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Anatomy Flashcards

1-53 Anatomy of Orbital Contents 54-90 Visual Pathway 91-156 Structure of Eyeball 157-241 The Limbic System and Hypothalamus 242-318 Anatomy of the Thalamus 319-349 Anatomy of the Basal Ganglia 350-396 Meninges and Ventricle of the Brain 397-466 Anatomy of the Cerebellum 467-519 Blood Supply of the Brain 520-617 Organization of Cerebrum I

1
Q

What bones contribute in forming the orbital margin?

A

Frontal
Maxillary
Zygomatic

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2
Q

What structures make up the roof of the orbital cavity?

A

Frontal bone
Lesser wing of sphenoid bone

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3
Q

What structures make up the lateral walls of the orbital cavity?

A

Zygomatic bone
Greater wing of sphenoid bone

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4
Q

What structures make up the medial wall of the orbital cavity?

A

Frontal process of maxilla
Lacrimal bone
Orbital plate of ethmoid bone

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5
Q

What structures make up the floor of the orbital cavity?

A

Zygomatic bone
Maxillary bone
Palatine bone

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6
Q

Where is the supraorbital notch found?

A

On the frontal bone, on the roof of orbital cavity

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7
Q

What is the superior orbital fissure?

A

Bony aperture that allows communication between cavernous sinus and the apex of the orbit

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8
Q

What structures pass through the Superior orbital fissure?

A

CN III [oculomotor nerve]
CN IV [trochlear nerve]
CN V [trigeminal nerve]
CN VI [abducens nerve]
Superior ophthalmic vein

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9
Q

What foramen is found on the medial wall?

A

Anterior ethmoidal foramina
Posterior ethmoidal foramina
Lacrimal groove

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10
Q

What foramen is found on the floor of the orbital cavity?

A

Infraorbital groove
Infraorbital foramen
Inferior Orbital fissure

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11
Q

What structures form the fibrous skeleton of the eyelid?

A

Tarsal plate
Orbital septum
Canthus medial ligament
Canthus lateral ligament

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12
Q

Describe the structure of the periorbital fascia

A

Posteriorly continuous with periosteum lining the interior of the skull / endosteal layer of the dura mater
Anteriorly continuous with periosteum covering external surface of skull

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13
Q

What is bulbar conjunctiva?

A

Thin, moist transparent membrane covering the cornea

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14
Q

Describe the structure of the bulbar conjunctiva

A

Reflects posterior surface of eyelid, forming palperbra conjunctiva

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15
Q

What does the palperbra conjunctiva form?

A

Superior and inferior fornices

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16
Q

What covers the inner surface of the eyelids?

A

Palpebral conjunctiva

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17
Q

What structure reinforces the eyelid

A

orbicularis oculi

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18
Q

What structures make up the lacrimal apparatus?

A

Lacrimal punctum
Lacrimal canaliculus
Lacrimal sac
Nasolacrimal duct
Inferior nasal meatus

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19
Q

What is the origin of the levator palpebra superioris?

A

Lesser wing of sphenoid bone

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20
Q

What is the insertion of the levator palpebra superioris?

A

Skin of upper eyelid

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21
Q

What is the innervation of the levator palpebra superioris?

A

Superior branch of oculomotor nerve
Sympathetic fibers [innervates smooth muscle portion]

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22
Q

What is the origin of Muller’s muscle?

A

Superior tarsal plate

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23
Q

What muscles are implicated in ptosis and why?

A

Dysfunction of the muscles or their nerve supplies
Levator palpebrae superioris
Muller’s [superior tarsal] muscle

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24
Q

What is the origin of the recti muscles?

A

Common tendinous ring, at the junction of the superior and inferior orbital fissure

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25
Q

What is the insertion of recti muscles?

A

Posterior to corneal-sclera junctions

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26
Q

What nerve innervates the recti muscles

A

All supplied by oculomotor
[Except lateral rectus is innervated by abducens nerve]

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27
Q

What is the origin of the superior oblique muscle?

A

Body of sphenoid body

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28
Q

What is the origin of the inferior oblique muscle?

A

Maxilla

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29
Q

What is the insertion of the superior oblique muscle?

A

sclera at posterosuperior aspect of the lateral side of the orbit

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30
Q

What is the insertion of the inferior oblique muscle?

A

Sclera at the posteroinferior aspect of the lateral side of the orbit

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31
Q

What nerve innervates the superior oblique muscle?

A

Trochlear nerve

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32
Q

What nerve innervates the inferior oblique muscle?

A

Oculomotor nerve

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33
Q

What are the actions of the Superior oblique muscle?

A

Abduction, depression and Intorsion

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34
Q

What are the actions of the Inferior oblique muscle?

A

Abduction, elevation, and extorsion

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35
Q

What are the actions of the inferior rectus muscle?

A

Adduction, depression and extorsion

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36
Q

What are the actions of the superior rectus muscle?

A

Adduction, elevation and intorsion

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37
Q

What muscles elevate and depress the eyes as it’s in an adducted position?

A

Elevates: Inferior oblique
Depresses: Superior oblique

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38
Q

What is the course of the ophthalmic artery?

A

1st branch of the ICA as it emerges from the cavernous sinus

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39
Q

What are the branches of the ophthalmic artery?

A

Central artery of retina
Ciliaries arteries
Lacrimal artery
Muscular arteries
5 terminal branches:
[Supraorbital
Supratrochlear
Dorsal nasal
Anterior ethmoidal artery
Posterior ethmoidal artery]

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40
Q

Describe the course of the superior ophthalmic vein

A

Anastomoses with facial vein, exits through superior orbital fissure and ends in cavernous sinus

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41
Q

Describe the course of the inferior ophthalmic vein

A

Starts as plexus on orbital floor, communicates with pterygoid plexus through the inferior orbital fissure and ends in:
[Superior ophthalmic vein
Cavernous sinus ]

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42
Q

Describe the course of the central vein

A

Enters cavernous sinus or joins ophthalmic veins

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43
Q

What are the branches of the ophthalmic division?

A

Frontal nerve
Lacrimal nerve
Nasociliary nerve

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44
Q

What are the divisions of the frontal nerve?

A

Supratrochlear nerve
Supraorbital nerve

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45
Q

What does the lacrimal nerve innervate?

A

Sensory innervation to lacrimal gland
Cutaneous innervation to superior eyelid

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46
Q

What are the branches of the nasociliary nerves?

A

Anterior ethmoidal
Posterior ethmoidal
Long ciliary nerve
Infratrochlear nerve

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47
Q

What does the long ciliary nerve innervate?

A

Sensory innervation to eyeball
Sympathetic innervation to dilator pupillae muscle

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48
Q

What does the nasociliary nerve innervate?

A

Sensory root to ciliary ganglion (sympathetic fibers)

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49
Q

What are the two divisions of the oculomotor nerves?

A

Superior division
Inferior division

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50
Q

What does the superior division of the oculomotor nerve innervate?

A

Superior rectus muscle
Levator palpebrae superioris muscle

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51
Q

What does the inferior division of the oculomotor nerve innervate?

A

Sphincter pupillae
Inferior rectus muscle
Medial rectus muscle
Inferior oblique muscle

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52
Q

What does the trochlear nerve innervate?

A

Superior oblique muscle

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53
Q

What does the abducens nerve innervate?

A

Lateral rectus muscle

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54
Q

What forms the optic nerve?

A

Axons of ganglion cells in ganglionic layers of retina

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55
Q

Pathway of optic nerve?

A

Leave orbital cavity through optic canal and unites with the contralateral optic nerve to form optic chiasma

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56
Q

Where is the optic chiasma located?

A

Junction of anterior wall and floor of 3rd ventricle

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57
Q

What structures pass through the optic chiasma?

A

Nasal half of each retina crosses in the optic chiasma, entering the optic tract of the opposite side. Temporal half passes posteriorly directly

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58
Q

Pathway of Optic tract?

A

Passes posterolaterally around cerebral peduncle, terminate by synapsing with LGB

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59
Q

What forms the optic radiation?

A

Fibers of the radiation are axons of nerve cells of LGB

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60
Q

Pathway of Optic radiation?

A

Passes posteriorly through retrolenticular part of the internal capsule and terminates at the visual cortex

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61
Q

What is Area 17?

A

Primary Visual Cortex

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62
Q

What areas form the visual association area?

A

Area 18
Area 19

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63
Q

What is the function of the visual association cortex?

A

Recognition of objects and perception

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64
Q

What structures does the retinal ganglion cells project into?

A

LGB
Hypothalamus
Prectum
Superior colliculus

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65
Q

What layers of the LGB does the nasal field project to?

A

Layer 2, 3, 5

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66
Q

What visual information contributes to depth perception?

A

Images are upside down

Information from one half of the visual field is directed to opposite side of brai

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67
Q

What is the importance of the LGN in visual processing?

A

Principal subcortical site for processing visual information

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68
Q

What layers of the LGN make up the magnocellular layers?

A

Layer 1
Layer 2

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69
Q

What layers of the LGN make up the parvocellular layers?

A

Layer 3 - 6

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70
Q

Where does the LGN project to?

A

Primary Visual cortex [Area 17]

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71
Q

What is Meyer’s loop?

A

Fibers representing inferior retina loop into temporal lobe before turning posteriorly

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72
Q

Where is the primary visual cortex located?

A

Around calcarine sulcus in occipital lobe

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73
Q

Describe the representation of visual fields in visual cortex

A

Inferior field → above calcarine sulcus
Superior field → below calcarine sulcus
Fovea → represented posteriorly and much larger than peripheral representation
Peripheral → more anteriorly and smaller than fovea representation

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74
Q

What is the afferent limb of pupillary light reflex?

A

Optic Nerve

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75
Q

What is the efferent limb of the pupillary light reflex?

A

Oculomotor nerve

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76
Q

Pathway of Pupillary Light Reflex?

A

AL: Retina → Optic nerve → bilateral projection to ipsilateral pretectal nucleus of the midbrain

EL: Ipsilateral Pretectal nucleus → crossed and uncrossed fibers to Edinger-Westphal Nucleus → preganglionic parasympathetic fibers to ciliary ganglion → postganglionic parasympathetic fibers → ciliary sphincter

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77
Q

Lesion of the left optic nerve will result in?

A

Loss of pupillary reflex in both eyes

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78
Q

Lesion of the left oculomotor nerve will result in?

A

Loss of pupillary reflex in left eye

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79
Q

What is the afferent limb of the corneal reflex?

A

Ophthalmic division of Trigeminal nerve

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80
Q

What is the efferent limb of the corneal reflex?

A

Facial nerve

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81
Q

Lesion of the ophthalmic division of trigeminal nerve will result in?

A

Bilateral absence of blinking response

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82
Q

Lesion of the Facial nerve will result in?

A

Absent blinking on affected side

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83
Q

Describe the visual body reflex

A

Optic nerve → superior colliculus → Tectospinal + Tectobulbar → anterior gray columns of motor nuclei of SC and CN

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84
Q

What produces complete blindness in one eye?

A

Optic nerve lesion

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85
Q

What produces bitemporal hemianopia?

A

Lesion in optic chiasma
Pituitary tumor

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86
Q

What produces nasal hemianopia?

A

Outer optic tract lesion
ICA thrombus

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87
Q

What produces Homonymous Hemianopia?

A

Optic tract lesion

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88
Q

What produces superior quadrantanopia?

A

Meyer’s loop lesion
Contralateral temporal lesion

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89
Q

What produces inferior quadrantanopia?

A

Dorsal optic radiation lesion
Contralateral parietal lesion

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90
Q

What produces right hemianopia with macular sparing?

A

PCA infarcts

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91
Q

What are the three layers of the eye?

A

Fibrous layer
Vascular layer
Inner Layer of eyeball

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92
Q

What forms the fibrous layer of the eye?

A

Sclera
Cornea

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93
Q

What forms the vascular layer of the eye?

A

Choroid
Ciliary body
Iris

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94
Q

What forms the neural layer of the eye?

A

Retina

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95
Q

What are the functions of the fibrous layer of the eye?

A

External fibrous skeleton that provides shape and resistance

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96
Q

What is the sclera? Its function?

A

Opaque part of fibrous coat, covering posterior ⅚ of eyeball

Provides attachment for extrinsic and intrinsic muscles of the eye

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97
Q

What is conjunctiva?

A

Membrane that covers the eye and lines the inner surface of the eyelid

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98
Q

What is the function of the conjunctiva?

A

Lubricates the eye by secreting mucous and tear

Protective barrier against microbes

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99
Q

Describe the structure of the cornea

A

Stratified corneal epithelium
Bowman’s membrane
Stroma
Endothelium

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100
Q

Describe the stroma of the cornea

A

Avascular
Rich in collagen fibers that are arranged to allow transmission of light
Fibroblasts (some)

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101
Q

What is the vascular supply of the cornea?

A

[Avascular structure]
Nourished by peripheral capillary bed and fluids on its external and internal surfaces

Lacrimal fluids also provide oxygen absorbed from air

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102
Q

What is choroid?

A

A highly pigmented dark brown membrane found between the sclera and retina that attaches firmly to pigmented layer of retina but is easily stripped of the sclera
[Forms largest part of the vascular layer]

Consists of smaller vessels adjacent to the retina and larger vessels more peripherally

Represents ⅔ of vascular layer

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103
Q

What supplies the choroid?

A

6 short peripheral ciliary arteries

2 long posterior arteries [passes through sclera and choroid]

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104
Q

What is uveitis?

A

Inflammation of vascular layer of eye

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105
Q

What innervates the ciliary muscle?

A

Supplied by parasympathetic fibers from the oculomotor nerves

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106
Q

What is the function of the ciliary body?

A

Changing convexity of lens to focus on near/distant object

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107
Q

What is the function of the ciliary process?

A

Secretes aqueous humor

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108
Q

What is the ciliary body?

A

Musculature and vasculature body that connects the choroid to the iris

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109
Q

What is the iris?

A

Contractile, pigmented diaphragm with a central aperture for transmitting light

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110
Q

Describe the ciliary muscles and other muscles with and in the absence of parasympathetic stimulation

A

haha

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111
Q

What is the function of the iris?

A

Control light input to retina, by contracting peripheral sphincters and radial dilators

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112
Q

What is coloboma?

A

Absence of a section of the iris, may be a result of a birth defect

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113
Q

What are the two muscles controlling the iris?

A

Dilator pupillae
Sphincter pupillae

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114
Q

What is mydriasis?

A

dilation of the eye

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115
Q

Innervation of the dilator pupillae muscle?

A

Innervated by the superior cervical, and under the control of the Sympathetic system

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116
Q

Innervation of the sphincter pupillae?

A

Innervated by the CN3, and under control of the parasympathetic system

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117
Q

What is miosis?

A

Abnormal constriction of the eye

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118
Q

What is the anterior chamber?

A

Space between the cornea anteriorly and the iris/pupil posteriorly

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119
Q

What is the posterior chamber?

A

Space between the iris/pupil anteriorly and the lens and ciliary body posteriorly

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120
Q

Describe the flow of aqueous humor through the chambers

A

Aqueous humor is secreted into the posterior chamber, where it then flows through the pupil and into the anterior chamber

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121
Q

Aqueous humor is absorbed in?

A

This absorbed in the scleral venous sinus

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122
Q

What is the canal of schlemm?

A

The scleral venous sinus, which is found at the junction between the cornea and the iris

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123
Q

What maintains the intraocular pressure?

A

Aqueous humor

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124
Q

What are the three gross layers of the retina?

A

Optic [neural and pigmented layers]
Ciliary
Iridial

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125
Q

What is the ora serrata?

A

Irregular body found slightly posterior to the ciliary body and marks the anterior termination of light-receptive part of the retina

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126
Q

List the layers of the retina

A

1- Retinal pigment epithelium
2- Rodes and Cones layer
3- Outer Nuclear layer
4- Outer Plexiform layer
5- Inner nuclear layer
6- Inner Plexiform layer
7- Ganglion cell layer
8- Nerve Fiber layer

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127
Q

What makes up the Nuclear layers?

A

Outer nuclear Layer- Cell bodies of photoreceptors

Inner Nuclear Layer- Cell bodies of Bipolar, amacrine and Horizontal cells

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128
Q

What makes up the Plexiform layers?

A

Inner Plexiform Layer- Axons of Bipolar and Amacrine cells

Outer Plexiform Layer- Axons of Photoreceptors and Horizontal cells

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129
Q

What is the function of photoreceptors?

A

Neurons capable of phototransduction

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130
Q

What is the function of horizontal cells?

A

Integrate and regulate input from multiple photoreceptors to bipolar cells

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131
Q

What is the function of bipolar cells?

A

Transmits signals from photoreceptors and horizontal cells to retinal ganglion cells

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132
Q

What is the function of amacrine cells

A

Regulate input from multiple bipolar cells

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133
Q

What is the function of Retinal ganglion cells?

A

Transmit visual information from retina to multiple regions of the cortex

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134
Q

What is the retinal pigment epithelium?

A

Single cuboidal melanin rich layer found between choroid and the outer tip of photoreceptors

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135
Q

What is the function of the retinal epithelium layer?

A

Light absorption
Epithel transport
Glia
Visual Cycle
Phagocytosis
Secretion

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136
Q

What structures make up the blood-retinal barrier?

A

Retinal pigment epithelium
Bruch’s membrane

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137
Q

What is retinal detachment?

A

Detachment of the Retinal pigment epithelium from the neuronal layer

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138
Q

What is the optic disc?

A

Where the optic nerve enters the eyeball, thus contains nerve fibers and no photoreceptors, forming a blindspot

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139
Q

What are the characteristics of rods and cones?

A
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140
Q

What parts make up the fundus of the eye?

A

Macula
Fovea
Optic disc
Retina

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141
Q

What is the macula?

A

Small depression just about the center of the eye

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142
Q

What is the fovea?

A

Rod-free region at the center of the macula

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143
Q

What is the functional relevance of the fovea?

A

Center of the eye’s sharpest vision and location of most color perception [cones]

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144
Q

Blood supply of Eye:

A

Internal carotid artery → ophthalmic artery → :
1- Central retinal artery
2- Short and Long Posterior ciliary arteries
3- Anterior Ciliary Arteries

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145
Q

What vessel innervates the retina?

A

Central artery → supplies the retina, except the cones and rods
Choriocapillaris → supplies the cones and rods of the neural layer

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146
Q

Describe the course of the central artery and the optic nerve

A

Central artery runs within the dural sheath of the optic nerve, then it pierces the nerve and runs within it to emerge at the optic disc

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147
Q

Obstruction of Blood supply of the retina

A

Their terminal branches provide the only blood supply to the retina, if they are obstructed by an emboli, then it leads to total blindness

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148
Q

Pathophysiology of Papilledema

A

↑CSF pressure → slows venous return from retina → retinal edema → papilledema

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149
Q

What are the refractive medias in the eye?

A

Cornea
Aqueous humor
Lens
Vitreous humor

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150
Q

What is the primary refractive media of the eye?

A

cornea

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151
Q

What is the lens?

A

Transparent biconvex elastic disc enclosed by a capsule and anchored to the ciliary body by the zonular fibers

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152
Q

Describe lens accommodation

A

Parasympathetic stimulation of the ciliary muscle through CN 3 causes the tension on the lens to reduce, thus allowing the lens to round up

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153
Q

Define myopia

A

Near-sightedness, refractive error

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154
Q

Define hyperopia

A

Far-sightedness

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155
Q

What is vitreous humor?

A

Clear gel that occupies area behind the lens and before the retina at the back of the eye

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156
Q

What makes up the vitreous humor?

A

Mostly water, lower amounts of collagen, salt and sugar

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157
Q

What is the function of the limbic system?

A

Involved in control of emotions, behavior and memory

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158
Q

What structures form the limbic system?

A
  1. Subcallosal
  2. Cingulate
  3. Parahippocampal gyri
  4. Hippocampal formation
  5. Amygdaloid nucleus
  6. Mammillary bodies
  7. Anterior Thalamic nucleus
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159
Q

What structures form the hippocampal formation?

A
  1. Hippocampus proper
  2. Dentate gyrus
  3. Parahippocampal gyrus
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160
Q

What is the deepest layer of the hippocampal formation?

A

Dentate gyrus

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161
Q

What is the subiculum?

A

transitional area between hippocampus proper and the entorhinal cortex of the parahippocampal gyrus

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162
Q

What is the entorhinal cortex?

A

Part of the medial temporal lobe and constitutes the major gateway between the hippocampal formation and the neocortex

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163
Q

When does the Hippocampal formation begin ?

A

12-32 weeks post-conception

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164
Q

At which week does the hippocampus sulcus appears in the fetus

A

Week 10-11

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165
Q

Describe the formation of the fornix

A

Alveus → Fimbria → Crus of fornix

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166
Q

What part of the hippocampus formation plays a role in neurogenesis?

A

Dentate Gyrus

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167
Q

What structure does the entorhinal cortex communicate with?

A

Dentate Gyrus

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168
Q

What are the principal cells of the Hippocampus?

A

Large pyramidal neurons found in the pyramidal layer

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169
Q

Where is the molecular layer of the hippocampus found?

A

In the dentate gyrus

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170
Q

What are the three layers of the hippocampus?

A

The outer layer is the molecular layer, the middle layer is the pyramidal layer, and the inner layer the stratum oriens

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171
Q

Describe the structure of the hippocampal subfield [CA1, CA2, CA3, CA4]

A

The move along the c-shaped structure, starting at the beginning of the hippocampus and ends embedded into the dentate gyrus. CA1 → CA2 → CA3 → CA4

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172
Q

Describe the structure of the Molecular layer

A

In the centre of the hippocampal formation, the layer consists of interacting axons and dendrites

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173
Q

Describe the structure of the Pyramidal Layer

A

Composed of large pyramid neurons with their dendrites extending into the molecular layer and axons transverse alveus + fimbria to reach fornix

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174
Q

What are the three principle pathways for information processing in the hippocampus?

A
  1. Perforant pathway
  2. Mossy Fiber Pathway
  3. Schaffer Collateral pathway
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175
Q

Which processing pathway is the first to degenerate in AD?

A

Perforant pathway

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176
Q

Describe the Perforant pathway

A

From entorhinal cortex to granule cells of dentate gyrus

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177
Q

Describe the Mossy Fiber pathway

A

From granule cells of dentate gyrus to CA3 region of hippocampus

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178
Q

Describe the Schaffer Collateral pathway

A

From CA3 to CA1 region of the hippocampus

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179
Q

Which principal pathway is important for memory consolidation?

A

Schaffer Collateral pathway [memory consolidation + Long term potentiation]

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180
Q

What is the importance of the Schaffer Collateral pathway?

A

[memory consolidation + Long term potentiation]

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181
Q

Where does the entorhinal cortex receive input from?

A
  1. Neocortex
  2. Cingulate cortex
  3. Temporal lobe cortex
  4. Orbital cortex
  5. Olfactory bulb
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182
Q

Where does the fornix receive input from?

A

Septal area

Hypothalamus

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183
Q

What is the septal area?

A

Collection of nuclei in association to septum pellucidum. These nuclei play a role in regulating limbic system

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184
Q

List all the hippocampus efferents

A
  1. Subiculum
  2. Fornix
  3. Precommissural Fornix
  4. Postcommissural Fornix
  5. Anterior Commissure
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185
Q

Where does the fornix send information to?

A
  1. Alveus
  2. Fimbria
  3. Crura
  4. Hippocampal commissure
  5. Contralateral hippocampus
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186
Q

What structures does the postcommissural fornix send information to?

A

Mammillary bodies, then indirectly through the anterior thalamic nuclei through the mammillothalamic tract.

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187
Q

Describe the connection between the cingulate gyrus and the hippocampus

A

There’s no direct connection between the two structures instead:

Postcommissural fornix → mammillary bodies → anterior thalamic nuclei → Cingulate Gyrus → Entorhinal cortex + Hippocampus

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188
Q

What syndrome affects the mammillary bodies of the hypothalamus?

A

Korsakoff’s Syndrome

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189
Q

What is the major efferent structure of the Hippocampus?

A

Fornix

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190
Q

What structure connects the two hippocampi?

A

Anterior Commissure

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191
Q

What structures does the precommissural fornix of the hippocampus send information to?

A
  1. Septal nuclei
  2. Ventral striatum
  3. Orbital cortex
  4. Anterior cingulate cortex
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192
Q

List the Hippocampal Afferent

A
  1. Amygdala
  2. Contralateral Hippocampus
  3. Fornix
  4. Entorhinal Cortex
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193
Q

What structure connects the Anterior Thalamic nucleus to the Cingulate Gyrus?

A

Anterior Limb of the Internal Capsule

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194
Q

What structure connects the Cingulate Gyrus to the Parahippocampal Gyrus?

A

Cingulum

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195
Q

What structure connects the hippocampal formation, preoptic hypothalamus and the septal area together?

A

Precommissural fornix

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196
Q

What structure connects the Hippocampal Formation, Mammillary body and Anterior Thalamic Nucleus?

A

Postcommissural fornix

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197
Q

What structure connects the Mammillary body to the Anterior Thalamic Nucleus?

A

Mammillothalamic Tract

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198
Q

What structure is affected in AD?

A

Circuit of Papez

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199
Q

Describe the Circuit of Papez

A
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200
Q

What are the boundaries of the hypothalamus?

A
  • Superior:
    • Hypothalamic sulcus
  • Posterior [+inferior]
    • Mammillary bodies
  • Inferior:
    • Infundibulum
  • Anterior:
    • Anterior Commissure
    • Lamina terminalis
    • Optic chiasm
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201
Q

What are the zones of the hypothalamus?

A
  • Periventricular zone
  • Medial zone
  • Lateral zone
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202
Q

What is the function of the lateral zone of the hypothalamus?

A

Regulation of CVS

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203
Q

What is the function of the medial zone of the hypothalamus?

A

Regulating ANS [specifically GIT] and neuroendocrine system

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204
Q

What is the function of the Periventricular zone?

A

Regulating neuroendocrine functions

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205
Q

What nuclei compromise the periventricular zone of the hypothalamus?

A
  • Arcuate nucleus
  • Paraventricular nucleus
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206
Q

What nuclei compromise the medial zone of the hypothalamus?

A
  • Paraventricular
  • Preoptic
  • Anterior
  • Suprachiasmatic
  • Supraoptic
  • Dorsomedial
  • Ventromedial
  • Arcuate Nucleus
  • Posterior
  • Mammillary
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207
Q

Describe the hippocampus in Alzheimer’s patients

A

Significant atrophy of the hippocampus

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208
Q

What are the 3 principal pathways for information processing in the Hippocampus?

A
  • Perforant Pathway
    • Entorhinal cortex → Dentate gyrus [granular cells]
  • Mossy Fiber Pathway
    • Dentate Gyrus → CA3
  • Schaffer Collateral Pathway
    • CA1 → CA3
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209
Q

What nuclei compromise the lateral zone of the hypothalamus?

A
  • Median forebrain bundle [?]
  • Lateral Complex nucleus
  • Supraoptic nucleus
  • Preoptic nucleus
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210
Q

Describe the location and anatomy of the amygdala

A

Sits below uncus

Almond-shaped structure continuous with the hippocampus

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211
Q

Which structure(s) does the amygdala receive afferent visceral input from?

A
  • Hypothalamus
  • Septal area
  • Orbital Cortex
  • Hippocampus
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212
Q

Which structure(s) does the amygdala receive afferent olfactory input from?

A

Olfactory bulb

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213
Q

Which structure(s) does the amygdala receive afferent auditory, visual and somatosensory input from?

A

Temporal cortex

Anterior cingulate cortex

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214
Q

What are the 5 efferent pathways from the amygdala?

A
  • Ventral amygdalofugal pathway
  • Stria terminalis
  • Directly to hippocampus
  • Directly to entorhinal cortex
  • Directly to dorsomedial nucleus of thalamus
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215
Q

Describe the Ventral Amygdalofugal pathway

A

Sends information back to where it received the inputs

  • Hypothalamus
  • Septal area
  • Orbital cortex
  • Olfactory bulb
  • Ventral striatum [GP to the basal ganglia]
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216
Q

What is the role of stria terminalis?

A

Major efferent connection from the amygdala to the hypothalamus and septal nucleus

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217
Q

What is the function of the amygdala?

A

Integration center for emotions, emotional behaviour, and motivation

Involved in fear conditioning

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218
Q

What structure is involved in fear conditioning?

A

Amygdala

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219
Q

Describe the amygdala in patients with Bipolar disorder

A

Reduced volume and activity of amygdala

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220
Q

Describe the amygdala in patients with anxiety disorder

A

Higher activity

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221
Q

What is the effect of a lesion in the amygdala?

A

Lose fear ability and fear recognition

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222
Q

What structure connects the Hypothalamus and Amygdala?

A
  • Stria terminalis
  • Ventral Amygdalofugal tract
  • Direct projections
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223
Q

What structures connect the Hypothalamus and Hippocampus?

A

Fornix

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224
Q

What two structures connect the Hypothalamus and Pituitary gland?

A
  • Tubero-hypophyseal tract
  • Supraopticohypophyseal tract
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225
Q

What structure connects the Hypothalamus to the Brainstem?

A

Medial Forebrain Bundle

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226
Q

What structure connects the Brainstem to the Hypothalamus?

A

Dorsal Longitudinal Fissure

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227
Q

What structure in the hypothalamus receives information from the retina?

A

Supraoptic nucleus

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228
Q

What structure indirectly connects the septal nucleus to the brainstem via the hypothalamus?

A

Medial Forebrain bundle

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229
Q

What structures are found in the Tuberohypophyseal tract and what do they release?

A
  • Paraventricular and Arcuate Nuclei, they release:
    • CRH
    • TRH
    • GHRH
    • Dopamine
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230
Q

What structures are found in the Supraopticohypophyseal tract, and what do they release?

A
  • Paraventricular and Supraoptic nuclei, and they release
    • ADH [vasopressin]
    • Oxytocin
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231
Q

Which hypothalamic nuclei are found in the tuberal region?

A
  1. Paraventricular
  2. Dorsomedial
  3. Ventromedial
  4. Arcuate
  5. Lateral Complex
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232
Q

Which hypothalamic nuclei are found in the anterior region?

A
  • Paraventricular
  • Preoptic
  • Anterior
  • Suprachiasmatic
  • Supraoptic
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233
Q

Which hypothalamic nuclei are found in the posterior region?

A

Posterior

Mammillary

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234
Q

Which hypothalamic nuclei play a role in thermoregulation?

A

Posterior

Anterior

Preoptic

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235
Q

What are the similarities and differences between the Lateral Complex and Ventromedial nuclei?

A

Sim: Appetite + Body weight control

Dif: insulin [ventromedial]

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236
Q

Which hypothalamic nucleus is responsible for biological rhythms?

A

Suprachiasmatic nucleus

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237
Q

What are the functions of Preoptic and Anterior Thalamic Nuclei?

A

Lateral Anterior Thermoregulation and Sexual Behavior

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238
Q

What is the function of the dorsomedial nucleus?

A

Responsible for Emotions [Rage]

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239
Q

What structure regulates the dorsomedial nucleus?

A

Amygdala

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240
Q

What is the function of the Mammillary nucleus and How does it achieve it?

A

Responsible for emotion and Short term memory through its connection with the hippocampus

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241
Q

What are the similarities and differences between Paraventricular and Supraoptic nuclei?

A

Sim: Fluid balance, mild let-down and partition

Dif: Autonomic and Anterior Pituitary control [Paraventricular nucleus]

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242
Q

What is the function of the Arcuate nucleus?

A

Feeding

Control of Anterior Pituitary

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243
Q

What is the function of the thalamus?

A
  • Relay station of Somatostatic and visceral sensations through hypothalamus
  • Poorly perceives crude sensations [pain + temperature]
  • Cortex is still required for interpretation based on past experience
  • Maintenance of states of wakefulness and alertness through RAS
  • Regulates activities of motor pathways [VA & VL nuclei]
  • Regulates Emotional activity and memory function [dorsomedial nuclei]
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244
Q

Where would the thalamus be found?

A

Lateral wall of the 3rd ventricle

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245
Q

What structures are found on the upper surface of the thalamus?

A

Choroid fissure

Stria terminalis

Thalamostriate vein

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246
Q

What forms the floor of the central part of the lateral ventricle?

A

Upper surface of the thalamus

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247
Q

What does the upper surface of the thalamus form?

A

Central part of the lateral ventricle

248
Q

What does the medial surface of the thalamus form?

A

Lateral wall of the 3rd ventricle

249
Q

What surface of the thalamus interacts with its surrounding structures?

A

Lower Surface

250
Q

What structures are related to the lower surface of the thalamus?

A
  • Fasciculus subthalamicus
  • Dentato-rubro-thalamic fibers
  • Fasciculus lenticularis
  • Ansa lenticularis
  • Subthalamic nuclei
  • BG via the globus pallidus
251
Q

What is the external medullary lamina?

A

Thin white matter covering the lateral surface of the thalamus

252
Q

What separates the thalamus and the lentiform nucleus?

A

Posterior limb of the internal capsule

253
Q

What connects the hippocampus to the thalamus?

A

Indirectly through the mamillary bodies

  • Hippocampus → fornix → mammillary bodies → Mammilothalamic tract → Anterior thalamic nucleus → cingulate gyrus → cingulum → Hippocampus
254
Q

What structure is affected in Korsakoff’s syndrome?

A

Anterior Thalamic Nucleus

255
Q

What syndrome is associated with alcoholics?

A

Korsakoff’s syndrome

256
Q

What is the effect of a lesion to VPL and VPM?

A

Loss of complete sensation on the contralateral side of the body

257
Q

Why are the symptoms of thalamic lesions often overshadowed?

A

Lesions often result in dysfunction of neighbouring structures producing signs and symptoms that overshadow those that are produced by the thalamic lesion itself

258
Q

What is the effect of a lesion on the Intralaminar nucleus?

A

Thalamic neglect [unilateral]

259
Q

What is the effect of a lesion on the Anterior nucleus?

A

Korsakoff’s Syndrome

260
Q

What is the effect of a lesion on the Dorsomedial nucleus?

A

Spontaneous crying or laughing

261
Q

What is the effect of a lesion on the Ventral Anterior and Ventral Lateral nuclei?

A
262
Q

Why do lesions on VA and VL nuclei produce choreo-athetosis?

A

Through the connections from corpus striatum and cerebellum

263
Q

What is the effect of a lesion on the Ventral Posterior nucleus?

A

Diminished sensation on contralateral side

264
Q

What is thalamic neglect?

A

Unilateral neglect of stimuli originating from the contralateral body

265
Q

What is the function of the reticular thalamic nucleus?

A

Inhibitory modulation of thalamocortical transmission

266
Q

What is the function of the Intra-laminar nucleus?

A

Influences the level of consciousness and alertness

267
Q

What structures do the intra-laminar group of nuclei send eference to?

A

Caudate nucleus

Putamen

Cerebral cortex [via thalamic nuclei]

268
Q

What structures do the intra-laminar group of nuclei receive aference from?

A

Ascending reticular fibers from Brainstem RF

Spinothalamic tracts

Trigeminothalamic tracts

269
Q

What structures do the midline group of nuclei receive aference from?

A

Reticular Formation

NA, Cholinergic and serotonergic fibers

270
Q

What structures do the midline group of nuclei send eference to?

A

Hippocampal formation

Amygdala

Nucleus accumbens

271
Q

What structures does the reticular thalamic nuclei receive aference from?

A

Cerebral cortex

Brainstem reticular nuclei

272
Q

What structures does the reticular thalamic nuclei send eference to?

A

To other thalamic nuclei that sends afferents to reticular nucleus

273
Q

What is the function of the Ventral Posterior nucleus?

A

Processing and integrating sensory information

274
Q

What is the function of the Ventral Lateral and Ventral Anterior nuclei?

A

Sends motor information from the cerebellum and BG to the cortex

  • Regulates voluntary movement and muscle tone
275
Q

What is the function of the Dorsomedial nucleus?

A

Integration of sensory information / Emotional feelings

276
Q

What is the function of the Anterior Nucleus?

A

Recent memory and emotion

277
Q

What is the role of the thalamus in voluntary movement?

A

Regulates voluntary movement and influences the muscle tones via the direct and indirect pathways of the cerebellum

278
Q

What arteries supply the thalamus?

A
  • Thalamogeniculate artery [branch of PCA]
  • Anterior Choroidal artery [Branch of ICA]
  • Posterior communicating artery contributing to both
279
Q

What structures does the anterior thalamic nuclei receive aference from?

A
280
Q

What structures does the anterior thalamic nuclei send eference to?

A

Cingulate Gyrus

281
Q

What structures does the Dorsomedial nuclei receive aference from?

A

Orbitofrontal cortex

Amygdala

Hypothalamus

+ Other thalamic nuclei

282
Q

What structures does the Ventral anterior nuclei receive aference from?

A

Globus Pallidus

Substantia Nigra

283
Q

What structures does the Ventral Lateral nuclei receive aference from?

A

Dentate nucleus of Cerebellum

Red nucleus

Globus Pallidus

284
Q

What structures does the Ventral Posterolateral [VPL] nuclei receive aference from?

A

Medial Lemniscus

Spinal Lemniscus

285
Q

What structures does the Ventral Posteromedial [VPM] nuclei receive aference from?

A

Trigeminal lemniscus

Solitario-thalamic tract

286
Q

What structures does the Medial Geniculate body nuclei receive aference from?

A

Inferior Colliculus

287
Q

What structures does the Lateral Geniculate body nuclei receive aference from?

A

Optic tract

288
Q

What structures does the intralaminar nuclei receive aference from?

A

Reticular formation of brainstem

Pain fibers

289
Q

What structures does the dorsomedial nuclei send eference to?

A

Prefrontal cortex

290
Q

What structures send efference to the Premotor cortex?

A

Ventral Anterior & Ventral Lateral

291
Q

What structures send efference to the Postcentral gyrus [Area 3,1,&2]?

A

Ventral Posterolateral nucleus

Ventral Posteromedial nucleus

292
Q

What structures does the LGB nuclei send eference to?

A

Lips and Walls of Calcarine Sulcus [Area 17]

293
Q

What structures does the MGB nuclei send eference to?

A

Anterior and Posterior Transverse Temporal gyrus [41, 42]

294
Q

Describe the clinical presentation of Dejerine-Roussy disease

A
  • Absence of sensation and tingling of body contralateral to lesion [initial] → numbness [months] → severe chronic pain
  • Thalamic Phantom limb
  • Decrease in tension, aggression and anxiety
  • Increased forgetfulness
  • Emotional instability w/spontaneous crying/laughing
  • Intention tremor
  • Choreoathetosis
295
Q

What structure affected in Dejerine-Roussy disease causes decreased tension, anxiety and aggression?

A

Medial nucleus

296
Q

What structure is cauterized surgically for pain relief?

A

Intralaminar nuclei

297
Q

What structure affected in Dejerine-Roussy disease causes choreoathetosis or intention tremor?

A

Ventral Anterior nucleus

Ventral Lateral nucleus

298
Q

List all Thalamic nuclei

A
  1. Anterior nucleus
  2. Pulvinar nucleus
  3. Medial Geniculate body
  4. Lateral Geniculate body
  5. Dorsomedial nucleus
  6. Intralaminar nuclei
  7. Midline nucleus
  8. Dorsolateral nucleus
  9. Posterior Lateral nucleus
  10. Ventral Anterior nucleus
  11. Ventral Intermediate nucleus
  12. Ventral Posterolateral nucleus
  13. Ventral Posteromedial nucleus
299
Q

What does damage to the medial thalamic nucleus produce?

A

Decrease in tension, aggression, anxiety

Increases forgetfulness

Emotional instability with spontaneous crying or laughing

300
Q

What does damage to VA and VL nuclei produce?

A

Intention tremor

301
Q

Describe the clinical presentation of thalamic infarct

A

Initially, contralateral hemianesthesia

Months later, numbness → severe chronic pain

302
Q

Pathophysiology of Severe chronic pain in cases of thalamic nuclei

A

Absence of central cortical inhibition causing excruciating pain [involvement of thalamogeniculate branch]

303
Q

Surgery pain relief involves which thalamic nuclei?

A
304
Q

What is another name for Thalamic pain syndrome?

A

Dejerine - Roussy disease

305
Q

What is the function of the dorsomedial nucleus?

A

Integration of somatosensory information and relates it to emotional feelings and subjective states

306
Q

What is the input and output of the VPL?

A

Input: Medial and Spinal Lemniscus

Output: Area 3, 1, 2

307
Q

What is the input and output of the Anterior and Lateral Dorsal Thalamic Nuclei?

A

Input: Mamilary body

Output: Cingulate gyrus

308
Q

What is the input and output of the Dorsomedial Thalamic nuclei?

A

Prefrontal

Orbitofrontal cortex

Amygdala

Hypothalamus

309
Q

What is the input and output of the Lateral Posterior Thalamic nucleus?

A

Input: Ventral Lateral nucleus, Pulvinar Nucleus

Output: Superior Parietal lobule [Area 5 & 7]

310
Q

What is the input and output of the VPM?

A
311
Q

What is the input and output of the Ventral Lateral Thalamic Nucleus?

A
312
Q

What is the input and output of the Ventral Anterior Thalamic Nucleus?

A

Input: Brainstem Reticular nuclei, Substantia nigra, globus pallidus

Output: Area 6

313
Q

What structures are implicated in homonymous hemianopia?

A

Lateral Genicular

Optic radiations

Visual cortex

314
Q

What structures are implicated in dysesthesia?

A

Irritation of thalamus

315
Q

What structures are implicated in loss of proprioception?

A

VPL

Posterior limb of internal capsule

Medial Lemniscus

316
Q

What structures are implicated in spastic hemiplegia in lesion of posterior thalamus?

A

Posterior limb of internal capsule

317
Q

What structures are implicated in Involuntary choreoathetoid and blank face?

A

GP

Subthalamic nuclei

VL thalamic nucleus

318
Q

What are the signs of lesion of posterior thalamus?

A

Dysesthesia

Spastic hemiplegia

Loss of proprioception

Involuntary choreoathetoid movements

Face ‘blank mask’

Homonymous hemianopia

319
Q

What structures make up the Striatum or Neostriatum?

A

Caudate + Putamen

320
Q

What structure is found medial to the Straitum?

A

Globus Pallidus [Ext. → Int.]

321
Q

What structures make up the lenticular nucleus?

A

Putamen + Globus Pallidus

322
Q

What structure forms the major output of the BG?

A

Globus pallidus

323
Q

What structure forms the major input into the BG?

A

Striatum [Caudate + Putamen]

324
Q

What structure is found superior to the substantia nigra?

A

Subthalamic nucleus

325
Q

Which structure is affected in Parkinson’s?

A

Substantia Nigra

326
Q

What structures make up the Basal Ganglia?

A
  1. Substantia Nigra
  2. Subthalamic nucleus
  3. Caudate
  4. Putamen
  5. Globus Pallidus
  6. Amygdala
327
Q

What are the major afferent projections of the Basal Ganglia?

A
  1. Corticostriatal fibers
  2. Thalamostriate fibers
  3. Nigrostriatal fibers
  4. Brainstem Striatal fibers
328
Q

Describe the connection between SC and Basal Ganglia?

A

No direct input or output between the two

329
Q

Describe the corticostriatal fibers

A

Cerebral cortex → Caudate + Putamen

[Neurotransmitter: Glutamate]

330
Q

Describe the Thalamostriate fibers

A

Intralaminar nuclei of thalamus → Caudate + Putamen

331
Q

Describe the Nigrostriatal Fibers

A

Dopaminergic neurons from substantia nigra → Caudate + Putamen

332
Q

Describe the Brainstem Striatal Fibers

A

Ascending fibers from brainstem → Caudate + Putamen

[Serotonin release at their terminals]

333
Q

What are the major efferent projections of the Basal Ganglia?

A
  1. Striatopallidal fibers
  2. Striatonigral fibers
  3. Pallidothalamic fibers
  4. Pallido Tegmental fibers
334
Q

Describe the striatopallidal fibers

A

Caudate + Putamen → Globus Pallidus

[Neurotransmitter: GABA]

335
Q

Describe the Striatonigral fibers

A

Caudate + Putamen → Substantia nigra

[Neurotransmitters: GABA + Ach]

336
Q

Describe the Pallidothalamic fibers

A

Ansa lenticularis + Lenticularis fasciculus to form thalamic fasciculus

337
Q

What is the claustram?

A

Thin sheet of gray matter separated from the lateral surface of lentiform nucleus by the external capsule

338
Q

What blood vessel supplies the putamen?

A

Penetrating branches of ACA / Recurrent Artery of Heubner

339
Q

What blood vessel supplies the caudate nucleus?

A

Lenticulostriate arteries [branch of MCA]

340
Q

What blood vessel supplies the globus pallidus?

A

Anterior Choroidal artery

341
Q

What blood vessel supplies the thalamus?

A

Branches of the Posterior Choroidal artery:

  • Thalamogeniculate arteries
  • Thalamoperforator arteries
342
Q

Describe the Direct Pathway

A

Cortex→ striatum excited → GPi inhibited → Thalamus no longer inhibited → motor cortex excited

343
Q

Describe the Indirect Pathway

A

Cortex → Striatum excited → GPe inhibited → Subthalamic neurons are no longer inhibited → GPi excited → Thalamus inhibited → no signal sent to cortex

344
Q

Describe the relationship between the Thalamus, Subthalamus neurons and GPi

A

GPi inhibits the thalamus when its active

Subthalamic neurons increase firing rate of GPi when its activated

345
Q

What are cholinergic interneurons?

A

Neurons within the striatum, and synapse in GABAergic striatal neurons that project to GPi and GPe

346
Q

What role do cholinergic interneurons play in information processing?

A

Inhibits striatal cells of direct pathway and excite cells of the indirect pathway

347
Q

Describe the role of the nigrostriatal projection

A

Excites direct pathway [D1 receptor] and inhibits indirect pathway [D2 receptor]

348
Q

What anatomical changes are seen in HD?

A

Selective loss of striatal neurons in the indirect pathway, tipping the favor to the direct pathway, thus thalamic neurons fire randomly and inappropriately

349
Q

What anatomical changes are seen in PD?

A

Loss of dopaminergic neurons in substantia nigra pars compacta [nigrostriatal input], typing the favor to the indirect pathway

350
Q

What are dural fold?

A

Double fold of meningeal layer of dura mater than contain dural venous sinuses, which receive superficial veins from the brain

351
Q

What is the function of dural folds?

A

Provides support for brain

Incompletely divided cranial cavity into compartments

352
Q

What structures are found in the Superior Sagittal Sinus?

A

Emissary veins

CSF from subarachnoid space

353
Q

Where is the Superior Sagittal Sinus located?

A
354
Q

Where is the Falx Cerebri located?

A
355
Q

Where is the Inferior Sagittal Sinus located?

A

At free margin of falx cerebri

356
Q

What vessels are found in the Falx cerebri and Inferior Sagittal Sinus?

A
357
Q

What are the attachments of the Falx cerebri?

A

Cresta Gali

Sagittal Sulcus

Superior Surface of Tentorium cerebelli

358
Q

What are the attachments of the Falx Cerebelli?

A

Internal occipital crest

359
Q

What are the attachments of the Tentorium Cerebelli?

A

Superior border of petrous part of temporal bone

Transverse sulcus

Anterior Clinoid process [free margin]

360
Q

What are the attachments of the Diaphragma sellae?

A

Margins of Pituitary fossa

361
Q

What structures form the internal jugular vein?

A

Sigmoid sinus + Inferior Petrosal sinus → Superior bulb of intrajugular vein → Internal Jugular vein

362
Q

What is the Ophthalmic vein? And what is its clinical significance?

A

Allows communication between the facial vein and cavernous sinus

Clinical significance facial infection can spread to cavernous sinus

363
Q

Which part of the Internal Carotid artery is susceptible to aneurysm?

A

Cavernous part of ICA

364
Q

What vessels does the Cavernous sinus communicate with?

A
365
Q

What is the landmark for the Middle Meningeal Artery?

A
366
Q

What arteries supply the meninges?

A
  • Anterior and Posterior Ethmoidal arteries [of ICA]
  • Middle Meningeal artery [Maxillary artery]
  • Branches of occipital, Ascending pharyngeal and Vertebral arteries
367
Q

Describe the extension of the 4th ventricle into the surrounding structures

A

Extends into cerebellum as superior recess.

Opens into subarachnoid space(Cisterna magna) at median aperture in the roof and at the two lateral apertures at lateral ends of the lateral recess.

368
Q

What are the 4 parts of the lateral ventricles?

A

Anterior Horn

Body

Posterior Horn

Inferior Horn

369
Q

Describe the body of Lateral Ventricle

A

Forms the level of interventricular foramen to the level of splenium of corpus callosum

370
Q

What structure must be removed to visualize the lateral ventricle?

A

Septum Pellucidum

371
Q

What forms the boundaries of the anterior horn of the lateral ventricle?

A
372
Q

Where is the lateral ventricle found?

A

Anterior to level of interventricular foramen

373
Q

What forms the floor of the Inferior horn of the lateral ventricle?

A

Hippocampus [medial] + Collateral Eminence [Lateral]

374
Q

How does the choroid plexus enter the lateral ventricle?

A

Through the choroid fissure

375
Q

What forms the boundaries of the body of the lateral ventricle?

A

Roof: Corpus Callosum

Floor: Thalamus [medial] + Body of Caudate nucleus [lateral]

Medial: Septum pellucidum + Body of Fornix

376
Q

Describe the location of the choroid fissure

A

Superior part found between the body of fornix + thalamus

Inferior part found between fimbria of fornix + tail of caudate nucleus

377
Q

What structure forms the calcar avis?

A

Calcarine sulcus

378
Q

What forms the bulb of the posterior horn of the lateral horn?

A
379
Q

Where is the collateral eminence found?

A
380
Q

What forms the general boundaries of the 3rd ventricle?

A
381
Q

What forms the boundaries of the lateral wall of the 3rd ventricle?

A

Lateral wall: Thalamus + Hypothalamus

Floor: Optic chiasm + Optic recess + Infundibulum + Infundibular recess + Mammillary body + tegmentum of midbrain

Posterior: Pineal gland + Pineal recess

Anterior: Lamina terminalis + Anterior Commissure

382
Q

What forms the boundaries of the 4th ventricle?

A

Roof:

  • Upper part: Superior Cerebellar Peduncle + Superior Medullary Velum
  • Lower part: Medullary Velum + Tela chorodia
  • Floor: Posterior surface of Pons + Open part of medulla oblongata

Lateral:

  • Superolateral: Superior Cerebellar Peduncle
  • Inferolateral: Inferior Cerebellar Peduncle
383
Q

How does the choroid plexus project into the 4th ventricle?

A

Tela chorodia

384
Q

What nerves innervate the dura mater

A

C2-C3 Spinal nerves

Recurrent meningeal branch of ophthalmic nerve

Meningeal branches of maxillary and mandibular nerves

Anterior and Posterior Ethmoidal nerves

385
Q

What is the general mechanism of headaches?

A
386
Q

What are meningeal headaches indicative of?

A

Meningitis

Cerebral tumor

387
Q

Where is CSF produced?

A
388
Q

What is the choroid plexus?

A

Soft tuft of fenestrated capillaries covered by pia mater and ependyma

389
Q

Describe the ependyma of choroid plexus?

A

Cuboidal cells with microvilli

390
Q

What is the normal volume and secretion of CSF

A

Normal ~150ml

Active Secretion ~ 0.5ml/min

391
Q

What is controlled in CSF circulation, Regulation or Absorption?

A

Absorption

392
Q

What maintains CSF pressure?

A

Absorption mechanism [60-150mm of water]

393
Q

Where is CSF absorbed?

A

Perineural lymph vessels

394
Q

Describe CSF circulation

A

Lateral Ventricle → interventricular foramen → 3rd ventricle → cerebral aqueduct → 4th ventricle → Median + Lateral aperture of 4th ventricle → Subarachnoid space → arachnoid villi + granulation → Dural venous sinus / Superior Sagittal sinus

395
Q

What is the anatomical basis of ICP?

A
  1. Subarachnoid Hemorrhage
  2. Defective CSF absorption
  3. CSF flow pathway blockage
  4. Excessive CSF formation [pathological]
396
Q

Describe the mechanism of Papilledema

A

Through the subarachnoid space around the optic nerve and reaches upto the posterior pole of the eyeball

397
Q

What are the three lobes of the cerebellum?

A

Anterior lobe

Posterior lobe

Flocculonodular lobe

398
Q

What structure splits the cerebellum into the anterior and posterior lobes?

A
399
Q

What structure splits the cerebellum into the posterior and flocculonodular lobes?

A
400
Q

What structures act as gateways to axons entering the cerebellum?

A
401
Q

What are tonsils?

A
402
Q

What structures do the axons leave the cerebellum through?

A

Superior Cerebellar Peduncle [SCP]

Inferior Cerebellar Peduncle [ICP]

403
Q

What type of neurons are the intracerebellar nuclei?

A
404
Q

What are the four deep cerebellar nuclei?

A

Dentate nucleus

Emboliform nucleus

Globose nucleus

Fastigial nucleus

405
Q

Where is the dentate nucleus found?

A
406
Q

Where is the fastigial nucleus found?

A
407
Q

Where is the interposed nucleus found?

A
408
Q

What structures form the interposed nucleus?

A
409
Q

What are the vermis and flocculonodular lobes responsible for?

A

Control of proximal and trunk muscles

Vestibulo-ocular control

410
Q

What is the intermediate zone responsible for?

A

Control of distal muscles in arms and legs

411
Q

What is the lateral hemisphere responsible for?

A

Planning motor program for extremities

412
Q

How does the vermis act?

A

Via the fastigial nuclei

413
Q

How do the flocculonodular lobes act?

A
414
Q

How does the intermediate zone act?

A
415
Q

How does the lateral hemisphere act?

A
416
Q

What is the function of the lateral cerebellar hemispheres?

A
417
Q

What is the function of the Intermediate cerebellar hemispheres?

A

Distal limb coordination

418
Q

What is the function of the vermis and flocculonodular lobes?

A
419
Q

What regions of the cerebellum influence the lateral corticospinal tracts?

A
420
Q

What motor pathways are influenced by the intermediate hemispheres?

A
421
Q

What motor pathways are influenced by the vermis and flocculonodular lobe?

A
  1. Anterior corticospinal tract
  2. Reticulospinal tract
  3. Vestibulospinal tract
  4. Tectospinal tract
  5. Medial Longitudinal Fasciculus
422
Q

What structures do the efferent fibers from the cerebellum connect with?

A
423
Q

Describe the Corticopontocerebellar pathway

A
424
Q

Describe the Cerebro-olivocerebellar pathway

A
425
Q

Describe the anatomy of the Globose-Emboliform-Rubral Pathway

A
426
Q

Describe the anatomy of the Dentothalamic pathway

A
427
Q

Describe the Fastigial Vestibular Pathway

A
428
Q

What is the function of the Fastigial Vestibular Pathways?

A
429
Q

Describe the Fastigial Reticular Pathways

A
430
Q

What is the function of the Fastigial Reticular Pathways?

A
431
Q

What cerebellar pathways convey control from the cerebral cortex?

A
432
Q

What cerebellar pathways convey information from muscle and joints?

A
433
Q

What is the function of the Cuneocerebellar pathway?

A
434
Q

What is the function of the Vestibular nerve?

A
435
Q

What structures are supplied by SCA?

A

Anterior lobe

Deep Cerebellar nuclei

Superior Cerebellar Peduncle

436
Q

What structures are supplied by AICA?

A

Ventral part of the posterior lobe

Middle Cerebellar Peduncle

437
Q

What structures are supplied by PICA?

A
438
Q

What are the three layers of the cerebellar cortex?

A
439
Q

Pathway of Climbing fibers

A
440
Q

Pathway of Mossy Fibers

A
441
Q

Lesion in what part of the cerebellum would produce truncal ataxia? What other symptoms does it produce?

A
442
Q

Lesion in what part of the cerebellum would produce Appendicular ataxia?

A
443
Q

Where are cerebellar infarcts more common?

A
444
Q

Describe the clinical presentation of Cerebellar infarcts

A
445
Q

What are some risk factors for Cerebellar Hemorrhage?

A
446
Q

Describe the clinical presentation of Cerebellar Hemorrhage

A
447
Q

What is the clinical significance of the vestibular system in lesions of cerebellum?

A

Due to strong connections between the two structures

Lesions associated with

  • Vertigo
  • Nystagmus
  • Vomiting
448
Q

What pathways send somatosensory information to the cerebellum?

A
449
Q

Pathway of Anterior Spinocerebellar tract

A

DRG → Clarke’s column → Superior Spinocerebellar Peduncle, as mossy fibers and can give collateral branches

Ipsilateral and contralateral

450
Q

Pathway of Posterior Spinocerebellar tract

A

DRG → Clarke’s column → ipsilateral white column → ipsilateral inferior cerebellar peduncle as mossy fibers and gives collateral branches

451
Q

Pathway of Cuneocerebellar Tract

A
452
Q

What information does the Anterior Spinocerebellar tract carry?

A

Somatosensory information from the Upper and Lower Limbs

453
Q

What information does the Posterior Spinocerebellar tract carry?

A

Somatosensory information from the Trunk and Lower limbs

454
Q

What information does the Cuneocerebellar tract carry?

A

Somatosensory information from the Upper Limb and Upper part of the thorax

455
Q

What afferent pathway pass through the Superior Cerebellar Peduncle?

A

Anterior Spinocerebellar Tract

456
Q

What afferent pathways pass through the Inferior Cerebellar Peduncle?

A

Posterior Spinocerebellar Tract

Cuneocerebellar Tract

Vestibular input

457
Q

Where do afferents from the inner ear terminate?

A

Flocculonodular lobe

458
Q

Vestibular input to Cerebellum

A

Vestibular nerve → ipsilateral inferior cerebellar peduncle

Vestibular nerve → vestibular nuclei → ipsilateral inferior cerebellar peduncle

459
Q

What structures connect with efferent fibers from the cerebellum?

A

Red nucleus

Vestibular nucleus

Reticular formation

Thalamus

460
Q

What forms the output of the cerebellar cortex?

A

Through axons of purkinje cells, which

  • Synapse with deep cerebellar nuclei
  • Leave directly to lateral vestibular nucleus
461
Q

What are the interneurons in the cerebellum?

A

Stellate and Basket cells

462
Q

What is the function of interneurons?

A

Basket and Stellate cells inhibits purkinje cells through the parallel fibers

463
Q

Where are interneurons found?

A

In the molecular layer

464
Q

Describe the relationship between Climbing fibers and deep cerebellar nuclei

A

Climbing fibers can excite DCN directly or can indirectly inhibit it via the purkinje cells [exciting purkinje cells would inhibit DCN]

465
Q

Describe the relationship between Purkinje fibers and DCN

A

Has an inhibitory effect on DCN

466
Q

Pathway of Mossy Fibers

A

Mossy fibers → Granule cells → Parallel fibers → :

  • Golgi cells → inhibit granule cells → reduce excitatory effects on Purkinje cells
  • Basket cells → inhibits purkinje cells
467
Q

What vessels supply the pons and spinal cord?

A
468
Q

Describe the course of the vertebral arteries

A

Arises from the subclavian arteries and ascends the posterior aspect of neck through the foramen transversarium

469
Q

What vessel arises medially to the anterior scalene muscle?

A
470
Q

What are the branches of the Internal Carotid Arteries?

A
  1. Ophthalmic artery
  2. Posterior Communicating artery
  3. Anterior Choroidal artery
  4. Anterior Cerebral artery
  5. Middle Cerebral artery [continuation of ICA]
471
Q

Which branch of the ICA is important for motor control and vision?

A

Anterior Choroidal artery

472
Q

What are the three paired vessels that make up the Circle of Willis?

A
  1. Anterior Cerebral artery
  2. Posterior Cerebral artery
  3. Internal Carotid artery
473
Q

What are the branches of the Vertebral arteries?

A
  1. Meningeal branch
  2. Anterior Spinal Arteries
  3. Posterior Spinal Arteries
  4. Posterior Inferior Cerebellar artery
  5. Basilar artery
474
Q

What vessel is implicated in Locked-In Syndrome?

A
475
Q

What vessel is implicated in Medial Medullary Syndrome?

A
476
Q

What vessel is implicated in Lateral Pontine Syndrome?

A

AICA- Anterior Inferior Cerebellar Artery

477
Q

What vessel is implicated in Lateral Medullary [Wallenberg] Syndrome?

A
478
Q

How do the basilar arteries terminate?

A
479
Q

Where does the ICA originate

A
480
Q

What arteries supply the anteromedial portion of the cerebrum?

A
481
Q

What arteries supply the lateral portion of the cerebrum?

A
482
Q

What arteries supply the posterior portion of the cerebrum?

A
483
Q

What does the Anterior Cerebral artery supply?

A
484
Q

Why are ACA infarcts rare?

A
485
Q

What are the signs of ACA occlusion?

A

Medial paracentral gyrus

  • Contralateral hemiparesis
  • Loss of sensibility in foot and lower extremities
  • Urinary incontinence [sometimes]

Prefrontal cortex [possible]

  • Cognitive impairment
486
Q

What artery supplies Wernike’s area?

A
487
Q

What artery supplies Broca’s area?

A
488
Q

What are the signs of MCA occlusion?

A
489
Q

What does the Posterior Cerebral artery supply?

A
490
Q

What are the signs of PCA occlusion?

A

Contralateral Homonymous Hemianopia

Loss of same ½ of field of view in both eyes with sparing of macular vision

  • Loss of Temporal visual field
  • Loss of Nasal Visual field
491
Q

Where would a PCA emboli be more likely to infarct?

A
492
Q

What structure is implicated in Ruptured Berry Aneurysm?

A
493
Q

What % of strokes are due to brain hemorrhages?

A
494
Q

Describe the course of the Superior Cerebral veins

A
495
Q

Describe the course of the Superficial Middle Cerebral vein

A
496
Q

Describe the course of the Inferior Cerebral veins

A
497
Q

What veins drain into the superior sagittal sinus?

A
498
Q

What structures does the Lenticulostriate arteries supply?

A
499
Q

What does the Superior division of the Middle Cerebral artery supply?

A
500
Q

What does the Inferior division of the Middle Cerebral artery supply?

A
501
Q

What structures are implicated in subdural hemorrhage?

A

Superior Cerebral Veins

502
Q

Describe the course of the Internal Cerebral vein

A
503
Q

What veins join to form the Internal Cerebral vein?

A
504
Q

What veins join to form the Great Cerebral vein of Galen?

A
505
Q

Describe the course of the Great Cerebral Vein

A
506
Q

Describe the course of the Basal veins

A
507
Q

What veins join to form the Basal Veins?

A
508
Q

What arteries supply the Midbrain?

A
509
Q

What syndromes are implicated when blood supply to the midbrain is implicated?

A
510
Q

What arteries supply the pons?

A
511
Q

What syndromes are implicated when blood supply to the medulla oblongata is implicated?

A
512
Q

What arteries supply the medulla oblongata?

A
513
Q

What syndromes are implicated when blood supply to the medulla oblongata is implicated?

A
514
Q

What are the most common sites of hemorrhage?

A
  1. Basal nuclei
  2. Thalamus
  3. Cerebral hemispheres
  4. Brainstem
  5. Cerebellum
515
Q

What are some causes of Primary Intracerebral hemorrhage [PICH]

A
516
Q

What vessel is implicated in Subarachnoid hemorrhage?

A

Cerebral arteries

517
Q

What vessel is implicated in Epidural Hemorrhage?

A
518
Q

What vessel is implicated in Subdural Hemorrhage?

A
519
Q

What arteries supply the cerebellum?

A

AICA [1st of Basilar artery]

PICA [Vertebral artery]

SCA [Final + Largest of Basilar artery]

520
Q

What are the four lobes of the cerebral cortex?

A
  • Temporal
  • Occipital
  • Frontal
  • Parietal
521
Q

What structure separates the frontal lobe from the parietal?

A

Central sulcus

522
Q

What structure separates the parietal lobe from the temporal?

A
523
Q

What structure separates the occipital lobe from the temporal and parietal lobes?

A
524
Q

What are the three parts of the Inferior Frontal Gyrus?

A
525
Q

What gyri are found on the lateral surface of the cortex?

A
  1. Precentral Gyrus
  2. Postcentral Gyrus
  3. Superior Temporal Gyrus
  4. Middle Temporal Gyrus
  5. Inferior Temporal Gyrus
  6. Supramarginal Gyrus
  7. Angular Gyrus
  8. Superior Parietal Lobules
  9. Inferior Parietal Lobules
  10. Superior Frontal Gyrus
  11. Middle Frontal Gyrus
  12. Inferior Frontal Gyrus
526
Q

What sulci are found on the lateral surface of the cortex?

A
  1. Superior Frontal Sulcus
  2. Inferior Frontal Sulcus
  3. Precentral Sulcus
  4. Postcentral Sulcus
  5. Intraparietal Sulcus
  6. Parieto-occipital Sulcus
  7. Lateral Occipital Sulcus
  8. Calcarine Sulcus
  9. Lunate Sulcus
  10. Inferior Temporal Sulcus
  11. Superior Temporal Sulcus
527
Q

What sulci are found on the medial surface of the cortex?

A

Cingulate sulcus

Precentral sulcus

Central sulcus

Postcentral sulcus

Parieto-occipital sulcus

528
Q

What gyri are found on the medial surface of the cortex?

A

Medial Frontal Gyrus

Paracentral lobule

Cingulate Gyrus

Cuneus

Precuneus

529
Q

What sulci are found on the inferior surface of the cortex?

A
  1. Olfactory sulcus
  2. ‘H’ shaped sulcus
  3. Collateral sulcus
  4. Occipitotemporal sulcus
530
Q

What gyri are found on the inferior surface of the cortex?

A
  1. Orbital Gyrus
  2. Uncus
  3. Parahippocampal Gyrus
  4. Medial occipito-temporal Gyrus
  5. Lateral occipito-temporal Gyrus
531
Q

What areas of the cerebral cortex forms the Primary motor area?

A
532
Q

What areas of the cerebral cortex form the premotor area?

A
533
Q

What areas of the cerebral cortex form the Prefrontal area?

A
534
Q

What areas of the cerebral cortex form the Motor Speech centre?

A
535
Q

What areas of the cerebral cortex form the Taste area?

A
536
Q

What areas of the cerebral cortex form the Primary Auditory area?

A
537
Q

What areas of the cerebral cortex form the Auditory Association Area?

A
538
Q

What area of the cerebral cortex form the Wernicke’s area?

A
539
Q

What area of the cerebral cortex forms the Sensory speech area?

A

Area 22

540
Q

What area of the cerebral cortex forms the Primary Visual area?

A
541
Q

What areas of the cerebral cortex form the Visual Association Area?

A
542
Q

What areas of the cerebral cortex form the Primary Somesthetic area?

A
543
Q

What areas make up the Paracentral Lobule?

A

Contains the primary somesthetic area and primary motor area

  • Area 4
  • Area 3
  • Area 1
  • Area 2
544
Q

What is area 4?

A
545
Q

What is the location of Area 4/Primary Motor Area?

A

Precentral Gyrus and anterior part of the paracentral lobule

546
Q

What is the location of the supplementary motor area?

A
547
Q

What is the function of Area 4/Primary Motor Area?

A

Individual movements of different parts of the body [motor homunculus] [of simple nature w/o much skill]

548
Q

Efferent of Primary motor area?

A
  1. Premotor area
  2. Sensory cortex
  3. Thalamus
  4. Cerebellum
  5. Basal nuclei
549
Q

Afferent of Primary motor area?

A
  1. Corticospinal
  2. Corticonuclear
  3. Corticopontine
550
Q

What would a lesion on Area 4 produce?

A

Hemiplegia

UMNL

551
Q

What is the premotor area?

A

Area 6

Area 8

552
Q

What is the function of the Premotor area?

A

Carryout complex, skilled or learned movements

553
Q

Where is the Frontal eye field located?

A

Middle frontal Gyrus

554
Q

What is the Frontal Eye Field?

A
555
Q

What is the function of the Frontal Eye Field?

A
556
Q

What would a lesion in the Frontal Eye Field produce?

A
  • Both eyes deviate to side of lesion
  • Inability to turn eyes to opposite side
557
Q

What would a lesion of the Premotor area produce?

A
558
Q

Where is Broca’s area located?

A

Inferior Frontal Gyrus

559
Q

What is the function of the Broca’s motor speech area?

A
560
Q

Where is the premotor area located?

A
561
Q

Where is the writing centre located?

A
562
Q

Where is Broadman’s area located?

A
563
Q

Where is Wernicke’s area located?

A
564
Q

What functional areas are found in the Sensory Speech area?

A
565
Q

What does a lesion in the Prefrontal area produce?

A
  • Mental symptoms
  • Lack of responsibility in personal affairs
  • Vulgarity in speech
  • Clownish behavior
566
Q

What is the function of the Prefrontal area?

A
  • Regulates depth of feeling
  • Abstract thinking
  • Mature judgement
  • Foresight and tactfulness
  • Executive function
  • Social control
567
Q

What are the prefrontal areas?

A
568
Q

What is the location of the prefrontal area?

A

Anterior part of superior, middle and Inferior frontal gyrus

Orbital gyrus

Medial frontal gyrus

Anterior part of cingulate gyrus

569
Q

Where is the location of area 12?

A
570
Q

What is area 22?

A

Wernicke’s area

Sensory speech area

What is the location of Broca’s motor speech area?

Located in left [dominant] hemispheres

Pars triangularis

Pars opercularis

What does a lesion of Broca’s area produce?

Motor aphasia w/preserved comprehension

Connections of Broca’s area

Motor speech area connected with sensory speech area through arcuate fasciculus and primary motor and somatosensory area

What is the function of the Primary Somesthetic area?

Localizes, analyses and discriminates different modalities of sensation

Pain Area

Taste receptive center

Where is the pain area located?

Upper lip of posterior ramus of lateral sulcus along postcentral gyrus

Where is the Taste receptive area located?

Lower part of the postcentral gyrus

Where is the Primary Somesthetic area located?

Postcentral gyrus

Posterior part of the paracentral gyrus

571
Q

What is the location of Broca’s motor speech area?

A

Located in left [dominant] hemispheres

  • Pars triangularis
  • Pars opercularis
572
Q

What does a lesion of Broca’s area produce?

A

Motor aphasia w/preserved comprehension

Connections of Broca’s area

Motor speech area connected with sensory speech area through arcuate fasciculus and primary motor and somatosensory area

What is the function of the Primary Somesthetic area?

Localizes, analyses and discriminates different modalities of sensation

Pain Area

Taste receptive center

Where is the pain area located?

Upper lip of posterior ramus of lateral sulcus along postcentral gyrus

Where is the Taste receptive area located?

Lower part of the postcentral gyrus

Where is the Primary Somesthetic area located?

Postcentral gyrus

Posterior part of the paracentral gyrus

573
Q

Connections of Broca’s area

A
574
Q

What is the function of the Primary Somesthetic area?

A
575
Q

Where is the pain area located?

A
576
Q

Where is the Taste receptive area located?

A
577
Q

Where is the Primary Somesthetic area located?

A
578
Q

What is Primary Somesthetic area

A
579
Q

Afferent to Primary Somesthetic area

A
580
Q

Efferent from Primary Somesthetic area

A
  1. Thalamus
  2. Medulla
  3. SC
  4. Motor area
  5. Premotor area
581
Q

Where is the secondary sensory area located?

A
582
Q

Where is the sensory association area located?

A
583
Q

What is the sensory association area?

A
584
Q

What is the location of area 22?

A
585
Q

What is the function of area 22?

A
586
Q

What does the lesion of the area 22 produce?

A

Sensory aphasia [speaks gibberish]

If Wernicke’s + Broca then global aphasia

What is area 17?

Primary Visual Area

Striate area

What is the location of Area 17?

Lips and walls of posterior part of calcarine sulcus

What would a lesion of Area 17 produce?

PCA thrombosis → homonymous hemianopia [w/macular vision sparing]

What structures are connected to the primary visual area?

Temporal part of ipsilateral retina and nasal half of the contralateral one

Macular part of retina, projected into posterior part of area 17

What is the Visual association area?

Area 18

Area 19

What is area 18 called?

Parastriate

What is area 19 called?

Peristriate

What is the function of the Visual association area?

Recognition of objects by relating with past experience

587
Q

What is area 17?

A
588
Q

What is the location of Area 17?

A
589
Q

What would a lesion of Area 17 produce?

A
590
Q

What structures are connected to the primary visual area?

A
591
Q

What is the Visual association area?

A
592
Q

What is area 18 called?

A
593
Q

What is area 19 called?

A
594
Q

What is the function of the Visual association area?

A
595
Q

What would a lesion in the Visual association area produce?

A
596
Q

What is area 41?

A
597
Q

What is the location of area 41?

A
598
Q

What does a lesion of area 41 produce?

A
599
Q

What is area 42?

A
600
Q

What is the location of Area 42?

A
601
Q

What is the function of Area 42?

A
602
Q

What connections does area 41 receive?

A
603
Q

What is the location of Area 40?

A
604
Q

What is the function of Area 40?

A
605
Q

What does the lesion of Area 40 produce?

A
606
Q

What is the location of Area 39?

A
607
Q

What is the function of Area 39?

A
608
Q

What does a lesion of Area 39 produce?

A
609
Q

What is the function of the dominant temporal lobe?

A
610
Q

What is the function of the non-dominant temporal lobe?

A
611
Q

What is the function of the dominant parietal lobe?

A
612
Q

What is the function of the non-dominant parietal lobe?

A
613
Q

What is the effect of damage on the frontal lobe?

A
614
Q

What is the effect of damage on the non-dominant parietal lobe?

A

Spatial disorientation

Non-recognition of faces

What is the effect of damage on the dominant parietal lobe?

Dyscalculia

Dyslexia

Apraxia

Agnosia

What is the effect of damage on the non-dominant temporal lobe?

Reception aphasia

Impaired muscle skills

What is the effect of damage on the dominant temporal lobe?

Dyslexia

Verbal memory impaired

Receptive aphasia

615
Q

What is the effect of damage on the dominant parietal lobe?

A
616
Q

What is the effect of damage on the non-dominant temporal lobe?

A
617
Q

What is the effect of damage on the dominant temporal lobe?

A

Dyslexia

Verbal memory impaired

Receptive aphasia

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