Applied Anatomy

Question 1

Trauma is damage to the body. In regards to the head, concussion is a form of trauma. What is concussion and what does this do to the brain?

Answer 1

• brain moves backwards and forwards bumping of the skull in the CSF
• brain cells are damaged and even tear
• can cause metabolic and cell death

Question 2

Trauma is damage to the body. If there is trauma inside the brain there can be bleeding on the brain. There are 3 types of bleeds:

• Extradural (Epidural) haematomas
• Subdural haematomas
• Subarachnoid haemorrhage

What is an extradural (Epidural) haematoma?

Answer 2

• extradural = damage upon the dura matter
• haematoma = blood outside of vessels
• blood collects between the dura mater and skull

Question 3

Trauma is damage to the body. If there is trauma inside the brain there can be bleeding on the brain. There are 3 types of bleeds:

• Extradural (Epidural) haematomas
• Subdural haematomas
• Subarachnoid haemorrhage

An extradural (damage upon the dura matter) haematoma (blood outside of vessels) where blood collects between the dura mater and skull. Generally which blood vessel is damaged in a extradural haematoma?

1 - internal carotid artery
2 - external carotid artery
3 - circle of willis
4 - middle meningeal artery

Answer 3

4 - middle meningeal artery

- most common at the pterion site

Question 4

Trauma is damage to the body. If there is trauma inside the brain there can be bleeding on the brain. There are 3 types of bleeds:

• Extradural (Epidural) haematomas
• Subdural haematomas
• Subarachnoid haemorrhage

What is an subdural haematomas?

Answer 4

• subdural = damage below the dura matter
• haematoma = blood outside of vessels
• blood collects between dura and arachnoid mater

Question 5

Trauma is damage to the body. If there is trauma inside the brain there can be bleeding on the brain. There are 3 types of bleeds:

• Extradural (Epidural) haematomas
• Subdural haematomas
• Subarachnoid haemorrhage

What is an Subarachnoid haemorrhage?

Answer 5

• damage to the subarachnoid mater
• blood is able to leak into CSF
• CSF can be sampled and will contain blood

Question 6

Trauma is damage to the body. If there is trauma inside the brain there can be bleeding on the brain. A Subarachnoid haemorrhage is caused when there is damage to the subarachnoid mater. Blood is able to leak into CSF, and CSF can be sampled and will contain blood. What can this cause in the patient?

1 - weakness
2 - fatigue
3 - severe headache and vomiting
4 - infection

Answer 6

3 - severe headache and vomiting

Question 7

What are the 3 weakest parts of the skull?

1 - bregma, eye socket and pterion
2 - bregma, temporal bone and pterion
3 - bregma, lambda and pterion
4 - jaw, lambda and pterion

Answer 7

3 - bregma, lambda and pterion

• bregma (anterior fontallis) at frontal and sagittal suture
• lambda (posterior fonatallis) at sagittal and lambdoid suture
• pterion

Question 8

Which artery runs below the pterion?

1 - internal carotid artery
2 - external carotid artery
3 - circle of willis
4 - middle meningeal artery

Answer 8

4 - middle meningeal artery

Question 9

What is hydrocephalus?

1 - lack of fluid in the brain
2 - build up of fluid in the spinal cord
3 - build up of fluid in the brain

Answer 9

3 - build up of fluid in the brain

• head can enlarge of the head
• fluid volumes increase in ventricular system

Question 10

Hydrocephalus is a build-up of fluid in the brain causing enlargement of the head, where fluid volumes increase in ventricular system. What are the 4 ventricles of the ventricular system?

1 - medial x2, 3rd and 4th ventricles
2 - lateral x 2, 3rd and 4th ventricles
3 - superior, inferior, medlal and lateral

Answer 10

2 - lateral x 2, 3rd and 4th ventricles

Question 11

Hydrocephalus is a build-up of fluid in the brain causing enlargement of the head, where fluid volumes increase in ventricular system. There is communicating and non-communicating hydrocephalus, what do these 2 term refer to?

Answer 11

• communicating = CSF is flowing between ventricles

- non-communicating = obstruction of passages between ventricles

Question 12

What is a stroke?

Answer 12

• damage to any part of the brain due to reduced blood supply
• no blood means no O2 so brain tissue dies

Question 13

A stroke is damage to any part of the brain due to reduced blood supply, where no blood means no O2 so brain tissue dies. What is a transient ischemic attack?

Answer 13

• brief loss of blood supply to the brain
• causes short lived symptoms of stroke
• symptoms normally disappear within 24 hours

Question 14

Strokes can be due to ischaemia or haemorrhage, what is the difference?

Answer 14

• ischaemia = narrowing of blood vessels

- haemorrhage = blood vessel ruptures

Question 15

The entire blood supply of brain and spinal cord depends on 2 sets of arteries. Which arteries are these and what arteries do they originate from?

1 - internal and external carotid arteries
2 - external carotid and vertebral arteries
3 - internal carotid and middle meningeal artery
4 - internal carotid and vertebral arteries

Answer 15

4 - internal carotid and vertebral arteries

• vertebral arteries branch of subclavian arteries
• internal carotid arteries branch of common carotid arteries

Question 16

There are 3 main arteries that come off the circle of willis which the right and left internal carotid arteries supply. What are these 3 arteries called?

1 - anterior, medial and inferior cerebral arteries
2 - frontal, medial and inferior cerebral arteries
3 - anterior, medial and superior cerebral arteries
4 - anterior, medial and inferior cerebral arteries

Answer 16

4 - anterior, medial and inferior cerebral arteries

Question 17

There are 3 main arteries that come off the circle of willis which the right and left internal carotid arteries supply. These 3 arteries are called?

1 - anterior cerebral artery (ACA)
2 - medial cerebral artery (MCA)
3 - posterior cerebral artery (PCA)

Which part of the brain does each of these arteries supply?

Answer 17

1 - ACA = medial and superior surfaces of brain and frontal pole
2 - MCA = lateral surfaces and temporal pole
3 - PCA = inferior surfaces and occipital pole

Question 18

There are 3 main arteries that come off the circle of willis which the right and left internal carotid arteries supply. These 3 arteries are called?

1 - anterior cerebral artery (ACA) = medial and superior surfaces of brain and frontal pole
2 - medial cerebral artery (MCA) = lateral surfaces and temporal pole
3 - posterior cerebral artery (PCA) = inferior surfaces and occipital pole

Why is it important to know which artery supplies which part of the brain?

Answer 18

• when a patient has a stroke, if you know the area of stroke you know which artery has been affected and can try to treat

Question 19

The internal capsule is a white matter structure situated in the inferomedial part of each cerebral hemisphere of the brain. It carries information past the basal ganglia, separating the caudate nucleus and the thalamus from the putamen and the globus pallidus. Blood vessels are provided via the circle of willis off the middle cerebral artery. Which blood vessels supply the internal capsule?

1 - perforating branches of the anterior cerebral artery
2 - perforating branches of the medial meningeal artery
3 - perforating branches of the posterior cerebral artery
4 - perforating branches of the middle cerebral artery

Answer 19

4 - perforating branches of the middle cerebral artery

- lenticulostriate arteries

Question 20

The internal capsule is a white matter structure situated in the inferomedial part of each cerebral hemisphere of the brain. It carries information past the basal ganglia, separating the caudate nucleus and the thalamus from the putamen and the globus pallidus. Blood vessels are provided via the circle of willis via perforating/lenticulostriate arteries of the medial cerebral artery. What is important about these arteries if there is a loss of blood in one of them?

Answer 20

• they are terminal end branches

- if they are blocked the tissue they supply will die causing neurological damage

Question 21

What is the most common site for an infarction or hemorrhage in the brain?

1 - internal capsule
2 - external capsule
3 - pons
4 - internal and external capsule

Answer 21

4 - internal and external capsule

Question 22

Meningitis is when there is inflammation of meninges, where an Infection may enter the subarachnoid space and enter brain, called encephalitis. This can lead to stretching of the dura. A common symptom that patients can present with due to the stretching of the dura mater is what?

1 - pain
2 - muscle weakness
3 - headaches
4 - seizures

Answer 22

3 - headaches

Question 23

The 2 layers of the dura matter (periosteal/endosteal layer and the meningeal layer) is generally in close contact, except on 2 occasions:

1 - where venous sinuses are formed
2 - where dural folds are created.

What are the 3 dural folds?

1 - falx cerebri, tentorium cerebelli, vermis
2 - falx cerebri, pia mater, falx cerebelli
3 - falx cerebri, tentorium cerebelli, falx cerebelli
4 - tegmental area, tentorium cerebelli, falx cerebelli

Answer 23

3 - falx cerebri, tentorium cerebelli, falx cerebelli

Question 24

The 2 layers of the dura matter (periosteal/endosteal layer and the meningeal layer) is generally in close contact, except on 2 occasions: 1 - where venous sinuses are formed and 2 - where dural folds are created. The 3 folds are:

1 - falx cerebri
2 - tentorium cerebelli
3 - falx cerebelli

They are important for compartmentalising the brain to protect it in cases of infection so it cannot spread throughout. What does each of these folds segregate in the brain?

Answer 24

1 - falx cerebri = left from right cerebral hemispheres
2 - tentorium cerebelli = cerebrum and cerabellum
3 - falx cerebelli = left from right cerebellum hemispheres

Question 25

If a tumour is located in the brain, it can be supra or infratentorial. What does that mean?

Answer 25

- supratentorial = above tentorium cerebelli | - infratentorial = below tentorium cerebelli

Question 26

Where does the spinal cord attach to the brain?

Answer 26

- base of the brain | - brain stem connects to the spinal cord and is made up of the midbrain, pons, and medulla oblongata

Question 27

The 3 meningeal layers dura, arachnoid and pia encompass the brain. Is this the only place they can be located?

Answer 27

- no, they surround the spinal cord as well | - dura mater follows nerves until the exit the vertebral foramen

Question 28

A lumbar puncture (LP), also called a spinal tap, is an invasive outpatient procedure used to remove a sample of cerebrospinal fluid (CSF) from the subarachnoid space in the spine. (This test is similar to a blood test, in which a needle is inserted into an artery to collect blood for testing). What location on the spine would this be done at? 1 - below L3/L4 in children and below T11/T12 in adults 2 - below T12/L2 in children and below T12/L2 in adults 3 - below S1/S4 in children and below L1/L2 in adults 4 - below L3/L4 in children and below L1/L2 in adults

Answer 28

4 - below L3/L4 in children and below L1/L2 in adults - spinal cord terminates at L3/L4 in children and L1/L2 in adults - go below spinal cord to protect the spine

Question 29

Generally if different parts of the vertebral column (dorsal and ventral horn) were damaged what deficit would be observed?

Answer 29

- dorsal = sensory | - ventral = motor function

Question 30

Cranial nerve VII (7) is the facial nerve, which has 5 main branches. The nemonic To Zanzabar By Motor Car can help remember the 5 branches. What are the 5 branches?

Answer 30

``` 1 - Temporal branch 2 - Zygomatic branch 3 - Buccal branch 4 - Mandibular branch 5 - Cervical branch ```

Question 31

Cranial nerve VII (7) is the facial nerve, which has 5 main branches: ``` 1 - Temporal branch 2 - Zygomatic branch 3 - Buccal branch 4 - Mandibular branch 5 - Cervical branch ``` Where does this branch originate from in the brain and exit the skull?

Answer 31

- originates in the pons of the brainstem - travel along the internal acoustic and into the facial canal - exits the facial canal at the stylomastoid foramen

Question 32

Once the cranial nerve VII (7), the facial nerve exits the facial canal at the stylomastoid foramen, which gland does it enter and then does something within this gland? 1 - thyroid gland 2 - pituitary gland 3 - parotid gland 4 - lacrimal gland

Answer 32

3 - parotid gland | - bifurcates into the 5 branches

Question 33

Damage to the facial nerve can have severe effects on the face. What are the most common effects if the facial nerve is damaged?

Answer 33

- facial expressions will be lost - drooling - loss of eye control

Question 34

There is a branch of a nerve that travels through the ear. Which cranial nerve is this, which nerve is this and if this is damaged what would be affected?

Answer 34

- facial nerve CN VII - chorda tympani - taste on anterior 2/3 tongue would be affected

Question 35

Which vein do the venous sinuses drain into? 1 - external jugular vein 2 - internal jugular vein 3 - common subclavian vein 4 - carotid vein

Answer 35

2 - internal jugular vein

Question 36

There is a plexus of veins that are over the pterygoid muscles, what is this plexus called? 1 - pterygoid plexus 2 - parotid plexus 3 - mandibular plexus 3 - maxillary plexus

Answer 36

1 - pterygoid plexus - pterygoid plexus located on infratemporal fossa - lots of veins

Question 37

There is a large vein that runs below the pterygoid venous plexus that is a branch of the internal jugular vein. What is this vein called? 1 - pterygoid vein 2 - parotid vein 3 - mandibular vein 4 - facial vein

Answer 37

4 - facial vein

Question 38

The pterygoid plexus, a network of veins in the infratemproal region that is connected to the orbital region. What is the clinical relevance of this?

Answer 38

- infection in pterygoid plexus can spread through venous network into the brain

Question 39

What is the danger space located in? 1 - chest 2 - cranium 3 - pelvis 4 - neck

Answer 39

4 - neck - space in the deep compartment of the head and neck located behind the true retropharyngeal space - if there is an infection and it reaches this space, it can then spread to the mediastinum and the heart

Question 40

What is the Killian dehiscence site? 1 - triangular shaped area of weakness in pharynx 2 - triangular shaped area of weakness in larynx 3 - triangular shaped area of weakness in the soft palate 4 - triangular shaped area of weakness in cochlea

Answer 40

1 - triangular shaped area of weakness in pharynx | - can be site of hernia or damage as it is a weak area

Question 41

On either side of the laryngeal opening in humans is a recess, called the pyriform sinus. Why is this important?

Answer 41

- this is typical where food can get stuck if inhaled

Question 42

There are 2 nerves that leave the ear and make up cranial nerve VIII (8). What are these 2 nerves and what is the cranial nerve they make up?

Answer 42

- cochlear and vestibular nerve | - together they make up the vestibulocohclear nerve (CN VIII)

Question 43

What is presbyopia (greek for old man eye) in the eyes? 1 - lens of the eye no longer focuses light as well causing loss of site 2 - proteins in lens begin to clump and make lens cloudy causing gradual loss of sight 3 - increased pressure in eye that damages the optic nerve 4 - floaters in the eye that clump together forming shadows

Answer 43

1 - lens of the eye no longer focuses light as well causing loss of site - it is a gradual loss of your eyes' ability to focus on nearby objects

Question 44

What is cataract in the eyes? 1 - lens of the eye no longer focuses light as well causing loss of site 2 - proteins in lens begin to clump and make lens cloudy causing gradual loss of sight 3 - increased pressure in eye that damages the optic nerve 4 - floaters in the eye that clump together forming shadows

Answer 44

2 - proteins in lens begin to clump and make lens cloudy causing gradual loss of sight

Question 45

What is glaucoma in the eyes? 1 - lens of the eye no longer focuses light as well causing loss of site 2 - proteins in lens begin to clump and make lens cloudy causing gradual loss of sight 3 - increased pressure in eye that damages the optic nerve 4 - floaters in the eye that clump together forming shadows

Answer 45

3 - increased pressure in eye that damages the optic nerve | - fluid in anterior chamber builds up and is blocked and increases pressure

Question 46

What are floaters in the eye?

Answer 46

- spots in your vision - age-related changes that occur as the jelly-like substance (vitreous) inside the eyes becomes more liquid - they can clump together within the vitreous chamber and cast tiny shadows on you