ATI RN
Pediatric Neurology Test Questions Questions
Question 1 of 5
A 40 years old worker suffered from lower back pain in the gluteal region, physical examination revealed a sensory defect in the anterolateral aspect of his leg. Also, the patient cant stand on his heels. The patient has a herniated disc in what region:
Correct Answer: B
Rationale: L4-L5 . The symptoms gluteal pain, sensory loss in the anterolateral leg, and inability to stand on heels (weak tibialis anterior) indicate L5 nerve root compression, most commonly from an L4-L5 disc herniation. Choice A (L3-L4) affects L4, causing medial leg sensory loss and knee weakness. Choice C (L5-S1) affects S1, causing posterior leg/calf issuand tiptoe weakness. Choice D (S1-S2) affects S2, unrelated to these symptoms. Thus, L4-L5 matchthe L5 root symptoms, making B correct.
Question 2 of 5
All of the following statements apply to first order neurons that transmit discriminative tactile sensations from the arm EXCEPT:
Correct Answer: C
Rationale: They form internal arcuate fibers as they decussate , which is false for first-order neurons. In the dorsal column pathway, first-order neurons from the arm (pseudounipolar, D) ascend in the fasciculus cuneatus and synapse in the nucleus cuneatus . Second-order neurons from the nucleus cuneatus form internal arcuate fibers and decussate. Choice C attributthis to first-order neurons, which dont decussate they end in the medulla. Thus, C is the exception, making it the correct answer.
Question 3 of 5
One of the following structuris important to recognize the position of the lower limbs:
Correct Answer: D
Rationale: the gracile tract. The fasciculus gracilis (gracile tract) in the dorsal column carriconscious proprioception from the lower limbs, synapsing in the nucleus gracilis, then via medial lemniscus to the cortex. Choice A (medial lemniscus) is part but not the initial structure. Choice B (dorsal spinocerebellar) is for unconscious proprioception to cerebellum. Choice C (spinothalamic) is for pain/temperature. Choice D (ventral spinocerebellar) is also unconscious. Thus, D (gracile tract) is specific for lower limb position sense, making it correct.
Question 4 of 5
Which of the following statements concerning the white columns of the spinal cord is correct:
Correct Answer: B
Rationale: The anterior spinothalamic tract is found in the anterior white column . The anterior spinothalamic tract, carrying crude touch, ascends in the anterior (ventral) white column of the spinal cord after crossing. Choice A is wrong (posterior spinocerebellar is in the lateral column). Choice C is incorrect (lateral spinothalamic is in the lateral column). Choice D is false (fasciculus gracilis is in the posterior column). Thus, B correctly locatthe anterior spinothalamic tract, making it the right answer.
Question 5 of 5
The pathway that descends from brain stem to the spinal cord to excite pain inhibitory interneurons secretes:
Correct Answer: C
Rationale: serotonin . The descending pain inhibitory pathway, originating in the brainstem (e.g., periaqueductal gray, raphe nuclei), usserotonin to activate inhibitory interneurons in the spinal cord dorsal horn, reducing pain transmission. Choice A (endorphin) and B (enkephalin) are opioids involved in pain modulation but not the primary neurotransmitter here. Choice D (substance P) enhancpain. Thus, C correctly identifiserotonin, making it the right answer.