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14. Neurosurgery Primary Examination Review > Section 3 > Flashcards

Section 3 Flashcards

Anatomy and Neurosurgery

1
Q

Enkephalins are the main neurotransmitters from
A. Cerebral cortex to caudate
B. Subthalamic nucleus to caudate
C. Caudate to putamen
D. Putamen to globus pallldus extemus
E. Thalamus to cerebral cortex

A

D. Putamen to globus pallldus extemus

GABA and enkephalins are the main neurotransmitters from putamen to globus pallidus extemus (GPe), GABA and substance P from GPe to globus pallidus internus (GPi), GABA from caudate to SN, GPe to STN, and GPi to thalamus. Ach is
the main neurotransmitter from cerebral cortex to caudate, caudate to putamen, and lateral amygdala to cortex. Glutamate is the main neurotransmitter from cerebral cortex to putamen and STN, STN to GPe, GPi, and SN, thalamus to cortex and putamen. Dopamine is the main neurotransmitter from SN pars compacta to striatum, serotonin and cholecystokinin from dorsal raphe nucleus (DRN) to SN, serotonin and enkephalins from DRN to caudate.

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2
Q

Which thalamic nucleus receives mostly input from the cerebellum. and has output to the motor cortex?
A. VA (ventral anterior)
B. VLo (ventral lateral, pars oralis) (Voa: ventralis oralis anterior]
C. VLc (ventral lateral, pars caudalis) (Vop: ventralis oralis posterior and Vim: ventralis intermediate nucleus]
D. MD (medial dorsal)
E. LP (lateral posterior)

A

C. VLc (ventral lateral, pars caudalis) (Vop: ventralis oralis posterior and Vim: ventralis intermediate nucleus]

VLc (Vop and Vim) and VPLo receive input from dentate nucleus of the cerebellum and project to motor area 4, VA and VLo (Voa) receive input from GP and project to premotor cortex, MD from prefrontal cortex, temporal cortex, amygdala, SN, and GP and project to prefrontal cortex. LP receives input and projects to area 5.

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3
Q

With basilar tip aneurysm surgery, the highest risk of perforating vessel injury occurs when the aneurysm is directed
A. Anteriorly
B. Posteriorly
C. Cranially
D. To the right
E. To the left

A

B. Posteriorly

Basilar tip aneurysms pointing posteriorly carry the highest risk of perforator injury during clipping. Basilar tip aneurysms are now best treated endovascularly with coiling or stent-coiling.

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4
Q

Wartenberg’s sign is associated with which nerve injury?
A. Ulnar n
B. Median n
C. Radial n
D. Common peroneal n
E. Tibial n

A

A. Ulnar n

Wartenberg’s sign consists of inability to adduct the little finger due to weakness of interossei secondary to ulnar n palsy. The little finger is abducted due to the unopposed action of extensor digiti mini mi.

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5
Q

In the following diagram, the vein of Galen is labeled
A. 1
B. 2
C. 4
D. 5
E. 7

A

C. 4

  1. Inferior sagittal sinus; 2. straight sinus; 3. internal cerebral v; 4. vein of Galen; 5. basal v of Rosenthal; 6. thalamostriate v; 7. transverse sinus; 8. superior sagittal sinus.
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6
Q

In the same diagram, the Internal cerebral v is labeled
A. 1
B. 3
C. 4
D. 5
E. 6

A

B. 3

  1. Inferior sagittal sinus; 2. straight sinus; 3. internal cerebral v; 4. vein of Galen; 5. basal v of Rosenthal; 6. thalamostriate v; 7. transverse sinus; 8. superior sagittal sinus.
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7
Q

In the following figure, Ammon’s horn is number
A. 1
B. 2
C. 3
D. 4
E. 7

A

B. 2

  1. Dentate gyrus; 2. Cornu Ammonis (hippocampus); 3. subiculum; 4. entorhinal cortex; 5. optic tract; 6. temporal horn of lateral ventricle; 7. fimbria of fomix; 8. tail of caudate nucleus; 9. alveus; 10. choroid plexus.
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8
Q

In the same diagram. the dentate gyrus is number
A. 1
B. 2
C. 3
D. 4
E. 5

A

B. 2

  1. Dentate gyrus; 2. Cornu Ammonis (hippocampus); 3. subiculum; 4. entorhinal cortex; 5. optic tract; 6. temporal horn of lateral ventricle; 7. fimbria of fomix; 8. tail of caudate nucleus; 9. alveus; 10. choroid plexus.
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9
Q

During an endoscopic third ventriculostomy, the opening in the Door of the third ventricle should be made
A. Anterior to 3
B. Through 3
C. Through 1
D. Through 2
E. Posterior to 2

A

C. Through 1

An endoscopic third ventriculostomy is done through the membrane (1) between the Mammillary bodies (2) and the Median eminence; through the latter the pituitary infundibulum passes. The membrane (1) is part of the tuber cinereum.

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10
Q

In the figure above, the infundibular recess is
A. Anterior to 3
B. 3
C. 1
D. 2
E. Posterior to 2

A

B. 3

  1. infundibular recess.
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11
Q

The main neurotransmitter from the subthalamic nucleus to the globus pallidus is
A. Glutamate
B. Acetylcholine
C. Dopamine
D. Serotonin
E. GABA (Gamma Amino Butyric Acid)

A

A. Glutamate

Glutamate is the main neurotransmitter from STN to GPe, GPi, and SN.

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12
Q

The medial dorsal nudew of thalamus (MD) projects to the
A. Prefrontal cortex
B. Area 4
C. Areas 3, 1, and 2
D. Parietal association area
E. Banks of the calcarine sulcus

A

A. Prefrontal cortex

MD from prefrontal cortex, temporal cortex, amygdala, SN, and GP and project to prefrontal cortex.

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13
Q

In the following view of the foramen of Monro, the fornix is located at
A. 1
B. 2
C. 3
D. 4
E. None of the above

A

A. 1

In this endoscopic view of the right lateral ventricle, the fornix (1) forms the superior and anterior boundary of the foramen of Monro (4). The choroid plexus is observed between the septum pellucidum (3) and thalamus (2).

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14
Q

The corticospinal tract occupies which part of the internal capsule?
A. Anterior limb
B. Genu
C. Anterior part of the posterior limb
D. Posterior part of the posterior limb
E. Sublenticular part

A

D. Posterior part of the posterior limb

The corticospinal fibers occupy the posterior half of the posterior limb of the internal capsule with the legs represented posteriorly, corticobulbar the genu, auditory projections in sublenticular (inferior thalamic peduncle), visual in retrolenticular (posterior thalamic peduncle). The anterior limb contains the anterior thalamic peduncle, while the posterior limb contains the superior thalamic peduncle.

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15
Q

In the cerebellar architecture, all of the following structures are inhibitory, except
A. Basket cells
B. Outer stellate cells
C. Purkinje cells
D. Pyramidal cells
E. Granule cells

A

E. Granule cells

Excitatory structures in the cerebellum include: climbing fibers, mossy fibers, and granule cells. All other cells are inhibitory.

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16
Q

The risk of stroke from > 70 % symptomatic carotid a stenosis at 2 years is
A. 5 %
B. 9 %
C. 11%
D. 26 %
B. 70 %

A

D. 26 %

Based on NASCET, carotid endarterectomy reduces the risk of stroke from 26% to 9% over 2 years in symptomatic patients with 70-99% stenosis.

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17
Q

The annual rate of rupture of intracranial aneurysms is
A. 0,5 %
B. 1-2 %
C. 2-4 %
D. 6 %
E. 20 %

A

C. 2-4 %

The annual risk of rupture of cavernomas is 0.5-1%, aneurysms 1-2%, AVMs 2-4%. After AVM rupture: mortality 10%, morbidity 30%, rebleed 6% in the first 6 months. After aneurysm rupture, prehospital death is 50%, of the remaining patients there is 20% mortality, 20% morbidity, rebleed 50% in 6 months worst in the first 24 hours.

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18
Q

The meningohypophyseal trunk is a branch of which segment of the ICA?
A. Petrous
B. Cavernous
C. Clinoidal
D. Ophthalmic
E. Communicating

A

B. Cavernous

The cavernous carotid a gives the McConnell’s capsular a, the inferior cavernous a, and the meningohypophyseal trunk. The meningohypophyseal trunk gives the dorsal meningeal a, inferior hypophyseal a, and the tentorial artery of Bernasconi and Cassinari. The petrous carotid gives off vidian, caroticotympanic, and occasionally stapedial aa. The ophthalmic segment: ophthalmic and superior hypophyseal aa, the communicating segment: posterior communicating and anterior choroidal aa.

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19
Q

The normal cerebral blood flow is
A. <8 mL/100 g/min
B. 8-23 mL/100 g/min
C. 50 mL/100 g/min
D. 75 mL/100 g/min
E. >75 mL/100 g/min

A

C. 50 ml/100 g/min

The normal cerebral blood flow is 50 mL/100 g/min, with higher flow in the gray matter than the white matter. In the ischemic penumbra, it is 8-23 mL/100 g/min. The normal Oxygen consumption is 3,5 mL/100 g/min.

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20
Q

Which circumventricular organ is paired and enduces emesis?
A. Subforniceal organ
B. Subcommissural organ
C. Organum vasculosum
D. Area postrema

A

D. Area postrema

The circumventricular organs are devoid of BBB except the subcommissural organ. The subfornical organ and organum vasculosum detect serum osmolarity. The area postrema is the only paired organ and it induces emesis.

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21
Q

The cerebrospinal fluid (CSF) is normally produced at a rate of
A. 150 mL/d
B. 300 mL/d
C. 450 mL/d
D. 600 mL/d
E. 750 mL/d

A

C. 450 ml/d

The normal adult CSF volume is 150 mL, of which 30 mL intraventricular, 40 mL spinal subarachnoid space, and 80 mL cranial subarachnoid space. The body produces 3 times the CSF volume per day ( 450 mL).

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22
Q

The superior hypophyseal a is a branch of which segment of the ICA?
A. Petrous
B. Cavernous
C. Clinoidal
D. Ophthalmic
E. Communicating

A

D. Ophthalmic

Branches of the ophthalmic segment of ICA: ophthalmic and superior hypophyseal aa.

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23
Q

The anterior choroidal a supplies all of the following, except
A. Optic tract
B. Internal capsule
C. Thalamus
D. Red nucleus
E. None of the above

A

E. None of the above

The anterior choroidal a is a branch of the communicating segment of the ICA, has cisternal and plexal segments, and supplies internal capsule, optic chiasm, optic tract, optic radiation, thalamus, GP, cerebral peduncle, SN, red nucleus, and choroid plexus of lateral ventricle.

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24
Q

Which artery, when present, is a branch of the Pl segment of the PCA and supplies the thalamus and midbrain bilaterally?
A. Percheron
B. Benasconi and Cassinari
C. Adamkiewicz
D. Calcarine
E. Medial posterior choroidal

A

A. Percheron

The a of Percheron is a variant unpaired branch of the PCA supplying thalamus and midbrain bilaterally. Occlusion causes bilateral thalamic infarcts.

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25
Q

The proatlantal a connects
A. The ICA to the ECA
B. The ICA to the PCA
C. The petrous carotid a to the basilar a
D. The cervical carotid a to the basilar a
E. The cervical carotid a to the vertebral a

A

E. The cervical carotid a to the vertebral a

The proatlantal a is an anastomosis between the vertebral artery and either the ICA or ECA; it travels between the occiput and C1. The hypoglossal a (0.1%) connects the ICA to the basilar a and travels through the hypoglossal canal. The acoustic (otic) a connects the ICA to the basilar a through the internal auditory canal. The primitive trigeminal a (0.5%) connects ICA to basilar a.

26
Q

According to Lorente de No, the corticospinal tract starts in which layer of the cerebral cortex?
A. Layer I
B. Layer II
C. Layer III
D. Layer IV
E. Layer V

A

E. Layer V

In a 6-layer cortex model of Lorente de No, the main output from the internal pyramidal layer (V) is to the brain stem and spinal cord, from the multiform layer (VI) to the thalamus. The main afferents connect to the internal granular layer (IV). The molecular (I), external granular (II), and external pyramidal (III) layers connect to other cortical areas, while Ill connects the 2 hemispheres.

27
Q

The uncinate fasciculus connects
A. Orbital frontal gyri to anterior temporal lobe
B. Superior and middle frontal gyri to temporal lobe
C. Occipital to temporal lobes
D. Frontal to parieto-occipital lobes
E. Frontal and parietal to parahippocampal and temporal lobes

A

A. Orbital frontal gyri to anterior temporal lobe

The uncinate fasciculus connects orbito-frontal gyri to anterior temporal lobe. The arcuate fasciculus connects the superior and middle frontal gyri to the temporal lobe. The superior longitudinal fasciculus: frontal to parietal and occipital. The inferior longitudinal fasdculus: temporal to occipital.

28
Q

The corticospinal tract has 40 % of its fibers from
A. Pyramidal cells of Betz
B. Area 4
C. Area 6
D. Parietal cortex

A

D. Parietal cortex

The corticospinal tract originates from parietal cortex (40%), premotor (30%), and motor (30%). Only 3% of fibers arise from Betz cells.

29
Q

The thalamic nucleus targeted for DBS to treat tremors is
A. VA (ventral anterior)
B. Vim (ventralis intermediate)
C. Voa (ventralis oralis anterior)
D. Vop (ventralis oralis posterior)
E. MD (medial dorsal)

A

B. Vim (ventralis intermediate)

DBS for tremors (essential or Parkinsonian) targets Vim; bradykinesia and rigidity (Parkinson) targets STN; dystonia targets GPi.

30
Q

The main neurotransmitter from the substantia nigra to basal ganglia is
A. Dopamine
B. GABA: gamma aminobutyric acid
C. Serotonin
D. Enkephalins
E. Glutamate

A

A. Dopamine

Dopamine is the main neurotransmitter from SN pars compacta to striatum, serotonin and cholecystokinin from dorsal raphe nudeus (DRN) to SN, serotonin and enkephalins from DRN to caudate. GABA and enkephalins are the main neurotransmitters from putamen to GPe, GABA and substance P from GPe to GPi and from putamen to GPi, GABA from caudate to SN, GPe to STN, and GPi to thalamus. Ach is the main neurotransmitter from cerebral cortex to caudate, caudate to putamen, and lateral amygdala to cortex. Glutamate is the main neurotransmitter from cerebral cortex to putamen and STN, STN to GPe, GPi, and SN, thalamus to cortex and putamen.

31
Q

The rehemorrhage rate after an untreated ruptured cerebral aneurysm in the first 6 months is
A. 5%
B. 10%
C. 20%
D. 50%
E. 80%

A

D. 50%

Rebleeding from intracranial aneurysm is 20% in 2 weeks, 50% in 6 months. This is highest in the first 24 hours, especially the first 6 hours after subarachnoid hemorrhage.

32
Q

If a patient is lethargic and confused after subarachnoid hemorrhage, he is Hunt and Hess grade
A. 1
B. 2
C. 3
D. 4
E. 5

A

C. 3

The main features of the Hunt and Hess grading system for subarachnoid hemorrhage: grade 1: no or mild headache; 2: moderate-to-severe headache or cranial nerve deficits; 3: lethargy, confusion; 4: hemiparesis, stupor; 5: extensor posturing, coma.

33
Q

A cerebral AVM of 5 cm in diameter, involving the visual cortex, with deep venous drainage, has a surgical risk of major deficit of
A. 4%
B. 7%
C. 12%
D. 19%
E. 69%

A

B. 7%

The presented AVM is Spetzler-Martin grade 4, surgical morbidity: minor deficit 20%, major deficit 7%. Grade 5, minor deficit 19%, major deficit 12%. Grade 3, minor deficit 12%, major deficit4%.

34
Q

The most effective treatment of cranial subdural empyemais
A. Observation
B. Multiple lumbar punctures
C. Antibiotics alone
D. Treat the primary source
E. Surgical evacuation

A

E. Surgical evacuation

Subdural empyema is a surgical emergency due to the risk of venous thrombosis and cerebral infarct.

35
Q

The pterion is formed by all of the following bones, except
A. Frontal
B. Parietal
C. Squamous temporal
D. Greater wing of sphenoid
E. Zygoma

A

E. Zygoma

The pterion is H-shaped and is made of: frontal, parietal, squamous part of temporal bone, and the greater wing of the sphenoid bone.

36
Q

All of the following muscles are typically supplied by the median n in the hand, except
A. Adductor pollicis
B. Abductor pollids brevis
C. Flexor pollicis brevis
D. Opponens pollicis
E. The lateral 2 lumbrical muscles

A

A. Adductor pollicis

Adductor pollicis is supplied by the ulnar n. The remaining muscles (WAF) are supplied by the median n.

37
Q

Which of the following is not true about the special visceral afferent fibers of the facial n?
A. They transmit taste sensation from the anterior 2/3 of the tongue.
B. They travel through the chorda tympani n.
C. They reach the tongue through the lingual branch of the mandibular division of the trigeminal n.
D. They synapse in the caudal part of the nucleus

A

D. They synapse in the caudal part of the nucleus

The nucleus of tractus solitarius cranial part connects to the facial n, middle part glossopharyngeal n, caudal part vagus n.

38
Q

The oculomotor n supplies all of the following muscles, except
A. Superior rectus
B. Superior oblique
C. Inferior rectus
D. Inferior oblique
E. Medial rectus

A

B. Superior oblique

The superior oblique is supplied by the trochlear n, the lateral rectus abducens n, the remaining muscles oculomotor n.

39
Q

Which of the following nerves enters the orbit outside the annulus of Zinn?
A. Abducens n
B. Nasociliary branch of the ophthalmic division of the trigeminal n
C. Trochlear n
D. Superior division of oculomotor n
E. Inferior division of oculomotor n

A

C. Trochlear n

Structures entering the orbit outside the annulus of Zinn are: LFT: Lacrimal n (from V1 ), Frontal n (from V1), Trochlear n (IV), in addition to the superior ophthalmic vein.

40
Q

Bill’s bar separates which 2 nerves?
A. Cochlear and inferior vestibular
B. Cochlear and facial
C. Facial and superior vestibular
D. Facial and inferior vestibular
E. Cochlear and superior vestibular

A

C. Facial and superior vestibular

In the internal acoustic meatus, the facial n is above the cochlear n (7-up, coke down), the superior vestibular n is above the inferior vestibular n, and the facial n is medial to the superior vestibular n and separated from it by the Bill’s bar.

41
Q

Which ligament is the cranial extension of the posterior longitudinal ligament (PlL)?
A. Apical ligament
B. Alar ligament
C. Transverse atlantal ligament
D. Membrana tectoria
E. Anterior atlanto-occipital membrane

A

D. Membrana tectoria

The membrana tectoria is the cranial extension of the PLL and connects C2 to clivus. The transverse ligament of atlas is anterior to it. There is another tectorial membrane in the inner ear and is involved
with hearing.

42
Q

Which tract of the spinal cord conveys contralateral pain and temperature sensation?
A. VentraI spinothalamic
B. Lateral spinothalamic
C. Ventral spinocerebellar
D. Dorsal spinocerebellar
E. Fasciculus gracilis

A

B. Lateral spinothalamic

The lateral (neo) spinothalamic tract transmits pain and temperature from the contralateral body and is somatotopically organized with the legs laterally. The ventral (paleo) spinothalamic is involved in light touch. The gracil and cuneate tracts carry fine touch and proprioception from lower and upper halves of the body, respectively.

43
Q

When considering the Rexed laminae of the gray matter of the spinal cord, substance P is the main neurotransmitter in layer
A. II
B. IV
C. VI
D. VII
E. IX

A

A. II

Substance P is the main neurotransmitter in the substantia gelatinosa of Rolando (II) and is involved in pain sensation.

44
Q

The arcade of Struthers can be associated with entrapment of the
A. Musculocutaneous n
B. Median n
C. Ulnar n
D. Radial n
E. Peroneal n at the fibular neck

A

C. Ulnar n

The arcade of Struthers when present stretches between the medial head of triceps and medial intermuscular septum and can be associated with ulnar n compression above the elbow, while the
ligaMent of Struthers is associated with Median n entrapment.

45
Q

Froment’s sign is positive with paralysis of the
A. lnterossei
B. Flexor pollicis longus
C. Flexor pollicis brevis
D. Abductor pollicis brevis
E. Adductor pollicis

A

E. Adductor pollicis

Froment’s test is performed by asking the patient to hold a piece of paper between the thumb and index fingers. In case of ulnar palsy, the patient loses adductor pollicis. As the examiner tries to pull the paper, the patient compensates by flexing the distal phalanx of the thumb using flexor pollicis longus supplied by the AIN (a branch of the median n).

46
Q

An odontoid fracture best amenable to anterior screw fixation is
A. Type I
B. Os odontoideum
C. Oblique downward from anterior to posterior
D. Associated with barrel chest
E. Malunited from trauma 9 months ago

A

C. Oblique downward from anterior to posterior

Typical indication for an anterior odontoid screw is type II fracture, when the fracture line is horizontal or oblique downward from anterior to posterior. Barrel chest is a contraindication. Malunion is a relative contraindication unless decortication of the fracture surface is performed. Type I and III are usually treated in a collar. Os odontoideum is typically treated by posterior C1-C2 fusion.

47
Q

The approach with the least favorable outcome for thoracic disc herniation is
A. Laminectomy
B. Facetectomy
C. Transpedicular
D. Costotransversectomy
E. Lateral extracavitary

A

A. Laminectomy

Thoracic disc herniation can be successfully treated by a transpedicular, transfacet, costotransversectomy, extracavitary, or transthoracic (open or endoscopic) approaches. Laminectomy has a high risk of worsening motor function.

48
Q

The 10-year recurrence after microvascular decompression (MVD) for trigeminal neuralgia is
A. 10%
B. 20%
C. 30%
D. 50%
E. 80%

A

C. 30%

Recurrence after MVD for trigeminal neuralgia is 15% at 5 years and 30.% at 10 years, glycerol rhizotomy 54% at 4 years, and SRS 20% at 3 years.

49
Q

The neurotransmitter from the locus ceruleus to the caudate nucleus is
A. Acetylcholine
B. Glutamate
C. Dopamine
D. Norepinephrine
E. Serotonin

A

D. Norepinephrine

NE is the main neurotransmitter output from locus ceruleus and is involved in REM sleep.

50
Q

The two olfactory bulbs connect through
A. Fornix
B. Anterior commissure
C. Posterior commissure
D. Habenular commissure
E. None on the above

A

B Anterior rommissure

Fibers from the medial olfactory stria cross to the contralateral side through the anterior rommissure.

51
Q

All of the following tracts enter the cerebellum through the inferior cerebellar peduncle, except
A. VentraI spinocerebellar
B. Dorsal spinocerebellar
C. Ventral external arcuate fibers
D. Dorsal external arcuate fibers
E. Olivocerebellar

A

B. Dorsal spinocerebellar

The ventral spinocerebellar tract enters the cerebellum through the superior cerebellar pedunde. It is predominantly contralateral and originates in the lower extremities.

52
Q

What forms the posterior border of the anterior perforated substance?
A. Diagonal band of Broca
B. Medial longitudinal fasciculus
C. Stria medullaris
D. Stria terminalis
E. lndusium griseum

A

A. Diagonal band of Broca

The diagonal band of Broca forms the posterior border of the anterior perforated substance.

53
Q

Which nucleus of the oculomotor n carries general visceral efferent fibers?
A. Central nucleus
B. Medial nucleus
C. Lateral nucleus
D. Edinger-Westphal nucleus

A

D. Edinger-Westphal nucleus

Edinger-Westphal nudeus provides parasympathetic component of the oculomotor n (III) (general visceral efferent). The general somatic efferents arise from the central nucleus supplying levator palpebrae superioris bilaterally, medial nucleus supplying contralateral superior rectus, and lateral nucleus supplying ipsilateral inferior rectus, inferior oblique and medial rectus.

54
Q

The trigeminal n supplies all of the following muscles, except
A. Masseter
B. Pterygoids
C. Tensor tympani
D. Anterior belly of digastric
E. Buccinator

A

E. Buccinator

The facial n supplies the buccinator (buccal n).

55
Q

The general visceral efferent fibers of the glossopharyngeal nerve arise from the
A. Superior salivary nucleus
B. Inferior salivary nucleus
C. Rostral nucleus solitarius
D. Caudal nucleus solitarius
E. None of the above

A

B. Inferior salivary nucleus

The general visceral efferents of the glossopharyngeal n originate in the inferior salivary nudeus, travel through the lesser petrosal n, synapse in the otic ganglion, then supply the parotid gland
through the auriculotemporal n.

56
Q

According to the head trauma guidelines, a patient with a brain contusion should have an intracranial pressure (ICP) monitor if his Glasgow Coma Scale
(GCS) is
A. <8
B. <9
C. <10
D <11
E. None of the above

A

A. < 8

Based on the brain trauma foundation guidelines, ICP monitoring should be placed in cases of:
a. GCS :<8 and a positive head CT.
b. GCS :<8, a negative head CT, and 2 of the
following:
I. Age >40
II. SBP <90
III. Posturing

57
Q

All of the following statements are true about the thalamic fasciculus, except
A. It is formed by the junction of the ansa lenticularis and lenticular fasciculus.
B. It carries information from the globus pallidus internus.
C. It relays information to the lateral posterior (LP) nucleus of thalamus.
D. It receives contribution from the contralateral deep cerebellar nuclei.
E. It uses GABA (gamma amino butyric acid) as a neurotransmitter.

A

C. It relays information to the lateral posterior (LP) nucleus of thalamus.

The LP nucleus of thalamus receives input from area 5 and projects to areas 5 and 7.

58
Q

The stria terminalis connects
A. The hippocampus with the hypothalamus
B. The amygdala with the hypothalamus
C. The basal olfactory areas to the lateral
hypothalamus
D. The midbrain to the hypothalamus
E. The hypothalamus to the anterior thalamic nucleus

A

B. The amygdala with the hypothalamus

The stria terminalis connects amygdala to
hypothalamus and septal nuclei.

59
Q

The main hippocampal direct cortical input is from the
A. Dentate gyrus
B. Alveus
C. Fimbria of fornix
D. Entorhinal cortex
E. Ammon’s horn

A

D. Entorhinal cortex

The main cortical input to hippocampus is from entorhinal cortex, through the alvear (to CAl) or perforant (to dentate gyros and CA3) pathways.

60
Q

All of the following is true regarding the dentate nucleus of the cerebellum, except
A. It is part of the neocerebellum.
B. It projects to the contralateral thalamus.
C. Efferents pass through the superior cerebellar peduncle.
D. Output affects motor area 4.
E. It is supplied by PICA.

A

E. It is supplied by PICA.

The blood supply of the dentate nucleus is from the superior cerebellar a.

14. Neurosurgery Primary Examination Review (10 decks)

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