@Which one of the cranial nerves exits the brainstem from the dorsal aspect? . (A) CNI .

(B) CN II . (C) CN III . (D) CN IV . . @Heschls gyrus receives input from which of the following neural structures? . (A) angular gyrus . (B) medial geniculate nucleus . (C) primary auditory cortex . (D) sensory strip . 4B. Primary auditory cortex (41, 42) is found in the Heschl gyrus, and receives input from the medial geniculate nucleus. The postcentral gyrus is the sensory strip, the somatosensory cortex (3,1,2). The parietal lobe includes the angular gyrus, which receives visual impulses (39) and supramarginal gyrus, which interrelates somatosensory, auditory, and visual input (40). Destruction of the angular and supramarginal gyri on the dominant (usually left) side gives rise to the Gerstmann syndrome, whose symptoms include agraphia, acalculia, finger agnosia and left-right disorientation. 3D. The trochlear nerve (CN IV) is the only cranial nerve to exit the brainstem from the dorsal aspect.

@2. The hippocampal formation is part of the . (A) frontal lobe . (B) parietal lobe . (C) insular lobe . (D) limbic lobe . D. The hippocampus is part of the limbic system and plays a role in memory. The name derives from Greek and is based on its jelly-roll shape, which resembles a sea horse. The hippocampus is one of the first regions damaged in Alzheimers disease.

@The total volume of CSF found in the sub- arachnoid space and cerebral ventricles is . (A) 110 ml . (B) 140 ml . (C) 160 ml . (D) 170 ml B. The total volume of CSF found in the subarachnoid space and ventricles is 140 ml. @ Which part of the ventricular system con- tains choroid plexus? . (A) Frontal horn . (B) Occipital horn . (C) Cerebral aqueduct . (D) Third ventricle . D. The third ventricle has a choroid plexus; the frontal lobe, the occipital lobe, and the cere- bral aqueduct all are devoid of a choroid plexus; a terminal ventricle is a localized dilation of the caudal end of the central canal with no choroid plexus.

@5. Which one of the following circumventricu- lar organs is solely innervated by postganglion- ic fibers from the superior cervical ganglion of the ANS? . (A) Area postrema . (B) Pineal body . (C) Organum vasculosum of the lamina terminalis . (D) Subfornical organ . Ans : B. The pineal body (epiphysis) is innervated solely via postganglionic fibers from the superior ganglion of the autonomic nervous system; it synthesizes melatonin; it has antigonadotrophic function; the area postrema is a chemoreceptor zone that triggers vomiting in response to circu- lating emetic substances; the organum vasculosum of the lamina terminalis is a vascular outlet for luteinizing hormonereleasing hormone and somatostatin; the subfornical organ is a central receptor for angiotensin II; the subcommissural organ has a

capillary bed with nonfenestrated endothelial cell and a bloodbrain barrier. . . . . . . . @Choose the normal quantity of CSF daily production. (A) 300 ml (B) 400 ml (C) 500 ml (D) 600 ml Ans C. The choroid plexus produces CSF at a rate of 500 ml/day.

@ Obstruction at which of the following loci is most likely to produce Psuedotumor cerebri ? . (A) Arachnoid villi . (B) Cerebral aqueduct . (C) Foramen of Luschka . (D) Foramen of Magendie Ans A A. This condition, called pseudotumor cerebri (benign intracranial hypertension), is seen pri- marily in young obese women. Impaired absorptive function of the arachnoid villi is thought to be the cause. @ A 60-year-old hypertensive woman com- plains of numbness and weakness in her left leg and foot. Occlusion of which of the follow- ing vessels may account for this complaint? . (A) Anterior choroidal artery . (B) Anterior cerebral artery . (C) Interior carotid artery . (D) Middle cerebral artery . Ans B. The anterior cerebral artery perfuses the paracentral lobule, which represents the motor and sensory strips of the leg and foot areas.

. @Which artery supplies the caudate and puta- men and anterior limb of the internal capsule via the medial striate artery of Heubner? (A) Middle cerebral (B) Anterior communicating (C) Anterior cerebral (D) Anterior choroidal (E) Posterior communicating

Ans C. The anterior cerebral artery supplies part of the caudate nucleus and putamen and anterior limb of the internal capsule via the medial striate artery of Heubner @ 4. Which artery supplies the cochlea? (A) Anterior inferior cerebellar (B) Labyrinthine (C) Superior cerebellar (D) Posterior cerebral Ans B. The labyrinthine artery supplies the cochlea and the vestibular apparatus. In 15% of the population, it arises from the basilar artery; in the other 85% of the population, it arises from the anterior inferior cerebellar artery. @ 5. Which sinus drains the superior surface of the cerebellum? (A) Straight (B) Inferior sagittal (C) Inferior petrosal (D) Sigmoid Ans A. The straight sinus drains the superior surface of the cerebellum. It is formed by the great cerebral vein and the inferior sagittal sinus. @ Which of the following vessels is most likely to be the source of the hemorrhage? (A) Anterior cerebral artery (B) Anterior communicating artery (C Middle meningeal artery (D) Middle cerebral artery Ans C

@ Which artery gives rise to the aneurysm that cause occulomotor palsy? (A) Heubners (B) anterior communicating (C) posterior communicating (D) Charcot-Bouchards (E) anterior choroidal Ans c The posterior communicating artery may give rise to a berry aneurysm, which compresses the third cranial nerve and results incomplete third nerve palsy (see Figure 314). Heubners artery is a branch of the anterior cerebral artery. A communicating artery may harbor berry aneurysms that impinge on the optic chiasm, causing a bitemporal lower quadrantanopia. Charcot-Bouchard microaneurysms are found in the territory of the lateral striate arteries and are the most common cause of nontraumatic intraparenchymal hemorrhage. Rupture occurs most frequently in the basal ganglia. The

anterior choroidal artery is a branch of the internal carotid artery and irrigates the globus pallidus and posterior limb of the internal capsule. @ Which of the following vessels usually gives rise to the artery that supplies the inner ear . (A) Posterior cerebral artery . (B) Superior cerebellar artery . (C) Anterior inferior cerebellar artery . (D) Posterior inferior cerebellar artery . (E) Anterior spinal artery . Ans C. The anterior inferior cerebellar artery usually gives rise to the labyrinthine artery, which sup- plies the structures of the inner ear (i.e., the cochlea and vestibular apparatus).

@ Which of the following vessels Supplies the facial nucleus and the spinal trigeminal nucleus and tract . (A) Posterior cerebral artery . (B) Superior cerebellar artery . (C) Anterior inferior cerebellar artery . (D) Posterior inferior cerebellar artery . (E) Anterior spinal artery . Ans C. The facial nucleus and the spinal trigeminal nucleus and tract are supplied by the anterior inferior cerebellar artery.

@ Which of the following vessels Is the terminal branch of the basilar artery . (A) Posterior cerebral artery . (B) Superior cerebellar artery . (C) Anterior inferior cerebellar artery

. (D) Posterior inferior cerebellar artery . (E) Anterior spinal artery . Ans A. The posterior cerebral artery is the terminal branch of the basilar artery.

@ Which of the following vessels Supplies the deep cerebellar nuclei . (A) Posterior cerebral artery . (B) Superior cerebellar artery . (C) Anterior inferior cerebellar artery . (D) Posterior inferior cerebellar artery . (E) Anterior spinal artery Ans B. The superior cerebellar artery supplies the superior surface of the cerebellum and the cerebellar nuclei (dentate nucleus). @ Which of the following vessels Supplies the nucleus ambiguous . (A) Posterior cerebral artery . (B) Superior cerebellar artery . (C) Anterior inferior cerebellar artery . (D) Posterior inferior cerebellar artery . (E) Anterior spinal artery . Ans D. The posterior inferior cerebellar artery supplies the dorsolateral medullary field, including the nucleus ambiguus.

@Which of the following arteries Irrigates the posterior limb of the internal capsule a) b) c) d) proximal stem of the left middle cerebral artery anterior choroidal artery internal carotid artery anterior cerebral artery

Ans b The anterior choroidal artery irrigates the posterior limb of the internal capsule.

@Which of the following arteries Occlusion results in a fluent receptive aphasia a) b) c) d) proximal stem of the left middle cerebral artery choroidal artery internal carotid artery anterior cerebral artery

Ans A. Occlusion of the proximal stem of the left middle cerebral artery results in Wernicke apha- sia, a fluent receptive aphasia.

@Which of the following aneurysm of artery may result in Horner syndrome a) b) c) d) proximal stem of the left middle cerebral artery choroidal artery internal carotid artery anterior cerebral artery

Ans c . An aneurysm of the internal carotid artery within the cavernous sinus can interrupt post- ganglionic sympathetic fibers, resulting in Horner syndrome.

@Which of the following arteries Occlusion results in infarction of the paracentral lobule with Babinski sign a) b) c) d) proximal stem of the left middle cerebral artery choroidal artery internal carotid artery anterior cerebral artery

Ans D . The anterior cerebral artery perfuses the mesial aspect of the hemisphere from the frontal pole to the parieto-occipital sulcus, including the paracentral lobule. The paracentral lobule gives rise to corticospinal fibers to the contralateral foot and leg. Destruction of these fibers results in the Babinski sign.