1. Which of the following best completes the following analogy: Anterior circulation is to posterior circulation, as

A. anterior cerebral hemispheres, basal ganglia, thalamus, ventral brain stem, and ventral spinal cord are to the posterior cerebral hemispheres, cerebellum, dorsal brain stem, and dorsal spinal cord
B. internal carotid artery is to the vertebral and basilar arteries
C. vertebral and basilar arteries are to the internal carotid artery
D. anterior inferior cerebellar artery is to the posterior inferior cerebral artery

2. Which of the following statements best describes the normal path blood takes from one vertebral artery to the left occipital lobe?

A. Basilar artery, left posterior cerebral artery
B. Basilar artery, left posterior communicating artery, left middle cerebral artery
C. Basilar artery, left superior cerebellar artery, left posterior cerebral artery
D. Left posterior inferior cerebellar artery, left posterior cerebral artery

3. Which of the following arteries is NOT a branch of the internal carotid artery?

A. Posterior inferior cerebellar artery
B. Ophthalmic artery
C. Anterior choroidal artery
D. Posterior communicating artery

4. Which of the following best completes the analogy about cerebral arterial distributions: The middle cerebral artery is to the anterior cerebral artery, as

A. the basal ganglia is to the thalamus
B. the inferior frontal lobule is to the occipital pole
C. the cingulate gyrus is to the superior temporal gyrus
D. the lateral postcentral gyrus is to the medial postcentral gyrus

5. Which description of the brain stem arterial distributions is most accurate?

A. Arterial branches supply pie-shaped wedges of tissue, beginning at dorsal midline and extending circumferentially.
B. Short circumferential branches supply the dorsal brain stem; long circumferential branches supply the ventral brain stem.
C. Arteries course on the ventral surface and send branches dorsally.
D. The basilar artery supplies the midline; the vertebral arteries, the next lateral territory; and the cerebellar arteries supplying most laterally.

6. Which arterial interfaces are not locations of collateral circulation?

A. Anterior cerebral artery and middle cerebral artery
B. Middle cerebral artery and posterior cerebral artery
C. Anterior cerebral artery and posterior cerebral artery
D. Posterior inferior cerebellar artery and vertebral arteries

7. Which of the following arteries supplies part of the posterior limb of the internal capsule?

A. Anterior choroidal artery
B. Posterior cerebral artery
C. Posterior choroidal artery
D. Ophthalmic artery

8. Lenticulostriate arteries do not supply the

A. internal capsule
B. postcentral gyrus
C. globus pallidus
D. putamen

9. The C-shaped course of the anterior cerebral artery is best shown with an arteriogram that provides a

A. frontal view of the brain
B. medial or lateral view of the brain
C. frontal-inferior view of the brain
D. posterior view of the brain

Comment: The anterior cerebral artery has a C-shape. It is located on the medial surface of the cerebral hemispheres. Thus, a view from the side of the brain is best to reveal its shape.

10. A patient has a subdural hematoma. Which of the following best describes the space within which blood accumulates?

A. The space between the dura and the arachnoid
B. The space between the dura and the pia
C. The space between the dura and the cortex surface
D. Any space within a part of the central nervous system covered by the dura

11. Which of the following best describes the principal source of cerebrospinal fluid (CSF)?

A. Choroid plexus in the lateral ventricles
B. Choroid plexus in the lateral and third ventricles
C. Choroid plexus in the lateral, third, and fourth ventricles
D. Choroid plexus in the ventricles and central canal of the spinal cord

12. CSF exits the ventricles through the ___________ and then from the subarachnoid space to the venous sinuses through the ____________.

A. foramen of Luschka; foramen of Magendie
B. foramen of Magendie; foramen of Luschka
C. foramina of Luschka and Magendie; arachnoid granulations
D. arachnoid granulations; foramina of Luschka and Magendie

Comment: The foramina of Luschka and Magendie are located in the fourth ventricle. CSF exits here and then passes into the subarachnoid space. From the subarachnoid space, CSF flows into the dural sinuses through arachnoid granulations, which are small unidirectional valves.

13. A baby was born with hydrocephalus caused by constriction of the cerebral aqueduct during early development. In which part of the central nervous system would this constriction have occurred?

A. Olfactory bulb
B. Diencephalon
C. Midbrain
D. Medulla

14. Which of the following best describes the most likely cause of congenital hydrocephalus?

A. Most CSF is produced by the choroid plexus. With cerebral aqueduct constriction, CSF continues to be produced. This leads to enlargement of the lateral and third ventricles.
B. More CSF is produced by the choroid plexus than can be released by the arachnoid granulations.
C. Production of CSF that comes from nonchoroid plexus sources is increased.
D. There is enlargement of the subarachnoid space, after CSF exits from the arachnoid granulations.

15. A 38-year-old man suspected of having Guillain-Barré syndrome will have a lumbar tap to sample protein content in the CSF. Which of the following best explains why CSF sampling is by lumbar tap?

A. CSF pools within the subarachnoid space located at the most inferior portion of the central nervous system.
B. CSF exits from the ventricular system at the caudal terminus of the vertebral column.
C. The lumbar cistern is the only part of the subarachnoid space in which there is sufficient CSF for sampling.
D. CSF collects in multiple subarachnoid cisterns. The lumbar cistern is safe to sample because it contains only nerve roots since the caudal termination of the spinal cord is rostral to the lumbar cistern.