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CP3 @ UoN - Medicine & Surgery > Basic Neuroanatomy & Neurophysiology > Flashcards

Basic Neuroanatomy & Neurophysiology Flashcards

1
Q

What are the constituent portions of the cerebral cortex?

A

Frontal
Parietal
Temporal
Occipital

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2
Q

What are the arteries/branches that make up the Circle of Willis?

A

Anterior Cerebral Artery
Middle Cerebral Artery
Posterior Cerebral Artery
Vertebral/Basilar Arteries

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3
Q

What territories does the anterior cerebral artery supply?

A

Medial surface of cerebral hemisphere, as far back as peri-occipital sulcus

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4
Q

What territories does the middle cerebral artery supply?

A 
2/3 of lateral surface of brain
Central branches supply:
    -corpus striatum
    -thalamus
    -internal capsule
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5
Q

What territories does the posterior cerebral artery supply?

A 
Corpus callosum & cortex of occipital/temporal lobes
Central branches supply:
    -optic radiation
    -subthalamic nucleus
    -thalamus
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6
Q

Which territories are supplied by the Vertebral/Basilar arteries?

A

Brainstem

Cerebellum

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7
Q

What is the function of CN 1 (Olfactory)?

A

Special Sensory - smell from nasal mucosa

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8
Q

What is the function of CN 2 (Optic)?

A

Special Sensory - vision from retina

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9
Q

What is the function of CN 3 (Occulomotor)?

A

Somatic Motor - 4/6 extra-ocular muscles, levator palpebrae superioris
Visceral Motor - Pupil constriction

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10
Q

What is the function of CN 4 (Trochlear)?

A

Somatic Motor - superior oblique extra-ocular muscle

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11
Q

What are the three divisions of CN 5 (Trigeminal)?

A

Ophthalmic (V1)
Maxillary (V2)
Mandibular (V3)

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12
Q

What is the function of the Ophthalmic division of CN 5 (Trigeminal)?

A

Sensory - sup 1/3 of face, cornea

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13
Q

What is the function of the Maxillary division of CN 5 (Trigeminal)?

A

Sensory - med 1/3 of face, over maxilla

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14
Q

What is the function of the Mandibular division of CN 5 (Trigeminal)?

A

Sensory - sensation over mandible & lower lip

Motor - muscles of mastication (masseter & pterygoids)

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15
Q

What is the function of CN 6 (Abducent)?

A

Somatic Motor - lat rectus extra-ocular muscle

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16
Q

What is the function of CN 7 (Facial)?

A

Somatic Motor - muscles of facial expression
Visceral Motor - submandibular/sublingual glands, lacrimal gland
Special Sensory - taste from ant 2/3 of tongue
General Sensory - skin of external acoustic meatus

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17
Q

What is the function of CN 8 (Vestibulocochlear)?

A

Specail Sensory - hearing & balance

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18
Q

What is the function of CN 9 (Glossopharyngeal)?

A

Somatic Motor - stylopharyngeus (swallow)
Visceral Motor - parotid gland
Special Sensory - post 1/3 of tongue
General Sensory - sensation from external ear/pharynx
Visceral Sensory - visceral feedback from carotid body

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19
Q

What is the function of CN 10 (Vagus)?

A

Somatic Motor - palatal/laryngeal/pharyngeal muscles of swallowing
Visceral Motor - parasympathetic innervation to smooth muscle of trachea, bronchi, GI tract & heart
Visceral Sensory - Sensation from above viscera
Special Sensory - taste from epiglottis/palate
General Sensory - sensation from auricle & external acoustic meatus

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20
Q

What is the function of CN 11 (Spinal Accessory)?

A

Motor - sternocleidomastoid & trapezius

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21
Q

What is the function of CN 12 (Hypoglossal)?

A

Motor - intrinsic/extrinsic muscles of tongue

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22
Q

Where is the nuclei of CN 1?

A

Olfactory epithelium

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23
Q

Where is the nuclei of CN 2?

A

Retinal ganglion cells

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24
Q

Where are the nuclei of CN 3 & 4?

A

Midbrain

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25
Where are the nuclei of CN 5, 6 & 7?
Pons
26
Where is the nuclei of CN 8?
Vestibular/Spiral ganglion
27
Where are the nuclei of CN 9, 10 & 11?
Medulla
28
Where are the nuclei of CN 12?
Spinal cord
29
What syndromes may arise from a lesion in the brainstem?
Bulbar palsy | Pseudobulbar palsy
30
What is a Bulbar palsy?
LMN weakness of muscles supplied by CNs w/ cell bodies w/i medulla (CN 9, 10 & 11)
31
What are the sx/signs of a Bulbar palsy?
``` Wasted, flaccid, fasciculating tongue Dysphagia Poor elevation of soft palate Quiet, nasal speech Jaw jerk/gag reflex absent ```
32
What are the common causes of a Bulbar palsy?
``` Degenerative (MND) Vascular (Stroke) Inflammatory (Guillian-Barre) Infection (Botulism) Neoplastic (Brainstem tumours) Congenital ```
33
What is a Pseudobulbar Palsy?
Bilateral UMN disease of medullary CNs
34
What are the sx/signs of a Pseudobulbar palsy?
``` Stiff/spastic tongue, w/ slow movements Dysphagia Normal elevation of soft palate Gravelly, 'donald duck' speech (slurred, high pitched) Exaggerated jaw jerk/gag reflex Mood disturbances ```
35
What are the most common causes of a Pseudobulbar palsy?
Degenerative (MND) Vascular (Stroke) MS Head trauma
36
What are the sx/signs of frontal lesions?
``` Intellectual impairment Personality change Urinary incontinence Monoparesis/Hemiparesis Broca's aphasia (L. frontal) ```
37
What are the sx/signs of left temporo-parietal lesions?
``` Agraphia Alexia Acalculia Wernicke's aphasia Contralateral sensory neglect ```
38
What are the sx/signs of right temporo-parietal lesions?
Failure of face recognition | Contralateral sensory neglect
39
What are the sx/signs of occipital lesions?
Visual field defects | Visuospatial defects
40
What is the function of the constituent parts of the Cerebellum?
Lobe - controls movement of ipsilateral limbs | Vermis - maintains midline posture & balance
41
What are the sx/signs of lateral cerebellar lesions (cerebellar ataxia)?
Ipsilateral pathological signs - broad, ataxic gait - titubation (head tremor) - dysarthria (slurred, staccato) - nystagmus - dysmetric saccades - upward drift - rebound phenomenon - hypotonia/hyporeflexia - dysmetria/dysdiadochonkinesis
42
What are the sx/signs of midline cerebellar lesions?
Broad, rolling, ataxic gait Difficulty standing/sitting unsupported Vertigo/vomiting
43
What are the common causes of cerebellar dysfunction?
``` Bilateral -alcohol -drugs (phenytoin, anti-epileptics) -paraneoplastic cerebellar degeneration -hypothyroidism Unilateral -MS -stroke -tumour (acoustic neuroma, meningioma) ```
44
What structures make up the basal ganglia?
Corpus striatum (caudate nucleus, globus pallidum, putamen) Subthalamic nucleus Substantia nigra Parts of the thalamus
45
What are the sx/signs of basal ganglia lesions?
``` Bradykinesia Muscle rigidity Involuntary movements -tremor -dystonia -athetosis -chorea -hemiballismus ```
46
What clinical syndromes arise from basal ganglia pathology?
Parkinsonism Huntington's Hemiballismus
47
What is Hemiballismus?
Violent, involuntary movements, restricted to proximal muscles of just one arm
48
What is the location of the causative lesion in a central scotoma?
Macula (e.g. diabetic maculopathy)
49
What is the location of the causative lesion in monocular loss of vision?
Ipsilateral optic nerve lesion
50
What is the location of the causative lesion in bitemporal hemianopia/quadrantanopia?
Optic chiasm (affects nasal fibres) - sup bitemporal quadrantanopia due to pressure from below (pituitary tumour) - inf bitemporal quadrantanopia due to pressure from above (craniopharyngoma, carotid aneursym etc.)
51
What is the location of the causative lesion in homonymous hemianopia?
Contralateral optic tract lesion
52
What is the location of the causative lesion in homonymous quadrantanopia?
Contralateral optic radiation lesion -sup homonymous quadrantanopia (temporal) -inf homonymous quadrantanopia (parietal) PITS
53
What does macular sparing in homonymous hemianopia/quadrantanopia suggest about the location of the defect?
Visual cortex (occipital lobe)
54
What is the location/function of Broca's area?
Inferior frontal gyrus (44 & 45) | Motor speech
55
What is the location/function of Wernicke's area?
Superior temporal gyrus (22) | Speech comprehension
56
What structure links Broca's & Wernicke's area?
Association fibres of arcuate fasciculus
57
What is Broca's aphasia?
Express aphasia, loss of ability to produce speech - non-fluent, verbal output reduced - comprehension good, repetition poor
58
What is Wernicke's aphasia?
Receptive aphasia, loss of ability to understand speech - fluent, normal production of incorrect words - poor comprehension, poor repetition
59
What is Global aphasia?
Expressive AND receptive dysphasia
60
What is Nominal aphasia?
Difficulty word finding
61
What is dysarthria?
Disordered articulation/slurred speech, language remains intact
62
What are the causes of dysarthria?
``` Bulbar palsy (LMN, high pitched, nasal speech) Pseudobulbar palsy (UMN, 'donald duck' gravelly speech) Cerebellar palsy (slow, jerky, slurred speech) Extrapyramidal lesions (soft, indistinct, monotonous speech) Myaesthenia Gravis (speech fatigues/dies away) ```
63
What is Horner's syndrome?
Oculosympathetic palsy, caused by interruption of sympathetic chain
64
What are the sx of Horner's syndrome?
Unilateral pupillary constriction (miosis) Slight ptosis Apparent enopthalmos Anhydrosis Heterochromia (congenital/long-standing lesions)
65
What are the possible levels of the causative lesion in Horner's syndrome?
1st order neurone 2nd order neurone 3rd order neurone
66
What are the common causes of Horner's syndrome affecting 1st order neurones?
Brainstem disease - tumour - MS - stroke - syphillis
67
What are the common causes of Horner's syndrome affecting 2nd order neurones?
``` Intrathoracic lesiosn -pancoast -cervical rib -TB Neck lesions -lymphadenopathy -trauma -thyroid surgery ```
68
What are the common causes of Horner's syndrome affecting 3rd order neurones?
ICA aneurysm Migraine (transient) Idiopathic
69
What features can help distinguish the site of the causative lesion of Horner's syndrome?
Face/arm/trunk anhydrosis = 1st order Facial anyhdrosis only = 2nd order No anhydrosis = 3rd order
70
What do LMNs innervate?
Ipsilateral muscles
71
What do UMNs innervate?
Contralateral muscles
72
What are the signs of LMN disease?
``` Weakness Wasting Fasciculation Hypotonia Hyporeflexia ```
73
What are the signs of UMN disease?
``` Weakness (pyramidal ie. flexor in upper, extensor in lower) No wasting Hypertonia, spasticity Hyperreflexia Loss of fine motor movements Pronator drift Extensor plantar Clonus ```
74
What are the facial signs of LMN disease?
Ipsilateral facial weakness of all muscles of facial expression
75
What are the facial signs of UMN disease?
Contralateral facial weakness, sparing frontalis
76
What is the ddx for a LMN lesion?
Ventral horn pathology Peripheral nerve pathology NMJ pathology Muscular pathology
77
What is the ddx for a UMN lesion?
VINDIE - vascular (stroke) - inflammatory (MS, MND) - neoplastic (tumour) - degenerative (Parkinson's) - infective (post-meningitis) - extras (drugs)
78
What are the descending tracts of the spinal cord?
Lateral corticospinal tract (motor) | Ventral corticospinal tract (motor)
79
What are the ascending tracts of the spinal cord?
Dorsal columns (deep touch, proprioception, vibration) Lateral spinothalamic tract (pain, temperature) Ventral spinothalamic tract (light touch)
80
What is the function of the spinothalamic tract?
Transmits pain, temperature, light touch to the thalamus | Decussates at spinal level
81
What is the function of the dorsal columns?
Transmit deep touch, proprioception & vibration to parietal cortex Consists of fasciculus cuneatus/gracilis Decussates in brainstem
82
What is the function of the corticospinal tract?
Transmit motor axons from motor cerebral cortex to spinal cord Decussates in brainstem
83
What clinical syndrome would arise from cord transection at C3?
``` Neurogenic shock Resp insufficiency Quadriplegia Anaesthesia below affected level Loss of bladder/bowel sphincter tone Sexual dysfunction Horner's syndrome ```
84
What clinical syndrome would arise from cord transection at T10?
Paraplegia Anaesthesia Loss of rectal/bladder sphincter tone Sexual dysfunction
85
What clinical syndrome would arise from a cord hemisection?
Brown-Sequard syndrome Ipsilateral reduced power/vibration/proprioception (PC) Contralateral reduced pain/temp/light touch (STT)
86
What clinical syndrome would arise from a posterior cord lesion?
Tingling, numbness, electric-shock like syndromes Clumsiness Sensory ataxia Loss of proprioception/vibration/2-point discrimination below the level of th elesion

CP3 @ UoN - Medicine & Surgery (135 decks)

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