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Neuroanatomy > 473 MT 1 > Flashcards

473 MT 1 Flashcards

1
Q

diencephalon

A

thalamus and hypothalamus + associated structures

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2
Q

hindbrain

A

pons and cerebellum and medulla

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3
Q

ventral
dorsal
rostral
caudal

A 
ABOVE MIDBRAIN
toward earth=inferior
toward sky=superior
toward snout=anterior
toward tail=posterior
BELOW MIDBRAIN
anterior
posterior
superior
inferior
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4
Q

multipolar

bipolar

A

=multiple axons and dendrites

=1 axon and 1 dendrite arising from cell body

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5
Q

cauda equina

A

=collection of nerve roots where spinal chord ends

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6
Q

lower motor neuron symptoms

A

weakness, atrophy, fasciculations, hypotonia and hyporeflexia

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7
Q

upper MN symptoms

A 
"spastic paralysis"-motion starts and then gives way
weakness
hyperreflexia
hypertonicity-spasticity and rigidity
positive Babinski sign
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8
Q

somatotopic organization main points

A
  • foot and leg in midline, knee @ corner
  • next is trunk
  • then shoulder–>upper limb
  • neck, face, tongue
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9
Q

epi-

A

means above

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10
Q

what level of brainstem is cerebellum at?

A

pons

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11
Q

meninges in brain

A 
PAD (inside to outside)
pia 
arachnoid 
dura
-periosteal layer adheres to skull
-meningial layer fuses w/periosteal layer except where it extends to separate hemispheres or cortex from cerebellum
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12
Q

falx cerebri
tentorium cerebelli
where they meet

A

meningial layers of dura
separates two hemispheres
separates cerebellum and cerebrum
triangular notch called tentorial notch/incisura @ midbrain (which connects them all)

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13
Q

tentorial notch

A

=where falx cerebri and tentorium cerebelli meet and form an opening
-potential site of injury for midbrain (swelling or tumor could displace or damage it)

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14
Q

arachnoid granulations

A

arachnoid adheres to inner surface of dura

places where arachnoid mater bulges through dura

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15
Q

pia mater

A

adheres to surface of brain and follows gyri and sulci

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16
Q

potential spaces b/t meninges vs. actual space

A

epidural-skull and periosteal dura
sub-dural-meningial dura and arachnoid

sub-arachnoid space-b/t arachnoid and pia
-contains CSF

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17
Q

epidural hematoma

A
  • bleeding above dura: bulges into skull
  • lens shaped b/c of more anchored parts of dura
  • arterial bleed, fast spreading (heart pumping blood)
  • can cross midline
  • common b/c of middle meningeal artery being outside the dura and b/t two plates of thin skull
  • common w/temporal bone fracture
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18
Q

subdural hematoma

A
  • damage to bridging veins b/t arachnoid and meningeal dura (drain to dural sinuses)
  • commonly b/c of shear by acceleration of the brain
  • slow to develop
  • crescent shaped and more widely distributed-arachnoid less anchored to dura so it get’s pulled away more easily
  • does not cross midline b/c of falx cerebri
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19
Q

chronic bleeding in the brain?

A

looks darker on scans
older adults sometimes
bridging veins taught from aging and more easily sheared

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20
Q

subarachnoid hematoma

A
  • blood disperses into CSF from damaged arteries/veins w/in subarachnoid space and clogs arachnoid villi
  • –>pressure and herniation and death
  • commonly from aneurism or major trauma
  • blood can be seen in sulci
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21
Q

meninges in spinal chord

A
  • only meningeal layer of dura b/c periosteal fuses to periosteum as it passes through foramen magnum
  • pia wraps around spinal chord
  • epidural fat lies in b/t dura and periosteum in b/t ligaments that run along the bone
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22
Q

denticulate ligaments

A

ligaments that hold the spinal chord in space

connect pia to dura

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23
Q

filum terminale

A

lig that anchors spinal chord

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24
Q

CSF

A

made in choroid plexus

protection, buoyancy, nutrient and hormone transfer

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25
Q

foramen of munroe

A

-connects 3rd and lateral ventricles

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26
Q

foramen of luschka

A

2 lateral foramen coming out of 4th ventricle

-connects subaracnoid spaces of brain to 4th ventricle

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27
Q

cerebral aqueduct

A

connects 3rd and 4th ventricles

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28
Q

foramen of magendie

A

connects 4th ventricle to subarachnoid space of spinal chord

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29
Q

how much CSF is made/day

A

500 CCs-3x turnover since space holds 150 CCs

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30
Q

cistern magna

A

opening @ bottom of spinal chord

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31
Q

lumbar cista

A

space where vertebral column continues w/out spinal chord

-contains CSF and nerve roots (lumbar puncture

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32
Q

rexed’s laminae

A

=divisions of grey matter in spinal chord

-IX contains 2 regions of motor nuclei-medial and lateral

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33
Q

somatotopic organization of ventral horn

A

more proximal muscles are more medial

more distal are more lateral

34
Q

conus medullaris

A

end of spinal chord at L1/L2 vertebre

35
Q

cervical enlargement

lumbar enlargement

A

C3-T1

L1-S2

36
Q

where is there more white matter in the spinal chord?

A

higher up–all nerves projecting

37
Q

myotome

A

=the muscles innervated by a single spinal segment

38
Q

deltoid
biceps, brachioradialis, brachialis
triceps

A

C5, C6
C5, C6
C7

39
Q

hand muscles

A

C7, C8, T1

40
Q

wrist extenders

A

C6

41
Q

chest muscles

A

T2-T8

42
Q

abdominal muscles

A

T7-T12

43
Q

leg muscles

A

L1-L5
knee extensors L4
dorsiflexors L5
plantar flexors S1

44
Q

bowel, bladdar muscles

A

sacral nerves

45
Q

paresis

A

weakness but some preserved function

46
Q

characteristics of high steppage gait

A
  1. excessive flexion of knee on ipsilateral side
  2. lack of ankle dorsiflexion on ipsilateral side
  3. foot lands toe first

ie damage to L5 (dorsiflexors)

47
Q

what causes fasciculations?

A

denervation causes hypersensitivity in the muscle b/c it’s not receiving input and causes individual fibers to fire in response to other things
-at muscle level

48
Q

why does lower MN damage result in atrophy?

A

b/c they provide trophic factors for life and growth

49
Q

what is a normal reflex?

A

2 (1 is dec, 0 is absent)

4 and 5 are abnormal clonus

50
Q

hypotonia

A

tonic activity decreased

-seen in less resistance to passive at endpoints of a joint’s range of motion

51
Q

hypertonia

A

more resistance in middle of passive movement

52
Q

3 places lower MN’s can be effected

A

damage to any of the 3 areas:

  • motor nuclei in anterior horn gray matter of spinal chord
  • ventral nerve roots (called radiculopathy)
  • spinal nerves
53
Q

poliomyelitis

A
  • attacks anterior horn motor neurons

- mostly lumbar and sacral, sometimes involves thoracic which can affect breathing

54
Q

what would you expect if there was spinal chord damage involving the anterior horn?
how would this have happened?

A

lower MN symptoms in muscles innervated by axons AT that level
upper MN symptoms in muscles innervated by levels below the injury
-spinal chord lesion
-disk herniation
-tumor

55
Q

what exception to the effect of disk herniation for lumbar disk exists?

A
  • it can compress that level and the one below it
  • the intervertebral foremen is big enough in this region that it can also impinge on nerve below
  • more central will affect more nerves travelling farther down
56
Q

mechanisms of injury for ventral and spinal roots

A

compression, traction, laceration, or entrapment

57
Q

corticospinal tract

A

upper motor neuron in precentral gyrus in primary motor cortex, axon decussates @ pyramids in medulla and continues to it’s spinal level
lower MN synapses in anterior horn of spinal chord
-directly or indirectly (through interneurons)

58
Q

cortico-spinal tracts as they travel through brain

A

fan-like projection fibers in the cortex=CORONA RADIATA
as they converge near the thalamus=INTERNAL CAPSULE
at the midbrain level=BASIS PEDUNCULI
at the anterior medulla=PYRAMIDS
where they cross at cervical medullary junction=PYRAMIDAL DECUSSATION

59
Q

internal capsule

A

V shape w/point at midline

  • anterior limb and posterior limb (on each L and R side)
  • posterior limb contains upper motor neurons from cortex (ie corticospinal tract)
  • genu=where they meet
60
Q

how many cortico-spinal tracts do we have?

A

lateral-85%
anterior-15%
-each in the columns named after them

61
Q

lateral corticospinal tracts

A

-primarily distal (hand and feet) muscles (contra-lateral side)
-terminate at all levels of the spinal chord, cervical and lumbro-sacral enlargements primarily
called pyramidal tract also

62
Q

where do lateral corticospinal upper motor neurons synapse?

A

they enter the anterior horn at the level of the spinal chord they will innervate and synapse w/interneurons in grey matter
-more laterally (they control distal muscles primarily)

63
Q

anterior cortico-spinal tracts

A
  • primarily axial muscles (neck and trunk)
  • MAY divide and cross at the spinal level (anterior commissure), some don’t
  • ie fibers do not decussate, some bifurcate and cross
  • controls muscles bilaterally
  • terminate in cervical and upper thoracic spinal chord
64
Q

cortico-bulbar tract

A

UMN: facial region of cortex to nuclei in pons
LMN: in pons (lower motor nuclei called facial nuclei extends as CNVII facial nerve)

65
Q

how are facial muscles controlled?

A

CN VII travels ipsi-laterally to muscles

  • UMNs travel bilaterally for muscles above eyes
  • UMNs travel contra-laterally to CN VII for muscles below eyes
66
Q

what is bell’s palsy?

A
  • inflammation of the facial nerve
  • affects muscles on entire side of face on ipsilateral side of inflammation
  • RARELY inflammation occurs bilaterally
  • inability to close the eye, taste is affected, etc.
  • full recovery takes 3-6 mo and people sometimes have persistent symptoms
67
Q

what is the somatotopic organization at the midbrain level/basis pedunculi?

A

face is medial, then arm, then trunk, leg is lateral

-(after 2 90 degree turns)

68
Q

what is the somatotopic organization of the internal capsule?

A

face forward (after 90 degree turn), posterior is legs

69
Q

rubrospinal tract

A

from red nucleus (midbrain) to spinal chord in lateral column

  • decussation at midbrain level
  • terminate in cervical chord
  • contralaterally controls limbs: facillatates flexor muscle tone and inhibits extensor muscle tone (limited voluntary control)
70
Q

reticulospinal tract

A

reticular formation (throughout brainstem) to spinal chord in ventral column

  • does not decussate
  • balance, startle reflex, general muscle tone
71
Q

vestibulospinal tract

A

from 4 vestibular nuclei (pons and medulla) to spinal chord
lateral vestibular nuclei: to distal limbs on ipsilateral side
-facillatates extensor muscle tone
medial and inferior: to mostly axial muscles on both sides
-bilaterally controls vestibular reflexes
-NO decussation

72
Q

tectospinal tract

A

from superior colliculus (midbrain) to spinal chord

-for coordination of hand/eye movements

73
Q

where can upper MNs be injured?

A

-in the upper motor nuclei in the motor cortex
-in axons descending through brain, brainstem, or spinal chord
ie, ipsilateral lesion @ spinal level or contra-lateral at cortical level will affect distal muscles on that side

74
Q

how does type of tone help identify location?

A
  • de-corticate posture-lesion above midbrain
  • involves rubrospinal tract
  • flexion of contralateral hand and extension of leg
  • de-cerebrate posture-lesion is below midbrain
  • involves vestibulo-spinal tract
75
Q

babinski reflex

A

dorsiflextion of big toe and fanning=positive sign

=injury to corticospinal tract

76
Q

hemiplegic gait is typical of what injury?

A

UMN lesion

  • flexion of contralateral arm and extension of leg
  • leg, knee, and ankle extended throughout walking
  • leg swings through w/hip hiking and then circumduction and arm is held flexed
77
Q

causes of UMN lesions

A
  • injury to cortex (stroke, tumor, trauma)
  • damage to internal capsule or cerebral peduncles (hemiplegic type injury b/c axons for all regions travel together)
  • spinal chord lesion or compression (lateral column) (symptoms on ipsilateral side)
  • diseases attacking UMNs
78
Q

which side would you expect symptoms on if there was damage to the internal capsule?

A

contra-lateral

whole side

79
Q

what type of spinal chord injuries cause upper and lower motor neuron damage?
where do the symptoms occur?

A
  • if just lateral part is damaged, upper motor neurons are affected below that level
  • if it extends into grey matter, there are lower motor neuron symptoms for that level
80
Q

PLS

A
  • unknown origin
  • degeneration of UMN’s (UMN symptoms)
  • progressive (from legs up) but not fatal
81
Q

ALS

A

lou Gehrig’s disease
UMN and LMN degeneration
-unknown origin, potentially genetic
-fatal in 2-4 years, affects breathing, swallowing, speaking

Neuroanatomy (3 decks)

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