BB anatomy

Question 1

Where does the middle meningeal artery enter the skull?

Answer 1

Foramen spinosum

Question 2

Where does the middle meningeal artery branch from?

Answer 2

Maxillary artery

From external carotid

Question 3

What makes up the nasal septum?

Answer 3

Ethmoid
Vomer
Nasal hyaline cartilage

Question 4

What is found on the ventral surface of the brainstem?

Answer 4

Cerebral peduncles 
Pons 
Pyramids (where CST decussate) 
Olives 
All cranial nerves leaving the brainstem except for IV

Question 5

What is found on the dorsal surface of the brainstem?

Answer 5

Superior colliculi (visual)
Inferior colliculi (auditory)
Trochlear nerve emerging at the midbrain-pons junction
Superior, middle and inferior cerebellar peduncles
Cuneate fasciculi laterally
Gracile fasciculi medially
Obex = 1/3 of the way up of the medulla where 4th ventricle begins

Question 6

Blood supply to the dorsal brainstem

Answer 6

PCA
AICA
PICA

Question 7

Blood supply to the ventral brainstem

Answer 7

Basilar

ASA

Question 8

What does CN III innervate?

Answer 8

Extraocular muscles (except superior oblique and lateral rectus) 
Levator palpebrae superioris 
Ciliary muscle (parasympathetic)
Sphincter pupillae (parasympathetic)

Question 9

CN III lesion

Answer 9

Dilated pupil

Eye in down and out position

Question 10

CN IV lesion

Answer 10

Double vision when looking down

Question 11

2 major branches of V3

Answer 11

Lingual nerve

• supplies sensation to the anterior 2/3 of the tongue
• carries chorda tympani from facial nerve for taste sensation

Inferior alveolar nerve

• sensation to lower teeth
• enters mandible though mandibular foramen
• exits though mental foramen

Question 12

Clinical significance of abducens damage

Answer 12

Long intradural course

Easily compressed when ICP is raised

Question 13

CN VI lesion

Answer 13

Medial deviation on affected side

Loss of abduction

Question 14

CN VII branches

Answer 14

Greater petrosal nerve –> lacrimal gland
Nerve to stapedius
Chorda tympani
Posterior belly of digastric and stylohyoid
Terminal branches

Question 15

Terminal branches of CN VII

Answer 15

Temporal --> frontalis 
Zygomatic --> orbiculairs oculi
Buccal --> buccinator, orbicularis oris 
Mandibular --> mentalis 
Cervical --> platysma

Question 16

Bell’s palsy vs stroke

Answer 16

Bell’s palsy = complete unilateral paralysis

Stroke = forehead sparing

Question 17

Tympanic branch of CN IX

Answer 17

Sensation to middle ear, tympanic membrane and Eustachain tube
Parasympathetic to parotid gland

Question 18

What innervates the carotid sinus and body?

Answer 18

CN IX

Question 19

Which muscle does CN IX supply?

Answer 19

Stylopharyngeus

Question 20

Which tonsils does CN IX innervate?

Answer 20

Palatine via tonsillar nerve

Question 21

What muscles are supplied by CN X?

Answer 21

Palate (except tensor veli palatini –> V3)
Pharynx (except stylopharyngeus –> CN IX)
Palatoglossus
Laryngeal muscles

Question 22

What does the transverse fissure separate?

Answer 22

Occipital lobe

Cerebellum

Question 23

What makes up the lentiform nucleus?

Answer 23

Putamen

Globus pallidus

Question 24

What makes up the dorsal striatum

Answer 24

Caudate

Putamen

Question 25

Superior cerebellar peduncle

Answer 25

Output from the cerebellum to the pons --> thalamus --> cortex

Question 26

Middle cerebellar peduncle

Answer 26

Input to the cerebellum from the pons | About motor activities initiated by the cortex

Question 27

Inferior cerebellar peduncle

Answer 27

Input to the cerebellum via the spinocerbellar tract from peripheral proprioceptors

Question 28

Signs of cerebellar injury

Answer 28

``` DANISH Dysdiadochokinesia Ataxia Nystagmus Intention tremor Slurred speech Hypotonia ```

Question 29

Thalamic nuceli

Answer 29

``` LGN = vision MGN = hearing VPL = touch, pain, pressure Anterior = memory VL = motor from BG and cerebellum VA = motor from BG ```

Question 30

What does the epithalamus/pineal gland secrete?

Answer 30

Melatonin

Question 31

Layers of the scalp

Answer 31

``` Skin = many sweat and sebaceous glands Connective tissue Aponeurosis = tendinous sheet Loose CT = allows movement of scalp Pericranium = dense CT that is the periosteum ```

Question 32

T1 weighted

Answer 32

CSF and bone = black Fat = white Grey matter darker than white

Question 33

T2 weighted

Answer 33

CSF and bone = white Fat = black White matter darker than grey

Question 34

Which parts of the orbit are most commonly fractured?

Answer 34

Medial and inferior walls | Ethmoid and maxillary

Question 35

Epidural haematoma

Answer 35

Impact to the head Tearing a vessel running between skull and dura Arterial bleed Lucid interval then sudden unconsciousness Convex shaped on scan

Question 36

Subdural haematoma

Answer 36

Caused by an acceleration/deceleration incident Tearing of bridging veins between dura and arachnoid Gradual headache and confusion Crescent shaped appearance on scan

Question 37

Subarachnoid haemaorrhage

Answer 37

May be with small trauma or spontaneous rupture of an aneurysm Blood within the subarachnoid space Blood can be seen within the sulci and fissures on scan Thundercap headache, vomiting, confusion, loss of consciousness

Question 38

Common sites of brain contusion

Answer 38

Inferior surface of frontal lobes Lateral and inferior temporal lobes Region adjacent to lateral fissures Occipital poles

Question 39

Symptoms of posterior parietal damage

Answer 39

Sensory neglect | Constructional apraxia

Question 40

Symptoms of visual cortex lesion

Answer 40

Contralateral homonymous hemianopia

Question 41

ACA stroke

Answer 41

Urinary incontinence Behaviour changes Lower body sensorineural loss

Question 42

PCA stroke

Answer 42

Contralateral homonymous hemianopia Reading and writing deficits Impaired memory

Question 43

What is the anterior choroidal artery?

Answer 43

From the MCA | Supplies the hippocampus, amygdala and medial temporal lobe

Question 44

Lateral medullary syndrome

Answer 44

``` Wallenburg syndrome PICA stroke Sudden onset Ipsilateral horner syndrome Vertigo Nystagmus Dysarthria (slurred speech) Dysphonia Loss of gag reflex ```