Nokea
The cervical sympathetic trunk
- A. Descends from the upper posterior triangle to the first rib
- B. Runs lateral to the vertebral artery
- C. Lies behind the carotid sheath
- D. Lies behind the prevertebral fascia
Correct Answer: B
Rationale: The cervical sympathetic trunk runs lateral to the vertebral artery and posterior to the carotid sheath. It contains ganglia that provide sympathetic innervation to the head and neck.
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Electrical stimulation of the reticular formation would most likely cause an animal to:
- A. sneeze
- B. become blind
- C. wake up if it had been sleeping
- D. stop breathing
Correct Answer: C
Rationale: The reticular formation is a network of neurons located in the brainstem that plays a key role in regulating arousal and consciousness. Electrical stimulation of this area can activate the ascending reticular activating system (ARAS), which promotes wakefulness and alertness. This is why stimulating the reticular formation would most likely cause a sleeping animal to wake up. The reticular formation also helps filter sensory information and maintain attention.
Millions of sensory receptors detect changes, called ________, which occur inside and outside the body.
- A. neuron
- B. skin
- C. motor
- D. stimuli
Correct Answer: D
Rationale: Sensory receptors detect changes, known as stimuli, which occur both inside and outside the body. These stimuli can include temperature, pressure, light, and chemical changes. Neurons are the cells that transmit these signals, while the skin is an organ that contains sensory receptors. Motor refers to the output of the nervous system, such as muscle movement. Stimuli is the correct answer as it refers to the changes detected by sensory receptors.
A 33-year-old female presents with drooping of her eyelid that seem to occur while reading or watching television. This appears to get worse later in the day. She also reports that at times she sees "double." A few weeks ago, she was prescribed an antibiotic medication for a urinary tract infection. She does not recall the name of the antibiotic. On physical exam, bilateral ptosis, with the left affected more than the right is seen. Pupillary function intact. A glove is filled with ice, and subsequently applied to the patient's eyelid. After two minutes, the patient's ptosis has improved. Which of the following is most likely to yield rapid symptom improvement?
- A. Corticosteroids
- B. Plasma exchange
- C. Acetylcholinesterase inhibitor
- D. Thymectomy
Correct Answer: C
Rationale: The patient's symptoms of ptosis and diplopia that worsen with activity and improve with rest are classic for myasthenia gravis. The ice pack test, which improves ptosis, further supports this diagnosis. Acetylcholinesterase inhibitors, such as pyridostigmine, are the first-line treatment for symptomatic improvement in myasthenia gravis. Corticosteroids and plasma exchange are used for long-term management or severe cases, while thymectomy is a surgical option for thymoma-associated myasthenia gravis.
Cerebellar function is assessed by which of the following tests?
- A. Muscle size and strength
- B. Cranial nerve examination
- C. Coordination - hop on one foot
- D. Spinothalamic tract
Correct Answer: C
Rationale: Cerebellar function is assessed by testing coordination, balance, and fine motor skills. Asking the patient to hop on one foot evaluates their balance and coordination, which are controlled by the cerebellum. Muscle size and strength, cranial nerve examination, and the spinothalamic tract are not specific to cerebellar function.
The following are neurotransmitters in the autonomic ganglia:
- A. GABA
- B. noradrenaline
- C. acetylcholine
- D. 5 HT
Correct Answer: C
Rationale: Acetylcholine is the primary neurotransmitter in autonomic ganglia, where it mediates synaptic transmission between pre- and post-ganglionic neurons. GABA, noradrenaline, and 5-HT are not involved in ganglionic transmission.