MedIS exam 2013
Course title: Nervesystemet og bevægeapparatet II - MedIS Programme: Bachelor in education Semester: 5. semester Exam date: 21-1-12 Time: 9:00 - 12:00 Evaluation form 7-point scale – External censur
Important information: Remember to bring your student identification card Remember to put your student number – not your name and cpr no – on all sheets that you hand in for evaluation Remember to hand in the assignment if you leave the exam before it has ended No written aid is allowed Quicktionary pen is allowed Your paper must be handed in on paper in hand written form The study board/the university cannot be held liable if any problems should occur regarding the electronic aid during the examination It will be considered cheating or attempting to cheat if the technical equipment of the student is communicating or trying to communicate with other equipment not relevant to the exam, without an explicit permission. Before the beginning of the exam, the student should make sure that all communication devices in the equipment at the exam are turned off.
Communication is not allowed
The exam consists of a mixture of multiple choice questions and essay questions. The total amount of questions is 36. The total amount of points is 60.
This lists the grades corresponding to the points: 12 (passed): 56-60 points 10 (passed): 51-55.5 points 07 (passed): 46-50.5 points 04 (passed): 41-45.5 points 02 (passed): 36-40.5 points 00 (failed): 18-35.5 points -2 (failed): 0-17.5 points
1 1. Eye muscle innervations A. M. levator palpebrae superioris B. M. obliquus superior C. M. rectus lateralis D. M. obliquus inferior E. M. rectus medialis Lead in: From the list above, select the appropriate option. This muscle is innervated by the N. trochlearis (cranial nerve IV). B This muscle is innervated by the N. abducens (cranial nerve VI). C Max point: 2 Achieved point:
2. Eye muscle functions A. M. levator palpebrae superioris B. M. obliquus superior C. M. rectus lateralis D. M. obliquus inferior E. M. rectus medialis F. M. rectus inferior G. M. rectus superior Lead in: Select the appropriate muscle function from the list above. Eye looks laterally (abduction) C Eye rolls, looks down, laterally B Eye looks medially (adduction) E Eye rolls, looks up, laterally D Max point: 4 Achieved point:
3. What are the three branches of the cranial nerves V (N. trigeminus)? Give them in ascending order (V1, V2, V3) Where do these nerves pass through? - N. ophthalmicus/V1 (0.5); Fissura orbitalis superior (0.5) - N. maxillaris/V2 (0.5); Foramen rotundum (0.5) - N. mandibularis/V3 (0.5); Foramen ovale (0.5)
Max point: 3 Achieved point:
4. Which of the following cranial nerves has no primary sensory-motor function (mixed)? A. N. vagus B. N. vestibulocochlearis C. N. facialis D. N. trigeminus E. N. glossopharyngeus Max point: 1 Achieved point:
2 5. Which of the following cranial nerves does not pass through the foramen jugulare? A. N. vagus B. N. glossopharyngeus C. N. hypoglossus D. N. accessorius Max point: 1 Achieved point:
6. Which of the following statements is not true?
A. The vitreous humor fills the space between the lens and the retina. B. The vitreous humor enters the Canal of Schlemm that delivers the humor to veins in the sclera. C. The aqueous humor fills the space in front of the lens. D. The aqueous humor is actively secreted by epithelial cells. E. The intraocular pressure is considered normal in the range of 12 to 21 mm/Hg. Max point: 1 Achieved point:
7 Visual information processing from the retina to the visual cortex involves different structures. Arrange the following terms in the correct order: Chiasma opticum, Tractus opticus, Nervus opticus, Radiatio optica, Corpus geniculatum laterale. Nervus opticus, Chiasma opticium, Tractus opticus, Corpus geniculatum laterale, Radiatio optica
Max point: 2 Achieved point:
8. A left tractus opticus lesion induces which one of the following clinical signs? A. Medial deviation of the eyeball B. Ptosis C. Anosmia D. Hemianopia E. Miosis Max point: 1 Achieved point:
9 Which one of the following statements concerning the corneal reflex is true? A. The afferent nerve fibers belong to the N. occulomotorius. B. It is a monosynaptic reflex. C. The reflex fails in a complete peripheral palsy of the N. facialis. D. The efferent nerve fibers originate in the Mesencephalon. E. A positive reflex is a pathological sign. Max point: 1 Achieved point:
3 10 The pupillary light reflex mainly involves two inner eye muscles. Give the exact latin names of these muscles and their functions. Musculus sphincter pupillae - Miosis (1) Musculus dilatator pupillae - Mydriasis (1)
Max point: 2 Achieved point:
11 Which one of the following statements concerning the Nervus vestibulocochlearis is NOT true? A. Lesions of the semicircular canals induce sensorineural deafness. B. Sensory receptors are located in the cochlea. C. It passes through the Meatus acusticus internus. D. Nuclei are located in the Medulla oblongata. E. Sensory receptors are located in the semicircular canals. Max point :1 Achieved point:
12 Which one of the following statements concerning the Sound Pressure Level (SPL) is true? A. The physical unit of SPL is phon. B. A tenfold increase of the sound pressure corresponds to an increase of SPL by 20 dB SPL. C. The reference pressure is 0.02 Pa. D. The auditory pain threshold is approx. 80 dB SPL. E. The SPL of a jackhammer is 40 dB SPL. Max point: 1 Achieved point:
13 Clinical testing of hearing impairment includes the Weber and Rinne test. A - Describe the performance of the Weber test. B - Give the results of the test in a patient with a conductive hearing loss on the right side (Weber). C – briefly define the meaning of a positive and negative Rinne test A. In the Weber test a tuning fork (either 256 or 512 Hz) is struck and the stem of the fork is placed on the top of the patient's skull - equal distance from the patient's ears, in the middle of the forehead - equal distance from the patient's ears or above the upper lip over the teeth. The patient is asked to report in which ear the sound is heard louder. (2) B. Weber: Lateralization of sound in the affected right ear. (1) C. Conductive hearing loss: AC
Max point: 4 Achieved point:
4 14 Anatomy of the ear
Lead in: Identify the appropriate name to accompany each label Label: A Membrana tympani B Stapes C Cochlea D Tuba auditiva (Eustachii) Max point: 4 Achieved point:
15. When it comes to the transmission of sound waves from the inner ear, what are the sound amplification mechanisms that involves the 3 ossicles?
The 3 ossicle are a series of levers: Movement of the malleolus causes a greater movement of the incus which in turn causes an even greater movement of the stapes.
Max point: 1 Achieved point:
16 Which one of the following statements is true regarding clinical signs of N. facialis impairment? A. Paresis of Mm. masticatorii B. Bell’s sign C. Vertigo D. Diplopia E. Anosmia Max point: 1 Achieved point:
5 17 Which one of the following statements is NOT a typical clinical test of N. vagus impairment? A. Intraoral, pharyngeal sensations B. Uvula position C. Speak & cough D. Protrude & retract tongue E. Gag reflex Max point: 1 Achieved point:
18 Which one of the following statements concerning accommodation is true? A. Contraction of the Musculus ciliaris decreases the refractory power of the lens. B. Total loss of accommodation is called Myopia. C. Accommodation is clinically tested by the Snellen Chart. D. Emmetropia corresponds to loss of sympathetic innervation. E. Parasympathetic input to inner eye muscles mediates near accommodation. Max point: 1 Achieved point:
19 Which one of the following vessels does NOT belong to the Circulus arteriosus cerebri? A. Arteria subclavia B. Arteria cerebri anterior C. Arteria cerebri media D. Arteria cerebri posterior E. Arteria basilaris Max point: 1 Achieved point:
20 Which one of the following statements concerning Liquor cerebrospinalis is true? A. Flows from 4th ventricle to Cavitas subarachnoidalis via Apertura lateralis and via Apertura mediana. B. Is absorbed by Plexus choroideus in the 4th ventricle. C. The rate of formation in adults is approx. 5 l/day. D. Is secreted by Granulationes arachnoidales (Pacchioni). E. Has a total volume of approx. 500 ml. Max point: 1 Achieved point:
21 A minor head injury often causes a bump or bruise on the exterior of the head. Give 3 other typical symptoms. nausea, mild headache, tender bruising or mild swelling of the scalp, mild dizziness
Max point: 3 Achieved point:
6 22 Circulus arteriosus cerebri
Lead in: Identify the appropriate name to accompany each label Label: A Arteris communicans anterior B Arteria cerebri anterior C Arteria cerebri media D Arteria cerebri posterior E Arteria vertebralis Max point: 5 Achieved point:
23 The concept of raised intracranial pressure is described with a specific course containing the following 3 “stages” due to for example hemorrhage: Acidosis, systemic arterial vasoconstriction, CSF displacement. Put them into an ascending order (what appears first). Stage 1: CSF displacement Stage 2: Arterial vasoconstriction, Stage 3: Acidosis, systemic Max point: 3 Achieved point:
7 24 Which neurological disorder does NOT lead to dementia? A Myasthenia gravis X B Parkinson’s disease C Multiple sclerosis D Huntington’s chorea E Alzheimer’s disease Max point 1 Achieved point:
25 The typical morphological feature of dementia is NOT: A Brain atrophy B Inflammation around white matter tracts X C Inflammatory cells dispersed in grey and white matter of the telencephalon D Loss of cholinergic neurons E Neuronal loss Max point 1 Achieved point:
26 Which of the following is not typically a symptom of dementia?: A Aphasia B Change of personality C Apraxia D Apathy E Seizures X Max point 1 Achieved point:
27 Which of the following is not considered an appropriate new treatment method?: A Menantine B Sulfasalazine X C Beta-secretase inhibitors D Immunization with amyloid beta-peptides Max point 1 Achieved point:
28 Mechanism of actions. Local anaesthetics work via … A … blocking of calcium channels. B … binding of potassium channels. C … blocking of anionic channels. D … blocking of sodium channels. X E … binding of chloride channels. Max point 1 Achieved point:
8 29 Minimal alveolar concentration (MAC) is defined as … A … the equilibration of partial pressure of oxygen and the inhaled anaesthetic. B … the amount of anaesthetics needed to reduce ventilation by 50%. C … the concentration of an inhaled anaesthetic that leads to bronchoconstricition. D … the concentration of an inhaled anaesthetic, at which the response to D surgical incision is abolished in 50% of subjects. E … 50% of the amount of an anaesthetic for reaching the equilibrium. Max point 1 Achieved point:
30 Briefly describe the Overton-Meyer correlation.
Anaesthetic potency is closely related to lipid solubility, not with chemical structure
Max point: 3 Achieved point:
31 Neuromuscular blocking agents. Which of the following substance is a depolarizing neuromuscular blocking agent? A Gallamine B Atracurium C Mivacurium D Metocurine E Succinylcholine E Max point 1 Achieved point:
32 Which of the following nerve fibers is most sensitive to a conduction block via local anaesthetics? A A-alpha B A-beta C A-gamma D A-delta E C E Max point 1 Achieved point:
33 Choose the incorrect answer! Osteoarthritis is a disease that involves the following factor(s): A. Pannus Formation B. Low-grade inflammation C. Calcification of articular cartilage D. Genetics E. Metabolic disorders Max point: 1 Achieved point:
9 34 Choose the correct statement in regard to gouty arthritis (GA)! A. The formation of Bouchard nodes is a prominent sign in GA. B. The formation of Heberden nodes is a prominent sign in GA. C. GA is highly correlated with chronic inflammation of bursal sacks. D. Tophi deposits typically appear in and around joints in GA. E. Ulnar drift is one of the cardinal symptoms in GA. Max point: 1 Achieved point:
35 Choose the correct statement in regard to septic arthritis (SA)! Lyme arthritis is caused by … A. Borrelia burgdorferi B. H. influenza C. Hepatitis C virus D. Staphylococcus aureus E. E. coli Max point: 1 Achieved point:
36 Choose the correct answer! Medical therapy of osteoarthritis can consist of treatment with … A. Acetaminophen B. Corticosteroids C. Hyaluronate D. NSAIDS E. All of the above Max point: 1 Achieved point:
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