Answers and Explanations

1. Answer: A. Broca, motor, or nonfluent aphasia is localized to the frontal lobe adjacent to primary motor cortex.

2. Answer: C. The mammillary bodies in the hypothalamus seem to be particularly sensitive -to chronic alcohol abuse and the related thiamine deficiency. Mammillary degeneration is irreversible and results in retrograde amnesia with confabulations.

3. Answer: A. The anterior cerebral artery supplies cortical areas associated with somatosensory input from and upper motor neuron control of the contralateral lower limb. ;

4. Answer: C. All patients with aphasia have an impaired ability to repeat. If this is the only language deficit, then the lesion is most likely in the arcuate fasciculus, which connects the i Wernicke and Broca areas. Because speech is fluent and comprehension seems intact, the conclusion is that the patient has suffered from a conductive aphasia.

5. Answer: B. The patient suffers from unilateral neglect, where she ignores the entire left side of her visual and somatosensory world, and presents with constructional apraxia. Neglect is seen in lesions of the nondominant or right parietal lobe supplied by branches of the right middle cerebral artery.

6. Answer: D. All thalamocortical somatosensory information comes from the entire contralateral body and face, and axons of upper motor neurons course through the posterior limb of the internal capsule, so that the patient may present with an anaesthesia of the contralateral face. Transcortical apraxia is seen in lesion of the corpus callosum, lower face weakness would be seen if the lesion included the genu of the internal capsule, amnesia is not seen in a capsular lesion, and macular sparing deficits are seen only in visual cortex lesions.

7. Answer: A. The posterior cerebral artery supplies primary visual cortex and, if occluded, results in a homonymous hemianopsia with macular sparing. All other choices are seen in occlusion of either the anterior (bladder incontinence, transcortical apraxia) or middle cerebral artery (alexia with agraphia, acalculia).

8. Answer: D. The patient has a Wernicke aphasia, a fluent or a sensory aphasia in which he cannot comprehend the spoken word, his speech is normal but frequently doesn't make sense, and he is unaware of his deficit.

9. Answer: D. The patient suffers from trauma to the frontal lobe in the area of the prefrontal cortex, which is a center for personality traits.

10. Answer: D. The patient had bilateral removal of the anterior parts of the temporal lobes including the amygdala and has the signs associated with Kluver-Bucy syndrome.

11. Answer: B. The patient has the signs of Gerstmann syndrome, which affects the angular gyrus of the dominant parietal lobe.

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