1. Which of the following is incorrect in regard to cerebrospinal fluid?

 A.  It is normally clear and colorless.
 B.  Increased glucose concentration is usually meaningless.
 C.  Normal concentration of lymphocytes is approximately 100/mm3.
 D.  Normal specific gravity is approximately 1.007.
 E.  Normal pressure is approximately 160 mm. H2O cerebrospinal fluid.

2. All of the following may result in herniation of the brain resulting in brainstem compression except:

 A.  Cerebral edema.
 B.  Subdural hematoma.
 C.  Subarachnoid hemorrhage.
 D.  Extradural hematoma.
 E.  Arteriovenous malformation.  

3. All of the following are true of the meninges except:

 A.  The blood supply for the dura is the anterior, middle and posterior meningeal arteries.
 B.  The blood supply for the arachnoid is the circumferential branches of arteries.
 C.  The term used to denote the dura is pachymeninx.
 D.  Nerve supply is primarily from the trigeminal (V)
 E.  One of the most important anastomatic channels of cerebral circulation is with the opthalamic
            via the meningeal arteries.

4.  Which of the following structures is relatively unimportant in regard to CSF circulation?

 A.  Cerebral aqueduct of Sylvius.
 B.  Foramen of Monro.
 C.  Central canal.
 D.  Paccionian bodies.
 E.  Vascular pulsations.

5. An example of the blood-brain barrier would be:

 A.  The increased bilirubin seen in children with Rh negative incompatibility.
 B.  The ease at which brain infections are treated with antibiotics.
 C. The lack of diffusion into the brain parenchyma after injection of tryphan blue dye intraventricularly.
 D.  The lack of diffusion into the choroid plexus after injection of tryphan blue I.V.
 E. The lack of diffusion into the brain parenchyma after injection of tryphan blue dye I.V.

6.  Which of the following is associated with the meningeal cisterns:

 A.  Cisterna Magna.
 B.  Lumbar cistern.
 C.  Arachnoid villi.
 D.  Cavernous sinus.
 E.  Pacchionian granulation's.
	
7.  Which of the following is true about the meninges:

 A.  The brain is sensitive to pain due to free nerve plexuses in the pia.
 B.  The dura is innervated by VII nerve.
 C.  Arachnoid is avascular and innervated by the V nerve.
 D.  Produces approximately 10% of available CSF.

8.  In which of the following CSF compartments is the choroid plexus absent:

 A.  Lateral ventricles. 
 B.  Third ventricle.
 C. Cerebral aqueduct 
 D.  Fourth ventricle.
 E.  Present in all of the above.

9.  Which of the following is not associated with the cranial meninges:
	
 A.  Epidural space containing fats and veins.
 B.  Dura mater continuous with the periosteal layer.
 C.  Venous sinuses.
 D.  Pia mater containing blood vessels.
 E.  Arachnoid villi.

10.  The most important change in CSF that is indicative of pathology is:

 A.  Increased Cl- level.
 B.  Increased K +level.
 C.  Increased protein.
 D.  Increased viscosity.

11. Which of the following statements regarding the CSF system is true?

 A.  The lateral ventricles produce A. 50% of the total CSF.
 B.  The normal CSF is clear, amber colored and has an odor of walnuts.
 C.  The normal CSF pressure is approximately 40 mm Hg.
 D.  The major difference between CSF and plasma is the small amount of protein, sugar, 
            and potassium.

12.  A technique in which air is injected into the lumbar subarachnoid space so that the cerebral ventricles 
       can be studied is:

 A.  CAT scan.
 B.  Ventriculography.
 C.  Myelography.
 D.  Pneumoencephalography.
 E.  Electroencephalopathy.

13. You inject tryphan blue into the patient's ventricle and observe that the CSF turns blue but the brain 
      tissue does not. This represents an example of:

 A.  Blood-brain barrier.
 B.  Blood-CSF barrier.
 C.  CSF-brain barrier.
 D.  CSF-blood barrier.
 E.  Blood-blood barrier.

14. All of the following are considered circumventricular organs except:

 A.  Anterior pituitary.
 B. Supraoptic Crest of Lamina terminalis.
 C.  Area postrema.
 D.  Subfornical organ.
 E.  Subcommissural organ.

15. The CSF sample obtained during the lumbar tap would be considered pathological if:

 A.  The CSF was clear and colorless.
 B.  The CSF had a large amount of protein (200 mg.%).
 C.  The CSF had a small amount of sugar (65 mg %).
 D.  The CSF had a high amount of chloride (720 mg %).
 E.  The CSF had a small amount of potassium.

16. Which is not true of the meninges?

 A.  It is formed by pia, arachnoid, and dura mater.
 B.  It is innervated by the trigeminal and vagus nerve.
 C.  The vascular supply to the arachnoid is the middle meningeal artery.
 D.  The pia and arachnoid vary at certain positions to form cavities called cisterns.

17. Pachymeninx refers to:

 A.  The arachnoid.
 B.  The pia.
 C.  The dura.
 D.  The arachnoid and pia.
 E.  A meningeal abnormality.

18. A lumbar puncture:

 A.  Is a method to study carotid blood flow.
 B.  Is best demonstrated when the patient is standing up.
 C.  Is performed at the T12-Ll vertebral space.
 D.  Is a method to enable the study of the chemical composition of the CSF.
 E.  None of the above.

19. Which is not an important difference between cerebrospinal fluid and blood plasma?

 A.  It contains little protein.
 B.  It contains few cells.
 C.  It contains little glucose.
 D.  It is clear, colorless and odorless.
 E.  None of the above.