Neuroanatomy and Physiology

Surface Anatomy

1. Characterize the lateral cortical surface.		G7 p.84:65mm
a. The pre-central sulcus is not_____.	complete
b. The middle frontal gyrus connects with the_____gyrus through this_____.	precentral, isthmus
c. The central sulcus is separated from the sylvian fissure_____% of the time.	98%
d. The tissue separating them is called the_____ _____.	sub-central gyrus
e. The inferior and superior parietal lobules are separated by the_____sulcus.	intra-parietal
f. The inferior parietal lobule is composed of
i. the s_____m_____g_____	supra marginal gyrus (SMG)
ii. and the a_____g_____.	angular gyrus
g. The sylvian fissure
i. terminates in the_____,	SMG
ii. which is the Brodmann area #_____.	40
h. The superior temporal gyrus
i. terminates in the_____,	AG
ii. which is the Brodmann area #_____.	39
2. Complete the following regarding surface anatomy:		G7 p.84:80mm
a. The middle frontal gyrus often connects with the_____ _____.	pre-central gyrus
b. The central sulcus joins the sylvian fissure in only _____%.	2%
c. A sub-central sulcus is present in_____% of patients.	98%
d. The sylvian fissure terminates in the_____ _____.	supra-marginal gyrus
e. The superior temporal sulcus is capped by the_____ _____.	angular gyrus
3. Matching. Match the following Brodmann cortical areas and their functional significance:		G7 p.84:128mm
Functional significance:
primary motor cortex; Broca area (motor speech); Wernicke area dominant hemisphere; primary auditory area; frontal eye fields; primary somatosensory area; premotor area; primary visual cortex
Area:
a. Area 3,1,2
b. Area 41,42
c. Area 4
d. Area 6
e. Area 44
f. Area 17
g. Area 40,39
h. Area 8
4. Complete the following regarding pars marginalis:		G7 p.85:18mm
a. is the terminal part of the_____gyrus	cingulate
b. is visible on axial view in >_____%	90%
c. is the_____ _____ of the midline paired grooves	most prominent
d. extends_____into the hemispheres	deeper
e. on axial CT is located just posterior to the line_____(the widest diameter)	9-3
f. it curves_____in lower slices	posteriorly
g. it curves_____in higher slices	anteriorly
5. Complete the following regarding central sulcus:		G7 p.85:95mm
a. Is visible in almost_____%	95%
b. Does it reach the midline?	no
c. Terminates in the_____ _____	para-central lobule
6. True or False. The pterion is a region where each of the following bones comes together:		G7 p.86:110mm
a. frontal	true
b. sphenoid (greater wing)	true
c. parietal	true
d. temporal	true
e. sphenoid (lesser wing)	false
7. Matching. Match the bones/sutures that form the listed craniometric points.
Bone/suture:		G7 p.86:125mm
lambdoid suture; occipitomastoid suture; parietomastoid suture; frontal; parietal; temporal; greater wing sphenoid Craniometric point:
a. asterion	, ,
b. pterion	, , ,
8. True or False. The name of the junction of lambdoid, occipitomastoid, and parietomastoid sutures is		G7 p.86:140mm
a. pterion	false
b. asterion	true (Asterion is the junction of lambdoid, occipitomastoid suture, and parietomastoid suture.)
c. lambdoid	false
d. stephanion	false
e. glabella	false
f. opisthion	false
9. The asterion junction overlies the		G7 p.86:160mm
a. _____sinus and the	transverse
b. _____sinus.	sigmoid
10. External landmark for the sylvian fissure is a line from the lateral canthus to a spot three quarters of the way posterior along an arc running over the convexity in the mid line from the		G7 p.87:135mm
a. _____to the	nasion
b. _____.	inion
11. True or False. In relation to external landmarks the angular gyrus is		G7 p.87:145mm
a. one finger’s breadth above the zygomatic arch	false
b. just above the pinna	true (The angular gyrus is just above the pinna and important as part of the Wernicke area in the dominant hemisphere.)
c. a thumb’s breadth behind the frontal process of the zygomatic bone	false
d. at the junction of the lambdoid and sagittal suture	false
12. True or False. The motor strip of the motor cortex lies		G7 p.87:165mm
a. at the level of the coronal suture	false
b. within 2 cm of the coronal suture	false
c. 3 to 4 cm posterior to the coronal suture	false
d. 4 to 5.4 cm posterior to the coronal suture	true
e. 2 cm posterior to the mid-position of the	true inion-nasion arc	true
f. 5 cm straight up from the external	auditory meatus	true
13. True or False. In the non-hydrocephalic adult the lateral ventricles lie		G7 p.88:87mm
a. 2 to 3 cm below the outer skull surface	false
b. 3 to 4 cm below the outer skull surface	false
c. 4 to 5 cm below the outer skull surface	true
d. 5 to 6 cm below the outer skull surface	false
14. True or False. In the non-hydrocephalic adult the anterior horns extend		G7 p.88:108mm
a. 1 to 2 cm anterior to the coronal suture	true
b. 2 to 3 cm anterior to the coronal suture	false
c. 3 to 4 cm anterior to the coronal suture	false
15. True or False. In the non-hydrocephalic adult the anterior horns extend		G7 p.88:130mm
a. 1 to 2 cm anterior to the foramen of Monro	false
b. 2.5 cm anterior to the foramen of Monro	true
c. 3 to 4 cm anterior to the foramen of Monro	false
16. True or False. The fastigium is located at		G7 p.88:145mm
a. the midpoint of the Twinings line	false
b. the floor of the fourth ventricle	false
c. the apex of the fourth ventricle within the cerebellum	true (The fastigium is the apex of the fourth ventricle in the cerebellum.)
d. 1 to 2 cm anterior to the coronal suture	false
17. List the surface landmarks of the following cervical levels.		G7 p.89:35mm
Hint: htcc
a. C3-4_____ _____	hyoid bone
b. C4-5_____ _____	thyroid cartilage
c. C5-6_____ _____	cricothyroid membrane
d. C6-7_____ _____	cricoid cartilage
18. Matching. Match the following surface landmarks and cervical levels:		G7 p.89:35mm
Surface landmark:
level of thyroid cartilage; cricoid cartilage; angle of mandible; cricothyroid membrane; carotid tubercle; 1 cm above thyroid cartilage (hyoid bone)
Cervical level:
a. C1-2
b. C3-4
c. C4-5
d. C5-6
e. C6
f. C6-7

Cranial Foramina and Their Contents

19. Matching. Match the foramen with contents (choices may be used more than once).		G7 p.89:75mm
Contents:
nothing; middle meningeal artery; VII facial; V2; V3; V1; IX, X XI
Foramen:
a. superior orbital fissure
b. inferior orbital fissure
c. foramen lacerum
d. foramen rotundum
e. foramen ovale
f. foramen spinosum
g. stylomastoid foramen
h. jugular fora men
20. List the cranial nerves and the three branches of one found within the superior orbital fissure (SOF).		G7 p.89:85mm
a. o_____	CN III oculomotor
b. t_____	IV trochlear
c. n_____	nasociliary nerve
d. f_____	frontal nerve ophthalmic division: all three branches
e. l_____	lacrimal nerve
f. a_____	VI abducens nerve
21. Additional structures found in the SOF include the		G7 p.89:85mm
a. s_____o_____v_____	superior ophthalmic vein
b. r_____m_____a_____	recurrent meningeal artery
c. which arises from the l_____artery	lacrimal
d. o_____b_____ of the m_____m_____a_____	orbital branch of the middle meningeal artery
e. s_____p_____ of the ICA	sympathetic plexus of the ICA
22. Another name for the transverse crest is_____ _____.	crista falciformis	G7 p.89:182mm
23. Another name for the vertical crest is_____ _____.	Bill’s bar	G7 p.89:187mm
24. Draw and label the nerves in the right porus acusticus.		G7 p.90:22mm
	a. Bill’s bar b. transverse crest crista falciformis c. cranial nerve VII d. SV—superior vestibular e. VIII f. IV—inferior vestibular
Fig. 5.1
25. Label the diagram of the right internal auditory canal.		G7 p.90:22mm
	a. transverse crest b. acoustic portion of CN VIII c. cranial nerve VII in facial canal d. superior vestibular nerve e. inferior vestibular nerve f. Bill’s bar—vertical crest
Fig. 5.2
26. Matching. Match the nerves of the IAC with the areas that they serve.		G7 p.90:23mm
Nerves:
facial n.; nervus intermedius; acoustic portion of VIII n.; superior branch of vestibular n.; inferior branch of vestibular n.
Areas served:
a. Facial muscles
b. Hair follicles
c. Taste buds
d. Hearing
e. Utricle
f. Superior semi-circular canal
g. Lateral semi-circular canal
h. Saccule

Occipitoatlantoaxial-complex Anatomy

27. Matching. Match the ligaments of the occipito-atlantoaxial complex with the statements below.		G7 p.91:32mm
Ligaments:
apical; alar; cruciate; ascending portion; descending portion; transverse portion; posterior longitudinal; tectorial; anterior longitudinal; anterior atlanto occipital
Statements:
a. Attaches the odontoid to the foramen magnum
b. Attaches the odontoid to the occipital condyle
c. Attaches the odontoid to the lateral mass of C1
d. Attaches C1 to the clivus and to C2
e. Attaches odontoid to clivus
f. Attaches C1 to C2
g. Traps the odontoid against the atlas
h. Extends cephalad to become the tectorial
i. The cephalad extension of the PLL
j. Extends cephalad to become the anterior atlanto-occipital
k. The cephalad extension of the anterior longitudinal
28. The most important spinal ligaments in maintaining atlanto-occipital stability are the		G7 p.92:95mm
a. _____membrane and the	tectorial
b. _____ligaments.	alar

Spinal Cord Anatomy

29. The very large ascending tract closest to the dentate ligament is the _____.	lateral spinothalamic tract (LST) for pain and temperature from the opposite side of the body	G7 p.93:120mm
30. How is the lateral spinothalamic tract (LST) somatotopically organized?		G7 p.93:120mm
a. Cervical is_____.	medial
b. Sacral is_____.	lateral
31. Which descending motor tract facilitates		G7 p.92:158mm
a. extensor tone?	vestibulospinal tract
b. flexor tone?	rubrospinal tract
32. Matching. Match sensory function and anatomy.		G7 p.93:175mm
Sensory function:
pain and temperature: body; fine touch, deep pressure and proprioception: body; light (crude) touch: body
Anatomy:
a. Receptors
i. Free nerve ending
ii. Meissner and pacinian corpuscles	–
b. First order neurons
i. Small
ii. Heavily myelinated	–
iii. Finely myelinated
iv. Large
c. Soma in dorsal root ganglion	––
d. Enter cord at
i. Zone of Lissauer
ii. Ipsilateral posterior columns	–
e. Synapse in
i. Rexed layer II
ii. Rexed layer III and IV
iii. Rexed layer VI and VII
f. Second order neurons
i. Cross obliquely in anterior white commissure	–
ii. Form the internal arcuate fibers
g. And enter the
i. Lateral spino-thalamic tract
ii. Medial lemniscus
iii. Anterior spino-thalamic tract
h. Second order neurons synapse on the ventral posterior lateral nucleus of the Thalamus	––
i. Third order neurons pass through IC to post-central gyrus	––
33. The major blood supply of the spinal cord vasculature		G7 p.95:60mm
a. to the anterior cord arises from
i. the vertebral artery and enters at_____	C3
ii. the deep cervical artery and enters at_____	C6
iii. the costo cervical trunk and enters at_____	C8
iv. thoracic levels_____or_____	T4 or T5
v. and from the a_____of A_____	artery of Adamkiewicz
b. to the posterior spinal cord arises from:_____to_____radicular branches	10 to 23
c. The “watershed zone” is at the_____or_____region	T4 or T5
34. List the body area with the appropriate root.		G7 p.95:70mm
a. Nipple, root:_____	T4
b. Umbilicus, root:_____	T10
c. Inguinal crease, root:_____	T12
d. Anterior thigh, root:_____	L2-L3
e. Posterior thigh, root:_____	S1
f. Lateral calf, root:_____	L5
g. Medial calf, root:_____	L4
h. Posterior calf, root:_____	S1
i. Big toe, root:_____	L5
j. Little toe, root:_____	S1
k. Sole of foot, root:_____	S1
l. Lateral shoulder, root:_____	C5
m. Lateral forearm	C6
n. Thumb	C6
o. Middle finger	C7
p. Little finger	C8
q. Medial forearm	T1
Complete the following regarding upper extremity vs trunk dermatomes. Trunk sensory level is reported at T3 on a trauma patient.		G7 p.95:70mm
a. This is a little the clavicle.	below
b. You must check the_____dermatomes.	arm
c. Dermatomes_____to_____are not represented on the trunk.	C5 to T2
36. Characterize spinal cord vasculature. The artery of Adamkiewicz serves the spinal cord from		G7 p.96:35mm
a. T_____distally and from the	T8
b. _____side in	left
c. _____% of the population.	80%
37. The artery of Adamkiewicz is also known as		G7 p.96:35mm
a. a_____	arteria
r_____	radicularis
a_____	anterior
m_____	magna
b. Which side does it arise from?	L 80%, R 20%
c. What levels does it arise from 100% inclusive?	T9 and T12 75%
	T9 and L2 85%
	T5 and T8 15%
	T5 and L2 100%
d. What is its appearance on angiography?	characterisitc hairpin shape
38. An artery that has a hairpin shape on angiography is named the_____.	artery of Adamkiewicz	G7 p.96:52mm

Cerebrovascular Anatomy

39. The artery that feeds a tentorial meningioma is named after		G7 p.99:118mm
a. _____.and	Bernasconi
b. _____.	Cassinari
40. The artery that has a bayonet-type kink is the_____ _____.	ophthalmic artery	G7 p.99:118mm
41. Circle of Willis is intact in _____%.	18%	G7 p.97:55mm
42. Hypoplasia of at least one of the posterior communicating arteries occurs in_____%.	22 to 32%	G7 p.97:55mm
43. Absent or hypoplastic A1 occurs in_____%.	25%	G7 p.97:55mm
44. What are the seven segments of the internal carotid artery?		G7 p.98:20mm
Hint: can Peter laugh can Charlie only clap
a. c_____	cervical
b. p_____	petrous
c. l_____	lacerum
d. c_____	cavernous
e. c_____	clinoid
f. o_____	ophthalmic
g. c_____	communicating
What portion of the PCA traverses the ambient cistern?	P2	G7 p.98:95mm
46. What choroidal artery arises from it?	medial posterior choroidal artery	G7 p.98:103mm
47. Which cistern is traversed by the P3 segment of the PCA?	quadrigeminal cistern	G7 p.98:102mm
48. Name the segments of the carotid artery and their main branches.		G7 p.99:45mm
a. C1 c_____	cervical-carotid sheath
	IJV × PGSN × vagus posterior medial to external carotid
b. C2 p_____	petrous
c. C3 l_____	lacerum
d. C4 c_____	cavernous
i. m_____t_____	meningohypophyseal trunk
ii. a_____m_____a_____	anterior meningeal artery
e. C5 c_____	clinoidal
f. C6 o_____	ophthalmic
i. o_____	ophthalmic
ii. s_____h_____	superior hypophyseal
iii. p_____c_____	posterior communicating
iv. a_____ c_____	anterior choroidal
g. C7 c_____d_____i_____	communicating divides into
i. A_____	ACA
ii. M_____	MCA
49. What are the branches of the meningohypophyseal trunk?		G7 p.99:107mm G7 p.99:100mm
Hint: dit
a. d_____m_____	dorsal meningeal
b. i_____h_____	inferior hypophyseal
c. t_____a_____	tentorial artery of Bernasconi and Cassinari
50. Complete the following concerning anterior circulation:		G7 p.99:125mm
a. Occlusion of which artery results in Sheehan syndrome?	inferior hypophyseal artery
b. It serves_____ _____ _____	posterior lobe of pituitary
c. It is a branch of the_____artery,	meningohypophyseal
d. which is a branch off the_____ _____segment of carotid.	cavernous C4
e. Occlusion causes pituitary infarct in_____patients.	postpartum
51. The ophthalmic artery		G7 p.99:145mm
a. arises from the_____segment of the ICA.	sixth
b. Is distal or inside cavernous sinus?	distal 89%, intracavernous 8%
c. Has what shape on lateral angiogram?	a bayonet-type kink
52. The sixth segment of the carotid artery		G7 p.99:150mm
a. is known as the_____	ophthalmic
b. begins at the_____dural ring	distal
c. ends just proximal to_____-_____	P-comm
d. has its branches
i. o_____artery and the	ophthalmic
ii. s_____h_____artery	superior hypophyseal
53. What vessel supplies the inferior half of the posterior limb of the internal capsule?	anterior choroidal artery	G7 p.100:23mm
54. Complete the following about the anterior choroidal artery:		G7 p.100:30mm
a. The anterior choroidal artery serves six sites. (Hint: gogoup)
i. g_____p_____	globus pallidus
ii. o_____t_____	optic tract
iii. g_____of i_____c_____	genu of internal capsule
iv. o_____r_____	optic radiations
v. u_____	uncus
vi. p_____l_____	posterior limb of internal capsule
b. Occlusion may produce: Hint: 3 H _____,_____,_____ _____	hemiplegia, hemihypesthesia, homonymous hemianopsia
c. MRI shows infarct in the_____.	posterior limb of the internal capsule
55. What artery enters the supracornual recess of the temporal horn to supply the choroid plexus?	plexal segment of the anterior choroidal artery	G7 p.100:30mm
56. Complete the following regarding P-comm and the anterior choroidal artery (ACH):		G7 p.100:35mm
a. They are_____ mm apart.	2
b. The origin of the_____-_____ is proximal.	P-comm
c. Is the Ach smaller or larger than the P-comm?	smaller
d. Which artery has the hump of the plexal point?	Ach
57. True or False. The carotid siphon		G7 p.100:53mm
a. is only that part of the carotid that passes within the cavernous sinus.	false
b. If an aneurysm ruptures on the siphon there is no SAH.	false
58. The carotid siphon		G7 p.100:53mm
a. begins at the posterior bend of the_____ carotid and	cavernous
b. ends at the ICA_____.	bifurcation
c. It includes the
i. ca_____	cavernous
ii. op_____	ophthalmic
iii. co_____	communicating
59. Complete the following about vertebral artery segments:		G7 p.102:168mm
a. The first segment enters the_____ foramen transversarium.	sixth
b. The second ascends_____ within the foramina transversaria.	veritcally
c. The second turns_____as it exits the axis.	laterally
d. The third curves_____and_____.	posteriorly and medially
e. The fourth pierces the_____.	dura
60. The vertebral artery joins the other side at the level of the		G7 p.103:20mm
a. _____ _____to form the	lower pons (pontomedullary junction)
b. _____ _____.	basilar artery
61. The junction of the vertebral arteries is called the_____ _____.	vertebral confluens	G7 p.103:20mm
62. What are the six branches arising from the vertebral artery?		G7 p.103:105mm
Hint: A postman puts postcards away.
a. a_____m_____	anterior meningeal
b. p_____m_____	posterior meningeal medullary (bulbar)
c. m_____	medullary (bulbar)
d. p_____s_____	posterior spinal
e. p_____	PICA
f. a_____s_____	anterior spinal
63. Complete the following statements about the PICA:		G7 p.103:120mm
a. PICA arises_____mm distal to the point where VA becomes intradural.	10
b. PICA has an extradural origin in_____to_____%.	5 to 8%
c. It includes five segments named
i. a_____m_____	anterior medullary
ii. l_____m_____	lateral medullary
iii. t_____-m_____has_____loop	tonsillo-medullary, caudal
iv. t_____-v_____has_____loop	telo-velo-tonsillar, cranial (supratonsillar)
v. c_____s_____	cortical segments
d. and has three branches named
i. c_____	choroidal
ii. t_____-h	tonsillo-hemispheric
iii. i_____v_____	inferior vermian
64. The cranial loop on angio of the PICA is the_____artery.	supratonsillar (telo-velo-tonsillar)	G7 p.103:165mm
65. The choroidal point		G7 p.103:173mm
a. is the point where the_____artery	choroidal
b. arises from the_____artery	supratonsillar
c. which is a branch of the_____	PICA
d. enters into the_____ _____	fourth ventricle
e. to serve the_____ _____	choroid plexus
66. The copular point		G7 p.103:65mm
a. is the point where the_____ _____artery	inferior vermian	G7 p.103:65mm
b. arises from the_____.	PICA
67. Name the three segments of the posterior cerebral artery.		G7 p.104:65mm
a. c_____	crural (peduncular) segment (P1)
b. a_____	ambient segment (P2)
c. q_____	quadrigeminal segment (P3)
68. Medial posterior choroidal artery arises from the		G7 p.104:84mm
a. _____segment of PCA.	crural
b. It is also called_____.	P1
69. Lateral posterior choroidal artery arises from the		G7 p.104:92mm
a. _____segment of the PCA.	ambient
b. It is also called_____.	P2
70. The third segment of PCA is named the_____segment.	quadrigeminal	G7 p.104:117mm
71. Name the branches of the external carotid from proximal to distal.		G6 p.104:30mm
Hint: salfops m
a. s_____ _____	superior thyroid
b. a_____ _____	ascending pharyngeal
c. l_____	lingual
d. f_____	facial
e. o_____	occipital
f. p_____ _____	posterior auricular
g. s_____ _____	superficial temporal
h. m_____	maxillary
72. In relation to ICA, the ECA lies		G6 p.79:45mm
a. _____and	anterior
b. _____to ICA.	lateral
73. Which internal jugular vein is usually dominant?	the right	G7 p.104:140mm
74. Which transverse sinus is usually dominant?	the right	G7 p.104:147mm
75. Which vertebral artery is usually dominant?	the left by 60%	G7 p.102:156mm
76. Name the major contributors to the great cerebral vein of Galen.		G7 p.105:25mm
a. p_____c_____v_____	precentral cerebellar vein
b. b_____v_____of R_____	basal veins of Rosenthal
c. i_____c_____v_____	internal cerebral veins
77. The joining of the septal vein and the thalamostriate vein with the internal cerebral vein forms an angiographic landmark called the _____ _____at the foramen of Monro.	venous angle	G7 p.105:35mm
78. True or False. The cavernous sinus is		G7 p.105:140mm
a. a large venous space with multiple trabeculations	false
b. a plexus of veins	true
79. Draw the right and left cavernous sinus coronal view. On your drawing, label the following:		G7 p.106:15mm
	1. oculomotor (III) 2. trochlear (IV) 3. Parkinson triangle 4. ophthalmic (V1) 5. maxillary (V2) 6. abducent (VI) 7. carotid
Fig. 5.3
80. Name six major contents of the cavernous sinus.		G7 p.106:15mm
a. _____	CN III
b. _____	CN IV
c. _____	CN V1
d. _____	CN V2
e. _____	CN VI
f. _____	internal carotid artery
81. Complete the following regarding the cavernous sinus:
a. Which nerve in the cavernous sinus does not also pass through the superior orbital fissure?	V2 maxillary division of trigeminal	G7 p.106:30mm
b. Which foramen of the skull does that nerve pass through?	foramen rotundum	G7 p.106:30mm
c. Which nerve is not attached to the wall?	VI is not attached to lateral wall (abducens)	G7 p.106:85mm
82. With regard to the cavernous sinus, the triangular space of Parkinson is bounded by what structures?		G7 p.106:90mm
a. on its superior border_____	III and IV
b. on its inferior border_____	trigeminal V1 andV2
83. Complete the following regarding persistent fetal anastomosis:		G7 p.107:28mm
a. How many are there?	4
b. They result from a failure to_____.	involute
c. Name them.
i. t_____	trigeminal
ii. o_____	otic
iii. h_____	hypoglossal
iv. p_____	proatlantal
84. The most common persistent fetal anastomosis is the_____.	trigeminal	G7 p.107:60mm
85. First to involute in persistent fetal anastomsosis is the_____.	otic	G7 p.107:125mm

Internal Capsule

86. Name the vascular supply for the following components of the internal capsule:		G7 p.107:165mm
a. anterior limb	lateral striate branches of MCA
b. posterior limb	lateral striate branches of MCA
c. ventral posterior limb	anterior choroidal
d. genu	direct branches of ICA
e. optic radiations	anterior choroidal
87. Name four thalamic peduncles and where their radiations go.		G7 p.108:75mm
a. a_____, f_____ l_____	anterior, frontal lobe
b. s_____, p_____ g_____	superior, postcentral gyrus
c. P_____, o_____ P_____ a_____	posterior, occipital parietal areas
d. i_____, a_____ a_____	inferior, auditory area
88. Draw the internal capsule and label which blood vessel serves which area.		G7 p.108:15mm
Hint: MIMA

Fig. 5.4
89. Matching. Match the area in internal capsule with its function.		G7 p.108:20mm
Area in internal capsule:

Fig. 5.5
Function:
1. Movement of face ________	C—genu
2. Movement of foot ________	D—posterior limb
3. Vision ________	F—lateral geniculate
4. Hearing ________	G—medial geniculate

Miscellaneous

90. The Obersteiner-Redlich zone is		G7 p.108:130mm
a. also known as the_____ _____ _____.	root entry zone
b. It is where the central_____ and peripheral_____transition.	myelin, myelin
c. It is the zone where_____tend to grow.	neoplasms
d. It is located on CN VIII,_____from the brain stem.	8 to 12 mm
91. The dentate ligament		G7 p.108:150mm
a. separates_____	dorsal
b. from_____roots in the spinal nerves.	ventral
92. Which cranial nerve lies dorsal to the dentate ligament?	CN XI spinal accessory	G7 p.108:155mm

Neurophysiology

93. Answer the following concerning the blood-brain barrier (BBB):		G7 p.109:60mm
a. What chemical opens the BBB?	mannitol
b. What chemical closes the BBB?	steroids
c. Which sites have no BBB?	pituitary	G7 p.109:70mm
Hint: pppcta	pineal
	preoptic recess
	choroid plexus
	tuber cinereum
	area postrema
d. What pathology injures BBB?	hepatic encephalopathy
Hint: histt	infections
	stroke
	trauma
	tumor
94. Complete the following statements about cerebral edema:		G7 p.109:75mm
a. Cytotoxic
i. occurs with h_____ i_____	head injury
ii. occurs with h_____	hematoma
iii. shape is c_____	circular
iv. occurs with C_____	CVA
v. BBB is c_____	closed
b. Vasogenic
i. shape is_____	V-shaped (like fingers of white matter edema)
ii. occurs with t_____	tumors
iii. occurs with m_____	metastasis
iv. treat with s_____	steroids
v. with contrast it_____ and _____	enhances on CT and MR
vi. BBB is o_____	open
95. Matching. Match the type of edema with the characteristics.		G7 p.109:80mm
Type of edema:
cytotoxic edema; vasogenic edema Hint: cytotoxic—early letters of alphabet vasogenic—later letters of alphabet Characteristics:
a. BBB open
b. BBB closed
c. Head injury
d. Tumor
e. Enhances
f. Does not enhance
g. Not appropriate to use steroids
h. Appropriate to use steroids
i. Circular shape on MR
j. V-shaped finger like extensions on MR
k. Occurs with hematoma
l. Occurs with CVA
96. True or False. Cytotoxic edema has:		G7 p.109:89mm
a. a disrupted BBB	false
b. expansion of the extracellular space	false
c. enhancement when contrast injected	false
d. no protein extravasation	true
97. Study Sheet.		G7 p.109:100mm
a. Cytotoxic:
b. Closed BBB
c. Head injury
d. Hematoma
e. Circular shape
f. CVA
g. Cells swell then shrink
h. Vasogenic:
i. BBB
j. Tumors
k. Metastasis
l. Steroids
m. Protein extravasates
n. Enhances on CT and MRI
o. Wide extracellular space
p. Stable cells
98. In pituitary embryology, posterior pituitary		G7 p.109:110mm
a. derives from the_____evagination	downward
b. of_____ _____ cells (neuroectoderm)	neural crest
c. from the_____	floor
d. of the_____ventricle.	third
99. The anterior pituitary		G7 p.109:120mm
a. develops from the_____	evagination
b. of_____ _____	epithelial ectoderm
c. of the_____ _____	oropharynx
d. known as_____ _____	Rathke’s pouch
100. Complete the following regarding neuroendocrinology.		G7 p.109:150mm
a. The pituitary releases_____hormones	8
b. from the anterior pituitary gland:_____hormones.	6
c. Name them.
Hint: pcpgtg
i. p_____	propriomelanocortin
ii. c_____	corticotropin
iii. p_____	prolactin
iv. g_____ _____	growth hormone
v. t_____	thyrotropin
vi. g_____	gonadotropin
d. and from the posterior pituitary
i. a_____	antidiuretic
ii. o_____	oxytocin
101. The pituitary hormones that are released from the posterior pituitary are synthesized		G7 p109:165mm
a. in_____neurons	neurons
b. in the_____.	hypothalamus
c. Are these cells glands?	no
d. The hormones are conveyed by_____	axons
e. within the_____ _____	pituitary stalk
f. to the_____pituitary gland	posterior
g. where they are_____.	released

Regional Brain Syndromes

102. Matching. Match region with deficit.		G7 p.112:30mm
Region:
Pre-frontal lobes; frontal lobe; parietal lobe—dominant; parietal—non dominant; occipital lobe; cerebellum; brain stem; pineal; olfactory groove
Deficit:
a. Apathy abulia
b. Disorganized thoughts
c. Contralateral neglect	or
d. Language disorders
e. Anosognosia
f. Dressing apraxia
g. Homonymous hemianopsia
h. Truncal ataxia
i. Ipsilateral ataxia
j. Paralysis of upward gaze
k. Poor planning
l. Unilateral anosmia
103. Frontal eye fields for contra lateral gaze are		G7 p.112:55mm
a. located in the_____frontal lobe	posterior
b. in Broadmann area_____.	8
c. With a destructive lesion there, the patient’s eyes look_____the lesion.	toward Hint: destructive=toward
d. With an irritative lesion there, the patient’s eyes look_____ _____ the lesion.	away from Hint: irrigitative=away
e. Usually the lesions are_____.	destructive
104. True or False. Regarding Foster-Kennedy syndrome:		G7 p.114:125mm
a. usually from olfactory groove or medial third sphenoid wing tumor	true
b. contralateral anosmia	false (Ipsilateral not contralateral anosmia is part of the classic triad.)
c. ipsilateral central scotoma	true
d. contralateral papilledema	true
e. contralateral optic atrophy	false (ipsilateral optic atrophy)
f. usually meningioma	true
105. True or False. Regarding Weber syndrome:		G7 p.X:X mm
a. Weber syndrome includes CN III palsy with contralateral hemiparesis.	true
b. Weber syndrome includes CN VII palsy with contralateral hemiparesis.	false
c. Weber syndrome includes CN III palsy with ipsilateral hemiparesis.	false
d. Weber syndrome includes CN VI and VII palsy with contralateral hemiparesis.	false
e. Weber syndrome includes		G7 p.114:105
i. Cranial nerve III palsy	false
ii. Contralateral hemiparesis	false
iii. Arm hyperkinesis	false
iv. Ataxia	false
v. Intention tremor	false
106. True or False. Benedict syndrome is due to disruption of		G7 p.114:115mm
a. cerebral peduncle	true
b. issuing fibers of CN III	true
c. red nucleus	true
107. True or False. Millard-Gubler syndrome is due to disruption of		G7 p.114:130mm
a. nucleus of VII	true
b. nucleus of VI	true
c. cortico spinal tract	true
108. True or False. Regarding Parinaud syndrome:		G7 p.114:135mm
a. Parinaud syndrome includes downgaze palsy.	false
b. Parinaud syndrome includes lid retracion.	true
c. Parinaud syndrome includes nystagmus retractorius.	true
d. When Parinaud syndrome is combined with downgaze palsy it is known as the syndrome of the _____ _____.	sylvian aqueduct
109. True or False. The following are contents of the jugular foramen:		G7 p.115:70mm
a. transverse sinus	false
b. CN IX, X, and XI	true
c. CN X, XI, and XII	false
d. sigmoid sinus	true
e. petrosal sinus	true
f. branches from the ascending pharyngeal artery	true
g. branches from the occipital artery	true
110. Matching. Match the following numbered descriptions with the lettered syndromes. Also indicate the nerves involved and the results of the lesion.		G7 p.115:110mm
Description:
Vernet; Collet-Sicard; Villaret Syndrome:
a. Which jugular foramen syndrome is most likely due to an intracranial lesion?	involves CN,IX,X,XI taste, vocal cords and SCM (sterno cleido mastoid muscle)
b. Extracranial lesion?	above plus XII tongue
c. Retropharyngeal lesion?	above plus Horner
111. True or False. A jugular foramen syndrome that spares CN IX is		G7 p.115:155mm
a. Vernet	false
b. Collet-Sicard	false
c. Villaret	false
d. Tapia	true (Tapia X, XII vocal cords and tongue)
112. True or False. The following jugular foramen syndrome also results in a Horner syndrome:		G7 p.115:180mm
a. Vernet	false
b. Collet-Sicard	false
c. Jackson	false
d. Villaret	true
113. True or False. Gerstmann syndrome includes		G7 p.113:70mm
a. agraphia without alexia	true
b. left-right confusion	true
c. digit agnosia	true
d. tactile agnosia	false
e. acalculia	true
114. True or False. Gerstmann syndrome patients can read.	true	G7 p.113:70mm
115. True or False. Gerstmann syndrome patients can write.	false	G7 p.113:70mm
116. True or False. Cortical sensory syndrome includes		G7 p.113:110mm
a. loss of position sense	true
b. inability to localize tactile stimuli	true
c. astereognosis	true
d. loss of pain and temperature sense	false (Pain and temperature as well as vibration sense are preserved.)
117. True or False. Anton Babinski syndrome includes		G7 p.113:155mm
a. anosognosia	true
b. apathy	true
c. ipsilateral extinction to double-sided stimulation	false (contralateral extinction to double-sided stimulation)
d. dressing apraxia	true
118. True or False. Wernicke aphasia includes		G7 p.114:27mm
a. fluent aphasia	true
b. lesion is in Brodmann areas 41 and 42	false (The lesion is in Brodmann 39 and 40.)
c. speech devoid of meaning	true
d. normal intonation	true
119. True or False. Broca aphasia includes		G7 p.114:40mm
a. dysarthria	true
b. lesion is in area 44	true
c. an “apraxia” of motor sequencing	true
d. similar to conduction aphasia	false (Broca is a motor aphasia—faltering dysarthric speech. Conduction aphasia is fluent speech with paraphasias.)
120. Alexia without agraphia		G7 p.114:78mm
a. means that the patient can_____	write
b. but cannot_____.	read
c. Surprisingly, such patients can usually do what with numbers?	read and name them
d. Lesion is located in the_____lobe.	parietooccipital
e. On which side?	dominant (left) side
f. Serves to disconnect_____ _____and	angular gyrus
g. _____ _____	occipital lobes
h. also known as_____ _____ _____.	pure word blindness
i. This is contrasted with what syndrome?	Gerstmann
j. Where patient can_____	read
k. but can’t_____	write
l. also known as_____ _____ _____.	agraphia without alexia
121. Matching. Match the numbered syndromes with the lettered phrases.		G7 p.114:78mm
Syndrome: Gerstmann; Pure word blindness Phase:
a. alexia without agraphia
b. agraphia without alexia
c. where patient can’t read
d. where patient can’t write

Babinski Sign

122. Fill in the blanks to complete the details of the Babinski reflex.		G7 p.116:35mm
Hint: pcrstlpt
a. lateral_____ stimulation	plantar
b. originates as a_____ _____	cutaneous reflex
c. and stimulates the_____	receptors
d. in the_____dermatome	S1
e. that travel via the_____ _____	tibial nerve
f. to the spinal cord segments number_____(_____limb)	L4-S2, afferent
g. The efferent limb travels via the_____nerve (_____limb)	peroneal, efferent
h. to the_____ _____	toe extensors
123. Summarize the Babinski sign.		G7 p.116:65mm
a. receptor_____	S1 dermatome
b. afferent limb_____	tibial nerve
c. cord_____	L4-S2
d. efferent limb_____	peroneal nerve
124. Fill in the blanks to complete the details of eliciting the plantar reflex.		G7 p.116:92mm
Stimulate the_____ _____ surface	lateral plantar
b. and the_____ _____	transverse arch
c. in a_____movement	single
d. that lasts_____seconds.	5 to 6
e. Response consists of_____of the_____ _____.	extension of the great toe
f. _____of the small toes is	Fanning
g. _____clinically important.	not
125. True or False. The Chaddock maneuver is described as		G7 p. 116:108mm
a. scratching the lateral foot	true
b. pinching the Achilles tendon	false
c. sliding knuckles down shin	false
d. momentarily squeezing lower gastrocnemius	false
126. Complete the following concerning Hoffman sign:		G7 p.116:128mm
a. H (from Hoffman) is the_____letter of the alphabet.	eighth
b. If unilaterally present Hoffman sign indicates a lesion above_____.	C8

Bladder Neurophysiology

127. Complete the following concerning bladder physiology:		G7 p.116:170mm
a. The primary coordinating center for bladder function is in the
i. n_____ l_____ c_____	nucleus locus coeruleus
ii. of the p_____.	pons
b. This center coordinates
i. b_____ c_____ (d_____) with	bladder contraction (detrusor)
ii. s_____ r_____ (e_____ s_____).	sphincter relaxation (external sphincter)
128. Voluntary cortical control		G7 p.116:182mm
a. inhibits the p_____ c_____.	pontine center—nucleus locus coeruleus
b. It originates in the
i. a_____ f_____ l_____	anteromedial frontal lobes
ii. and g_____of the c_____ c_____and	genu of the corpus callosum
c. travels via the p_____t_____	pyramidal tract
d. to inhibit
i. c_____of the	contraction of the
ii. d_____ and contraction	detrusor and contraction
iii. of the e_____ s_____.	external sphincter
129. Immaturity, infarct, or cortical lesions cause		G7 p.117:17mm
a. inability to s_____	suppress
b. the m_____r_____	micturition reflex
c. and results in i_____.	incontinence
130. The efferents to the bladder		G7 p.117:28mm
a. travel in the_____portion	dorsal
b. of the_____ _____.	lateral columns
131. Parasympathetic control		G7 p.117:48mm
a. detrusor_____	contracts
b. internal sphincter_____	relaxes
c. travels via the p_____ s_____nerves	pelvic splanchnic
132. Somatic nerve		G7 p.117:48mm
a. external sphincter_____	contracts
b. maintains c_____	continence
c. travels via p_____ nerve	pudendal
133. Sympathetic nerve		G7 p.117:48mm
a. provides bladder neck_____and	closure
b. travels via the i_____ h_____plexus.	inferior hypogastric
134. True or False. The detrusor muscle of the bladder contracts and the internal sphincter relaxes under		G7 p.117:53mm
a. PNS stimulation	true (parasympathetic nervous system stimulation)
b. somatic nerve stimulation	false
c. sympathetic nervous system stimulation	false
d. all of the above	false
135. True or False. The following can cause detrusor hyperreflexia:		G7 p.117:125mm
a. CVA	true
b. spinal cord tumor	true
c. chronic bladder catheterization	false (Detrusor hyperreflexia can result from interruption of efferents anywhere from cortex to sacral cord.)
d. multiple sclerosis	true
e. Parkinson disease	true
136. True or False. Interruption of the efferents results in		G7 p.117:142mm
a. atonic bladder	false—root lesion
b. overflow incontinence	false—root lesion
c. uncontrollable voiding	true
d. reflex bladder empting	true
e. voiding triggered by critical volume	true
f. produced by myelopathy	true
g. produced by head injury	true
h. produced by certain drugs	false—detrusor areflexia
i. produced by diabetes mellitus	false—automatic neuropathy
137. True or False. Patients with multiple sclerosis develop voiding symptoms from demyelination primarily involving the		G7 p.118:127mm
a. posterior and lateral columns of lumbar spinal cord	false
b. lateral column of cervical spine	false
c. posterior column of lumbar spine	false
d. lateral column of lumbar spine	false
e. posterior and lateral columns of cervical spinal cord	true (posterior and lateral columns of cervical spinal cord)
138. True or False. Causes of urinary retention are		G7 p.118:145mm
a. urethral stricture	true
b. prostatic enlargement	true
c. detrusor areflexia	true
d. herpes zoster	true