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Neuro-Physiology-Practice-Test-With-Answer-And-Explanation

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Neuro-Physiology-Practice-Test-With-Answer-And-Explanation

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•1
A 63-year-old man who visits his doctor for a regular checkup admits that he is having trouble
.2
wife when she speak s to him. However, he seems able to hear his favorite cowboys on the tele
•3 Western, and this certainly angers his w ife. The physician conducts an aud itory test and reassu
·4 patient that his pathology is part of the normal process of aging and not a newfound aversion t
•5
What physiologic changes would one expect to find in this patient on a cellular level?


A. Compression of cranial nerve VIII as it exits the internal auditory meatus
B. Degeneration of the distal hair cells at the apex of the organ of Corti
C. Degeneration of the proxima l hair cells of the organ of Corti
D. Degeneration of the utricle and the saccule
E. Trauma to the coch lear nuclei




a
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1
.2
The correct a n s wer is C. 64°/o chose this.
•3
Age-related degeneration of the organ of Corti (depicted in the Inn
·4 drawing) lies in the proximal portion of the basilar membrane
Tectorial membra
•5 (farthest from the helicotrema or apex and closest to the ossicles
and oval w indow). Because this is the th innest and least compliant Outer hair cells
part of the basilar membrane, it is responsible for sensing high-
pitched sounds. The loss of hair cells in this region is called
presbycusis, and this is the classic pattern of sensorineural hearing
loss in older patients. It also explains why the patient is having
progressively more trouble hearing his wife's voice while hearing
most of the characters (cowboys with low-pitched voices) on
television just fine.
Helicotrema Presbycusis Basilar membrane Organ of Corti Sensorineural hearing loss Hair cell Basilar fi r
Ossicles Oval window Hearing loss Anatomical terms of location
Spiral gan
Coch
Image courtesy of Wikime

A is not correct. 2°/o chose this.
Compression or trauma to crania l nerve VIII wou ld not only disrupt al l frequencies of sound fr
would also affect the vestibu lar system . Therefore, this man would present with hearing loss a
nystagmus, nausea, and/or vomiting .
Vestibular system Nystagmus Vertigo Vestibulocochlear nerve Cranial nerves Nausea Vomiting Hearing loss Skull Vestibular exam Majo

B is not correct. 31°/o chose this.
a
Lock

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e - e - e e- • I - - e • - - :l - :f. U e I e e e :l e I a - -- e I - - e e I e
1
would also affect the vestibular system. Therefore, this man would present with hearing loss a
.2
nystagmus, nausea, and/or vomiting.
•3 Vestibular system Nystagmus Vertigo Vestibulocochlear nerve Cranial nerves Nausea Vomiting Hearing loss Skull Vestibular exam Majo

.4
B is not correct. 31% chose this.
•5
The ha ir cel ls located more distal ly near the apex of the organ of Corti rest on a broader and f
the basilar membrane . Therefore, they process sounds that have a lower pitch, and they are u
age-related hearing loss.
Basilar membrane Organ of Corti Hair cell Presbycusis Hearing loss


D is not correct. 2°/o chose this.
The utricle and the saccule are portions of the vestibular apparatus, and they are responsible
changes in head position with respect to linear acce leration . They are not involved in hearing.
Saccule Utricle (ear) Vestibular system linear particle accelerator


E is not correct. 1°/o chose this.
Trauma to a coch lear nucleus would result in the loss of hea ring of al l f requencies in the ipsila
Therefore, this man would not be able to hea r the te levision or his wife in one ear.
Cochlear nucleus Anatomical terms of location Ipsilateral Cell nucleus Major trauma




Bottom Line:
Hai r cel ls on the proximal region of the organ of Corti, where the basi lar membrane is thinne
for high-pitched sound perception and are frequently lost in presbycusis.
Basilar membrane Organ of Corti Presbycusis Hair cell




6
lock

, Item: 1 of 7 ~. I • M k <:] t> al ~· ~
QIO: 3577 .l. ar Previous Next lab 'lifllues Notes Calculator

1
- - - - -
- - - -- --- ------ - - - -- -
changes in head position with respect to linear acce leration . They are not involved in hearing.
.2 Saccule Utricle (ear) Vestibular system linear particle accelerator
•3
E is not correct. 1°/o chose this.
.4
Trauma to a coch lear nucleus would result in the loss of hea ring of al l frequencies in the ipsila
•5 Therefore, this man would not be able to hear the te levision or his wife in one ear.
Cochlear nucleus Anatomical terms of location Ipsilateral Cell nucleus Major trauma




Bottom Line:
Hair cel ls on the proximal region of the organ of Corti, where the basi lar membrane is thinne
for high-pitched sound perception and are frequently lost in presbycusis.
Basilar membrane Organ of Corti Presbycusis Hair cell




1iU;fii!1J•J for year:[ 2017
FI RST AID FA CTS
"




Diagnosing hearing loss
RINNE TEST WEBER TEST
Conduct ive Abnormal (bone> air) Localizes to affected ear
Sensorineural ormal (air> bone) Localizes to unaffected ear



6
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