Question 1

A 12-year-old boy loses his baseball helmet when he rounds second base. As he nears third base the pitcher throws the baseball, which hits the left side of the boy's head. Computed tomography reveals a fracture at the location of the pterion. Which of the following structures make up the pterion?

A) Temporal, parietal, frontal, and ethmoid bones
B) Parietal, frontal, and sphenoid bones
C) Frontal, parietal, temporal, sphenoid, and ethmoid bones
D) Sphenoid, parietal, temporal, and frontal bones
E) Ethmoid, parietal, temporal, and frontal bones

D

Accepted Answer

The pterion is the region where four skull bones meet: the sphenoid, parietal, temporal, and frontal bones.

Question 2

A 31-year-old female is referred to a neurologist for intractable headaches. Magnetic resonance imaging reveals an aneurysm originating from one of the vessels surrounding the optic chiasm. The aneurysm is most likely located on which of the following?

A) Basilar artery
B) Middle cerebral artery
C) Posterior communicating artery
D) Medial striate artery
E) Anterior communicating artery

E

Accepted Answer

The aneurysm is most likely located on the anterior communicating artery because it is one of the vessels surrounding the optic chiasm.

Question 3

Which of the following contribute to the formation of the confluence of sinuses?&#10;A) Straight, occipital, and transverse sinuses&#10;B) Straight, transverse, and superior sagittal sinuses&#10;C) Superior sagittal, occipital, and sigmoid sinuses&#10;D) Sigmoid, straight, and transverse sinuses&#10;E) Superior sagittal, straight, and occipital sinuses

Accepted Answer

The confluence of sinuses is formed by the meeting of the superior sagittal sinus, straight sinus, and occipital sinus.

Question 4

A 12-year-old girl develops an embolism in her anterior choroidal artery as a complication of a temporal lobectomy for intractable epilepsy. Which of the following structures is most likely affected by this interruption of blood supply?

A) Optic tract
B) Dorsal thalamus
C) Mammillary body
D) Body of the caudate
E) Olfactory bulb

Accepted Answer

The anterior choroidal artery supplies blood to the optic tract among other structures, so an embolism in this artery would most likely affect the optic tract.

Question 5

A neurologist explains to the daughter of a 78-year-old woman that her mother has a hemorrhage in the posterior limb of the internal capsule, putamen, and portions of the globus pallidus. Which of the following vessels is most likely involved in the hemorrhage?

A) M₄
B) A₂
C) Anterior communicating arteries
D) P₃
E) Lenticulostriate arteries

Accepted Answer

The lenticulostriate arteries, branches of the middle cerebral artery, supply the putamen, portions of the globus pallidus, and the internal capsule. Hemorrhage in these areas is most commonly associated with hypertension and is indicative of a pathology involving these arteries.

Question 6

A 29-year-old man is referred to a neurologist with visual motor deficits that have progressively worsened over the past few months. Magnetic resonance imaging reveals a mass in the cavernous sinus. Which of the following cranial nerves is likely to be affected by this growing tumor?

A) I, II, IV, V-1, VI
B) III, IV, V-1, V-2, VI
C) II, III, V-1, V-2, VI
D) II, IV, V-1, V-2, VI
E) I, II, III, VI, VII

Accepted Answer

The cavernous sinus is a venous sinus located on either side of the pituitary gland, and it is closely associated with several cranial nerves. The cranial nerves that pass through or are located in the vicinity of the cavernous sinus include the oculomotor nerve (III), the trochlear nerve (IV), the ophthalmic (V-1) and maxillary (V-2) branches of the trigeminal nerve, and the abducens nerve (VI). Therefore, a mass in the cavernous sinus is likely to affect these cranial nerves.

Question 7

A 40-year-old woman suddenly begins to uncontrollably smack her lips while attending her son's soccer game. MRI reveals a hemorrhagic lesion in the area supplied by the recurrent artery of Huebner. Which of the following structures represents the most likely location of this lesion?

A) Body of caudate
B) Tail of caudate
C) Genu of caudate
D) Head of caudate

Accepted Answer

The recurrent artery of Heubner, a branch of the anterior cerebral artery, primarily supplies the head of the caudate nucleus. The symptoms described, such as uncontrollable lip smacking, suggest a lesion in the basal ganglia, which includes the caudate nucleus. The head of the caudate is the most likely location for these symptoms given the artery involved.

Question 8

A fracture at this location most likely damaged which of the following structures?&#10;A) Middle meningeal artery&#10;B) Deep temporal artery&#10;C) Maxillary artery&#10;D) Infraorbital artery&#10;E) Calcarine artery

Accepted Answer

The middle meningeal artery is most likely to be damaged in a fracture at the pterion, where the frontal, parietal, sphenoid, and temporal bones meet. This area is vulnerable to trauma, and injury here can lead to an epidural hematoma due to the artery's close proximity to the inner skull.

Question 9

A 5-year-old boy is riding his bike along the sidewalk in front of his house when he is knocked onto the concrete head-first by his older brother. His parents take him to the emergency department after the boy complains of a headache and dizziness and begins vomiting. A computed tomographic scan reveals a large pool of blood between the dura and arachnoid mater. What type of bleed is this?

A) Subdural hemorrhage
B) Subarachnoid hemorrhage
C) Intraventricular hemorrhage
D) Epidural hemorrhage
E) Intracerebral hemorrhage

Accepted Answer

A subdural hemorrhage is characterized by a collection of blood between the dura mater and the arachnoid mater, which matches the description provided.

Deck 6: Blood Supply of the Brain