Brain Study guide for Anatomy Exam 1 & Clin Medicine Exam 2-- by Dr. Witwer Flashcards
The Cerebrum is divided into the _____ and ____ hemispheres
Left and Right Cerebral hemispheres
What is the function of the Frontal Lobe?
Executive functions
Attention
Personality
Problem Solving
What lobe contains the primary visual area/cortex?
Occipital Lobe
What are two key areas in the Temporal Lobe?
Hippocampus
Portions of the Limbic System
The Central Sulcus is also called what?
The Rolandic Fissure
The Anterior portion of the Central Sulcus contains what specific cortex?
Motor Cortex (Pyrimidal Motor System)
What is the name of the motor strip of the Motor Cortex?
Homunculus - initiates movement
The Auditory Cortex contains what system?
Limbic System
What are the functions of the Limbic System?
Creation and modulation of emotion Memory Feeding Breeding Homeostatic regulation
Damage to the Hippocampal region results in what?
Inability to convert short term to long term memory
True/False: The majority of patients have left sided hemispheric dominance - 90+%
True
Broca’s Area is the center for what function?
expressive speech
When there is damage to Broca’s Area a patient has what?
Broca’s aphasia (motor)
Patient has trouble speaking but comprehension is preserved
Wernicke’s Area is the center for what function?
repetitive, sensory speech
When there is damage to Wernicke’s Area a patient has the following Sx:
Patient has difficulty speaking in coherent sentences (word salad) or understanding others’ speech
Note: this is different from Wernicke’s encephalopathy
What are the structures that make up the Basal Ganglia?
- Caudate Nucleus
- Lentiform nucleus (=Putamen + Globus pallidus**)
- Globus pallidus**
- Substantia Nigra
- Subthalamic Nucleus
What are the functions of the Basal Ganglia?
Initiation, control, and modulation of skeletal motor function
Learning, cognition, and emotion
What is the function of the Internal Capsule?
transmits motor and sensory fibers from the cortex to the brain stem and spinal cord
What is the function of the Thalamus?
processes and relays sensory information
The Hypothalamus is part of what system?
The Limbic System
The Hypothalamus maintains homeostasis by regulating (7 things)
temperature blood pressure water sleep endocrine autonomic NS emotion
What is the function of the Reticular Activating System?
arousal and alertness
What system is affected in comatose states?
The Reticular Activating System
What happens in a Cerebral Contusion?
Coup and contra-coup - edema and hemorrhage
What is a diffuse axonal injury?
A shear injury
What two lobes make up the Pituitary Gland?
- Anterior Lobe - adenohypophysis
2. Posterior Lobe - neurohypophysis
According to Dr. Witwer, the Reticular activating system involves anything that
keeps you awake! (i.e. Hearing, visual, motor, proprioception, etc)
Regulation and control of balance, posture, muscle tone, coordination of voluntary motor function is the function of the _________
Cerebellum
The cerebellum does NOT ______ movement, but organizes, coordinates and modulates that movement
initiate
Cerebellar damage–> Sx present on the same side as ____
lesion
Diseases of the Cerebellum are manifested by:
- Signs are usually on the same side as the lesion
- Uncoordinated motor acts
- Inability to judge distance (pass-pointing)
- Inability to perform rapid alternating movements
- Intention tremor
- Abnormal gait (ataxia), falling, hypotonia
- Nystagmus
Cerebellum includes which structures?
- Brain stem and Cerebral Peduncles
- Pons
- Medulla oblongata
Brain stem and cerebral peduncles include the _______ and red nucelus
substantia nigra
The cerebellopontine angle cistern is located between the ______ and ____
pons and cerebellum
Vestibular schwannoma is a benign intracranial tumor of the ______
myelin-forming cells of the vestibulocochlear nerve (8th cranial nerve)
Cranial nerve 8 goes through the _____ angle cistern
cerebellopontine
90% of the pyramidal tracts decussates in the ___________
medulla oblongata
The pyramidal system_____ movement
controls
Pyramidal system motor pathway
Corticospinal tracts–> cortex to spine via the internal capsule–> decussates in the pyramids of the medulla
What would be affected if the anterior cerebral artery was damaged?
lower extremities would be affected
What body parts would be affected if the middle cerebral artery was damaged?
hands and face
Extrapyramidal system______ movement
coordinates
Diseases of the Extrapyramidal system
- Parkinson’s
- Tardive Dyskinesia
- Huntington’s chorea
- Syndenham’s chorea
Parkinson’s is degeneration of the ____ and _____
globus pallidus and substantia nigra
Orienting sensory inputs comes from Proprioception, position (spinocerebellar tracts), and CN ____, and ____ muscles
- proprioception
- position (spinocerebellar tracts)
- Vetibular apparatus (CN VIII)
- EOMs (CN 3, 4, 6) sensory modalities
Disease characterized by Tinnitus, vertigo, and deafness
Meniere’s disease
DDx for Meniere’s would include:
tumor in the internal auditory meatus
Congenital Hydrocephalus occurs as a result of the obstruction of the _______.
Aqueduct of Sylvius
What is the most common cause of congenital hydropcephalus?
Obstruction of the aqueduct of sylvius
Normal pressure Hydrocephalus is characterized by the 3 W’s
-Wacky, wobbly, and wet= dementia, ataxia, urinary incontinence
CSF flow can be obstructed by _______ secondary to meningitis
scarring
Other causes of CSF flow obstruction
Scarring secondary to:
- subarachnoid hemorrhage,
- tumor in the subarachnoid spaces over the convexity (top) of the brain
- May cause hydrocephalus
The subarachnoid space and cisterns are where ______ hemorrhages occur
Subarachnoid
What 3 main structures are included in the subarachnoid space and cisterns?
Suprasellar cistern
Cerebellopontine angle cistern
Cisterna Magna
Cardinal Sx of Uncal Herniation
Fixed and dilated pupils
Uncal Herniation occurs when the ______ and _______ are herniated into the tentorial notch, often with impingement of CN III
Uncas and Hippocampal gyrus are herniated
Where can herniation occur for Uncal herniation? (3 places)
Across the midline against the falx, through the tentorium (uncal), through the foramen magnum (cerebellar tonsils)
Leptomeninges, aka the inner two meninges are_____ and _____
arachnoid and pia mater
Infections, inflammations, intracerebral hemorrhages, and tumors will ____ _____ the blood brain barrier
break down
The “lucid interval” is associated with _____ hematomas
extradural hematomas
The majority of epidural hematomas are secondary to head trauma & injury to the ________
Middle meningeal artery
Albert (a 77 yr old grandpa) was hit in the head with a baseball and fell over unconscious for a few minutes. He was quickly aroused, and suddenly felt better– despite the swelling that had developed on the back of his head from where the ball hit. This phenomenon is known as the ___
“lucid interval” –> Pts get knocked out, suddenly feel better. The bleed will slowly progress and get to the point of irreversibility and death occurs
Causes: injury to middle meningeal artery, secondary to head trauma.
Subdural hematomas are most commonly secondary to the rupture of ________
bridging cerebral veins
T/F- Subdural hematomas can be acute and chronic
True
In which population are subdural hematomas most common?
elderly
85% of subarachnoid hemorrhages are caused by _____
ruptured cerebral aneurysms
______ aneurysms tend to appear at the base of the brain where the major blood vessels meet, also known as the Circle of Willis. When they rupture they can be VERY deadly
Berry aneurysms
69 yr. old man named Jeff presents to the clinic with “the worst HA of his life.” He also complains of neck stiffness, and his wife found him unconscious on the floor this morning.
What is your #1 dx for Jeff? What should you order?
SAH (subarachnoid hemorrhage)
Diagnosis: Non Contrast CT, Spinal tap, and Cerebral Arteriogram (angiography).
Anterior cerebral artery supplies blood to __________
the frontal lobes
Middle cerebral artery supplies blood to ____
a portion of the frontal lobe and the lateral surface of the temporal and parietal lobes
Posterior cerebral arteries supply blood to_____
temporal and occipital lobes of the left cerebral hemisphere and the right hemisphere.
Left middle cerebral artery strokes will involve ______ areas in a large % of patients
language areas
Vertebrobasilar insufficiency can cause ischemia to the ____, ___, and ____
Pons, brainstem, and medulla
Vertigo, fainting, dropping secondary to weak quadriceps are clinical manifestations of _____
Vertebrobasilar insufficiency
Blood clots in ______ sinuses result in the back up of blood and edema in the brain (name 3)
Superior sagittal sinus, Transverse, and Sigmoid sinuses