Clinical Neuroanatomy Flashcards
Hyperacute presentation
- time frame
- possible atieology
Hyperacute presentation
- instantenous, seconds
- possible vascular pathology
Acute presentation
- time frame
- possible atieology
Acute
- minutes to days
- possible inflammatory, infectious pathology
Subacute presentation
- time frame
- possible atieology
Subacute
- weeks to months
- possible etiology: neoplasia
Chronic presentation
- time frame
- possible atieology
Chronic presentation
- years
- possible aetiology: genetic, degenerative
hemiparesis vs hemiplegia
Hemiparesis - weakness on one side of the body
Hemiplegia - paralysis of one side of the body
Aphasia vs dysphasia
Aphasia – loss of the ability to effectively communicate verbally due to a cognitive communication deficit. May be expressive, receptive or both
Dysphasia – cognitive communication impairment that does not prohibit verbal communication. May be expressive or receptive.
What’s anarthria and what’s dysarthria?
Anarthria/dysarthria – loss of/difficulty with verbal communication due to problems articulating words, for example, due to bulbar palsy or cerebellar disease
What’s apraxia; what’s dyspraxia?
What are the types?
Apraxia/dyspraxia – loss of/difficulty planning to reach a given motor endpoint or perform sequenced activity.
May be (types):
- ideational -> unable to sequence an imagined act e.g. ‘turn a key’
- ideomotor -> unable to mimic an observed posture or movement
What pyramidal tract connects?
Pyramidal corticospinal -> from motor cortex to lower motor neurons (via pyramid shaped tracts in brainstem)
Extrapyramidal tract
- where does it go from?
- what does it do?
Extrapyramidal tract
- goes from basal ganglia
Primes motor cortex to produce activity and suppress the ones the areas that are not needed
What does the cerebellum do in terms of movement?
Cerebellar area -> fine-tuning of activity; comparing planned with actual movements -> learned movements can be acted upon (performed)
What does reticular formation do?
It is crucial for arousal and autonomic activity
What gives rise to cranial nerves? Where anatomically is it located?
Cranial nuclei - locate in the brain stream
Where do cranial nerves 1-2 arise from?
From the brain
Where do cranial nerves 3-4 arise from?
Midbrain
Where do cranial nerves 5-8 arise from?
Pons
Where do cranial nerves 9-12 arise from?
Medulla
What’s the role of Medial Longitudinal Fasciculus (MLF)?
Medial Longitudinal Fasciculus
It’s the main pathway that connects the vestibular and cochlear nuclei -> control the ‘gaze’ (oculomotor, trochlear and abducens)
Where does the spinal cord terminate?
T12 or L1 level with the conus _> which gives rise to cauda equina (lumbar spine houses cauda equina)
*cauda equina from T12 / L1 to the coccyx
Where is C8 nerve root located?
Between C7 and T1 vertebrae
Label the picture
What’s input to the brain?
What’s the output?
- Input - 5 senses, propriception
- Output - motor and speech & autonomic regulation
What brain lobes do optic radiations go through?
Parietal and temporal
Where in the optic pathway do the projections from L and R visual fields go to?
Lateral Geniculate Nucleus
What are the parts of ‘association cortex’?
Association cortex:
- prefrontal -> executive function
- posterior -> sensory
What are main (2) subcortical parts of the brain?
- thalamus
- basal ganglia
What is the function of (in terms of movement):
- basal ganglia
- cerebellum
Basal ganglia -> Initiation and amplification of movement
Cerebellum -> fine tuning
L and R Brain hemispheres and (3) areas/skills that they are responsible for
L -> language, praxis (learnt motor movement), maths
R -> music, space, attention
Midbrain
- cranial nerves in it
- what centres are located there
Midbrain
- CN III and IV
- auditory and visual reflex centres
Pons
- what cranial nerves are there
- what does it do?
Pons
- CN V - VIII
- relay between cerebellum and cerebrum
Medulla
- what cranial nerves are there
- what centres does it contain?
Medulla
- CN IX - XII
- centres: cardiac, respiratory, vasomotor and autonomic
Front dermatomes (draw)
Back dermatomes (draw)
What is spondylosis?
*complications
Spondylosis
- degeneration of the spinal column ( any cause)
- it refers to spinal osteoarthritis-> age-related wear and tear of the spinal column (most common cause)
- mostly the vertebral bodies are affected -> neural foramina and the facet joints (facet syndrome).
*If severe, it may cause pressure on the spinal cord or nerve roots with subsequent sensory or motor disturbances, such as pain, paresthesia, imbalance, and muscle weakness in the limbs.
What nerve supplies:
Wrist and finger extensors
Radial nerve
What nerve supplies
LOAF (lateral two lumbricals. opponens pollicis.abductor pollicis brevis.flexor pollicis brevis) muscles, grip, sensory lateral hand
Median nerve
What nerve supplies small muscles of hand and grip?
Ulnar n.
Diffuse vs focal nerve dysfunction (what do they mean)
focal - localised lesion
a diffuse - widespread area of injury/damage
What symptoms may be seen in global cognitive impairment?
- disorientation and cognitive slowing
- confusion and agitation
- personality change
What areas are involved in:
- cortical dysfunction
- subcortical dysfunction
- brainstem dysfunction
- cerebellar dysfunction
What areas are involved in:
- cognitive disorders
- emotional/psychiatric disorders
- movement disorders
- pain
Mention a few disorders related to brainstem
- tinnitus and deafness
- bulbar and pseudobulbar (related to cranial motor neurones)
- nausea and vomiting
- vertigo
- double vision
- sensory disturbance
- autonomic dysfunction
- quadriparesis (paresis = weakness)
- possible ataxia
- locked-in-syndrome
What may be clinical signs of ataxia?
- ipsilateral motor incoordination
- slurring or scanning dysarthria
*scanning dysarthria = spoken words are broken down into the syllables
- jerky eye movements
How does ataxia may present on clinical examination?
- dysmetria
- dysdiadochokinesis
- tremor
Which nerve does that?
Hip flexion and knee extension
femoral n.
What nerve does that?
Hip extension and knee flexion
Sciatic n.
What nerve does that?
Ankle dorsiflexion and eversion
Common peroneal nerve
Ankle plantarflexion and inversion
What nerve does that?
Tibial n.
What disorders may cause peripheral neuropathy?
- axonal polyneuropathy (diabetes, age)
- demyelinating (GBS, chronic inflammatory demyelinating polyneuropathy)
- mononeuritis multiplex (vasculitis, lymphoma)
What disorders may cause peripheral neuropathy?
- Myasthenia Gravis
- Lambert-Eaton Myasthenic syndrome
What disorders may cause myopathy?
inflammatory or genetic dystrophies
