8 - Radiography of the Skull and Brain

Question 1

What cranial fossa do each of the lobes of the brain sit in?

Answer 1

- Anterior: frontal

- Middle: temporal

- Posterior: occipital, brain stem, cerebellum

Question 2

What are the tentorium cerebelli and the falx cerebri attached to?

Answer 2

FC: Crista Galli to TC. Slots down longitudinal fissure

TC: Clinoid and Petrous processes laterally to the transverse sinus grooves posteriorly

Question 3

What is A and why is it black?

Answer 3

• Lateral ventricles - filled with CSF.
• Any subarachnoid space will be black due to CSF

Question 4

What is cortical homunculus?

Answer 4

Question 5

How do lesions of the cerebellum present?

Answer 5

• Ipsilaterally
• Sensitive to alcohol
• Many important functions e.g. modulating and co-ordinating voluntary motor activity e.g. speech, eye movements, limbs, and in maintaining balance and posture

Question 6

Answer 6

Question 7

Answer 7

Question 8

What colour is acute and chronic haemorraghes on a CT scan?

Answer 8

Acute: lighter more white

Chronic: darker

Question 9

What is anisocoria?

Answer 9

• Unequal size of the eyes’ pupils

Question 10

How could a subdural haemorraghe cause anisocoria and how is it treated?

Answer 10

• Uncal herniation onto oculomotor nerve
• Craniotomy and evacuation

Question 11

What is paresis?

Answer 11

• Muscles weakness
• When figuring out what side has paresis think about decussation

Question 12

Where is the cingulate gyrus and the calcarine sulcus?

Answer 12

Question 13

What is the role of the frontal lobe?

Answer 13

behaviour, personality and planning and motor cortex

Question 14

What symptoms would you get in a cavernous sinus thrombosis?

Answer 14

- Orbital Oedema due to blockage of IJV

- Diplopia and Ptosis due to interruption of CN III, IV, VI

- Pain/Numbness on side of face as sensory trigeminal

• No issue with mastication as Vc not in cavernous sinus

Question 15

Which cranial nerves move the eyeball?

Answer 15

• Abducens
• Trochlear
• Occulomotor

Question 16

What makes up the forebrain?

Answer 16

Cerebrum and Diencaphelon (hypo/thalamus)

Question 17

What cranial nerves are involved in the corneal reflex?

Answer 17

• Va sensory afferent
• VII motor efferent

Question 18

Which lobe has the metastatic lesion?

Answer 18

• Left cerebellum
• Remember MRIs and CTs look up

Question 19

Answer 19

• Optic nerve is an extension of forebrain so the ICP has irritated and compressed this nerve
• Wouldn’t be the oculomotor nerve as this is affected by herniation of the temporal lobe

Question 20

Why may someone have CSF rhinorrhoea when presenting with this?

Answer 20

• Basillar skull fracture
• Tear in the dura
• CSF can get from dura through the fracture

Question 21

What nerves is the gag reflex and saying AHH testing?

Answer 21

Gag: Glossopharyngeal and vagus

Ahh: vagus, both sides of soft pallate should elevate. If to one side, lesion is opposite side

Question 22

What is the role of the supra and infrahyoid muscles when swallowing?

Answer 22

Question 23

Describe in detail the phases of swallowing.

Answer 23

Question 24

How do you manage a peritonsillar abscess?

Answer 24

Question 25

What secondary condition can acoustic neuroma lead to?

Answer 25

Bells Palsy