Touch is a near-essential sensory modality that we use so regularly. This MCQ begins to touch on areas of fine/crude touch and further afferent inputs to the CNS. See how you get on with this quiz.  Best of luck!

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Clinical Neuroanatomy: Part Two

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Question 1
Study the image below
Which of the following scenarios is most likely were an infarct to occur in the RED pin region of the internal capsule?
A
Poorly coordinated complex motor functionality contralaterally
B
Sensory loss to the face contralaterally
C
Ipsilateral loss of trunk motor supply
D
Contralateral loss of upper limb motor supply
E
Ipsilateral loss of hearing (rarely beyond subclinical)
Question 1 Explanation: 
This region demonstrates the corticopontine fibres which terminate in the deep cerebellar nuclei.
Question 2
Regarding the BLUE pin, which information is mostly carried in this portion of the internal capsule?
A
Frontopontine fibres
B
Sensory tracts from the VPL thalamic nucleus
C
Sensory tracts from the VPM thalamic nucleus
D
Corticothalamic fibres
E
Audio-visual information for the geniculate nuclei
Question 3
A space-occupying lesion has affected the internal capsule on the right side from the genu, ranging posteriorly. Which of the following vignettes below is the most likely clinical consequence?
Select all that apply ...
A
Left sided reduction in deep tendon reflexes
B
Ipsilateral sensory defect
C
Visual field scotoma
D
Contralateral sensory loss to the face and limbs
E
Loss of fine coordination movement to the contralateral limbs
Question 3 Explanation: 
A widespread internal capsule defect posteriorly will affect sensory and motor neurologic function contralaterally.
Question 4
A tertiary afferent neuron from the DCML system arises in the VPL nucleus and follows which flow to the primary somatosensory cortex?
A
Internal capsule -> corona radiata -> S2 -> S1
B
Internal capsule -> corona radiata -> S2 and S1
C
Corona radiata -> Internal capsule -> S2 -> S1
D
Corona radiata -> Internal capsule -> S2 -and S1
E
Internal capsule -> Thalamus -> corona radiata -> S2 and S1
Question 5
Where is the cell soma cluster of the second-order neuron for pain sensation to the face?
A
Contralateral thalamus
B
Contralateral midbrain
C
Contralateral pons
D
Contralateral medulla oblongata
E
Contralateral thoracic spinal cord intermediolateral horn of grey matter
Question 6
The chief nucleus of the fifth cranial nerve conveys which sensory modality?
A
Vibrational sense
B
Fine touch
C
Unconscious proprioception
D
Nociception
E
Thermoception
Question 7
Which of the following lesions would cause ipsilateral loss of vibrational sense?
A
Midbrain
B
Pons
C
Medulla
D
Diencephalon
E
Spinomedullary junction
Question 8
A patient with metastatic cancer (prostate primary) has seen neoplasia of a vertebral body and compression of the spinal cord affecting the dorsal column of one side.  Resultantly, there is notable writhing of the digits and a positive sign. Which of the following would be positive?
A
Cullen
B
Grey Turner
C
Murphy
D
Romberg
E
Weber
Question 9
Tabes dorsalis includes degeneration of a spinal cord funiculus. Were this to occur in a patient, which type of neuron would be lesioned?
A
Primary order neuron
B
Second order neuron
C
Tertiary order neuron
D
Quaternary order neuron
E
Quinary order neuron
Question 10
A patient has suffered a compressive injury to the anterolateral spinal cord white matter, left side, T7.
Which sensory sign is apparent?
A
T8 left side pain modality loss
B
T8 right side hyperalgesia
C
T9 right side crude touch loss
D
T7 right side crude touch loss
E
T12 right side proprioceptive sense loss (conscious)
Question 11
The lateral-most lateral spinothalamic tract is topically organised to contain which fibre subset?
A
Cervical
B
Thoracic
C
Lumbar
D
Sacral
E
Coccygeal
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Neuroanatomy imaging (Q1) shows wavered licence under CC1.0, with thanks to Lindsay Hanford, Geoff B Hall. (2011). Globus Pallidus Imaging. Available: https://upload.wikimedia.org/wikipedia/commons/1/13/Globus_Pallidus_sturctural_MRI.png. Last accessed 23rd October 2019.