Hall: Guyton and Hall Textbook of Medical Physiology, 12th Edition
Chapter 47: Somatic Sensations: I. General Organization, the Tactile and Position
Senses
Test Bank
Choose the best answer.
1. For a sensory nerve fiber that is connected to a Pacinian corpuscle located on the palmer
surface of the right hand, the synaptic connection with the next neuron in the appropriate
sensory pathway is located in:
A. The right dorsal column nucleus
B. The left dorsal column nucleus
C. The dorsal horn of the right side of the spinal cord
D. The dorsal horn of the left side of the spinal cord
2. For a sensory nerve fiber that is connected to a free nerve ending located on the left hand,
the synaptic connection with the next neuron in the appropriate sensory pathway is
located in:
A. The right dorsal column nucleus
B. The dorsal horn of the right side of the spinal cord
C. The left dorsal column nucleus
D. The dorsal horn of the left side of the spinal cord
3. The second neuron in the appropriate sensory pathway that connects a Meissner’s
corpuscle in the left palm to the somatosensory cortex travels in the:
A. The contralateral lateral lemniscus
B. The ipsilateral anterolateral column
C. The ipsilateral medial lemniscus
D. The contralateral medial lemniscus
4. The second neuron in the appropriate sensory pathway that connects a free nerve ending
in the left thumb to the somatosensory cortex travels in the:
A. The ipsilateral anterolateral column
B. The ipsilateral medial lemniscus
C. The contralateral anterolateral column
D. The contralateral medial lemniscus
Test Bank
47-2
Questions 5 – 8: A 36-year-old male was involved in a motor vehicle collision and received
an injury to the spine at the C-7 level. The injury transected exactly half (anterior to
posterior) of the spinal cord on the patient’s right side.
5. During the physical examination of this patient, two-point discrimination (fine touch)
would:
A. Be absent on the left side of the body
B. Be absent on the right side of the body
C. Not be affected by the injury
D. Be enhanced on the right side
6. On which side of the patient would you expect pain and temperature sensations to be
ABSENT?
A. The left side
B. The right side
C. Pain and temperature sensations would not be affected on either side of the body
D. Both sides
7. On which side of this patient would you expect vibration sense to be ABSENT?
A. The left side
B. The right side
C. Vibration sensation would be not be affected
D. Both sides
8. On which side of this patient would the position sensation (proprioception) be ABSENT?
A. The left side
B. The right side
C. Proprioceptive sensation would not be affected
D. Both sides
Questions 9 – 12: An individual was brought into the emergency department following a
motor vehicle collision. This individual is conscious and reports no loss of consciousness
during the incident. There is no physical evidence of any head trauma. However, upon
examination of this individual, the following sensory deficits are noted: loss of fine touch
and vibration sense in both the left arm and leg including the hand and foot, loss of pain and
temperature sense in the right arm and leg including the hand and foot.
9. In the description above, the loss of fine touch and vibration sense involves which of the
following nerve tracts?
A. The anterolateral system
B. The dorsal column system
C. The corticospinal tract
D. The medial forebrain bundle
10. In the description above, the loss of pain and temperature sense involves which of the
following nerve tracts?
A. The corticospinal tract
B. The pontocerebellar tract
C. The dorsal column system
D. The anterolateral system
11. In the description above, one can rule out a lesion in which of the following areas of the
nervous system?
A. The cortex
B. The brainstem
C. The peripheral nerves
D. The spinal cord
12. Which of the following is the most likely location of the injury to the nervous system in
the above example?
A. The left side of the cervical spinal cord
B. The right side of the cervical spinal cord
C. The brain stem involving the left medial lemniscus
D. The left side of the lumbar spinal cord
13. Which of the following areas of the body has the greatest representation in the primary
somatosensory cortex?
A. The foot
B. The face
C. The trunk
D. The forearm
14. Which of the following nerve structures carries axons from the dorsal column nuclei to
the thalamus?
A. The spinothalamic tract
B. The lateral lemniscus
C. The mammillothalamic tract
D. The medial lemniscus