494-868 Flashcards

494-868

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1
Q
1. The fourth cranial nerve emerges from the
(A) interpeduncular fossa
(B) superior pontine sulcus
(C) dorsal surface of the midbrain
(D) lateral aspect of the pons
(E) cerebellopontine angle
A

(C) dorsal surface of the midbrain

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2
Q
2. Which of the following structures separates
the anterior cerebellar lobe from the
posterior cerebellar lobe?
(A) Sulcus limitans
(B) Horizontal fissure
(C) Primary fissure
(D) Posterolateral fissure
(E) Prepyramidal fissure
A

(C) Primary fissure

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3
Q
3. The medulla includes all of the following
structures EXCEPT the
(A) cuneate tubercle
(B) olive
(C) vagal trigone
(D) facial colliculus
(E) glossopharyngeal nerve
A

(D) facial colliculus

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4
Q
4. The limbic lobe includes all of the following
structures EXCEPT the
(A) cingulate gyrus
(B) paraterminal gyrus
(C) parahippocampal gyrus
(D) dentate gyrus
(E) Ungual gyrus
A

(E) Ungual gyrus

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5
Q
5. All of the following statements concerning
the hippocampal formation are correct
EXCEPT it
(A) gives rise to the fornix
(B) includes the subiculum
(C) includes the dentate gyrus
(D) includes the posterior commissure
(E) lies between the hippocampal and
choroidal fissures
A

(D) includes the posterior commissure

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6
Q
  1. All of the following statements concerning
    the central sulcus are correct EXCEPT it
    (A) separates the frontal lobe from the parietal
    lobe
    (B) separates the motor cortex from the sensory
    cortex
    (C) extends into the paracentral lobule
    (D) is located on the lateral convex surface of
    the hemisphere
    (E) joins the lateral sulcus
A

(E) joins the lateral sulcus

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7
Q
7. The basal ganglia include all of the following
structures EXCEPT the
(A) caudate nucleus
(B) putamen
(C) thalamus
(D) globus pallidus
(E) amygdaloid nucleus
A

(C) thalamus

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8
Q
8. The telencephalon includes all of the following
structures EXCEPT the
(A) thalamus
(B) cerebral hemispheres
(C) globus pallidus
(D) caudate nucleus
(E) internal capsule
A

(A) thalamus

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9
Q
9. The mesencephalon includes all of the following
structures EXCEPT the
(A) cerebral peduncle
(B) cerebral aqueduct
(C) inferior colliculus
(D) pineal body
(E) oculomotor nerve
A

(D) pineal body

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10
Q
10. The frontal lobe includes all of the following
areas EXCEPT
(A) Wernicke's speech area
(B) the motor strip (area 4)
(C) the precentral gyrus
(D) Broca's speech area
(E) the center controlling eye movements
A

(A) Wernicke’s speech area

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11
Q
  1. All of the following statements concerning
    the cerebellum are correct EXCEPT it
    (A) is found in the posterior cranial fossa
    (B) is part of the brainstem
    (C) is separated from the occipital lobes by
    the tentorium cerebelli
    (D) has three lobes
    (E) has a tonsil
A

(B) is part of the brainstem

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12
Q
12. The parietal lobe contains all of the following
structures EXCEPT the
(A) angular gyrus
(B) sensory strip (areas 3, 1, and 2)
(C) supramarginal gyrus
(D) primary auditory cortex
(E) precuneus
A

(D) primary auditory cortex

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13
Q
1. Which one of the following is only a potential
space?
(A) Subarachnoid space
(B) Subarachnoid cistern
(C) Spinal epidural space
(D) Cerebral aqueduct
(E) Cranial epidural space
A

l-E. The cranial epidural space and the subdural space are normally potential spaces.
Hemorrhage of a meningeal artery creates an epidural space between the periosteal and
meningeal layers of the dura (epidural hematoma). Laceration of the superior cerebral veins
(“bridging veins”) as they enter the superior sagittal sinus creates a subdural space between
the dura and the arachnoid (subdural hematoma

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14
Q
2. The cranial dura is innervated by the
(A) ophthalmic nerve
(B) facial nerve
(C) intermediate nerve
(D) glossopharyngeal nerve
(E) major petrosal nerve
A

2-A. The cranial dura is innervated by the trigeminal nerve (CN V), the meningeal (recurrent)
branches of the vagal nerve (CN X), and the upper spinal nerves (CI and C2), via the hypoglossal
nerve (CN XII).

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15
Q
3. The calcified glomus of the choroid plexus,
which is visible on x-ray and computed
tomography (CT), is seen in the
(A) frontal horn
(B) third ventricle
(C) occipital horn
(D) trigone
(E) fourth ventricle
A

3-D. The calcified glomus is found in the trigone of the lateral ventricle. It, as well as the calcified
pineal gland, can be seen on x-ray and computed tomography (CT) [but not on magnetic
resonance image (MRI)].

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16
Q
  1. Which one of the following statements concerning
    the spinal epidural space is true?
    (A) It contains the denticulate ligaments
    (B) It contains cerebrospinal fluid (CSF)
    (C) It contains the dorsal root ganglia
    (D) It may be injected with an anesthetic to
    produce a paravertebral nerve block
    (E) It contains the cauda equina
A

4-D. The spinal epidural space contains loose areolar tissue, venous plexuses, and lymphatics.
It may be injected with an anesthetic to produce a paravertebral nerve block. The denticulate
ligaments are subdural pial structures that extend from the surface of the spinal cord and
attach to the internal surface of the dura. The dorsal root ganglia are located within the intervertebral
foramina. Cerebrospinal fluid (CSF) and the cauda equina are found in the subarachnoid
space.

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17
Q
5. The caudate nucleus is a boundary of all of
the following structures EXCEPT the
(A) frontal horn
(B) body of the lateral ventricle
(C) occipital horn
(D) trigone
(E) temporal horn
A

5-C. The caudate nucleus forms the lateral wall of the frontal horn, body, trigone of the lateral
ventricle, and the roof of the temporal horn. It does not extend into the occipital horn.

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18
Q
  1. All of the following statements concerning
    the pia mater are correct EXCEPT it
    (A) is a delicate, highly vascular layer of connective
    tissue
    (B) gives rise to the denticulate ligaments
    (C) extends into the sulci and fissures
    (D) is connected to the arachnoid by
    trabeculae
    (E) is a boundary of the epidural space of the
    vertebral canal
A

6-E. The pia mater is a delicate, highly vascular layer of connective tissue, which gives rise to
the denticulate ligaments. It extends into the sulci and fissures of the brain and spinal cord
and is connected via trabeculae to the arachnoid membrane. The spinal epidural space lies
between the dura and the periosteum of the vertebrae; it contains loose areolar tissue and a
venous plexus.

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19
Q
  1. All of the following statements concerning
    the arachnoid granulations are correct
    EXCEPT they
    (A) are found along the superior sagittal
    sinus
    (B) project into the dural venous sinuses
    (C) play a role in the absorption of cerebrospinal
    fluid (CSF)
    (D) produce CSF
    (E) consist of arachnoid villi
A
7-D. Arachnoid granulations are tufts of pia—arachnoid tissue that extends into the venous
lacunae or directly into the venous dural sinuses. Microscopically, they are arachnoid villi and
are prominent along the superior sagittal sinus. They play a major role in the absorption of
cerebrospinal fluid (CSF).
20
Q
  1. All of the following statements concerning
    the dura mater are correct EXCEPT it
    (A) forms the periosteum of the vertebral
    canal
    (B) forms the walls of the venous sinuses
    (C) forms the roof of the pituitary fossa
    (D) is innervated by two cranial nerves
    (E) is continuous with the sclera of the
    eyeball
A

8-A. The dura mater forms the walls of the venous sinuses and the diaphragma sellae, which
form the roof of the hypophyseal fossa. The dura of the anterior and middle cranial fossae is
innervated by the ophthalmic and maxillary divisions of the trigeminal nerve (CN V). The
infratentorial dura of the posterior cranial fossa is innervated by the vagal nerve (CN X) and
the meningeal branches of the upper cervical spinal nerves. The spinal dura consists of one
layer, the meningeal dura; it does not form the periosteum of the vertebrae. The dura is continuous
with the sclera; it forms the outer connective tissue layer of the optic nerve (CN II).

21
Q
  1. All of the following statements concerning
    the cranial epidural space are correct EXCEPT
    it
    (A) contains a branch of the facial artery
    (B) contains meningeal veins
    (C) usually is associated with arterial hemorrhage
    (D) is bounded by two layers of dura
    (E) is normally a potential space
A

9-A. The cranial epidural space is actually a potential intradural space that is created only
after trauma and hemorrhage. Epidural hematomas are arterial hemorrhages. The cranial
epidural space lies between tbe periosteal and meningeal dural layers. Meningeal arteries and
veins are found in this space.

22
Q
  1. All of the following statements concerning
    the subarachnoid space are correct EXCEPT it
    (A) communicates via the foramina of
    Luschka with the fourth ventricle
    (B) is found between the arachnoid and the
    pia mater
    (C) extends, in the adult, from the conus
    medullaris to S2
    (D) is lined with ependymal cells
    (E) communicates via the median foramen of
    Magendie with the fourth ventricle
A

10-D. The subarachnoid space is found between the arachnoid and the pia. It extends in the
adult from the conus medullaris to S2. The subarachnoid space is lined with leptomeningeal
(mesothelial) cells. The subarachnoid space communicates via the foramina of Luschka and the
median foramen of Magendie with the fourth ventricle. Ependymal cells line the ventricles.

23
Q
  1. All of the following statements concerning
    meningiomas are correct EXCEPT they
    (A) are derived from arachnoid cells
    (B) are characterized by cellular whorls and
    psammoma bodies
    (C) are more frequent in males
    (D) are benign, slow growing, and well-circumscribed
    tumors
    (E) comprise approximately 20% of primary
    intracranial tumors
A

11-C. Meningiomas occur more frequently in women (60%) than in men.

24
Q
1. The thalamus, hypothalamus, and subthalamus
are perfused by the
(A) anterior choroidal artery
(B) medial striate artery
(C) anterior communicating artery
(D) posterior communicating artery
(E) anterior cerebral artery
A

l-D. The thalamus, hypothalamus, and subthalamus are irrigated by the posterior communicating
artery and the thalamoperforating branches of the posterior cerebral artery.

25
Q
2. The optic chiasm is supplied by all of the
following arteries EXCEPT the
(A) internal carotid artery
(B) anterior communicating artery
(C) anterior choroidal artery
(D) posterior communicating artery
(E) anterior cerebral artery
A

2-C. The anterior choroidal artery lies outside of the circle of Willis and does not supply the
optic chiasm.

26
Q
3. The internal capsule is supplied by all of
the following arteries EXCEPT the
(A) internal carotid artery
(B) posterior cerebral artery
(C) anterior choroidal artery
(D) anterior cerebral artery
(E) middle cerebral artery
A

3-B. The internal capsule is supplied by the anterior cerebral artery, the internal carotid
artery, the anterior choroidal artery, and the middle cerebral artery.

27
Q
  1. All of the following statements concerning
    the internal carotid artery are correct
    EXCEPT it
    (A) enters the skull via the sphenoid bone
    (B) lies within the cavernous sinus
    (C) gives off direct branches to the internal
    capsule
    (D) gives rise to the anterior choroidal artery
    (E) gives rise to the posterior communicating
    artery
A

4-A. The internal carotid artery enters the skull via the carotid canal of the temporal bone.

28
Q
  1. All of the following statements concerning
    the vertebral artery are correct EXCEPT it
    (A) may give off a posterior spinal artery
    (B) gives rise to the labyrinthine artery
    (C) is a branch of the subclavian artery
    (D) gives rise to the anterior spinal artery
    (E) gives rise to the posterior inferior cerebellar
    artery
A

5-B. The vertebral artery, a branch of the subclavian artery, may give off a posterior spinal
artery and does give off an anterior spinal artery. The posterior spinal artery is most commonly
a branch of the posterior inferior cerebellar artery. The anterior inferior cerebellar
artery is the first major branch of the basilar artery and usually (in 85% of the population)
gives rise to the labyrinthine artery. In the remaining cases, the labyrinthine artery is a
branch of the basilar artery. The posterior inferior cerebellar artery is the largest branch of the
vertebral artery.

29
Q
  1. The cavernous sinus and its lateral wall
    contain all of the following structures EXCEPT
    the
    (A) carotid siphon
    (B) oculomotor, abducent, and trochlear nerves
    (C) ophthalmic and maxillary nerves
    (D) optic nerve
    (E) postganglionic sympathetic fibers
A

6-D. The cavernous sinus and its lateral wall contain the carotid siphon; the oculomotor, abducent,
and trochlear nerves; a sympathetic plexus; and the ophthalmic and maxillary divisions
of the trigeminal nerve. The optic nerve and ophthalmic artery reach the orbit via the optic
canal.

30
Q
  1. All of the following statements concerning
    the ophthalmic artery are correct EXCEPT it
    (A) enters the orbit via the superior orbital
    fissure
    (B) is a branch of the internal carotid artery
    (C) accompanies the optic nerve to the orbit
    (D) supplies the inner layers of the retina
    (E) gives rise to the central artery of the retina
A

7-A. The ophthalmic artery is the first major branch of the internal carotid artery. It reaches
the orbit with the optic nerve via the optic canal. It gives rise to the central artery of the
retina, which perfuses the inner five layers of the retina. The ophthalmic nerve, a division of
the trigeminal nerve, enters the orbit with the ophthalmic vein via the superior orbital fissure.

31
Q
  1. All of the following statements concerning
    the middle meningeal artery are correct
    EXCEPT
    (A) it is usually a branch of the maxillary
    artery
    (B) it enters the cranium through the foramen
    spinosum
    (C) laceration results in epidural hemorrhage
    (D) it supplies most of the dura of the calvarium
    (E) it supplies the dura of the posterior cranial
    fossa
A

8-E. The middle meningeal artery usually is a branch of the maxillary artery, which enters the
cranium via the foramen spinosum and supplies most of the dura of the calvarium. Laceration
of this artery leads to epidural hemorrhage (hematoma). The artery and its accompanying
dural veins lie between the periosteal and meningeal layers of the dura. The dura of the posterior
fossa is supplied by branches of the ascending pharyngeal, vertebral, and occipital arteries
(posterior meningeal arteries).

32
Q
1. The anterior and posterior neuropores
close during which week of embryonic development?
(A) Second
(B) Third
(C) Fourth
(D) Fifth
(E) Sixth
A

1-C. The anterior and posterior neuropores close during the fourth week of embryonic
development: the anterior on day 25, the posterior on day 27. Failure of the anterior neuropore
to close results in anencephaly; failure of the posterior neuropore to close results in
myeloschisis.

33
Q
2. At birth, the conus medullaris is found at
which vertebral level?
(A) VT12
(B) VL1
(C) VL3
(D) VS1
(E) VS4
A

2-C. At birth, the conus medullaris extends to VL3, and in the adult it extends to the
VL1-VL2 interspace. At 8 weeks, the spinal cord extends the entire length of the vertebral
canal.

34
Q
3. Failure of the anterior neuropore to close
results in
(A) hydrocephalus
(B) anencephaly
(C) mongolism
(D) craniosynostosis
(E) meningoencephalocele
A

3-B. Failure of the anterior neuropore to close results in anencephaly. The brain fails to
develop; no cranial vault is formed.

35
Q
4. Caudal herniation of the cerebellar tonsils
and medulla through the foramen magnum is
called
(A) Dandy-Walker syndrome
(B) Down's syndrome
(C) Arnold-Chiari syndrome
(D) cranium bifidum
(E) myeloschisis
A

4-C. Arnold-Chiari syndrome is a cerebellomedullary malformation in which the inferior vermis
and medulla herniate through the foramen magnum, resulting in communicating hydrocephalus.
Arnold-Chiari syndrome is frequently associated with spina bifida.

36
Q
5. The flexure that develops between the
metencephalon and the myelencephalon is
called the
(A) cephalic flexure
(B) mesencephalic flexure
(C) pontine flexure
(D) cerebellar flexure
(E) cervical flexure
A

5-C. The pontine flexure develops between the metencephalon (pons) and the myelencephalon
(medulla). The pontine flexure results in lateral expansion of the walls of the metencephalon
and myelencephalon, stretching of the roof of the fourth ventricle, and widening of the floor of
the fourth ventricle (rhomboid fossa).

37
Q
  1. Which of the following statements best
    describes the sulcus limitans?
    (A) It is found in the interpeduncular fossa
    (B) It is located between the alar and basal
    plates
    (C) It separates the medulla from the pons
    (D) It separates the hypothalamus from the
    thalamus
    (E) It separates the neocortex from the allocortex
A

6-B. The sulcus limitans separates the sensory alar and motor basal plates. It is found in the
developing spinal cord and on the surface of the adult rhomboid fossa of the fourth ventricle.
The bulbopontine sulcus separates the medulla from the pons. The hypothalamic sulcus separates
the thalamus from the hypothalamus. The rhinal sulcus separates the neocortex from the
allocortex.

38
Q
7. The telencephalon gives rise to all of the
following structures EXCEPT the
(A) caudate nucleus
(B) putamen
(C) globus pallidus
(D) claustrum
(E) amygdala
A

7-C. The globus pallidus develops from the diencephalon. Globus pallidus cells migrate into
the telencephalon.

39
Q
8. The diencephalon gives rise to all of the
following structures EXCEPT the
(A) mamillary bodies
(B) pineal body
(C) subthalamic nucleus
(D) adenohypophysis
(E) neurohypophysis
A

8-D. The adenohypophysis (pars distalis, pars tuberalis, and pars intermedia) develops from
Rathke’s pouch, an ectodermal diverticulum of the stomodeum. The neurohypophysis develops
from the infundibulum of the hypothalamus.

40
Q
9. The alar plate gives rise to all of the following
structures EXCEPT the
(A) dentate nucleus
(B) inferior olivary nucleus
(C) nucleus gracilis
(D) nucleus ambiguus
(E) cerebellar cortex
A

9-D. The alar plate of the mantle layer gives rise to sensory relay nuclei and the cerebellum.
The nucleus ambiguus, a SVE nucleus, is derived from the basal motor plate.

41
Q
  1. All of the following statements concerning
    myelination are correct EXCEPT it
    (A) is accomplished by neural crest cells
    (B) is accomplished by Schwann cells in the
    peripheral nervous system (PNS)
    (C) is accomplished by oligodendrocytes in
    the central nervous system (CNS)
    (D) commences in the fourth fetal month
    (E) is completed by birth
A

10-E. Myelination is not complete at birth. The corticospinal tracts are not completely myelinated
until the end of the second postnatal year.

42
Q
  1. All of the following statements concerning
    spina bifida are correct EXCEPT
    (A) spina bifida results from failure of vertebral
    arches to fuse
    (B) spina bifida is frequently associated with
    Arnold-Chiari malformation
    (C) spina bifida usually occurs in the cervicothoracic
    region
    (D) spina bifida occulta is the least severe
    variation
    (E) spina bifida with myeloschisis is the most
    severe variation
A

11-C. Spina bifida usually occurs in the lumbosacral region.

43
Q
  1. All of the following statements concerning
    the neural tube are correct EXCEPT it
    (A) lies between the surface ectoderm and
    the notochord
    (B) is completely closed by the sixth week
    (C) contains the neural crest
    (D) gives rise to the central nervous system
    (CNS)
    (E) gives rise to myelin-producing cells
A

12-C. The neural tube, which lies between the surface ectoderm and the notochord, gives rise
to the brain and spinal cord. Closure is already complete in the fifth week. The neural crest lies
between the neural tube and the surface ectoderm. The neural tube gives rise to oligodendrocytes,
which produce the myelin of the central nervous system (CNS).

44
Q
13. The cerebellum develops from all of the
following structures EXCEPT the
(A) rhombencephalon
(B) metencephalon
(C) rhombic lips
(D) alar plates
(E) myelencephalon
A

13-E. The cerebellum arises from the alar plates of the rhombencephalon, which form the
rhombic lips. The metencephalon, a division of the rhombencephalon, includes the pons and
the cerebellum. The myelencephalon develops from the rhombencephalon and becomes the
medulla oblongata.

45
Q
14. The neural crest gives rise to all of the
following cells EXCEPT
(A) odontoblasts
(B) ohgodendrocytes
(C) cells of enteric ganglia
(D) Schwann cells
(E) chromaffin cells
A

14-B. The neural crest gives rise to dorsal root ganglion cells, the cells of autonomic and
enteric ganglia, Schwann cells, satellite cells, and chromaffin cells of the suprarenal medulla.
The neural crest also gives rise to pigment cells (melanocytes), odontoblasts, meninges, and
mesenchyme of the branchial arches. Oligodendrocytes arise from the glioblasts of the neural
tube.