SCRN Chapter 3 Anatomy and Physiology Exam Questions and Answers

1. Subarachnoid hemorrhage is most commonly caused by A. Aneurysmal rupture B. Arteriosclerotic vascular disease C. Arteriovenous vascular malformation rupture D. Amyloid angiopathy - Answer- 1. A: Aneurysms are almost always located in the subarachnoid space, and are the most common cause. Choices C and D result in intracerebral hemorrhage (ICH), not subarachnoid hemorrhage (SAH), and choice B is a risk for ischemic stroke, not hemorrhagic stroke. 2. The dural fold that separates the cerebrum from the cerebellum is the? A. Corpus callosum B. Tentorium C. Falx D. Posterior fossa - Answer- 2. B: The tentorium is also called the tentorium cerebelli, and means "tent of the cerebellum," so picture it as a tent over the cerebellum, separating it from the cerebrum. The corpus callosum is a band of fibers that connects the two hemispheres; the falx is a dural fold that separates the two hemispheres; and the posterior fossa is the space where the brainstem and cerebellum lie. 3. The innermost meningeal layer that fits the brain like a latex glove hand is the A. Dura mater B. Arachnoid mater C. Central mater D. Pia mater - Answer- 3. D: There are three layers of the meninges, the membrane covering the brain. The outermost layer is the dura mater, the middle layer is the arachnoid mater, and the innermost layer is the pia mater. There is no such thing as a central mater. 4. The frontal lobe contains which of the following? A. Wernicke's area B. Motor strip C Sensory strip D. Globus pallidus - Answer- 4. B. The motor strip is located at the back of the frontal lobe. Wernicke's area is located at the junction of the temporal and parietal lobes, the sensory strip-although it lies right next to the motor stripis located at the front of the parietal lobe; the globus pallidus is in the basal ganglia, a subcortical structure. 5. The postcentral gyrus is located in the A. Parietal lobe B. Occipital lobe C. Pons D. Cerebellum - Answer- 5. A: The postcentral gyrus is where the sensory strip lies--in the parietal lobe. 6. Which of the following best describes the homunculus? A. Portion of midbrain responsible for being awake and aware B. Another name for the large third ventricle C. Diagram that represents the optic path from frontal to occipital lobe D. Diagram that depicts what body parts are controlled by the motor sensory strips is the relay station between the cerebral cortex and the - Answer- 6. D: The homunculus comes from the a 16th century alchemist's description of a "little man" and this term has been used to describe the pattern of the motor and sensory control of the body. 7. The _______ is the relay station between the cerebral cortex and the brainstem A. Thalamus B. Hypothalamus C. Putamen D. Circle of Willis - Answer- 7. A: The thalamus relays auditory, somatosensory, visual, and gustatory signals between the cortex and the brainstem structures. 8. The diencephalon refers to which structures? A. Midbrain, pons, medulla B. Basal ganglia, putamen, internal capsule C. Thalamus, hypothalamus, pineal gland D. Thalamus, globus pallidus, caudate nucleus - Answer- 8. C: The thalamus, hypothalamus, and pineal gland are referred to as the diencephalon, which relays sensory information among brain regions and controls many autonomic functions of the peripheral nervous system. 9. Someone who cannot understand what is said to them has had an infarct of the A. Frontal lobe B. Occipital lobe C. Temporal lobe D. Brainstem - Answer- 9. C: The temporal lobe is where Wernicke's area is. It is responsible for receptive speech. Someone with damage to this area might have trouble understanding spoken or written language. 10. Which brainstem structure connects to the spinal cord and controls the respiratory and heart rates? A. Medulla oblongata B. Pons C. Midbrain D. Cerebellum - Answer- 10. A: The medulla oblongata is sometimes called the extension of the spinal cord within the skull. It controls heart rate and respiration; without its proper function, we cannot survive. 11. You are an emergency department (ED) nurse whose patient presents with staggering gait and slurred speech. The patient denies having drinking and the alcohol level is normal, but the CT scan is positive to an infarct in the A. Midbrain B. Right parietal lobe C. Occipital lobe D. Cerebellum - Answer- 11. D: The cerebellum is responsible for coordination and balance. When damaged, it can produce symptoms that have been mistaken for inebriation. 12. The most common cardioembolic source for stroke is A. Mitral valve insufficiency B. Endocarditis of the tricuspid valve C. Atrial fibrillation D. Supraventricular tachycardia - Answer- 12. C: Atrial fibrillation is a common cause of stroke because it can result in clots forming in the "quivering" atria; these clots can flow through to the cerebral circulation. Endocarditis can produce emboli, but the tricuspid valve is located in the right side of the heart, and any emboli formed there would flow to the pulmonary system, not to the cerebral circulation. 13. Which of these is not part of the circle of Willis? A. Middle cerebral arteries B. Internal carotid arteries C. Posterior communicating arteries D. Posterior cerebral arteries - Answer- 13. A: The middle cerebral artery is connected to the circle of Willis, but is not considered to be part of it. The components of the circle of Willis are the internal carotid arteries, the anterior cerebral arteries, the anterior communicating artery, the posterior cerebral arteries, and the posterior communicating arteries. 14. Patients with adequate blood supply around the borders of their infarct zone have good A. Communicating circulation B. Cerebral perfusion pressure C. Collateral circulation D. Borderline circulation - Answer- 14. C: Collateral circulation refers to the "detoured" circulation via small vessels that circumvent a blocked larger vessel. 15. Which statement is true? A. The vertebral arteries connect the subclavian arteries and the posterior brain B. The basilar arteries connect the common carotids with the circle of Willis C. The posterior cerebral arteries connect to the cerebellum via the anterior inferior cerebellar artery D. The cerebellar arteries connect the vertebral arteries to the spinal arteries - Answer- 15. A: The vertebral arteries connect the subclavian arteries to the posterior brain via the basilar artery. 16. A deep vein thrombosis can cause a stroke only if there is a presence of what cardiac structure? A. Atrial fibrillation B. Endocarditis C. Mitral valve regurgitation D. Patent foramen ovale - Answer- 16. D: A deep vein thrombosis (DVT), if it becomes mobile, will flow into the right side of the heart via the vena cava. Blood from the right atria passes through the right ventricle , and flows out the pulmonary artery to the lungs, so most DVTs cause pulmonary embolus (PE). A patent foramen ovale (PFO) is an opening between the two atria. If this is present, the DVT can enter the right atrium and pass through the PFO into the left atrium, then through the left ventricle and out the aorta where it can get into the carotid circulation and into the cerebral circulation causing a stroke. 17. Your patient with an anterior cerebral artery territory stroke is acting "frontal." What is the patient doing? A. Having trouble hearing B. Exhibiting left arm weakness C. Behaving inappropriately D. Seeing double - Answer- 17. C: The frontal lobe is responsible for many things—motor function, problem solving, spontaneity, memory, language, initiation, judgment, impulse control, and social and sexual behavior. Damage to the frontal lobe can result in inappropriate behavior, often sexual in nature. 18. Which syndrome would you think of for a patient who presents with acute right-sided weakness; that is, right facial droop, right arm = 2/5 strength, right leg = 4/5 strength? A. Middle cerebral artery syndrome B. Anterior cerebral artery syndrome C. Internal carotid artery syndrome D. Lacunar syndrome - Answer- 18. A: Middle cerebral artery (MCA) syndrome is characterized by motor and sensory loss in the face, arm, and, to a lesser degree, the leg, on the contralateral (opposite) side of the infarct. 19. Which of the following is not a lacunar syndrome? A. Disconjugate gaze syndrome B. Pure motor syndrome C. Pure sensory syndrome D. Dysarthria-clumsy hand syndrome - Answer- 19. A: Lacunar syndromes are small infarcts of territories supplied by a penetrating artery branch of one of the major cerebral arteries. The area involved is small with finite impact on function. Pure motor syndromes produce only motor symptoms; pure sensory syndromes produce only sensory symptoms; and dysarthria-clumsy hand syndromes produce dysarthria and mild hand weakness. There is no such thing as a dysconjugate gaze syndrome. 20. Intraparenchymal hemorrhage is synonymous with A. Intradural hemorrhage B. Subarachnoid hemorrhage C. Intracerebral hemorrhage D. Intraventricular hemorrhage - Answer- 20. C: Intraparenchymal hemorrhage refers to blood within the brain or parenchymal tissue. Intracerebral hemorrhage refers to the same thing, thus is synonymous with intraparenchymal hemorrhage. Intradural hemorrhage is between the layers of the meninges, so not within the brain tissue; subarachnoid hemorrhage is under (sub) the arachnoid mater, between the arachnoid mater and the pia mater; intraventricular hemorrhage is blood in the ventricles, which may have come from either a subarachnoid hemorrhage or an intracerebral hemorrhage. 21. Ondine's Curse refers to a syndrome characterized by cessation of respiration during sleep owing to failure of the automatic respiratory center in the