INBR 7 - Neuroanatomy Flashcards
- Daerah-daerah otak yang tidak memiliki sawar darah-otak meliputi semua hal di bawah ini, kecuali:
A. Pineal body
B. Organ subfornikal
C. Organum vaskulosum dari lamina terminalis
D. Eminensi mediana dari hipotalamus
E. Nukleus habenulare
(E) The pineal body, subfornical organ, organum vasculosum of the lamina terminalis, median eminence of the hypothalamus, neurohypophysis, subcommissural organ, and the area postrema are devoid of a blood-brain barrier and are commonly referred to as circumventricular organs. The habenular nucleus is not a circumventricular organ (Carpenter, pp. 18-20; Kandel, p. 1293).
- Manakah diantara hal-hal di bawah ini yang merupakan jaras keluar utama dari ganglia basalis
A. Fasikulus lentikularis (H2 dari Forel)
B. Ansa Lentikularis
C. Faskikulus talamikus (H1 dari Forel)
D. Ansa Retikularis
E. Traktus mammillotalamikus
(A) The major fibers projecting from the basal ganglia originate in the medial globus pallidus as a fiber tract known as the lenticular fasciculus, or Forel’s field I-12 . Another tract, known as ansa lenticularis, loops around the internal capsule, merges with the lenticular fasciculus in Forel’s field H, and continues with the dentatorubrothalamic tract as the thalamic fasciculus (Forel’s field H 1 ) . These fibers then synapse in the centromedian (CM), ventrolateral (VL), and ventroanterior (VA) nuclei of the thalamus before being relayed to the cerebral cortex. Three other efferent tracts of the basal ganglia include the pallidosubthalamic, pallidohabenular (via the stria medullaris), and pallidotegmental, which terminate in the subthalamic nucleus, habenular nucleus, and midbrain tegmentum, respectively (Carpenter, pp. 341-344).
3. Cedera pada Segitiga GUILLAIN-MOLLARET dapat menyebabkan A. Tremor pada lengan B. Torsional nistagmus C. Hipotonia D. Tuli E. Mioklonus
(E) Guillain-Mollaret’s triangle is a physiologic connection between the red nucleus, inferior olives, and dentate nucleus of the cerebellum. Injury to this pathway has been !mown to result in palatal myoclonus. This occurs mainly from hypertrophic degeneration of the inferior olive secondary to either red or dentate nucleus damage. Other muscles of branchial origin (face, tongue, vocal cords, and diaphragm) may also be affected. Vascular lesions and multiple sclerosis are common causes of secondary palatal myoclonus that persists during sleep. The etiology of primary myoclonus is unclear and is often associated with bothersome clicking sounds i n the ear caused by contractions of the tensor veli palatini (CN V) muscles, which open the eustachian tubes. Primary myoclonus disappears during sleep (Merritt, pp. 666-667; Wilkins, p. 149 ) .
4. Melalui struktur manakah serabut dari olive inferior mencapai serebelum? A. Pedunkulus serebelaris superior B. Pedunkulus serebelaris inferior C. Pedunkulus serebelaris medius D. Nukleus vestibularis E. Lobe flokulonodularis
(B) The fibers exiting the inferior olive are climbing fibers and reach the cerebellum through the inferior cerebellar peduncle. Climbing fibers are excitatory and synapse with Purkinje cells in a distinctive morphologic fashion. They wrap around the cell body and dendrites of Purkinje cells, where numerous synaptic contacts are made. Each climbing fiber contacts 1 to 10 Purkinje cells, and each Purkinje cell receives input from only a single climbing fiber. The response elicited by the interaction between climbing fibers and Purkinje cells is believed to be the most powerful in the CNS and results in a large action potential (complex spike) secondary to Ca2+ influx into the Purkinje cell. The other major afferent fibers reaching the cerebellum are mossy fibers, which influence Purkinje cells indirectly through synapses with granule cells (Carpenter, pp. 230-234) .
5. Semua di bawah ini adalah serabut asosiasi, KECUALI A. Faskikulus longitudinal superior B. Faskikulus arkuatus C. Fascikulus unsinatus D.Corona radiata E.Singulum
(D) The corona radiata is made u p of projection fibers conveying impulses to subcortical structures including the thalamus, basal ganglia, brainstem, and spinal cord. The superior and inferior longitudinal fasciculus, arcuate fasciculus, uncinate fasciculus, external capsule, and cingulum are six of the more notable association fibers that connect different lobes within the same hemisphere. Commissural fibers connect corresponding regions of the two hemispheres, which include the corpus callosum, anterior commissure, and hippocampal commissure (Carpenter, pp. 33-3 7 ) .
6. Neuron ordo pertama untuk dilatasi pupil berasal dari struktur yang mana? A. Thalamus B. Hipothalamus C. Kolukulus superior D. Ganglion servikalis superior E. Nukleus EDINGER-WESTPHAL
(B) First-order neurons involved with pupillary dilation originate in the hypothalamus and descend through the brainstem and cervical spinal cord to the T 1-T2 level of the spinal cord. They then synapse on ipsilateral preganglionic sympathetic fibers, exit the cord, travel with the sympathetic fibers as second-order neurons,. and synapse on postganglionic sympathetic fibers. The third-order neurons travel with the internal carotid artery to the orbit and innervate the radial smooth muscle of the iris ( Kandel, p. 905).
7. Nukleus basalis (dari MEYNERT) mengandung jenis neuron yang mana? A. Kolinergik B. Adrenergik C. Serotonergik D. Dopaminergik E. Noradrenergik
(A) The basal nucleus (of Meynert) contains neurons with acetylcholine that project to the cingulate gyrus, septal nuclei, and the nucleus of the diagonal band of Broca. Dopaminergic fibers are located mainly in the substantia nigra and ventral tegmental area, w
- Awal insisi untuk graf krista iliaka anterior pada sekitar 3 cm lateral dari spina iliaka anterior adalah upaya untuk mencegah kerusakan struktur berikut :
- Muskulus Sartorius
- Nervus kutaneus femoralis lateralis
- Ligamen ilio-inguinal
- Muskulus iliakus
(A) Beginning the incision for an anterior iliac crest graft approximately 3 em lateral to the anterior iliac spine av()ids the attachments of the sartorius muscle and ilioinguinal ligament. The lateral femoral cutaneous nerve courses through this region_ and is also vulnerable to injury with this approach, but it does not attach to or originate from the iliac crest (Connolly, pp. 818-819).
9. Serabut mossy yang berasal dari girus dentatus akan berakhir di sini. A. CA1 B. CA2 C. CA3 D. CA4 E. Griseum indusium F. Girus dentate G. Bukan, A-F
(C) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .
10. Sangat rentan terhadap hipoksia. A. CA1 B. CA2 C. CA3 D. CA4 E. Griseum indusium F. Girus dentate G. Bukan, A-F
(A) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .
11. Kolateral-kolateral SCHAFFER berproyeksi pada neuron piramidial dari sub-lapisan ini A. CA1 B. CA2 C. CA3 D. CA4 E. Griseum indusium F. Girus dentate G. Bukan, A-F
(A) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .
12. Terletak pada konkavitas girus dentatus. A. CA1 B. CA2 C. CA3 D. CA4 E. Griseum indusium F. Girus dentate G. Bukan, A-F
(D) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .
13. Sisa vestigial dari pembentukan hipokampus A. CA1 B. CA2 C. CA3 D. CA4 E. Griseum indusium F. Girus dentate G. Bukan, A-F
(E) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .
14. Cedera pada sektor ini bisa menyebabkan masalah memori yang lalu. A. CA1 B. CA2 C. CA3 D. CA4 E. Griseum indusium F. Girus dentate G. Bukan, A-F
(G) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .
15. Sektor yang paling besar A. CA1 B. CA2 C. CA3 D. CA4 E. Griseum indusium F. Girus dentate G. Bukan, A-F
(A) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer’s sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .
- Pada orang normal, sirkuit langsung dan tidak langsung dari ganglia basal diseimbangkan oleh
A. Aksi-aksi perlawanan dari proyeksi-proyeksi nigrostriatal dopaminergik pada sub-tipe-sub-tipe reseptor D1 dan D2 pada putamen
B. Aktivitas penghambatan dari nukleus subthalamik pada globus pallidus interna.
C. Meningkatnya aktivitas neuron-neuron GABAergik pada segmen bagian dalam dari globus pallidus ileh jalur langsung
D. Serat-serat dopaminergik yang semakin naik dab berasal dari tegmentum bagian
tengah otak dari substantia nigra ( yang mempengaruhi reseptor-reseptor D1 dan D2 dari globus pallidus).
E. A, B, C dan D semuanya benar
(A) . T h e dopaminergic projections o f t h e SNc t o t h e striatum facilitate movements by influencing the direct and indirect pathways. The nigrostriatal projections to the spiny neurons of the direct pathway ( 0 1 receptors) are excitatory, while the nigrostriatal projections to the spiny neurons of the indirect pathway (02 receptors) are inhibitory. In normal individuals, the direct and indirect circuits of the basal ganglia are balanced by the opposing actions of these projections on these receptors. The loss of SNc dopaminergic projections to the striatum results in increased activity of the indirect circuit (and decreased activity of the direct circuit), which accounts for the hypokinetic aspects of Parkinson’s disease. It is important to realize, however, that the segregation of the 0 1 and 02 receptors between the direct and indirect pathways is probably not as strict as described above, but it still serves as a nice framework to explain the differential action of dopamine on striatal output. The subthalamic nucleus has an excitatory effect on the internal segment of the globus pallidus via the indirect pathway. In normal individuals, the activation of striatal GABAergic neurons inhibits GABAergic neurons within the internal segment of the globus pallidus instead of activating them. The ascending dopaminergic activating system originates in the brainstem reticular
17. Lesi visual yang menyebabkan defek sentral pada satu lapang pandang dengan defek temporo-superior sisi berlawanan, kemungkinan berasal dari lokasi yang mana? A. Kiasm depan B. Lobe okipital C. Lobe temporal D. Saraf optik E. Lobe parietal inferior
(A) A visual lesion producing a central defect i n one field with a superior temporal defect in the opposite field s uggests 38 Intensive Neurosurgery Board Review a lesion near the anterior optic chiasm. This is likely the result of damage to the ipsilateral optic nerve and the fibers that loop forward from the inferonasal retina of the opposite eye (Wille brand’$ knee). (Brazis, p. 136, Kline, pp. 3 , 9).
- Serat-serat dari medan-medan mata frontal lewat melalui genu dari kapsul bagian dalam, melakukan dekusasi di dalam pons, dan bersinapse di dalam struktur yang terlibat dengan sakkades yang mana?
A. Faskikulus longitudinal medial (MLF)
B. Kolikulus inferior
C. Nukleus Edinger-Westphal
D. Nukleus soliteris
E. Formasi retikular pontin paramedian (PPRF)
(E) Fibers controlling saccades originate in the contralateral frontal eye fields (Brodmann’s area 8), pass through the internal capsule, decussate in the pons, and synapse in the paramedian pontine reticular formation (PPRF) . Efferent fibers from the PPRF project to the ipsilateral abducens nucleus (VI) and contralateral oculomotor nucleus (III) via the medial longitudinal fasciculus (MLF) , which results in saccadic eye movements. Saccades that are organized in the PPRF are usually under the control of the superior colliculus, although some saccadic eye movements occur independently, without collicular influence (Kandel, pp. 789-792 ) .
- Oklusi dari pembuluh ini merupakan penyebab yang paling lazim dari sindroma medularis lateral (Wallenberg) .
(E) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner’s syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)’ occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and ‘tract), ipsilateral Horner’s syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner’s syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a “fetal” PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .
- Memasok piramis, tuber, flokulus, dan bagian-bagian kaudal dari tegmentum pontin
(C) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner’s syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)’ occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and ‘tract), ipsilateral Horner’s syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner’s syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a “fetal” PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .
- Oklusi dapat menyebabkan gangguan pendengaran kontra-lateral.
(B) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner’s syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)’ occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and ‘tract), ipsilateral Horner’s syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner’s syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a “fetal” PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .
- Pembuluh yang lazim berasosiasi dengan neuralgia trigeminal .
(B) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner’s syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)’ occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and ‘tract), ipsilateral Horner’s syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner’s syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a “fetal” PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .
- Pembuluh yang paling berisiko cedera selama dekompresi Chiari.
(D) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner’s syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)’ occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and ‘tract), ipsilateral Horner’s syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner’s syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a “fetal” PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .
- Nukleus dentate biasanya dipasok oleh pembuluh ini.
(B) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner’s syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)’ occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and ‘tract), ipsilateral Horner’s syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner’s syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a “fetal” PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .
- Memasok pedunkel serebelar tengah.
(C) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner’s syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)’ occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and ‘tract), ipsilateral Horner’s syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner’s syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a “fetal” PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .
26. Serat-serat yang lewat dari amigdala ke hypothalamus bisa berjalan pada bundel serat yang mana? A. Stria medullaris B. Forniks C. Terminal-terminal stria D. Bundel otak depan tengah E. Singulum
(C) Afferent connections into the hypothalamus are umerous and complex. Seven of the main pathways are described below. 1. Amygdalohypothalamic fibers pass from the amygdala to the hypothalamus by two pathways: the stria terminalis and a pathway under the lentiform nucleus (ventral amygdalofugal fibers). The stria terminalis arises mainly from the corticomedial part of the amygdala and distributes fibers to the medial preoptic nucleus, anterior hypothalamic nucleus , and ventromedial and arcuate nuclei. Ventral amygdalofugal fibers arise from the basolateral amygdala and pyriform cortex and spread medially and rostrally under the lentiform nucleus to reach the lateral hypothalamus and medial forebrain bundle. 2. Visceral and somatic fibers reach the hypothalamus through collateral branches of the lemniscal tracts and reticular formation. 3. Basal olfactory, septal nuclei, periamygdaloid, and subiculum fibers reach the lateral and preoptic hypothalamic regions via the medial forebrain bundle . 4. Cortical fibers to the hypothalamus arise mainly from the frontal lobe. 5. Hippocampohypothalamic fibers travel through the fornix to the mammillary body. 6. Thalamohypothalamic fibers arise from the dorsomedial and midline thalamic nuclei. 7. Brainstem fibers to the hypothalamus arise from the raphe nuclei of the midbrain, the lateral parabrachial nuclei of the pons, and the locus ceruleus. Brainstem reticular fibers also ascend to the hypothalamus by the mammillary pedicle and dorsal longitudinal fasciculus (Carpenter, pp. 304-307 ; Kandel, pp. 972-981 , 992-993 ) .
- Sebuah glomerulus serebelar terdiri dari semua hal di bawah ini, KECUALI
A. Serat-serat mendaki
B. Kapsul glial
C. Dendrit neuron-neuron granula
D. Akson & dendrite dari neuron-neuron Golgi Tipe-II
E. Serat-serat Mossy
(A) The cerebellar glomeruli have synaptic connections consisting of mossy fiber rosettes, axons of Golgi type II neurons, and dendrites of granule cells. A glial capsule surrounds this conglomeration. The axons of the granule neurons, which enter the molecular layer, provide the output from the glomerulus. Climbing fibers bypass the glomeruli to synapse directly on Purkinje cells (Carpenter, pp. 224-234). 2 8 .
28. Situs utama proliferasi neuroblas pada Sistem Saraf Pusat adalah A. Lapisan III dari korteks serebral B. Daerah ependimal periventrikular C. Zat putih D. Spinal cord E. Lapisan araknoid
(B) The major site of neuroblast proliferation in the CNS is the periventricular ependymal surface. After undergoing mitosis, these young neural cells migrate away from the ependyma ( El liso n , p. 7 1 ) .
29. Diantara sel-sel di bawah ini, sel manakah yang hanya mewakili keluaran dari korteks serebelar? A. Sel granula B. Sel Golgi C. Sel Stellate D. Sel Purkinje E. Sel horisontal
(D) The cerebellar cortex consists of a molecular layer, Purkinje cell layer, and granular layer. The granular layer is deepest and lies just above the central medullary white matter. This layer contains the granule cells, which utilize glutamate as their neurotransmitter and are the only excitatory cells of the cerebellar cortex. Granule cell dendrites terminate in glomeruli, and their axons ascend to the molecular layer of the cerebellum as parallel fibers, which synapse with Purkinje cell dendrites. Golgi type II cells also reside in the granular layer of the cerebellar cortex. These cells are inhibitory (GABA) interneurons; their dendrites contact parallel fibers while their axons terminate in glomeruli. Each glomerulus consists of granule cell dendrites, Golgi cell axons , and a mossy fiber rosette. The Purkinje cells reside in the middle layer of the cerebellar cortex; they are large cells that project inhibitory fibers (GABA) to the deep cerebellar nuclei and the vestibular nuclei. The Purkinje cell represents the only output of the cerebellar cortex, which is inhibitory. Purkinje cells have extensive dendritic arborizations that extend into the molecular layer and are stimulated by parallel fibers and climbing fibers. Specialized astrocytes, called Bergman cells (Golgi epithelial cells) , surround Purkinje cells within the Purkinje cell layer and provide supportive functions. The molecular layer is the most superficial layer of the cerebellar cortex; it contains stellate cells, basket cell . Purkinje dendrites, and pqrallel fibers (from granule cells). Stellate cells make synaptic contacts with Purkinje cell dendrites, while basket cells form synapses on Purkinje cell bodies. Both stellate and basket cells are inhibitory and utilize GABA as their neurotransmitter. Cerebellar cortical input occurs via climbing fibers an • mossy fibers. Climbing fibers originate in the inferior oli,•e (olivocerebellars) ; they ascend to the molecular layer. “‘•h;:re they directly stimulate the dendrites of small numb rs u
- Struktur-struktur manakah yang melewati annulus tendineus ( dari Zinn)?
- Ophthalmic vein
- Muskulus rektus lateral
- Cabang lakrimal dari saraf optalmik
- Pencabangan inferior saraf okulomotor
(C) The annulus tendineus (of Zinn) lies at the apes the periorbita and gives rise to four rectus muscles. The o
- Saraf-saraf memasok otot yang bersifat antagonis bagi seratus anterior.
(K) The brachial plexus is formed from the anterior primary rami of segments CS, C6, C7, C8, and T l . It is about 15 em long in adults and e,xtends from the spinal cord to the axilla. It is divided into five major components, as follows : roots, trunks, divisions, cords, and branches. The fifth and sixth cervical roots unite to form the upper trunk of the plexus, and the eighth cervical and first thoracic spinal roots unite to form the lower trunk. The seventh cervical root emerges as the middle trunk of the plexus. The three trunks then traverse the supraclavicular fossa, behind the axillary artery, and .s.e.parate into three anterior and three posterior divi
- Cedera pada saraf ini dapat menyebabkan winged scapula .
(A) The brachial plexus is formed from the anterior primary rami of segments CS, C6, C7, C8, and T l . It is about 15 em long in adults and e,xtends from the spinal cord to the axilla. It is divided into five major components, as follows : roots, trunks, divisions, cords, and branches. The fifth and sixth cervical roots unite to form the upper trunk of the plexus, and the eighth cervical and first thoracic spinal roots unite to form the lower trunk. The seventh cervical root emerges as the middle trunk of the plexus. The three trunks then traverse the supraclavicular fossa, behind the axillary artery, and .s.e.parate into three anterior and three posterior divi
- Menginervasi otot halus teres .
(I) The brachial plexus is formed from the anterior primary rami of segments CS, C6, C7, C8, and T l . It is about 15 em long in adults and e,xtends from the spinal cord to the axilla. It is divided into five major components, as follows : roots, trunks, divisions, cords, and branches. The fifth and sixth cervical roots unite to form the upper trunk of the plexus, and the eighth cervical and first thoracic spinal roots unite to form the lower trunk. The seventh cervical root emerges as the middle trunk of the plexus. The three trunks then traverse the supraclavicular fossa, behind the axillary artery, and .s.e.parate into three anterior and three posterior divi
- Cedera pada saraf ini dapat menyebabkan kelemahan fleksi, khususnya jika lengan bagian depan yang terkena.
(J) The brachial plexus is formed from the anterior primary rami of segments CS, C6, C7, C8, and T l . It is about 15 em long in adults and e,xtends from the spinal cord to the axilla. It is divided into five major components, as follows : roots, trunks, divisions, cords, and branches. The fifth and sixth cervical roots unite to form the upper trunk of the plexus, and the eighth cervical and first thoracic spinal roots unite to form the lower trunk. The seventh cervical root emerges as the middle trunk of the plexus. The three trunks then traverse the supraclavicular fossa, behind the axillary artery, and .s.e.parate into three anterior and three posterior divi
- Menginervasi otot supinator
(G) The brachial plexus is formed from the anterior primary rami of segments CS, C6, C7, C8, and T l . It is about 15 em long in adults and e,xtends from the spinal cord to the axilla. It is divided into five major components, as follows : roots, trunks, divisions, cords, and branches. The fifth and sixth cervical roots unite to form the upper trunk of the plexus, and the eighth cervical and first thoracic spinal roots unite to form the lower trunk. The seventh cervical root emerges as the middle trunk of the plexus. The three trunks then traverse the supraclavicular fossa, behind the axillary artery, and .s.e.parate into three anterior and three posterior divi
- Saraf yang paling sering terpengaruh oleh neuropati entrapmen
(H) The brachial plexus is formed from the anterior primary rami of segments CS, C6, C7, C8, and T l . It is about 15 em long in adults and e,xtends from the spinal cord to the axilla. It is divided into five major components, as follows : roots, trunks, divisions, cords, and branches. The fifth and sixth cervical roots unite to form the upper trunk of the plexus, and the eighth cervical and first thoracic spinal roots unite to form the lower trunk. The seventh cervical root emerges as the middle trunk of the plexus. The three trunks then traverse the supraclavicular fossa, behind the axillary artery, and .s.e.parate into three anterior and three posterior divi
- Luka murni pada cabang saraf ini dapat menyebabkan kelemahan pada flekstor-flekstor panjang dari ibu jari dan kelingking ( yang menimbulkan tanda jepitan) dan pronator quadratus.
(H) The brachial plexus is formed from the anterior primary rami of segments CS, C6, C7, C8, and T l . It is about 15 em long in adults and e,xtends from the spinal cord to the axilla. It is divided into five major components, as follows : roots, trunks, divisions, cords, and branches. The fifth and sixth cervical roots unite to form the upper trunk of the plexus, and the eighth cervical and first thoracic spinal roots unite to form the lower trunk. The seventh cervical root emerges as the middle trunk of the plexus. The three trunks then traverse the supraclavicular fossa, behind the axillary artery, and .s.e.parate into three anterior and three posterior divi
- Cedera pada saraf ini dapat terjadi pada saluran Guyan.
(F) The brachial plexus is formed from the anterior primary rami of segments CS, C6, C7, C8, and T l . It is about 15 em long in adults and e,xtends from the spinal cord to the axilla. It is divided into five major components, as follows : roots, trunks, divisions, cords, and branches. The fifth and sixth cervical roots unite to form the upper trunk of the plexus, and the eighth cervical and first thoracic spinal roots unite to form the lower trunk. The seventh cervical root emerges as the middle trunk of the plexus. The three trunks then traverse the supraclavicular fossa, behind the axillary artery, and .s.e.parate into three anterior and three posterior divi
- Jika saraf ini ditekan, bisa menyebabkan ligamen yang menjembatani proses suprakondilar ke epikondile medial.
(H) The brachial plexus is formed from the anterior primary rami of segments CS, C6, C7, C8, and T l . It is about 15 em long in adults and e,xtends from the spinal cord to the axilla. It is divided into five major components, as follows : roots, trunks, divisions, cords, and branches. The fifth and sixth cervical roots unite to form the upper trunk of the plexus, and the eighth cervical and first thoracic spinal roots unite to form the lower trunk. The seventh cervical root emerges as the middle trunk of the plexus. The three trunks then traverse the supraclavicular fossa, behind the axillary artery, and .s.e.parate into three anterior and three posterior divi
- Menginervasi otot-otot interosei
(F) The brachial plexus is formed from the anterior primary rami of segments CS, C6, C7, C8, and T l . It is about 15 em long in adults and e,xtends from the spinal cord to the axilla. It is divided into five major components, as follows : roots, trunks, divisions, cords, and branches. The fifth and sixth cervical roots unite to form the upper trunk of the plexus, and the eighth cervical and first thoracic spinal roots unite to form the lower trunk. The seventh cervical root emerges as the middle trunk of the plexus. The three trunks then traverse the supraclavicular fossa, behind the axillary artery, and .s.e.parate into three anterior and three posterior divi
- Memasok sensasi kepada lengan bagian depan anteromedial dan posteromedial ke arah siku.
(E) The brachial plexus is formed from the anterior primary rami of segments CS, C6, C7, C8, and T l . It is about 15 em long in adults and e,xtends from the spinal cord to the axilla. It is divided into five major components, as follows : roots, trunks, divisions, cords, and branches. The fifth and sixth cervical roots unite to form the upper trunk of the plexus, and the eighth cervical and first thoracic spinal roots unite to form the lower trunk. The seventh cervical root emerges as the middle trunk of the plexus. The three trunks then traverse the supraclavicular fossa, behind the axillary artery, and .s.e.parate into three anterior and three posterior divi
- Entrapmen pada rongga kuadrilateral.
(I) The brachial plexus is formed from the anterior primary rami of segments CS, C6, C7, C8, and T l . It is about 15 em long in adults and e,xtends from the spinal cord to the axilla. It is divided into five major components, as follows : roots, trunks, divisions, cords, and branches. The fifth and sixth cervical roots unite to form the upper trunk of the plexus, and the eighth cervical and first thoracic spinal roots unite to form the lower trunk. The seventh cervical root emerges as the middle trunk of the plexus. The three trunks then traverse the supraclavicular fossa, behind the axillary artery, and .s.e.parate into three anterior and three posterior divi
- Semua fitur di bawah ini adalah fitur dari korteks serebral, KECUALI
A. Batas-batas sitoarsitektural kabur
B. Susunan laminar dari neuron-neuron yang ada
C. Garis-garis rapat pada serat tak termielinasi
D. Susunan neuron radial atau kolom
E. Banyak sel piramidal pada lapisan V dari korteks visual tang mengirimkan serat ke pusat otak untuk pergerakanpergerakan mata refleksif yang diarahkan secara visual.
(C) The cells of the cerebral cortex show both a laminar and radial or columnar arrangement. Several areas of cortex have grossly visible stripes of myelinated fibers, most notably the band of Gennari in layer IV of the occipital cortex. Most cytoarchitectural boundaries are vague rather than sharp. The large pyramidal neurons located in layer V of the visual receptive cortex send axons to the brainstem that mediate visually directed ret1ex eye movements (Carpenter, pp. 390- 433 ) .
- Arcuate fasciculus terdiri dari serat-serat asosiasi yang saling menghubungkan
struktur yang mana?
A. Lobule parietal superior dan lobe okipital
B. Girus frontal atas dan tengah dan lobe temporal
C. Girus frontal atas dan bawah dan lobelimbik
D. Thalamus dan amigdala
E. Giri frontal orbital dan lobe temporal
(B) The arcuate fasciculus projects from the superior temporal gyrus (STG) to the superior and middle frontal gyri. More commonly, it is known as the tract that links the receptive area of speech in the superior temporal gyrus (Wernicke’s area) with the inferior frontal gyrus (Broca’s area) . Lesions in this tract often produce conduction aphasia, in which patients have t1uent speech with poor repetition of spoken language. \Vernicke’s aphasia (WA) is a receptive aphasia characterized by poor comprehension of spoken language, neologisms, literal and verbal paraphasias, poor repetition, and a lack of concern regarding the speech problem. Injury to Broca’s area results in an executive aphasia characterized by slow and effortful speech, agrammatic sounds, and telegraphic speech. The uncinate fasciculus connects the orbital frontal gyri with the anterior portions of the temporal lobe, while the cingulum connects the medial regions of the frontal and parietal lobes with the parahippocampal and temporal regions. The fibers of the superior and inferior longitudinal fasciculus lie close to the arcuate fasciculus and connect the parietal and occipital lobes with the frontal and temporal lobes, respectively. The anterior commissure (association tract) crosses the midline rostral to the fornix and has two parts: the smaller anterior portion interconnects the olfactory bulbs, and the larger posterior portion interconnects the middle and inferior temporal gyri (Carpenter, pp. 33-3 7 ) .
45. Seorang laki-laki berumur 27 tahun dibawa ke ruang gawat darurat dengan ptosis pada alis mata kanan dan konstriksi pupilaris pada mata yang sama, tapi tidak terdapat tanda gaze palsy atau diplopia. Penjelasan yang paling mungkin dari hal ini adalah adanya luka pada lokasi: A. CN II B. CN III C. CN V D. CN VII E. Saraf simpatetik carotid
(E) The combination o f pupillary constriction and ptosis suggests a Horner’s syndrome. Two muscles ele'ate the eyelid: the levator palpebrae (CN III) and the superior tarsal muscle of •Muller (carotid sympathetic nerve). The key to further differentiation is the size of the pupil. A lesion of cranial .nerve I I I may likely result in pupillodilation (due to pupilloconstrictor muscle paralysis), whereas injury to the sympathetic nerve would result in pupil constriction , as seen in this patient. In addition, the ptosis of sympathetic paralysis may improve when the patient volitionally looks up , because the levator palpebrae is the muscle that mediates voluntary upward gaze. The lesion causing injury to the sym- CHAPTER 2 Neuroanatomy Answers 41 pathetics may originate i n any location along the descending pathways from the hypothalamus through the spinal cord and out through the peripheral pathways along the sympathetic chain and carotid artery (see discussion for question 6) (Brazis, pp. 181-182; Greenberg, p. 578).
mengandung kolom-kolom dominansi ocular?
1. Daerah kortikal yang mencerminkan blind spot dari retina
2. Daerah kortikal yang mencerminkan
paruh nasal dari retina ipsilateral
3. Daerah kortikal yang mencerminkan bulan sabit temporal monocular dari medan visual
4. Sistem kolom, yang terutama berhubungan dengan orientasi garis dan posisi retinal
(B) The striate cortex is organized in both vertical and horizontal systems. The vertical or columnar system is mainly concerned with line orientation, retinal position, detection of movements, and ocular dominance. Ihe two regions of the striate cortex that do not contain ocular dominance columns include the region representing the blind spot of the eye and the cortical regimi representing the monocular temporal crescent of the visual fields (Carpenter, pp. 411-414) .
- Rentan terhadap cedera selama prosedur obsetrik dan ginekologi.
(D) The first clinically relevant branch of the lumbar plexus is the lateral femoral cutaneous nerve of the thigh (A, L2-3), which reaches the thigh by passing under the lateral aspect of the inguinal ligament. Entrapment of this nerve as it enters the thigh can produce a numb, tingling, or burning hypersensitivity over the lateral thigh known as meralgia paresthetica. It is often encountered in obese patients of either sex who have lost a significant amount of weight, or, conversely, can be seen in late pregnancy due to a sagging anterior abdominal wall. This condition often remits on its own, but surgical decompression is sometimes warranted. The femoral nerve (B, E, L2-4) passes down along the lateral aspect of the psoas muscle and emerges under the inguinal ligament into the femoral triangle. It innervates the iliopsoas (hip t1exion), sartorius (hip t1exion, thigh eversion), and quadriceps femoris muscles (knee extension). I n the abdomen and pelvis, a primary or secondary neoplasm, psoas abscess, or pelvic hematoma may damage the upper portion of this nerve (B). In the femoral ring (E), this nerve is particularly vulnerable to local compression and possibly pressure palsy from diabetes mellitus. Although diabetes can also affect the L2-4 roots of this nerve, diabetic neuropathy of the femoral nerve is most often encountered in the femoral triangle. The patient usually presents with pain that resolves, only to be followed by rapid wasting and weakness of the quadriceps, which makes walking very difficult. Fortunately, the condition eventually improves, although it may take up to 2 years. The obturator nerve (D, L2-4) lies, on the medial side of the iliopsoas muscle and comes into close relationship with the uterus before reaching the obturator foramen. In the pelvis, it is particularly vulnerable to injury during obstetric and gynecologic procedt1res. This nerve supplies the adductor muscles of the thigh, which includes the pectineus; adductor longus, brevis, and magnus; and gracili.t; muscles. I ts integrity is tested by having the patient hold the legs together against resistance. The sciatic nerve (C, F) consists of two discrete components invested by the same fascia called the peroneal and 42 Intensive Neurosurgery Board Review tibial nerves. This major nerve may also be damaged in the pelvis by direct spread of neoplasms (along with the femoral nerve), particularly from the rectum or genitourinary tract. In the buttock, misplaced deep intramuscular injections, complicated hip ‘ fractures, and penetrating trauma are the most frequent causes of sciatic nerve damage. Misplaced injections can be especially problematic, because they can produce not only significant weakness but also severe causalgic pain over the leg and foot that is often refractory to medications. The superior gluteal neurovascular bundle lies in the superomedial gluteal quadrant. The sciatic nerve and inferior gluteal neurovascular bundle lie in the inferolateral and inferomedial quadrants, respectively. The safest location for intramuscular injection is the superolateral gluteal quadrant. The peroneal nerve is particularly vulnerable to injury as it crosses near the fibular neck, although this nerve is more resilient to injury than the tibial nerve after sciatic nerve injury. The reason for this is not entirely clear ( Patten, pp. 299-310; Brazis, pp. 62-65, 73-7 7; April , p. 584).
- Saraf yang berasosiasi dengan “neuralgia paresthetica” .
(A) The first clinically relevant branch of the lumbar plexus is the lateral femoral cutaneous nerve of the thigh (A, L2-3), which reaches the thigh by passing under the lateral aspect of the inguinal ligament. Entrapment of this nerve as it enters the thigh can produce a numb, tingling, or burning hypersensitivity over the lateral thigh known as meralgia paresthetica. It is often encountered in obese patients of either sex who have lost a significant amount of weight, or, conversely, can be seen in late pregnancy due to a sagging anterior abdominal wall. This condition often remits on its own, but surgical decompression is sometimes warranted. The femoral nerve (B, E, L2-4) passes down along the lateral aspect of the psoas muscle and emerges under the inguinal ligament into the femoral triangle. It innervates the iliopsoas (hip t1exion), sartorius (hip t1exion, thigh eversion), and quadriceps femoris muscles (knee extension). I n the abdomen and pelvis, a primary or secondary neoplasm, psoas abscess, or pelvic hematoma may damage the upper portion of this nerve (B). In the femoral ring (E), this nerve is particularly vulnerable to local compression and possibly pressure palsy from diabetes mellitus. Although diabetes can also affect the L2-4 roots of this nerve, diabetic neuropathy of the femoral nerve is most often encountered in the femoral triangle. The patient usually presents with pain that resolves, only to be followed by rapid wasting and weakness of the quadriceps, which makes walking very difficult. Fortunately, the condition eventually improves, although it may take up to 2 years. The obturator nerve (D, L2-4) lies, on the medial side of the iliopsoas muscle and comes into close relationship with the uterus before reaching the obturator foramen. In the pelvis, it is particularly vulnerable to injury during obstetric and gynecologic procedt1res. This nerve supplies the adductor muscles of the thigh, which includes the pectineus; adductor longus, brevis, and magnus; and gracili.t; muscles. I ts integrity is tested by having the patient hold the legs together against resistance. The sciatic nerve (C, F) consists of two discrete components invested by the same fascia called the peroneal and 42 Intensive Neurosurgery Board Review tibial nerves. This major nerve may also be damaged in the pelvis by direct spread of neoplasms (along with the femoral nerve), particularly from the rectum or genitourinary tract. In the buttock, misplaced deep intramuscular injections, complicated hip ‘ fractures, and penetrating trauma are the most frequent causes of sciatic nerve damage. Misplaced injections can be especially problematic, because they can produce not only significant weakness but also severe causalgic pain over the leg and foot that is often refractory to medications. The superior gluteal neurovascular bundle lies in the superomedial gluteal quadrant. The sciatic nerve and inferior gluteal neurovascular bundle lie in the inferolateral and inferomedial quadrants, respectively. The safest location for intramuscular injection is the superolateral gluteal quadrant. The peroneal nerve is particularly vulnerable to injury as it crosses near the fibular neck, although this nerve is more resilient to injury than the tibial nerve after sciatic nerve injury. The reason for this is not entirely clear ( Patten, pp. 299-310; Brazis, pp. 62-65, 73-7 7; April , p. 584).
- Saraf yang kemungkinan rusak oleh hematoma pada pelvis.
(B) The first clinically relevant branch of the lumbar plexus is the lateral femoral cutaneous nerve of the thigh (A, L2-3), which reaches the thigh by passing under the lateral aspect of the inguinal ligament. Entrapment of this nerve as it enters the thigh can produce a numb, tingling, or burning hypersensitivity over the lateral thigh known as meralgia paresthetica. It is often encountered in obese patients of either sex who have lost a significant amount of weight, or, conversely, can be seen in late pregnancy due to a sagging anterior abdominal wall. This condition often remits on its own, but surgical decompression is sometimes warranted. The femoral nerve (B, E, L2-4) passes down along the lateral aspect of the psoas muscle and emerges under the inguinal ligament into the femoral triangle. It innervates the iliopsoas (hip t1exion), sartorius (hip t1exion, thigh eversion), and quadriceps femoris muscles (knee extension). I n the abdomen and pelvis, a primary or secondary neoplasm, psoas abscess, or pelvic hematoma may damage the upper portion of this nerve (B). In the femoral ring (E), this nerve is particularly vulnerable to local compression and possibly pressure palsy from diabetes mellitus. Although diabetes can also affect the L2-4 roots of this nerve, diabetic neuropathy of the femoral nerve is most often encountered in the femoral triangle. The patient usually presents with pain that resolves, only to be followed by rapid wasting and weakness of the quadriceps, which makes walking very difficult. Fortunately, the condition eventually improves, although it may take up to 2 years. The obturator nerve (D, L2-4) lies, on the medial side of the iliopsoas muscle and comes into close relationship with the uterus before reaching the obturator foramen. In the pelvis, it is particularly vulnerable to injury during obstetric and gynecologic procedt1res. This nerve supplies the adductor muscles of the thigh, which includes the pectineus; adductor longus, brevis, and magnus; and gracili.t; muscles. I ts integrity is tested by having the patient hold the legs together against resistance. The sciatic nerve (C, F) consists of two discrete components invested by the same fascia called the peroneal and 42 Intensive Neurosurgery Board Review tibial nerves. This major nerve may also be damaged in the pelvis by direct spread of neoplasms (along with the femoral nerve), particularly from the rectum or genitourinary tract. In the buttock, misplaced deep intramuscular injections, complicated hip ‘ fractures, and penetrating trauma are the most frequent causes of sciatic nerve damage. Misplaced injections can be especially problematic, because they can produce not only significant weakness but also severe causalgic pain over the leg and foot that is often refractory to medications. The superior gluteal neurovascular bundle lies in the superomedial gluteal quadrant. The sciatic nerve and inferior gluteal neurovascular bundle lie in the inferolateral and inferomedial quadrants, respectively. The safest location for intramuscular injection is the superolateral gluteal quadrant. The peroneal nerve is particularly vulnerable to injury as it crosses near the fibular neck, although this nerve is more resilient to injury than the tibial nerve after sciatic nerve injury. The reason for this is not entirely clear ( Patten, pp. 299-310; Brazis, pp. 62-65, 73-7 7; April , p. 584).
- Amiotropi diabetik paling mungkin mempengaruhi situs ini.
(E) The first clinically relevant branch of the lumbar plexus is the lateral femoral cutaneous nerve of the thigh (A, L2-3), which reaches the thigh by passing under the lateral aspect of the inguinal ligament. Entrapment of this nerve as it enters the thigh can produce a numb, tingling, or burning hypersensitivity over the lateral thigh known as meralgia paresthetica. It is often encountered in obese patients of either sex who have lost a significant amount of weight, or, conversely, can be seen in late pregnancy due to a sagging anterior abdominal wall. This condition often remits on its own, but surgical decompression is sometimes warranted. The femoral nerve (B, E, L2-4) passes down along the lateral aspect of the psoas muscle and emerges under the inguinal ligament into the femoral triangle. It innervates the iliopsoas (hip t1exion), sartorius (hip t1exion, thigh eversion), and quadriceps femoris muscles (knee extension). I n the abdomen and pelvis, a primary or secondary neoplasm, psoas abscess, or pelvic hematoma may damage the upper portion of this nerve (B). In the femoral ring (E), this nerve is particularly vulnerable to local compression and possibly pressure palsy from diabetes mellitus. Although diabetes can also affect the L2-4 roots of this nerve, diabetic neuropathy of the femoral nerve is most often encountered in the femoral triangle. The patient usually presents with pain that resolves, only to be followed by rapid wasting and weakness of the quadriceps, which makes walking very difficult. Fortunately, the condition eventually improves, although it may take up to 2 years. The obturator nerve (D, L2-4) lies, on the medial side of the iliopsoas muscle and comes into close relationship with the uterus before reaching the obturator foramen. In the pelvis, it is particularly vulnerable to injury during obstetric and gynecologic procedt1res. This nerve supplies the adductor muscles of the thigh, which includes the pectineus; adductor longus, brevis, and magnus; and gracili.t; muscles. I ts integrity is tested by having the patient hold the legs together against resistance. The sciatic nerve (C, F) consists of two discrete components invested by the same fascia called the peroneal and 42 Intensive Neurosurgery Board Review tibial nerves. This major nerve may also be damaged in the pelvis by direct spread of neoplasms (along with the femoral nerve), particularly from the rectum or genitourinary tract. In the buttock, misplaced deep intramuscular injections, complicated hip ‘ fractures, and penetrating trauma are the most frequent causes of sciatic nerve damage. Misplaced injections can be especially problematic, because they can produce not only significant weakness but also severe causalgic pain over the leg and foot that is often refractory to medications. The superior gluteal neurovascular bundle lies in the superomedial gluteal quadrant. The sciatic nerve and inferior gluteal neurovascular bundle lie in the inferolateral and inferomedial quadrants, respectively. The safest location for intramuscular injection is the superolateral gluteal quadrant. The peroneal nerve is particularly vulnerable to injury as it crosses near the fibular neck, although this nerve is more resilient to injury than the tibial nerve after sciatic nerve injury. The reason for this is not entirely clear ( Patten, pp. 299-310; Brazis, pp. 62-65, 73-7 7; April , p. 584).
- Memasok otot pektineus dan grasilis.
(D) The first clinically relevant branch of the lumbar plexus is the lateral femoral cutaneous nerve of the thigh (A, L2-3), which reaches the thigh by passing under the lateral aspect of the inguinal ligament. Entrapment of this nerve as it enters the thigh can produce a numb, tingling, or burning hypersensitivity over the lateral thigh known as meralgia paresthetica. It is often encountered in obese patients of either sex who have lost a significant amount of weight, or, conversely, can be seen in late pregnancy due to a sagging anterior abdominal wall. This condition often remits on its own, but surgical decompression is sometimes warranted. The femoral nerve (B, E, L2-4) passes down along the lateral aspect of the psoas muscle and emerges under the inguinal ligament into the femoral triangle. It innervates the iliopsoas (hip t1exion), sartorius (hip t1exion, thigh eversion), and quadriceps femoris muscles (knee extension). I n the abdomen and pelvis, a primary or secondary neoplasm, psoas abscess, or pelvic hematoma may damage the upper portion of this nerve (B). In the femoral ring (E), this nerve is particularly vulnerable to local compression and possibly pressure palsy from diabetes mellitus. Although diabetes can also affect the L2-4 roots of this nerve, diabetic neuropathy of the femoral nerve is most often encountered in the femoral triangle. The patient usually presents with pain that resolves, only to be followed by rapid wasting and weakness of the quadriceps, which makes walking very difficult. Fortunately, the condition eventually improves, although it may take up to 2 years. The obturator nerve (D, L2-4) lies, on the medial side of the iliopsoas muscle and comes into close relationship with the uterus before reaching the obturator foramen. In the pelvis, it is particularly vulnerable to injury during obstetric and gynecologic procedt1res. This nerve supplies the adductor muscles of the thigh, which includes the pectineus; adductor longus, brevis, and magnus; and gracili.t; muscles. I ts integrity is tested by having the patient hold the legs together against resistance. The sciatic nerve (C, F) consists of two discrete components invested by the same fascia called the peroneal and 42 Intensive Neurosurgery Board Review tibial nerves. This major nerve may also be damaged in the pelvis by direct spread of neoplasms (along with the femoral nerve), particularly from the rectum or genitourinary tract. In the buttock, misplaced deep intramuscular injections, complicated hip ‘ fractures, and penetrating trauma are the most frequent causes of sciatic nerve damage. Misplaced injections can be especially problematic, because they can produce not only significant weakness but also severe causalgic pain over the leg and foot that is often refractory to medications. The superior gluteal neurovascular bundle lies in the superomedial gluteal quadrant. The sciatic nerve and inferior gluteal neurovascular bundle lie in the inferolateral and inferomedial quadrants, respectively. The safest location for intramuscular injection is the superolateral gluteal quadrant. The peroneal nerve is particularly vulnerable to injury as it crosses near the fibular neck, although this nerve is more resilient to injury than the tibial nerve after sciatic nerve injury. The reason for this is not entirely clear ( Patten, pp. 299-310; Brazis, pp. 62-65, 73-7 7; April , p. 584).
- Komunikan-komunikan ramus abu-abu, yang membentang antara ganglion tanduk. simpatetik dengan ramus primer depan dari saraf spinal, mengandung:
A. Serat aferen somatik umum
B. Serat-serat termielinasi
C. Neuron-neuron simpatetik pra-ganglionik
D. Serat-serat yang menjadi sistem saraf enteric
E. Serat-serat adrenergic
(E) Sympathetic preganglionic fibers originate from the T1 through L2 (thoracolumbar) levels of the spinal cord and pass successively through the ventral roots, anterior primary rami of the spinal nerves, and myelinated white rami communicans before synapsing in the sympathetic chain (composed of paravertebral ganglia and interconnecting fiber bundles) . Sympathetic postganglionic fibers from the paravertebral ganglia then may take one of several routes. They may pass back to a spinal nerve along an unmyelinated gray ramus communicans to innervate dermal sweat glands, smooth muscle cells of arterioles, and/or arrector pili muscles of the body and extremities. They may exit the sympathetic ganglia through splanchnic nerves to innervate the abdominal or pelvic viscera or may course up or down the sympathetic chain to synapse with postganglionic neurons located several spinal levels away. Every spinal nerve receives a gray ramus from the sympathetic chain, whereas only spinal levels T1-L2 have white rami communicans (myelinated). Preganglionic sympathetic neurons are cholinergic, whereas the sympathetic postganglionic fibers (some tra'eling through gray ramus communicans) are adrenergic. Because the paravertebral and preVertebral ganglia are located some distance away from the organ innervated, the sympathetic preganglionic fibers are shorter, whereas postganglionic fibers are longer as compared to the parasympathetic division (Apri l , pp. 28-30).
53. Saraf-saraf yang terinervasi oleh ansa servikalis meliputi sebagai berikut, KECUALI A. Omohioid B. Geniohioid C. Tirohioid D. Geniohioid E. Stilohioid
(E) The superior ramus of the ansa cervicalis, which arises from C1 and the •hypoglossal nerve, innervates the geniohyoid (protracts hyoid) and thyrohyoid (raises larynx) muscles, whereas the inferior ramus, arising from C 1-C3, inner'ates the omohyoid (lowers hyoid) and sternothyroid (lowers larynx) muscles. Since the muscles supplied by the ansa cervicalis often have collateral innervation, sectioning or mobilization of this structure during various surgical procedures (such as carotid endarterectomy) rarely has clinical consequences. The stylohyoid (elevates and retracts hyoid) muscle is innervated by CN VII (Apri l , p. 5 12).
54. Seorang laki-laki berumur 46 tahun dengan riwayat lama luka tembak di wajah dan penyalahgunaan obat-obatan intravenus dibawa ke ruang gawat darurat dalam keadaan demam dan luka pada sisi kiri leher dan wajahnya. CT scan mengungkapkan adanya abses di dekat fossa pterigopalatin. Infeksi ini mungkin langsung dapat dilacak ke seluruh kompartemen dibawah ini, KECUALI, A. Rongga orbital B. Rongga nasal C. Fossa kranial tengah D. Telinga bagian dalam E. Rongga oral
(D) . The pterygopalatine fossa harbors many nerves and blood vessels, which directly communicate with various compartments of the face and skull. The pterygopalatine fossa communicates directly with the middle cranial fossa through the foramen rotundum and vidian canal, with the orbital cavity through the inferior orbital fissure, with the nasal cavity via the sphenopalatine foramen, and with the oral cavity by way of the palatine canal. It does not directly communicate with the inner ear (Apri l , pp. 490- 491).
55. Saraf siliaris pendek A. Pupil Marcuss-Gunn B. Pupil Horner C. Pupil Adie (Pupil Tonik) D. Pupil Argyll-Robertson E. Bukan, A-D
(C) Adie’s pupil (dilated pupil) is thought to be due to impaired postganglionic parasympathetics from a viral infection of the ciliary ganglion. Adie’s pupil often constricts with dilute (0. 1 to 0. 1 25%) pilocarpine, a parasympathomimetic, because of denervation hypersensitivity (normal pupils react to 1% pilocarpine). The ArgyllRobertson pupils are believed to result from disruption of pathways leading to the Edinger-Westphal nucleus, which produces light-near dissociation (pupillary constriction with convergence and absent light response). The Marcus-Gunn pupil is best detected by the swinging flashlight test, as the consensual reflex is stronger than the direct reflex (afferent pupillary defect). It is caused by lesions anterior to the optic chiasm, such as retinal detachment or infarct, optic or retrobulbar neuritis, or trauma to the optic nerve. The presence of the consensual reflex is evidence of a preserved third nerve (with parasympathetics) on the side of the direct reflex. Horner’s syndrome (HS) results from interruption of the sympathetic pupillomotor pathways anywhere between the primary motor neuron in the hypothalamus, the second motor neuron i n the cervicothoracic junction, and thirdorder neuron i n the superior cervical ganglion. Findings may include miosis, ptosis, enophthalmos, eye hyperemia, or anhidrosis of the face. Cocaine can be used if the diagnosis is i n doubt; however, this has no localizing value. Cocaine blocks norepinephrine (NE) reuptake by postganglionic sympathetic fibers at the neuroeffector junction. In HS, no NE is released, so cocaine cannot dilate the eye. If the pupil dilates normally, there is no HS. To differentiate a secondfrom a third-order neuron injury, administer 1% hydroxyamphetamine, which releases NE from nerve terminals at the neuroeffector junction. This causes pupillary dilation with second-order neuron lesions but not with third-order neuron damage (since third-order neurons do not release NE) (Greenberg, p. 578).
56. Ganglion servikal superior A. Pupil Marcuss-Gunn B. Pupil Horner C. Pupil Adie (Pupil Tonik) D. Pupil Argyll-Robertson E. Bukan, A-D
(B) Adie’s pupil (dilated pupil) is thought to be due to impaired postganglionic parasympathetics from a viral infection of the ciliary ganglion. Adie’s pupil often constricts with dilute (0. 1 to 0. 1 25%) pilocarpine, a parasympathomimetic, because of denervation hypersensitivity (normal pupils react to 1% pilocarpine). The ArgyllRobertson pupils are believed to result from disruption of pathways leading to the Edinger-Westphal nucleus, which produces light-near dissociation (pupillary constriction with convergence and absent light response). The Marcus-Gunn pupil is best detected by the swinging flashlight test, as the consensual reflex is stronger than the direct reflex (afferent pupillary defect). It is caused by lesions anterior to the optic chiasm, such as retinal detachment or infarct, optic or retrobulbar neuritis, or trauma to the optic nerve. The presence of the consensual reflex is evidence of a preserved third nerve (with parasympathetics) on the side of the direct reflex. Horner’s syndrome (HS) results from interruption of the sympathetic pupillomotor pathways anywhere between the primary motor neuron in the hypothalamus, the second motor neuron i n the cervicothoracic junction, and thirdorder neuron i n the superior cervical ganglion. Findings may include miosis, ptosis, enophthalmos, eye hyperemia, or anhidrosis of the face. Cocaine can be used if the diagnosis is i n doubt; however, this has no localizing value. Cocaine blocks norepinephrine (NE) reuptake by postganglionic sympathetic fibers at the neuroeffector junction. In HS, no NE is released, so cocaine cannot dilate the eye. If the pupil dilates normally, there is no HS. To differentiate a secondfrom a third-order neuron injury, administer 1% hydroxyamphetamine, which releases NE from nerve terminals at the neuroeffector junction. This causes pupillary dilation with second-order neuron lesions but not with third-order neuron damage (since third-order neurons do not release NE) (Greenberg, p. 578).
57. Midbrain dorsal A. Pupil Marcuss-Gunn B. Pupil Horner C. Pupil Adie (Pupil Tonik) D. Pupil Argyll-Robertson E. Bukan, A-D
(D) Adie’s pupil (dilated pupil) is thought to be due to impaired postganglionic parasympathetics from a viral infection of the ciliary ganglion. Adie’s pupil often constricts with dilute (0. 1 to 0. 1 25%) pilocarpine, a parasympathomimetic, because of denervation hypersensitivity (normal pupils react to 1% pilocarpine). The ArgyllRobertson pupils are believed to result from disruption of pathways leading to the Edinger-Westphal nucleus, which produces light-near dissociation (pupillary constriction with convergence and absent light response). The Marcus-Gunn pupil is best detected by the swinging flashlight test, as the consensual reflex is stronger than the direct reflex (afferent pupillary defect). It is caused by lesions anterior to the optic chiasm, such as retinal detachment or infarct, optic or retrobulbar neuritis, or trauma to the optic nerve. The presence of the consensual reflex is evidence of a preserved third nerve (with parasympathetics) on the side of the direct reflex. Horner’s syndrome (HS) results from interruption of the sympathetic pupillomotor pathways anywhere between the primary motor neuron in the hypothalamus, the second motor neuron i n the cervicothoracic junction, and thirdorder neuron i n the superior cervical ganglion. Findings may include miosis, ptosis, enophthalmos, eye hyperemia, or anhidrosis of the face. Cocaine can be used if the diagnosis is i n doubt; however, this has no localizing value. Cocaine blocks norepinephrine (NE) reuptake by postganglionic sympathetic fibers at the neuroeffector junction. In HS, no NE is released, so cocaine cannot dilate the eye. If the pupil dilates normally, there is no HS. To differentiate a secondfrom a third-order neuron injury, administer 1% hydroxyamphetamine, which releases NE from nerve terminals at the neuroeffector junction. This causes pupillary dilation with second-order neuron lesions but not with third-order neuron damage (since third-order neurons do not release NE) (Greenberg, p. 578).
58. Retina A. Pupil Marcuss-Gunn B. Pupil Horner C. Pupil Adie (Pupil Tonik) D. Pupil Argyll-Robertson E. Bukan, A-D
(A) Adie’s pupil (dilated pupil) is thought to be due to impaired postganglionic parasympathetics from a viral infection of the ciliary ganglion. Adie’s pupil often constricts with dilute (0. 1 to 0. 1 25%) pilocarpine, a parasympathomimetic, because of denervation hypersensitivity (normal pupils react to 1% pilocarpine). The ArgyllRobertson pupils are believed to result from disruption of pathways leading to the Edinger-Westphal nucleus, which produces light-near dissociation (pupillary constriction with convergence and absent light response). The Marcus-Gunn pupil is best detected by the swinging flashlight test, as the consensual reflex is stronger than the direct reflex (afferent pupillary defect). It is caused by lesions anterior to the optic chiasm, such as retinal detachment or infarct, optic or retrobulbar neuritis, or trauma to the optic nerve. The presence of the consensual reflex is evidence of a preserved third nerve (with parasympathetics) on the side of the direct reflex. Horner’s syndrome (HS) results from interruption of the sympathetic pupillomotor pathways anywhere between the primary motor neuron in the hypothalamus, the second motor neuron i n the cervicothoracic junction, and thirdorder neuron i n the superior cervical ganglion. Findings may include miosis, ptosis, enophthalmos, eye hyperemia, or anhidrosis of the face. Cocaine can be used if the diagnosis is i n doubt; however, this has no localizing value. Cocaine blocks norepinephrine (NE) reuptake by postganglionic sympathetic fibers at the neuroeffector junction. In HS, no NE is released, so cocaine cannot dilate the eye. If the pupil dilates normally, there is no HS. To differentiate a secondfrom a third-order neuron injury, administer 1% hydroxyamphetamine, which releases NE from nerve terminals at the neuroeffector junction. This causes pupillary dilation with second-order neuron lesions but not with third-order neuron damage (since third-order neurons do not release NE) (Greenberg, p. 578).
- Istilah lentiform nuclei merujuk kepada struktur atau struktur-struktur yang mana?
A. Nukleus kaudata dan globus pallidum
B. Putamen dan amygdale
C. Putamen dan globus pallidum
D. Nukleus kaudata, globus pallidum dan putamen
E. Globus pallidus
C. The term corpus striatum refers to the caudate, putamen, and pallidum, whereas the term striatum typically includes only the caudate nucleus and putamen. The lentiform nuclei consist of the globus pallidus and putamen, which lie between the internal and extreme capsules and are separated by a curved vertical lamina of white matter called the lateral medullary lamina. Other terms commonly used to refer to the basal ganglia include neostriatum (caudate nucleus and putamen), paleostriatum (globus pallidus), and archistriatum (amygdaloid complex). All the structures mentioned above except for the globus pallid us (and subthalamic nucleus) are believed to have originated from the telencephalon, which is a diencephalic structure (Carpenter, p. 325).
- Nukleus subtalamik (STN) menerima asupannya yang dominan dari struktur yang mana?
A. Nukleus ventral-lateral (VL) dari thalamus
B. Nukleus sentromedian (CM) dari Thalamus
C. Globus pallidus lateral
D. Globus pallidus medial
E. Korteks serebral
C. The largest number of afferent fibers into the STN originate in the lateral pallidal segment. Afferents to the STN from the motor, premotor, and prefrontal cortex are mainly collaterals from other tracts, while a relatively small number of afferents originate from the Clvl nucleus of the thalamus. Mferents to the STN from the lateral pallidal segment are mainly GABAergic, while most cells of the STN are believed to release glutamate and exert excitatory effects on their targets. The medial globus pallidus is the major outflow site of the basal ganglia, as described in the discussion for question 2 (Carpenter, pp. 347-351) .
61. Semua saluran di bawah ini merupakan saluran-saluran aferen melalui pedunkel serebelar bawah, KECUALI A. Vestibuloserebelar B. Olivoserebelar C. Spinoserebelar Dorsal D. Reticuloserebelar E. Kortikopontoserebelar
E. The corticopontocerebellar tract consists almost entirely of crossed fibers from the pontine nuclei that transmit impulses from the cerebral cortex to the intermediate and lateral zones of the cerebellum through the middle cerebellar peduncle (brachium pontis). The inferior cerebellar peduncle connects the medulla to the cerebellum and consists of two divisions: the restiform body contains afferent fibers from the olivocerebellar, dorsal spinocerebellar, reticulocerebellar, and cuneocerebellar tracts, while the juxtarestiform body contains both afferent (vestibulocerebellar) and efferent ( cerebellovestibular) fibers. The superior cerebellar peduncle (brachium conjuctivum) consists principally of efferents from the cerebellum. Rubral , thalamic, and reticular projections arise from the dentate and interposed nuclei, which exit the cerebellum via the superior cerebellar peduncle. Mferent tracts into the superior cerebellar peduncle include the ventral spinocerebellar, trigeminocerebellar, and tectocerebellar tracts ( Kandel, pp. 626-646; Fix, pp. 196-197 ) .
62. Akson dari sel-sel yang manakah yang meninggalkan lapisan V dari neokorteks yang terutama sebagai serat-serat proyeksi? A. Sel-sel Stellata B. Sel-sel fusiform C. Sel-sel piramidal D. Sel-sel horisontal E. Sel-sel fusiform
(C) T h e following layers are distinguished in the neocortex in passing from the pial surface toward the white matter: Layer I (molecular layer): contains cells with horizontal axons and Golgi type II cells. Layer II (external granular layer): consists mostly of closely packed granule cells. Layer I I I (external pyramidal layer) : consists of two sublayers of pyramidal neurons. Layer IV (internal granular layer) : comprises closely packed stellate cells with either short aJwns ramifying within the layer or larger axons projecting to deeper layers. Myelinated fibers of the external band of Baillarger form a prominem horizontal plexus in this layer. Layer V (internal pyramidal layer) : consists mainly of medium and large pyramidal cells (Betz cells). Apical dendrites of large pyramidal cells project to the molecular layer. while axons mainly leave the cortex as projection fibers. Layer VI (multiform layer): contains spindle-shaped cells whose long axes are perpendicular to the cortical suriace
- Bagian tubuh yang manakah diantara bagian tubuh di bawah ini yang memiliki
representasi terbesar dalam korteks sensorimotor?
A. Genitalia
B. Jari Tengah
C. Putting Susu
D. Ibu Jari
E. Jari Kelingking
D. Some areas o f the body have a greater sensori representation than others. -The largest areas in, tongue, thumb, little finger, and corresponding digirs or foot, as well as the hands and feet in general. The complexi - of motor actions of the thumb requires a larger circuitry than the trunk, index finger, nipple, geniralia middle finger (Carpenter, p p . 401-404). I 44 Intensive Neurosurgery Board Review
- Perbedaan utama antara arkikorteks dan neokorteks meliputi?
A. Tidak adanya laminasi pada arkikorteks
B. Susunan lapis-enam dari arkikorteks
C. Adanya sebuah lapisan semu dan materi putih pada arkikorteks
D. Kurangnya sel-sel Betz pada arkikorteks
E. Arkikorteks memiliki hubungan-hubungan utama hanya dengan sistem limbik
C. Both the archicortex and neocortex are laminated, contain pyramidal neurons, and have connections with the limbic system. One major difference is that the archicortex has a distinct sup
- Nukleus hypothalamus yang manakah yang terlibat di dalam produksi faktor-faktor
yang pelepasan-hipothalamik dan menyebabkan tumbuhnya saluran tuberohipofisial?
A. Dorsomedial
B. Suprakiasmatik
C. Arkuate
D. Belakang
E. Praoptik
C. The nuclei of the hypothalamus are divided by an imaginary plane formed by the columns of the fornix and mammillothalamic tract into medial and lateral groups. The medial hypothalamic area is again divided into four regions from anterior to posterior: preoptic, supraoptic, tuberal, and mammillary regions. Each of these regions contains a separate subgroup of nuclei . Medial group 1. Preoptic region: contains the medial preoptic nucleus involved with the release of gonadotropic hormones. This nucleus is sexually dimorphic and requires testosterone for development. 2. Supraoptic region: contains the supraoptic nucleus (synthesizes ADH and oxytocin), paraventricular nucleus (makes and releases ADH, oxytocin, and CRH) , anterior nucleus (plays a role in temperature regulation) , and suprachiasmatic nucleus (controls circadian rhythms), which lie dorsal to the optic chiasm. 3 . Tuberal region: the arcuate nucleus is located in the tuber cinereum; it contains neurons that produce hypothalamic releasing factors and gives rise to the tuberohypophysial tract, which terminates in the hypophyseal portal system of the infundibulum. This nucleus regulates the release of adenohypophyseal hormones into the systemic circulation. The arcuate nucleus, along with the dorsomedial and ventromedial nuclei, lies dorsal to the tuber cinereum and makes up the nuclei adjacent to this structure. 4. Mammillary region: this contains the mammillary and posterior nuclei, which lie dorsal to the mammillary bodies. The lateral hypothalamic area is traversed by the medial forebrain bundle and includes two major nuclei: the lateral preoptic and lateral hypothalamic nuclei (Carpenter, pp. 297-303).
- Diantara konstelasi-konstelasi mengenai fungsi hipothalamik di bawah ini, konstelasi atau konstelasi-konstelasi yang manakah yang paling benar?
- Daerah-daerah hipothalamik lateral dan belakang berhubungan dengan respons-respons simpatetik
- Daerah-daerah hipothalamik depan dan tengah mengendalikan respons-respons parasimpatetik
- Luka setempat dua arah dari nukleus hipothalamik pada daerah tuberal dapat
menyebabkan hiperphagia - Luka-luka hipothalamik belakang dua arah dapat menyebabkan poikilotermia
E. The supraoptic and paraventricular nuclei of the hypothalamus synthesize and secrete vasopressin and oxytocin, respectively. The anterior portion of the hypothalamus controls mechanisms that dissipate heat. Stimulation of this area causes dilaticm of blood vessels and sweating, which lowers body temperature. Stimulation of the posterior hypothalamus results in vasoconstriction of blood vessels, inhibition of sweating, and possibly shivering, which may increase body temperature. The posterior (mainly) and lateral hypothalamic nuclei are also involved with the sympathetic nervous system control. The lateral region of the hypothalamus is sometimes referred to as either the hunger and thirst center, as stimulation can result in increased food and water intake. Stimulation of the medial region of the hypothalamus results in decreased food intake; it is often referred to as the satiety center. The suprachiasmatic nucleus controls circadian rhythms, and the anterior and preoptic nuclei help to control parasympathetic responses as well as gonadotropin secretion (Carpenter, pp. 3 1 7 -324).
- Saraf peroneal dalam menginervasi otot-otot yang mana?
- Ekstensor halusis longus
- Digitorum longus ekstensor
- Tibialis depan
- Peroneos longus
A. The sciatic nerve (L4-S3) is the major branch of the sacral plexus and is also the largest nerve in the body. The sciatic nerve consists of the tibial and common peroneal nerves. The tibial nerve (L4-S3) innervates the flexors of the leg, including the semitendinosus, semimembranosus, biceps femoris, gastrocnemius, soleus, flexor hallucis longus, flexor digitorum longus, popliteus, tibialis posterior, and plantaris. The tibial nerve gives rise to the lateral sural cutaneous nerve, which unites with the communicating branch of the peroneal nerve to form the sural nerve. This nerve supplies cutaneous innervation to the lateral inferior leg and lateral foot. The tibial nerve may become entrapped in the tarsal tunnel posterior and inferior to the medial malleolus, which results in pain and paresthesias in the toes and sole of the foot (often sparing the heel because these sensory branches often originate proximal to the tarsal tunnel) and wealmess on plantarflexion . The common peroneal nerve (L4-S2) innervates extensors and adductors of the leg (and part of the biceps femoris) and gives rise to the lateral sural cutaneous nerve (to the inferolateral leg), the deep peroneal nerve, and the superficial peroneal nerve. The deep peroneal nerve innervates the foot and toe extensors (tibialis anterior, extensor hallucis longus, extensor digitorum longus) and provides sensation to a small area between the great and second toes. The superficial peroneal nerve i nnervates the peroneus longus/brevis (foot eversion) and the skin of the distal anterior leg, the dorsum of the foot, and the digits. Lesions of the common peroneal nerve (most common) result in paralysis of dorsiflexion (foot-drop) and foot eversion. The posterior femoral cutaneous nerve (Sl-S3) innervates the skin of the inferior buttocks, perineum, posterior thigh, and proximal leg (Greenberg, pp. 522, 544-546).
68. Anggota bagian belakang kapsul intern mengandung semua saluran di bawah ini, KECUALI A. Kortikopontin prefrontal B. Kortikospinal C. Kortikotektal D. Kortikorubral E. Radiasi talamik atas
A. Refer to Figure 2.68A. The corticospinal, frontopontine, superior thalamic radiations, and a relatively smaller number of corticotectal and corticorubral fibers run in the posterior limb of the internal capsule. The prefrontal corticopontine tract and anterior thalamic radiations run in the anterior limb of the internal capsule, while the corticobulbar and corticoreticular tracts are contained within the genu of the internal capsule (Carpenter, p. 282).
69. Karakteristik mana yang paling lazim ditemukan pada thalamus? A. Glutamat B. Apartat C. GABA D. Asetilkolin E. Senyawa P
C . Although glutamate appears to be the main neurotransmitter of the corticothalamic tracts, the thalamus itself is rich in GABA. Virtually all cells of the thalamus are rich in this neurotransmitter; in primates, the major projections of the medial pallidum to the VA and VL nuclei of the thalamus are GABAergic. Moreover, the projections from the pars reticulata of the substantia nigra to the VA and MD nuclei of the thalamus are also rich in GABA (Carpenter, pp. 278- 2 79).
- Serat-serat silang pada saluran optik berhenti pada lapisan-lapisan tubuh genikulat lateral yang mana?
A. 2. 4. dan 6 D. 1, 3 dan 5
B. 1, 4, dan 6 E. 2, 5 dan 6
C. 2, 3 dan 5
B. The LGN contains six layers, numbered 1 through 6. The ventralmost layers contain large cells and are known as “magnocellular”; they receive their input from M ganglion cells. The dorsal four layers are known as “parvocellular” and receive their input from P ganglion cells. An individual layer receives input from only one eye. Fibers from the contralateral nasal hemiretina synapse in layers 1, 4, and 6, and fibers from the ipsilateral temporal hemiretina synapse in layers 2, 3 , and 5 ( Ka ndel, pp. 528-532) .
