Examination of Cerebrum and Meninges Flashcards
Total surface area of the cerebral cortex
2.5 sq.ft.
Total weight of the brain in Adults
1400gms
Total number of neurons in cerebral cortex
10 Billion
Total number of synapses in cerebral cortex
60 trillion
Total weight of the brain in newborns
400 gms
Transmission and transmission speed
30-360 ft/sec
Number of neurons
10^11to 10^12neurons
Based on studies of stained cells
Cytoarchitectonic organization
Based on studies of myelinated fiber preparations
Myeloarchitectonic organization
Layer I of Cytoarchitectonic Organization
Principal Cells
Principal Fibers
Molecular
C: Axons & dendrites
F: Association and commisural fibers Source of corticocortical fibers
Layer II of Cytoarchitectonic Organization
Principal Cells
Principal Fibers
External granular
C: Small pyramidal cells
F: Association and commisural fibers
Source of corticocortical fibers
Layer III of Cytoarchitectonic Organization
Principal Cells
Principal Fibers
External Pyramidal
C: Medium pyramidal cells
F: Association and commisural fibers
Source of corticocortical fibers
Layer IV of Cytoarchitectonic Organization
Principal Cells
Principal Fibers
Inner Granular
C: Stellate cells
F: Thalamocortical
Where most incoming signals go to
Layer V of Cytoarchitectonic Organization
Principal Cells
Principal Fibers
Inner Pyramidal
C: Large pyramidal cells
F: Corticobulbar, corticospinal & corticostriatal
Mostly outgoing fibers
Layer VI of Cytoarchitectonic Organization
Principal Cells
Principal Fibers
Polymorph
C: Fusiform cells
F: Source of corticothalamic fibers
Layer I of Myeloarchitectonic Organization
Fibers
Tangential
F: NA
Layer II of Myeloarchitectonic Organization
Fibers
Dysfibrous
F: NA
Layer III of Myeloarchitectonic Organization
Fibers
Suprastriatal
F: Cortico-cortical
Layer IV of Myeloarchitectonic Organization
Fibers
External Baillarger
F: Thalamic projection
Lines of Gennari
Layer V of Myeloarchitectonic Organization
Fibers
Internal Baillarger
F: Corticostriate
Layer VI of Myeloarchitectonic Organization
Fibers
Infrastriatal
F: Cortico-thalamic
Frontal Lobe
Initiation of voluntary movements
Primary motor cortex (pre-central gyrus)
Frontal Lobe
voluntary movements
Pre-motor area (pre-central + superior and middle frontal gyri)
Frontal Lobe
motor control of speech
Broca’s area (inferior frontal gyrus, dominant lobe)
Frontal Lobe
personality, insight and foresight, emotion
Prefrontal cortex
BA 4
Primary motor area
Location of BA 4
Precental gyrus, paracentral lobule
BA 6
Premotor area
Location of BA 6
Superior, middle frontal gyri, precentral gyrus
BA 8
Frontal eye field
Location of BA 8
Superior and middle frontal gyri
BA 44. 45
Broca’s area
Location of BA 44, 45
Opercular/ triangular region, inferior frontal gyrus
3 General functions of the parietal lobe
- Primary somatosensory cortex
- Language Comprehension
- Spatial and temporal orientation
BA 3,1,2
Primary somatosensoryarea
Location of BA 3,1,2
Post-central gyrus, paracentrallobule
BA 5,7
Secondary Somatosensoryassociation area
Location of BA 5,7
Superior parietal lobule
BA 39
Anglar gyrus
Location of BA 39
Inferior parietal lobule
BA 40
Supramarginalgyrus
Location of BA 40
Inferior parietal lobule
BA 43
Primary gustatory cortex
Location of BA 43
Parietal operculum
3 General functions of Temporal Lobe
- Primary auditory cortex
- Limbic system
- Learning and memory recall orientation
BA 41
Primary auditory area (A1), Heschl’s gyrus
Location of BA 41
Superior temporal gyrus, paracentral lobule
BA 42
Auditory association area
Location of BA 42
Superior temporal gyrus
BA 22
Auditory association area, Wernicki’s area
Location of BA 22
Superior temporal gyrus
General functions of occipital lobe
- Primary visual cortex
2. Visual association cortex
BA 17
Primary visual area (V1)
Location of BA 17
Banks of calcarinefissure
BA 18, 19
Visual associationarea (V2, V3)
Location of BA 18,19
Surrounding area
What do you check for Mental Status?
General behavior and appearance Stream of talk Mood and affective responses Content of thought Intellectual Capacity Sensorium
Maximum Score in Glasgow Coma Scale
15
Minimum Score in Glasgow Coma Scale
3
Common Causes of Depressed Sensorium
Hypoglycemia Alcohol intoxication Hyponatremia Systemic Infection Large Strokes Brainstem Strokes
Inability to understand the meaning of ordinary sensory stimuli even though the sensory pathways and sensorium are relatively intact
Agnosia
Inability to perform a willed act even though the motor system and mental status is relatively intact
Apraxia
Agnosia and apraxia of language
Aphasia
Patient loses the normal rhythms and inflections of speech with poverty of associations
Patient has difficulty writing
Patient retains the ability to read
Broca’s(motor) Aphasia
Patient produces plentiful or even an excessive number of words, but words are often wrong or assembled of the wrong sounds
Wernicke’s (sensory) Aphasia
Patients lose the ability to audit their own words and the words of others
Wernicke’s (sensory) Aphasia
Patient has severe expressive and receptive dysphasia virtually eliminating all receptive and expressive communication by words
Global Aphasia
Brain and the spinal cord are surrounded by three distinct connective tissue membranes or (meninges)
- thick dura materexternally
- delicate arachnoid
- thin pia mater
Rich in blood vessels and nervesand adherent to the cranium
Outer periosteal layer of the dura mater
Closely attached to underlying arachnoid
Inner meningeal layer of the dura mater
Sickle shaped double layer of the dura matter,
lying in between the cerebral hemisphere
Falx cerebri
Small sickle shaped projection between the
cerebellar hemispheres
Falx cerebelli
Crescentic fold that supports the
occipital lobes and covers the cerebellum, divides the cranial cavity in supratentorial and infratentorial
compartments
Tentorium cerebelli
Circular fold wc covers the sella turcica
separating the pituitary gland fr the hypothalamus
Diaphragma sellae
Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed
Kernig’s Sign
Severe neck stiffness causes a patient’s hips and knees to flex when the neck is flexed
Brudzinki’s Sign