EXERCISE PHYSIOLOGY LABORATORY
MANUAL
9TH EDITION
• AUTHOR(S)WILLIAM BEAM, GENE
ADAMS
TEST BANK
1) CNS vs PNS localization
Reference: Ch. 1 — General Organization — CNS vs PNS
Clinical/Applied Stem:
A 19-year-old develops progressive weakness and spasticity
after a spinal cord injury. On exam, the affected muscles are
weak, tone is increased, and reflexes are brisk below the lesion.
Sensation is also altered below the injury level.
Which structure is most likely damaged?
,A. Peripheral nerve
B. Anterior horn cell
C. Central nervous system tract
D. Neuromuscular junction
Correct Answer: C. Central nervous system tract
Rationale — Correct Answer:
Spasticity and hyperreflexia indicate an upper motor neuron
pattern, which localizes to the CNS. A spinal cord lesion disrupts
descending motor tracts and often produces both motor and
sensory deficits below the level of injury. This is a classic CNS
localization pattern.
Rationale — Incorrect Options:
A. Peripheral nerve lesions usually cause flaccid weakness,
reduced reflexes, and sensory loss in a nerve distribution.
B. Anterior horn cell disease causes lower motor neuron
findings, not spasticity.
D. Neuromuscular junction disorders cause weakness without
sensory loss and do not produce hyperreflexia.
Teaching Point:
Spasticity and hyperreflexia point to a CNS upper motor neuron
lesion.
Citation:
Goldberg, S. (2022). Clinical Neuroanatomy Made Ridiculously
Simple (6th ed.). Ch. 1.
,2) Upper motor neuron vs lower motor neuron
Reference: Ch. 1 — General Organization — Motor System
Organization
Clinical/Applied Stem:
A patient has weakness in one leg, marked muscle atrophy,
fasciculations, and absent reflexes in that limb. Sensation is
intact.
Which lesion best fits this pattern?
A. Corticospinal tract in the spinal cord
B. Peripheral motor nerve
C. Primary motor cortex
D. Cerebellar hemisphere
Correct Answer: B. Peripheral motor nerve
Rationale — Correct Answer:
Atrophy, fasciculations, and absent reflexes are lower motor
neuron signs. A peripheral motor nerve lesion affects efferent
output to muscle and does not directly impair sensation if the
lesion is purely motor. This is a peripheral localization.
Rationale — Incorrect Options:
A. Corticospinal tract lesions cause upper motor neuron signs
such as spasticity and hyperreflexia.
C. Primary motor cortex lesions usually produce upper motor
neuron findings, not fasciculations.
D. Cerebellar lesions cause incoordination and ataxia, not
denervation atrophy.
, Teaching Point:
Fasciculations and atrophy localize to the lower motor neuron.
Citation:
Goldberg, S. (2022). Clinical Neuroanatomy Made Ridiculously
Simple (6th ed.). Ch. 1.
3) Gray matter vs white matter
Reference: Ch. 1 — General Organization — Gray and White
Matter
Clinical/Applied Stem:
A demyelinating process preferentially disrupts long myelinated
axons in the spinal cord. The patient develops slowed
conduction and patchy deficits across multiple body regions.
Which tissue is primarily affected?
A. Gray matter
B. White matter
C. Pia mater
D. Dorsal root ganglion
Correct Answer: B. White matter
Rationale — Correct Answer:
White matter contains myelinated axon tracts that conduct
signals over long distances. Demyelination impairs conduction
velocity and tract function, producing distributed neurologic
MANUAL
9TH EDITION
• AUTHOR(S)WILLIAM BEAM, GENE
ADAMS
TEST BANK
1) CNS vs PNS localization
Reference: Ch. 1 — General Organization — CNS vs PNS
Clinical/Applied Stem:
A 19-year-old develops progressive weakness and spasticity
after a spinal cord injury. On exam, the affected muscles are
weak, tone is increased, and reflexes are brisk below the lesion.
Sensation is also altered below the injury level.
Which structure is most likely damaged?
,A. Peripheral nerve
B. Anterior horn cell
C. Central nervous system tract
D. Neuromuscular junction
Correct Answer: C. Central nervous system tract
Rationale — Correct Answer:
Spasticity and hyperreflexia indicate an upper motor neuron
pattern, which localizes to the CNS. A spinal cord lesion disrupts
descending motor tracts and often produces both motor and
sensory deficits below the level of injury. This is a classic CNS
localization pattern.
Rationale — Incorrect Options:
A. Peripheral nerve lesions usually cause flaccid weakness,
reduced reflexes, and sensory loss in a nerve distribution.
B. Anterior horn cell disease causes lower motor neuron
findings, not spasticity.
D. Neuromuscular junction disorders cause weakness without
sensory loss and do not produce hyperreflexia.
Teaching Point:
Spasticity and hyperreflexia point to a CNS upper motor neuron
lesion.
Citation:
Goldberg, S. (2022). Clinical Neuroanatomy Made Ridiculously
Simple (6th ed.). Ch. 1.
,2) Upper motor neuron vs lower motor neuron
Reference: Ch. 1 — General Organization — Motor System
Organization
Clinical/Applied Stem:
A patient has weakness in one leg, marked muscle atrophy,
fasciculations, and absent reflexes in that limb. Sensation is
intact.
Which lesion best fits this pattern?
A. Corticospinal tract in the spinal cord
B. Peripheral motor nerve
C. Primary motor cortex
D. Cerebellar hemisphere
Correct Answer: B. Peripheral motor nerve
Rationale — Correct Answer:
Atrophy, fasciculations, and absent reflexes are lower motor
neuron signs. A peripheral motor nerve lesion affects efferent
output to muscle and does not directly impair sensation if the
lesion is purely motor. This is a peripheral localization.
Rationale — Incorrect Options:
A. Corticospinal tract lesions cause upper motor neuron signs
such as spasticity and hyperreflexia.
C. Primary motor cortex lesions usually produce upper motor
neuron findings, not fasciculations.
D. Cerebellar lesions cause incoordination and ataxia, not
denervation atrophy.
, Teaching Point:
Fasciculations and atrophy localize to the lower motor neuron.
Citation:
Goldberg, S. (2022). Clinical Neuroanatomy Made Ridiculously
Simple (6th ed.). Ch. 1.
3) Gray matter vs white matter
Reference: Ch. 1 — General Organization — Gray and White
Matter
Clinical/Applied Stem:
A demyelinating process preferentially disrupts long myelinated
axons in the spinal cord. The patient develops slowed
conduction and patchy deficits across multiple body regions.
Which tissue is primarily affected?
A. Gray matter
B. White matter
C. Pia mater
D. Dorsal root ganglion
Correct Answer: B. White matter
Rationale — Correct Answer:
White matter contains myelinated axon tracts that conduct
signals over long distances. Demyelination impairs conduction
velocity and tract function, producing distributed neurologic
