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clin med III, exam 3 > clinical neuroanatomy > Flashcards

clinical neuroanatomy Flashcards

1
Q

List the meninges

A

PAD

  • Pia: closest to brain
  • Arachnoid
  • Dura
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2
Q

List the cerebri that seperate the brain into compartments

A
  • falx cerebri
  • tentorium cerebelli
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3
Q

clinical presentation

  • initially unconscious after a head trauma, but then “seemed okay”
  • lucid interval
  • rapidly deteriorates
A
  • epidural hematoma
    • middle meningeal artery
    • Lentiform lesion
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4
Q

clinical presentation

  • no h/o hitting head
  • over the next 2-3 weeks
    • headache
    • confusion
    • problems with speech
    • drowsiness
A
  • subdural hematoma
    • bridging veins
    • half moon
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5
Q

clinical presentation

  • sudden onset
  • “worst headache of life”
  • rapidly deteriorates -> comatose
A
  • subarachnoid hemorrhage
    • Aneurysm
    • crab
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6
Q

CSF is created by

A

choroid plexus in lateral ventricles

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7
Q

flow of CSF through ventricles

A
  1. lateral ventricles -> foramen on monroe
  2. 3rd ventricle -> cerebral aqueduct
  3. 4th ventricle
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8
Q

clinical presentation

  • developed headaches, confusion, difficulty walking, and urinary incontinence over 2-3 months
A
  • “Wet, wacky, wobbly”
  • normal pressure hydrocephalus
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9
Q

describe vasculature to right side of brain off aorta

A
  • aorta -> BRachiocephalic artery -> Right common carotid and R subclavian artery
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10
Q

describe vasculature to left side of brain off aorta

A

aorta -> left common carotid and left subclavian

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11
Q

vertebral arteries arise from the and join to form the

A
  • vertebral arteries arise from the subclavian arteries
  • vertebral arteries join to form the basilar artery
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12
Q

function of circle of willis

A
  • conncects the anterior and posterior circulations
  • connects the L and R sides
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13
Q

describe vasculature of the brain in the circle of willis

A
  • need to know
    • internal carotid artery
    • middle cerebral artery
    • anterior cerebral artery
    • posterior cerebral artery
    • basilar artery
    • vertebral artery
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14
Q

Draw out Venous circulation of brain

A
  • superior sagittal sinus
  • straight sinus
  • cavernous sinus
  • transverse sinus
  • jugular vein
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15
Q

What lies inside the cavernous sinus

A
  • all nerves that control EOM (III, IV, VI)
  • all divisions of CN V except V3
  • internal carotid artery
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16
Q

motor cortex lies in what part of the brain

A

frontal lobe

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17
Q

Right frontal eye feild turns the eyes to what side

A

to the LEFT

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18
Q

Anterior cerebral artery supplies blood to what part of homunculus

A

leg

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19
Q

Middle cerebral artery supplies blood to what part of homunculus

A
  • arm
  • face
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20
Q

Where do the motor nerves from the homunculus come the closest together

A
  • posterior limb of internal capsule
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21
Q

What cranial nerves are located in the midbrain

A
  • CN II, III, IV
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22
Q

What cranial nerves are located in the pons

A
  • CN V, VI, VII
  • CN VIII
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23
Q

What cranial nerves are located in the medulla

A
  • CN VIII
  • CN IX, X, XI, XII
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24
Q

what happens at pyramidal decussation

A
  • where motor tracks cross at lower medulla (brainstem)
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25
Q

If you see “crossed signs”

ipsilateral cranial nerve deficits and contralateral body weakness, then lesion is located

A

brain stem

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26
Q

pain and temperature are located in what spinal cord tract

A
  • lateral spinothalamic
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27
Q

vibration and proprioception are located in what spinal cord tract

A

posterior spinal cord tract

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28
Q

voluntary movement is located in what spinal cord tract

A

lateral corticospinal

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29
Q

lateral corticospinal tract crosses over at

A

pyramidal decussation at the level of the brainstem (medulla)

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30
Q

lateral spinothalamic tract crosses over at

A

the level of the spinal cord

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31
Q

posterior column crosses over at

A

the level of the brainstem (medulla)

32
Q

what is brown sequard syndrome

A
  • damage to one half of the spinal cord
    • loss of pain, temperature on opposite side as cord damage
      • lateral spinothalamic tract crosses at spinal cord
    • loss of motor function, vibration and position sensation on same side as cord damage
33
Q

central cord syndromes will result in

A
  • loss of pain and temperature
34
Q

anterior cord syndromes will result in

A
  • paralysis and loss of pain and temperature
35
Q

posterior cord syndrome will result in

A
  • loss of vibration and proprioception
36
Q

cauda equina syndrome presents with what symptom more than conus medullaris syndrome

A

severe pain and weakness

37
Q

conus medullaris syndrome presents with what symptom more than cauda equina syndrome

A

early, severe bowel and bladder problems

38
Q

upper motor neuron injury will result in

A
  • increase in tone: spastic weakness
  • hyper-reflexia
  • babinski
39
Q

lower motor neuron injury will result in

A
  • decrease in tone: flaccid weakness
  • hypo-reflexia
  • atrophy
  • fasciculations
40
Q

peripheral nervous sytem neuroaxis is composed of

A
  • motor neuron
  • peripheral nerve
  • NMJ
  • muscle
41
Q

Where is the lesion

  • aphasia
  • apraxia
  • neglect, agnosia
  • hemianopia
  • hemiparesis/hemisensory involving face and arm vs. leg
A

cortex

42
Q

what are the subcortical structures

A
  • internal capsule
  • basal ganglia
43
Q

Where is the lesion

  • dense hemiplegia: unilateral motor or sensory deficit
  • equal weakness of face, arm, and leg
  • abnormal movements (chorea, tremor)
A

subcortical

44
Q

Where is the lesion

  • truncal vs limb ataxia
  • dysmetria (can’t do finger-to-nose)
A

cerebellum

45
Q

Where is the lesion

  • Cranial nerve palsies +
  • crossed signs
A

brainstem

46
Q

Where is the lesion

  • paraparesis
  • loss of rectal tone
  • loss of sensory
  • bowel, bladder involvement
  • saddle anesthesia
A

spinal cord

47
Q

Where is the lesion

  • fasciculations
  • no sensory involvement
A

motor neuron

48
Q

Where is the lesion

  • distal weakness and sensory involvement (usually stocking-glove)
  • areflexia or hyporeflexia
A

peripheral nerve

49
Q

Where is the lesion

  • fatigability
  • no sensory involvement
  • normal DTRs
A

NMJ

50
Q

Where is the lesion

  • proximal weakness
  • symmetric
  • no sensory involvement
A

muscle

51
Q

mneumonic for underlying pathology

A

VITAMINCDE

  • vascular
  • inflammatory
  • trauma
  • autoimmune
  • metabolic
  • infectious
  • neoplastic
  • congenital
  • drugs
  • epilepsy/sz
52
Q

list the cranial nerves

A
  • I: olfactory
  • II: optic
  • III: occulomotor
  • IV: trochlear
  • V: Trigeminal
  • VI: abducens
  • VII: facial
  • VIII: vestibulocochlear
  • IX: glossopharyngeal
  • X: vagus
  • XI: spinal accessory
  • XII: hypoglossal
53
Q

what is the most common color affected if color vision is impaired

A

red desaturation

54
Q

lesion of the right optic nerve will produce

A

right monocular blindness

55
Q

a lesion at the optic chiasm will produce

A

bitemporal hemianopia

56
Q

a lesion to the right optic tract (before optic chiasm) will result in what visual field defect

A

left homonymous hemianopia

57
Q

what is the pupillary reflex: direct and consensual reponse and what cranial nerves are being tested

A
  1. shine light in one eye
    • CN II senses light and CN III causes constriction in both eyes
58
Q

how can you test for a CN II lesion

A
  1. shine light in affected eye
  2. neither pupil will constrict because CN II is not sensing information
59
Q

which cranial nerves are associated with which EOM

A
  • SO ‘4’
  • LR ‘6’
  • all the rest ‘3’
60
Q

draw the 6 cardinal directions of eye movement

A
61
Q

cranial nerve V is responsible for

A
  • sensation to face
  • muscle of mastication
  • sensory limb of corneal reflex
62
Q

cranial nerve VII is responsible for

A
  • muscles of facial expression
  • motor limb of corneal reflex
  • eyelid closure
63
Q

what cranial nerve is responsible for keeping the eyes open

A

CN III

  • CN III lesion -> lack of eyelid opening: ptosis
64
Q

what cranial nerve is responsible for eyelid closure

A
  • CN VII
  • CN VII lesion: eye unable to close
65
Q

a stroke resulting in central facial palsy will affect what aspects of the face

A
  • loss of voluntary control over lower muscles of facial expression on the contralateral side
    • ​mouth droop
    • upper face preserved
66
Q

a peripheral facial nerve palsy (ex: bells palsy) will result in what appearance of the face

A
  • ipsilateral upper and lower asymmetry​
67
Q

gag reflex involes what CN

A
  • afferent: CN IX
  • efferent: CN X
68
Q

what is the Vestibulo-ocular reflex and what cranial nerves are involved

A
  • “dolls eyes” normal: head rotated to right -> eyes move to the left
  • abnormal: head rotated to right -> eyes follow. indicates brainstem damage
  • afferent: VIII
  • efferent: VI and III
69
Q

a right sided lesion to CN XII will result in what

A
  • “Lick your lesion”
    • tongue points toward right
70
Q

differentiate between spasticity and rigidity

A
  • spasticity: velocity dependent
    • ​UMN lesion
  • rigidity: velocity independent
    • ​basal ganglia lesion
71
Q

biceps reflex tests what spinal nerve roots

A
  • C5
  • C6
72
Q

brachioradialis reflex tests what spinal nerve roots

A

C6

73
Q

Triceps reflex tests what spinal nerve roots

A

C7

74
Q

Patellar reflex tests what spinal nerve roots

A

L4

75
Q

Achilles tendon reflex tests what spinal nerve roots

A

S1

clin med III, exam 3 (6 decks)

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