **discriminative touch**, which includes the ability to precisely localize tactile stimuli and distinguish between two closely spaced points. - These are the **most characteristic deficits** of S1 lesions, representing the cortex's unique role in processing **spatial discrimination and fine sensory analysis**. - S1 is essential for the **integrative functions** that allow precise spatial mapping of sensory inputs. *Pain, temperature, and touch* - Basic touch perception is affected, but **pain and temperature** are primarily mediated by the **spinothalamic tracts** with substantial processing in the thalamus, insular cortex, and anterior cingulate cortex rather than S1. - Crude touch sensation remains relatively preserved with S1 lesions; it is the **discriminative quality** that is lost. - These modalities are NOT the most directly affected by isolated S1 lesions. *Vibration and proprioception* - **Vibration** and **proprioception** are indeed significantly impacted by S1 lesions as S1 receives thalamic projections from the **dorsal column-medial lemniscus (DCML) pathway**. - However, these modalities have substantial **subcortical representation** in the thalamus and can be partially preserved even with cortical damage. - In contrast, **localization and two-point discrimination** are purely cortical functions with no subcortical processing, making them the MOST directly and exclusively dependent on S1 integrity. *All of the options* - This is incorrect because pain and temperature perception is NOT most directly affected by S1 lesions—these are primarily processed by other pathways and cortical areas (spinothalamic system, insular cortex).

Question 1

Which of the following substances has the same concentration in cerebrospinal fluid (CSF) and plasma?

Accepted Answer

Cl

Answer

Glucose

Answer

Ca

Answer

HCO3

Question 2

Unable to consolidate long-term memory. Which lobe of the brain is involved?

Accepted Answer

Temporal

Answer

Frontal

Answer

Parietal

Answer

Occipital

Question 3

Lesion of globus pallidus causes

Accepted Answer

Athetosis

Answer

Chorea

Answer

Hemibalismus

Answer

Dystonia

Question 4

Narcolepsy is due to abnormality in ?

Accepted Answer

Hypothalamus

Answer

Neocortex

Answer

Cerebellum

Answer

Medulla oblongata

Question 5

Which of the following statements is true regarding the function of the spinocerebellar tract?

Accepted Answer

Smoothens and coordinates movements

Answer

Involved in planning and programming motor activities

Answer

Involved in maintaining equilibrium

Answer

Facilitates learning through vestibulo-ocular reflex changes

Question 6

Which tract is responsible for the loss of proprioception and fine touch?

Accepted Answer

Dorsal column

Answer

Anterior spinothalamic tract

Answer

Lateral spinothalamic tract

Answer

Corticospinal tract

Question 7

What is the normal range for the CSF/plasma glucose ratio?

Accepted Answer

0.6 - 0.8

Answer

1.2 - 1.6

Answer

0.2 - 0.4

Answer

1.0 - 1.2

Question 8

Neurotransmitter involved in nigrostriatal pathway is?

Accepted Answer

Dopamine

Answer

Acetylcholine

Answer

Serotonin

Answer

Norepinephrine

Question 9

Which part of the brain is responsible for setting posture before planned movement?

Accepted Answer

Supplementary motor cortex

Answer

Motor cortex

Answer

Frontal eye fields

Answer

Premotor cortex

Question 10

Which sensory modalities are most directly affected by lesions of the primary somatosensory cortex?

Accepted Answer

Localization and two-point discrimination

Answer

Pain, temperature, and touch

Answer

Vibration and proprioception

Answer

All of the options

Neurophysiology — MCQs

Neurophysiology — MCQs

On this page

Practice by Chapter

Want unlimited practice?