Cranial Cavity, Scalp, Meninges and the Brain (Clinical case questions) Flashcards
During an intramural baseball game a player is hit in the side of the head, between the eye and the ear. He immediately loses consciousness, wakes up momentarily and then becomes comatose. He is rushed to the ER and is immediately given a CT scan. The scan shows a skull fracture and an accumulation of blood between the dura and the cranial bone on the side of his head, compressing his cerebrum. He is rushed to surgery where a hole is bored into his skull to relieve the pressure. After a few tense hours, he regains consciousness and has an uneventful recovery. The hemorrhage from the fracture would be described as:
Epidural
An infant was diagnosed as having hydrocephalus. It was determined that there was a blockage in the ventricular system of the baby’s brain between the third and fourth ventricles. The blockage therefore must have involved the:
A. Central canal
B. Cerebral aqueduct
C. Foramen of Luschka (lateral foramen)
D. Foramen of Magendie (medial foramen)
E. Interventricular foramen
B. Cerebral aqueduct
An 84-year old woman suffers a stroke, with paralysis on the right side of her body. Neurological tests show that the intracerebral hemorrhage has interrupted the blood supply to the posterior part of the frontal, the parietal and medial portions of the temporal lobes of the left cerebral hemisphere. Which vessel was involved? A. Anterior cerebral artery B. Great cerebral vein C. Middle cerebral artery D. Middle meningeal artery E. Posterior cerebral artery
C. Middle cerebral artery
A sixty-four-year old man was diagnosed with an acoustic neuroma (tumor of the VIIIth cranial nerve) where it entered the temporal bone. What other cranial nerve might also be affected since this nerve uses the same foramen as the VIIIth in its course? A. Abducens B. Facial C. Glossopharyngeal D. Trigeminal E. Vagus
B. Facial
Infections may spread from the nasal cavity to the meninges along the olfactory nerves, as its fibers pass from the mucosa of the nasal cavity to the olfactory bulb via the: A. Cribriform plate of the ethmoid B. Crista galli C. Foramen caecum D. Superior orbital fissure
A. Cribriform plate of the ethmoid
The "danger zone" of the scalp is recognized as which of the following layers? A. Galea aponeurotica B. Loose connective tissue C. Pericranium D. Skin E. Subcutaneous connective tissue
B. Loose connective tissue
The presence of blood in a spinal tap taken from an individual with a closed head injury signals arterial bleeding into the: A. Cavernous sinus B. Epidural space C. Subarachnoid space D. Subdural space
C. Subarachnoid space
An infection in which scalp layer is likely to spread most readily? A. Skin B. Connective tissue layer C. Aponeurotic layer D. Loose areolar tissue E. Pericranium
D. Loose areolar tissue
A patient who has sustained a fracture to the middle cranial fossa following a fall from a height, might have any of these nerves injured EXCEPT: A. Trigeminal B. Oculomotor C. Abducens D. Trochlear E. Hypoglossal
E. Hypoglossal
The most likely source of blood in a patient with an epidural hemorrhage is: A. Vertebral artery B. Middle meningeal artery C. Superior cerebral veins D. Anterior cerebral artery E. Circle of Willis
B. Middle meningeal artery
In a fall from a horse, a rider sustains a severe neck injury at the C6 level. In addition to crushing the spinal cord, the left transverse process of the C6 vertebra is fractured. What artery is endangered? A. Common carotid B. Costocervical C. Inferior thyroid D. Internal carotid E. Vertebral
E. Vertebral
A 35-year-old man was admitted to the hospital complaining of double vision (diplopia), inability to see close objects, and blurred vision in the right eye. A vertebrobasilar angiogram revealed an aneurysm of the superior cerebellar artery close to its origin on the right side. The doctor attributed the symptoms to the compression of an adjacent cranial nerve by the aneurysm. The compressed nerve is the:
Oculomotor (CN III)
An elderly patient developed fever and worsening headache a few days after sustaining a scalp laceration and subsequent infection due to a car accident. At the hospital the case was diagnosed as meningitis and superior sagittal sinus thrombosis. The attending physician suggested that infection to the sinus initially spread through one of the scalp layers. The scalp layer involved is:
Loose areolar tissue
While riding her bicycle on campus without a helmet a student is hit by a car and falls, hitting her head on the pavement. She is brought to the Emergency Room in an unconscious state with signs of a closed head injury. Tests reveal blood in her cerebrospinal fluid taken from a spinal tap. Diagnosis is of torn cerebral veins as they pass from the brain to the superior sagittal sinus. From which of the following was the bloody fluid taken?
Subarachnoid space
You have been asked to assess the neurological deficit that might exist in a patient diagnosed with cavernous sinus thrombosis. You will focus your examination on cranial nerves related to the sinus that includes all the following EXCEPT:
A. Abducens (CN VI)
B. Facial (CN VII)
C. Oculomotor (CN III)
D. Ophthalmic division of the trigeminal nerve (CN V1)
E. Trochlear (CN IV)
B. Facial (CN VII)
