clinical neuroanatomy Flashcards
1
Q
List the meninges
A
PAD
- Pia: closest to brain
- Arachnoid
- Dura
2
Q
List the cerebri that seperate the brain into compartments
A
- falx cerebri
- tentorium cerebelli
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
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
5
Q
clinical presentation
- sudden onset
- “worst headache of life”
- rapidly deteriorates -> comatose
A
- subarachnoid hemorrhage
- Aneurysm
- crab
6
Q
CSF is created by
A
choroid plexus in lateral ventricles
7
Q
flow of CSF through ventricles
A
- lateral ventricles -> foramen on monroe
- 3rd ventricle -> cerebral aqueduct
- 4th ventricle
8
Q
clinical presentation
- developed headaches, confusion, difficulty walking, and urinary incontinence over 2-3 months
A
- “Wet, wacky, wobbly”
- normal pressure hydrocephalus
9
Q
describe vasculature to right side of brain off aorta
A
- aorta -> BRachiocephalic artery -> Right common carotid and R subclavian artery
10
Q
describe vasculature to left side of brain off aorta
A
aorta -> left common carotid and left subclavian
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
12
Q
function of circle of willis
A
- conncects the anterior and posterior circulations
- connects the L and R sides
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
14
Q
Draw out Venous circulation of brain
A
- superior sagittal sinus
- straight sinus
- cavernous sinus
- transverse sinus
- jugular vein
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
16
Q
motor cortex lies in what part of the brain
A
frontal lobe
17
Q
Right frontal eye feild turns the eyes to what side
A
to the LEFT
18
Q
Anterior cerebral artery supplies blood to what part of homunculus
A
leg
19
Q
Middle cerebral artery supplies blood to what part of homunculus
A
- arm
- face
20
Q
Where do the motor nerves from the homunculus come the closest together
A
- posterior limb of internal capsule
21
Q
What cranial nerves are located in the midbrain
A
- CN II, III, IV
22
Q
What cranial nerves are located in the pons
A
- CN V, VI, VII
- CN VIII
23
Q
What cranial nerves are located in the medulla
A
- CN VIII
- CN IX, X, XI, XII
24
Q
what happens at pyramidal decussation
A
- where motor tracks cross at lower medulla (brainstem)
25
If you see "**crossed signs"**
**ipsilateral cranial nerve deficits** and **contralateral body weakness**, then lesion is located
brain stem
26
pain and temperature are located in what spinal cord tract
* lateral spinothalamic
27
vibration and proprioception are located in what spinal cord tract
posterior spinal cord tract
28
voluntary movement is located in what spinal cord tract
lateral corticospinal
29
lateral corticospinal tract crosses over at
pyramidal decussation at the level of the brainstem (medulla)
30
lateral spinothalamic tract crosses over at
the level of the spinal cord
31
posterior column crosses over at
the level of the brainstem (medulla)
32
what is brown sequard syndrome
* 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
central cord syndromes will result in
* loss of pain and temperature
34
anterior cord syndromes will result in
* paralysis and loss of pain and temperature
35
posterior cord syndrome will result in
* loss of vibration and proprioception
36
cauda equina syndrome presents with what symptom more than conus medullaris syndrome
severe pain and weakness
37
conus medullaris syndrome presents with what symptom more than cauda equina syndrome
early, severe bowel and bladder problems
38
upper motor neuron injury will result in
* increase in tone: spastic weakness
* hyper-reflexia
* babinski
39
lower motor neuron injury will result in
* decrease in tone: flaccid weakness
* hypo-reflexia
* atrophy
* fasciculations
40
peripheral nervous sytem neuroaxis is composed of
* motor neuron
* peripheral nerve
* NMJ
* muscle
41
Where is the lesion
* **aphasia**
* apraxia
* **neglect,** agnosia
* hemianopia
* hemiparesis/hemisensory involving **face and arm vs. leg**
cortex
42
what are the subcortical structures
* internal capsule
* basal ganglia
43
Where is the lesion
* dense hemiplegia: unilateral motor or sensory deficit
* equal weakness of face, arm, and leg
* abnormal movements (chorea, tremor)
subcortical
44
Where is the lesion
* truncal vs limb **ataxia**
* dysmetria (can't do finger-to-nose)
cerebellum
45
Where is the lesion
* Cranial nerve palsies +
* **crossed signs**
brainstem
46
Where is the lesion
* paraparesis
* loss of rectal tone
* loss of sensory
* bowel, bladder involvement
* saddle anesthesia
spinal cord
47
Where is the lesion
* fasciculations
* no sensory involvement
motor neuron
48
Where is the lesion
* distal weakness and sensory involvement (usually **stocking-glove)**
* areflexia or hyporeflexia
peripheral nerve
49
Where is the lesion
* **fatigability**
* no sensory involvement
* normal DTRs
NMJ
50
Where is the lesion
* **proximal weakness**
* symmetric
* no sensory involvement
muscle
51
mneumonic for underlying pathology
**VITAMINCDE**
* vascular
* inflammatory
* trauma
* autoimmune
* metabolic
* infectious
* neoplastic
* congenital
* drugs
* epilepsy/sz
52
list the cranial nerves
* 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
what is the most common color affected if color vision is impaired
**red** desaturation
54
lesion of the right optic nerve will produce
right monocular blindness
55
a lesion at the optic chiasm will produce
bitemporal hemianopia
56
a lesion to the right optic tract (before optic chiasm) will result in what visual field defect
left homonymous hemianopia
57
what is the pupillary reflex: direct and consensual reponse and what cranial nerves are being tested
1. shine light in one eye
* **CN II** senses light and **CN III** causes constriction in **both eyes**
58
how can you test for a CN II lesion
1. shine light in affected eye
2. neither pupil will constrict because CN II is not sensing information
59
which cranial nerves are associated with which EOM
* SO '4'
* LR '6'
* all the rest '3'
60
draw the 6 cardinal directions of eye movement
61
cranial nerve V is responsible for
* sensation to face
* muscle of mastication
* sensory limb of corneal reflex
62
cranial nerve VII is responsible for
* muscles of facial expression
* motor limb of corneal reflex
* eyelid closure
63
what cranial nerve is responsible for keeping the eyes open
CN III
* CN III lesion -\> lack of eyelid opening: **ptosis**
64
what cranial nerve is responsible for eyelid closure
* CN VII
* CN VII lesion: eye unable to close
65
a stroke resulting in central facial palsy will affect what aspects of the face
* loss of voluntary control over **lower muscles** of facial expression on the **contralateral side**
* ****mouth droop
* upper face preserved
66
a peripheral facial nerve palsy (ex: bells palsy) will result in what appearance of the face
* **ipsilateral upper** and **lower asymmetry******
67
gag reflex involes what CN
* afferent: CN IX
* efferent: CN X
68
what is the Vestibulo-ocular reflex and what cranial nerves are involved
* "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
a right sided lesion to CN XII will result in what
* "Lick your lesion"
* tongue points toward right
70
differentiate between spasticity and rigidity
* spasticity: velocity **dependent**
* **UMN lesion**
* rigidity: velocity **independent**
* **basal ganglia lesion**
71
biceps reflex tests what spinal nerve roots
* C5
* C6
72
brachioradialis reflex tests what spinal nerve roots
C6
73
Triceps reflex tests what spinal nerve roots
C7
74
Patellar reflex tests what spinal nerve roots
L4
75
Achilles tendon reflex tests what spinal nerve roots
S1
