1. The most caudal(inferior) portion of the trigeminal nucleus receives pain, temperature and light touch from:

 A. The opthalamic region of the head
 B. The maxillary region of the head
 C. The mandibular region of the head
 D. The occipital region of the head
 E. The auricular region of the head

2. All of the following would be considered trigeminal reflexes except:

 A. lacrimal or tearing reflex
 B. vomiting reflex
 C. carotid sinus reflex
 D. corneal reflex
 E. sneezing reflex

3. All of the following are true in regard to the glossopharyngeal nerve except:

 A. It is composed of the functional components GVA, SVA, GSA, GVE, and SVE.
 B. The carotid sinus reflex involves vagal visceral afferents and glossopharyngeal visceral efferents.
 C. The inferior salivatory nucleus innervating the parotid gland is part of this nerve.
 D. Lesions result in the loss of a gag reflex.
 E. Severe pain triggered by coughing or swallowing is known as glossopharyngealneuralgia.

4. Upon stimulating the left cornea, the patient displays blinking of the left eye, you thus conclude:

 A. Everything is absolutely normal
 B. The left trigeminal nerve is damaged
 C. The left division I of the trigeminal is damaged.
 D. There is an ipsilateral lesion in the upper medulla-pons 
 E. There is a contralateral lesion in the upper medulla-pons.

5. Horner's Syndrome includes all of the following except:

 A. A pupil ipsilateral to the lesion which is smaller.
 B. A pupil ipsilateral to the lesion which doesn't dilate when the pupil is shaded.
 C. Ptosis on the ipsilateral eye.
 D. The face is dry, red and warm ipsilateral to the lesion.
 E. Can result only from spinal cord or cervical trunk sympathetic lesions.

6. The nucleus ambiguus:

 A. Is efferent to skeletal muscle derived from the visceral arches.
 B. Is composed of cranial nerves VII, IX and X.
 C. Is the largest motor nucleus in the brainstem.
 D. Is a GVE nucleus.
 E. Is a reticular formation nucleus.

7. A unilateral lesion of the vagus nerve would result in all of the following except:

 A. Coughing attack which in time diminishes and disappears.
 B. Hoarseness, dyspnea, and dysphagia
 C. During phonation, the soft palate is elevated on the normal side.
 D. Ipsilateral loss of the carotid sinus reflex
 E. A contralateral loss of the palatal reflex.

8. The solitary nucleus:

 A. Is a GVE nucleus
 B. Is the origin of the medial reticulospinal tract
 C. Has second order fibers which project only to the VPM nucleus of the thalamus.
 D. Is somatotopically arranged for facial sensations.
 E. Contains afferents of cranial nerves IX, X and XI

9.  All of the following cranial nerves have afferent fibers terminating in the mesencephalic trigeminal 
     nucleus except:

 A. III
 B. IV
 C. VII
 D. IX
 E. XII

10. All of the following are true except.

 A. About 85% of the pyramidal fibers cross in the pyramidal decussation.
 B. The nucleus ambiguus supplies the muscles of the larynx and the pharynx.
 C. The facial nerve supplies taste for the anterior 2/3 of the tongue.
 D. There are 4 vestibular nuclei.
 E. The commissural portion of the solitary nucleus is often referred to as the gustatory nucleus.

11. In a lesion of the right frontal lobe, one would see.

 A. Right adversive seizures.
 B. Right hemiparesis.
 C. Left hemiparesis.
 D. Right gaze impairment so the eyes look toward the paralyzed limb.
 E. Left gaze impairment so the eyes look toward the paralyzed limb. 
 F. The eyes cannot be moved to the lesioned side.
 G. A, B, D and F.
 H. C and E.
 I. A, C, E and F.
 J. None of the above.

12. All of the following are true except.

 A. the axons of the ventral spinocerebellar tract terminate in the ipsilateral cerebellar cortex.
 B. the axons of the dorsal spinocerebellar tract terminate in the ipsilateral cerebellar cortex.
 C. the rubrospinal tract arises from the ipsilateral red nucleus. 
 D. the lateral vestibulospinal tract is an uncrossed tract. 
 E. the fasciculus cuneatus contains ipsilateral axons destined for the external cuneate nucleus.

13. All of the following are true except.

 A. The inferior colliculus is enveloped by fibers of the lateral leminiscus.
B. Some fibers from the inferior colliculus pass to the superior colliculus.
C. Most of the fibers constituting the visual pathway from the retina go to the medial geniculate nucleus 
          of the thalamus.
D. The inferior colliculus acts as a relay for auditory information. 
E. The superior colliculus donates some fibers to the posterior commissure.


14. Which is not true in regard to the auditory system.

 A. The ventral acoustic striae originates from the ventral cochlear nucleus.
 B. The medial accessory superior olivary nucleus gives rise to the olivocochlear bundle.
 C. The medial accessory olivary nucleus is involved in 
 D. The lateral leminiscus projects to the inferior colliculus and medial geniculate nucleus.
 E. A lesion of the trapezoid body results in bilateral deafness. 

15. A left anterior inferior cerebellar artery occlusion would result in all of the following structures to 
      undergo ischemia except.

 A. L. superior colliculus
 B. L. spinothalamic tract
 C. L. medial leminiscus
 D. L. Inferior colliculus
 E. L. mesencephalic tract and nucleus
 F. L. lateral leminiscus
 G. L. abducens
 H. All of the above

16. If you are rotated in a chair from clockwise.

 A. After rotation  stops, the endolymph will continue to stimulate the left semicircular ampullae.
 B. You would  demonstrate left nystagmus.
 C. The fast phase  would be to the left.
 D. The pursuit  phase will be to the right.
 E. The saccadic  phase will be to the right.

17. The pontine nuclei.

A. are a  nondescript group of cells with no anatomical boundaries. 
B. are a cortico-cerebellar relay.
C. projects axons to the cerebellum only ipsilaterally.
D. are a phylogentically old structure.
E. are very seldom involved in disease processes.

18. Which is not true in regard to the red nucleus.

 A. The superior cerebellar peduncle passes through it.
 B. The rubrospinal axons decussate in the dorsal tegmental decussation.
 C. The magnocellular portion receives axon projections from the globose embiliform nuclei.
 D. It has projections to the inferior olive and reticular formation in the medulla by means of 
           the central tegmental tract 
 E. The caudal portion gives rise to the rubrospinal tract. 

19. The lateral tier nuclei grouping of the occulomotor complex does not contain a nucleus related to the following 
      extraocular muscle of the eye. 

 A. Superior rectus
 B. Inferior oblique
 C. Inferior rectus
 D. Medial rectus
 E. None of the above

20. All of the following are true except.

 A. Fibers from all of the vestibular nuclei ascend in the MLF.
 B. The internal genu of the facial nerve becomes the motor root.
 C. The abducens nerve innervates the lateral rectus muscle. 
 D. The facial nerve is responsible for the major symptoms seen in hayfever.
 E. The trapezoid body is an acoustically related structure. 

21. Nystagmus.

A. Is named for the direction of the pursuit phenomena.
B. Is named for the semicircular canal being stimulated.
C. Is an abnormal phenomena.
D. Consists of movements in the range of 836/second.
E. Is always pendular

22. Which of the following statements is incorrect in regard to vestibular-cerebellar interactions.

A. Medulloblastoma in children is the major cause of an archicerebellar syndrome.
B. The vestibular nerve projects direct fibers to the nodulus and flocculus.
C. All vestibular fibers, both direct and indirect, terminate as mossy fibers.
D. Lesions of these systems always result in vertical nystagmus. 
E. The floccular nodular lobe is known as the archicerebellum. 

23. Upon analysis of conjugate vision related to lateral gaze and convergence, one discovers that.

A. They have nothing in common.                         
B. Both require contraction of the same muscles laterally.
C. Excitation of the medial rectus muscle in convergence is most often ipsilaterally controlled by 
          the occulomotor while it is contralaterally controlled by horizontal gaze.
D. The occulomotor nucleus has no relation to either type of gaze.
E. none of the above are correct.

24 . All of the following are true except.

 A. The central tegmental tract runs primarily from the red nucleus to the inferior olive.
 B. The spino-olivary nucleus projects to the cerebellum.
 C. Cerebello-olivary fibers pass to the midbrain by way of the superior cerebellar peduncle.
 D. The accessory olivary nucleus projects to the vermis and paravermal region of the cerebellum.
 E. The inferior olive is the major source of mossy fibers to the cerebellum.

25. Select the discordant pair

 A. Accessory cuneate nucleus-Clarke's column
 B. Inferior olive-cerebellar relay
 C. Nucleus ambiguus-muscles of the pharynx-larynx
 D. Medial longitudinal fasciculus (MLF)-dorsal column axons 
 E. Tractus solitarius-visceral sensation

26. If one did a CHAT stain for acetlycholine, you would expect to see cells stained in all of the following 
      structures except. 

 A. Nucleus ambiguus
 B. Nucleus solitarius
 C. Hypoglossal nucleus
 D. Dorsal motor nucleus of the vagus
 E. Inferior salivatory nucleus

27. Trigeminal tractotomy (i.e. section of the spinal trigeminal tract) performed at the level of the obex
       in a patient with trigeminal neuralgia. 

 A. Will eliminate pain and thermal sense ipsilaterally only in the mandibular distribution of the 
            trigeminal nerve. 
 B. Will abolish pain and thermal sense in the ipsilateral half of the face with minimal impairment of   
            tactile sense.
 C. Will eliminate pain in the face ipsilaterally and abolish the corneal reflex
 D. Will abolish all sensation in the trigeminal distribution. 
 E. Will eliminate the jaw reflex (myotactic reflex)

28. Stimulating the dorsal motor nucleus of the vagus might elicit each of the following except.

 A. Contraction of the bladder
 B. Gastrointestinal peristalsis
 C. Contraction of the gall bladder
 D. Bronchial constriction
 E. Bradycardia

29. The most immediate threat of survival associated with bilateral lesions of the vagus nerve is.

 A. Loss of vagal respiratory reflexes.
 B. Complete laryngeal paralysis.
 C. Cardiac acceleration.
 D. Loss of the gag reflex and inability to swallow.
 E. Regurgitation and aspitration of liquids.

30. The carotid sinus reflex:

 A. Involves chemoreceptors in the carotid body.
 B. Involves the glossopharyngeal afferents and efferent fibers from the dorsal motor nucleus of the vagus.
 C. Involves afferent impulses from the baroreceptor which produce an elevation of arterial blood pressure.
 D. Is mediated entirely by the vagus nerve.
 E. Is mediated only by the glossopharyngeal nerve.

31. Injection of horseradish peroxidase (HRP) into the solitary nuclear complex would retrogradely label 
      cells in the:

 A. Superior ganglion of cranial nerve IX.
 B. Hypoglossal nucleus.
 C. Dorsal root ganglia of C1-C5.
 D. Inferior ganglion of cranial nerve X.
 E. Superior ganglion of cranial nerve X.

32. Which of the following cranial nerve nuclei is not involved in a parasympathetic function.

 A. Dorsal motor nucleus of the vagus.
 B. Nucleus hypoglossus.
 C. Edinger-Westphal of III nerve.
 D. Inferior salivatory nucleus of IX nerve.
 E. Superior salivatory nucleus of VII nerve.

33. A lesion of the vagus nerve bilaterally will result in all of the following except.

 A. A flaccid soft palate.
 B. Difficulty in swallowing.
 C. An increased salivation with drooling from the mouth.
 D. A hoarse and brassy sounding voice.
 E. A cardiac arrhythmia and tachycardia..

34. The neurological disorder in which the cerebellum is drawn down into the foramen magnum and puts 
      pressure on the respiratory centers in the medulla, resulting in respiratory depression is.

 A. Friedrich's ataxia.
 B. Marie-Charcot Tooth Disease.
 C. Dandy-Walker Syndrome.
 D. Acoustic neuroma.
 E. Combined System Disease.

35. All of the following are true except.

 A. The origin of the lateral vestibulospinal tract is the lateral vestibular nucleus.
 B. The ventral trigeminothalamic goes to the ventroposterior lateral nucleus of the thalamus.
 C. Fibers from the medial vestibular nucleus form the descending MLF.
 D. The spinal trigeminal tract transmits pain, temperature, light and low-intensity touch.
 E. The lateral reticulospinal tract originates from the medullary reticular formation.

36. All of the following are true except.

 A. The glossopharyngeal nerve is motor only.
 B. The pyramids consist of corticospinal fibers.
 C. 7 cranial nerves are attached to the medulla or at the junction between the medulla and pons.
 D. The accessory nerve is motor only.
 E. The hypoglossal nerve is motor only.

37. The solitary nucleus.

 A. Receives axons from cranial nerves VII, X, and XI.
 B. It projects fibers to the thalamus via the MLF.
 C. It's most caudal portion is related to taste.
 D. It is the principal receiving center for cardiovascular, respiratory, and GI afferent information. 
 E. Is classified as GSA.

38. The epicratic structures found in the medulla, pons, and midbrain would include all of the following 
       except.

 A. Medial leminiscus.
 B. Ventral trigeminal leminisci.
 C. Principal sensory nucleus of V.
 D. Dorsal trigeminal leminisci.
 E. Nucleus gracilus.

39.The nucleus ambiguus:

 A. Is efferent to skeletal muscle derived from the visceral arches
 B. Is composed of cranial nerves VII, IX and X
 C. Is the largest motor nucleus in the brainstem.
 D. Is a GVE nucleus
 E. Is a reticular formation nucleus.

40. All of the following axons may be found in the inferior cerebellar peduncle except:

 A. Dorsal spinocerebellar.
 B. Cuneocerebellar.
 C. Arcuocerebellar.
 D. Olivocerebellar.
 E. Ventral spinocerebellar.

41. Which cranial nerve does not contain GVE fibers.

 A. III
 B. V
 C. VII
 D. IX
 E. X

42. Respiratory rate increases at the commencement of exercise before metabolic changes have had a 
      time to produce their effect because.

 A. Proprioceptors in the body and the lung can prejudge activity. 
 B. The individual increases CO2 before they actually exercise. 
 C. It's a conditioned reflex.
 D. No such phenomenon occurs.
 E. Because higher levels of O2 exist in individuals who exercise. 

43. The sharp intake of breath due to cold or painful stimuli is due to.

 A. A pain response.
 B. The body receptor only like warm receptors.
 C. These stimuli via the spinal cord causes an active stimulation of the inspiratory center.
 D. Intercostal and abdominal muscles inhibit expiration.
 E. None of the above.

44. The dorsal motor nucleus of the vagus.

 A. Contains lower motoneurons.
 B. Innervates the rectum.
 C. Is a major mechanism of control for cardiac functions.
 D. Is concerned with tast innervation.
 E. Innervates the parotid gland.

45. The lateral nuclei grouping of the occulomotor complex does not contain a nucleus related to the 
      following extraocular muscle of the eye. 

 A. Superior rectus
 B. Inferior oblique
 C. Inferior rectus
 D. Medial rectus
 E. None of the above

46. In regard to the red nucleus.

 A. It controls ipsilateral flexors and contralateral extensors. 
 B. The rubrospinal axons decussate in the ventral tegmental decussation. 
 C. The caudal portion projects primarily to the thalamus.
 D. It has projections to the inferior olive and reticular formation via the medial leminixcus.
 E. It is excitatory to contralateral flexors and inhibitory to contralateral extensors and is responsible for the 
           swing phase of locomotion. 

47. The nucleus cuneatus and gracilus.

 A. Are located in the cervical spinal cord.
 B. If lesioned ipsilateral would result in terminal degeneration in the ventroposterior medial thalamic nucleus. 
 C. Have projections to the cerebellum
 D. Is part of the protopathic system.
 E. Contain the second order neurons to relay touch, vibration, position sense, and two-point discrimination.

48. The solitary nucleus.

 A. Is somatotopically arranged for facial sensations.
 B. Is an SVE nucleus
C. Has a caudal (inferior) component known as the commissural nucleus. 
 D. Has second order neurons which project to the VPL nucleus of the thalamus.
 E. Is the origin of the medial reticulospinal tract.

49. A lesion of the parabducens nucleus would result in.

 A. Paralysis of the lateral rectus on the side of the lesion.
 B. Nystagmus to the side of the lesion.
 C. Inability to look upward on command.
 D. Inability of lateral gaze to the side of the lesion.
 E. Intranuclear opthalomoplegia

50. All of the following are true in regard to unilateral facial lesions except.

 A. Corneal reflex is lost bilaterally.
 B. Inability to wrinkle the forehead, close the eye, show the teeth, purse the lips, or whistle on the side of the lesion.
 C. Hyperacusis on the side of the lesion.
 D. Impairment of taste on 2/3 of the tongue on the side of the lesion. 
 E. Lacrimation is lost on the side of the lesion and the cornea dries out.

51. The MLF contains descending axons from all of the following except.

 A. Interstitial nucleus of Cajal.
 B. Nucleus of Darkschwitsch.
 C. Superior colliculus.
 D. Substantia nigra.
 E. Pretectal nuclei.

52. The posterior commissure is composed of all of the following except.

 A. MLF.
 B. Occulomotor fibers.
 C. Tectal fibers.
 D. Nucleus of Darkschwitsch fibers.
 E. Red nucleus fibers.

53. If a patient displayed lack of epicratic sensations over both lower limbs, deviation of the left lateral 
      rectus muscle, blindness in the right eye, left intra-nuclear opthalomoplegia, and loss of urinary 
      control with all other sensations being normal, one would first think of which of the following disease 
      entities as being the culprit. 

 A. Poliomyelitis.
 B. Tabes dorsalis.
 C. Guillain-Barre syndrome
 D. Multiple sclerosis.
 E. Combined system disease.

54. The preganglionic neurons of the parasympathetic nervous system would be found in all of the following 
       structures except. 

 A. Dorsal motor nucleus of the vagus.
 B. Interomediolateral nucleus thoracicus.
 C. Inferior salivatory nucleus.
 D. Superior salivatory nucleus.
 E. Edinger-Westphal nucleus.

55. A small lesion of cranial nerves 3, 6, and 12 often result in upper motor neuron symptomology as well. 
      This phenomenon is referred to as. 

 A. Hemiplegia cruciata.
 B. Paraplegia.
 C. Quadraplegia.
 D. Alternating hemiplegia.
 E. Anaesthesia.

56. Lesions of the auditory system include all of the following except.

 A. Destruction of the cochlea or cochlear nuclei result in complete deafness ipsilaterally.
 B. A benign tumor of the eighth nerve specifically is known as an acoustic neuroma.
 C. Lesions of the contralateral superior olive results in a loss of ipsilateral sound localization.
 D. using the Rinne test, air and bone conductance to a tuning fork are diminished.                
 E. With the Weber test, a tuning fork placed in the midline of the skull results in a increase in sound in the 
           normal ear.

57. A patient is in your office where he precedes to have a seizure because he gets excited. Initially you see his 
      left hand convulse, then his head and eyes turn to the left, after which a generalized bilateral convulsion occurs. Identify the location of the origin of the seizure. 

 A. Left frontal lobe.
 B. Right frontal lobe.
 C. Left parietal lobe.
 D. Right parietal lobe.
 E. Left temporal lobe.
 F. Right temporal lobe.
 G. None of the above.

58. In a bilateral MLF lesion, one would find all of the following except.

 A. Left nystagmus upon looking left.
 B. Right nystagmus upon looking right.
 C. Impaired adduction of the right eye.
 D. Impaired adduction of the left eye.
 E. Normal convergence.
 F. Normal divergence.

59. An occlusion of the superior cerebellar artery could have an effect upon all the following 
      structures except. 

 A. Cerebellum.
 B. Medial leminiscus.
 C. Lateral spinothalamic tract.
 D. Inferior colliculus.
 E. Mesencephalic tract and nucleus.
 F. Medial longitudinal fasciculus.
 G. Lateral tegmentum.

60. One would expect to see termination of the striate cortex projections terminating in the superior 
      colliculi layer. 

 A. Zonale
 B. Leminisci
 C. Opticus
 D. Griseum
 E. Album

61. All of the following are true in regard to Horners syndrome except.

 A. Damage to the superior cervical ganglion can cause it.
 B. Results in ptosis of the eye because of denervation of the superior palpebral muscle.
 C. Results in the face being wet, pallored and cold.
 D. Results in a smaller pupil on the affected side.
 E. Can be found in medullary, pontine and midbrain tegmental lesions.

62. All of the following are true in regard to the Argyll-Robertson pupil except.

 A. It is due to syphilis.
 B. The pupil will contract very slowly to light or not at all. 
 C. The pupil will be dilated.
 D. The eyes can converge during accommodation.
 E. The eyes can diverge during accommodation.

63. All of the following are true in regard to the trochlear nerve except.

 A. Diplopia is a common symptom after damage.
 B. The nuclei contain lower motoneurons.
 C. It depresses the eye when abducted.
 D. The axons decussate to the contralateral side.
 E. It innervates the superior oblique muscle.

64. A unilateral lesion to the corticobulbar system in the internal capsule results in voluntary control in all of 
      the following motor nuclei or structures except. 

 A. Hypoglossal.
 B. Abducens.
 C. Lower face.
 D. Upper face.
 E. Uvula.

65. A lesion of the right red nucleus will result in all of the following except. 

 A. Resting tremor on left
 B. Right sided truncal ataxia.
 C. Left sided choreoathetotic movements.
 D. Left sided hypotonia.
 E. Decrease in left tendon reflexes.

66. Opthalomostatic refers to.

 A. Motion of the eyes in response to acceleration.
 B. Motion of the eyes to de-acceleration.
 C. Motion of the eyes to rotation.
 D. Maintenance of gaze when the head is still.
 E. None of the above.

67. A lesion of the occulomotor nerve bilaterally will result in all of the following except.

 A. Loss of accommodation.
 B. Diplopia.
 C. Ptosis.
 D. Constricted pupil.
 E. Strabismus (squinting and abnormal eye positions).

68.  If one turned in a right-to-left direction, one would see the following post-rotational effects.  

 A. Left endolymph ampullopetal and is maximally stimulated.
 B. Left nystagmus.
 C. Slow component to the left. D. Past-pointing to the right.
 D. Falling to the right.
 E. Past-pointing to the right.

69. All of the following are related to the lateral leminiscus except.

 A. Superior olivary nucleus
 B. Olivocochlear bundle
 C. Ventral cochlear nucleus.
 D. Trapezoid nucleus.
 E. Inferior colliculus.

70. A lesion of the right frontal cortex will result in all of the following except:

 A. Paresis of the left hand.
 B. Paresis of the left leg.
 C. Eyes will look away from the paralyzed left limbs.
 D. Eyes cannot be moved to the right.
 E. Paresis of the left trunk.

71. Anterior internuclear opthalmoplegia includes all of the following except:

 A. Paralysis or paresis of occular adduction on attempted lateral gaze to the opposite side to the lesion.
 B. Horizontal nystagmus in the adducting eye.
 C. Horizontal nystagmus in the abducting eye.
 D. Preservation of occular convergence.
 E. Due to lesions rostral to the VI nucleus of the MLF.

72. Under what circumstances might the caloric test be useful as a differential diagnostic aid?

 A. When sudden unilateral deafness occurs.
 B. When a person is brought to the emergency room comatose.
 C. Meniere's disease.
 D. Acoustic schwannoma
 E. All of the above
 F. A and C only

73. A patient comes to see you complaining of ringing sounds persisting in his left ear. On clinical evaluation, 
      he showed a slight left sided weakness of the facial muscles. Caloric vestibular testing indicated a difference
      in the two sides. There was also a slight decrease in hearing in the left ear. The most likely cause for this 
      problem would be:

 A. Vascular lesion of long circumflex pontine arteries.
 B. A peripheral vascular lesion of the vestibulo-cochlear apparatus .
 C. Meniere's disease
 D. Schwannoma
 E. Ependymoma

74.  The olivocochlear bundle:

 A. Is concerned with "auditory sharpening".
 B. Consists of both crossed and uncrossed fibers which emerge from the brain stem with the vestibular nerve.
 C. Innervates the stapedius muscle.          
 D. Is associated with the phenomenon of paracusis.
 E. Conveys impulses only to specific parts of the cochlea.

75.  Primary vestibular fibers:
      
 A. Project upon the vestibular nuclei and specific parts of the cerebellar cortex.
 B. Pass to all parts of the vestibular nuclei and to the fastigial nuclei.
 C. Ascend in the medial longitudinal fasciculus (MLF) to the extraocular muscles.
 D. Project bilaterally to the vestibular nuclei.
 E. Project ipsilaterally to the vestibular nuclei and the  reticular formation.

76.  The pretectal nucleus most involved in the pupillary light reflex is:
       
 A. Nucleus of the optic tract.
 B. Nuclei of posterior commissure.
 C. Pretectal olivary nucleus.
 D. Nucleus of the pretectal area.
 E. Interstitial nucleus of Cajal.

77.  A complete lesion of the occulomotor nerve results in: 
        
 A. Ptosis of the eyelid, an internal strabismus, and severe limitations of ipsilateral eye movements
 B. A fully dilated pupil not responsive to light but reactive to accommodation.
 C. A fully dilated pupil and only a consensual puppillary response to light.
 D. A contralateral ptosis and an immobile abducted eye.
 E. Anisocoria (unequal pupils) with reduction of both direct and consensual pupillary responses to light

78.  The principal ascending auditory pathway in the brain stem is :
           
 A. Medial leminiscus.
 B. Trapezoid body.
 C. Ventral acoustic stria.
 D. Lateral leminiscus.
 E. Acoustic tubercle

79.  A patient with a lesion of the trochlear nerve might have difficulty: 
         
 A. Looking upward and outward
 B. Crossing his eyes.
 C. Making conjugate lateral eye movements.
 D. Walking down stairs.
 E. Accommodating for near vision. 

80.  A voluntary central type facial palsy: 
       
 A. Involves only muscles in the lower part of the face ipsilaterally. 
 B. Results in a relatively mild lower facial weakness and loss of the corneal reflex.
 C. Is due to involvement of crossed corticobulbar fibers.
 D. Results from a brain stem lesion destroying fibers of the facial nerve.
E. Is a consequence of destruction of reticular neurons which project to particular parts of the facial nucleus.

81.  Lesions of the midbrain tegmentum frequently are associated with:

 A. Hypersomnia, muscular relaxation, slow respiration, and an EEG characterized by large amplitude slow waves.
 B. Unconsciousness, irregular respiration, and impaired cardiovascular function.
 C. An EEG pattern similar to that associated with paradoxical sleep and rapid eye movements.
 D. Decerebrate rigidity and loss of thermo-regulatory control.
 E. Increased muscle tone and collapse of the cardiovascular function.

82.  The following are true concerning the red nucleus, except:
      
 A. It receives projections from the interposed and dentate nuclei.
 B. It has a caudal magnocellular portion. 
 C. It receives a somatotopic projection from the motor cortex.
 D. It sends uncrossed fibers to the inferior olive via the central tegmental tract.
 E. It projects uncrossed fibers to the intermediate zone (lamina VII) of the spinal gray.

83.  A lesion in right medial longitudinal fasciculus (MLF) rostral to the abducens nucleus produces: 
        
 A. Paralysis of right lateral gaze.
 B. Horizontal diplopia on the right gaze.
 C. Impairment of ocular convergence. 
 D. Paralysis of ocular adduction on attempted lateral gaze to the left.
 E. Monocular horizontal nystagmus on attempted lateral gaze to the right.

84.  A patient with a peripheral facial palsy, loss of taste in the anterior 2/3 of the tongue, hyperacusis, impaired 
       salivary secretion, and profuse lacrimation in response to a salivary stimulus, has had a:
        
 A. Lesion in the major superficial petrosal nerve or in the pterygopalatine ganglion
 B. Lesion distal to the geniculate ganglion 
 C. Partial lesion of the facial nerve at the stylomastoid foramen
 D. Lesion of the geniculate ganglion
 E. Complete lesion of the facial and intermediate nerve Proximal to the geniculate ganglion

85.  A brain stem lesion associated with horizontal diplopia on attempted gaze to the right, a left hemiplegia, 
       and impaired kinesthetic and discriminative tactile sense on the left most likely involves:

 A. Structures in the cerebellopontine tegmentum.
 B. The abducens nucleus and the pontine tegmentum.
 C. The basal part of the pons on the right and the adjacent ventral pontine tegmentum.
 D. The ventromedial part of the midbrain tegmentum and the crus cerebri on the right.
 E. The medullary pyramid and medial leminiscus on the right.

86. The neuronal pacemaker (biological clock) entrained by photic cues is:

 A. Hypothalamic paraventricular nucleus.
 B. Lateral geniculate body pars ventralis.
 C. Lateral geniculate body pars dorsalis.
 D. Suprachiasmatic nuclei
 E. Supraoptic  nucleus.

87. After decortication, an animal exhibits extensor rigidity.  Upon removal of the cerebellum, this ridigity
is increased even more so.  Which of the following best describes this phenomena?

 A.  The excitatory neurons of the deep cerebellar nuclei no longer exert an effect upon the reticular formation.
 B. The spino-olivary tract becomes excited when it isn't connected to the cerebellum.
 C. Loss of the inhibitory control to vestibulospinal neurons cause an increase in spontaneous firing to extensor musculature.
 D. The pons becomes involved directly in motor activities when it doesn't have to worry about cerebellar functions.
 E. The loss of the deep cerebellar inhibitory neurons causes an increase in excitability of vestibular and reticular neurons.

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