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Neuroanatomy can be tough.  But with time, and effort, it is a very logical and rewarding system that can make you seem like a pro. “Where’s the lesion?” isn’t the only thing you’ll be tested on in this series however.  Best of luck! 

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Clinical Neuroanatomy: Part Four

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Question 1
Brodmann area four corresponds to the
A
Primary somatosensory cortex
B
Parietal eye fields
C
Superior parietal lobule
D
The second association visual cortex
E
Primary motor cortex
Question 2
Which of the following is not an integral input to the premotor cortex strip?
A
Premotor cortex
B
Supplementary motor cortex
C
Ventrolateral thalamic nucleus
D
Primary somatosensory cortex
E
Ventroposterior medial thalamic nucleus
Question 3
Localisation of function to the medial sixth Brodmann area is classically defined as
A
Cessation of unplanned movement
B
Coordination of movement
C
Commencement of movement
D
Modification of complex movement
E
None of the above
Question 4
Patient presents with a small infarct to the cerebral cortex unilaterally.  The result is contralateral paresis of postural (anti-gravity) muscles.   Which tract is most affected?
A
Rubrospinal tract
B
Reticulospinal tract
C
Corticobulbar tract
D
Corticospinal tract
E
All of the above in equal measure
Question 5
A "lower motor neuron with all extrafusal fibres innervated" is the definition of which neuroanatomical concept?
A
Motor unit
B
Neuromuscular junction
C
Sympathetic ganglion
D
Motor end plate
E
Peripheral nervous system
Question 6
Intrafusal muscle spindles send afferent input from mechanoceptors to the central nervous system via ...
A
Alpha motor neurons
B
Delta motor neurons
C
Gamma motor neurons
D
Lambda motor neurons
E
Beta motor nuerons
Question 7
The patella tendon reflexes does not utilise which fibre type below?
A
Interneuron
B
Alpha motor neuron
C
Gamma motor neuron
D
Ia fibre-type neuron
E
C fibre-type neuron
Question 8
Infarct of which artery will preferentially cause pseudoathetosis and sensory ataxia?
A
Vertebral artery
B
Basilar artery
C
Anterior spinal artery
D
Posterior spinal artery
E
Radicular artery
Question 8 Explanation: 
The PSpA supplies the majority of the dorsal funiculi of the spinal cord (DCML system).
Question 9
A 59 year-old man presents with slow-onset, worsening cramping for 3 months in all limbs.  There is notable fasciculation in the cervical and limb regions as a slight slurring of his speech.

Which of the following is the best matched differential?
A
Anterior circulation infarct
B
Multiple sclerosis
C
Amyotrophic lateral sclerosis
D
Posterior circulation syndrome
E
Basilar artery aneurysm
Question 10
Which of the following is not representative of a Brodmann area 6 infarct consequence?
A
Decreased muscle strength
B
Increased stretch reflex
C
Mild atrophy
D
Fibrillation of muscle belly
E
Clonus noted on movement
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