BRAIN & SPINE Flashcards
Contralateral paralysis and sensory loss (LE >UE) , Urinary Incontinence.
Anterior Cerebral Artery
-Contralateral paralysis and sensory loss (Face & UE > LE)
-Aphasia in dominant (usually L) hemisphere
-Hemineglect in non dominant (usually R) hemisphere
Middle Cerebral Artery
Wernicke aphasia associated with right superior quadrant visual field defect due to temporal lobe involvement.
Middle Cerebral Artery
▪️Contralateral paralysis
▪️Pure motor stroke
▪️Absence of cortical signs
Lenticulostriate artery
▪️Contralateral hemianopia with macular sparing
▪️ Alexia without agraphia (dominant hemisphere)
▪️ Prosopagnosia (nondominant hemisphere)
Posterior Cerebral Artery
▪️Quadriplegia , loss of voluntary facial, mouth and tongue movements.
▪️Loss of horizontal, but not vertical, eye movements .
Basilar Artery (Locked-in Syndrome)
▪️Paralysis of face , decreased lacrimation, decreased salivation, decreased taste from anterior 2/3 of tongue.
▪️Vomiting, vertigo, nystagmus
▪️Decreased pain and temperature sensation from ipsilateral face & contralateral body
Anterior Inferior Cerebellar Artery
▪️Ipsilateral Horner Syndrome
▪️Ipsilateral ataxia, dysmetria
▪️Ipsilateral sensorineural deafness, vertigo
Anterior Inferior Cerebellar Artery
▪️Good fluency
▪️Good comprehension
▪️Poor repetition
▪️Poor naming
Conduction Aphasia
Aphasia where patient can comprehend and is fluent but has difficulty repeating words.
Conduction Aphasia
Most common type of neuron according to number of processes.
Multipolar
Cerebellum is a derivative of what secondary brain vesicle.
Metencephalon
Function of Broca’s area. (3)
▪️Motor Speech area
▪️For speech production
▪️Regulates breathing patterns while speaking and vocalizations required for normal speech
▪️Dysphagia, hoarseness, Decreased gag reflex, hiccups
▪️Vomiting, vertigo, nystagmus
▪️Decreased pain and temperature sensation from ipsilateral face and contralateral body
▪️Ipsilateral Horner Syndrome
▪️Ispilateral ataxia, dysmetria
Posterior Inferior Cerebellar Artery ( Wallenburg Syndrome)
Ipsilateral ptosis, meiosis, anhidrosis. Da,age along oculosymphathetic pathway.
Horner Syndrome
What are the watershed zones? (2)
- Cortical border zones: ACA/MCA , MCA/PCA
- Internal border zones: Between LCA & MCA
Brodmann area 4
Primary motor (moves all four)
Brodmann area 1,2,3
Primary Somatosensory (Sensor 3)
Brodmann area 17
seVenteen = Visual
What is Heschl gyrus ?
Temporal gyrus for hearing = Primary Auditory Cortex
Brodmann area 41, 42
Horton Hears a who? = Hearing
Brodmann area 44, 45
Broca = Broc45 area
Brodmann area 22
Two U’s for a W= Wernicke
Only 2 nerves that are supratentorial.
CN I & II
▪️Contralateral paralysis
▪️Decreased contralateral propioception
▪️Ipsilateral hypoglossal dysfunction (ipsilateral tongue deviation)
Anterior Spinal Artery
▪️No pupillary involvement
▪️Consciousness often preserved
▪️ ACA compression -> contralateral LE weakness
Subfalcine herniation
▪️Ipsilateral CN III compression -> Ipsilateral dilated and fixed pupil
▪️Early : Ipsilateral cerebral peduncle compression -> contralateral hemiparesis
▪️Late: Contralateral cerebral peduncle compression -> ipsilateral hemiparesis
Uncal herniation / Lateral DTH
▪️Bilateral mid position and fixed pupils (loss of symphathetic and parasympathetic innervation)
▪️Decorticate -> Decerebrate posturing
Central Transtentorial Herniation
Brainstem compression -> coma , loss of CN reflexes, flaccid paralysis, respiratory arrest.
Tonsillar Herniation
Neural Tube Defects associated with elevated AFP. (5)
- Gastrochisis
- Anencephaly
- Conjoined twins
- Omphalocele
- Spina bifida
(GACOS)
With lucid interval , CT scan appearance is lemon shaped or convex shaped. Caused by injury to the middle meningeal artery.
Extradural Hemorrhage
What are the 2 layers of dura mater?
- Endosteal layer
- Meningeal layer
What are the 2 unpaired facial bones?
- Vomer
- Mandible
What are the 2 paired cranial bones?
- Parietal
- Temporal
Tearing of bridging veins, CT scan appearance is banana shaped or concave crescent shaped.
Subdural Hematoma
Parts of the brain that doesn’t have blood brain barrier? (8)
- Subcommisural organ
- Subfornical organ
- Habenula
- Organosum vaculosm of lamina terminalis
- Pineal body
- Median eminence
- Area of postrema
- Neurohypophysis
SSHOP lifter MAN has no barrier
Point of meeting and articulation of frontal , parietal, squamous temporal and great wing sphenoid.
Pterion
Weakest part of the skull.
Pterion
Location of gray and white matter in the CNS.
- Brain: Inside - White matter, Outside- gray matter (BIWOG)
- Spinal cord: Inside- Gray matter, Outside- White matter (SIGOW)
Weight of Pineal gland?
172mg
What is the derivative of notochord?
Nucleus pulposus
Absent in baby hair.
Medulla
Formation of the three primary brain vesicles occurs how many weeks of conception?
Primary - 4 weeks AOG
Secondary - 5 weeks AOG
Myelencephalon derivatives. (2)
- Medulla oblongata
- Spinal cord
The dangerous area of the face.
Root of the nose and two angles of the mouth.
Actions of the inferior oblique muscle. (3)
- Extorsion
- Elevation
- Abduction
(ExEl Abd)
Actions of the superior oblique muscle. (3)
- Intorsion
- Depression
- Abdsuction
(SIDAb)
Location of venous sinuses of the brain?
Between the periosteal and meningeal layers of the dura mater.
Pituitary gland blood supply are branches of ___________?
Internal carotid artery
Visual field defect associated with pituitary adenoma.
Bitemporal hemianopia
Releases vasopressin and oxytocin .
Posterior pituitary gland
Compression of the pituitary gland by tumors expanding superiorly can cause ___________.
Bitemporal hemianopsia
Patient with hemilateral sensory loss and hemilateral pain with hypersensitivity of affected side without weakness of contralateral side.
Dejerine-Roussy Syndrome
CSF FLOW (10)
Mnemonic: Come Lets Meet Tita Sylvia For Lunch Mamaya sa Aristocrat
1. Choroid
2. Lateral ventricle
3. Foramen of Monroe
4. Third ventricle
5. Aqueduct of Sylvius
6. Fourth ventricle
7. Luschka
8. Magendie
9. Subarachnoid
10. Arachnoid
Subdivision of cerebellum responsible for coordination of voluntary movements.
Posterior lobe (Nocerebellum or Cerebrocerebellum)
Inability to perform rapid alternating movements.
Dysdiadochokinesia
Foramen that transmits the middle meningeal artery and vein.
Foramen spinosum
CSF is produced by ____________.
Ependymal cells
Total volume of CSF.
130-150ml
Cranial nerves with parasympathetic component.
CN III, VII, IX, X (1973)
Papez circuit. (4)
- Mammillary bodies
- Anterior thalamic nuclei
- Cingulate gyrus
- Hippocampus
Part of the brain that maintains coordination of limb movements and regulation of muscle tone.
Spinocerebellum / Anterior Lobe/ Paleocerebellum
Part of the brain that controls coordination of paraxial muscles associated with equilibrium.
Vestibulocerebellum / Flocculonodular lobe/ Archiecerebellum
Area affected in patients with ataxia, dysmetria, dysdiadokinesia, intention tremor.
Cerebrocerebellum / Posterior lobe/ Neocerebellum
Blockage of this artery can result to contralateral hemianopia with macular sparing.
Posterior cerebral artery
Characteristic of UMN lesion. (6)
- Spastic paralysis
- Atrophy (-)
- Fasciculation (-)
- Pathologic reflex (+)
- Clonus (+)
- Increased muscle tone
Fracture of C2 (axis) vertebra.
Hangman’s fracture
Fracture of C1 (atlas).
Jefferson Burst Fracture
Atlanto-axial (C1-C2) joint movement.
Rotation
Atlanto-occipital joint movements.
Flexion-extension
Lateral flexion
Blood supply of the Pituitary gland.
Superior hypophyseal artery which is a branch of Internal carotid artery.
Lobes of the pituitary gland. (2)
- Anterior:
- Pars distalis
- Pars intermedia
- Pars tuberalis - Posterior:
- Pars nervosa
Calcified secretions of the pineal gland, also known as Brain Sands.
Corpora Arenacea
Epidural hemorrhage most commonly injured artery?
Anterior division of the Middle Meningeal Artery
Subdural hemorrhage most commonly injured artery?
Tearing or Bridging / Superior Cerebral Veins
Subarachnoid hemorrhage most commonly injured artery?
Rupture of Congenital Aneurysm in the Circle of Willis
- Posterior Cerebral
- Posterior communicating
- Internal Carotid
- Anterior cerebral
- Anterior communicating
Intracerebral hemorrhage most commonly injured artery?
Most common in hypertensive patients from rupture of Lenticulostriate Arteries.