Neuroanatomy: Wernicke aphasia: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Neuroanatomy: Wernicke aphasia

Sample item

A 68-year-old man has fluent, well-articulated but meaningless speech with made-up words, and cannot follow commands. He has a right superior quadrantanopia but no limb weakness. Which vessel branch was occluded?

AInferior division of the left middle cerebral arteryBLeft anterior cerebral arteryCLeft posterior inferior cerebellar arteryDSuperior division of the left middle cerebral artery

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Inferior division of the left middle cerebral artery

Fluent aphasia with poor comprehension is Wernicke aphasia from damage to the posterior superior temporal gyrus, supplied by the inferior division of the dominant MCA. The optic radiation in the temporal lobe is often damaged as well, causing superior quadrantanopia. The superior division supplies the frontal lobe, so weakness is usually absent.

Option by option

A. Inferior division of the left middle cerebral artery (correct)
The inferior division of the MCA supplies the posterior temporal cortex including Wernicke area.
B. Left anterior cerebral artery
The anterior cerebral artery supplies the medial frontal and parietal lobes and causes leg weakness.
C. Left posterior inferior cerebellar artery
The posterior inferior cerebellar artery supplies the lateral medulla and the cerebellum, not the temporal lobe.
D. Superior division of the left middle cerebral artery
The superior division supplies the frontal lobe including Broca area and causes non-fluent aphasia with weakness.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is A, Inferior division of the left middle cerebral artery. Fluent aphasia with poor comprehension is Wernicke aphasia from damage to the posterior superior temporal gyrus, supplied by the inferior division of the dominant MCA.

Why is "Left anterior cerebral artery" not the answer?

The anterior cerebral artery supplies the medial frontal and parietal lobes and causes leg weakness.

Why is "Left posterior inferior cerebellar artery" not the answer?

The posterior inferior cerebellar artery supplies the lateral medulla and the cerebellum, not the temporal lobe.

Why is "Superior division of the left middle cerebral artery" not the answer?

The superior division supplies the frontal lobe including Broca area and causes non-fluent aphasia with weakness.

What concept does this question test?

It tests Neuroanatomy: Wernicke aphasia in Anatomy. The optic radiation in the temporal lobe is often damaged as well, causing superior quadrantanopia. The superior division supplies the frontal lobe, so weakness is usually absent.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroanatomy: Wernicke aphasia?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.