Neuroanatomy MCQ Quiz for Medical Students
Updated
Lesion location determines deficit: corticospinal damage above the medullary decussation causes contralateral weakness; below causes ipsilateral. Brainstem lesions often produce crossed signs (ipsilateral cranial nerve, contralateral body).
This 15-question neuroanatomy quiz tests medical students on clinically relevant pathways, vascular territories, and cranial nerve deficits. Each question includes a detailed explanation, so you learn while you self-assess. It covers corticospinal and spinothalamic tracts, brainstem syndromes, arterial supply, and common lesion scenarios seen on exams and wards.
Before you begin, remember that neuroanatomy is about localization. Damage to a tract or nucleus produces a predictable pattern of signs. Think about where fibers cross, which cranial nerve nuclei sit in the brainstem, and which artery supplies each structure. Reviewing these rules will help you diagnose lesions from a vignette.
The questions
Which tract carries pain and temperature sensation from the body to the thalamus?
A patient has a lesion of the left optic nerve. What visual field deficit results?
A stroke in the anterior spinal artery at the level of the medulla causes which syndrome?
Which artery supplies the lateral medulla, and its infarction causes Wallenberg syndrome?
Damage to the left frontal eye field causes what gaze deviation?
A patient has right-sided weakness and aphasia. Which artery is most likely occluded?
A patient presents with ptosis, mydriasis, and downward-outward eye on the right. Which cranial nerve is affected?
Which structure is the main output nucleus of the basal ganglia, tonically inhibiting the thalamus?
A lesion of the right medial lemniscus in the medulla causes what sensory deficit?
Which artery supplies the primary motor cortex for the lower limb?
A patient has loss of pain and temperature on the right side of the body and loss of pain and temperature on the left side of the face. Where is the lesion?
Which thalamic nucleus relays somatosensory information from the face to the cortex?
A lesion of the left inferior olivary nucleus would most affect which pathway?
Which brain region is responsible for speech production and is supplied by the superior division of the middle cerebral artery?
A patient has left homonymous hemianopia with macular sparing. Which artery is most likely occluded?
0 of 15 answered · 0 correct
Cheat sheet: key terms
| Corticospinal tract | Motor pathway from cortex to spinal cord; decussates in medulla, so lesion above causes contralateral weakness, below causes ipsilateral. |
|---|---|
| Spinothalamic tract | Carries pain/temperature; crosses in spinal cord, so cord lesion causes contralateral loss of pain/temp below lesion. |
| Dorsal column-medial lemniscus | Carries vibration/proprioception; crosses in medulla, so brainstem lesion causes contralateral loss, cord lesion ipsilateral. |
| Medial medullary syndrome | Infarct of anterior spinal artery; ipsilateral tongue weakness, contralateral hemiplegia and loss of proprioception. |
| Lateral medullary syndrome (Wallenberg) | PICA infarct; ipsilateral Horner's, ataxia, facial pain/temp loss, contralateral body pain/temp loss. |
| Weber syndrome | Midbrain infarct; ipsilateral oculomotor palsy, contralateral hemiplegia. |
| Internal capsule | Contains corticospinal fibers; small lesion causes dense contralateral hemiplegia. |
| Circle of Willis | Arterial anastomosis at brain base; supplies most cerebral hemispheres; common site of aneurysms. |
Answers explained
Show all 15 answers
- Which tract carries pain and temperature sensation from the body to the thalamus? Spinothalamic tract. The spinothalamic tract carries pain and temperature. It crosses in the spinal cord before ascending to the thalamus.
- A patient has a lesion of the left optic nerve. What visual field deficit results? Left monocular blindness. A complete optic nerve lesion causes total blindness in that eye only (monocular). The other eye remains unaffected.
- A stroke in the anterior spinal artery at the level of the medulla causes which syndrome? Medial medullary syndrome. The anterior spinal artery supplies the medial medulla. Occlusion causes medial medullary syndrome: ipsilateral tongue weakness, contralateral hemiplegia, and contralateral loss of vibration/proprioception.
- Which artery supplies the lateral medulla, and its infarction causes Wallenberg syndrome? Posterior inferior cerebellar artery. The posterior inferior cerebellar artery (PICA) supplies the lateral medulla. Infarction causes Wallenberg syndrome with crossed sensory findings and ipsilateral ataxia.
- Damage to the left frontal eye field causes what gaze deviation? Eyes deviate to the left. The frontal eye field drives conjugate gaze to the opposite side. With left FEF damage, the right FEF is unopposed and pushes the eyes to the left (ipsilateral to lesion).
- A patient has right-sided weakness and aphasia. Which artery is most likely occluded? Left middle cerebral artery. Aphasia localizes to the left hemisphere. The left middle cerebral artery supplies language areas and the motor cortex for the right side.
- A patient presents with ptosis, mydriasis, and downward-outward eye on the right. Which cranial nerve is affected? CN III. Oculomotor nerve (CN III) palsy causes ptosis (levator palpebrae), mydriasis (pupillary sphincter), and downward-outward eye due to unopposed actions of CN IV and VI.
- Which structure is the main output nucleus of the basal ganglia, tonically inhibiting the thalamus? Globus pallidus internal segment. The internal segment of the globus pallidus (GPi) sends GABAergic projections to the thalamus, providing tonic inhibition. It is the main basal ganglia output nucleus.
- A lesion of the right medial lemniscus in the medulla causes what sensory deficit? Loss of vibration and proprioception on left body. The medial lemniscus carries dorsal column information (vibration/proprioception). Since it has already crossed in the medulla, a right-sided lesion affects the left side of the body.
- Which artery supplies the primary motor cortex for the lower limb? Anterior cerebral artery. The anterior cerebral artery supplies the medial surface of the brain, including the paracentral lobule where the lower limb is represented.
- A patient has loss of pain and temperature on the right side of the body and loss of pain and temperature on the left side of the face. Where is the lesion? Left lateral medulla. A left lateral medullary lesion affects the left spinal trigeminal nucleus (ipsilateral face) and the left spinothalamic tract (contralateral body), producing the described crossed sensory loss.
- Which thalamic nucleus relays somatosensory information from the face to the cortex? Ventral posteromedial nucleus (VPM). The ventral posteromedial nucleus (VPM) receives trigeminothalamic fibers from the face. The ventral posterolateral nucleus (VPL) serves the body.
- A lesion of the left inferior olivary nucleus would most affect which pathway? Climbing fibers to cerebellum. The inferior olivary nucleus sends climbing fibers to Purkinje cells in the cerebellar cortex. Damage disrupts cerebellar learning and timing.
- Which brain region is responsible for speech production and is supplied by the superior division of the middle cerebral artery? Broca's area. Broca's area, located in the inferior frontal gyrus, is critical for speech production. Its blood supply comes from the superior division of the MCA.
- A patient has left homonymous hemianopia with macular sparing. Which artery is most likely occluded? Right posterior cerebral artery. Left homonymous hemianopia indicates damage to the right visual cortex. The right posterior cerebral artery supplies the occipital lobe; macular sparing occurs due to dual blood supply to the macular region.
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