Rapid Review Flashcards
1
Q
The inferior parietal lobule is composed of what two structures?
A
- supramarginal gyrus and angular gyrus.
2
Q
Where does the Sylvian fissure terminate and what Brodman area?
A
- in the supramarginal gyrus (Brodman area 40).
3
Q
Where does the superior temporal gyrus terminate and what Brodman area?
A
- in the angular gyrus (Brodman area 39).
4
Q
Brodman area for the primary motor cortex?
A
- Area 4.
5
Q
Brodman area for Broca’s area?
A
- Area 44.
6
Q
Brodman area for Wernicke’s area?
A
- Area 40 and 39.
7
Q
Brodman area for the primary auditory area?
A
- Area 41 and 42.
8
Q
Brodman area for the frontal eye fields?
A
- Area 8.
9
Q
Brodman area for the primary somatosensory area?
A
- Areas 3,1 and 2.
10
Q
Brodman area for the premotor area?
A
- Area 6.
11
Q
Brodman area for the primary visual cortex?
A
- Area 17.
12
Q
What is the terminal part of the cingulate sulcus?
A
- Pars marginalis.
13
Q
Where does the central sulcus terminate?
A
- Paracentral lobule.
14
Q
What bones make up the pterion?
A
- Frontal.
- Greater wing of the sphenoid.
- Parietal.
- Temporal.
15
Q
What sutures converge to make up the asterion?
A
- Lamboid.
- Occipitomastoid.
- Parietomastoid.
16
Q
What does the asteroid overlie?
A
- Transverse and sigmoid sinuses.
17
Q
Where is the external landmark for the angular gyrus?
A
- Just above the pinna (important as part of Wernicke’s area in the dominant hemisphere).
18
Q
What cervical levels does the thyroid cartilage lie?
A
- C4-5.
19
Q
What cervical levels does the hyoid bone lie?
A
- C3-4.
20
Q
What nerves traverse the superior orbital fissure?
A
- CN III.
- CN IV.
- Nasociliary nerve.
- Frontal nerve ophthalmic division.
- Lacrimal nerve.
- CN VI.
21
Q
What is another name for the transverse crest in the IAC?
A
- Crista falciformis.
22
Q
Vascular supply to the anterior limb of the internal capsule?
A
- Lateral striate branches of MCA.
23
Q
Vascular supply to the posterior limb of the internal capsule?
A
- Lateral striate branches of MCA.
24
Q
Vascular supply to the ventral posterior limb of the internal capsule?
A
- Anterior choroidal.
25
Vascular supply to the genu of the internal capsule?
1. Direct branches of the ICA.
26
Vascular supply to the optic radiations?
1. Anterior choroidal.
27
What ligaments are most important in maintaining atlanto-occipital stability?
1. Tectorial membrane and the alar ligaments.
28
How is the lateral spinothalamic tract somatotopically organized?
1. Cervical is medial.
| 2. Sacral is lateral.
29
What motor tract facilitates extensor tone?
1. Vestibulospinal tract.
30
What motor tract facilitates flexor tone?
1. Rubrospinal tract.
31
Branches of the cavernous carotid artery?
1. Meningohypophyseal trunk.
| 2. Anterior meningeal artery.
32
Branches off the meningohypophyseal trunk?
1. Dorsal meningeal.
2. Inferior hypophyseal.
3. Tentorial artery of Bernasconi and Cassinari.
33
Occlusion of what artery leads to Sheehan necrosis?
1. Inferior hypophyseal.
34
The inferior hypophyseal artery supplies what?
1. Posterior lobe of pituitary.
35
What structures do the anterior choroidal artery supply?
1. Globus pallidus.
2. Optic tract.
3. Genu of IC.
4. Optic radiations.
5. Uncus.
6. Posterior limb of IC.
7. Lateral geniculate body.
36
What 3 segments are included in the carotid siphon?
1. Cavernous.
2. Ophthalmic.
3. Communicating.
37
Where does the recurrent artery of Heubner typically originate?
1. A1/A2 junction.
38
What structures are supplied by the recurrent artery of Heubner?
1. Head of caudate.
2. Putamen.
3. Anterior limb of the internal capsule.
39
What percentage of people have a fetal PCOM?
1. 15-35%.
40
What are the branches of the vertebral artery?
1. Anterior meningeal.
2. Posterior meningeal.
3. Medullary.
4. Posterior spinal.
5. PICA.
6. Anterior spinal.
41
What are the 3 branches of PICA?
1. Choroidal.
2. Tonsillohemispheric.
3. Inferior vermian.
42
What are the 3 segments of the PCA?
1. P1 - peduncular.
2. P2 - ambient.
3. P3 - quadrigeminal.
43
What is the artery of Percheron?
1. Anatomic variant where a solitary trunk arises from one PCA to supply bilateral paramedian thalami and rostral midbrain.
44
What are the 4 types of persistent fetal anastomoses?
1. Trigeminal.
2. Otic.
3. Hypoglossal.
4. Proatlantal.
45
What are the main contributors to the vein of Galen?
1. Precentral cerebellar.
2. Basal vein of Rosenthal.
3. Internal cerebral vein.
46
The junction of the septal vein and thalamostriate vein with the internal cerebral vein forms what on angio?
1. Venous angle.
47
Where does the junction of the septal vein, thalamostriate vein and internal cerebral vein occur?
1. At the foramen of Monro.
48
Which cranial nerve is the only one in the cavernous sinus that does not pass through the superior orbital fissure?
1. V2.
| 2. It exits the skull through the foramen rotundum.
49
Which sites of the brain have no BBB?
1. Pituitary.
2. Pineal.
3. Preoptic recess.
4. Tuber cinereum.
5. Area postrema.
50
If unilateral, a Hoffman sign indicates a lesion above which level?
1. C8.
51
Which nucleus is the primary coordinating center for bladder function?
1. Nucleus locus coeruleus in the pons.
52
Which is more common with cauda equina...urinary retention or incontinence?
1. Urinary retention is more common with cauda equina although overflow incontinence can occur.
53
Pure word blindness is caused by what?
1. Lesion in the parietooccipital lobe on the dominant side.
54
What syndrome causes alexia without agraphia?
1. Pure word blindness (meaning they can write but cannot read).
55
What syndrome causes agraphia without alexia?
1. Gerstmann syndrome (meaning they can read but cannot write).
56
Symptoms in Weber syndrome?
1. CN III palsy.
| 2. Contralateral hemiparesis.
57
What is the syndrome of the Sylvian aqueduct?
1. Parinaud's syndrome combined with downgaze palsy.
58
What is the posterior pituitary derived from?
1. Derived from downward evagination of neural crest cells from the floor of the third ventricle.
59
What is the anterior pituitary derived from?
1. Derived from evagination of epithelial ectoderm which is also called Rathke's pouch.
60
Presentation of Waterhouse-Friderichsen syndrome?
1. Large petechial hemorrhages in the skin and mucous membranes.
2. Fever.
3. Septic shock.
4. Adrenal failure.
5. DIC.
Seen in children with disseminated meningococcal infection.
61
Empiric antibiotics used for spinal epidural abscess?
1. Ceftriaxone or cefepime.
2. Vancomycin.
3. Metronidazole.
4. +/- rifampin.
62
What percentage of patients with SCI with no function on initial exam will develop some recovery within 24 hours?
1. 3%.
63
Central cord syndrome usually results from hyperflexion or hyperextension?
1. Hyperextension.
64
Which type of incomplete SCI has the best prognosis?
1. Brown-Sequard.
65
What are some indications for surgery in central cord syndrome?
1. Spinal instability.
| 2. Continued cord compression in a patient who fails to improve or progressively worsens.
66
What is the normal atlantodental interval (ADI) in adults?
1. Less than 3mm.
67
Describe the 3 types of atlanto-occipital dislocation.
1. Type 1 - anterior.
2. Type 2 - superior.
3. Type 3 - posterior.
68
What structure is the cephalad extension of the ALL?
1. Anterior antlanto-occipital membrane.
69
What structure is the cephalad extension of the PLL?
1. Tectorial membrane.
70
What two structures are most important in maintaining atlanto-occipital stability?
1. Tectorial membrane.
| 2. Alar ligaments.
71
AOD is suspected if the atlanto-occipital interval is greater than what?
1. 2 mm.
72
What are 4 causes of atlanto-axial rotatory subluxation?
1. Spontaneous.
2. Trauma.
3. Upper respiratory tract infection (Grisel syndrome).
4. RA.
73
What are 3 causes of vertical nystagmus?
1. Posterior fossa pathology.
2. Sedatives.
3. AEDs.
74
Seesaw nystagmus occurs with a lesion where?
1. Diencephalon.
75
Nystagmus retractorius occurs with a lesion where?
1. Upper midbrain tegmentum.
76
Where is the lesion that results in ocular bobbing?
1. Pontine tegmentum.
77
How long does it take for papilledema to develop?
1. 24-48 hours.
78
DDx for unilateral papilledema?
1. Foster-Kennedy syndrome.
2. Inflammation.
3. Optic glioma.
4. Multiple sclerosis.
79
What are 3 causes of non-pupil sparing oculomotor palsy?
1. Tumor.
2. Aneurysm (Pcom, basilar tip).
3. Uncal herniation.
80
Where does the trochlear nucleus lie in relation to the aqueduct?
1. Ventral at the level of the inferior colliculi.
81
A trochlear nerve palsy results in the eye deviated in what direction?
1. Up and in.
82
What side does the head tilt in a trochlear nerve palsy?
1. The opposite side of the lesion.
83
What is Tolosa-Hunt syndrome?
1. Nonspecific inflammation of the superior orbital fissure.
84
What are two components of Raeder's paratrigeminal neuralgia?
1. Unilateral oculosympathetic paresis.
| 2. Homolateral trigeminal nerve involvement.
85
What is Gradenigo's syndrome?
1. Apical petrositis.
86
What is the classic triad of Gradenigo's syndrome?
1. Abducens palsy.
2. Retro-orbital pain.
3. Drainage from the ear.
87
Ocular bobbing is associated with bilateral paralysis of what?
1. Horizontal gaze.
88
What is opsoclonus?
1. Rapid, conjugate, irregular, non-rhythmic eye movement.
89
What is oscillopsia?
1. Visual sensation that stationary objects are vibrating or swaying from side to side.
90
What is a type 1 occipital condyle fracture?
1. Comminuted fracture.
91
What is a type 2 occipital condyle fracture?
1. Extension of basilar skull fracture.
92
What is a type 3 occipital condyle fracture?
1. Avulsion fracture.
93
What are the indications for halo or fusion in occipital condyle fractures?
1. Craniocervical misalignment.
| 2. Occipital-C1 interval > 2mm.
94
What are 4 possible causes of atlanto-axial dislocation?
1. Spontaneous.
2. Trauma.
3. Upper respiratory tract infection (Grisel syndrome).
4. Rheumatoid arthritis.
95
What mechanism causes Hangman's fractures?
1. Hyperflexion and axial loading.
96
What determines disc disruption in Hangman's fractures?
1. Subluxation of C2 on C3 by more than 3mm.
97
Myelopathy correlates with an AP canal diameter of less than what?
1. 13mm.
98
What is another name for Paget's disease?
1. Osteitis deformans.
99
What CN is most commonly affected in Paget's disease as it exits through its bony foramina?
1. CN VIII.
100
Most common symptom in Paget's disease?
1. Bone pain.
101
How does Paget's disease present in the spine?
1. Spans several contiguous levels and has thickened pedicles/lamina, dense vertebral bodies, and discs are replaced by bone.
102
What is another name for ankylosing spondylitis?
1. Marie-Strumpell disease.
103
What is the first site usually affected by ankylosing spondylitis?
1. SI joint.
104
What site of the spine is usually spared in DISH?
1. SI joint.
105
What is Scheuermann's kyphosis?
1. Anterior wedging of at least 5 degrees of 3 or more adjacent thoracic vertebral bodies.
106
What are 4 upper C-spine abnormalities associated with rheumatoid arthritis?
1. Basilar impression.
2. Atlantoaxial subluxation.
3. Subaxial subluxation.
4. Vertebral artery insufficiency - due to changes at the craniocervical junction.
107
Most common presentation of a spinal AVM?
1. Onset of back pain.
| 2. Progressive LE weakness and sensory loss.
108
What is the eponym for acute onset of SAH and sudden excruciating back pain from a spinal AVM?
1. Coup de Poignard of Michon.
109
What is a Tarlov's cyst?
1. Spinal meningeal cyst.
110
What percentage of aSAH patients die before reaching the hospital?
1. 10-15%.
111
What is the risk of rebleeding from an aSAH within 2 weeks?
1. 15-20%.
112
What is the risk of death from vasospasm after aSAH?
1. 7%.
113
What is the risk of severe deficit from vasospasm after aSAH?
1. 7%.
114
What is the 30 day mortality rate after aSAH?
1. About 50%.
115
What is the incidence of sentinel hemorrhage in aSAH?
1. 30-60%.
116
What percentage of aSAH patients will have acute onset of hydrocephalus?
1. 21%.
117
What is the most sensitive sequence on MRI for detecting blood in the subarachnoid space?
1. FLAIR.
118
To call an angiogram negative for aneurysm, you must see what two areas?
1. Take off both PICAs and ACOM.
119
What are the three criteria about an infundibulum?
1. Triangular shape.
2. Size of mouth is less than 3mm.
3. Vessel at apex.
