Guyton & Hall: Textbook of Medical Physiology, 11th Edition

UNIT XI: The Nervous System: C. Motor and Integrative Neurophysiology

MULTIPLE CHOICE

1. The neuronal circuits that induce movement are located in

a. The spinal cord and cerebellum
b. The motor cortex
c. The cerebellum
d. The spinal cord and are controlled by higher brain areas

ANS: D

2. The spinal cord is organized in the following way:

a. Sensory input arrives at the posterior root, and motor output leaves at the anterior
root.
b. Sensory input arrives at the anterior root, and motor output leaves at the posterior
root.
c. Interneurons are located at the anterior root.
d. Interneurons and motoneurons project from the anterior root.

ANS: A

3. A muscle spindle contains

a. A sensory neuron to detect stretch
b. A sensory neuron to detect stretch and a motoneuron to adjust the spindle length
c. Sensory neurons of different thickness to detect stretch and motoneurons of
different thickness to adjust the spindle length
d. Sensory neurons of different thickness to detect stretch and a fast motoneuron to
adjust the spindle length

ANS: C

4. Sensory neurons in the muscle spindle fire

a. In an all-or-nothing type of response
b. In a tonic, continuous way, enabling them to signal by reducing or increasing the
firing rate
c. Continuously and signal by slowly increasing the firing rate
d. By reducing firing rates quickly when stimulated

ANS: B

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5. The stretch reflex

a. Contains two parts: the fast, dynamic part and the slower, static part
b. Is fast and terminates quickly
c. Has a fast onset and continues for several seconds
d. Reduces muscle contractions when the muscle is suddenly shortened

ANS: A

6. During voluntary movements, the stretch reflex is

a. Actively inhibited by blocking signals from the muscle spindle sensory neurons
b. Passively active
c. Maintained at a lower level
d. Not triggered, because the alpha and gamma motoneurons are coactivated, keeping
the length of the receptor portion of the muscle spindle from changing

ANS: D

7. An increased reflex reaction can be an indication of

a. A good state of health
b. Reduced activity in the higher brain areas that have inhibitory activity on reflex
circuits in the spinal cord
c. A lack of exercise
d. An increase in signal conduction of the stretch receptor

ANS: B

8. A reduced reflex reaction can indicate

a. Reduced muscle strength
b. Reduced sensitivity of the stretch receptors
c. Signal conduction problems in the spinal cord
d. Overexcitation of the motor cortex

ANS: C

9. The flexor reflexes in the arm involve

a. The contraction of several muscle groups of one arm
b. The contraction of several muscle groups of both arms
c. Activation of the flexor muscles in two arms
d. Activation of one flexor muscle in the affected arm and the extensor muscle in the
other arm

ANS: A

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10. The crossed extensor reflexes in the arm involve

a. The contraction of several muscle groups of one arm
b. The contraction of several muscle groups of both arms
c. Activation of the flexor muscles in two arms
d. Activation of one flexor muscle in the affected arm and the extensor muscle in the
other arm

ANS: D

11. Postural and righting reflexes in animals involve

a. The contraction of several muscle groups of one leg
b. The contraction and extension of several legs, with signals traveling along several
spinal cord segments
c. Contralateral inhibition of opposite limbs
d. Synchronous activation of flexor muscles of limbs diagonally across the other side

ANS: B

12.The primary motor cortex

a.Represents the body parts topographically true to scale
b.Represents the muscle groups of the body true to scale
c.Represents the muscle groups in the body that can be controlled voluntarily and
not the body true to scale
d. Represents the number of motor programs stored for different body parts

ANS: C

13. The premotor area

a. Contains motor programs for different muscle groups in the body
b. Represents the muscle groups of the body true to scale
c. Activates muscles individually and directly
d. Contains spatiovisual information

ANS: A

14. Broca's area in the premotor area

a. Is involved in language and grammar analysis
b. Coordinates the pronunciation of words
c. Contains language programs
d. Contains motor programs for lip and tongue movements

ANS: B

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15.The corticospinal tract originates from

a.The motor cortex
b.The motor cortex and the premotor and supplementary motor areas
c.The motor cortex, the premotor and supplementary motor areas, and the
somatosensory areas
d. The somatosensory cortex

ANS: C

16. The corticospinal tract projects

a. Mainly to the putamen and caudatum
b. Mainly to the pontile nuclei, which project to the basal ganglia
c. Primarily onto interneurons in the spinal cord
d. Primarily to the motoneurons in the spinal cord

ANS: C

17. The rubrospinal system is functionally associated with

a. The corticospinal tract
b. The extrapyramidal system
c. The cerebellar motor projection
d. Somatosensory afferent connections

ANS: A

18. Somatosensory feedback to the motor cortex

a. Supports muscle activation by adding excitatory input
b. Helps control movements by reporting the actual location of limbs and contraction
of muscles
c. Helps control movements by inactivating reflex circuits
d. Inhibits motor activity as a safety feature

ANS: B

19. Damage to the motor cortex

a. Causes muscle tone increase
b. Causes muscle tone reduction
c. Has no effect on muscle tone
d. Causes spastic cramps

ANS: B

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20. The brain stem is involved in coordinating

a. Osmoregulation of the body
b. Cardiovascular and respiratory activity
c. Attention and association
d. Fight-flight reactions

ANS: B

21. The pontine reticular nuclei play a role in

a. Exciting the motor system and activating antigravity muscle action
b. Driving flexor reflexes
c. Inhibiting breathing responses
d. Inhibiting vestibular motor input

ANS: A

22. The medullary reticular system

a. Activates righting reflexes
b. Inhibits cardiovascular activation
c. Inhibits pontine reticular activation of the motor system
d. Controls the vestibular-acceleration sensory system

ANS: C

23. The vestibular apparatus consists of

a. The basal and tectorial membrane
b. The bony and membranous labyrinth
c. The utricle and saccule
d. The central crista ampullaris and the organ of macula

ANS: B

24. Rotational movements are detected by

a. The maculae
b. The utricle
c. The saccule
d. The semicircular canals

ANS: D

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25. Acceleration is detected by

a. The maculae
b. The cochlea
c. The ampullae
d. The semicircular canals

ANS: A

26. The statoconia of the macula

a. Inhibit rotational sensory input
b. Pull at the stereocilia during motion
c. Activate collateral inhibition
d. Keep the kinocilium upright

ANS: B

27.Directional information is obtained by

a.Hyperpolarization of the hair cell membrane of the saccule
b.Depolarization of the hair cell membrane
c.Hyperpolarization or depolarization of the hair cell membrane, depending on the
direction of movement
d. Rotation of the statoconia

ANS: C

28. The three semicircular canals are oriented

a. At 45 degrees to each other, with each in one of the three dimensions of space
b. At 90 degrees to each other, with each in one of the three dimensions of space
c. In linear connection to detect linear acceleration
d. In circular configuration to detect rotational movements

ANS: B

29. The utricle and saccule maculae

a. Detect constant linear speed
b. Detect linear acceleration
c. Detect linear acceleration and constant linear speed
d. Detect circular and linear speed

ANS: B

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30. Other factors that detect equilibrium include

a. Stretch receptors in neck muscles
b. Pressure receptors from feet and hands
c. Visual feedback
d. All of the above

ANS: D

31. Sensory information from the vestibular apparatus is sent to

a. The pontine nuclei of the cerebellum
b. The olive nucleus
c. The red vestibular nucleus
d. Four vestibular nuclei in the brain stem

ANS: D

32. Removal of the cerebellum causes

a. Sensory hallucinations
b. Inability to learn new motor tasks
c. Hyperactivity and muscle spasms
d. Fine motor control impairments

ANS: D

33. The cortical areas of the cerebellum consist of

a. The vermis, flocculonodular lobe, and the anterior and posterior lobes
b. The vermis and the dorsal and ventral lobes, including the intermediate lobes
c. The posterior lobe, the anterolateral lobe, and the dorsolateral lobe
d. The parietal lobes, the frontal lobes, and the dorsolateral lobes plus vermis

ANS: A

34. The main afferents of the cerebellum include

a.Olivocerebellar tract, basal ganglia pedicle, and reticular nuclei projections
b.Inferior olive projections, dorsal spinocerebellar tract, and pontocerebellar tract
c.Dorsal and ventral spinocerebellar tract, ventral spinocerebellar tract, and
pontocerebellar tract
d. Corticospinal tract, dorsal spinocerebellar tract, and pontocerebellar tract

ANS: C

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35.The function of the cerebellum is mainly

a.As a main motor output structure
b.As an associate motor output structure in combination with the motor cortex
c.As a sensory input processing station that modulates and refines motor output from
other structures
d. As a motor output processing station that additionally modulates and refines motor
output from other structures

ANS: C

36. Purkinje cells and deep nuclear cells are

a. Directly connected, with Purkinje cells receiving input from the deep nuclear cells
b. Are indirectly connected by climbing fibers
c. Directly connected, with Purkinje cells projecting onto deep nuclear cells
d. Are indirectly connected by interneurons

ANS: C

37. To achieve precise timing of motor movement, the

a. Mossy fibers input to the deep nuclear cells activates fast positive feedback from
the cerebellum to the motor areas and slow negative feedback through the Purkinje
cells to deep nuclear cells
b. Parallel fibers input to the deep nuclear cells activates fast positive feedback from
the cerebellum to the motor areas and slow negative feedback through the mossy
fiber cells to deep nuclear cells
c. Mossy fibers input to the deep nuclear cells activates fast negative feedback from
the cerebellum to the motor areas and slow negative feedback through the Purkinje
cells to basal ganglia
d. Purkinje cell input to the deep nuclear cells activates fast positive feedback from
the cerebellum to the motor areas and slow negative feedback through the deep
nuclear cells

ANS: A

38. The cerebellum can be functionally divided into three parts:

a. The somatosensory part, the cerebrocerebellum, and spinocerebellum
b. The cerebrocerebellum, vestibulocerebellum, and spinocerebellum
c. The flocculocerebellum, cerebrocerebellum, and spinocerebellum
d. The vestibular, somatosensory, and motor part

ANS: B

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39. Clinical abnormalities of the cerebellum cause

a. Ataxia (i.e., overshooting of movements)
b. Akinesia (i.e., inability to initiate motor activity)
c. Dystonia (i.e., muscle tone is too strong on the ipsilateral side of the body)
d. Dyskinesia (i.e., activation of inappropriate motor programs)

ANS: A

40. The basal ganglia receive most of their input from the
a. Nucleus ruber
b. Cerebellum
c. Pontine nuclei
d. Neocortex

ANS: D

41. The neural pathways of the putamen circuit include

a. The motor cortex, the basal ganglia, and thalamic motor nuclei
b. The motor cortex, the substantia nigra, the cerebellum, and the basal ganglia
c. The nucleus ruber, the substantia nigra, the motor cortex, and the basal ganglia
d. The substantia nigra, the basal ganglia, the cerebellum, and the inferior olive
nucleus

ANS: B

42. Damage to the putamen circuit can produce

a.Spontaneous bursts of movements, akinesia, or hemiballism
b.Akinesia, tremor, and nystagmus
c.Failure to initiate motor activities or failure to put spoken words in proper
sequences
d. Impairment in timing and sequence precision of motor activity

ANS: A

43. The caudate circuit is involved in

a. Somatosensory input analysis
b. Cognitive control of motor activity
c. Integration of balance information to motor program planning
d. Fine tuning the precise timing and sequences of motor sensory programs

ANS: B

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44. The left parietal cortex is involved in

a. Motor sequence planning
b. Muscle strength scaling
c. The spatial coordination of movements
d. Coordination of several limbs in movements

ANS: C

45. The main neurotransmitters involved in basal gangliasubstantia nigra

communication are
a. Glutamate and acetylcholine
b. Acetylcholine and GABA
c. Dopamine and glutamate
d. Dopamine and GABA

ANS: D

46. Patients with Parkinson's disease are treated with

a. Dopamine and L-deprenyl
b. L-dopa and L -deprenyl
c. Dopamine and L-dopa
d. Surgical lesions of the lateral reticular formation

ANS: B

47. The main cell types of the cerebral cortex are

a. Granular neurons, fusiform and pyramidal neurons, and mossy fiber cells
b. Purkinje, mossy fiber, and fusiform cells
c. Pyramidal, fusiform, and cubicle cells
d. Granular, fusiform, and pyramidal cells

ANS: D

48. The neocortex can be divided into several functional sections:

a. The prefrontal section (motor planning), the parietal section (spatial coordinates),
the temporal section (sound, vision)
b. The prefrontal section (planning and management), the parietal section (spatial
coordinates), the occipital section (sound and taste), and the temporal section
(emotions)
c. The prefrontal section (planning and management), the parietal section (spatial
coordinates), the occipital section (vision), and the temporal section (vision,
hearing)
d. The prefrontal section (motor planning), the parietal section (vision and sound
coordinates), the occipital section (sound and vision), and the temporal section
(emotions, memory)

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ANS: C

49. The parieto-occipitotemporal association area is involved in

a. Analysis of spatial coordinates of the body and movements, language
comprehension, object identification, and reading
b. Analysis of spatial coordinates of vision, language comprehension, object
identification, and planning of actions
c. Analysis of motor coordinates, language comprehension, object identification,
word recognition, and sound analysis
d. Analysis of spatial coordinates of the body and movements, object identification,
reading, writing, and motor program execution

ANS: A

50. Damage to the Wernicke association area can cause

a. Inability to speak words correctly
b. Impairments in recognizing words
c. Problems recognizing people
d. Impairments in identifying objects

ANS: B

51. The prefrontal association area is involved in

a. Planning complex sequential tasks to reach a goal
b. Planning complex motor programs
c. Associating sound with word meaning
d. Coordinating the proper pronunciation of words

ANS: A

52. Possible language impairments are

a. Receptive aphasia
b. Apraxia
c. Dyspnea
d. Dystonia

ANS: A

53. The corpus callosum

a. Is part of the anterior commissure
b. Contains bidirectional connections between the neocortex
c. Is damaged in schizophrenic patients
d. Conveys language information to the Broca area

ANS: B

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54. Mechanisms to store memory include

a. Formation of new fiber projections
b. Synthesis of memory specific proteins
c. Activation of memory areas in the cortex
d. Changes in synaptic transmission between neurons

ANS: D

55. Classification of memories include

a. Sensory memory
b. Spatial working memory
c. Short-term motor memory
d. All of the above

ANS: D

56. Habituation is
a. Caused by fatigue of neuronal firing
b. Induced by negative stimuli
c. A form of memory
d. A common problem in neurotransmission

ANS: C

57. Changes in neurotransmission during learning include

a. Increase of vesicle release
b. Increase of neurotransmitter release
c. Growth in multiplication of synaptic connections
d. All of the above

ANS: D

58. Consolidation of memory

a. Is instantaneous
b. Takes at least 1 hour
c. Takes a lifetime
d. Is not necessary

ANS: B

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59. Hippocampal lesions affect

a. Anterograde declarative memory
b. Motor learning
c. Memory of events in the distant past
d. All of the above

ANS: A

60. The reticular area in the brain stem is important for

a. Sensory input gating
b. Motor output control
c. General arousal of cortical cerebral activity
d. Day and night rhythm

ANS: C

61. Projections from the cortex to the brain stem nuclei

a. Control arousal by negative or positive feedback
b. Convey sensory information to the basal brain
c. Establish memory loops in the brain
d. Inhibit the activity of the medulla and pons

ANS: A

62. The thalamus is

a. Part of the general arousal system
b. Involved in inhibiting cortical activity
c. Involved in sensory input modulation to the basal brain
d. Connected to all parts of the neocortex by specialized nuclei

ANS: D

63. Inhibitory reticular brain stem areas use the neurotransmitter

a. Acetylcholine
b. Dopamine
c. Serotonin
d. GABA

ANS: C

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64. Four main projection systems exist that control brain activity. They use which
neurohormones?
a. Dopamine, serotonin, acetylcholine, and endorphin
b. Glutamate, serotonin, GABA, and dopamine
c. Acetylcholine, epinephrine, dopamine, and GABA
d. Norepinephrine, dopamine, serotonin, and acetylcholine

ANS: D

65. Which group of nuclei in the basal brain use serotonin?

a. The reticular excitatory area
b. The substantia nigra
c. The raphe nuclei
d. The locus ceruleus

ANS: C

66. Which group of nuclei in the basal brain use acetylcholine?

a. The substantia nigra
b. The reticular excitatory area
c. The raphe nuclei
d. The locus ceruleus

ANS: B

67. The limbic system is involved in

a. Somatosensory control
b. Sensory input modulation
c. Controlling body functions and vegetative functions
d. Memory storage

ANS: C

68. The hypothalamus controls

a. Hunger and thirst sensation
b. Breathing and oxygen levels
c. Heartbeat and rhythm
d. All of the above

ANS: A

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69. Stimulation of the lateral hypothalamus can induce

a. Fear and defense reactions
b. Satiety feeling and inactivity
c. Thirst and hunger, rage, and aggression
d. None of the above

ANS: C

70. Reward centers exist in the hypothalamus

a. That can be stimulated through the anterior commissure
b. That can be found near the periventricular gray
c. That travel anteriorly to the preoptic nucleus
d. That can be stimulated through the medial forebrain bundle

ANS: D

71. Punishment centers can be found in

a. The ventromedial nucleus and surrounding areas
b. The central gray area of the mesencephalon and the periventricular zones
c. The posterior preoptic areas
d. The central reticular nucleus

ANS: B

72. The hippocampus is involved in

a. Behavioral patterns and emotions such as pleasure, rage, and anxiety
b. Consolidation of long-term memory
c. Intermediate or working memory
d. All of the above

ANS: D

73. The amygdala is involved in

a. Behavioral patterns and emotions that increase heart rate, such as rage, anxiety,
and pain
b. Stimulating reward centers
c. Associating declarative memory with motor activity
d. Controlling limbic system arousal

ANS: A

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74. Sleep is defined as

a. A time of rest
b. A state of unconsciousness from which the person can be aroused
c. A state of unconsciousness
d. A state of unconsciousness and of dreaming

ANS: B

75. Slow-wave sleep is a state of

a. Coma
b. Dreaming
c. Mostly dreamless sleep
d. Restless sleep with many body turns in the night

ANS: C

76. In rapid eye movement (REM) sleep, movement is

a. Greatly reduced, with slow breathing patterns
b. Not affected
c. Reduced, with irregular breathing patterns
d. Increased, with irregular breathing patterns

ANS: C

77. In REM sleep, muscle activity is

a. Less depressed than in slow-wave sleep
b. More depressed to avoid stronger movements
c. Less depressed than in slow-wave sleep, with slower breathing rhythms
d. Not directly affected

ANS: B

78. Sleep is an active process controlled by

a. Most basal brain nuclei
b. The substantia nigra
c. The nucleus reticularis
d. The raphe nuclei

ANS: D

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79. The wake-sleep cycle is controlled by

a. The suprachiasmatic nuclei
b. Pacemaker nuclei in the hypothalamus
c. Circadian rhythms originating in oscillating networks in the hypothalamus
d. All of the above, but not described in this textbook

ANS: D

80. Brain activity can be recorded from outside the skull as

a. Action potentials
b. Ion channel activity
c. Field potential oscillations as recorded in the electroencephalogram (EEG)
d. Membrane hyperpolarizations

ANS: C

81. Amplitudes of EEG oscillations are usually around

a. 2 millivolts
b. 200 microvolt
c. 26 volts
d. 200 millivolts

ANS: D

82. Alpha waves are

a. In the 8 to 13 cycles per second range and occur during quiet, awake states
b. In the 20 to 80 cycles per second range and occur during sleep
c. In the 14 to 80 cycles per second range and occur during quiet, awake states
d. In the 20 to 80 cycles per second range and occur during states of high mental
activity

ANS: A

83. Beta waves are

a. In the 8 to 13 cycles per second range and occur during quiet, awake states
b. In the 20 to 80 cycles per second range and occur during sleep
c. In the 20 to 80 cycles per second range and occur during quiet, awake states
d. In the 14 to 80 cycles per second range and occur during states of high mental
activity

ANS: D

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84. During active mental states, EEG oscillations

a. Develop increased amplitudes
b. Show increased frequencies
c. Show decreased amplitudes and more desynchronization
d. Show stronger oscillations

ANS: C

85. During epilepsy, the EEG oscillations become

a. Desynchronized
b. More synchronized at high amplitudes
c. More synchronized with lower amplitudes
d. Reduced in frequencies

ANS: B

86. A petit mal epilepsy sequence

a. Lasts for about 3 to 30 seconds
b. Lasts for 3 to 30 minutes
c. Shows normal EEG oscillations
d. Can be detected by desynchronized, high-frequency EEG oscillations

ANS: A

87. The main neurotransmitter systems involved in depression are

a. Acetylcholine and dopamine
b. Norepinephrine and serotonin
c. GABA and dopamine
d. Dopamine and epinephrine

ANS: B

88. The main neurotransmitter system involved in schizophrenia is

a. Acetylcholine
b. Serotonin
c. Dopamine
d. Epinephrine

ANS: C

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