Chapter·AnatomyHead & Neck

Skull and cranial cavityDownloads

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1

During an examination of the cranial nerves, a patient shows inability to move their eye laterally past the midline. Which of the following structures in the cavernous sinus is most likely affected?

AOculomotor nerve

BTrochlear nerve

COphthalmic nerve

DAbducens nerve

2

A 28-year-old man is brought to the emergency department by ambulance after developing an altered mental state following blunt trauma to the head. The patient was competing at a local mixed martial arts competition when he was struck in the head and lost consciousness. A few minutes later, upon regaining consciousness, he had a progressive decline in mental status. Past medical history is noncontributory. Upon arrival at the hospital, the temperature is 37.0°C (98.6°F), the blood pressure is 145/89 mm Hg, the pulse is 66/min, the respiratory rate is 14/min, and the oxygen saturation is 99% on room air. He is alert now. A noncontrast CT scan is performed, and the result is provided in the image. Which of the following structures is most likely affected in this patient?

ASubarachnoid space

BSuprasellar cistern

CMiddle Meningeal artery

DVentricular system

EBridging veins

3

A 7-year-old boy is brought to the emergency department by his mother 1 hour after falling off his bike and landing head-first on the pavement. His mother says that he did not lose consciousness but has been agitated and complaining about a headache since the event. He has no history of serious illness and takes no medications. His temperature is 37.1°C (98.7°F), pulse is 115/min, respirations are 20/min, and blood pressure is 100/65 mm Hg. There is a large bruise on the anterior scalp. Examination, including neurologic examination, shows no other abnormalities. A noncontrast CT scan of the head shows a non-depressed linear skull fracture with a 2-mm separation. Which of the following is the most appropriate next step in management?

AInpatient observation

BContact child protective services

CCT angiography

DDischarge home

EMRI of the brain

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