Anatomy of the brain Flashcards
1
Q
6 major bones of the skull
A
frontal parietal bones occipital bone temporal bones sphenoid bone - winged ethmoid
2
Q
5 bones of the face
A
Mandible - jaw under teeth maxilla main face bone -2 nasal bone- top of the nose -2 lacrimal - on the inside of the eye -2 zygomatic on the side of the head - 2
3
Q
what nerves are housed by the temporal bone
A
cranial nerves 7 and 8
so the facial and the vestibulocochlear nerves
4
Q
what is a fontanelle
A
soft spot where cranial bones haven’t fused together - allow for modelling of the fetal head during passage through the brith canal
5
Q
frontal fontanelle- year to close
between what sutures
A
largest and junction between sagittal suture, coronal suture and the frontal suture
6
Q
occipital/posterior fontanelle 3-6months close
junction between what sutures
A
junction between the sagittal suture and lambdoid suture
7
Q
What is a suture - joint
A
suture is a type of fibrous joint in the brain
8
Q
coronal suture
A
separates 2 parietal bones from the frontal bone
9
Q
sagital suture
A
between the two parietal bones
10
Q
lambdoid suture
A
between the occipital bone and the parietal bones
11
Q
5 parts of the temporal bone
A
squamous - spine zygomatic process juts out tympanic - external auditory meatus styloid process is the little long bit petromastoid
12
Q
how many fossas does the skull have
A
3
13
Q
anterior fossa houses what
A
frontal lobe
14
Q
middle fossa houses what
A
temporal lobe
15
Q
posterior fossa houses
A
mid brain
16
Q
what are the 4 lobes of the cerebrum/brain
A
frontal
parietal
occipital
temporal
17
Q
frontal lobe
A
voluntary movement
18
Q
parietal
A
somatosensory and sensation
19
Q
occipital
A
vision
20
Q
temporal
A
hearing
21
Q
middle cerebral artery supplies- imagining the picture here like local area not specifically
A
most of the lateral side of the brain
22
Q
anterior cerebral artery- image of picture not specific here
A
most of the medial side of the brain and anterior
23
Q
posterior cerebral artery- portion or diagram
A
posterior cerebrum
24
Q
the precentral gyrus is a prominent gyrus(ridge) on the surface of the posterior frontal lobe - what is it the site of
A
primary motor cortex
25
the postcentral gyrus is a prominent gyrus in the lateral parietal lobe . what is it the location of
primary somatosensory cortex ( sensory homunculus )
26
What fissure separates the two cerebral hemispheres
| what joins them at the bottom
great longitudinal fissure – they are joined at the bottom by the corpus callosum.
27
What sulcus separates the parietal lobe from the frontal lobe and the primary motor cortex from the primary somatosensory cortex
central sulcus
28
What sulcus/fissure separates the frontal and parietal lobes from the temporal lobe
Lateral sulcus/fissure
| the insular cortex lies deep within the lateral sulcus
29
What is the insular cortex
portion of the cerebral cortex folded within the lateral sulcus
receives sensory info from the environment , sensory experience and emotional valence
taste and sensation
30
frontal lobe syndrome is involved in planning and problem solving
what else is a common problem with frontal lobe syndrome
difficulty initiating behaviour or stopping a behavioural pattern
31
Apraxia ( axis- movement)
difficulty planning and performing motor activities
32
Agnosia
inability to recognise objects , face smell and sounds
33
Aphasia
difficulty with production or comprehension of speech and language
34
Amnesia
memory loss - new memories recognises familiar places or faces
35
Brocas aphasia (BLOCK)
motor and expressive aphasia - cant produce words but comprehension is ok
i.e. can't speak or write but know what they want to say
36
wernickes aphasia
Wernckes aphasia is receptive/sensory aphasia , speech production is ok but it is meaningless gibberish and comprehension reduced - parietal lobe , very fluent no words
supplied by inferior medial cerebral artery
37
What sulcus separates the occipital lobe into two parts the lingual gyrus and cuneus
calcarine( visual) fissure
38
what is the limbic system and what is it composed of
deals with emotions and memory made up of
Regulates endocrine and autonomic function in response to emotion and behaviour
hypothalamus
amygdala
thalamus
hippocampus
39
What is the diencephalon that consists of structures that are either side of the third ventricle
division of the forebrain
thalamus
hypothalamus
and ( epithalamus and sub thalamus )
40
Function of the hypothalamus
controls homeostatic mechanisms. Brain centre for regulation of autonomic functions
posterior - sympathetic
anterior -parasympathetic
41
function of the thalamus
composed of nuclei involved in relaying sensory and motor signals
regulation of consciousness and alertness
forms lateral wall of 3rd ventricle
42
The vast majority of the axons that pass between the cerebral cortex and the subcortical structures form a broad white sheet called the
internal capsule
43
function of the caudate nucleus
planning and execution of movement
| memory and learning
44
function of the amygdala
emotions are given meaning and remembered
45
function of hippocampus
learning and memory
46
function of basal ganglia
motor refinement
| nuclei
47
What does the brain stem consist of
midbrain
pons
medulla
Respiratory, cardiovascular, vomiting centres
Motor control, sleep, bladder control nuclei all found here
48
which part of the brainstem is important in controlling motor movement in particular movements of the eye, auditory and visual processing
mid brain
49
function of pons
connection between cerebrum and cerebellum
50
what part of the brain stem contains the cardiac, respiratory, vomtiing and vasomotor centres
medulla oblongata ( BP too)
51
what connect the brainstem to the cerebellum
peduncles
52
function of the cerebellum
balance, coordination, muscle tone and posture
- Archicerebellum – oldest part of brain which controls balance.
- Paleocerebellum – muscle tone and posture.
- Neocerebellum – muscular coordination, including trajectory speed and force of movements.
Nuclear masses of the cerebellum
- Dentate nucleus – white matter
- Emboliform
- Fastigal nucelus
- Gobose nucleus
53
what are the 3 subdivisions of the cerebellum
- Archicerebellum
- Paleocerebellum
- Neocerebellum
54
What part of the cerebellum is the oldest part of brain which controls balance.
Archicerebellum
55
what part of the cerebellum controls muscle tone and posture.
Paleocerebellum
56
what part of the cerebellum controls muscular coordination, including trajectory speed and force of movements.
Neocerebellum
57
In the circle of willis where does the main blood supply come from - 2 arteries
internal carotid
| veterbral arteries
58
internal carotid artery is a branch of the common carotid artery through what cranial cavity does it enter
Enters the middle cranial cavity through the internal carotid foramen and carotid canal with characteristic bends called the carotid syphon
59
what artery does the vertebral artery arise from
subclavian artery
60
through what foramen does the vertebral artery enter the cranial cavity
- Ascends through the foramen transversaria from the 6th cervical vertebra
- Enters cranial cavity through the foramen magnum
61
Where does the vertebral arteries combine to form the basilar artery
- Units at the junction of the medulla and pons to form the midline basilar arter
62
what is an ischemic stroke
blockage of blood vessel to the brain - clot or atherosclerosis ( build up of fats in or on walls or arteries forming a plaque)
63
hemorrhagic stroke
weakened blood vessel bursts into surrounding brain hypertension, injury, aneurysm( enlargement of artery caused by weakness in wall) , clotting issue.
64
How do you differentiate between types of strokes
CT scan
65
What common clinical problems occurs at the carotid syphon
intercranial aneurysm
66
Where does blood from the external carotid go to
face and neck
67
Where does the basilar artery supply blood to
cerebellum, brainstem and occipital lobes
68
the internal carotid and posterior cerebral arteries are connected by which artery
posterior communicating arteries - provide alternating route - supply diencephalon
69
through what fissure does the middle cerebral artery run
lateral fissure
70
What artery supple the frontal, lateral surface of temporal and parietal including the primary and motor and sensory areas of face throat and hands and is superficial.
middle cerebral artery
71
damage to the insular cortex causes what
apathy - lack of feeling or emotion
loss of libido - sex drive
inability to tell fresh food from rotten
72
what artery supplies the frontal lobe , personality and voluntary movement - especially the legs
also supplies corpus callosum
- Anterior cerebral artery – lateral surface from lateral fissure
73
a stroke in the ACA results in what
opposite leg weakness
74
what artery supplies the occipital, temporal , midbrain, thalamus and choroid plexus of 3rd and lateral ventricles
- Posterior cerebral artery – posterior lobes
75
what does occlusion mean
blockage or closing of a blood vessel
76
what is Webber syndrome
stroke affecting medial portion of mid Brain
| characterised by ipsilateral oculomotor nerve palsy and hemiplegia
77
what artery connects the two anterior cerebral arteries and acts as anastomosis. It also allows the collateral flow into opposite hemispheres if carotid artery is occluded
anterior communicating artery
78
what structure to the anterior and posterior spinal arteries supply
medulla and spinal cord
79
what artery supplies the superior inferior aspect of the cerebellum
posterior inferior cerebellar arteries PICA
80
The PICA arteries passes up through inferior pons and descends on the lateral border of the 4th ventricle then to the undersurface of the cerebellum. If severe occlusion of this artery occurs what syndrome can develop
Wallenburg syndrome
81
What are the signs of Wallenberg syndrome
dysphagia , nausea and hoarseness , bradycardia and low BP and balance problems due to stroke
82
The pontine arteries supply where
pons
83
What artery supplies the anterior and inferior portions of the cerebellum and arises at the junction between the pons and medulla. also supplies middle cerebellar peduncle
anterior inferior cerebellar arteries ( AICA)
84
the superior cerebellar arteries supplies the whole superior surface of the cerebellar hemispheres down to horizontal fissure. Does ir supply most of the cerebellar white matter?
yes
85
where can you find the dural venous sinuses
in between the periosteal and meningeal layer of dura mata
86
Where do all the dural venous sinuses drain into
internal jugular vein
87
what is CVST
cervical venous sinus thrombosis
88
why do sinuses have no vlaves
pressure in peripheral circulatory system propel blood back to the heart
89
why do sinuses have no valves
pressure in peripheral circulatory system propel blood back to the heart
90
What are the two ventral folded flexures - feotus
mesencephalic - midbrain
| cervical - junction of telencephalon and spinal cord
91
what Is the one dorsally folded flexure
pontine located at pons
92
what is the angulate gyrus control
emotions and regulating behaviour
93
what sulcus divides the occipital lobes
calcarine
94
cingulate sulcus
separates cingulate cortex and limbic lobes from parietalanx frontal lobes on medial surface
95
Two layers of dura mata
periosteal dura mater outside (endosteal layer – directly below periosteum of brain) and meningeal dura mater inside
96
what lies between the two layers of the dura mata
dural venous sinuses
97
what are dural reflections
Meningeal layer folds down to partition brain in to sections with what are called dural reflections:
98
3 dural reflections
Tentorium cerebelli
Falx cerebelli
falx cerebri
99
Tentorium cerebelli
T for transverse
transverse between cerebellum and cerebrum
| horizontal layer – meets the vertical falx cerebri posterior to the brain
100
Falx cerebelli
sagittal between each half of cerebellum
| Falx cerebelli is below the confluence of sinuses
101
falx cerebri
sagittal between each hemisphere of cerebrum
| within the greater longitudinal fissur
102
what is the middle layer of the meninges called
Arachnoid mater
103
what space separates the dura mata from the arachnid mater
subdural space
104
How does the arachnoid mater help with returning the CSF into he venous drainage
- Forms processes called villi project into the superior sagittal sinus, helping with returning the CSF into the venous drainage
105
what is the inner layer called of the meninges
pia mater
106
meningitis
Inflammation of meninges
107
what gram negative and gram positive diplococci bacteria meningitis bacteria respectively
Neisseria meningitidis (gram negative diplococci) and Streptococcus pneumoniae (gram positive diplococci)
108
An immune response causes a cerebral oedema to meningitis what does this cause
increases ICP
109
symptoms of meningitis
Sx: stiff neck (flexion), photophobia, rash (non-blanching), headache, fever, decreased GCS, seizures, vomiting
Tx/ antibiotics. Fluids and o2 sometime needed. Viral will normally recover on own
110
how many ventricles are there
4
- Left lateral 1
- Right lateral 2 – choroid plexus creates CSF
- Middle 3
- Inferior 4
111
ventricular system function
communicating cavities responsible for production, transport and removal of cerebrospinal fluid which bathes the nervous system
112
Why are the ventricles so important
Produce CSF from choroid plexus lining them.
113
where does the csf drain too
Drain to central spinal canal and subarachnoid cisterns
114
how is csf absorbed
CSF reabsorbed by arachnoid granulations in to sinuses
115
what joins the 3rd and 4th ventricle
cerebral aqueduct
116
where must spinal taps been taken from in the back
Spinal taps must be taken below L2 in adults and L3 in children
117
What is the end of the spinal cord called
Below the termination of spinal cord (conus medullaris) the spinal nerves descend in Cauda Equina
118
which part of the spine also has a lateral horn as well as ventral and dorsal
thoracic
119
what artery could be ruptured with a blow to the pterion causing what type of haematoma
middle meningeal artery causing an epidural haematoma
120
due to vascular insufficiency where is spinal cord most vulnerable
thoracic region and anterior portion of the cord
| ASA and 2 PSA
121
the middle meningeal artery supplies the dura mata and calvaria, periosteum and cranial bones. What artery is it a branch of
maxillary artery
122
what is the weakest part of the skull
pterion - junction between the frontal , parietal and sphenoid and temporal bones
123
epidural haematoma
bleeding between the dura mata and the skull
124
Blockage of one of which 3 arteries could cause ischaemic stroke affecting relevant motor distribution
anterior,middle and posterior cerebral arteries
125
Speech difficulties known as
dysarthria
126
Difficulty initiating behaviour, Inability to stop a behavioural pattern , Difficulties in planning and problem solving and Incapable of creative thinking are all symptoms of what injury
Frontal lobe syndrome
127
what is an (intention tremor)
(intention tremor)- Incoordination of the upper limbs
128
do unilateral lesions of cerebellum cause ipsilateral or contralateral symptoms
contralateral
129
bilateral lesion to the cerebellum can be caused by
alcohol intoxication and hypothyroidism – incoordination, speech difficulties, wide based unsteady gait – cerebellar ataxia – aka ed syndrome.
130
midline cerebellar lesion cause
lack of postural control
131
Dejerine-Roussy syndrome
- Caused by lesion to thalamus
- Loss of sensation to face and limbs on contralateral side
- Thalamic pain
132
CSF Rhinorrhoea-how can it be confirmed
- CSF leaks from the nose due to fractured cribiform plate of ethmoid bone
- Can be confirmed by glucose presence in the liquid that comes out of the nose – no glucose in the nose
133
Brown – Sequard syndrome
- lesion in one side of the spinal cord caused by trauma or tumour.
- contralateral loss of temperature and pain
- ipsilateral loss of gross motor and proprioception, vibration etc.
- caused by the lateral spinothalamic tract being blocked by a tumour or lesion
134
Anterior spinal artery syndrome
blood supply of lateral spinothalamic tract and anterior corticospinal tracts are affected.
- Loss of pain and temperature sensation bilaterally inferior (everywhere below) to the level that the problem occurs
135
Syringomyelia
Fluid filled cyst within the spinal cord – causes obstruction to the crossing over of the lateral spinothalamic tract at the spinal cord
- Pain/temp loss bilaterally inferior
- 2nd order neurone is affected as they cross the spinal cord
136
- Upgoing plantar reflex (Babinski’s sign), increased spasticity, tonicity and tetany.
UMN disease
137
- Normal plantar reflex, decreased spasticity, tonicity and tetany + fasciculations
LMN disease
138
- narrowing of the c5 nerve root – common in elderly patients and presents as pain in the neck and shoulders
Spondylosis
139
Myositis
- autoimmune attack of muscle – measured by listening to muscles
140
Hydrocephalus
- blockage of the movement of CSF- explained on CSf one
- communicating – blocked reabsorptions at arachnoid granulations causing rise in ICP
- non-communicating – blocked cerebral aqueduct causing increased ICP
141
Parkinson’s disease
- degeneration of dopamine producing neurone in the pars compacta region of the substantia nigra
- seen on a CT scan as no black staining in this region
- no idea if we need to know this but was on the iCAST so got it just in case
142
How are low pressure headaches often caused
- often caused by a lumbar puncture where CSF is taken from the spinal cord at 4th lumbar vertebra
- causes decreased intracranial pressure due to decreased volume
- internal strain on meninges as they are pulled away from the skull
- fookin hurts mate
143
what is coning
Caused by an increase in Intra cranial pressure (ICP)
- Brain is pushed down through the foramen magnum
- Affects brainstem and causes particular type of shallow, sporadic breathing as the breathing centre is affected.
144
treatment for ischaemic stroke
Thrombolysis within 4 hours of symptoms onset
- Thrombectomy within 4/5 hours
- Outside of 4 hour window – 300mg aspit
145
posterior circulation stroke
cerebellar arteries (anterior inferior/superior) can be occluded or haemorrhage.
- Causes ataxic gait due to cerebellum’s role in balance and coordination – dysdiadochokinesia
146
what stroke can cause contralateral pain, temp and coarse touch loss due to role in supplying the medulla.
- Posterior cerebellar artery stroke
147
Anterior/middle cerebral artery stroke causes
- unilateral weakness/sensory loss
- supplies the motor and sensory cortex
- upgoing plantar reflexes and clonus present due to it being an upper motor nerve lesion
148
in one type of stroke is vision affected due to the occipital lobe losing blood supply
posterior cerebral artery stroke
149
In a carcinoma to the tongue the lingual nerve is affected- pain if felt where
Pain is felt in the ear due to auriculotemporal nerve
150
a tumour on which gland causes bitemporal hemianopia( tunnel vision)
Pituitary tumours on the optic chiasma
151
Schwann cells tumours on the cochlear nerve
Acoustic neuromas
152
What acronym do you use for cerebellar injury
DANISH
153
what does DANISH stand for
Dysdiadochokinesia - perform movements inability
ataxia - gait and posture without coordination
nystagmus - rapid eye movement
intention tremor
slurred, staccato speech
Hypotonia - decreased muscle tone
154
how many cerebellar peduncles are there and what do they contain
3 pairs and contain nerve tracts between brainstem and cerebellum
inferior - sensory info about positions
middle - desired position of these parts
superior - mid brain
155
what connects the thalami to the brainstem
cerebral peduncle
156
forebrain
diencephalon and cerebral hemispheres
157
hindbrain
medulla, pons and cerebellum
158
Horners syndrome is caused by damage to a certain pathway in the sympathetic nervous system - what are the symptoms ( obviously going to be things that this pathway controls)
```
mitosis ( constricted pupil)
ptosis- dropping of upper eyelid
anhisorsis
exophthalmos - sinking of eyeball into bony Cavity that protects the eye
ipsilateral
```
159
wallenburg syndrome causes nystagmus , pain and temp loss on 1 side of the face and opposite body , problem with balance and gait coordination , Dysphagia and horsiness - what part of the brain does it affect
lateral medulla
160
pons controls sleep and respirator as well as taste and hearing and facial expresions what cranial nerves originate here
CN5-8
161
what cranial nerves start in the medulla
CN9-12 and 5
162
what cranial nerves start in the mid brain
CN3-7 and 5
163
what is bells palsy
temporary weakness or lack of movement from one side of the face - LMN
164
where is the transverses fissure
separates cerebrum and cerebellum
165
when does tonsils descent occur - look for on ct
raised ICP
166
what is the corpus callosum
bundle of white matter tracts enabling communication between hemispheres
Running over the top of the corpus callosum is the cingulate gyrus
167
pineal gland-above pregnant women produces what
melatonin - sleep
| cysts develop here leading to hydrocephalus
168
what is the Basal cisterns
csf reservoirs around the centre of the brain
169
what colour to infarcts show on ct
darker grey
170
what is a good sign of Sagittal sinus thrombosis
the veins appear to stop under mri just no fluid indicating blockage
171
what is epilepsy
sudden bursts of electrical activity in Brain cause seizures and fits
172
what causes epilepsy
brain tumours
| strokes
173
symptoms of epilepsy
fit
loosing awareness an staring blankly
stiff
2 or more seizures more than 24 hours apart
- Focal – speech, sight, hearing, autonomic disturbance
- Generalised – tonic – clonic, myoclonic, atonic, absence
- Can start as focal and become generalised
174
A thrombus in the superior sagittal sinus can cause what
Headache, seizures, altered conscious level, focal neurology (e.g. weakness)
formed between layers of dura. The superior sagittal sinus is formed between the dural reflections forming the falx cerebri, in the midline.
175
if the right anterior cerebral artery is occluded by a thrombus in which limb would you expect weakness to be worst
left lower limb- ACA supplies both frontal and super medial parietal lobe - contralateral limb
