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(PA school) Neuroanatomy > Highlighted content lectures 2.1 & 2.2 > Flashcards

Highlighted content lectures 2.1 & 2.2 Flashcards

1
Q

If a patient has a gaze toward the side of the lesion, what kind of stroke may they have had?

A

MCA (middle cerebral artery)

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2
Q

What causes a watershed zone?

A

When the blood supply to 2 adjacent cerebral arteries is compromised

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3
Q

What are two causes of two adjacent cerebral arteries being compromised? [and thus causing watershed infarction]

A

1) Sudden occlusion of the internal carotid or
2) A drop in BP in setting of carotid stenosis

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4
Q

What are the 3 main somatosensory and motor pathways? List what each does

A

1) Lateral corticospinal tract: Motor
2) Anterolateral columns: Sensory; pain, temperature & crude touch
3) Posterolateral columns: Sensory; vibration, fine touch, proprioception

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5
Q

1) Where is the primary motor cortex?
2) Where is the primary somatosensory cortex?

A

1) Primary motor = precentral
2) Primary somatosensory = postcentral

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6
Q

1) What is the most important descending motor pathway of the nervous system?
2) What does it do?

A

1) Lateral corticospinal tract
2) Controls the movement of extremities

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7
Q

1) What forms the anterior spinal artery?
2) What supplies most of the cord?
3) What forms the posterior spinal artery?

A

1) Vertebral arteries
2) Anterior spinal artery
3) Vertebral arteries

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8
Q

Where is venous return for the spinal cord?

A

Epidural space

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9
Q

Where does pyramidal decussation occur?

A

At medulla/spinal cord junction

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10
Q

Where does the corticospinal tract go?

A

Posterior limb

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11
Q

Is the ANS afferent, efferent, or both?

A

Only efferent pathways

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12
Q

What are the two ANS divisions?

A

Sympathetic and parasympathetic divisions

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13
Q

1) What do sympathetic neurons release to end organs?
2) What about parasympathetic?

A

1) Sympathetic: norepinephrine to the end organs
2) Parasympathetic: acetylcholine

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14
Q

What 3 things control the ANS?

A

Hypothalamus, brainstem nuclei, and the amygdala

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15
Q

What are the 3 long tracts of the spinal cord?

A

1) Posterior column-medial leminiscal system
2) Anterolateral systems
3) Corticospinal tract

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16
Q

1) What does the Posterior column-medial leminiscal pathway convey?
2) Where does it decussate?

A

1) Proprioception, vibration sense, and fine touch
2) In lower medulla

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17
Q

What pathway’s nerves cross over at the same level?

A

Anterolateral pathway **

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18
Q

What can vitamin B12 deficiency affect?

A

Posterior cord

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19
Q

Anterior cord syndrome damage causes what?

A

Loss of pain and temperature sensation below the level of the lesion
**anterior spinal artery infarct is a common cause

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20
Q

What are the 4 dermatomes we need to know?

A

T4 – nipple line
T10 – umbilicus
C6 – thumb (6 shooter)
S5 - perianal

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21
Q

What is the biggest cause of radiculopathy?

A

Diabetes

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22
Q

1) What can cauda equina syndrome cause?
2) What can this then cause?

A

1) Saddle anesthesia (sensory loss in S2-5, numbness in inguinal area)
2) Bladder disfunction, constipation, fecal incontinence and loss of erections

23
Q

Almost all pathways projecting into the cerebral cortex, relay through the thalamus; which one doesn’t?

A

Olfactory

24
Q

1) What supply anterior hemispheres?
2) What about posterior hemispheres?
3) What forms the basilar artery?
4) What forms the Circle of Willis?

A

1) Internal carotid arteries
2) Vertebral arteries
3) Vertebral arteries
4) The anterior and posterior blood supplies form the anastomotic ring

25
Q

1) What come off the aorta?
2) What does the common carotid arteries split into?
3) List the arteries that supply the cerebral hemispheres

A

1) Common carotid arteries
2) Internal and external carotid arteries
3) Anterior, middle and posterior cerebral arteries (ACA, MCA, PCA)

26
Q

What are the anterior and middle cerebral arteries (ACA & MCA)?

A

The termination of the internal carotids

27
Q

What supply the Wernicke’s and Broca’s areas?

A

Middle cerebral artery

28
Q

What supply the basal ganglia and the internal capsule?

A

Branches of the MCA

29
Q

What can cause lacunar infarctions?

A

HTN

30
Q

What is the watershed?

A

The region in-between the 2 adjacent compromised vessels

31
Q

What are watershed infarcts?

A

2 adjacent cerebral arteries are compromised

32
Q

1) What type of stroke is caused by lack of adequate blood supply to the brain for long enough to cause cell death?
2) What can cause it?

A

1) Ischemic stroke
2) Can be caused by embolus or thrombus

33
Q

1) What links the anterior cerebral arteries together?
2) What do the posterior communicating arteries do? Be specific

A

1) The anterior communicating artery
2) Link anterior and posterior circulations; specifically they join the internal carotids and the posterior cerebrals

34
Q

1) Where does the anterior cerebral artery (ACA) go?
2) What does it supply?

A

1) Travels forward, splits into 2 main branches, then turns back over the corpus collosum
2) The cortex on the anterior medial surface of the brain from frontal to anterior parietal lobe.
-Includes the medial sensorimotor cortex.

35
Q

1) Where does the middle cerebral artery (MCA) go?
2) What does it supply?

A

1) Enters Sylvian Fissure and then splits into 2-4 main branches, which form loops.
2) The cortex above and below the Sylvian Fissure; including the lateral temporal lobe and parts of the parietal lobe.
-Also includes thalamus and posterior limb of the internal capsule

36
Q

1) Where does the posterior cerebral artery (PCA) go?
2) What does it supply?

A

1) Curves back off the basilar artery
2) Through its many branches supplies: the inferior and medial temporal lobes and the medial occipital cortex.

37
Q

1) What artery supplies the medial sensorimotor cortex?
2) What supplies the the inferior and medial temporal lobes?
3) What supplies the lateral temporal lobes?

A

1) ACA
2) PCA
3) MCA

38
Q

1) What supplies blood to the thalamus and posterior limb of the internal capsule?
2) What could a lacunar infarction in this area cause?

A

1) Small branches of the MCA
2) Contralateral hemiparesis

39
Q

1) What is lacunar infarct syndrome?
2) What is it characterized by?
3) Give examples

A

1) The clinical manifestations of a lacunar infarct
2) Pure motor hemiparesis.
3) Contra/Unilateral face, arm and leg weakness.
-Location ex/posterior limb of internal capsule.

40
Q

1) What strokes are most common, MCA, ACA, or PCA?
2) What is its unique symptom?

A

1) MCA
2) Patients often have a gaze toward the side of the lesion

41
Q

What two things can watershed infarctions cause?

A

1) Sudden occlusion of the internal carotid
2) Drop in BP in setting of carotid stenosis

42
Q

1) How long does a TIA last?
2) Give 4 common causes

A

1) <24 hours (usually closer to 10 minutes)
2) Migraines, seizures, arrhythmias and hypoglycemia

43
Q

_____% of patients with TIAs with have a stroke within ___ months and most of those within the next _____ hours

A

10%; 3 months; 48 hours

44
Q

What is leading cause of significant disability?

A

Strokes

45
Q

1) What are the two main types of strokes?
2) What type of stroke is caused by a thrombus or embolus?

A

1) Ischemic and hemorrhagic
2) Ischemic

46
Q

What is the biggest difference between a thrombus and embolus?

A

1) Embolus: travels
2) Thrombus: doesn’t travel

47
Q

1) What type of stroke is usually caused by an embolus, large vessel or small vessel?
2) What are small vessel strokes also called?

A

1) Large vessel
2) Lacunar infarcts

48
Q

1) What are emboli most often made of?
2) Where do they commonly come from?

A

1) Most often blood clots.
2) The heart

49
Q

Define dissection [in the context of strokes]

A

Tear on the inner surface of an artery

50
Q

1) What do cortical signs come from?
2) What are they?

A

1) Lobar strokes
2) Aphasia, neglect, homonymous visual field defects, apraxia, hemiparesis, and sensory loss

51
Q

What sometimes causes headaches with ischemic strokes?

A

Innervation of the blood vessels and meninges

52
Q

What is usually the cause of strokes in younger patients?

A

Dissection/trauma

53
Q

What do the internal jugular veins do?

A

Drain the dural sinuses (which is where the veins that drain the brain go)

(PA school) Neuroanatomy (24 decks)

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