Topic 27. External structure of cerebral hemispheres. 1. Describe the cerebral hemispheres with related surfaces, principal parts and the boundaries 2. Describe the sulci and gyri of the superolateral face of cerebral hemispheres. 3. Describe the sulci and gyri of the medial surface of cerebral hemispheres. 4. Describe the sulci and gyri of the inferior surface of cerebral hemispheres. 5. Describe structure of the cerebral cortex. Discuss V.A. Betz’s researches. 6. Give definition of the analyzer. 7. Describe location of the cortical ends of analyzers. B. Choose the correct answer. 1. Specify surfaces of the cerebral hemispheres. A. Superolateral and medial B. Ventral, dorsal and lateral C. Superolateral, medial, inferior D. Anterior and posterior E. Medial and lateral 2. Match cerebral cortex to the region in which it is located: A. Telencephalon B. Diencephalon C. Mesencephalon D. Metencephalon E. Myelencephalon
Topic 28. The rhinencephalon. Limbic brain. The basal nuclei. Limbic system
Specify anatomical structures
Basal nuclei
Theoretical questions for the self-check: 1. Describe structure and functions of the rhinencephalon. 2. Discuss topography, compartments and functional significance of the basal nuclei. 3. Discuss topography, compartments and functional significance of the corpus striatum. 4. Describe the parts and functional significance of the limbic system. B. Situational tasks. 1. A 60-year-old man after cerebral hemorrhage felt asleep for a long time. Damage of what structure caused this state? A. Nuclei of the cranial nerves B. Hippocampus C. Reticular formation D. Cortex of the large hemispheres E. Black substances 2. Match cerebral cortex to the region in which it is located: A. Telencephalon B. Diencephalon C. Mesencephalon D. Metencephalon E. Myelencephalon 3. Specify functions of the reticular formation. A. Carry gustatory impulses from tongue, oral cavity, walls epiglottis and the pharynx B. Regulate circulation, respiration and digestion together with some complex visceral reflexes like vomiting, deglutition C. Supply the lacrimal, sublingual and submandibular glands, the glands of nasal and palatine mucosa D. Supply the striated muscles of the soft palate, the pharynx, the larynx and the upper one third of esophagus E. Supply the parotid gland
Topic 29. Structure of grey matter and cortex of cerebral hemispheres. Functional arrangement of the cerebral cortex.
Picture. The structure of the brain
A. Theoretical questions for the self-check: 1. Give definition of the analyzer. 2. Describe location of the cortical ends of analyzers.
B. Choose the correct answer. 1. After a craniocerebral trauma a patient lost the ability to execute learned purposeful movements (apraxia). The injury is most likely localized in the following region of the cerebral cortex: A. Gyrus supramarginalis B. Gyrus angularis C. Gyrus paracentralis D. Gyrus lingualis E. Gyrus parahippocampalis 2. A patient got a trauma that caused dysfunction of motor centres regulating activity of head muscles. In what parts of cerebral cortex is the respective centre normally localized? A. Inferior part of precentral gyrus B. Superior part of precentral gyrus C. Supramarginal gyrus D. Superior parietal lobule E. Angular gyrus 3. A patient after a brain blood supply disturbance lost the ability to write, letters and figures. In what lobe of the brain was the pathology? A. Occipital. B. Frontal. C. Temporal. D. Parietal. E. Insula. 4. Neurological examination of a 65-y.o. patient revealed a haemorrhage within the superior temporal gyrus. In the blood supply area of which artery is it? A. Middle cerebral artery B. Anterior cerebral artery C. Posterior cerebral artery D. Anterior communicating artery E. Basilar artery 5. A 63-year-old patient applied to a neuropathologist complaining of inability to perform woodwork, which demands accuracy, as his right hand had been doing a lot of errant movement for 3 months. Examination showed that the patient had injured: A. Angular gyrus. B. Precentral gyrus. C. Postcentral gyrus. D. Superior temporal gyrus E. Supramarginal gyrus. 6. A 45-year-old patient had a severe brain blood circulation disturbance. After stabilization of the general condition he is unable to pronoun words distinctly. Damage of what area of cerebral cortex caused the impairment the speech-motor center? A. Angular gyrus. B. Inferior frontal gyrus. C. Supramarginal gyrus. D. Precentral gyrus. E. Superior temporal gyrus 7. After a cerebral hemorrhage (hemorrhagic stroke), a patient could pronounce words with a big effort (motor aphasia). Which convolution of brain was injured? A. Superior frontal. B. Angular gyrus C. Inferior frontal. D. Superior temporal. E. Inferior temporal. 8. After a craniocerebral trauma, a 47-year-old man appealed with complaints of impossibility of exact movements of the upper extremities: he cannot button, light a match, pour water into a glass. Examination has shown that muscle strength, deep muscular sense, and mechanisms of coordination are preserved. Which site of cerebral cortex has been affected? A. Supramarginal gyrus. B. Calcarine sulcus. C. Precentral gyrus. D. Temporal gyri. E. Angular gyrus. 9. A hemorrhage in the occipital lobe (calcarium sulcus zone) has appeared. Which functions of organism are violated? A. Movements are absent. B. Hearing is absent. C. Olfaction is absent. D. Vision is absent. E. Sensitivity is absent. 10. After a craniocerebral trauma, skin sensitivity is reduced. Which part of the cerebral cortex might be damaged? A. Postcentral gyrus. B. Occipital part. C. Cingulate gyrus. D. Frontal part of cortex. E. Precentral gyrus. 11. A patient has a large meningioma involving the parasagittal region and falx cerebri. Which of the following neurologic deficits would this mass lesion be expected to produce? A. Altered taste B. Leg paralysis C. Loss of facial sensation D. Ptosis E. Unilateral deafness 12. After brain injury, a patient has lost his vision. What zone of the brain cortex is damaged in this case? A. Temporal and parietal B. Temporal C. Occipital D. Frontal E. Parietal 13. When a patient with traumatic impairment of the brain was examined, it was discovered that he had stopped to distinguish displacement of an object on the skin. What part of the brain was damaged? A. Parietal zone of the cortex B. Posterior central gyrus C. Occipital zone of the cortex D. Frontal central gyrus E. Frontal zone 14. Specify surfaces of the cerebral hemispheres. A. Superolateral and medial B. Ventral, dorsal and lateral C. Superolateral, medial, inferior D. Anterior and posterior E. Medial and lateral 15. Match cerebral cortex to the region in which it is located: A. Telencephalon B. Diencephalon C. Mesencephalon D. Metencephalon E. Myelencephalon 16. After injury, the patient suffers from violation of motor centres regulating activity of head muscles. In what areas of the cortex of hemispheres in the normal localized matching center? A. The lower part of the precentral gyrus B. The upper part precentral gyrus C. The supramarginal gyrus D. The superior parietal lobule E. The angular gyrus 17. After craniocerebral trauma, the patient has the loss of ability to perform familiar complex coordinated movements before the injury (apraxia). In what area of the cortex of hemispheres in the normal localized matching center? A. Gyrus supramarginalis B. Gyrus angularis C. Gyrus paracentralis D. Gyrus lingualis E. Gyrus parahipocampalis 18. The patient complains of inability to understand speech (sensory aphasia), even though he hears the sounds. The breach of which the cortical analyzer talk about? A. Auditory analyzer of oral speech B. Monologue analyzer C. Motor analyzer of written speech D. Visual analyzer of written speech E. The nucleus of the auditory analyzer
Topic 30. The lateral ventricles. The white matter of the cerebral hemispheres. The meninges of the brain. Circulation of cerebrospinal liquid. Lateral ventricules
Lateral ventricules Internal capsule
Meninges of the brain Cerebrospinal fluid circulation
Theoretical questions for the self-check: 1. Describe development, topography, walls and featured communications of the lateral ventricles. 2. Discuss classification and functional significance of the white mater of cerebral hemispheres. 3. Describe topography, parts and related pathways of the internal capsule. 4. Describe the spaces between the meninges and their contents. 5. Describe production and circulation of the cerebrospinal fluid. B. Situational tasks. 1. Occlusive syndrome develops in case of liquor tracts blockade on the level of the interventricular foramens. Into which space is liquor outflow complicated? A. Third ventricle. B. Lateral ventricles. C. Aqueduct of cerebrum. D. Subarachnoid space. E. Fourth ventricle. 2. Occlusive syndrome develops in case of liquor tracts blockade on the level of the middle and lateral ventricle apertures. Into which space is liquor outflow complicated? A. Third ventricle. B. Lateral ventricles. C. Aqueduct of cerebrum. D. Subarachnoid space. E. Fourth ventricle. 3. Occlusive syndrome develops in case of liquor tracts blockade on the level of the aqueduct of cerebrum. Into which space is liquor outflow complicated? A. Third ventricle. B. Lateral ventricles. C. Aqueduct of cerebrum. D. Subarachnoid space. E. Fourth ventricle. 4. Cavity of the midbrain is: A. Forth ventricle. B. Third ventricle. C. Lateral ventricle. D. Aqueductus. E. Central canal. 5. Cavity of the rhomboid fossa is: A. Forth ventricle. B. Third ventricle. C. Lateral ventricle. D. Aqueductus. E. Central canal. 6. Cavity of the diencephalon is: A. Forth ventricle. B. Third ventricle. C. Lateral ventricle. D. Aqueductus. E. Central canal. 7. Cavity of the telencephalon is: A. Forth ventricle. B. Third ventricle. C. Lateral ventricles. D. Aqueductus. E. Central canal. 8. A patient has a large meningioma involving the parasagittal region and falx cerebri. Which of the following neurologic deficits would this mass lesion be expected to produce? A. Altered taste B. Leg paralysis C. Loss of facial sensation D. Ptosis E. Unilateral deafness 9. A 55-year-old male mechanic suffers a stroke while trying to replace a flat tire on the road. He has a history of hypertension, but had not been taking his medications regularly. In addition, he is a heavy smoker, and drinks a six-pack of beer every weekend. On examination, he is conscious and has difficulty speaking clearly. A right upper motor neuron paralysis of the facial nerve is noted; the other cranial nerves are normal. He has a dense hemiplegia on the right side, with equal paralysis of the arm and leg. His lesion most likely involves the A. Convexity of the left frontal lobe B. Convexity of the right frontal lobe C. Corticospinal tract in the upper cervical spinal cord D. Left internal capsule E. Right internal capsule 10. Specify parts of the corpus callosum. A. Hemispheres and vermis B. Cerebral peduncles and tegmentum C. Thalamus, epithalamus, metathalamus, hypothalamus D. Trunk, splenium, genu, rostrum E. Columns, body, crura 11. Specify parts of the fornix. A. Hemispheres and vermis B. Cerebral peduncles and tegmentum C. Thalamus, epithalamus, metathalamus, hypothalamus D. Trunk, splenium, genu, rostrum E. Columns, body, crura
Topic 31,32. General esthesiology. Visual analyzer. Eyeball: layers, chambers, refracting medias. Accessory structures of visual analyzer. Nervous pathway of visual analyzer.
The structure of the eyeball. The structure of the retina
Lacrimal apparatus Muscles of the eye
Nervous pathway of the visual analyzer.
B. Choose the correct answer. 1. To the ophthalmologist the woman with complaints to sight deterioration has addressed. At inspection the diagnosis has been established: a coloboma (a slitlike foramen at one of the eyeball structures). What of structures is involved? A.Iris B.Corpus vitreum C.Lens D.Cornea E.Corpus ciliare 2. To the oculist the patient of pension age has addressed. After the carried investigation the glaucoma (ophthalmotonus rising) is diagnosed. The cause of it is deterioration of outflow of fluid from an eye anterior chamber. What structure does not carry out function inherent in it? A. Subchoroidal space B. Slit spaces iridokorneal angle C. Vitreous body. D. Pupil E. Perichoroidal space 3. The patient of 45 years old, has addressed to the doctor with complaints to possibility loss to distinguish colours that has appeared after the tolerated electrical trauma. After survey of a retina of an eye lesions of receptors which are responsible for this kind of sensitivity are found. What it for receptors? A. Bipolar cells B. The rods C. The cones D. Amacrine cells E. Horizontal cells 4. The patient of 52 years old, complains of a pain of eyeballs. At survey ophthalmotonus rising is found. Disturbance of outflow of what fluid has provoked the given state? A. Lymph B. Endolimph C. Perilymph D. Aqueous humor E. Tears 5. The patient had a steady expansion of the pupil after application of drops which contain atropine. Name muscle which does not work? A. The dilator pupillae B. The superior rectus C. The ciliary muscle D. The medial rectus E. The sphincter pupillae 6. In the patient with rupture of a. carotis interna in the cavernous sinus is observed pulsating exophthalmos (sync pulse), blowing noise is listened (in the eyeball), expansion orbit fissure. Which pair of cranial nerves that pass in sinus cavernosus with damaged vessel, hematoma compressed? A. III, IV, VI, I branch of the V. B. II, IV, I branch of the V. C. IV, VI, a branch of the V. D. VI. E. VII. 7. A patient with epidemic encephalitis has uni- or bilateral ptosis (blepharoptosis), divergent strabismus (squint), accomodation disorder, dilation pupil (mydriatic pupils). The nuclei of what pair of cranial nerves have been affected? A IV B III C I branch of the V. D VI. E VII. 8. In patients with epidemic encephalitis observed one-or two-sided ptosis (drooping eyelids), strabismus divergent, disturbance of accommodation. The pupils were dilated. Nuclei which pair of cranial nerves affected? A V B IV. C III. D VI. E VII. 9. The patient turned to the eye doctor with complaints of ptosis. The examination was diagnosed with brain tumors. The core of a pair of cranial nerves affected pathological process? A VII B II C IV D III E VI 10. A patient has appealed with complaints of visual impairment accompanied by blepharoptosis, impossibility to lift the eyeball upwards and to the middle. Examination has shown that the eyeball is diverted outside, the pupil is dilated, does not react to light, the patient can′t see at a short distance. Which nerve has been injured? A n. abducens dexter B n. trochlearis C n. opticus D n. abducens sinister E n. oculomotorius 11. At the man, 40 years old, after cranial trauma are observed loss of sight of both right half of retina. Eyes without a pathology. Where damage can be found? A. At the end of the cortical visual center on the right B. At the end of the cortical visual center on the left C. In the optic chiasm D. In the optic nerve E. In the optic tract 12. At what damage of part of the conductive pathway of the visual analyzer absence of lateral fields of vision is found? A. The left optic tract B. The optic chiasm C. The right optic tract D. The right optic nerve E. The left optic nerve 13. To the child of 2th years the diagnosis is established: a converging squint. What muscles of an eyeball are damaged? A. The superior oblique B. The superior rectus C. The lateral rectus D. The inferior rectus E. The medial rectus 14. Owing to a trauma at the patient different diameter of pupils (anisocoria) is observed. Activity of what muscle is blocked? A. M. rectus superior B. M. rectus inferior C. M. ciliaris D. M. sphinter pupillae E. M. rectus lateralis 15. The patient, 50 years old, began to complain of blurred vision at close range. Fibres what muscle have started worse work? A. Skeletal muscle of the eye. B. Circular fibers of ciliary muscle. C. Radial fibers of the iris. D. Circular fibers of the iris. E. Meridional fibers of ciliary muscle. 16. The patient, 15 years old, complains on strong a headache, a pain in eyes, blurred letters while reading after a long work at close range. The lesion of what muscle of an eye takes place in this case? A. M. sphinter pupillae B. The superior oblique muscle C. The medial rectus muscle D. The inferior oblique muscle E. The superior rectus muscle 17. Patient C, 53 years old, diagnosed a pituitary body tumor. The examination revealed loss of sight in the medial half of both eyes. What area of the visual pathway is affected? A. Retina B. The medial part of the optic chiasm C. The optic tract D. The optic nerve E. Cornea 18. In the patient with glaucoma there is increasing ocular pressure in normal aqueous humor secretion by ciliary body. The cause of it is deterioration of outflow of fluid from an eye anterior chamber. What structure does not carry out function inherent in it? A. Choroid B. The lens C. Scleral venous sinus D. The retina E. The ciliary muscle 19. In patients with epidemic encephalitis observed one-or two-sided ptosis (drooping eyelids), strabismus divergent, disturbance of accommodation. The pupils were dilated. Nuclei which pairs of cranial nerves affected? A. V B. IV. C. VI. D. III. E. VII. 20. Young mother has addressed to the doctor with the complaint to absence of lacrimation during crying at the child age of 2 weeks. When does the lacrimal gland start to work for children? A. Immediately after birth B. With 2 months of life C. With 6 months of age D. From 8 weeks of life E. From 3 weeks of life
Topic 33,34. General characteristic of organ for hearing. External and middle ears. Bones of middle ear, tympanic cavity, its walls. Internal ear. Periotic and otic labyrinths. The eights pair of cranial nervous.
General structure of the ear. External ear Auditory ossicles Bony labyrinth
Membranous labyrinth Cochlea
Nervous pathway of the hearing analyzer Nervous pathway of the equilibrium B. Choose the correct answer. 1. In the рatient was diagnosed mesootitis (inflammation of the mucousa of the middle ear). This morbid condition was complicated with mastoiditis (inflammation of the mucousa of the mastoid process). On which wall of the tympanic cavity are holes that connect the tympanic cavity and cells of the mastoid process? A. Posterior wall B. Medial wall C. Lateral wall D. Upper wall E. Anterior wall 2. In the the child was found signs of meningitis (inflammation of the dura mater) which appeared after suffering of the boy from a purulent otitis (inflammation of the inner ear). Through which way infection could spread in the dura mater? A. Utriculosaccular duct B. Endolymphatic duct C. Aqueductus cochleae D. Oval window E. Round window 3. In the patient is observed the smoke from the ear while he is smoking out. What is the structure of the organ of hearing was damaged? A. The cochlea B. The vestibule C. The tympanic membrane D. The auditory ossicles E. The Eustachian tube 4. Boy 4 years old often suffer from pneumonias. As a result - he has enlarging tonsils, which close pharyngeal opening of auditory tube. The auditory tube connects the cavity of the pharynx with: A. With the larynx B. With an inner ear C. With the nasal cavity D. With the middle ear E. With the oral cavity 5. At the patient the deсrease of the acuteness of the hearing is observed. What anatomical structure does not participate in carrying out of mechanical vibrations of the organ of Corti (spiral organ)? A. The cochlea B. The vestibule C. The tympanic membrane D. The auditory ossicles E. The Eustachian tube 6. To the doctor the woman, 54 years old, with complaints to giddiness, a nausea, disturbance of balance after falling and a head injury has addressed. Disturbance of function of what structure of the internal ear is more probable? A. Bony labyrinth B. The auditory tube C. The tympanic cavity D. Tympanic membrane E. The malleus 7. The child, 7 years, often is ill acute respiratory diseases. At survey substantial growth of a pharyngeal tonsil that occludes a pharyngeal foramen of the tuba auditiva is taped. It has led to the decrease of acoustical sensitivity at the child. On what wall of the tympanic cavity does the auditory tube open? A. Paries jugularis B. Paries caroticus C. Paries labyrinthicus. D. Paries mastoideus. E. Paries tegmentalis. 8. The patient, 18 years old, has addressed to hospital with complaints of noise painful sensations in the ear. At objective inspection at the patient acute respiratory disease, a rhinitis has been found. Through what foramen in the pharynx the infection contamination has got to the tempanic cavity and has entailed its inflammation? A. Choanae B. Tympanic opening of auditory tube C. Pharyngeal opening of auditory tube D. The mouth E. Entrance to the larynx 9. The diagnosis the mastoiditis is put to the patient. Specify a probable source of the diffusion of the pyoinflammatory process in mastoid alveoles. A. The tensor tympani muscle B. The auditory tube C. Tympanic membrane D. The tympanic cavity E. The stapedius muscle 10. At the child, 2 years old, after the tolerated flu have appeared complaints to a pain in an ear. The doctor has found the deсrease of hearing and the inflammation of the mucous of the middle ear. How the infection contamination has got to a middle ear? A. Due to the auditory tube B. A foramen jugularis. C. A canalis caroticus. D. After atrium mastoideum. E. A canalis nasolacrimalis. 11. The boy, 4 years old, often is ill acute respiratory virus diseases. Owing to what at it the tubal tonsil is strongly enlarged and occludes a pharyngeal foramen of the auditory tube. With what anatomical formation does the auditory tube connect a pharyngeal cavity? A. With larynx B. With the middle ear C. With the external ear D. With the inner ear E. With oral cavity 12. At a purulent otitis the upper wall of the tympanic cavity was blasted by pus . In what cranial fossa can pus extend from the tympanic cavity ? A. In the posterior cranial fossa B. In the anterior cranial fossa C. In the middle fossa D. In the eyeball E. In the pterygopalatine fossa 13. In patients with acute tonsillitis complicated by otitis (the inflammation of the mucous of the middle ear). What are the anatomical prerequisites exist for this? A. Pharyngeal lymphoid ring of Pirogov B. Fallopian tube C. Defects of the pharynx D. Eustachian tube E. Tympanic membrane 14. At the patient the inflammation of the mucous of the middle ear has become complicated a mastoiditis. Further threat of a purulent clottage of a near venous sinus was found. Name this venous sinus. A. Lower petrosal B. Upper sagittal C. Transverse D. Rectus E. Sigmoid