Neuroscience Fundamentals Rehabilitation 4th Edition Lundy Ekman – Test Bank

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Lundy-Ekman: Neuroscience: Fundamentals for Rehabilitation, 4th Edition

Chapter 5: Development of the Nervous System

Test Bank

1. Somites are derived from which one of the following pre-embryonic cell layers?

A. Endoderm

B. Mesoderm

C. Ectoderm

D. Neural crest

E. None of the above

ANS: B

Rationale: Somites are spherical cell clusters that develop from the mesoderm as the neural tube closes.

2. Which one of the following statements about somites is NOT true?

A. The sclerotome develops into the vertebrae and skull.

B. The myotome develops into skeletal muscle.

C. The dermatome develops into skin.

D. Somites are added in a caudal-to-rostral direction.

E. Somites develop adjacent to the neural groove.

ANS: D

Rationale: Somites initially appear in the occipital region, adjacent to the neural groove, and are added in a rostral-to-caudal direction. The anteromedial sclerotome becomes the vertebrae and skull, the posteromedial myotome develops into skeletal muscle, and the lateral dermatome develops into the dermis. 

3. Neurons that develop in the ventral region of the neural tube become:

A. Interneurons and projections neurons.

B. Interneurons and the motor neurons that innervate skeletal muscle. 

C. Interneurons of the autonomic nervous system.

D. Both A and B

E. All of the above 

ANS: B

Rationale: Neurons in the ventral region of the neural tube proliferate to form interneurons and the motor neurons that innervate skeletal muscles. Neurons in the dorsal tube proliferate to form interneurons and projection neurons, whereas neurons from the neural crest form autonomic neurons.

4. Which one of the following forms of spina bifida is the least severe and usually does not result in neural symptoms?

A. Spina bifida with myeloschisis

B. Spina bifida with meningomyelocele

C. Spina bifida with meningocele

D. Spina bifida occulta

E. All forms of spina bifida result in neural symptoms.

ANS: D

Rationale: Spina bifida is a neural tube defect that results when the inferior neuropore does not close, producing a bony defect at the distal end of the tube. The severity of the defect varies, ranging from normal spinal cord function (spina bifida occulta) to severe malformation and exposure of the spinal cord to the surface of the body (myeloschisis). 

5. Which one of the following statements is true regarding the stages of development?

A. The pre-embryonic stage involves the formation of a blastocyst.

B. The embryonic stage occurs after the 8th week of development.

C. Myelination occurs during the fetal stage of development.

D. Both A and C

E. All of the above

ANS: D

Rationale: In utero, humans undergo three stages of development. The pre-embryonic stage lasts from conception until day 14 and involves fertilization, as well as the formation and implantation of a blastocyst. The embryonic stage lasts from day 15 until the end of the 8th week, during which time the organ systems are formed. The fetal stage lasts from the end of the 8th week until birth, during which time the nervous system develops more fully and myelination occurs.

6. Which one of the following structures is derived from the neural crest?

A. Dorsal horn of the spinal cord

B. Motor neurons to skeletal muscle

C. Peripheral nerve except motor neurons

D. Ventral horn of the spinal cord

E. Both A and D

ANS: C

Rationale: Nearly all of the peripheral nervous system, with the exception of motor neurons to skeletal muscles, develops from the neural crest. Motor neurons develop from the ventral motor (basal) plate, as does the ventral gray matter of the mature spinal cord. The dorsal association (alar) plate generates the dorsal horn of the spinal cord.

7. Which one of the following correctly pairs a brain structure with its developmental source?

A. Forebrain; hypothalamus

B. Midbrain; cerebellum

C. Hindbrain; basal ganglia

D. Both A and B

E. All of the above

ANS: A

Rationale: During development, the brain region of the neural tube expands into three enlargements: hindbrain, midbrain, and forebrain. The hindbrain ultimately becomes the medulla, pons, and cerebellum. The midbrain retains its name. The forebrain becomes the thalamus, hypothalamus, cerebral hemispheres, and deep nuclei including the basal ganglia.

8. During development, the nervous system is sculpted through which of the following?

A. Neuronal death

B. Neuronal activity

C. Axon retraction

D. All of the above

ANS: D

Rationale: As many as one-half of the neurons formed during development do not survive, which is likely the result of inactivity or a failure to reach a target cell. In some cases, neurons that survive will retract axons from certain target cells.

9. An Arnold-Chiari type II malformation:

A. Is not associated with a defect of the lower neural tube.

B. Consists of herniation of the cerebellar tonsils into the vertebral canal.

C. Is associated with progressive hydrocephalus.

D. Usually manifests during adolescence or early adulthood.

ANS: C

Rationale: Arnold-Chiari malformation is a developmental deformity of the hindbrain. A type I malformation is not associated with a lower neural tube defect and occurs when the cerebellar tonsils herniate into the vertebral canal. If symptomatic, this malformation is usually characterized by headache and neck pain, hydrocephalus, and visual disturbances. Signs of type II malformation are visible beginning in infancy and result from extension of the medulla and cerebellum through the foramen magnum. This malformation often produces progressive hydrocephalus, deafness, weakness of eye movements, as well as facial and neck muscle weakness. In addition, it is nearly always accompanied by incomplete closure of the lower neural tube.

10. A child with motor deficits is being prepared for a clinical examination. Her chart reads that she has been diagnosed with Werdnig-Hoffman disease. This is a form of which of the following?

A. Spina bifida

B. Cerebral palsy

C. Spinal muscle atrophy

D. Autism

ANS: C

Rationale: Werdnig-Hoffman disease, also known as type I spinal muscle atrophy, is the most severe form of spinal muscle atrophy. In Werdnig-Hoffman disease, motor neurons with cell bodies in the spinal cord degenerate, producing muscle weakness and atrophy.

11. When working with a child with cerebral palsy, involuntarily slow, writhing movements in the arms and legs are observed. This is most likely classified as:

A. Dystonic cerebral palsy

B. Spastic cerebral palsy

C. Ataxic cerebral palsy

D. Hypotonic cerebral palsy

ANS: A

Rationale: Dystonia involves involuntary fluctuations in muscle tone, ranging from hypertonia to hypotonia. Dystonic cerebral palsy can result in slow, writhing (e.g., athetoid) movements.

12. Which one the following statements is true?

A. Cerebral palsy is permanent and progressive.

B. Damage to the basal ganglia produces ataxic cerebral palsy.

C. Hypoxia during birth is a common cause of cerebral palsy.

D. Cognitive, visual, and speech deficits are common in cerebral palsy.

E. None of the above

ANS: D

Rationale: Cerebral palsy is the result of permanent, but nonprogressive damage to the developing brain. This damage often produces motor, cognitive, visual, auditory, and/or speech deficits. Damage to axons near the lateral ventricles causes spastic cerebral palsy (spasticity is neuromuscular overactivity). Damage in the basal ganglia causes dyskinetic CP (characterized by involuntary movements and postures). Cerebellar damage causes ataxic CP (characterized by uncoordinated movements). Cerebral palsy is also described as hypotonic or mixed. Cerebral palsy is rarely caused by hypoxia or difficulties during labor but may be caused by genetic, metabolic, immune and coagulation disorders, and maternal infection.

13. Developmental coordination disorder (DCD):

A. Is often associated with behavioral and social problems.

B. Usually continues into adulthood.

C. Is not associated with an identifiable neurologic problem.

D. All of the above

ANS: D

Rationale: In DCD, a child with normal intellect and without a history of a neurologic injury or problems lacks the motor ability to perform tasks that most children of the same age are able to perform. DCD is usually permanent and persists into adulthood. DCD is also associated with mood and anxiety disorders, behavioral problems, and social difficulties.

14. Pharmacologic treatment of attention deficit hyperactivity disorder (ADHD) involves:

A. Depressant drugs that increase serotonin and epinephrine availability.

B. Stimulant drugs that increase dopamine and norepinephrine availability.

C. Depressant drugs that decrease glutamate and acetylcholine availability.

D. Stimulant drugs that decrease dopamine and epinephrine availability.

ANS: B

Rationale: Individuals with ADHD have reduced volume of the prefrontal cortex, caudate and putamen, dorsal cingulate cortex, and cerebellum. Treatment of ADHD involves the use of stimulant drugs to increase the availability of dopamine and norepinephrine in the synapses.

15. The autism spectrum is made up of:

A. Autistic disorder.

B. Asperger’s syndrome.

C. Pervasive developmental disorder.

D. Both A and B

E. All of the above

ANS: E 

Rationale: The autism spectrum is a range of abnormal behaviors including impaired social skills. The autism spectrum is made up of three disorders: (1) autistic disorder; (2) Asperger’s syndrome; and (3) pervasive developmental disorder.

16. Factors associated with autistic disorders include:

A. Abnormality of the caudate and putamen.

B. Temporal cortical damage.

C. Cerebellar atrophy.

D. Prenatal hypoxia.

ANS: A

Rationale: Brain differences observed in autism include reduced communication between cerebral areas, a larger amygdala during childhood, and abnormal shape of the caudate and putamen.

17. During critical periods of neurologic development:

A. Neuronal projections compete for synaptic sites.

B. Conditions for learning a new task are optimal.

C. Permanent structural changes occur in the nervous system.

D. Both A and B

E. All of the above

ANS: E

Rationale: Critical periods during development occur when neural projections are competing for synaptic sites, allowing the nervous system to optimize neural connections. During these critical periods, the conditions for learning new tasks and skills are optimal and produce permanent structural changes in the nervous system.

18. A 2-year-old boy is recently identified as having a motor impairment in the lower extremities because of a perinatal injury. This is an example of which of the following?

A. Congenital motor delay 

B. Progressive developmental disorder

C. Growing into deficit 

D. Developmental coordination disorder (DCD)

ANS: C

Rationale: In some cases, nervous system damage that occurs early in development may not become evident until the damaged systems normally become functional. This is referred to as growing into deficit.

19. The central nervous system is most susceptible to major malformation during which one of the following periods of development?

A. Weeks 1 to 10

B. Weeks 2 to 20

C. Weeks 20 to 40

D. Postnatal

ANS: B

Rationale: The central nervous system is most susceptible to major malformation between day 14 and week 20; the fundamental structures of the nervous system form during this period.

20. Alcohol abuse during pregnancy can result in which of the following?

A. Physical deformities

B. Holoprosencephaly 

C. Cognitive, motor, and behavioral problems

D. Both A and C

E. All of the above

ANS: D

Rationale: Alcohol abuse during pregnancy can result in fetal alcohol syndrome and alcohol-related birth defects. Fetal alcohol syndrome consists of central nervous system impairments, growth deficiencies before and/or after birth, and facial abnormalities. Alcohol-related birth defects include a milder series of characteristic facial abnormalities, as well as cognitive, motor, and behavioral problems. Holoprosencephaly is a genetic forebrain malformation characterized by the formation of a single cerebral hemisphere and severe facial deformities.