BB2 Anatomy2 Flashcards
Looking at the axial CT images carefully, you see mass which has taken up the contrast and appears bright. Which of these cerebral cortical regions does this mass overlie?
Prefrontal cortex
Auditory cortex
Primary motor cortex
Visual cortex
Looking at the axial CT images carefully, you see mass which has taken up the contrast and appears bright. Which of these cerebral cortical regions does this mass overlie?
Prefrontal cortex
Auditory cortex
Primary motor cortex
Visual cortex
According to a colleague of Marina - Lydia - who witnessed the event, the seizure was preceded by abnormal, repetitive movements. Looking again at the coronal view of the CT brain (below) and recalling the motor homunculus, in which body part would these abnormal movements most likely be observed:
Right face
Left face
Right upper limb
Left upper limb
RIght lower limb
Left lower limb
According to a colleague of Marina - Lydia - who witnessed the event, the seizure was preceded by abnormal, repetitive movements. Looking again at the coronal view of the CT brain (below) and recalling the motor homunculus, in which body part would these abnormal movements most likely be observed:
Right face
Left face
Right upper limb
Left upper limb
RIght lower limb
Left lower limb
The mass is probably closest to the upper limb region of the primary motor cortex. The lower limb is represented more medially and the face is represented more laterally.
Of course, the problem is in the right hemisphere, so this will manifest on the left side peripherally.
Clinically, this phenomenon of abnormal, unprovoked sensorimotor activity is known as a focal or partial seizure, and reflects involvement of distinct funtional areas of cortex.
Lydia adds that after 30-60 seconds of these abnormal movements, Marina lost consciousness, fell to the floor, and her whole body started tensing and shaking violently. What does this represent, anatomically? [1]
Acceptable responses: generalised seizure, tonic clonic seizure, tonic-clonic seizure, secondary generalised seizure, generalised tonic clonic seizure, global cortical involvement
An aneurysm is defined as swelling of a vessel [] times greater than the normal diameter
An aneurysm is defined as swelling of a vessel 1.5 times greater than the normal diameter
Which of the following is the right common carotid artery
A
B
C
D
E
F
Which of the following is the right common carotid artery
A
B
C
D
E
F
Which of the following is the left internal carotid artery
A
B
C
D
E
F
Which of the following is the left internal carotid artery
A
B
C
D
E
F
Which of the following is the left vertebral artery
A
B
C
D
E
F
Which of the following is the left vertebral artery
A
B
C
D
E
F
Through which foramen do the internal carotid arteries (ICA) enter the skull?
Foramen lacerum
Carotid canal
Foramen rotundum
Foramen magnum
Through which foramen do the internal carotid arteries (ICA) enter the skull?
Foramen lacerum
Carotid canal
Foramen rotundum
Foramen magnum
Which of the following is predominately filled with cartliage?
Foramen lacerum
Carotid canal
Foramen rotundum
Foramen magnum
Which of the following is predominately filled with cartliage?
Foramen lacerum
Carotid canal
Foramen rotundum
Foramen magnum
A 22-year-old man sustains a blunt-force head injury and briefly loses consciousness. CT head finding shows a skull base fracture involving the foramen in the middle cranial fossas, traversed by the internal carotid artery. Which of the following nerves travels through this foramen?
A. Maxillary
B. Greater petrosal
C. Nerve to stapedius
D. Posterior auricular
A 22-year-old man sustains a blunt-force head injury and briefly loses consciousness. CT head finding shows a skull base fracture involving the foramen in the middle cranial fossas, traversed by the internal carotid artery. Which of the following nerves travels through this foramen?
A. Maxillary
B. Greater petrosal
C. Nerve to stapedius
D. Posterior auricular
A 70-year-old male presented to the emergency department complaining of blurred vision on his right eye. CT angiogram shows an embolus on the right ophthalmic artery. By which route would an embolus most likely reach the ophthalmic artery?
A. Internal carotid canal – foramen rotundum – cavernous sinus to medial anterior clinoid process
B. Internal carotid canal – foramen lacerum – cavernous sinus to medial anterior clinoid process
C. Internal carotid canal – foramen lacerum – cavernous sinus lateral to anterior clinoid process
D. Internal carotid canal – foramen spinosum – cavernous sinus medial to anterior clinoid process
A 70-year-old male presented to the emergency department complaining of blurred vision on his right eye. CT angiogram shows an embolus on the right ophthalmic artery. By which route would an embolus most likely reach the ophthalmic artery?
A. Internal carotid canal – foramen rotundum – cavernous sinus to medial anterior clinoid process
B. Internal carotid canal – foramen lacerum – cavernous sinus to medial anterior clinoid process
C. Internal carotid canal – foramen lacerum – cavernous sinus lateral to anterior clinoid process
D. Internal carotid canal – foramen spinosum – cavernous sinus medial to anterior clinoid process
Through which foramen do the vertebral arteries enter the skull?
Foramen lacerum
Hypoglossal canal
Jugular foramen
Foramen magnum
Through which foramen do the vertebral arteries enter the skull?
Foramen lacerum
Hypoglossal canal
Jugular foramen
Foramen magnum
A 58-year-old man presents to the clinic with three months of progressively worsening headaches and balance problems. An MRI reveals a circumscribed extra-axial homogenous mass compressing the foramen shown in the image (red arrow). Which one of the following nerves passes through this foramen?
A. Glossopharyngeal
B. Vagus
C. Accessory
D. Hypoglossal
A 58-year-old man presents to the clinic with three months of progressively worsening headaches and balance problems. An MRI reveals a circumscribed extra-axial homogenous mass compressing the foramen shown in the image (red arrow). Which one of the following nerves passes through this foramen?
A. Glossopharyngeal
B. Vagus
C. Accessory
D. Hypoglossal
A 58-year-old man presents to the clinic with three months of progressively worsening headaches and balance problems. An MRI reveals a circumscribed extra-axial homogenous mass compressing the foramen shown in the image (red arrow). Which one of the following nerves passes through this foramen?
A. Glossopharyngeal
B. Vagus
C. Accessory
D. Hypoglossal
A 58-year-old man presents to the clinic with three months of progressively worsening headaches and balance problems. An MRI reveals a circumscribed extra-axial homogenous mass compressing the foramen shown in the image (red arrow). Which one of the following nerves passes through this foramen?
A. Glossopharyngeal
B. Vagus
C. Accessory
D. Hypoglossal
A 65-year-old female presents to the clinic for a follow-up of a long history of refractory headaches. The pain is transmitted via a branch of the mandibular division of the trigeminal nerve that supplies sensory input to the dura mater. From the image shown, through which opening does the corresponding nerve enter the skull?
A
B
C
D
A 65-year-old female presents to the clinic for a follow-up of a long history of refractory headaches. The pain is transmitted via a branch of the mandibular division of the trigeminal nerve that supplies sensory input to the dura mater. From the image shown, through which opening does the corresponding nerve enter the skull?
A
B
C
D
What kind of haemorrhage is shown?
Extradural haemorrhage
Subarachnoid haemorrhage
Subdural haemorrhage
What kind of haemorrhage is shown?
Extradural haemorrhage
Subarachnoid haemorrhage
Subdural haemorrhage
Which vessel is most likely to have ruptured?
Right MCA
The right middle cerebral artery is the most likely to have ruptured in this scenario, as this travels out laterally to supply the lateral region of the cortex.
Based on the appearances on the imaging and the vessel most likely to have been affected, what symptoms might the patient experience? Tick all that apply. [2]
Left sided upper limb paraesthesia and weakness
The haemorrhage is in the region of the right middle cerebral artery. Applying the knowledge we have of the homunculus and the regions which the vasculature supply, we can try and make sense of the symptoms the patient may experience.
We know there is cross over, and as the bleed is on the right-hand side of the brain, the left-hand side of the body will be affected.
We know that the MCA has been affected, and that this supplies the lateral portion of the brain including the primary motor cortex (pre-central gyrus) and primary somatosensory cortex (post-central gyrus). This more lateral region of the brain (if we think back to the homunculus), is responsible for the trunk, upper limb and face. Therefore, of the symptoms listed, the patient is most likely to have left-sided upper limb paraesthesia and left-sided upper limb weakness.
Aphasia is less likely in this case, as Broca’s area (responsible for expressive speech) is most commonly found on the left hemisphere, along with Wernicke’s area (responsible for receptive speech).
Sometimes, the blood can irritate the layers of the meninges disturbing the arachnoid granulations and flow of CSF. Clots can also occasionally form after certain types of intracranial bleeds. Both of these can lead to swelling of the ventricles due to lack of absorption or obstruction.
What is the name of the condition where the ventricles within the brain enlarge?
Acceptable responses: Hydrocephalus, Communicating hydrocephalus, Non-communicating hydrocephalus, Obstructive hydrocephalus
diencephalon is a collection of grey matter structures in the forebrain, found between the telencephalon and the mesencephalon.
It includes a number of very important subcortical structures. These are:[4]
Thalamus
Hypothalamus
Epithalamus
Subthalamus
Thalamus: lies either side of the []
Thalamus: lies either side of the lateral ventricles
The only sensory information to bypass the thalamus is [] information,
Olfactory
Oplthalmic
Proprioception
Audiology
The only sensory information to bypass the thalamus is [] information, which travels directly to olfactory cortex
Olfactory
Oplthalmic
Proprioception
Audiology
Which of the following thalamic nuclei is involved with hearing
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with hearing
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with memory
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with memory
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with motor input from cerebellum
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with motor input from cerebellum
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with motor input from basal ganglia
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with motor input from basal ganglia
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with vision
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with vision
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with touch, pain, pressure & proprioception
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with touch, pain, pressure & proprioception
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
The epithalamus has two main components. What are they? [2]
Pineal gland
Habenular nuclei
Habenular
Which hormone does the pineal gland secrete and what is its function? [2]
secretesmelatonin;
which regulates circadian rhythm.
Which of the following is the pineal gland?
A
B
C
D
E
Which of the following is the pineal gland?
A
B
C
D
E
Which of the following is the pineal gland? [1]
Having revised the anatomy of the diencephalon, you have another look at Christina’s imaging and notice a mass. From which structure is this mass arising?
Hypothalamus
Pituitary
Thalamus
Pineal gland
Having revised the anatomy of the diencephalon, you have another look at Christina’s imaging and notice a mass. From which structure is this mass arising?
Hypothalamus
Pituitary
Thalamus
Pineal gland
The pituitary gland appears moderately enlarged - this is more noticeable on the axial and coronal views. Here, we can see it filling the sella turcica, and we can see the hypothalamus displaced superiorly.