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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
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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
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3
Q

what nerves are housed by the temporal bone

A

cranial nerves 7 and 8

so the facial and the vestibulocochlear nerves

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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

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5
Q

frontal fontanelle- year to close

between what sutures

A

largest and junction between sagittal suture, coronal suture and the frontal suture

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6
Q

occipital/posterior fontanelle 3-6months close

junction between what sutures

A

junction between the sagittal suture and lambdoid suture

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7
Q

What is a suture - joint

A

suture is a type of fibrous joint in the brain

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8
Q

coronal suture

A

separates 2 parietal bones from the frontal bone

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9
Q

sagital suture

A

between the two parietal bones

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10
Q

lambdoid suture

A

between the occipital bone and the parietal bones

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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
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12
Q

how many fossas does the skull have

A

3

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13
Q

anterior fossa houses what

A

frontal lobe

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14
Q

middle fossa houses what

A

temporal lobe

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15
Q

posterior fossa houses

A

mid brain

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16
Q

what are the 4 lobes of the cerebrum/brain

A

frontal
parietal
occipital
temporal

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17
Q

frontal lobe

A

voluntary movement

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18
Q

parietal

A

somatosensory and sensation

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19
Q

occipital

A

vision

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20
Q

temporal

A

hearing

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21
Q

middle cerebral artery supplies- imagining the picture here like local area not specifically

A

most of the lateral side of the brain

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22
Q

anterior cerebral artery- image of picture not specific here

A

most of the medial side of the brain and anterior

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23
Q

posterior cerebral artery- portion or diagram

A

posterior cerebrum

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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

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25
Q

the postcentral gyrus is a prominent gyrus in the lateral parietal lobe . what is it the location of

A

primary somatosensory cortex ( sensory homunculus )

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26
Q

What fissure separates the two cerebral hemispheres

what joins them at the bottom

A

great longitudinal fissure – they are joined at the bottom by the corpus callosum.

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27
Q

What sulcus separates the parietal lobe from the frontal lobe and the primary motor cortex from the primary somatosensory cortex

A

central sulcus

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28
Q

What sulcus/fissure separates the frontal and parietal lobes from the temporal lobe

A

Lateral sulcus/fissure

the insular cortex lies deep within the lateral sulcus

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29
Q

What is the insular cortex

A

portion of the cerebral cortex folded within the lateral sulcus

receives sensory info from the environment , sensory experience and emotional valence
taste and sensation

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30
Q

frontal lobe syndrome is involved in planning and problem solving
what else is a common problem with frontal lobe syndrome

A

difficulty initiating behaviour or stopping a behavioural pattern

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31
Q

Apraxia ( axis- movement)

A

difficulty planning and performing motor activities

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32
Q

Agnosia

A

inability to recognise objects , face smell and sounds

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33
Q

Aphasia

A

difficulty with production or comprehension of speech and language

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34
Q

Amnesia

A

memory loss - new memories recognises familiar places or faces

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35
Q

Brocas aphasia (BLOCK)

A

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

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36
Q

wernickes aphasia

A

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

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37
Q

What sulcus separates the occipital lobe into two parts the lingual gyrus and cuneus

A

calcarine( visual) fissure

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38
Q

what is the limbic system and what is it composed of

A

deals with emotions and memory made up of
Regulates endocrine and autonomic function in response to emotion and behaviour

hypothalamus
amygdala
thalamus
hippocampus

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39
Q

What is the diencephalon that consists of structures that are either side of the third ventricle

A

division of the forebrain
thalamus
hypothalamus
and ( epithalamus and sub thalamus )

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40
Q

Function of the hypothalamus

A

controls homeostatic mechanisms. Brain centre for regulation of autonomic functions
posterior - sympathetic
anterior -parasympathetic

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41
Q

function of the thalamus

A

composed of nuclei involved in relaying sensory and motor signals
regulation of consciousness and alertness
forms lateral wall of 3rd ventricle

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42
Q

The vast majority of the axons that pass between the cerebral cortex and the subcortical structures form a broad white sheet called the

A

internal capsule

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43
Q

function of the caudate nucleus

A

planning and execution of movement

memory and learning

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44
Q

function of the amygdala

A

emotions are given meaning and remembered

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45
Q

function of hippocampus

A

learning and memory

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46
Q

function of basal ganglia

A

motor refinement

nuclei

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47
Q

What does the brain stem consist of

A

midbrain
pons
medulla
Respiratory, cardiovascular, vomiting centres
Motor control, sleep, bladder control nuclei all found here

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48
Q

which part of the brainstem is important in controlling motor movement in particular movements of the eye, auditory and visual processing

A

mid brain

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49
Q

function of pons

A

connection between cerebrum and cerebellum

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50
Q

what part of the brain stem contains the cardiac, respiratory, vomtiing and vasomotor centres

A

medulla oblongata ( BP too)

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51
Q

what connect the brainstem to the cerebellum

A

peduncles

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52
Q

function of the cerebellum

A

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
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53
Q

what are the 3 subdivisions of the cerebellum

A
  • Archicerebellum
  • Paleocerebellum
  • Neocerebellum
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54
Q

What part of the cerebellum is the oldest part of brain which controls balance.

A

Archicerebellum

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55
Q

what part of the cerebellum controls muscle tone and posture.

A

Paleocerebellum

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56
Q

what part of the cerebellum controls muscular coordination, including trajectory speed and force of movements.

A

Neocerebellum

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57
Q

In the circle of willis where does the main blood supply come from - 2 arteries

A

internal carotid

veterbral arteries

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58
Q

internal carotid artery is a branch of the common carotid artery through what cranial cavity does it enter

A

Enters the middle cranial cavity through the internal carotid foramen and carotid canal with characteristic bends called the carotid syphon

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59
Q

what artery does the vertebral artery arise from

A

subclavian artery

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60
Q

through what foramen does the vertebral artery enter the cranial cavity

A
  • Ascends through the foramen transversaria from the 6th cervical vertebra
  • Enters cranial cavity through the foramen magnum
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61
Q

Where does the vertebral arteries combine to form the basilar artery

A
  • Units at the junction of the medulla and pons to form the midline basilar arter
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62
Q

what is an ischemic stroke

A

blockage of blood vessel to the brain - clot or atherosclerosis ( build up of fats in or on walls or arteries forming a plaque)

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63
Q

hemorrhagic stroke

A

weakened blood vessel bursts into surrounding brain hypertension, injury, aneurysm( enlargement of artery caused by weakness in wall) , clotting issue.

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64
Q

How do you differentiate between types of strokes

A

CT scan

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65
Q

What common clinical problems occurs at the carotid syphon

A

intercranial aneurysm

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66
Q

Where does blood from the external carotid go to

A

face and neck

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67
Q

Where does the basilar artery supply blood to

A

cerebellum, brainstem and occipital lobes

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68
Q

the internal carotid and posterior cerebral arteries are connected by which artery

A

posterior communicating arteries - provide alternating route - supply diencephalon

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69
Q

through what fissure does the middle cerebral artery run

A

lateral fissure

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70
Q

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.

A

middle cerebral artery

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71
Q

damage to the insular cortex causes what

A

apathy - lack of feeling or emotion
loss of libido - sex drive
inability to tell fresh food from rotten

72
Q

what artery supplies the frontal lobe , personality and voluntary movement - especially the legs
also supplies corpus callosum

A
  • Anterior cerebral artery – lateral surface from lateral fissure
73
Q

a stroke in the ACA results in what

A

opposite leg weakness

74
Q

what artery supplies the occipital, temporal , midbrain, thalamus and choroid plexus of 3rd and lateral ventricles

A
  • Posterior cerebral artery – posterior lobes
75
Q

what does occlusion mean

A

blockage or closing of a blood vessel

76
Q

what is Webber syndrome

A

stroke affecting medial portion of mid Brain

characterised by ipsilateral oculomotor nerve palsy and hemiplegia

77
Q

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

A

anterior communicating artery

78
Q

what structure to the anterior and posterior spinal arteries supply

A

medulla and spinal cord

79
Q

what artery supplies the superior inferior aspect of the cerebellum

A

posterior inferior cerebellar arteries PICA

80
Q

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

A

Wallenburg syndrome

81
Q

What are the signs of Wallenberg syndrome

A

dysphagia , nausea and hoarseness , bradycardia and low BP and balance problems due to stroke

82
Q

The pontine arteries supply where

83
Q

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

A

anterior inferior cerebellar arteries ( AICA)

84
Q

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?

85
Q

where can you find the dural venous sinuses

A

in between the periosteal and meningeal layer of dura mata

86
Q

Where do all the dural venous sinuses drain into

A

internal jugular vein

87
Q

what is CVST

A

cervical venous sinus thrombosis

88
Q

why do sinuses have no vlaves

A

pressure in peripheral circulatory system propel blood back to the heart

89
Q

why do sinuses have no valves

A

pressure in peripheral circulatory system propel blood back to the heart

90
Q

What are the two ventral folded flexures - feotus

A

mesencephalic - midbrain

cervical - junction of telencephalon and spinal cord

91
Q

what Is the one dorsally folded flexure

A

pontine located at pons

92
Q

what is the angulate gyrus control

A

emotions and regulating behaviour

93
Q

what sulcus divides the occipital lobes

94
Q

cingulate sulcus

A

separates cingulate cortex and limbic lobes from parietalanx frontal lobes on medial surface

95
Q

Two layers of dura mata

A

periosteal dura mater outside (endosteal layer – directly below periosteum of brain) and meningeal dura mater inside

96
Q

what lies between the two layers of the dura mata

A

dural venous sinuses

97
Q

what are dural reflections

A

Meningeal layer folds down to partition brain in to sections with what are called dural reflections:

98
Q

3 dural reflections

A

Tentorium cerebelli
Falx cerebelli
falx cerebri

99
Q

Tentorium cerebelli

T for transverse

A

transverse between cerebellum and cerebrum

horizontal layer – meets the vertical falx cerebri posterior to the brain

100
Q

Falx cerebelli

A

sagittal between each half of cerebellum

Falx cerebelli is below the confluence of sinuses

101
Q

falx cerebri

A

sagittal between each hemisphere of cerebrum

within the greater longitudinal fissur

102
Q

what is the middle layer of the meninges called

A

Arachnoid mater

103
Q

what space separates the dura mata from the arachnid mater

A

subdural space

104
Q

How does the arachnoid mater help with returning the CSF into he venous drainage

A
  • Forms processes called villi project into the superior sagittal sinus, helping with returning the CSF into the venous drainage
105
Q

what is the inner layer called of the meninges

106
Q

meningitis

A

Inflammation of meninges

107
Q

what gram negative and gram positive diplococci bacteria meningitis bacteria respectively

A

Neisseria meningitidis (gram negative diplococci) and Streptococcus pneumoniae (gram positive diplococci)

108
Q

An immune response causes a cerebral oedema to meningitis what does this cause

A

increases ICP

109
Q

symptoms of meningitis

A

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
Q

how many ventricles are there

A

4

  • Left lateral 1
  • Right lateral 2 – choroid plexus creates CSF
  • Middle 3
  • Inferior 4
111
Q

ventricular system function

A

communicating cavities responsible for production, transport and removal of cerebrospinal fluid which bathes the nervous system

112
Q

Why are the ventricles so important

A

Produce CSF from choroid plexus lining them.

113
Q

where does the csf drain too

A

Drain to central spinal canal and subarachnoid cisterns

114
Q

how is csf absorbed

A

CSF reabsorbed by arachnoid granulations in to sinuses

115
Q

what joins the 3rd and 4th ventricle

A

cerebral aqueduct

116
Q

where must spinal taps been taken from in the back

A

Spinal taps must be taken below L2 in adults and L3 in children

117
Q

What is the end of the spinal cord called

A

Below the termination of spinal cord (conus medullaris) the spinal nerves descend in Cauda Equina

118
Q

which part of the spine also has a lateral horn as well as ventral and dorsal

119
Q

what artery could be ruptured with a blow to the pterion causing what type of haematoma

A

middle meningeal artery causing an epidural haematoma

120
Q

due to vascular insufficiency where is spinal cord most vulnerable

A

thoracic region and anterior portion of the cord

ASA and 2 PSA

121
Q

the middle meningeal artery supplies the dura mata and calvaria, periosteum and cranial bones. What artery is it a branch of

A

maxillary artery

122
Q

what is the weakest part of the skull

A

pterion - junction between the frontal , parietal and sphenoid and temporal bones

123
Q

epidural haematoma

A

bleeding between the dura mata and the skull

124
Q

Blockage of one of which 3 arteries could cause ischaemic stroke affecting relevant motor distribution

A

anterior,middle and posterior cerebral arteries

125
Q

Speech difficulties known as

A

dysarthria

126
Q

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

A

Frontal lobe syndrome

127
Q

what is an (intention tremor)

A

(intention tremor)- Incoordination of the upper limbs

128
Q

do unilateral lesions of cerebellum cause ipsilateral or contralateral symptoms

A

contralateral

129
Q

bilateral lesion to the cerebellum can be caused by

A

alcohol intoxication and hypothyroidism – incoordination, speech difficulties, wide based unsteady gait – cerebellar ataxia – aka ed syndrome.

130
Q

midline cerebellar lesion cause

A

lack of postural control

131
Q

Dejerine-Roussy syndrome

A
  • Caused by lesion to thalamus
  • Loss of sensation to face and limbs on contralateral side
  • Thalamic pain
132
Q

CSF Rhinorrhoea-how can it be confirmed

A
  • 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
Q

Brown – Sequard syndrome

A
  • 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
Q

Anterior spinal artery syndrome

A

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
Q

Syringomyelia

A

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
Q
  • Upgoing plantar reflex (Babinski’s sign), increased spasticity, tonicity and tetany.
A

UMN disease

137
Q
  • Normal plantar reflex, decreased spasticity, tonicity and tetany + fasciculations
A

LMN disease

138
Q
  • narrowing of the c5 nerve root – common in elderly patients and presents as pain in the neck and shoulders
A

Spondylosis

139
Q

Myositis

A
  • autoimmune attack of muscle – measured by listening to muscles
140
Q

Hydrocephalus

A
  • 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
Q

Parkinson’s disease

A
  • 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
Q

How are low pressure headaches often caused

A
  • 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
Q

what is coning

A

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
Q

treatment for ischaemic stroke

A

Thrombolysis within 4 hours of symptoms onset

  • Thrombectomy within 4/5 hours
  • Outside of 4 hour window – 300mg aspit
145
Q

posterior circulation stroke

A

cerebellar arteries (anterior inferior/superior) can be occluded or haemorrhage.

  • Causes ataxic gait due to cerebellum’s role in balance and coordination – dysdiadochokinesia
146
Q

what stroke can cause contralateral pain, temp and coarse touch loss due to role in supplying the medulla.

A
  • Posterior cerebellar artery stroke
147
Q

Anterior/middle cerebral artery stroke causes

A
  • 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
Q

in one type of stroke is vision affected due to the occipital lobe losing blood supply

A

posterior cerebral artery stroke

149
Q

In a carcinoma to the tongue the lingual nerve is affected- pain if felt where

A

Pain is felt in the ear due to auriculotemporal nerve

150
Q

a tumour on which gland causes bitemporal hemianopia( tunnel vision)

A

Pituitary tumours on the optic chiasma

151
Q

Schwann cells tumours on the cochlear nerve

A

Acoustic neuromas

152
Q

What acronym do you use for cerebellar injury

153
Q

what does DANISH stand for

A

Dysdiadochokinesia - perform movements inability
ataxia - gait and posture without coordination
nystagmus - rapid eye movement
intention tremor
slurred, staccato speech
Hypotonia - decreased muscle tone

154
Q

how many cerebellar peduncles are there and what do they contain

A

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
Q

what connects the thalami to the brainstem

A

cerebral peduncle

156
Q

forebrain

A

diencephalon and cerebral hemispheres

157
Q

hindbrain

A

medulla, pons and cerebellum

158
Q

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)

A 
mitosis ( constricted pupil) 
ptosis- dropping of upper eyelid 
anhisorsis 
exophthalmos - sinking of eyeball into bony Cavity that protects the eye 
ipsilateral
159
Q

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

A

lateral medulla

160
Q

pons controls sleep and respirator as well as taste and hearing and facial expresions what cranial nerves originate here

161
Q

what cranial nerves start in the medulla

A

CN9-12 and 5

162
Q

what cranial nerves start in the mid brain

A

CN3-7 and 5

163
Q

what is bells palsy

A

temporary weakness or lack of movement from one side of the face - LMN

164
Q

where is the transverses fissure

A

separates cerebrum and cerebellum

165
Q

when does tonsils descent occur - look for on ct

A

raised ICP

166
Q

what is the corpus callosum

A

bundle of white matter tracts enabling communication between hemispheres
Running over the top of the corpus callosum is the cingulate gyrus

167
Q

pineal gland-above pregnant women produces what

A

melatonin - sleep

cysts develop here leading to hydrocephalus

168
Q

what is the Basal cisterns

A

csf reservoirs around the centre of the brain

169
Q

what colour to infarcts show on ct

A

darker grey

170
Q

what is a good sign of Sagittal sinus thrombosis

A

the veins appear to stop under mri just no fluid indicating blockage

171
Q

what is epilepsy

A

sudden bursts of electrical activity in Brain cause seizures and fits

172
Q

what causes epilepsy

A

brain tumours

strokes

173
Q

symptoms of epilepsy

A

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
Q

A thrombus in the superior sagittal sinus can cause what

A

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
Q

if the right anterior cerebral artery is occluded by a thrombus in which limb would you expect weakness to be worst

A

left lower limb- ACA supplies both frontal and super medial parietal lobe - contralateral limb

Neurology (13 decks)

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