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Week 13 - neurology > Clinical neuroanatomy > Flashcards

Clinical neuroanatomy Flashcards

1
Q

Explain the visual system

A
  • The contralateral visual field projects onto the temporal or lateral portion of the retina, the ipsilateral visual field projects onto the nasal or medial portion of the retina
  • The optic nerve carriers all information from the ipsilateral eye
  • Nasal retinal fibres cross in the optic chiasm
  • The optic tract contains fibres from the contralateral visual field
  • Optic radiations are the projections from the lateral geniculate body to the primary visual cortex
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2
Q

What leads to monocular vision loss?

A

A lesion to the optic nerve of one eye

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3
Q

what leads to a bitemporal hemianopia?

A

•A lesion to the optic chiasm leads to the loss of the nasal fibres from each side

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4
Q

What leads to a contralateral homonymous hemianopia?

A
  • A lesion to the optic tract

* A lesion of the entire primary visual cortex

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5
Q

What leads to a contralateral superior quadrantanopia?

A

•A lesion to the Meyer loop

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6
Q

What leads to a contralateral inferior quadrantanopia?

A

A lesion to the optic radiations

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7
Q

Where is Broca’s area

A

Frontal lobe

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8
Q

What does a lesion to Broca’s area result in?

A

Expressive dysphasia - speech may be non fluent, can’t say what they want to but they understand what is being said

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9
Q

What does a lesion to Wernickes area result in?

A
  • Receptive aphasia

* Cannot understand what is being said

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10
Q

Describe the structure of the brainstem

A
  • Midbrain most superior
  • Pons is kind of a bulge anteriorly
  • Medulla is most inferior and in posterior to the pons, anterior to the cerebellum
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11
Q

When does the spinal cord end?

A

L1-2

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12
Q

What is the order of the meninges?

A

Pia around spinal cord then arachnoid then dura

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13
Q

What is the denticulate ligament?

A
  • Extensions of the Pia mater the anchor the spinal cord to the dura
  • The lateral denticulate ligaments separate the anterior and posterior roots
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14
Q

What does the anterior root carry?

A

Motor information

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15
Q

How does the anterior root exit the spinal cord?

A

Through the anterolateral sulcus

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16
Q

What does the posterior root carry?

A

Sensory information

17
Q

How does the posterior root enter the spinal cord

A

Postero-lateral sulcus

18
Q

Where does the dura extend to?

A

S2

19
Q

What is the epidural space?

A
  • True space between the dura and the vertebral periosteum

* Filled with fat and venous plexus

20
Q

Fasciculus gracilis

A
  • Sensory - fine touch, vibration, proprioception

* Ipsilateral lower limb

21
Q

Fasciculus cuneatus

A
  • Sensory fine touch, vibration, proprioception

* ipsilateral upper limb

22
Q

Spinocerebellar tract

A

Proprioception from the limbs to the cerebellum

23
Q

Lateral corticospinal tract

A

•Motor to ipsilateral anterior horn

24
Q

Spinothalamic tract

A

•Pain and temperature from the contralateral side of the body

25
Q

Anterior corticospinal tract

A

•Motor to ipsilateral and contralateral anterior horn

26
Q

At what level of the spine do the fibres enter the fasciculus gracilis vs fasciculus cuneate

A

T6

27
Q

Where do the fibres that have travelled in the fasciculus gracilis/cuneate terminate?

A

Nucleus gracilis and nucleus cuneatus in brainstem

28
Q

Where do the fibres carrying sensory information (fine touch, birbaiton and proprioception) cross?

A

After they have terminated in the nucleus cuneatus and gracilis, secondary fibres cross the midline as internal arcuate fibres and form the medial lemniscus

29
Q

Where does the medial lemniscus terminate?

A

In the VPL of the thalamus

30
Q

What happens after the medial lemniscus terminates in the VPL?

A

Fibres project through the internal capsule and corona radiata to terminate in the primary somatosensory cortex

31
Q

Explain the route of the sensory tract carrying light touch, vibration and proprioception

A
  • Axons enter the spinal cord from the spinal ganglion and pass directly to the ipsilateral posterior column. (Caudal fibres below T6 = gracilis, rostral = cuneatus)
  • Ascend then terminate in culceus gracilis and nucleus cuneatus
  • From these nuclei, axons of secondary neurones cross the midline as internal arcuate fibres and form medial lemniscus
  • in the rostral medulla, the fibres travel as the medial lemniscus adjacent to the midline
  • In the caudal pons, the medial lemniscus flattens horizontally
  • As the medial lemniscus continues to ascend through the rostral pons and midbrain it moves horizontally and laterally
32
Q

Explain the route of the sensory tract carrying pain and temperature

A
  • Axons enter the spinal cord from the spinal ganglion, travel up or down 1-2 segments in the lissauer tract then synapse in the posterior horn
  • Axons of secondary neurones cross the midline in the anterior commissure and ascend as the anterolateral tract in the spinal cord
  • Anterolateral tract ascends through the caudal medulla
  • In the rostral medulla, the anterolateral tract lies between the inferior olivary nucleus and the nucleus of the spinal tract of the trigeminal nerve
  • in the pons and midbrain, the anterolateral tract lies lateral to the medial lemniscus
  • The anterolateral tract terminates in the VPL of the thalamus
  • From the thalamus the fibres project through the internal capsule and corona radiate to terminate in the primary somatosensory cortex (post central gyrus)
33
Q

Explain the route of the motor corticospinal tract

A
  • Originates from the primary motor cortex
  • Descending fibres form the corona radiata and converge to pass through the posterior limb of the internal capsule
  • Corticospinal fibres descend through the middle three fifths of the crus cerebra in the anterior part of the midbrain
  • In the pons, the fibres are broken up into many bundles
  • The corticospinal tract descends as the pyramids in the anterior part of the medulla
  • At the junction of the medulla and the spinal cord, most of the fibres cross the midline in the decussation fo the pyramids
  • Crossed fibres = lateral corticospinal tract, uncrossed = anterior corticospinal tract
34
Q

What fibres cross in the anterior white commissure?

A
  • Pain and temperature fibres

* Anterior corticospinal tract fibres

35
Q

Explain the spinal reflex of the hamstring

A
  • Ia fibre from the muscle spindle senses stretching of the muscle
  • Ia fibre synapses directly with an alpha motor neurone in the anterior horn and an inhibitory interneurone
  • The alpha motor neurone to the extensor muscles are excited and the inhibitory interneurone inhibits the alpha motor neurone of the antagonist muscle

Week 13 - neurology (12 decks)

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