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13Anatomy and Physiology
QUESTIONS
1. Subarachnoid hemorrhage is most commonly caused by
A. Aneurysmal rupture
B. Arteriosclerotic vascular disease
C. Arteriovenous vascular malformation rupture
D. Amyloid angiopathy
2. The dural fold that separates the cerebrum from the cerebellum is the
A. Corpus callosum
B. Tentorium
C. Falx
D. Posterior fossa
3. The innermost meningeal layer that fits the brain like a latex glove fits the hand is the
A. Dura mater
B. Arachnoid mater
C. Central mater
D. Pia mater
4. 14The frontal lobe contains which of the following?
A. Wernicke’s area
B. Motor strip
C. Sensory strip
D. Globus pallidus
5. The postcentral gyrus is located in the
A. Parietal lobe
B. Occipital lobe
C. Pons
D. Cerebellum
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
7. The _____________ is the relay station between the cerebral cortex and the brainstem.
A. Thalamus
B. Hypothalamus
C. Putamen
D. Circle of Willis
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
9. Someone who cannot understand what is said to them has had an infarct of the
A. Frontal lobe
B. Occipital lobe
C. 15Temporal lobe
D. Brainstem
10. Which brainstem structure connects to the spinal cord and controls respiratory and heart rates?
A. Medulla oblongata
B. Pons
C. Midbrain
D. Cerebellum
11. You are an emergency department (ED) nurse whose patient presented with staggering gait and slurred speech. The patient denies having been drinking and the alcohol level is normal, but the CT scan is positive for an infarct in the
A. Midbrain
B. Right parietal lobe
C. Occipital lobe
D. Cerebellum
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
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
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
15. 16Which 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 posterior inferior cerebellar artery
D. The cerebellar arteries connect the vertebral arteries to the spinal arteries
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
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
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
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
20. 17Intraparenchymal hemorrhage is synonymous with
A. Intradural hemorrhage
B. Subarachnoid hemorrhage
C. Intracerebral hemorrhage
D. Intraventricular 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
A. Medulla oblongata
B. Pons
C. Limbic lobe
D. Thalamus
22. Locked-in syndrome refers to a stroke in which area of the brain?
A. Central occipital lobe
B. Pons
C. Thalamus
D. Right cerebellum
23. Which symptom is characteristic in a patient with damage to the Broca’s area?
A. Dysarthria
B. Dysphagia
C. Expressive aphasia
D. Inability to understand instructions
24. The most common cause of intracerebral hemorrhage (ICH) is
A. Extreme hyperthermia causing capillary leakage
B. Extreme hyperglycemia damaging the blood–brain barrier
C. Aneurysmal rupture causing high intracranial pressure (ICP)
D. Hypertension causing arterial wall rupture
25. Which area is affected in patients with extinction, formally known as neglect?
A. Parietal lobe
B. Medial frontal lobe
C. 18Occipital lobe
D. Basal ganglia
26. A stroke between two adjacent cerebral arteries is known as a/an
A. Lacunar infarct
B. Watershed infarct
C. Subacute infarct
D. Associated infarct
27. Which of the following best describes the cerebral cortex?
A. Folds of gray matter playing an important role in consciousness
B. Folds of white matter playing an important role in consciousness
C. Tracts of white matter playing an important role in autonomic function
D. Tracts of gray matter playing an important role in motor function
28. The corpus callosum is best described by which of the following statements?
A. A band of gray matter fibers that facilitates communication between the cerebral cortex and the brainstem
B. A band of white matter fibers that facilitates communication between the left and right hemispheres
C. The posterior portion of the petrosal sinus that facilitates drainage between the transverse sinus and the jugular vein
D. The sixth ventricle present in approximately 20% of the population
29. The vascular wall structure that is impacted by uncontrolled diabetes and uncontrolled hypertension is the
A. Tunica media
B. Tunica adventitia
C. Tunica intima
D. Tunica lateralis
30. Arteriovenous malformations (AVMs) can result in an hemorrhagic stroke. This is due to which of the following reasons?
A. Arteries and veins connecting directly rather than the usual route of arteries to arterioles, to capillaries, to venules, to veins
B. Connection of arteries to veins is underdeveloped
C. 19Circle of Willis anomalies
D. Arteries and veins become fused as a result of chronic hypertension
31. Name the condition that is related to a hypercoagulable state, but can present as intracerebral hemorrhage (ICH) and is treated with heparinization.
A. Subacute bacterial endocarditis
B. Horner’s syndrome
C. Moya Moya disease
D. Venous sinus thrombosis
32. The blood–brain barrier plays what role in an acute ischemic stroke?
A. Disruption results in locked-in syndrome
B. An intact blood–brain barrier provides protection from hyperthermia
C. Disruption allows the influx of inflammatory cells resulting in edema and hemorrhagic transformation
D. Partial disruption results in homonymous hemianopia secondary to optic tract irritation
33. Multiple tiny infarcts in the same hemisphere is a clue to which condition?
A. Binswanger’s disease
B. Incomplete circle of Willis
C. Vertebral dissection
D. Carotid dissection
34. Normal cerebral blood flow is 45 to 60 mL/100 g/min. At what flow rate does irreversible brain damage occur?
A. Less than 40 mL/100 g/min
B. Less than 30 mL/100 g/min
C. Less than 20 mL/100 g/min
D. Less than 10 mL/100 g/min
35. Under conditions of hyperthermia, what changes occur in the brain?
A. Increase in metabolic needs
B. Decrease in metabolic needs
C. Mitochondrial suppression
D. Cessation of adenosine release
36. 20Name the circumstance in which thrombolysis might be administered to a hemorrhagic stroke patient.
A. There is no circumstance for thrombolysis in hemorrhagic stroke
B. Small subarachnoid hemorrhage
C. Intraventricular hemorrhage
D. Interosseous hemorrhage