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Tim 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
Q

Where are the nuclei of CN 5, 6 & 7?

A

Pons

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26
Q

Where is the nuclei of CN 8?

A

Vestibular/Spiral ganglion

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27
Q

Where are the nuclei of CN 9, 10 & 11?

A

Medulla

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28
Q

Where are the nuclei of CN 12?

A

Spinal cord

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29
Q

What syndromes may arise from a lesion in the brainstem?

A

Bulbar palsy

Pseudobulbar palsy

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30
Q

What is a Bulbar palsy?

A

LMN weakness of muscles supplied by CNs w/ cell bodies w/i medulla (CN 9, 10 & 11)

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31
Q

What are the sx/signs of a Bulbar palsy?

A 
Wasted, flaccid, fasciculating tongue
Dysphagia
Poor elevation of soft palate
Quiet, nasal speech
Jaw jerk/gag reflex absent
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32
Q

What are the common causes of a Bulbar palsy?

A 
Degenerative (MND)
Vascular (Stroke)
Inflammatory (Guillian-Barre)
Infection (Botulism)
Neoplastic (Brainstem tumours)
Congenital
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33
Q

What is a Pseudobulbar Palsy?

A

Bilateral UMN disease of medullary CNs

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34
Q

What are the sx/signs of a Pseudobulbar palsy?

A 
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
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35
Q

What are the most common causes of a Pseudobulbar palsy?

A

Degenerative (MND)
Vascular (Stroke)
MS
Head trauma

36
Q

What are the sx/signs of frontal lesions?

A 
Intellectual impairment
Personality change
Urinary incontinence
Monoparesis/Hemiparesis
Broca's aphasia (L. frontal)
37
Q

What are the sx/signs of left temporo-parietal lesions?

A 
Agraphia
Alexia
Acalculia
Wernicke's aphasia
Contralateral sensory neglect
38
Q

What are the sx/signs of right temporo-parietal lesions?

A

Failure of face recognition

Contralateral sensory neglect

39
Q

What are the sx/signs of occipital lesions?

A

Visual field defects

Visuospatial defects

40
Q

What is the function of the constituent parts of the Cerebellum?

A

Lobe - controls movement of ipsilateral limbs

Vermis - maintains midline posture & balance

41
Q

What are the sx/signs of lateral cerebellar lesions (cerebellar ataxia)?

A

Ipsilateral pathological signs

  • broad, ataxic gait
  • titubation (head tremor)
  • dysarthria (slurred, staccato)
  • nystagmus
  • dysmetric saccades
  • upward drift
  • rebound phenomenon
  • hypotonia/hyporeflexia
  • dysmetria/dysdiadochonkinesis
42
Q

What are the sx/signs of midline cerebellar lesions?

A

Broad, rolling, ataxic gait
Difficulty standing/sitting unsupported
Vertigo/vomiting

43
Q

What are the common causes of cerebellar dysfunction?

A 
Bilateral
   -alcohol
   -drugs (phenytoin, anti-epileptics)
   -paraneoplastic cerebellar degeneration 
   -hypothyroidism
Unilateral
   -MS
   -stroke
   -tumour (acoustic neuroma, meningioma)
44
Q

What structures make up the basal ganglia?

A

Corpus striatum (caudate nucleus, globus pallidum, putamen)
Subthalamic nucleus
Substantia nigra
Parts of the thalamus

45
Q

What are the sx/signs of basal ganglia lesions?

A 
Bradykinesia
Muscle rigidity
Involuntary movements
   -tremor
   -dystonia
   -athetosis
   -chorea
   -hemiballismus
46
Q

What clinical syndromes arise from basal ganglia pathology?

A

Parkinsonism
Huntington’s
Hemiballismus

47
Q

What is Hemiballismus?

A

Violent, involuntary movements, restricted to proximal muscles of just one arm

48
Q

What is the location of the causative lesion in a central scotoma?

A

Macula (e.g. diabetic maculopathy)

49
Q

What is the location of the causative lesion in monocular loss of vision?

A

Ipsilateral optic nerve lesion

50
Q

What is the location of the causative lesion in bitemporal hemianopia/quadrantanopia?

A

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
Q

What is the location of the causative lesion in homonymous hemianopia?

A

Contralateral optic tract lesion

52
Q

What is the location of the causative lesion in homonymous quadrantanopia?

A

Contralateral optic radiation lesion
-sup homonymous quadrantanopia (temporal)
-inf homonymous quadrantanopia (parietal)
PITS

53
Q

What does macular sparing in homonymous hemianopia/quadrantanopia suggest about the location of the defect?

A

Visual cortex (occipital lobe)

54
Q

What is the location/function of Broca’s area?

A

Inferior frontal gyrus (44 & 45)

Motor speech

55
Q

What is the location/function of Wernicke’s area?

A

Superior temporal gyrus (22)

Speech comprehension

56
Q

What structure links Broca’s & Wernicke’s area?

A

Association fibres of arcuate fasciculus

57
Q

What is Broca’s aphasia?

A

Express aphasia, loss of ability to produce speech

  • non-fluent, verbal output reduced
  • comprehension good, repetition poor
58
Q

What is Wernicke’s aphasia?

A

Receptive aphasia, loss of ability to understand speech

  • fluent, normal production of incorrect words
  • poor comprehension, poor repetition
59
Q

What is Global aphasia?

A

Expressive AND receptive dysphasia

60
Q

What is Nominal aphasia?

A

Difficulty word finding

61
Q

What is dysarthria?

A

Disordered articulation/slurred speech, language remains intact

62
Q

What are the causes of dysarthria?

A 
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
Q

What is Horner’s syndrome?

A

Oculosympathetic palsy, caused by interruption of sympathetic chain

64
Q

What are the sx of Horner’s syndrome?

A

Unilateral pupillary constriction (miosis)
Slight ptosis
Apparent enopthalmos
Anhydrosis
Heterochromia (congenital/long-standing lesions)

65
Q

What are the possible levels of the causative lesion in Horner’s syndrome?

A

1st order neurone
2nd order neurone
3rd order neurone

66
Q

What are the common causes of Horner’s syndrome affecting 1st order neurones?

A

Brainstem disease

  • tumour
  • MS
  • stroke
  • syphillis
67
Q

What are the common causes of Horner’s syndrome affecting 2nd order neurones?

A 
Intrathoracic lesiosn
   -pancoast
   -cervical rib
   -TB
Neck lesions
   -lymphadenopathy
   -trauma
   -thyroid surgery
68
Q

What are the common causes of Horner’s syndrome affecting 3rd order neurones?

A

ICA aneurysm
Migraine (transient)
Idiopathic

69
Q

What features can help distinguish the site of the causative lesion of Horner’s syndrome?

A

Face/arm/trunk anhydrosis = 1st order
Facial anyhdrosis only = 2nd order
No anhydrosis = 3rd order

70
Q

What do LMNs innervate?

A

Ipsilateral muscles

71
Q

What do UMNs innervate?

A

Contralateral muscles

72
Q

What are the signs of LMN disease?

A 
Weakness
Wasting
Fasciculation
Hypotonia
Hyporeflexia
73
Q

What are the signs of UMN disease?

A 
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
Q

What are the facial signs of LMN disease?

A

Ipsilateral facial weakness of all muscles of facial expression

75
Q

What are the facial signs of UMN disease?

A

Contralateral facial weakness, sparing frontalis

76
Q

What is the ddx for a LMN lesion?

A

Ventral horn pathology
Peripheral nerve pathology
NMJ pathology
Muscular pathology

77
Q

What is the ddx for a UMN lesion?

A

VINDIE

  • vascular (stroke)
  • inflammatory (MS, MND)
  • neoplastic (tumour)
  • degenerative (Parkinson’s)
  • infective (post-meningitis)
  • extras (drugs)
78
Q

What are the descending tracts of the spinal cord?

A

Lateral corticospinal tract (motor)

Ventral corticospinal tract (motor)

79
Q

What are the ascending tracts of the spinal cord?

A

Dorsal columns (deep touch, proprioception, vibration)
Lateral spinothalamic tract (pain, temperature)
Ventral spinothalamic tract (light touch)

80
Q

What is the function of the spinothalamic tract?

A

Transmits pain, temperature, light touch to the thalamus

Decussates at spinal level

81
Q

What is the function of the dorsal columns?

A

Transmit deep touch, proprioception & vibration to parietal cortex
Consists of fasciculus cuneatus/gracilis
Decussates in brainstem

82
Q

What is the function of the corticospinal tract?

A

Transmit motor axons from motor cerebral cortex to spinal cord
Decussates in brainstem

83
Q

What clinical syndrome would arise from cord transection at C3?

A 
Neurogenic shock
Resp insufficiency
Quadriplegia
Anaesthesia below affected level
Loss of bladder/bowel sphincter tone
Sexual dysfunction
Horner's syndrome
84
Q

What clinical syndrome would arise from cord transection at T10?

A

Paraplegia
Anaesthesia
Loss of rectal/bladder sphincter tone
Sexual dysfunction

85
Q

What clinical syndrome would arise from a cord hemisection?

A

Brown-Sequard syndrome
Ipsilateral reduced power/vibration/proprioception (PC)
Contralateral reduced pain/temp/light touch (STT)

86
Q

What clinical syndrome would arise from a posterior cord lesion?

A

Tingling, numbness, electric-shock like syndromes
Clumsiness
Sensory ataxia
Loss of proprioception/vibration/2-point discrimination below the level of th elesion

Tim CP3 @ UoN - Medicine & Surgery (136 decks)

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