Anatomic Sciences 159-230 (endocrine s nervous system).txt

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  1. The pituitary gland is composed of two distinct tissue types. these tissue types have their embryonic origin in what layer(s)?

    - Ectoderm
    - Mesoderm
    - Endoderm
    - Ectoderm and mesoderm
    - Ectoderm and endoderm
    - All of the above
    • Ectoderm
    • Pituitary gland (hypophysis) is the size of a pea and rests in the sella turcica (a depression in the sphenoidal bone at the base of the brain)
    • The pituitary gland is referred to as the master endocrine gland because it controls many other glands through the action of tropic hormones, that affect the activity of other endocrine glands.
    • Develops from an upgrowth from the ectoderm of the stomodeum and a downgrowth from the neuroectoderm of the diencephalon (upgrowth from the roof of the mouth and downgrowth from the floor of the brain)
    • The double origin explains two types of tissue: adenohypohysis (glandular portion from the oral ectoderm) and the neurohypophysis (nervous portion from the neuroectoderm)
    • Develops from a diverticulum called Rathke's pouch at three weeks of developmental
  2. Diabetes insipidus is characterized by the secretion of large amounts of dilute urine because of a deficiency in antidiuretic hormone (ADH). ADH is secreted from the:

    - Anterior pituitary
    - posterior pituitary
    - Adrenal medulla
    - Adrenal cortex
    - Thyroid
    • Posterior pituitary
    • The anterior pituitary produces at least six hormones
    • Growth Hormone, Prolactin from Acidophil cell general and skeletal growth, milk production.
    • Basophils: FSH (follice), LH (luteinizing), ACTH (corticotropin), TSH (thyroid).
    • Posterior pituitary: makes up about 25% of the gland, storage area for ADH and Oxytocin which is produced in the hypothalamus.
  3. Which of the following could result from the excision of the parathyroid glands?

    - Strengthening of muscles
    - Weakening of bones
    - Muscle convulsions
    - Decalcification of bones
    • Muscle convulsions
    • Deficiency of PTH can lead to tetany, muscle weakness due to lack of available calcium in the blood.
    • Each Parathyroid gland has a fibrous tissue capsule and two types of cells:
    • Chief cells - produce PTH, which acts to raise the concentration of calcium in the blood and reduce the concentration of phosphate ions.
    • Oxyphil cells - function is undetermined.
    • PT Gland receives postganglionic sympathetic fibers of the superior cervical ganglion. Blood supply from superior and inferior thyroid arteries respectively. 
    • Tiny pineal gland lies in the back of the 3rd ventricle of the brain. This gland produces melatonin, hormone that plays a role in circadian rhythms, body temperature and appetite.
  4. The innervation to the parotid gland and its sheath comes from all of the following EXCEPT:

    - Auriculotemporal nerve
    - Great auricular nerve
    - Buccal nerve
    - Glossopharyngeal nerve
    • Buccal nerve
    • Although the terminal branches of the facial nerve pass through the parotid, they do NOT participate in its innervation.
    • The parotid sheath and overlying skin are innervated by the auriculotemporal nerve and the great auricular nerve (C2 and C3)
    • Parasympathetic secretomotor fibers from the inferior salivary nucleus of the glossopharyngeal nerve supply the patorid.
  5. The part of the salivary gland destined to become responsible for its functioning is called the:

    - Nephron
    - Follicle
    - Adenomere
    - Lobule
    • Adenomere, the functional part of the salivary gland.
    • Glands consist of: Lobes, Lobules, Adenomeres (secretory subunits of lobules, all the secretory cells) Acini (smaller secretory subunits)
    • Adenomere: Intercalated ducts (transport saliva to larger ducts), Striated ducts (mitochondria, electrolyte and water), glandular cells (synthesize glycoproteins)
    • Major salivary glands: Parotid (purely serous), Submandibular (mixed), sublingual (mixed, mucous predominates)
    • Minor salivary glands: Lips, cheek, Tongue (von ebner's glands on circumvallate papilla), Hard palate.
  6. Secretion of excessive catecholamines is located on which endocrine gland?

    - Anterior pituitary
    - Pancreatic islets (Langerhans)
    - Adrenal medulla
    - Parathyroids
    - Adrenal cortex
    • Adrenal medulla
    • Catecholamines in the body are: Epinephrine, Norepinephrine and Dopamine.
    • Two adrenal glands
    • Adrenal cortex (produces 3 main types of hormones): Glucocorticoids (produced and released under ACTH adrenocorticotropic hormone from anterior pituitary metabolism of fat, proteins and sugars. Mineralocorticoids (enhance sodium reabsorption in the collecting duct of kidneys). Sex steroids.
    • Adrenal medulla: produces epinephrine and norepinephrine (raise blood sugar level, blood pressure, breathing)
    • The adrenal medulla develops from the neuroectoderm while the adrenal cortex from the mesoderm.
  7. The portion of the pituitary gland that does not arise from the hypothalamus is the:

    - Neurohypophysis
    - Pars nervosa
    - Adenohypophysis
    - Infundibulum
    • Adenohypophysis
    • The posterior lobe (neurohypothysis, pars nervosa), the infundibulum and pituitary stalk all arise from the hypothalamus.
    • The anterior lobe (adenohypophysis) is formed from an invagination of the pharyngeal epithelium Rathke's pouch
    • Posterior pituitary is not really an organ but an extension of the hypothalamus. It also forms the so-called pituitary stalk.
  8. Exocrine glands include all of the following EXCEPT one?

    - Sweat glands
    - Prostate gland
    - Bile producing glands of the liver
    - Pituitary gland
    - Lacrimal glands
    - Gastric glands
    • Pituitary gland
    • Exocrine glands are glands whose secretions ultimately lead to a system that leads to the exterior of the body
    • Can be classified by the mode of secretion: Merocrine, Apocrine and Holocrine.
    • By type of secretion: Mucous, serous and mixed.
  9. A patient with a history of hypertension and insulin resistance as a result of increased cortisol from Cushing's syndrome. Which anterior pituitary hormone controls the production and secretion of glucocorticoids such as cortisol?

    - Follicle-stimulating hormone (FSH)
    - Lutenizing hormone (LH)
    - Adrenocorticotropic hormone (ACTH)
    - Thyroid-stimulating hormone (TSH)
    • Adrenocorticotropic hormone (ACTH), as the name implies stimulates the adrenal cortex secreting glucocorticoids such as cortisol and little control over secretion of aldosterone (the other major hormone from the adrenal cortex)
    • ACTH is secreted from the anterior pituitary in response to corticotropin-releasing hormone from the hypothalamus (secreted in response to many types of stress).
    • Other anterior pituitary hormones: TSH, Lutenizing hormone, FSH.
  10. A pancreatic cancer patient has a tumor that presses on the ampulla of Vater. This has been causing him GI problems because the tumor obstructs the common bile duct and the main excretory duct of the pancreas known as:

    - Wharton's duct
    - the duct of Wirsung
    - Bartholin's duct
    - Wolffian duct
    • The duct of Wirsung: THe main pancreatic duct begins at the tail and joins the common bile duct to form the hepatopancreatic ampulla (ampulla of Vater) before opening into the duodenum. The ampulla discharges bile and enzymatic products into the descending portion (second part) of the duodenum.
    • The other accessory pancreatic duct (Santorini's duct), when present opens separately into the duodenum.
    • The endocrine function of the pancreas is concerned with both foodstuff during fasting and foodstuff storage after meals by using glucagon and insulin respectively. Inside the islets of Langerhans the alpha cells secrete glucagon (elevates blood sugar) while the beta cells secrete insulin (metabolize fats, carbs and AA), delta cells secrete somatostatin, which inhibits the release of both glucagon and insulin.
  11. Which of the following salivary glands creates the depression in bone that radiographically gives a radiolucency inferior to the mandibular canal?

    - Sublingual gland
    - Von Ebner's glands
    - Submandibular gland
    - Parotid gland
    • - Submandibular gland: weighs half of the parotid, lies in the submandibular triangle (formed by anterior and posterior bellies of digastric muscle and inferior margin of the mandible. Secretions are mostly serous with some mucous.
    • - Marginal mandibular branch of the facial nerve courses the superficial to the submandibular gland and deep to the platysma.
    • - Submandibular duct is Whartons duct (the lingual nerve wraps around, while the hypoglossal nerve parralells), Sublingual duct is Bartholin's duct.
    • - Blood supply: from the facial and lingual arteries.
  12. The major gland(s) of the immune system is:

    - The thyroid gland
    - The adrenal glands
    - The pineal gland
    - The thymus gland
    • The thymus gland, is a prominent feature of the superior mediastinum during infancy and childhood. It plays an important role in development and maintenance of the immune system. It is eventually replaced by adipose tissue and barely recognizable but continues to produce T lymphocytes.
    • Thymus has no afferent lymphatics or lymphatic nodules.
    • Has a double embryological origin, mesenchyme and endoderm. Innervated by the vagus nerve.
  13. An aggressive duodenal ulcer has the potential to perforate the small intestine and involve other organs. A posteriorly penetrating ulcer has the potential to adhere to this organ, which is both an exocrine and endocrine organ.

    - Spleen
    - Pancreas
    - Kidney
    - Gallbladder
    • Pancreas, is a retroperitoneal organ, posterior to the stomach.
    • Endocrine portion (islets of Langerhans):
    • Alpha cells - glucagon, counters insulin
    • Beta cells - insulin - helps carb metabolism
    • Delta cells - secrete somatostatin depresses both glucagon and insulin.
    • Exocrine portion:
    • Acinar cells - filled with secretory granules containing digestive enzymes
    • * Pancreatic secretions contain bicarbonate ions and are alkaline to neutralize the acidic chyme the stomach churns out.
  14. The pterygopalatine ganglion contains preganglionic parasympathetic axons from which cranial nerve?

    - Oculomotor
    - Facial
    - Trigeminal
    - Glossopharyngeal
    - Vagus
    • Facial
    • These four paired ganglia supply all parasympathetic innervation to the head and neck:
    • Ciliary ganglion
    • pterygopalatine ganglion
    • Submandibular ganglion
    • Otic ganglion
  15. Mature lymphocytes constantly travel through the blood to the lymphoid organs and then back to the blood. This constant re-circulation insures that the body is continuously monitored for invading substances. The major areas of antigen contact and lymphocyte activation are the secondary lymphoid organs. These include all of the following EXCEPT?
    • Thymus gland (is actually a primary lymph organ) consists of two lobes and a thin layer of connective tissue. Located deep to the sternum (superior mediastinum). Consists of an outer cortex (primarily lymphocytes and an inner medulla with lymphocytes and Hassall's corpuscles)
    • Primary function is processing and maturation of T lymphocytes (T cells). Also produces a hormone called "thymosin" that stimulates the maturation of lymphocytes in other secondary lymphatic organs.
    • Also produces the hormone thymic lymphopoietic factor (TFL) that enduces lymphopoiesis
    • MALT ranges from loose clusters of lymphoid cells in the intestinal lamina propia to more complex organizations as in the Peyer's patches, tonsils and appendix.
  16. All of the following contain mucus-secreting cells EXCEPT:

    - Submandibular glands
    - Sublingual glands
    - Parotid glands
    - Glands of the esophagus
    - Mucosa of the trachea
    • Parotid glands (completely serous) SERIOUS
    • All salivary glands are composed of epithelium (produce saliva) and connective tissue (supports the gland).
    • Epithelial cells that produce saliva are secretory cells. They are either Mucus or Serous and are found in a group or acinus/acini (resemble grapes, cuboidal cells). Acini come in 3 forms; Serous, Mucous or Mixed.
  17. The thyroid gland can be examined in which of the following triangles of the neck?

    - Submental
    - Glandular
    - Carotid
    - Submandibular (digastric)
    - Muscular (visceral)
    • Muscular (visceral)
    • The neck is arbitrarily divided into two triangles by the sternocleidomastoid (anterior and posterior triangles).
    • Anterior: divided into submental, submandibular, muscular (visceral) or carotid triangles
    • Posterior: occipital and supraclavicular
    • Thyroid is the largest of the endocrine glands, H-shaped, joined together by a thin band called isthmus, located at the upper part of the trachea joined to the larynx.
    • Thyroid epithelial cells make Thyroid hormone, arranged in spheres called follicles that contain colloid (contain T3 and T4, aka thyroid hormones)
    • Thyroid hormone is under the control of TSH from the anterior pituitary.
    • * In spaces between the thyroid follicles are the parafollicular or C cells, that secrete calcitonin (reduces blood calcium, the opposite effect of PTH)
  18. Hospital tests on a patient identify a tumor in the hypophysis that is excessively secreting growth hormone. Given that the patient is a 4yo male, what is the expected outcome if no treatment is performed?

    - Pituitary giantism
    - Acromegaly
    - Pituitary dwarfism
    - Achondroplasia
    • Pituitary giantism: tumor prior to adolescence, excessive GH delays ossification of epiphyseal cartilage (non fusion of epiphysis)
    • Acromegaly: tumor after adolescence, excess GH secreted after epiphyseal cartilages have been replaced by bone (fusion of epiphysis)
    • Pituitary dwarf: GH deficiency resulting in early replacement of epiphyseal cartilages by bone.
    • * Deciding factor between whether acromegaly or Pituitary giantism will occur is if the epiphyses of long bones have been fused or not.
  19. In which zone of the adrenal gland are the mineralcorticoids secreted from?

    - Medulla
    - zona glorumerulosa
    - zona fasciculata
    - zona reticularis
    • Zona glorumerulosa, 
    • Adrenal cortex is formed by
    • Zona glorumerulosa: thin layer of cells beneath connective tissue, cells secrete mineralocorticoids mainly aldosterone which involved in the maintenance of electrolyte and water balance.
    • Zona fasciculata: thick layer, secretes glucocorticoids (primarily cortisol) and small amounts of estrogenic and androgenic subtances.
    • Zona reticularis: inner layer of the cortex, secretes small amounts of cortisol and weak androgens.
    • * The medulla is a modified nervous tissue and functions similar to postganglionic sympathetic cells. Stimulation causes release of large quantities of epinephrine and norepinephrine.
  20. Meibomian glands (or tarsal glands) are sebaceous glands located at the rim of the eyelid that function to protect the eyes from drying out. Meibomian glands, which release the entire secretory cell with the sebum secretion, are this type of gland.

    - Merocrine
    - Apocrine
    - Holocrine
    • Holocrine: acumulate their secretions in each cells cytoplasm and release the whole cell into the duct, this destroys the cell and is replaced by a new cell (sebaceous glands of the skin)
    • Apocrine: secretions accumulate in one part of the cell (the apex) and that part breaks off along with some cytoplasm (mammary glands, certain sweat glands)
    • Merocrine: glands that produce their secretion and release them into the duct, no damage is done to the cell (salivary and pancreatic glands, some sweat glands)
    • Endocrine glands: secrete their products into the interstitial fluid to be diffused into capillaries and carried away by blood.
    • Parotid gland and von Ebner's glands are the only adult glands that are purely serous.
  21. Which salivary gland can have either numerous small ducts that open onto the floor of the mouth or a single main excretory duct (Bartholin's duct) that empties at the sublingual caruncle?

    - Submandibular gland
    - Parotid gland
    - Sublingual gland
    • Sublingual gland, smallest of the three main salivary glands, contains both serous and mucous acini. Sits on the mylohyoid muscle and can drain through approximately 12-20 small ducts (Rivinus ducts).
    • Sublingual gland is innervated by the parasympathetic secretomotor fibers from the nucleus of the facial nerve, the fibers pass through the submandibular ganglion via the chorda tympani and the lingual nerve.
    • Irrigation from the lingual artery and the submental branch of the facial.
  22. Which portal venous system is critical for proper endocrine function?

    - Hypophyseal
    - Renal
    - Hepatic
    Hypophyseal, blood supply to the pituitary gland is from right and left superior hypophyseal arteries and from the right and left inferior hypophyseal arteries (branches of the internal carotid)
  23. A pathologist recieves a salivary tissue biospy of what the dentist believes is a pleomorphic adenoma. However, the dentist forgot to mention the site of the biopsy. The pathologist identifies certain histological structures that would indicate that this sample is not from the parotid gland. What structures can be seen in histologic examination of the submandibular and sublingual glands but not in the adult parotid gland?

    - Myoepithelial cells
    - Serous cells
    - Intercalated ducts
    - Serous demilunes
    - Striated ducts
    • Serous demilunes, the mucous cells form tubules, but their ends are capped by serous cells that secrete between the mucous cells' intercellular space. These serous caps on mucous cells are called serous demilunes.
    • Aprroximately 10% of submandibular glands contain serous demilunes
    • Serous demilunes are prominent on sublingual glands because of its predominant mucous cell population.
    • All of the major salivary glands are classified as compound tubuloalveolar glands, this means that their ducts branch repeatedly and their secretory portions are composed of small sacs called alveoli or acini.
  24. Follicular colloid is a protein substance that stores:

    - Thyroglobulin
    - Triiodothyronine
    - Thryotropin
    - Thyroxine
    • Thyroglobulin
    • Colloid is composed of thyroglobulin and iodine and is the storage form of thyroid hormones T3 and T4. When the pituitary gland secretes thyrotropin (TSH), the colloid becomes active and the thyroglobulin molecules are broken down into thyroid hormones.
  25. After being seen by a neurologist, a patient is diagnosed with a pituitary adenoma. As the neoplasm increases in size, it will most likely affect which cranial nerve?

    - CN I
    - CN II
    - CN III
    - CN IV
    • CN II
    • Blood supply is from the right and left superior hypophyseal arteries and from the right and left inferior hypophyseal arteries, which are branches of the interal carotid artery (these all form the rich hypophyseal system)
  26. Oxytocin and vasopressin are synthesized in the hypothalamus and are transported to the pituitary gland for storage by way of:

    - Myelinated nerve fibers
    - Both myelinated and unmyelinated nerve fibers
    - Unmyelinated nerve fibers
    • Unmyelinated nerve fibers, as opposed to the anterior lobe (adenohypophysis), which presents epithelial characteristics, the posterior lobe (neurohypophysis) consists of about 100,000 unmyelinated axons of secretory nerve cells (housed in the supraoptic and paraventricular nuclei of the hypothalamus).
    • Oxytocin and ADH are transported down axons and stored in axon terminals, known as Herring bodies, in the neurohypophysis.
    • Oxytocin and ADH (vasopressin) are synthesized in the hypothalamus and stored in and released by the neurohypophysis (pars nervosa or posterior pituitary it is an extension of the hypothalamus).
  27. A fighter pilot in WWII gets shot down during a mission. Miraculously, he survives but arrives at the hospital unable to perform fine motor movements such as writing his name or buttoning his shirt. Which descending tract of the spinal cord would be damaged in this case?

    - Corticospinal tract
    - Rubrospinal tract
    - Vestibulospinal tract
    - Reticulospinal tract
    • Corticospinal tract
    • Tracts descending to the spinal cord are concerned with voluntary motor function, muscle tone, reflexes and equilibrium. Regarded as the most important tract concerned with skilled voluntary activity, the corticospinal tract originates from pyramid shared cells.
  28. A 56yo male patient with type II diabetes comes into the emergency room with a painful blistering skin rash localized over the left side of his forehead. The unilateral nature indicated a herpes zoster infection. The localized area of skin with sensory innervation from a single nerve root of the spinal cord is called what?

    - Fasciculus
    - Dermatome
    - Spindle
    - Bundle
    • Dermatomes, are the areas of the skin supplied by a single spinal nerve, however there is usually some overlap between adjacent dermatomes.
    • Spinal nerve C1, does not play a role in dermatomes.
    • Peripheral nerve innervation of the skin usually forms a different pattern from spinal nerve skin innervation (dermatome) because the ventral primary divisions of spinal nerves from plexusesThe pattern of distribution of the peripheral nerve is different from the dermatome pattern.
    • Cranial nerve patterns DO NOT overlap, whereas spinal nerve dermatomes overlap eachother by 50%, as insurance against anesthesia of a dermatome. The loss of the overlap requires the loss of innervation to three adjacent dermatomes to produce anesthesia in the middle dermatome (to anesthetize T5, you need to anesthesize T4, T5 and T6)
    • The brain is poor at determining visceral pain and instead interprets it as pain from the somatic area of the dermatome (pain in the heart is perceived as pain in left arm or shoulder)
  29. Which cerebral lobe is the visual processing center of the human brain?

    - Parietal
    - Occipital
    - Temporal
    - Frontal love
    • Occipital
    • The cerebral cortex (extensive layer of gray matter of the cerebral hemispheres) is associated with thought and action. It is divided into lobes.
    • Frontal lobe: Reasoning, motor skills, expressive language, high-level cognition
    • Parietal lobe: Tactile sensory information, pressure touch and pain
    • Occipital: primary visual area
    • Temporal lobe: primary auditory cortex and olphactory area
    • Hippocampus: associated with the formation of memories
    • Limbic system: primitive brain, emotional is buried within the cerebrum.
  30. Which structural component of a neuron sends impulses away from the cell body?

    - Neuroglial cell
    - Perikaryon
    - Dendrite
    - Axon
    • Axon
    • Nervous tissue is composed of two types of cells:
    • Neurons: transmit nerve impulses
    • Neuroglial cells (glial cells): non-conducting support cells of nervous tissue (astrocytes, microglial cells, etc..)
    • Structure of a neuron:
    • Cell body (perikaryon): contains the nucleus and most of the cytoplasm. Located mostly in the central nervous system as clusters called nuclei.
    • Dendrites: neural processes that send impulse toward the body.
    • Axon (nerve fiber): neural processes that send impulses away from the cell
    • If the axon is covered by fatty substance called myelin, it is referred to as myelinated fiber. If there is no myelinated cover, it is unmyelinated fiber.
    • Neurons can also be classified by structure: bipolar, unipolar and multipolar (most common)
    • Also classified by functionmotor (efferent), sensory (afferent) or interneurons (lie between sensory and motor neurons in the CNS)
  31. A 14 year old presents to the physician with hyperpigmented lesions (cafe-au-lait spots), hamartomas of the iris (Lisch nodules), and axiliary freckling (Crowe's sign). The patient had previously been diagnosed with neurofibromatosis, but is now complaining of generalized pain and tingling. The physician discovers multiple neurolemmomas, classifying the disease as a form of neurofibromatosis. Neurilemmomas are a neoplasm of myelin producing cells in the peripheral nervous system known as.

    - Astrocye
    - Oligodendrocyte
    - Schwann cell
    - Microglial cell
    - Satellite cell
    • Schwann cell (also called neurolemmocyte or neurolemma cell). In the PNS they serve as supportive, nutritive and service facilities for neurons. Gaps between adjacent Schwann cells are called nodes of Ranvier.
    • ** There are no Schwann cells in the CNS; they myelin sheath in the CNS is formed by the processes of oligodendrocytes.
    • Microglial cells: are the resident immune cells of the CNS, they function like macrophages.
  32. Which of the following ascending tracts of the spinal cord function to carry pain and temperature sensory information to the thalamus?

    - Lateral spinothalamic duct
    - Anterior spinothalamic duct
    - Fasciculi gracilis
    - Cuneatus
    - Spinocerebellar tract
    • Lateral spinothalamic duct
    • The anterior spinothalamic duct transmits crude touch and pressure sensations.
    • Ascending tracts travel toward the brain and are sensory. Descending tracts are motor.
    • For most tracts, the name will indicate if it is sensory or motor. Sensory begin with spino indicating that the origin is the spinal cord. Tracts whose name begin with a part of the brain are motor (corticospinal tract).
  33. Which of the following spinal nerve structures is exclusively composed of sensory fibers?

    - Ventral root
    - Dorsal root
    - Ventral rami
    - Dorsal rami
    • Dorsal root
    • Spinal cord is the connection center for afferent and efferent pathways for most of the body below the head and neck. It goes from the brainstem to the second lumbar vertebra.
    • Sensory neurons have their cell bodies in the dorsal root. Motor neurons have their bodies in the ventral root
    • Nerve plexus networks
    • Cervical: head, neck, shoulders, diaphragm
    • Brachial: Upper limbs, some neck and shoulder muscles
    • Lumbar: part of the abdominal wall, lower limbs, external male genitalia
    • Sacral: perineum, buttocks, most lower limbs
    • Pudendal: external female genitalia
  34. A student dozing off in class unexpectedly gets called on by the professor to answer a question. Not knowing the answer, the hair on the back of the students neck stands up, his pupils dilate, and his heart starts to race. This fight-or-flight response is controlled by the:

    - Somatic nervous system
    - Autonomic nervous system
    - Central nervous system
    - Sensory nervous system
    • - Autonomic nervous system
    • - The CNS: contains the brain and spinal cord.
    • - The PNS: all nervous structure outside of the CNS, contains all of the body nerves. Divided into afferent (sensory, somatic) and efferent (motor, somatic and autonomic) 
    • - Motor neuron pathways can be
    • - Somatic: skeletal
    • - Autonomic: smooth muscle, cardiac muscle and glands. ANS is divided into sympathetic and parasympathetic.
  35. Which meningeal forms the falx cerebri and the falx cerebelli?

    - Dura matter
    - Arachnoid mater
    - Pia mater
    • Dura matter
    • The meninges are three concentric protective membranes surrounding the brain and spinal cord (CNS):
    • Dura matter: outermost tough fibrous later that lines the skull and forms folds that descend into the brains fissures. Dural folds are Falx cerebri (longitudinal fissure that separates the cerebral hemispheres. Tentorium cerebelli separatse the cerebrum and the cerebellum. Falx cerebelli separates the two lobes of the cerebellum.
    • Arachnoid membrane: fragile network of collagen and elastin fibers with web-like appearance, lies between dura matter and the pia mater.
    • Pia mater: innermost membrane, extremely thin, made up of collagen and elastic fibers, adheres closely to the brain and spinal cord.
    • * These are the structures involved in meningitis, which when complicated turns into encephalitis.
    • The subarachnoid space, when filled with cerebrospinal fluid separates the arachnoid space and the pia matter and can form:
    • Epidural space, in presence of pathology can form accumulation of blood from torn meningeal artery (epidural hematoma)
    • Subdural space, closed space that can be the site for hemorrhage after head trauma.
  36. A patient in the dental clinic hates getting alginate impressions taken on him because he is a "gagger". Which most inferior portion of the brainstem controls the reflex activities such as coughing, gagging and vomiting.

    - Midbrain
    - Pons
    - Cerebrum
    - Medulla
    • Medulla, the most inferior portion of the brain (right before the brainstem)
    • Midbrain: connects dorsally with the cerebellum, relays motor signals from the cerebral cortex to the pons. Substantia nigra controls movement and lesions cause Parkinsons disease
    • Pons: Lies below the midbrain, connects the cerebellum to the cerebrum. Motor activity Exit point from TRIGEMINAL NERVE
    • Medulla oblongata: most inferior portion, small at the level of the foramen magnum. Controls reflex activities. The junction between the Medulla and the Pons is the site for cranial nerves 4,5,6 and 7. regulates sleep and arousal, pain, breathing and heart.
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  37. Which of the following meningeal structures is a ring shaped fold that allows the passage of the infundibulum of the pituitary gland?

    - Tentorium cerebelli
    - Falx cerebri
    - Falx cerebelli
    - Diaphragm sellae
    • Diaphragm sellae, is a ring-shaped fold of dura mater covering the sella turcica and containing an aperture for passage of the infundibulum of the pituitary gland.
    • Dura matter: 2 layers; Endosteal (inner surface of the cranium) and meningeal layer (partitions that descend into the brains fissures)
    • Dural folds: 2 vertical; Falx cerebri (separates cerebral hemispheres, contains inferior and sagital sinus) and falx cerebelli (separates the 2 cerebellum lobes, contains occipital sinus) 1 horizontal fold; Tentorium cerebelli (separates the cerebrum and cerebellum)
  38. The hypothalamus is part of the:

    - Basal nuclei
    - Diencephalon
    - Cerebrum
    - Cerebellum
    • Diencephalon
    • The brain can be divided into 4 main parts: The cerebrum (largest part, two hemispheres connected by the corpus callosum, high functions), diencephalon (beneath the cerebral hemispheres and has 2 main parts thalamus and hypothalamusCerebellum (Important in control of movement and balance). Brainstem (composed of midbrain, pons and medulla)
    • Each part of the brain consists of 3 areas:
    • White mattermyelinated nerve fibers
    • Gray matter: unmyelinated nerve fibers
    • Ventricles: spaced filled with cerebrospinal fluid
  39. Which type of Neuroglial cells form myelin in the CNS?

    - Astrocytes
    - Oligodendrocytes
    - Microlia
    - Epidymal cells
    • Oligodendrocytes
    • Neuroglial cells provide structural integrity to the nervous system and do NOT have synapses, they exist ONLY in the CNS
    • Cells in the PNS that support neurons are Schwann cells and satellite cells.
    • Phagocytic cells in the CNS are MICROGLIA
  40. As a general rule, parasympathetic preganglionic neurons synapse with postganglionic axons in ganglia:

    - Near the thoracolumbar region
    - At the cranial nerve nuclei
    - Near or within the target organs
    - Along the paravertebral chain
    • Near or within the target organs
    • Sympathetic vs. parasympathetic
    • Most organs have dual innervation
    • Actions of one opposes the other
    • Both are cooperative in salivary glands
    • Parasympathetic is predominant in most organs
    • Sympathetic distribution is more diffused while parasympathetic is more specific.
  41. The third ventricle of the brain communicates with the fourth ventricle by the:

    - The two foramina of Luschka
    - The interventricular foramen
    - The cerebral aqueduct
    - The foramen Magendie
    • The cerebral aqueduct
    • There are 4 ventricles in the brain, they all connect in the central canal of the spinal cord and the subarachnoid space surrounding the bran and spinal cord. 2 lateral ventricles, a third and a 4th ventricle.
  42. A 32 year old male medical student is experiencing diplopia and goes to get an MRI done. The scan shows the non-descript periventricular lesions, and so a spinal tap is done to determine whether the patient has multiple sclerosis. Which space is entered when a spinal tap is performed.

    - Conus medullaris
    - Subarachnoid space
    - Arachnoid space
    - Central canal
    • Subarachnoid space
    • The spinal cord ends in adults as a constriction around L1, the dura and arachnoid, however, will continue down to S2m thus a needle entered between L3, L4 and L5 will enter the subarachnoid space.
    • Cerebrospinal fluid (CSF): colorless, thin fluid found in the ventricles of the brain, the subarachnoid space and the central canal of the spinal cord. It is produced mainly by a structure called the choroid plexus, along with ependymal cells
    • CSF along with bony and ligamentous walls of the vertebral canal protect the spinal cord from injury.
  43. Neuron cell bodies are located in:

    - White matter of the spinal cord
    - Meninges
    - Gray matter of the spinal cord
    • Gray matter of the spinal cord
    • Spinal cord extends from the base of the skull to a point above two-thirds of the way down the back, running through the vertebral canal.
    • Spinal cord
    • Posterior (dorsal horns): specialized sensory information, touch pain, joint sensation
    • Anterior (ventral horns): motor neurons, transmit messages out to the muscles via the spinal nerves.
  44. In the peripheral nervous system, which fibers carry impulses to the skeletal muscle?

    - Somatic sensory fibers
    - Visceral sensory fibers
    - Somatic motor fibers
    - Visceral motors fibers
    • Somatic motor fibers
    • The PNS can be either somatic or visceral and either sensory (afferent) or motor (efferent).
    • There are four types of fibers
    • Somatic sensory (afferent): Impulses from cutaneous and propioceptive receptors
    • Visceral sensory (afferent): fibers carry impulses from the viscera
    • Somatic motor (efferent): carry impulses to skeletal muscle
    • Visceral motor (efferent): carry impulses to smooth and cardiac muscles and to glands
    • * Visceral motor neurons are from the hypothalamus and mid-brain and are involuntary.
  45. The ciliary (eye), pterygopalatine (eye and nasal mucosa and submandibular (eye and nasal muscosa) and otic ganglia (parotid) are all:

    - Sympathetic ganglia
    - Parasympathetic ganglia
    - Both sympathetic and parasympathetic ganglia
    - Neither sympathetic nor parasympathetic
    Parasympathetic ganglia
  46. Which of the following embryonic tissue types gives rise to the central nervous system?

    - Endoderm
    - Mesoderm
    - Ectoderm
    • Ectoderm
    • During the latter part of the third week of development, a group of cells differentiates from the ectoderm, these cells are called the neuroectoderm, they are localized to the neural plate of the embryo. This plate grows and thickens and invaginates centrally forming a nerual groove, near the end of the third week the folds meet superior to the neural groove and a nerual tube is formed during the fourth week. This neural tube undergoes fusion and forms the future spinal cord.
    • The neural crest cells are essential in the development of the face, neck and oral tissues. During the third week they develop from the neuroectoderm, fold and disperse withinthe mesenchyme and develop face and beck structures like the branchial arches.
  47. An endodontist is performing root canal therapy on his anxious dental patient. His anesthesia has been successful throughout the access preparation, cleaning and shaping. Just before he starts to obturate, he sticks a paper point in the first canal to dry it out. The patient jumps up in pain from the stimulus. Which type of primary afferent fiber carries information related to sharp pain and temperature.

    - A- alpha fibers
    - A- beta fibers
    - A- delta fibers
    - C- nerve fibers
    • A- delta fibers
    • Primary afferent axons are nerve fibers connected to different types of receptors in skin, muscle and internal organs, they come in different diameters and can be divided into different groups depending on their size.
    • A-alpha (propioception), A-beta (touch) and A-delta (pain and temp) are insulated with myelin.
    • C-nerve fibers  (pain, temp and itch)are unmyelinated
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Anatomic Sciences 159-230 (endocrine s nervous system).txt
2015-08-13 19:48:22
Anatomic Sciences 159 230

Anatomic Sciences 159-230
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