The ANS has two divisions: sympathetic and parasympathetic

 The activity of both divisions of the ANS is integrated by the medulla

oblongata All of the preceding statements are true, except that the activity of both divisions of the ANS
is integrated by the medulla oblongata, because it is the hypothalamus that regulates and integrates the
activity of both divisions of the Autonomic Nervous System. (Brunner, 2009)

The thalamus consists of paired oval masses of gray matter organized into nuclei
with interspersed tracts of white matter. Which of the following is not a function of
the thalamus?

  It regulates emotional and behavioral patterns  The thalamus is the major relay
station for most sensory impulses that reach the primary sensory areas of the cerebral cortex from the spinal
cord and brain stem. Crude perception of painful, thermal, and pressure sensations arises at the level of the
thalamus but precise localization of these sensations depends on nerve impulses arriving at the cerebral
cortex. The thalamus contributes to motor functions by transmitting information from the cerebellum and
basal ganglia to the primary motor area of the cerebral cortex. It also relays nerve impulses between
different areas of the cerebrum and plays a role in the regulation of autonomic activities and the
maintenance of consciousness. Regulation of emotional and behavioral patterns is a function of the
hypothalamus. (Tortora & Derrickson, 2006)

This cranial nerve originates in the midbrain and passes through the superior orbital
fissure. This cranial nerve’s somatic motor function is the movement of upper eyelids
and eyeballs:

 Oculomotor nerve The optic nerve is responsible for vision. The oculomotor nerve is responsible
for the movement of the upper eyelids and eyeballs and also for the accommodation of lens for near vision
and constriction of pupil. The trochlear nerve is responsible for the movement of the eyeballs. The trigeminal
nerve is responsible for chewing. (Tortora & Derrickson, 2006)

The autonomic nervous system is the portion of the peripheral nervous system that
consists of visceral motor neurons to smooth muscle, cardiac muscle and glands.
The major control and integration center of the ANS is the:

 Hypothalamus The hypothalamus is the major control and integration center of the ANS. It receives
sensory input related to visceral functions, olfaction, gustation, as well as changes in temperature,
osmolarity, and levels of various substances in blood. Anatomically, the hypothalamus is connected to both
the sympathetic and parasympathetic divisions of the ANS. (Tortora, 2006)

The pathway followed by a nerve impulse that produce a reflex is called a reflex arc.
A reflex arc has five functional components. Which of the following choices shows
the correct pathway of a reflex arc?

 Sensory receptor -> sensory neuron -> integrating center -> motor
neuron -> effector  The sensory receptor responds to a stimulus by producing a generator or
receptor potential. In the sensory neuron, the axon conducts impulses from receptor to integrating center. In
the integrating center, one or more regions within the CNS that relay impulses fom sensory to motor
neurons. The axon of a motor neuron then conducts impulsews from the integrating center to the effector.
 Finally, the part of the body that responds to the motor nerve impulse is the effector. (Tortora and
Grabowski, 2004)

The existence of a blood-brain barrier protects brain cells from harmful substances
and pathogens by preventing passage of many substances from blood into brain
tissue. Which of the following substances are not able to cross the blood-brain
barrier?

 Proteins A few water-soluble substances such as glucose, cross the BBB by active transport. Other
substances, such as creatinine, urea and most ions cross the BBB very slowly. Still other substances –
proteins and most antibiotic drugs – do not pass at all from the blood into brain tissue. However, lipid-soluble
substances, such as oxygen, carbon dioxide, alcohol and most anesthetic agents, easily cross the blood-
brain barrier. Trauma, certain toxins and inflammation can cause a breakdown of the BBB. (Tortora &
Derrickson, 2006)

Spinal nerves innervate skin and muscles, and can be both sensory and somatic.
Which spinal nerve is largely responsible for innervating the diapghragm?

 Phrenic Sciatic nerves can be tibial (innervates posterior thigh muscles, anterior and posterior leg
muscles and most foot muscles) and common peroneal (innervates lateral thigh and left and some foot
muscles). Median nerves innverate mostly anterior forearm muscles and most of the intrinsic hand muscles.
Cervical branches of the cervical plexus innervate several neck muscles. The phrenic nerve of the cervical
plexus innervates the diaphragm. Contraction of the diaphragm is largely responsible for the ability to
breathe. (Tate, [Link]., 1994).

Reflexes may be somatic or visceral. There are four important somatic spinal
reflexes. Which among the four reflexes is ipsilateral and moves the limb away from
the source of painful stimulus?\

  Flexor Reflex; The stretch reflex is ipsilateral and is important in maintaining muscle tone – it causes
contraction of the skeletal muscle in response to stretching of the muscle. It can be elicited by tapping on
tendons attached to muscles at the elbow, wrist, knee and ankle joints. A tendon reflex operates as a
feedback mechanism to control muscle tension by causing muscle relaxation before muscle force becomes
so great that tendons might be torn. The flexor reflex is also called the withdrawal reflex. It is ipsilateral and
moves the limb away from the source of a painful or traumatic stimulus. The crossed extensor reflex extends
the limb contralateral to a painfully stimulated limb, allowing the weight of the body to shift when a
supporting limb is withdrawn. (Tortora and Grabowski, 2004)

Autonomic neurons are classified based on the neurotransmitters they release.

Cholinergic neurotransmitters may bind with all but one of the following:

 Alpha receptors Alpha receptors bind with neurotransmitters released by adrenergic neurons.
Cholinergic neurotransmitters bind with cholinergic receptors which are either nicotinic or muscarinic.
(Tortora, 2006)

Injuries to specific nerve plexus may affect sensations and movements of the
corresponding body parts being innervated. You notice that a patient’s foot has been
plantar flexed for a long time. You identify this as a case of foot drop. Which Plexus
is most likely affected?

 Sacral plexus: Rationale Footdrop is caused by damage to the common fibular nerve, which is part of
the sacral plexus. Nerves of the cervical plexus supply the skin and muscles of the head, neck, and upper
part of the shoulders, they connect with some cranial nerves and the diaphragm. Nerves of the brachial
plexus supply the upper limbs and several neck and shoulder muscles. Nerves of lumbar plexus supply the
anterolateral abdominal wall, external genitals, and part of the lower limbs. (Tortora and Grabowski, 2004).

Several age-related changes occur in the eyes. In addition to the lens losing some of its
elasticity, other changes include:

  Retinal detachment Retinal detachment is not expected with advanced age. In old age, the lenses
may lose transparency (cataract formation); the irises may fade or develop irregular pigment; the muscles
that regulate the size of the pupil may weaken and the pupils may become smaller and react more slowly to
light. (Tortora, 2006)

There are different types of neurons as characterized by the following statements,

except:

  None of the above None of the above statements are false. Receptors detect external or internal
changes and send the information to the CNS in the form of impulses by way of the afferent neurons. The
central nervous system interprets these impulses as a sensation. (Brunner, 2009)

Nerve cells are called neurons, or nerve ?bers. Whatever their speci?c functions, all
neurons have the same physical parts. Which of the following statement/s best
describes the parts of the neuron?

 All of the above  All of the above statements accurately describe the parts of a neuron. The cell body
contains the nucleus and is essential for the continued life of the neuron. Dendrites are processes
(extensions) that transmit impulses toward the cell body. The one axon of a neuron transmits impulses away
from the cell body. It is the cell membrane of the dendrites, cell body, and axon that carries the electrical
nerve impulse. (Brunner, 2009)

Several reflexes have clinical significance. Among the most important is the plantar
flexion reflex. It can be elicited by gently stroking the lateral outer margin of the sole.
Which statement describes an abnormal response?

 Both of the statements are abnormal responses The normal response for individuals above 18
months of age is a curling of toes. Damage to descending motor pathways such as the corticospinal tract,
alters this reflex Stroking the sole causes the great to extend, with or without fanning of the other toes, is a
response called the Babinski sign. In children under 18 months of age, the Babinski sign is normal due to
incomplete myelination of axons in the corticospinal tract. The normal response after 18 months of age is the
plantar flexion reflex. (Tortora and Grabowski, 2004).

The cerebellum occupies the inferior and posterior aspects of the cranial cavity. Which
of the following statements about the cerebellum is incorrect?
   The cerebellum is anterior to the medulla and pons and inferior to the anterior portion of
the cerebrum.  The cerebellum accounts for about a tenth of the brain mass yet contains nearly half of
the neurons in the brain. The cerebellum is posterior to the medulla and pons and inferior to the posterior
portion of the cerebrum. In superior or inferior views, the shape of the cerebellum resembles a butterfly. The
central constricted area is the vermis and the lateral wings or lobes are the cerebellar hemispheres. The
anterior lobe and posterior lobe govern subconscious aspects of skeletal muscle movements. The
flocculonodular lobe on the inferior surface contributes to equilibrium and balance. The primary function of
the cerebellum is to evaluate how movements initiated by the motor areas in the cerebrum are actually being
carried out. When movements initiated by the cerebral motor areas are not being carried out correctly, the
cerebellum detects the discrepancies and sends feedback to the cerebral cortex. (Tortora & Derrickson,
2006)

The nervous system has specific divisions. Which of the following statements best
characterizes these divisions?

 The autonomic nervous system is a part of the central nervous system. The autonomic
nervous system (ANS) is actually part of the peripheral nervous system in that it consists of motor portions
of some cranial and spinal nerves. (Brunner, 2009)

The transmission of impulses across neurons involves an intricate process. Which of

the following statements is true regarding this?

 An axon does not have neurotransmitter receptor sites. The only true statement is that an
axon does not have neurotransmitter receptor sites. Transmission of an impulse through the synapse is
done first when the presynaptic membrane on the axon of the cell sends out neurotransmitters into the
synapse. The neurotransmitters then diffuse into the space and latch on to the receptor sites on the
postsynaptic membrane of the dendrite on the other neuron. The dendrites do not have neurotransmitters
and the axons do not have receptor sites so there can be no backward sending of impulses among two
neurons. (Brunner, 2009)

Aside from the cell body, dendrites and axons, other nerve tissues also play very
important roles. Which of the following statements least characterizes these nerve
tissues?

 Schwann cells are specialized cells which ‘wrap’ axons and dendrites in the central
nervous system.  Schwann cells are not found in the central nervous system. They wrap axons and
dendrites in the peripheral nervous system. The oligodendrocytes are the ones responsible for ‘wrapping’
axons and dendrites in the central nervous system. (Brunner, 2009)

The parasympathetic division operates under normal nonstressful conditions. Among

the following statements, which of the following is incorrect about the parasympathetic
division:

  It uses epinephrine as a neurotransmitter The sympathetic division uses epinephrine as a

neurotransmitter while the parasympathetic division uses acetylcholine. The parasympathetic division
stimulates or speeds up the body’s vegetative activities and restores or slows down other activities. It
supports body functions that conserve and restore energy during rest. (Delmar, 2001)
There are several structures which serve as protective barriers for the spinal cord.
Which of the following is not a protective structure of the spinal cord?

  Skull Two types of connective tissue coverings – bony vertebrae and touch, connective tissue meninges –
plus a cushion of cerebrospinal fluid surround and protect the delicated nervous tissue of the spinal cord.
The skull protects the brain, not the spinal cord primarily. (Tortora and Grabowski, 2004)

The spinal cord has two principal functions in maintaining homeostasis: nerve impulse
propagation and information integration. Which of the following statements is correct?

 None of the choices Gray matter receives and integrates incoming and outgoing information. White
matter tracts are highways for nerve impulse integration. Along the white matter tracts, sensory impulses
flow toward the brain and motor impulses flow from the brain toward skeletal muscles and other effector
tissues. (Tortora and Grabowski, 2004)

The cerebrospinal fluid is a clear, colorless liquid that protects the brain and spinal cord
from chemical and physical injuries. Which of the following statements is true?

 CSF contains glucose, proteins, lactic acid, urea, cations and anions. CSF carries oxygen,
glucose and other needed chemicals from the blood to neurons and neuroglia. It contains glucose, proteins,
lactic acid, urea, cations, anions and some white blood cells. The total volume of CSF is 80 to 150mL in an
adult. It continuously circulates through cavities in the brain and spinal cord and around the brain and spinal
cord in the subarachnoid space (between the arachnoid mater and pia mater). The CSF serves as
mechanical protection as it is a shock-absorbing medium that protects the delicate tissues of the brain and
spinal cords. It provides an optimal chemical environment for accurate neuronal signaling and it allows for
exchange of nutrients and waste products between the blood and nervous tissue. (Tortora & Derrickson,
2006)

The hypothalamus is a small part of the diencephalon located inferior to the thalamus.
Which of the following is not a role of the hypothalamus?

 Direct control of endocrine glands Important functions of the hypothalamus are as follows: control of
the autonomic nervous system, production of hormones, regulation of emotional and behavioral patterns,
regulation of eating and drinking, control of body temperature and regulation of circadian rhythms and states
of consciousness. The hypothalamus controls and integrates activities of the autonomic nervous system,
which regulates contraction of smooth and cardiac muscle and the secretions of many glands. The
hypothalamus produces several hormones and has important connections with the pituitary gland, an
endocrine gland located inferior to the hypothalamus. Together with the limbic system, the hypothalamus
participates in expressions of rage, aggression, pain and pleasure and the behavioral patterns related to
sexual arousal. The hypothalamus regulates food intake through the arcuate and paraventricular nuclei. It
also contains a thirst center. The hypothalamus controls body temperature. If the temperature of blood
flowing through the hypothalamus is above normal, the hypothalamus directs the ANS to stimulate activities
that promote heat loss. Finally, the suprachiasmatic nucleus of the hypothalamus establishes patterns of
awakening and sleep that occur on a circadian schedule. (Tortora & Derrickson, 2006)

Understanding the external anatomy is important in order to fully appreciate the different
details and parts of the spinal cord. This refers to the tail-like array of roots of spinal
nerves at the inferior end of the spinal cord . What is the term being referred to? 

  Cauda Equina  Cauda Equina refers to the tail-like array of roots of spinal nerves at the inferior end of
the spinal cord. Inferior to the lumbar enlargement, the spinal cord tapers to a conical portion referred to as
 Conus medullaris. This ends at the level of the intervertebral disc between the first and second lumbar
vertebrae in adults. Filum terminale is the non-nervous fibrous tissue of the spinal cord that extends inferiorly
from the conus medullaris to the coccyx. Denticulate ligaments are triangular-shaped extensions of the pia
mater that suspend the spinal cord in the middle of the dural sheath.(Tortora and Grabowski, 2004)

Neurons that transmit impulses to other neurons do not actually touch one another.
Impulses are transmitted through synapses through the use of:

 Neurotransmitters Neurotransmitters on each of the synapses on a nerve cell diffuse across the
synapse, combine with a speci?c receptor sites on the cell membrane of the postsynaptic neuron, and there
generate an electrical impulse that is, in turn, carried by this neuron’s axon to the next one. (Brunner, 2009)

Meninges are connective tissue that cover thespinal cord and brain. Which meninx is
the most superficial covering? 

 Dura Mater  Dura mater is the outermost and toughest meninx among the three. It is composed of dense irregular
connective tissue. The epidural space is the space between the dura mater and the wall of the vertebral canal. The
arachnoid mater is an avascular covering and is the middle meninx. It has spider’s web arrangement of delicate collagen
fibers and some elastic fibers, thus its name. It is deep to the dura mater and is continuous with the arachnoid matter of
the brain. The innermost meninx ist he pia mater which is a thin transparent connective tissue layer that adheres to the
surface of the spinal cord and brain. It consists of interlacing bundles of collagen fibers and some fine elastic fibers.
(Tortora and Grabowski, 2004)

The cerebellum maintains proper posture and balance. In addition to this, it also
performs all but one of the following functions: 

 Processing of sensory information Processing of sensory information is a function of the cerebrum. The
cerebellum monitors intentions for movement by receiving impulses from the motor cortex and basal ganglia regarding
what movements are planned. It also monitors actual movement by receiving input from proprioceptors in joints and
muscles. If there is a discrepancy between the intended and actual movement, the cerebellum sends out corrective
feedback to upper motor neurons. (Tortora, 2006)

The Sympathetic and Parasympathetic Nervous Systems have opposing effects on the
body. These effects are characterized by the following analogies, except:
i. Sympathetic: Anal sphincter contracts
ii. Parasympathetic: Urinary bladder relaxes
iii. Sympathetic: Pancreas secretes insulin
iv. Parasympathetic: Decreased peristalsis

 .ii, iii and iv The only correct statement is that the anal sphincter contracts with sympathetic stimulation because this
will prevent defecation. The remaining three statements are false. With parasympathetic stimulation, the urinary bladder
should constrict, thus encouraging elimination of urine. There should also be increased peristalsis in order to promote
fecal elimination. With sympathetic stimulation, the pancreas will secrete glucagon, and not insulin, so that more glucose
will be produced to accommodate with the increased need for energy. (Brunner, 2009)

The twelve pairs of cranial nerves pass through various foramina in the bones of the
cranium. This cranial nerve’s motor function involves the movement of the tongue
during speech and swallowing:
   Hypoglossal nerve  The glossopharyngeal nerve is responsible for the taste and somatic sensations from the
posterior third of the tongue, it elevates the pharynx during swallowing and speech and it stimulates secretion of saliva.
The facial nerve is responsible for facial expressions and the secretion of saliva and tears. The hypoglossal nerve is
responsible for the movement of the tongue during speech and swallowing. The accessory nerve’s cranial roots mediate
swallowing movements while the spinal root mediates the movement of the head and shoulders. (Tortora & Derrickson,
2006)

Specific types of sensory, motor and integrative signals are processed in certain regions
of the cerebral cortex. This motor area is located in the frontal lobe close to the lateral
cerebral sulcus and is involved in the articulation of speech:

 Broca’s area  The Wernicke’s (posterior language) area is a broad region in the left temporal and parietal lobes
and it interprets the meaning of speech by recognizing spoken words. The Broca’s (speech) area is located in the frontal
lobe close to the lateral cerebral sulcus and is involved in the articulation of speech. Neural circuits established between
Broca’s speech area, the premotor area and primary motor area activate muscles of the larynx, pharynx and mouth and
breathing muscles. The primary motor area is located in the precentral gyrus of the frontal lobe. Each region in the
primary motor area controls voluntary contractions of specific muscles or groups of muscles. The common integrative
area is bordered by somatosensory, visual and auditory association areas. It receives nerve impulses from these areas
and from the primary gustatory area, primary olfactory area, the thalamus and parts of the brain stem. (Tortora &
Derrickson, 2006)

Neurotransmitters act as chemical messengers that serve as communication agents

between different neurons. Different neurotransmitters have different properties, and
these properties are explained in the following statements, except:

 None of the above The answer is none of the above. Aside from the aforementioned, other neurotransmitters
include epinephrine, which also has a role in the stress response; dopamine, which influences body movement, histamine,
which is released in response to an allergic reaction, acetylcholine, which is believed to be associated with muscle
activation, learning, and memory, Gamma-aminobutyric acid (GABA), a major inhibitory neurotransmitter, and glutamate,
which is an excitatory neurotransmitter and is the most abundant chemical messenger in the brain. (Brunner, 2009)

Spinal nerves and the nerves that branh from them are part of the peripheral nervous
system. They connect the CNS to the sensory receptors, muscles and glands in all
parts of the body. Which of the following statements is incorrect about spinal nerves?

 The 31 spinal nerves are further names and numbered according to region: There are 9
pairs cervical, 12 pairs thoracic, 3 pairs lumbar, 6 pairs sacral, and 1 pair coccygeal
nerves.  There are 31 spinal nerves, named and numbered according to the region and level of the spinal cord from
which they emerge. There are 8 cervical, 12 pairs thoracic, 5 pairs lumbar, 5 pairs sacral and 1 pair coccygeal nerves.
Spinal nerves are connected with the spinal cord by a posterior root and an anterior root. All spinal nerves contain both
sensory and motor axons (they are mixed nerves). (Tortora and Grabowski, 2004)

The impulses involved in sensations follow very precise pathways which consists of
several parts. This part detects changes and generate impulses

 Receptors Receptors detect stimuli and generate impulses. Sensory neurons transmit impulses from receptors to
the central nervous system. Sensory tracts consist of white matter in the spinal cord or brain that transmit the impulses to
a specific part of the brain. Sensory areas, which are mostly found in the cerebral cortex, interpret the sensations. (Davis,
2007)
The right and left halves of the cerebrum, called cerebral hemisphere, consist an outer
rim of gray matter, an internal region of white matter and gray matter deep within the
white matter. The following functions are performed by the left hemisphere except:

 Generating emotional content of language The left hemisphere receives somatic sensory signals from
and controls muscles on the right side of the body. The left hemisphere is responsible for reasoning, numerical and
scientific skills, ability to use and understand sign language and spoken and written language. The right hemisphere
receives somatic sensory from and controls muscles of the left side of the body. The right hemisphere functions in musical
and artistic awareness, space and pattern perception, recognition of faces and emotional content of facial expressions,
generating emotional content of language and identifying and discriminating among odors. (Tortora & Derrickson, 2006)

The brain stem is the part of the brain between the spinal cord and the diencephalon. It
consists of the (1) medulla oblongata, (2) pons, and (3) midbrain. Which part of the
brain stem is continuous with the superior part of the spinal cord and forms the inferior
part of the brain stem?\

 Medulla oblongata The medulla begins at the foramen magnum and extends to the inferior border of the pons.
The medulla’s white matter contains all sensory and motor tracts that extend between the spinal cord and other parts of
the brain. The medulla relays sensory input and motor output between other parts of the brain and the spinal cord. The
pons lies directly superior to the medulla and anterior to the cerebellum. It is a bridge that connects parts of the brain with
one another. The pons relays impulses from one side of the cerebellum to the other and between the medulla and
midbrain. The midbrain or mesencephalon extends from the pons to the diencephalon. The midbrain relays motor output
from the cerebral cortex to the pons and sensory input from the spinal cord to the thalamus. The reticular formation is the
broad region where white matter and gray matter exhibit a netlike arrangement. It extends from the upper part of the
spinal cord, throughout the brain stem, and into the lower part of the diencephalon. (Tortora & Derrickson, 2006)

Sensory receptors can be grouped based on the location of the receptors and the origin
of the stimuli that activate them. Proprioceptors:

 Provide information about body position  Proprioceptors are located in muscles, tendons, joints and the
inner ear. They provide information about body position, muscle length, and the position and movement of joints.
Exteroceptors are located at or near the external surface of the body; they are sensitive to stimuli originating outside the
body. Interoceptors are located in blood vessels, visceral organs, and the nervous system. They provide information about
the internal environment. (Tortora, 2006)

During physical or emotional stress, the sympathetic division dominates the

parasympathetic division. Which of the following responses does not occur during
sympathetic stimulation?

 Digestive secretions are increased  n response to stress, processes that are not essential for meeting the
stressful situation are inhibited. For example, muscular movements of the gastrointestinal tract and digestive secretions
slow down or even stop. Blood vessels that supply organs involved in exercise or fighting off danger dilate, and glycogen
is broken down to provide energy. (Tortora, 2006)

The ANS has two divisions: sympathetic and parasympathetic. The sympathetic division
is dominant in the following instances, except:

 None of the choices Stressful situations often involve the need for intense physical activity. The sympathetic
division is dominant in stressful situations, which include anger, fear or anxiety, as well as exercise. (Davis, 2007)
Sensations have certain characteristics that help one understand how sensory areas
work with information from receptors. This phenomenon is when the sensation seems to
come from the area where the receptors were stimulated

 Projection Projection is when the sensation seems to come from the area where the receptors were stimulated.
Intensity is when some sensations are felt more distinctly and to a greater degree than are others. After-image is when the
sensation remains in the consciousness even after the stimulus has stopped. Adaptation is becoming unaware of a
continuing stimulus. (Davis, 2007)

The neuroglia (glial cells) are specialized cells found only in the brain and spinal cord.
Which of the following statements least characterizes the function of the different kinds
of neuroglia?

 . Oligodendrocytes produce the myelin sheath to electrically insulate neurons of the

PNS.  Oligodendrocytes do produce myelin sheath; however, they are not present in the peripheral nervous system
as these specialized cells can only be found in the central nervous system (the brain and the spinal cord). (Brunner, 2009)