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NOTES: Neuro Review by Minnie > Brain: How it grows and works (43b - 53b) > Flashcards

Brain: How it grows and works (43b - 53b) Flashcards

Including what each part of the brain does

1
Q

Which efferent pathway is involved in generating movement?

A

Corticostriate

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2
Q

Which MRI technique is used to evaluate contrast enhancement?

A

T1

  • is less sensitive to pathology, but is used to evaluate contrast enhancement
  • CSF is dark, white matter is bright
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3
Q

Occlusion of which artery leads to contralateral motor and sensory deficits in the lower limb?

A

Anterior cerebral artery

it supplies the anteriomedial cortex, which contains the medial portion of the frontal and parietal lobes, which is where the sensory (postcentral gyrus) + motor (precentral gyrus) homunculus are

the lower limbs are more medial on the homunculus

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4
Q

What is the most medial aspect of the temporal lobe?

A

The uncus of the temporal lobe

Clinical significance: swelling can compress the oculomotor nerve

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5
Q
A

A

due to occlusion of anterior spinal artery, damages the anterior 2/3 of spinal cord

  • Loss of motor function: cortical spinal tract bilaterally
  • Loss of Pain and temperature: loss of both lateral spinothalamic tracts bilaterally
  • Preservation of pressure, vibration, fine touch, proprioception because dorsal column is intact
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6
Q

Which areas of the brain are supplied by the posterior cerebral artery?

Occlusion leads to what deficits?

A
  • Occipital lobe
  • Inferior temporal lobe
  • Posterior limb of the internal capsule

Loss of contralateral visual fields, color vision, visual/spatial problems

(Minimal motor or sensory deficits)

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7
Q

What neurotransmitter is synthesized in the raphe nuclei?

A

Serotonin

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8
Q

The outermost layer of the neocortex is layer ___

This layer developes [latest/earliest]

A

The outermost layer of the neocortex is layer 1

This layer developes latest

  • Layer 6 is the innermost layer and develops first
  • Neurons of subsequent layers prolifereate, differentiate, and then migrate from deep to superficial
  • Layer 6 neurons are the oldest, while layer 1 neurons are the youngest
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9
Q

At what gestational age can 6 cortical layers be identified?

A

18 weeks post conception

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10
Q

What makes up a “disynaptic pathway?”

A

Sensory neuron + interneuron + motor neuron

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11
Q

A 63yo man with a history of hypertension, hyperlipidemia, and diabetes presents with acute onset of weakness and numbness of the right face and arm, global aphasia, and a left gaze palsy.
He is able to raise his right leg.

A stroke due to occlusion of what artery might cause these symptoms?

A

Middle cerebral artery

  • Supplies the lateral surface of the frontal, parietal, and temporal lobes
    • Language areas
    • lateral motor cortex, area of the face on the motor homunculus
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12
Q

A lateral lesion in the brainstem, as occurs in the lateral medullary syndrome, will damage which of the following cranial nerve nuclei?

  1. Hypoglossal nucleus
  2. Trochlear nucleus
  3. Abducens nucleus
  4. Oculomotor nucleus
  5. Spinal nucleus of V
A

E. Spinal nucleus of V

  • A lateral lesion will damage sensory nuclei
  • All other options are motor nuclei
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13
Q

Which cortical layer receives thalamic input?

Which cortical layer sends output back to the thalamus?

A

Which cortical layer receives thalamic input? Layer IV

Which cortical layer sends output back to the thalamus? Layer VI

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14
Q

What does fMRI measure?

What is this technique used for?

A

fMRI measures deoxyhemoglobin

  • Helps us assess which areas of the brain are usign the most oxygen
  • It is an indirect measurement of electrical activity in the brain
  • Used to determine which areas are used in different functions so they can be avoided durign surgery
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15
Q

A 21 year old man with a history of precocious puberty presents for evaluation of transient episodes characterized by uncontrolled laughing?

Which image best fits this description?

A

iii

  • Hypothalamus
  • Produces hormones involed in endocrine axes
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16
Q

Which structures are contained in the tegmentum of the midbrain?

A
  • Red nucleus
  • Principle sensory nucleus of the trigeminal nerve
  • Reticular formation
  • Substantia nigra
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17
Q

At what level of the brainstem is the decussation of the pyramids?

A

Spinomedullary junction

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18
Q
A
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19
Q

What is the etiology of Rett syndrome?

A
  • MECP-2 Related Disorder (Rett) is a disorder of synaptogenesis where there are a lot less dendrites on axons b/c they failed to make synaptic connections
    • characterized by profound intellectual deficits, stereotypic hand movements, deceleration of head growth, epilepsy, and sleep problems
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20
Q

The [area of the brain] is the relay from the brainstem to the cerebral cortex

A

The diencephalon is the relay from the brainstem to the cerebral cortex

Contains the thalamus

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21
Q

Which nerve exits throught the intervertebral foramen between the C6 and C7 vertebrae?

A

The C7 spinal nerve

Although there are seven cervical vertebrae (C1-C7), there are eight cervical nerves C1–C8. C1–C7 emerge above their corresponding vertebrae, while C8 emerges below the C7 vertebra. Elsewhere in the spine, the nerve emerges below the vertebra with the same name (T1 nerve emerges below T1 vertebrae, etc)​

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22
Q

What neurotransmitter is synthesized in the ventral area of the tegmentum?

A

Dopamine

synthesized in the substantia nigra

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23
Q

CSF appears bright in [T1/T2] weighted MRIs

A

CSF appears bright in T2 weighted MRIs

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24
Q

Loss of pain and temperature sensation on the right side of the face might be due to a lesion in which tract?

A

Right spinal tract of V

  • Spinal tract of V consists of afferent fibers (Aδ and C) from the trigeminal nerve that transmits pain and temperature sensations from the face.
    • The fibers synapse on 2nd order neurons in the spinal nucleus of V that project to the ventral posteromedial (VPM) thalamic nucleus via the trigeminothalamic tract.
    • 3rd order neurons in the thalamus project to the postcentral gyrus (areas 3, 1, 2).
    • A lesion of the spinal tract and its nucleus (ex. lateral medullary (Wallenberg’s) syndrome) results in ipsilateral loss of pain and temperature sensation from the face.

(Aka right trigeminothalamic tract)

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25
Q

A 60 y.o. male presents with dysphagia, decreased coordination (falling to left side), and left lower facial droop after a bicycle accident in which he hyperextended his neck. On imaging, he is found to have a stroke.

Which brain structures are most likely affected?

A

Left cerebellum

(likely medial/intermediat stuructures if posture is affected)

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26
Q

Which areas of the brain are supplied by the anteror cerebral artery?

What are the consequences of occluding this artery?

A

Medial surfaces of the frontal, parietal, and temporal lobes

Contralateral motor and sensory deficits in the lower limb

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27
Q

Which structure is labeled by D?

A

Third ventricle

  • This is a T2 weighted MRI
  • CSF is bright
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28
Q

What are the 4 types of glial cells?

A

Ependymal

Astrocytes

Microglia

Oligodendrocytes

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29
Q

A 44 y.o. woman presents with posterior headaches which are worse with coughing and straining as well as swallowing difficulty and frequent choking on foods. She is told she has a Chiari I malformation.

Which part of the cerebellum is used to diagnose this condition?

A

Cerebellar tonsils

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30
Q

The cell bodies of the first order neurons for proprioception from the face are located in which nucleus?

A

Mesencephalic nucleus

  • The mesencephalic nucleus of V consists of cell bodies of 1st order neurons (exception to the rest of the body).
    • Their peripheral processes (groups I + II) transmit proprioception from receptors in the muscles of mastication, TMJ and teeth.
    • Their central processes synapse on 2nd order in the reticular formation that sends axons into the crossed trigeminal lemniscus (up to the thalamus).
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31
Q

Which primodial tissue layers form the dura, arachnoid, and pia mater?

A
  • Dura - Mesenchyme
  • Arachnoid - Neural Crest Cells
  • Pia - Neural Crest Cells
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32
Q

A 73 year old man presents with right inferior quadrantopsia

Which image best fits this description?

A

i

  • Issues with vision = problem with the visual cortex, which is located in the occipital lobe
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33
Q

Radial crest cells expressing Nkx2 or Gsx2 will become [inhibitory/excitatory] neurons

A

Radial crest cells expressing Nkx2 or Gsx2 will become inhibiotry neurons

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34
Q

A lesion in the right ventral medulla will most likely affect which spinal tract?

Describe the effects

A

Left corticospinal tract

-> Left hemiparesis

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35
Q

In general, the medial aspects of the motor and sensory homunculi are associated with the _________, while the lateral surfaces are associated with the __________

A

In general, the medial aspects of the motor and sensory homunculi are associated with the legs** , while the lateral surfaces are associated with the **face and arms

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36
Q
A

E

The amygdala - in the superior, medial portion of the temporal lobe

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37
Q

What neurotransmitter is synthesized in the locus coeruleus?

A

Norepinephrine

in the pons

38
Q

A patient is experiencing loss of right visual fields, color vision, and ability to solve visual spacial problems.

There are no motor or sensory changes.

Which artery is likely occluded?

A

Left posterior cerebral artery

Supplies the occipital lobe, which is where we process visual information

39
Q
A

B - Stria terminalis

40
Q

How many weeks post-conception does gastrulation occur?

A

3 weeks

41
Q

A 29 y.o. female presents with headaches and double vision. She is found to be tilting her head to the left.

Which structures are likely involved?

  1. Hypothalamus and optic chiasm
  2. Midbrain at the level of superior colliculus
  3. Left cerebellum and lateral medulla
  4. Right cerebellum and lateral medulla
A

b. Midbrain at the level of superior colliculus
* Superior colliculus is involved with reflexive eye movements

42
Q

A 31 year old man presents with truncal ataxia and nausea

Which image best fits this description?

A

ii

  • This sounds like a cerebellar issue
  • Image ii is pointing to the cerebellum
43
Q

Where are motor nerve fibers found?

A

J

44
Q

Which structure is labeled by B?

A

Crus cerebri

(V hard to tell….)

45
Q

Which imaging modality was used to produce this image?

Be specific

A

T2 weighted MRI

  • White matter is darker than grey matter
  • CSF is bright
46
Q

Most local interneurons of the neocortex are [pyramidal/stellate]

A

Most local interneurons of the neocortex are stellate

47
Q

Which neuromodulator has a major source of origin (cell bodies) in the telencephalon?

A

Acetylcholine

in the basal nucleus of Meynert in the forebrain (telencephalon)

48
Q

What is the purpose of the ventral pons?

A

Corticocerebellar relay

The basal portion is a large relay station btwn the cerebral cortex and the opposite cerebellar cortex; is composed of longitudinal fiber bundles, transverse fibers and collections of pontine nuclei between the fibers.

49
Q

Which layer of the neocortex contains fusiform neurons?

A

Layer VI

50
Q

An 81 year old man presents with weakness and numbness in his left leg

Which image best fits this description?

A

iv

  • Motor homunculus: medial aspects are involved in leg actions
  • This looks like a pretty medial sagittal slice, in the right area for the sensory homunculus in the postcentral gyrus
51
Q

Which structure is labeled by A?

A

Hippocampus

52
Q
A

D
Corticospinal tract

The corticospinal tract (pyramid) is in the ventral medulla, while the dorsal column/medial lemniscus pathway (dorsal column nucleus) is in the dorsal medulla

53
Q

Global aphasia is associated with occlusion of which artery?

What other signs may be present?

A

Middle cerebral artery, usually left (dominant side)

  • If the dominant side is affected specifically, global aphasia occurs
  • In general, if an MCA is occluded:
    • Contralateral face and arm weakenss and numbness
    • Contralateral hemianopsia
    • Gaze preference - looks toward lesion side/away from affected limb
    • Dysarthria
54
Q

Occlusion of the posterior spinal arteries damages which spinal tract?

A

Dorsal column/medial lemniscus

-> posterior cord syndrome

55
Q

Which cells make up the blood brain barreir?

A
  1. tight junctions in capillary endothelial cells
  2. basement membrane
  3. Astrocytes
  4. pericytes

· Blood brain barrier (BBB): isolates the nervous system from circulating large molecules and protects from toxins

o not a physical gate, but is a property of capillaries throughout the CNS, endothelial cells have a tight junction structure

o astrocytes transport needed nutrients to neurons

o circumventricular organs: 7 regions of brain w/o a BBB so that the brain can know what substances are in the blood

§ area postrema = is the emetic center that initiates vomiting when toxins are detected so that no additional poison enters the bloodstream from the GI

§ pineal gland = secretes melatonin and regulates circadian rhythm

56
Q

What is the most common developmental disorder of the human forebrain?

A

Holoprosencephaly

  • Holoprosencephaly = failure of the prosencephalon (the anterior portion of the embryonic brain) to develop into two cerebral hemispheres ® fusion of the ventricles ® one monoventricle
    • most common developmental disorder of the human forebrain

Associated with trisomy 13 (Patau syndrome) and mutations in Shh

57
Q

Which section of the brain controls voluntary movement?

A

Cerebellum

  • Balance
  • Motor movement
  • Coordination
58
Q

Which letter labels sensory fibers exclusively?

A

B

59
Q

Which lobe of the cortex is most involved in our personality?

A

Frontal

60
Q

Where is the blood brain barrier weakest or absent?

A

Circumventricular organs (7 of them)

o circumventricular organs: 7 regions of brain w/o a BBB so that the brain can know what substances are in the blood

§ area postrema = is the emetic center that initiates vomiting when toxins are detected so that no additional poison enters the bloodstream from the GI

pineal gland = secretes melatonin and regulates circadian rhythm

61
Q

The [area of the brain] contains the cerebro-cerebellar relay

A

The pons contains the cerebro-cerebellar relay

62
Q

Which artery supplies the areas of the brain responsible for sensation and interpretation of visual input?

A

Posterior cerebral atery

63
Q

What neurotransmitter is synthesized in the basal forebrain nuclei?

A

ACh

64
Q

A mass in which legion is most likely to block CSF flow from the 3rd ventricle to the 4th ventricle?

  1. Right lateral ventricle
  2. Foramen of Monro
  3. Pineal region
  4. Foramen of Magendie
A

c. Pineal region

The pineal gland sits at the rostal portion of the cerebral aqueduct

Blockage of the cerebral aqueduct prevents CSF from flowing from the 3rd -> 4th ventricle

SO a pineal gland tumor could block the flow of CSF from the 3rd to the 4th ventricle

65
Q

What is dyspraxia?

It is associated with a lesion in which area of the brain?

A
  • Inabiltiy to plan/process motor tasks
    • Can’t voluntarily do a task, even though the limb is working and understanding of the task is there
  • Associated with frontal lobe damage (premotor cortex)
    • May be due to occlusion of the anterior cerebral artery

​

66
Q

The [area of the brain] is responsible for auditory and visual orientation/attention and oculomotor control

A

The midbrain is responsible for auditory and visual orientation/attention and oculomotor control

67
Q

Radial crest cells expressing Pax6 will become [inhibitory/excitatory] neurons

A

Radial crest cells expressing Pax6 will become excitatory neurons

68
Q

The [area of the brain] is the major route of communication between cerebral hemispheres

A

The corpus callosum is the major route of communication between cerebral hemispheres

69
Q

Why does blood appear bright on a CT of the brain?

A
  • Hemoglobin blocks the radiowaves -> brightness
  • For blood to appear white, hemoglobin must be intact
    • If a bleed is old, hemoglobin breaks down and will no longer appear bright
70
Q

What begins first: neuronal development or glial development?

A

Neuronal development

After the neurons develop, glial cells are required for synaptic formation

71
Q

The [area of the brain] is responsible for autonomic control, neuromodulators, and sensory and motor relays

A

The medulla is responsible for autonomic control, neuromodulators, and sensory and motor relays

72
Q

Which layer of the neocortex is the thalamic reciprocal projection layer?

What does this mean?

A

Layer VI - the fusiform layer

  • While layer IV is the main thalamic receiving layer, layer VI also receives some input from the thalamus
  • Layer VI sends these signals back to the thalamus so that they are sent to layer IV

Note: Layer VI contains many differently shaped neurons, while layer IV contains mostly stellate

(I think this is how it works, if you have a better explanation please lmk)

73
Q
A

C - subarachnoid space

74
Q

What neurotransmitter is synthesized in the tuberomammillary nucleus?

A

Histamine

75
Q

Which areas of the brain are supplied by the middle cerebral artery?

What are the consequences of occluding this artery?

A

Lateral surfaces of the frontal, parietal, and temporal lobes

Contralateral motor and sensory deficits in the face and hand

Global aphasia if left MCA is occluded

76
Q

What structure forms during neurulation?

A

Neural tube

77
Q

The [area of the brain] contains sensory and motor nerves and is responsible for reflexes

A

The spinal cord contains sensory and motor nerves and is responsible for reflexes

78
Q

The [area of the brain] is responsible for motor control, sensory processing for motor control, and balance

A

The cerebellum is responsible for motor control, sensory processing for motor control, and balance

79
Q

In general, which layers of the neocortext are considered granular?

Which are considered stellate?

A
  • Granular: II, IV, VI
    • Although layer VI has many different kinds of neurons
  • Stellate: III, V
  • Layer I is not well understood, and doesn’t have many neurons
80
Q

What usually causes central cord syndrome?

A

Spinal stenosis (in older patients)

After a high-speed trauma w/flexion and extension

Causes compression of the spinal cord inside of the bony canal, leading to damage in the center of the spinal cord

Afects cervical innervations most; motor and sensory pathways in arms and hands > legs/feet

81
Q

The [area of the brain] is responsible for sensation, perception, movement, consciousness, attention, cognition, and memory

A

The cerebral hemisphere is responsible for sensation, perception, movement, consciousness, attention, cognition, and memory

Cerebral hemisphere = cerebral cortex?

82
Q
A

B

The dorsal column medial leminiscus in the spinal cord is ipsilateral to the body parts it supplies

  • The dorsal area of the medulla consists of the gracile and cuneate fasciculi and tubercles, which are part of the dorsal column-medial lemniscus pathway.
  • Fibers of fasciculus gracilis and cuneatus synapse in the corresponding nucleus/tubercles.
    • gracilis ® sensation from lower body
    • cuneatus ® sensation from upper body
  • After synapsing, axons of cells in the dorsal column nuclei cross to the contralateral side and ascend as the medial lemniscus.
    • A lesion of the medial lemniscus (ex. medial medullary syndrome) results in tactile and kinesthetic deficits.
  • A lesion of fasciculus gracilis and cuneatus (Ex. Brown-Séquard syndrome) results in of proprioception (position and movement sense), tactile discrimination and vibratory sensation.
83
Q

A patient presents with right hemiplegia of the arm and leg combined with right lower facial paralysis and sensory deficits in the right face, arm, and leg.

Where is the most likely location of the stroke?

  1. Left posterior limb of the internal capsule near the genu
  2. Left middle cerebral artery
  3. Right posterior limb of the internal capsule near the genu
  4. Right middle cerebral artery
  5. Left middle and anterior cerebral arteries
A

A. Left posterior limb of the internal capsule near the genu

  • A stroke of the posterior limb would affect both the corticospinal and possibly corticobulbar tracts if near the genu
  • This is more likely than a stroke of both the middle and anterior cerebral arteries

Anterior limb: contains the thalamocortical tract

Genu: contains the corticobulbar tract

Posterior limb: contains the corticospinal tract and thalamocortical and somatosensory fibers

84
Q

A patient is seen who has paralysis of the right upper and lower face caused by a stroke of the facial motor nucleus. Additionally, he has loss of pain and temperature over the right side of the face and the left side of the body (alternating hemianesthesia). His lesion is probably located in the:

  1. Left lateral pons
  2. Right lateral medulla
  3. Right lateral pons
  4. Left lateral medulla
  5. Right posterior limb of the internal capsule
A

C. Right lateral pons

  • The facial motor nucleus and spinal nucleus of V are both located in the pons
    • Although it kind of looks like the spinal nucleus of V is both in the medulla and the pons?
85
Q

What are fasciculi and funiculi in the brain?

A

Large white matter pathways

86
Q

Damage to the anterior spinal artery causes damage to which major spinal tracts?

A

Corticospinal tract

Spinothalamic tract

(also Spinocerebellar from guiding questions)

This is anterior cord syndrome

Basically, everything except the dorsal column/medial lemniscus pathway is cut off

87
Q

What is the first intradural branch of the internal carotid artery?

A

Ophthalmic artery

88
Q

Which neurotransmitter modulates our highest functions?

(Cognition, consciousness, highest learning and memory)?

A

ACh

89
Q

Occlusion of which artery leads to:

  • Contralateral motor and sensory deficits in the face and hand
  • Global aphasia
A

Left middle cerebral artery

(Language areas are in the left hemisphere)

90
Q

Which structure is labeled by C?

A

Temporal horn/inferior horn of the lateral ventricle

  • Can tell its filled with CSF becaues its bright
  • This is a T2 weighted MRI

NOTES: Neuro Review by Minnie (12 decks)

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