Head and neck: vertebral artery in the suboccipital triangle: 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 · Head and neck: vertebral artery in the suboccipital triangle

Sample item

A young woman develops vertigo, ataxia and visual disturbance soon after vigorous neck rotation. Which part of the vertebral artery, lying in a groove on the posterior arch of the atlas, is the most vulnerable to stretch in this movement?

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

The answer and the reasoning

B. Third (suboccipital) part

The third part of the vertebral artery winds around the lateral mass of the atlas and lies in the groove on the posterior arch before piercing the dura. It is stretched and kinked in extreme rotation and extension, and dissection here can cause posterior circulation stroke.

Option by option

  • A. Fourth (intracranial) part

    This part lies in the cranial cavity after piercing the dura and is not exposed to neck rotation.

  • B. Third (suboccipital) part (correct)

    Correct. This part lies in the groove on the posterior arch of the atlas and is exposed to rotational stretch.

  • C. Second (foraminal) part

    This part passes within the transverse foramina of C6 to C2 and is protected by bony canals.

  • D. First (prevertebral) part

    This part runs from the subclavian artery to C6, in front of the transverse process, and is not related to atlas rotation.

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.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is B, Third (suboccipital) part. The third part of the vertebral artery winds around the lateral mass of the atlas and lies in the groove on the posterior arch before piercing the dura.

Why is "Fourth (intracranial) part" not the answer?

This part lies in the cranial cavity after piercing the dura and is not exposed to neck rotation.

Why is "Second (foraminal) part" not the answer?

This part passes within the transverse foramina of C6 to C2 and is protected by bony canals.

Why is "First (prevertebral) part" not the answer?

This part runs from the subclavian artery to C6, in front of the transverse process, and is not related to atlas rotation.

What concept does this question test?

It tests Head and neck: vertebral artery in the suboccipital triangle in Anatomy. It is stretched and kinked in extreme rotation and extension, and dissection here can cause posterior circulation stroke.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Head and neck: vertebral artery in the suboccipital triangle?

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.