Main Deck

Question 1

Parkinsonism

Answer 1

Movement abnormalities seen in Parkinson dx:
Tremor, slow movement, impaired speech or muscle stiffness

Question 2

Motor hand is represented where in the brain

Answer 2

Central sulcus at the inverted Omega

Question 3

Where is the pars marginalis

Answer 3

Immediately behind the central sulcus

Question 4

Name the sulci

Question 5

Name the gyri. Beginning at 12 o clock and moving clockwise

Answer 5

1. Superior frontal gyrus
2. superior frontal sulcus
3. Central sulcus
4. Post central sulcus
5. Intraparietal sulcus
6. Angular gyrus
7. Superior parietal gyrus
8. Pars marginalis
9. Supramarginal gyrus
10. Post central gyrus
11. Pre central gyrus
12. Middle frontal gyrus

Question 6

The most prominent sulcus that reaches the midline is the ?

Answer 6

Central sulcus

Question 7

Homunculous Trivia:

The ____ arterial territory gets legs

The _____ territory gets the rest

Answer 7

ACA, MCA

Question 8

How many latyers is the cortex?

Question 9

How many layers is the hippocampus?

Answer 9

3

Question 10

Define Virchow Robin spaces

Answer 10

Fluid filled perivascular spaces that do accompany perforating vessels and contain interstitial fluid (not CSF)

Question 11

The two lateral ventricles communicate with the 3rd ventricle via ? Which in turn communicates with the 4th ventricle via?

Answer 11

The foramen of Monroe

The cerebral aqueduct

Question 12

Fluid in the 4th ventricle escapes via ?

Answer 12

The median aperture (Foramen of Magendie) and the lateral apertures (foramen of Luschka)

Question 13

Define arachnoid granulations

Answer 13

Focal areas where the arachnoid projects into the venous system to allow for CSF resorption. Do not confuse with clot in the venous system. AG are hypodense on CT and usually round or oval and usually scallop the inner table from CSF pulsation. Clot is usually linear.

Question 14

Name the cisterns from 3oclock and clockwise

Answer 14

quadrigeminal plate cistern

cisterna magna

pontine cistern

interpeduncular cistern

suprasellar cistern

cavum velum interpositum

Question 16

Fibrous Dysplasia Synonyms

Answer 16

Craniofacial fibrous dysplasia (CFD), osteitis fibrosa, osteodystrophy fibrosa

McCune-Albright syndrome (MAS): One of the most common FD syndromes

Jaffe-Lichtenstein dysplasia (monostotic FD)

Question 17

Fibrous Dysplasia definition

Answer 17

• Congenital disorder
• Defect in osteoblastic differentiation and maturation
• Characterized by expanding lesions with mixture of fibrous tissue and woven bone.

Question 18

Osteopetrosis also known as “_____” Syndrome

Answer 18

C.O.M.M.A.D

1. Coloboma
2. Osteopetrosis
3. Micropthalmia
4. Macrocephaly
5. Albinism
6. Deafness

Question 19

BG structure located in the midbrain that plays an imp role in reward and movement.

Answer 19

Substantia Nigra

Question 20

Putaminal rim sign is assoc with

Answer 20

MSA at 1.5 T (Not 3T)

Question 21

Structure in the rostral midbrain involved with motor coordination

Answer 21

Red nucleus

Question 22

Characteristic imaging features of idiopathic intracranial hypertension (IIH)

Answer 22

1. Empty Sella: MC IIH finding (nonspecific)
2. Skull base findings: Scalloping of the skull bkase, prominent arachnoid pits, meningoencephalocele, enlargement of skull base foramina, low lying cerebellar tonsils
3. Meningoceles
4. cerebral venous sinuses
5. orbital findings

Question 23

Initial imaging study to evaluate for IIH

Answer 23

Thin section CT through the sinuses and mastoids

Question 24

Study used to evaluate for CSF leak

Answer 24

Beta 2 Transerrin

Question 25

Important CT findings in the setting of IIH

Answer 25

A polypoid nondependent soft tissue next to and osseous defect

Question 26

IIH treatment

Answer 26

Diamox or lumbar shunt

Question 27

Studies choice for the evaluation of patient with an active CSF leak

Answer 27

CT cisternogram

Question 28

Dx?

Answer 28

Stafne bone defect

well corticated 1 cm round defect in the medial cortex of the mandible in the right angle of the jaw (arrowed).

Also known as -lingual mandibular salivary gland depression- normal anatomical variant, as the depression is created by ectopic salivary gland tissue associated with the submandibular gland and does not represent a pathologic lesionas such.

Question 29

Characteristic imaging findings of allergic fungal sinusitis include opacified sinuses that are ______ on CT and _____ on T2 MRI.

Answer 29

hyperdense;hypointense

Question 30

Which imaging or clinical features favor pyogenic spondylitis over tuberculous spondylitis?

Answer 30

Patients with pyogenic spondylitis have a relatively short symptom to diagnosis interval and markely elevated inflammatory markers (ESR and CRP). Typical imaging features include involvement limited to 2 vertebral bodies, moderate to severe disc destruction and absence of a paraspinal or intraspinal abscess.

Question 31

Two Dx?

Answer 31

Cobalamin or B12 deficiency

Question 32

Conditions to screen for in Lhermitte Duclos?

Answer 32

Screening for breast, thyroid and genitourinary malignancies.

Question 33

What metabolite resonates at 2ppm?

Answer 33

N-acetylaspartate (NAA)

Question 34

Schizencephaly is associated with

Answer 34

SOD, gray matter heterotopia and absent septum pellucidum.

Question 35

When performing a balloon kyphoplasty at this level, which is the most appropriate trocar path?

Answer 35

C. Transpedicular

Question 36

Dx?

Answer 36

C1-2 rotary fixation

Generally there should not be greater than 45 degrees rotation at C1-2. If in doubt, repeat localized CT at C1-2 attempting to turn the head the other way.

Question 37

purely ectodermal in origin and present as cystic masses adjacent to external auditory canal.

Answer 37

Type I Branchial cleft cyst

Question 38

Have both ectodermal and mesodermal elements and may contain skin appendages. May present as cysts, sinuses or fistulae. The other cysts arise elsewhere.

Answer 38

Type II Branchial Cleft cyst

Question 39

What part of the incus articulates with the stapes capitellum?

Answer 39

What part of the incus articulates with the stapes capitellum?

Question 40

MRI shows hyperintense signal throughout the subarachnoid space on the FLAIR sequence but is otherwise negative. CSF analysis is normal. What is the most likely cause of the hyperintense CSF signal?

Answer 40

Paramagnetic effect of CSF dissolved O2

Question 41

What do the minimum elements of a “safety time out” include?

Answer 41

Identify patient, confirm site, confirm procedure

Question 43

Dx?

Answer 43

Guillain-Barre syndrome

Enhancement of the ventral nerve roots and the clinical history are both characteristic of Guillain-Barre syndrome.

Question 44

Dx?

Answer 44

Holoprosencephaly

Question 45

MC location for diastomatomyelia

Answer 45

thoracolumbar spine

Question 47

Name the lesions that arise from the post ear elements of the spine

Answer 47

When considering lesions arising in the osseous elements of the spine, it can be useful to divide lesions into those that predominantly involve the posterior elements (osteoblastoma, aneurysmal bone cyst, osteoid osteoma, myeloma, metastases) and those that predominantly involve the vertebral body (chordoma, giant cell tumor, Langerhans cell histiocytosis, Ewing sarcoma, lymphoma, metastases, myeloma). This can be a good starting point for discussion of the differential diagnosis.