Neurophysiology — MCQs

Neurophysiology Indian Medical PG Practice Questions and MCQs

Question 771: Cushing reflex is associated with all except?

A. Irregular respiration
B. Hypotension (Correct Answer)
C. Increased intracranial pressure
D. Bradycardia

Explanation: ***Hypotension*** - The **Cushing reflex** is a compensatory response to increased intracranial pressure (ICP) aiming to maintain cerebral perfusion, which typically involves **hypertension**, not hypotension. - While prolonged or severe ICP can lead to decompensation and eventual hypotension, it is not a direct component of the reflex itself. *Increased intracranial pressure* - The **Cushing reflex** is triggered by an elevation in **intracranial pressure (ICP)**, as the body attempts to maintain blood flow to the brain. - This increased ICP reduces cerebral perfusion pressure, prompting a systemic response to raise mean arterial pressure. *Bradycardia* - **Bradycardia** is a classic component of the **Cushing reflex**, occurring as a compensatory response to the reflex hypertension. - The increased arterial blood pressure stimulates carotid and aortic baroreceptors, leading to a vagal response that slows the heart rate. *Irregular respiration* - **Irregular respiration** is another key component of the **Cushing reflex**, often manifesting as **Cheyne-Stokes breathing** or **ataxic breathing**. - This respiratory dysregulation is due to direct compression and dysfunction of the brainstem, specifically the medullary respiratory centers, caused by increased ICP.

Question 772: Narcolepsy is due to abnormality in ?

A. Hypothalamus (Correct Answer)
B. Neocortex
C. Cerebellum
D. Medulla oblongata

Explanation: **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.

Question 773: Lesion of globus pallidus causes

A. Chorea
B. Athetosis (Correct Answer)
C. Hemibalismus
D. Dystonia

Explanation: ***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.

Question 774: Burning pain is carried by which type of fibres?

A. A alpha fibres
B. A delta fibres
C. A beta fibres
D. C fibres (Correct Answer)

Explanation: ***C fibres*** - These are **unmyelinated** and have a **slow conduction velocity**, responsible for transmitting **slow, dull, burning, or aching pain**. - They also transmit sensations of **temperature** and **itch**. *A alpha fibres* - These are **large, myelinated fibres** with the **fastest conduction velocity**, primarily involved in proprioception (sense of body position) and motor control. - They are not involved in the transmission of burning pain. *A delta fibres* - These are **small, myelinated fibres** that transmit **fast, sharp, localized pain** (the "first pain") and cold sensations. - While they transmit pain, it is characteristically sharp, not burning. *A beta fibres* - These are **large, myelinated fibres** that primarily transmit **touch and pressure sensations**. - They have a fast conduction velocity and are not involved in pain transmission.

Question 775: Neurotransmitter involved in nigrostriatal pathway is?

A. Acetylcholine
B. Serotonin
C. Dopamine (Correct Answer)
D. Norepinephrine

Explanation: ***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**.

Question 776: Which tract is responsible for the loss of proprioception and fine touch?

A. Anterior spinothalamic tract
B. Lateral spinothalamic tract
C. Dorsal column (Correct Answer)
D. Corticospinal tract

Explanation: ***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.

Question 777: Which part of the brain is responsible for setting posture before planned movement?

A. Motor cortex
B. Frontal eye fields
C. Premotor cortex
D. Supplementary motor cortex (Correct Answer)

Explanation: ***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

Question 778: Which of the following statements is true regarding the function of the spinocerebellar tract?

A. Smoothens and coordinates movements (Correct Answer)
B. Involved in planning and programming motor activities
C. Involved in maintaining equilibrium
D. Facilitates learning through vestibulo-ocular reflex changes

Explanation: ***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.

Question 779: Damage to the striatum primarily affects which type of memory?

A. Memory of how to perform tasks (Correct Answer)
B. Memory for recent events
C. Memory for past experiences
D. Memory for facts and events

Explanation: ***Memory of how to perform tasks*** - The **striatum**, a component of the **basal ganglia**, is crucial for **procedural memory**, which is the memory of how to perform skills and habitual tasks. - Damage to this area can impair the ability to learn new motor skills or execute previously learned ones, even if the person remembers the task explicitly. *Memory for recent events* - This type of memory, often referred to as **episodic memory**, relies heavily on the **hippocampus** and medial temporal lobe structures. - Damage to the striatum typically does not directly affect the recall of recent events or experiences. *Memory for past experiences* - **Autobiographical memory**, which includes past experiences, primarily involves widespread cortical networks, particularly in the **temporal and frontal lobes**. - While broad brain damage can affect this, the striatum's primary role is not in the storage or retrieval of experiential memories. *Memory for facts and events* - This describes **declarative memory**, which is subdivided into **semantic memory** (facts) and **episodic memory** (events). - These are largely mediated by the **hippocampus**, **medial temporal lobes**, and various cortical areas, not primarily the striatum.

Question 780: In bladder injury, pain is referred to which of the following areas?

A. Flank
B. Upper part of thigh
C. Lower abdominal wall (Correct Answer)
D. Penis

Explanation: ***Correct Option: Lower abdominal wall*** - **Referred pain** from the bladder is typically felt in the **suprapubic region** of the lower abdominal wall due to shared visceral and somatic afferent innervation. - The **parietal peritoneum** overlying the bladder is innervated by somatic nerves that also supply the abdominal wall. - This convergence of visceral afferents from the bladder and somatic afferents from the abdominal wall at the spinal cord level (particularly S2-S4) results in referred pain to the suprapubic area. *Incorrect Option: Upper part of thigh* - Pain in the upper thigh is more commonly associated with conditions affecting the **hip joint**, **femoral nerve**, or **inguinal region**. - Bladder innervation does not primarily refer pain to the upper thigh. *Incorrect Option: Flank* - Flank pain is typically associated with conditions of the **kidneys** or **ureters**, such as **nephrolithiasis** or **pyelonephritis**. - The bladder's referred pain pattern does not usually extend to the flank. *Incorrect Option: Penis* - While bladder irritation can sometimes cause sensations in the penis, it is more often associated with conditions like **urethritis**, **cystitis**, or **prostatitis**. - Direct referred pain from bladder injury to the penis is less common than to the lower abdominal wall.

Practice by Chapter

Neurons and Glial Cells

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Synaptic Transmission

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Sensory Processing

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Motor Control Systems

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Autonomic Nervous System

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Hypothalamus and Limbic System

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Cerebral Cortex Functions

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Electroencephalography

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Neuroplasticity

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Sleep and Wakefulness

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