NPTE-PT Test Test Neuromuscular and Nervous Systems 1

Question 1

A patient presents with spasticity, hyperreflexia, and a positive Babinski sign in both lower extremities following a stroke.
These findings are most consistent with a lesion affecting which neural structure?

Accepted Answer

Upper motor neurons of the corticospinal tract

Answer

Lower motor neurons in the anterior horn of the spinal cord

Answer

Peripheral sensory nerves of the lower extremities

Answer

Anterior roots of the lumbar plexus

Question 2

A patient with a complete T10 spinal cord injury would most likely present with which of the following functional profiles?

Accepted Answer

Paraplegia with full trunk control and intact respiratory function

Answer

Quadriplegia with impaired diaphragm function

Answer

Paraplegia with partial hand intrinsic muscle weakness

Answer

Hemiplegia with ipsilateral lower extremity spasticity

Question 3

Which descending motor pathway carries the primary commands for fine, skilled voluntary movements of the distal upper extremities, including individual finger control?

Accepted Answer

Lateral corticospinal tract

Answer

Vestibulospinal tract

Answer

Reticulospinal tract

Answer

Rubrospinal tract

Question 4

On repetitive nerve stimulation testing at 3 Hz, a patient shows a decremental response in the compound muscle action potential (CMAP) amplitude. Which disorder does this finding most strongly suggest?

Accepted Answer

Myasthenia gravis

Answer

Lambert-Eaton myasthenic syndrome

Answer

Axonal Guillain-Barré syndrome

Answer

Amyotrophic lateral sclerosis

Question 5

Selective damage to the dorsal columns of the spinal cord, as seen in the posterior cord syndrome or subacute combined degeneration, would produce ipsilateral loss of which sensory modalities below the lesion?

Accepted Answer

Proprioception and vibration sense

Answer

Pain and temperature sensation

Answer

Crude touch and nociception

Answer

Temperature and light touch only

Question 6

A patient demonstrates resting tremor that diminishes with voluntary movement, cogwheel rigidity, and bradykinesia. The primary pathophysiology underlying this presentation involves degeneration of which neural pathway?

Accepted Answer

Dopaminergic projections from the substantia nigra pars compacta to the striatum

Answer

Serotonergic projections from the dorsal raphe nucleus to the striatum

Answer

Cholinergic projections from the nucleus basalis of Meynert to the cortex

Answer

Glutamatergic projections from the subthalamic nucleus to the globus pallidus