WORKSHOP 3
Topography of the internal base of the skull, arachnoid membranes and coronary
sinuses. Interstitial spaces and fluid conductive channels. Blood supply.
1. What symptoms are more often evident of intracranial hematomas?
2. What foramen does a. meningea media penetrate?
3. What convolution of brain does the passage of the frontal branch of the middle
meningeal artery regard?
4. What convolution of brain does the passage of posterior branch of the middle
meningeal artery regard?
5. What projection is falx cerebri located in?
6. What does falx cerebri separate?
7. What is falx cerebri attached to?
8. In what direction is tentorium cerebelli localized?
9. Where does tentorium cerebelli penetrate?
10.What passes through tentorial fissure?
11.Where is sinus sagittalis superior located?
12.What is the sinus of dura mater that is directly connected with venous system of
the face?
13.Where does sinus sagittalis superior expose?
14.Where is sinus sagittalis inferior located?
15.Where does sinus sagittalis inferior open into?
16.Where is sinus rectus located?
17.Where does sinus rectus fall into?
18.Where is sinus transversus located?
19.Where is sinus occipitalis located?
20.Where does sinus occipitalis open into?
21.Where is sinus cavernosus located?
22.Due to what is the connection of cavernous sinus with superior sagittalis sinus
performed?
23.Due to what is the connection of cavernous sinus with the venous system of the
face performed?
24.What vein connects sinus cavernosus with sinus transversus?
25.What passes through the upper wall of sinus cavernosus?
26.What passes in lateral wall of sinus cavernosus?
27.What passes through sinus cavernosus?
28.What is observed at thrombosis of sinus cavernosus?
29.What are clinical signs of thrombosis at sinus cavernosus?
30.What is observed at sinus cavernosus damaged?
31.What artery supplies dura mater of anterior cranial fossa?
32.What artery supplies dura mater of the middle cranial fossa?
33.What artery supplies dura mater of posterior cranial fossa?
34.What nerves is dura mater of brain innervated by?
35.What is the pressure of cerebrospinal fluid at lying position?
36.What is the pressure of cerebrospinal fluid at sitting position?
37.What liquid dynamic tests are used to estimate patency of subarachnoid space?
38.What are the possible ways of cerebrospinal fluid circulation?
39.What arteries compose anterior arterial circle of brain?
40.What arteries compose lateral arterial circle of brain?
41.What arteries compose posterior arterial circle of brain?
42.What veins of brain compose collateral circulation and are of practical significance
at ligation of superior sinus sagittalis?
43.What is observed when the first pair of cranial nerves is damaged?
44.What is observed when the second pair of cranial nerves is damaged?
45.What is observed when the third pair of cranial nerves is damaged?
46.What is observed when the fourth pair of cranial nerves is damaged?
47.What is observed when the sixth pair of cranial nerves is damaged?
48.What is observed when the seventh pair of cranial nerves is damaged on the exit
of the channel?
49.A female patient with sinister suppurated mumps developed symptoms of smooth
nasolabial and nasobuccal folds. The diagnosis is paresis of mimic musculature of
the face on the left side. What nerve is involved into the inflammatory process in
this case?
50.What is observed when the facial nerve in the channel above the branch of chorda
tympani is damaged?
51.What is observed when the facial nerve in the channel above the branch of n.
stapedius is damaged?
52.What is observed when the facial nerve in the channel above the branch of n.
petrosus major is damaged?
53.What symptoms are typical for rr.temporales n. facialis damaged?
54.What is the broken skull at the point of foramen jugularis characterized by?
55.What is the damage of the ninth pair of cranial nerves characterized by?
56.What is the damage of the tenth pair of cranial nerves characterized by?
57.What is the damage of the 11th pair of cranial nerves characterized by?
58.A female patient is diagnosed with the damage of foramen jugularis. Which of the
following nerves penetrate though it?
59.What is the damage of the 12th pair of cranial nerves characterized by?
60.What intracranial hematomas and what spaces are more often formed when a.
meningea media is damaged?
61.A victim is diagnosed with craniocerebral injury resulted from the panch on the
face. What is the broken base of the brain at frontal cranial fossa characterized
by?
62.What is the break at the middle cranial fossa with the damaged pyramid of the
temporal bone characterized by?
! What symptoms are more often evident of intracranial hematomas?
Mydriasis, hemiparesis, bradycardia, lucid interval
#dysphagia, anesthesia of the mucous membrane of the pharynx, dysgeusia
Aphonia and cardiac disturbances
Hemiglossoplegia, dysphagia, dysarthria and deviation of the tongue
! What foramen does a. meningea media penetrate?
Through foramen spinosum
#through foramen rotundum
Through foramen ovale
Through foramen lacerum
! What convolution of brain does the passage of the frontal branch of the middle meningeal artery
regard?
Precentral gyrus
#postcentral gyrus
Angular gyrus
Upper lymbic lobe
! What convolution of brain does the passage of posterior branch of the middle meningeal artery
regard?
Temporal lobe
#precentral convolution
Postcentral convolution
Parietal lobe
! What projection is falx cerebri located in?
In sagittal
# in frontal
In vertical
In horizontal
! What does falx cerebri separate?
Hemispheres of the brain
#occipital part of the brain from the cerebellum
Hemispheres of the cerebellum
Medulla oblongata from the cerebellum
! What is falx cerebri attached to?
Margins of sulcus sinus sagittalis
#margins of sulcus sinus transversus
Internal occipital crest
Upper margin of the pyramid
! In what direction is tentorium cerebelli localized?
Horizontal
#vertical
Frontal
Sagittal
! Where does tentorium cerebelli penetrate?
In transverse fissure of cerebrum
#between the hemispheres of the brain
Between the hemispheres of the cerebellum
In cerebellar fissure
! What passes through tentorial fissure?
Brain column
#v. cerebri magna
Sinus sagittalis inferior
Sinus rectus
! Where is sinus sagittalis superior located?
On the upper margin of falx cerebri, in sulcus sinus sagittalis
#on the low margin of falx cerebri, in sulcus sinus sagittalis
At the point of fixation falx cerebri with tentorium cerebelli
Along sulcus transversi of occipital bone
! What is the sinus of dura mater that is directly connected with venous system of the face?
Cavernous
#sinus rectus
Superior petrosal sinus
Sigmoid
! Where does sinus sagittalis superior expose?
Into sinus transversus
#into sinus rectus
Into sinus sigmoideus
Into sinus cavernosus
! Where is sinus sagittalis inferior located?
Along the low margin of falx cerebri
#along the upper margin of falx cerebri
At the point of internal occipital protuberance
At the point of fixation falx cerebri with tentorium cerebelli
! Where does sinus sagittalis inferior open into?
Sinus rectus
#sinus transversus
Sinus sigmoideus
Sinus occipitalis
! Where is sinus rectus located?
At the point of fixation falx cerebri with tentorium cerebelli
#along the upper margin of falx cerebri
Along the low margin of falx cerebri
Along the internal occipital crest
! Where does sinus rectus fall into?
Sinus transversus
#sinus sigmoideus
Sinus cavernosus
Sinus sagittalis inferior
! Where is sinus transversus located?
At the point of fixation tentorium cerebelli to sulcus of occipital bone
#in sulcus sinus sagittalis
In sulcus sinus sigmoideus
On crista occipitalis interna
! Where is sinus occipitalis located?
Along the posterior margin of falx cerebelli, on crista occipitalis interna
#on sulcus transversi of occipital bone
On both sides of sella turcica
At the point of union of falx cerebri with tentorium cerebelli
! Where does sinus occipitalis open into?
Sinus sigmoideus
#sinus transversus
Sinus rectus
Sinus sagittalis superior
! Where is sinus cavernosus located?
On both sides of sella turcica
#superior margin of the pyramid of the temporal bone
Inferior margin of the pyramid of the temporal bone
On crista occipitalis interna
! Due to what is the connection of cavernous sinus with superior sagittalis sinus performed?
Trollar’s vein
#Labbe’s vein
v. cerebri magna
vv. ophthalmicae
! Due to what is the connection of cavernous sinus with the venous system of the face performed?
v. ophthalmica superior et inferior
#plexus venosus foraminis ovalis
Trollar’s vein
Labbe’s vein
! What vein connects sinus cavernosus with sinus transversus?
Labbe’s vein
#Trollar’s vein
v. cerebri magna
v. cerebri media superficialis
! What passes through the upper wall of sinus cavernosus?
n. oculomotoris and n. trochlearis
#n. ophthalmicus
n. abducens and a. carotis interna
n. facialis
! What passes in lateral wall of sinus cavernosus?
n. ophthalmicus
#n. oculomotorius
n. trochlearis
n. abducens
! What passes through sinus cavernosus?
n. abducens at a. carotis interna
#n. ophthalmicus
n. oculomotorius at n. trochlearis
n. opticus
! What is observed at thrombosis of sinus cavernosus?
Foix – Thevenard sign
#Behr’s symptom
MacKenzie’s syndrome
Sluder’s syndrome
! What are clinical signs of thrombosis at sinus cavernosus?
Complete ophthalmoplegia, protrusion, ptosis
#pulsing protrusion, dysphagia, amavrosis
torticollis
Aphonia
! What is observed at sinus cavernosus damaged?
Pulsing protrusion
# Dysphagia
Aphonia
Foix – Thevenard’s sign
! What artery supplies dura mater of anterior cranial fossa?
a. meningea anterior
#a. meningea media
a. ophthalmica
a. carotis interna
! What artery supplies dura mater of the middle cranial fossa?
a. meningea media
#a. meningea anterior
a. meningea posterior
a. carotis interna
! What artery supplies dura mater of posterior cranial fossa?
a. meningea posterior (a. pharyngea ascendens branch)
#a. meningea posterior (a. occipitalis branch)
a. meningea posterior (a. auricularis posterior branch)
a. meningea posterior (a. maxillaris branch)
! What nerves is dura mater of brain innervated by?
r. tentorii (n. ophthalmicus branch); r. meningeus medius (from n. maxillaris); r. meningeus (from n.
mandibularis); r. meningeus (from n. vagus)
# r. meningeus medius (from n. maxillaris); r. meningeus (from n. mandibularis); r. auricularis (from n.
vagus)
n. olfactorius; rr. ganglionares ad ganglion pterygopalatinum (from n. maxillaris); radix cranialis, radix
spinalis (from n. accessorius);
r. tentorius, r. meningeus recurrens, r. meningeus anterior (n. ophthalmicus branches ); r. meningeus
medius (from n. maxillaris)
! What is the pressure of cerebrospinal fluid at lying position?
120-180 mm of water column
#120-180 mm of Mercury column
200-250 mm of water column
200-250 mm of Mercury column
! What is the pressure of cerebrospinal fluid at sitting position?
200-250 mm of water column
#200-250 mm of Mercury column
120-180 mm of water column
120-180 mm of Mercury column
! What liquid dynamic tests are used to estimate patency of subarachnoid space?
Queckenstedt’s test
Delbe-Pertes test
Troyanov- Trendelenburg’s test
Hakkenbroeka’s test
! What are the possible ways of cerebrospinal fluid circulation?
From the fourth ventricle through aqueduct of cerebrum into the third ventricle
# From the fourth ventricle through Magendie’s and Luschka foramen into the third ventricle
From the fourth ventricle through Monro’s foramen into the third ventricle
From the fourth ventricle through aqueduct of cerebrum into the lateral ventricles
! What arteries compose anterior arterial circle of brain?
a. communicans anterior
#a. carotis interna
a. communicans posterior
a. cerebri anterior
! What arteries compose lateral arterial circle of brain?
a. communicans posterior
#a. cerebri posterior
a. cerebri anterior
a. communicans anterior
! What arteries compose posterior arterial circle of brain?
a. cerebri posterior
#a. cerebri anterior
a. communicans anterior
a. communicans posterior
! What veins of brain compose collateral circulation and are of practical significance at ligation of
superior sinus sagittalis?
Trollar’s vein and Labbe’s vein
##v. cerebri media superficialis
vv. cerebri superiores
vv. cerebri inferiores
! What is observed when the first pair of cranial nerves is damaged?
Anosmia
# Amavrosis
Amblyopia
Aphonia
! What is observed when the second pair of cranial nerves is damaged?
Amblyopia and amavrosis
#strabismus divergens, ptos et mydrias
strabismus convergens
Aphonia
! What is observed when the third pair of cranial nerves is damaged?
strabismus divergens, ptos et mydrias
# Amblyopia and amavrosis
Aphonia and anosmia
Haemianopsia
! What is observed when the fourth pair of cranial nerves is damaged?
Squint pupils, diplopia
#dysphagia
strabismus divergens
strabismus convergens
! What is observed when the sixth pair of cranial nerves is damaged?
strabismus convergens
#strabismus divergens
mydrias
amavrosis
! What is observed when the seventh pair of cranial nerves is damaged on the exit of the channel?
Haemimia, disproportion of oral fissure towards a healthy side, smoothing of a nasolabial fold,
lagophthalm
# Aphonia
Haemimia, ologoptialismis, dysgeuzia or agazia
Haemimia and disorders of lacrimal excretion
! A female patient with sinister suppurated mumps developed symptoms of smooth nasolabial and
nasobuccal folds. The diagnosis is paresis of mimic musculature of the face on the left side. What nerve
is involved into the inflammatory process in this case?
Facial nerve
#second branch of trigeminus nerve
third branch of trigeminus nerve
n.auriculotemporalis
! What is observed when the facial nerve in the channel above the branch of chorda tympani is
damaged?
Haemimia, oligoptialismis, dysgeuzia or agazia
#Haemimia, disproportion of oral fissure towards a healthy side, smoothing of a nasolabial fold
Haemimia and disorders of lacrimal excretion
Haemimia and hyperacuzia
! What is observed when the facial nerve in the channel above the branch of n. stapedius is damaged?
Haemimia and hyperacuzia
# Haemimia, oligoptialismis, dysgeuzia or agazia
Haemimia and disorders of lacrimal excretion
Anosmia
! What is observed when the facial nerve in the channel above the branch of n. petrosus major is
damaged?
Haemimia and disorders of lacrimal excretion
#Haemimia and hyperacuzia
Haemimia, oligoptialismis, dysgeuzia or agazia
Amavrosis
! What symptoms are typical for rr.temporales n. facialis damaged?
Lagophthalm
# midriazis
Ptosis
! What is the broken skull at the point of foramen jugularis characterized by?
MacKenzie’s syndrome
#Behr’s symptom
Foix – Thevenard sign
Villaret’s symptom
! What is the damage of the ninth pair of cranial nerves characterized by?
Dysphagia, anesthesia of mucous membrane of the larynx, dysgeusia
#aphonia and cardiac disturbances
Hemiglossoplegia, dysphagia, dysarthria and deviation of the tongue
Hemimia and disorders of lacrimal discharge
! What is the damage of the tenth pair of cranial nerves characterized by?
aphonia and cardiac disturbances
#Dysphagia, anesthesia of mucous membrane of the larynx, dysgeusia
Hemiglossoplegia, dysphagia, dysarthria and deviation of the tongue
Haemimia, oligoptialismis, dysgeuzia or agazia
! What is the damage of the 11th pair of cranial nerves characterized by?
Torticollis
#amavrosis
Aphonia
Anosmia
! A female patient is diagnosed with the damage of foramen jugularis. Which of the following nerves
penetrate though it?
Vagus nerve, accessory nerve, glossopharyngeal nerve
#vestibulocochlear nerve and intermediate nerve
Trigeminal nerve and vagus nerve
Sublingual nerve and facial nerve
! What is the damage of the 12th pair of cranial nerves characterized by?
Hemiglossoplegia, dysphagia, dysarthria and deviation of the tongue
#Dysphagia, anesthesia of mucous membrane of the larynx, dysgeusia
Haemimia, oligoptialismis, dysgeuzia or agazia
Torticollis
! What intracranial hematomas and what spaces are more often formed when a. meningea media is
damaged?
Epidural space and epidural hematomas
#epidural space and subdural hematomas
Subdural space and subdural hematomas
Subdural space and subarachnoid hematomas
! A victim is diagnosed with craniocerebral injury resulted from the panch on the face. What is the
broken base of the brain at frontal cranial fossa characterized by?
Nasal bleeding, liquorrhea from nose, fruises and subcutanous emphysema in the orbit, scent disorders
#complete ophthalmoplegia, protrusion, ptosis
Squint pupils, diplopia
Hemimia, disproportion of oral fissure towards a healthy side, smoothing of a nasolabial fold,
lagophthalm
! What is the break at the middle cranial fossa with the damaged pyramid of the temporal bone
characterized by?
Bleeding, liquorrhea from meatus acusticus externus and damage of the 7th and 8th pairs of
craniocerebral nerves
#nasal bleeding, liquorrhea from nose, fruises and subcutanous emphysema in the orbit, scent
disorders, aphonia and cardiac disturbances
Hemiglossoplegia, dysphagia, dysarthria, deviation of the tongue
Hemimia, disorders of the lacrimal discharge and damage of the 9th and 10th pairs of cranial nerves