NR 603 Week 1 | Exam
Questions & Rationalized
Answers (100% Verified) |
Newest Update 2026
Section 1: Spinal Cord Injuries & Neurological Trauma (Q 1–10)
Question 1: A 75-year-old man is involved in a motor vehicle accident
and strikes his forehead on the windshield. He complains of neck pain
and severe burning in his shoulders and arms. His physical examination
reveals weakness of his upper extremities. What type of spinal cord
injury does this patient have?
• A) Anterior cord syndrome
• B) Central cord syndrome
• C) Brown-Séquard syndrome
• D) Complete cord transection
• E) Cauda equina syndrome
,,,ANSWER,,,: B
Rationale: Central cord syndrome involves loss of motor function that
is more severe in the upper extremities than in the lower extremities, and
is more severe in the hands. There is typically hyperesthesia over the
shoulders and arms. This injury commonly occurs in older adults from
hyperextension injuries. Anterior cord syndrome presents with
paraplegia or quadriplegia with loss of lateral spinothalamic function but
,preservation of posterior column function. Brown-Séquard syndrome
(hemisection) causes weakness and loss of posterior column function on
one side with contralateral loss of pain/temperature sensation. Complete
cord transection affects all motor and sensory function distal to the
lesion. Cauda equina syndrome typically presents as low back pain with
radiculopathy and bowel/bladder dysfunction .
Question 2: A 37-year-old man fell from a ladder while hanging
Christmas lights. The right side of his head hit the cement, and he lost
consciousness for about 1 minute. He woke up with a headache but had
no other complaints. A few hours later, he is brought to the emergency
room with an intense headache, confusion, and left hand hemiparesis.
Examination reveals a bruise over the right temporal region, mydriasis
(right pupil dilated), right eye deviation, papilledema, and left extensor
plantar response. CT head without contrast shows a lens-shaped hyper-
density under the right temporal bone with mass effect and edema. What
is the most likely diagnosis?
• A) Epidural hematoma
• B) Subdural hematoma
• C) Subarachnoid hemorrhage
• D) Intracerebral parenchymal hemorrhage
• E) Acute meningitis
,,,ANSWER,,,: A
Rationale: Epidural hematoma most often results from a traumatic tear
of the middle meningeal artery (often associated with temporal bone
fracture). Although a "lucid interval" (minutes to hours of normal
,consciousness followed by deterioration) is classic, it occurs in only
about one-third of patients. The lens-shaped (biconvex) hyper-density on
CT is characteristic. Subdural hematoma results from rupture of bridging
veins, has a crescent-shaped appearance on CT, and typically presents
more gradually. Subarachnoid hemorrhage is usually from aneurysm
rupture (sudden "thunderclap" headache). Intracerebral hemorrhage is
typically from hypertension (basal ganglia location). Acute meningitis
presents with fever and nuchal rigidity, not trauma .
Question 3: A patient involved in a rear-impact motor vehicle collision
now experiences severe neck pain and decreased upper extremity motor
function, but normal motor function in the lower extremities. The patient
complains of paresthesias in both the upper and lower extremities but
greater in the arms. Based on these findings, what type of injury does
this patient most likely have?
• A) Cauda equina syndrome
• B) Brown-Séquard syndrome
• C) Anterior cord syndrome
• D) Central cord syndrome
,,,ANSWER,,,: D
Rationale: Central cord syndrome is characterized by greater motor
impairment in the upper extremities compared to the lower extremities,
with varying degrees of sensory loss. This pattern occurs because the
central cord syndrome affects the centrally located corticospinal tracts
that serve the upper extremities. This injury is commonly seen in older
, adults with pre-existing cervical stenosis following hyperextension
injuries (e.g., rear-end collisions) .
Question 4: Which of the following correctly describes the difference
between central cord syndrome and Brown-Séquard syndrome?
• A) Central cord syndrome affects only one side of the body
• B) Brown-Séquard syndrome results from hyperextension injury in
older adults
• C) Central cord syndrome causes greater upper extremity
weakness; Brown-Séquard causes ipsilateral weakness and
contralateral pain/temperature loss
• D) Both syndromes present with complete paralysis below the
lesion
,,,ANSWER,,,: C
Rationale: The key distinguishing feature is that central cord syndrome
produces motor weakness that is more severe in the arms than the legs,
often with a "sacral sparing" pattern. Brown-Séquard syndrome (spinal
cord hemisection) causes ipsilateral weakness and loss of
proprioception/vibration with contralateral loss of pain and temperature
sensation (spinothalamic tract) beginning 1-2 levels below the lesion.
Brown-Séquard typically results from penetrating trauma or tumor, not
hyperextension .
Questions & Rationalized
Answers (100% Verified) |
Newest Update 2026
Section 1: Spinal Cord Injuries & Neurological Trauma (Q 1–10)
Question 1: A 75-year-old man is involved in a motor vehicle accident
and strikes his forehead on the windshield. He complains of neck pain
and severe burning in his shoulders and arms. His physical examination
reveals weakness of his upper extremities. What type of spinal cord
injury does this patient have?
• A) Anterior cord syndrome
• B) Central cord syndrome
• C) Brown-Séquard syndrome
• D) Complete cord transection
• E) Cauda equina syndrome
,,,ANSWER,,,: B
Rationale: Central cord syndrome involves loss of motor function that
is more severe in the upper extremities than in the lower extremities, and
is more severe in the hands. There is typically hyperesthesia over the
shoulders and arms. This injury commonly occurs in older adults from
hyperextension injuries. Anterior cord syndrome presents with
paraplegia or quadriplegia with loss of lateral spinothalamic function but
,preservation of posterior column function. Brown-Séquard syndrome
(hemisection) causes weakness and loss of posterior column function on
one side with contralateral loss of pain/temperature sensation. Complete
cord transection affects all motor and sensory function distal to the
lesion. Cauda equina syndrome typically presents as low back pain with
radiculopathy and bowel/bladder dysfunction .
Question 2: A 37-year-old man fell from a ladder while hanging
Christmas lights. The right side of his head hit the cement, and he lost
consciousness for about 1 minute. He woke up with a headache but had
no other complaints. A few hours later, he is brought to the emergency
room with an intense headache, confusion, and left hand hemiparesis.
Examination reveals a bruise over the right temporal region, mydriasis
(right pupil dilated), right eye deviation, papilledema, and left extensor
plantar response. CT head without contrast shows a lens-shaped hyper-
density under the right temporal bone with mass effect and edema. What
is the most likely diagnosis?
• A) Epidural hematoma
• B) Subdural hematoma
• C) Subarachnoid hemorrhage
• D) Intracerebral parenchymal hemorrhage
• E) Acute meningitis
,,,ANSWER,,,: A
Rationale: Epidural hematoma most often results from a traumatic tear
of the middle meningeal artery (often associated with temporal bone
fracture). Although a "lucid interval" (minutes to hours of normal
,consciousness followed by deterioration) is classic, it occurs in only
about one-third of patients. The lens-shaped (biconvex) hyper-density on
CT is characteristic. Subdural hematoma results from rupture of bridging
veins, has a crescent-shaped appearance on CT, and typically presents
more gradually. Subarachnoid hemorrhage is usually from aneurysm
rupture (sudden "thunderclap" headache). Intracerebral hemorrhage is
typically from hypertension (basal ganglia location). Acute meningitis
presents with fever and nuchal rigidity, not trauma .
Question 3: A patient involved in a rear-impact motor vehicle collision
now experiences severe neck pain and decreased upper extremity motor
function, but normal motor function in the lower extremities. The patient
complains of paresthesias in both the upper and lower extremities but
greater in the arms. Based on these findings, what type of injury does
this patient most likely have?
• A) Cauda equina syndrome
• B) Brown-Séquard syndrome
• C) Anterior cord syndrome
• D) Central cord syndrome
,,,ANSWER,,,: D
Rationale: Central cord syndrome is characterized by greater motor
impairment in the upper extremities compared to the lower extremities,
with varying degrees of sensory loss. This pattern occurs because the
central cord syndrome affects the centrally located corticospinal tracts
that serve the upper extremities. This injury is commonly seen in older
, adults with pre-existing cervical stenosis following hyperextension
injuries (e.g., rear-end collisions) .
Question 4: Which of the following correctly describes the difference
between central cord syndrome and Brown-Séquard syndrome?
• A) Central cord syndrome affects only one side of the body
• B) Brown-Séquard syndrome results from hyperextension injury in
older adults
• C) Central cord syndrome causes greater upper extremity
weakness; Brown-Séquard causes ipsilateral weakness and
contralateral pain/temperature loss
• D) Both syndromes present with complete paralysis below the
lesion
,,,ANSWER,,,: C
Rationale: The key distinguishing feature is that central cord syndrome
produces motor weakness that is more severe in the arms than the legs,
often with a "sacral sparing" pattern. Brown-Séquard syndrome (spinal
cord hemisection) causes ipsilateral weakness and loss of
proprioception/vibration with contralateral loss of pain and temperature
sensation (spinothalamic tract) beginning 1-2 levels below the lesion.
Brown-Séquard typically results from penetrating trauma or tumor, not
hyperextension .
