c15.rtf

Chapter 15: Structure and Function of the Neurologic System MULTIL! C"#IC!

1. Which pathway carries sensory information toward the central nervous system (CNS)? a. Ascending c. Somatic  . !escending d. "fferent ANS# A

$eripheral nerve pathways can e afferent (ascending) pathways that carry sensory impulses toward the CNS. %he remaining options do not carry sensory information to the CNS. $%S# 1

&"'# $age 

*. Which type of a+on transmits a nerve impulse at the highest rate? a. ,arge nonmyelinated c. Small nonmyelinated  . ,arge myelinated d. Small myelinated ANS# -

f the myelin layer is tightly wrapped many times around the a+on and is forming the nodes of  &anvier/ then conduction velocity increases and the neuron is referred to as myelinated. %he increased diameter of the myelinated a+ons allows for the transmission of impulses at a faster rate. %he other options do not affect nervous impulse transmission rates. $%S# 1

&"'# $ages 02

3. Which nerves are capale of regeneration? a.  Nerves within the rain and spinal cord  . $eripheral nerves that are cut or severed c. 4yelinated nerves in the peripheral nervous system d. 5nmyelinated nerves of the peripheral nervous system ANS# C

 Nerve regeneration is limited to only myelinated fiers and generally occurs only in the  peripheral nervous system. $%S# 1

&"'# $ages 201

. %he neurotransmitter/ norepinephrine/ is secreted in the# a. Somatic nervous system c. Sympathetic postganglion  . $arasympathetic preganglion d. $arasympathetic postganglion ANS# C

4ost postganglionic sympathetic fiers release norepinephrine (adrenaline). %he remaining options do not reflect the correct site of norepinephrine n orepinephrine secretion. $%S# 1

&"'# $ages 6306

. -oth oligodendroglia and Schwann cells share the aility to# a. 'orm a myelin sheath c. %ransport nutrients  . &emove cellular deris d. ,ine the ventricles

ANS# A

%he function of oligodendroglia (oligodendrocytes) is to deposit myelin within the central nervous system (CNS). 7ligodendroglia are the CNS counterpart of S chwann cells. %he remaining options are not reflective of the common function of these structures. $%S# 1

&"'# $ages 802

9. !uring a synapse/ what change occurs after the neurotransmitter inds to the receptor? a. %he permeaility of the presynaptic neuron chan ges: conse;uently/ its memrane

 potential is changed as well.  . %he permeaility of the postsynaptic neuron changes: conse;uently/ its memrane memrane  potential is changed as well. c. %he postsynaptic cell prevents any change in permeaility and destroys the action  potential. d. %he presynaptic cell synthesi
%he inding of the neurotransmitter at the receptor site ch anges the permeaility of the  postsynaptic neuron and/ conse;uently/ its its memrane potential. %he remaining options do not accurately descrie the occurrence. $%S# 1

&"'# $ages *03

6. What name is given to a large networ= of neurons within the rainstem that is essential for

maintaining wa=efulness? a. 4idrain  . &eticular activating system

c. 4edulla olongata d. $ons

ANS# -

%he reticular activating system is essential for maintaining wa=efulness. %he remaining options are not essential to this function. $%S# 1

&"'# $age 

. %hought and goal0oriented ehaviors are functions of which area of the rain? a. Cereellum c. $refrontal loe  . ,imic system d. 7ccipital loe ANS# C

%he prefrontal area is responsile for goal0oriented ehavior (i.e./ aility to concentrate)/ short0term or recall memory/ and the elaoration of thought and inhiition on the limic (emotional) areas of the CNS. %he remaining options are not involved in these functions. $%S# 1

&"'# $age 9

8. %he region responsile for the motor aspects of speech is located in the# a. We c. Wron=a area in the parietal loe Wernic=e rnic=e area in the temporal loe  . -roca area in the frontal loe d. -arlow area in the occipital loe ANS# -

-roca speech area is the only region responsile for the motor aspects of speech.

$%S# 1

&"'# $age 6

12. $ar=inson and >untington diseases are associated with defects in which area of the rain? a. %halamus c. Cereellum  . 4edulla olongata d. -asal ganglia ANS# !

$ar=inson and >untington diseases are conditions associated with defects of the asal ganglia.  No current research supports the role of any of the other options in these diseases. $%S# 1

&"'# $age 6

11. 4aintenance of a constant internal environment a nd the implementation of ehavioral patterns

are main functions of which area of the rain? a. %halamus  . "pithalamus

c. Suthalamus d. >ypothalamus

ANS# !

>ypothalamic function falls into two maor areas# (1) maintenance of a constant internal environment/ and (*) implementation of ehavioral patterns. %he remaining op tions do not address these functions. $%S# 1

&"'# $age 8

1*. %he aility of the eyes to trac= moving oects through a visual field is primarily a function of 

which colliculi? a. nferior   . Superior 

c. 4id d. $osterior 

ANS# -

%he superior colliculi are involved with voluntary and involuntary visual motor movements (e.g./ the aility of the eyes to track  moving  moving oects in the visual field). %rac=ing moving oects is not the primary function of the remaining options. $%S# 1

&"'# $age 8

13. What parts of the rain mediate the e+pression e+ pression of affect/ oth emotional and ehavioral states? a. >ypothalamus and suthalamus c. ,imic system and prefrontal corte+  . $arietal and frontal loes d. -asal ganglia and medulla olongata ANS# C

"+tensive connections with the limic system and prefrontal corte+ mediate the e+pression of affect/ oth emotional and ehavioral states. %he remaining options are not involved in these e+pressions. $%S# 1

&"'# $age 6

1. &efle+ activities concerned with heart rate/ lood pressure/ respirations/ snee
and coughing are controlled y which area of the rain? a. $ons c. Cereellum  . 4idrain d. 4edulla olongata ANS# !

%he medulla olongata ma=es up the myelencephalon and is the lowest portion of the  rainstem. &efle+ activities/ such as heart rate/ respiration/ respiration/ lood pressure/ coughing/ snee
&"'# $age 92

1. 'rom which part of the midrain do cranial nerves @ to @ emerge? a. 4idrain c. 4edulla olongata  . $ons d. ,ateral colliculi ANS# -

%he nuclei of cranial nerves @ through @ (see %ale 109 for discussion) are located only in the pons. $%S# 1

&"'# $ages 8092

19. 'rom which part of the midrain do cranial nerves  to  emerge? a. 4idrain c. 4edulla olongata  . $ons d. ,ateral colliculi ANS# C

%he nuclei of cranial nerves  through  (see %ale %ale 109 for discussion) are located only in the medulla olongata. $%S# 1

&"'# $age 92

16. Which area of the rain assumes the responsiility for conscious and unconscious muscle

synergy and for maintaining alance and posture? a. Cererum c. !iencephalon  . Cereellum d. -rainstem ANS# -

%he cereellum is responsile for conscious and unconscious muscle synergy and for maintaining alance and posture. %his role is not assumed  y any of the remaining options. $%S# 1

&"'# $age 8

1. Which statement is true regarding true regarding upper motor neurons? a. 5pper motor neurons directly influence muscles.  . %hey modify spinal refle+ arcs. c. 5pper motor neurons are located in the gray matter of the spinal cord. d. %hey e+tend their dendritic processes out of the CNS. ANS# -

5pper motor neurons (i.e./ corticospinal tract) are the classification of motor pathways completely contained within the CNS. %heir primary roles include directing/ influencing/ and modifying refle+ arcs/ lower0level control centers/ and motor and some sensory neurons. %he remaining options do not accurately descrie the characteristic functions of upper motor neurons. $%S# 1

&"'# $age 9*

18. %he memrane that separates the rainBs cereellum from its cererum is the# a. %entorium c. Arachnoid memrane %entorium cereelli  . 'al+ cereri d. 'al+ cereelli ANS# A

%he tentorium cereelli is a memrane that separates the cereellum elow from the cereral structures aove. %he remaining options do not perform the function descried in the stem. $%S# 1

&"'# $age 9

*2. %he function of arachnoid villi is to# a. $roduce cererospinal fluid  . $rovide nutrients to the choroid ple+uses c. %ransmit impulses within the meninges d. Asor cererospinal fluid into the cereral venous sinuses ANS# !

CS' is reasored y means of a pressure gradient etween the arachnoid villi v illi and the cereral venous sinuses. %he remaining options do not accurately descrie the function of arachnoid villi. $%S# 1

&"'# $age 99

*1. Where is the cererospinal fluid produced? a. Arachnoid villi c. "pendymal cells  . Choroid ple+uses d. $ia mater  ANS# -

%he choroid ple+uses are the structures that produce CS': they arise from the pia mater. %he remaining options do not have a role in CS' production. $%S# 1

&"'# $ages 9099

**. Which of the meninges closely adheres to the surface of the rain and spinal cord and follows

the sulci and fissures? a. !ura mater   . Arachnoid

c. $ia mater  d. nner dura

ANS# C

%he delicate pia mater closely adheres to the surface of the rain and spinal cord and even follows the sulci and fissures. %he remaining options are not represented in the description  provided in the stem. $%S# 1

&"'# $ages 909

*3.  Norepinephrine produces what primary response? a. ncreased contractility of the heart c. @asoconstriction  . &elease of renin from the =idney d. $upillary dilation ANS# C

%he primary response from norepinephrine is the stimulation of the α10adrenergic receptors that cause vasoconstriction. %he remaining options do not accurately reflect the primary response of norepinephrine. $%S# 1

&"'# $age 6

*. What is an effect of the sympathetic nervous system? a. Stimulation of peristalsis c. &eduction in heart rate  . ncreased lood sugar levels d. $upillary constriction ANS# -

n general/ sympathetic stimulation promotes responses that are concerned with the protection of the individual/ which include increased lood sugar levels/ temperature/ and lood  pressure. %he responses noted in the remaining options are not a result of sympathetic sympathetic stimulation. $%S# 1

&"'# $age 69

*. %he rain receives appro+imately what percentage of the cardiac output? a. 2 c. *2  . 2 d. 12 ANS# C

%he rain receives appro+imately *2 of the cardiac output/ or 22 to 1222 ml of lood flow  per minute. $%S# 1

&"'# $age 

*9. %he collateral lood flow to the rain is provided y the# a. Carotid arteries c. Circle of Willis  . -asal artery d. @erteral arteries ANS# C

%he arterial circle (circle of Willis) Willis) (see 'igure 10*2) is a structure credited with the aility to compensate for reduced lood flow from any one of the maor contriutors (collateral lood flow). %he remaining options are not considered sources of collateral lood flow. $%S# 1

&"'# $age 96

*6. %he nurse recogni
layer is supported y which diagnostic laoratory result? a. Chloride D112 m";E, c. $rotein D12 mgEdl 3  . ,eu=ocytes F12Emm d. Glucose D2 mgEdl ANS# -

@iral infections causing meningitis will produce a white lood cell (leu=ocyte) count greater than 12Emm 3. %he chloride level is oserved in tuerculous tuercu lous meningitis/ the protein level has little clinical significance/ and the glucose level is oserved in patients with acute acterial meningitis. $%S# 1

&"'# $age 68 H %ale 10

MULTIL! $!S#NS!

*. Which cranial nerves contain parasympathetic nerves? (Select all that apply.) a.  (olfactory) d.  (glossopharyngeal)  .  (oculomotor) e.  (vagus) c. @ (facial) ANS# ANS# -/ C/ C/ !/ !/ "

All ut cranial nerve  (olfactory) contain parasympathetic nerves. $%S# 1

&"'# $age 63

*8. %he sympathetic nervous system primarily serves to protect an individual  y doing which of

the following? (Select all that apply.) a. !ecreasing mucous production d. !ecreasing sweat e+cretion  . ncreasing lood sugar levels e. ncreasing lood pressure c. ncreasing ody temperature ANS# -/ C/ C/ "

n general/ sympathetic stimulation promotes responses that are concerned with the protection of the individual/ which include increasing lood sugar levels/ temperature/ and lood  pressure. %he remaining options are not protective measures resulting resulting from initiatives made  y the sympathetic nervous system. $%S# 1

&"'# $age 69

32. %he aging process rings aout what changes to human cells? (Select all that apply.) a. ncreased neurofirillary tangles d. !ecreased myelin presence  . malance of neurotransmitters e. Altered dendrite structure c. ncreased neuron production ANS# ANS# A/ -/ -/ !/ !/ "

$rincipal cellular changes associated with aging include a decrease in the numer of neurons/ decreased myelin/ decreased numer of dendritic processes and synaptic connections/ intracellular neurofirillary tangles/ and an imalance in the amount and distriution of neurotransmitters. %he aging process does not ring aout an increase in neuron production. $%S# 1

&"'# $age 6 H -o+ 10

31. Which statement is true regarding true regarding the lood0rain arrier (---)? (Select all that apply.) a. %he --- is dependent on astrocytes.  . t uses the meningeal layers of the rain. c. t restricts the flow of large molecules/ such as potassium. d.  Naturally occurring inflammatory mediators affect affect the ---. e. %he --- appears to play a role in slowing down the onset of degenerative d egenerative rain

disease. ANS# ANS# A/ C/ C/ !/ !/ "

%he --- is a term used to descrie cellular structures that selectively inhiit certain sustances in the lood from entering the interstitial spaces of the rain or CS'. %his term emphasiormones/ >ormones/ neurotransmitters/ and inflammatory mediators can affect --- permeaility. nhiiting these endogenous chemicals with drug therapy may reduce rain edema and slow the onset of degenerative rain diseases. %he statement regarding the meningeal layers of the rain is incorrect. $%S# 1

&"'# $age 98 H -o+ 10

3*. A nurse caring for an older adult patient would e+pect which functional changes to occur? a.  . c. d. e.

(Select all that apply.) ncreased ris= for falls ncreased ris= for falls ,oss of muscle in the arms and legs !ecrease in the need for social interaction ncreased agitation and frustration levels

ANS# A/ -/ -/ C

'unctional changes with aging include s=eletal muscle atrophy/ progressive progressive deficits in taste and smell/ and a decrease in neuromuscular control with changes in gait and posture. Neither increased agitation and frustration nor a decreased need for social interaction is considered an e+pected change resulting from the aging process. $%S# 1

&"'# $age 6 H -o+ 10

33. What evidence does the nurse e+pect to see when a patient e+periences trauma to the

hypothalamus? (Select all that apply.) a. 5neven e+pression of mood  . 5nstale lood glucose levels c. $oor regulation of ody temperature d. @isual @isual disturances such as lurred vision e.  Nausea/ vomiting/ and symptoms of gastroesophageal reflu+ disease ANS# A/ -/ -/ C

%he hypothalamus forms the ase of the diencephalon. >ypothalamic function controls autonomic nervous system (ANS) function/ regulation of ody temperature/ endocrine function (e.g./ unstale glucose levels)/ and regulation of emotional e+pression. @isual @isual and gastrointestinal symptoms would not li=ely e related to hypothalamus function. $%S# 1

&"'# $age 8 H -o+ 103

3. A Schwann cell# (Select all that apply.) a. Can form the myelin sheath.  . s also referred to as a neurolemmocyte. neurolemmocyte. c. Affects the function of the nodes of &anvier. d. s located in the peripheral nervous system.

e.

s responsile of decreasing conduction co nduction velocity.

ANS# ANS# A/ -/ -/ C/ C/ !

%he Schwann cell/ or neurolemmocyte/ n eurolemmocyte/ is a glial cell that wraps around and covers a+ons in the peripheral nervous system. Schwann cells form and maintain the myelin sheath/ and the nodes of &anvier form the spaces on either side of the Schwann cell. f the myelin layer is tightly wrapped many times around the a+on/ a+o n/ forming nodes of &anvier/ then it increases conduction velocity and the neuron is referred to as myelinated. $%S# 1

&"'# $age 2

M%TC"IN&

 Match the function with the appropriate cranial nerve.  IIIIII A. 'iers emerge emerge from the posterior midrain and e+it from the s=ull to to run to the eye.  IIIIII -. $rovides motor and sensory functions to the face/ mouth/ nose/ and eyes.  IIIIII C. 'iers emerge from the midrain/ e+it from the s=ull/ and e+tend to the eye.  IIIIII !. Controls motor functions to the pharyn+ and salivary glands and sensory functions from the pharyn+ and tongue.  IIIIII ". nnervates muscles that move the eye laterally.  IIIIII '. Affects control over the motor fiers to the muscles of tongue and sensory impulses from the tongue to the rain.  IIIIII G. s purely sensory and carries impulses for the sense of smell. smell.  IIIIII >. s made up of parasympathetic motor fiers that supply the smooth muscles of the adominal organs.  IIIIII . %ransmits %ransmits impulses for the sense of hearing.  IIIIII J. Carries sensory and motor fiers to the pharyn+ and laryn+. 3. 39. 36. 3. 38. 2. 1. *. 3. .

Glossopharyngeal nerve 7culomotor nerve %rochlear nerve Aducens nerve %rigeminal nerve >ypoglossal nerve @agus nerve Spinal accessory nerve 7lfactory nerve @estiulocochlear nerve

3. ANS# ! $%S# 1 &"'# $age 6* H %ale 109 4SC# %he glossopharyngeal glossopharyngeal nerve affects affects control over the motor motor fiers that serve serve the pharyn+ (throat) (throat) and salivary glands/ as well as the sensory fiers that carry impulses from the pharyn+/ posterior tongue (taste uds)/ and pressure receptors of the carotid arter y. 39. ANS# C $%S# 1 &"'# $age 6* H %ale 109 4SC# %he oculomotor oculomotor nerve fiers emerge from the midrain/ midrain/ e+it from the s=ull/ and and e+tend to the eye. %hese fiers control# (1) the motor fiers to the inferior oli;ue/ superior/ inferior/ and medial rectus e+traocular muscles that direct the eyeall: (*) the levator muscles of the eyelid: (1) the smooth muscles of the iris and ciliary ody: and () proprioception (sensory) to rain from the e+traocular muscles.

36. ANS# A $%S# 1 &"'# $age 6* H %ale 109 4SC# %he trochlear nerve fiers emerge emerge from posterior posterior midrain and e+it e+it from s=ull s=ull to affect control control over the proprioceptor and motor fiers for the superior oli;ue muscle of eye (e+traocular muscle). 3. ANS# " $%S# 1 &"'# $age 6* H %ale 109 4SC# %he aducens nerve nerve affects control control over the motor fiers to the lateral rectus rectus muscle and the the  proprioceptor fiers from from the same muscle to the rain/ rain/ allowing the eyes to move move laterally. laterally. 38. ANS# $%S# 1 &"'# $age 6* H %ale 109 4SC# %he trigeminal nerve affects control over oth oth the motor motor and sensory functions functions to the the face: conducts sensory impulses from the mouth/ nose/ surface of e ye/ and dura mater: it also contains motor  fiers that stimulate the chewing muscles. 2. ANS# ' $%S# 1 &"'# $age 6* H %ale 109 4SC# %he hypoglossal hypoglossal nerve affects affects control over over the motor fiers fiers to the muscles of tongue tongue and sensory impulses from the tongue to the rain. 1. ANS# > $%S# 1 &"'# $age 6* H %ale 109 4SC# %he vagus nerve nerve affects control control over the fiers fiers that carry sensory and motor motor impulses for the  pharyn+. A large part of this nerve is parasympathetic parasympathetic motor fiers that supply supply smooth muscles of the adominal organs and is capale of receiving sensory impulses from the viscera. *. ANS# J $%S# 1 &"'# $age 6* H %ale 109 4SC# %he spinal accessory nerve affects affects control over over the sensory and motor fiers for the sternocleidomastoid sternocleidomastoid and trape