L4: Neuroanatomy P1 Flashcards by Julia Kuzmich

Cerebral angiography

angio = blood or lymph vessels

Xray to diagnose blockages or other structural problems in the vascular systems

catheter into femoral artery to carotid artery

contrast dye injected to fill arteries

used in concert w CT or MRI

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risks of cerebral angiography

allergic to dye

risk of perforation

renal issues could affect ability to get rid of dye

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computed tomography (CT)

3D rep from xray images

patient positioned in a rotating tube while a series of xrays are taken

computer complies the xrays across sectional slices of the brain

able to visualize the brain at diff depths

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downsides/risks of CT

poor dx sensitivity for acute ischemic strokes (aka acute changes of soft tissue) - led to use and advancement of perfusion tomography

exposed to radiation

can also be used w dye so risks w that

less sensitive

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on a CT white represents…. black represents… grey reps…

white reps high density aka bone

black reps lease dense so SCF

blood is more dense than CSF so it will look more grey

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profusion….
hyper profused ….
hypo profused…

uptake of a fluid

hyper = more blood like a hemmorrage

hypo = less fluid in an area

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magnetic resonance imaging (MRI)

magnet and radio waves

patient positioned in tube-like machine w a strong magnet

very noise due to clicking noises from radio pulses

MRI seqs typically used clinicially include T1, T2, FLAIR, and diffuse-weighted (dMRI)

dMRI detects infarcts w/i min

allows us to see pathology of soft tissue - more sensitive at detecting stroke than CT

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downsides/risks of MRI

very expensive

contrast dye issues

not great for those w claustrophobia or delirium

some may need to be sedated

those w metal implants cannot be used w it

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functional MRI (fMRI)

standard MRI technology that produces images of metabolic function

indirect measure of neural activity in the brain and spinal cord during a specific task

used to localize brain functions such as language

used more in research

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Positron emission tomography (PET)

3D image of metabolic processes, blood flow, or receptor density

IV injection of a radioactive tracer that travels thru the body and is absorbed by organs

can help detect underlying brain pathology before symps arise like alzheimer’s or PD

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on a PET red/orange reps… and blue/green reps…

red/orange = a lot of metabolic activity (aka using lots of oxygen)

blue/green = less metabolic activity

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downsides to PET

if the patient already has pathology like a tumour (which would need oxygen a lot) they may have areas that are red to begin w that do not have to do w brain functioning

exposed to radiation (but unlike CT it is transient)

v expensive and not accessible

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single-photon emission computed tomography (SPECT)

utilizes gamma-emitting radioactive isotopes

emits a single (rather than 2) photon

isotope administered thru IV

absorption associated w cerebral blood flow (CSF)

2T images taken and them computed into 3D

not as costly as PET, but not as sensitive

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electroencephalography (EEG)

measures cortical voltages fluctuations from electrodes placed on the scalp

signals are recorded as a series of tracings reflecting change over time

reveal abnormalities in brain electrical activity

epilepsy dx and management

evoked response potentials (ERP) - EEG + stimulus

great temporal sensitivity (changes at a point in time), but not great spatial sensitivity (cannot localize it)

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downsides to EEG

time consuming

if the patient is moving around EEG is vulnerable to eye movements or face movements

not great spatial sensitivity (cannot localize it)

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EEG on its own is looking at brain activity at ____ ERP is when you introduce a _____

rest

stimulus (ex. count from 1-10)

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magnetoencephalography (MEG)

magneto = magnetic, encephalo = brain, graphy= pictures

measures magnetic fields produced by the brain’s natural electrical currents

can be conducted at rest or w stimulus

often used in concert w MRI to localize brain activity (magnetic source imaging or MSI)

direct measure of brain function

rly great sensitivity for the locus of seizure activity

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CNS

cerebral hemispheres, brainstem, cerebellum, spinal cord

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PNS

Cranial and spinal nerves + ANS

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brainstem

midbrain + pons + medulla

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protective layers

skin, muscles, cranium, meningeal layers, CSF, vascular systems

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3 meningeal layers

pia = adheres to surface of brain

arachnoid = spider like

dura = adheres to inside of cranium

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subdural hematoma

bw dura and arachnoid - can get filled w blood

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subarachnoid hemorage

when the subarachnoid space gets filled w blood from trauma - type of stroke

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sulci are within a ____

lobe

fissures separate ____

lobes

3 types of fiber tracts

commissural association projection

commissural fiber tracts

inter-hemispheric and non-cortical regions (ex. thalamus, hippocampus) RH to LH ex. corpus callosum

association fiber tracts

intra-hemisphere one area w/i a hemisphere to another in the same hemisphere ex. long association fibres are one lobe to a diff lobe in the same hemisphere

projection fiber tracts

ascending (ex. sensory) and descending (ex. motor) from brain stem and up (ex. internal capsule)

_______% worlds popn R-handed, ____% of R handers show......

90-95% 95% show L-hemisphere language dominance

_____% worlds popn L-handed, _____% of L-handers or mixed handedness possess L hemisphere dominance, _____% of L-handers or mixed handedness show R-hemisphere language dominance, _____% of L-handers or mixed show bilateral language dominance

7-10% 65-70% 5-10% (!!!!) 20-35%

coronal

vertical - belly and back

saggital

vertical left and right

transverse/axial

horizontal head and toe

frontal lobe contains brodman's area ___ and ___ or Broca's area

44 and 45

Brodmann's area 44/45 and Broca's area involves

memories of motor patterns for speech production plus grammaticality especially for functor words

Damage to Brodmann's area 44/45 and Broca's area results in

non-fleunt output, labroious speech w poor reading aloud skills and poor repetition oftent co-exists w apraxia of speech and nonverbal/oral apraxia

frontal lobe also contains BA 4 which is the

primary motor area (precentral gyrus)

BA 4 - primary motor area involves

motor homunculus legs and feet are medial side; upper head, face, hands and mouth on lateral aspect inverted large area of face, and hands laterally voluntary movements for the contralateral side of body

damage to BA 4 - primary motor cortex would manifest as

UMN dysarthria

frontal lobe also contains B6 and parts of 8 which is the

premotor cortex (inferior lateral)

BA 6 - premotor cortex - stimulation results in...

movement but greats amount of stim are necessary to produce some degree of movement

Parts of BA 6, 8 and 9 are the

frontal eye field

BA 6, 8, 9 - Frontal eye field controls...

conjugate eye movement (eye scanning, the ability of eyes to track and work together) independent of visual stimuli, especially toward contralateral side

exner's area is a part of the

frontal lobe

Exner's area (BA 6, parts of 8/9) contains the

foot of 2nd frontal gyrus knowledge of how to make movements of the hands and fingers for writing

damage of exner's area linked to

motor agraphia

supplementary motor area is a part of the ______, anterior to the ____ and superior lateral and medial surface of ___

frontal lobe anterior BA 6

SMA is involved in

initiation of spontaneous speech and partial complex movements of upper limbs including fingers, arms, and limbs particularly involved in sensorimotor planning of movements and cog aspects of movement prep (ex. tongue elevation vs protrusion)

damage to SMA ...

some suggestions regarding its involvement in stuttering and in speech prod and other motor behaviours issues initiating speech

prefrontal cortex is ___ to precentral areas and includes BA ....

anterior BA 8, 9, 10, 11, 12, 46

Prefrontal cortex has numerous association efferent and afferent fiber pathways w

thalamus, hypothalamus, corpus striatum and other areas of cerebral cortex

prefrontal cortex is involved in

executive functions --> initiative, emotionality, regulatory of depth of feelings, role of judgment, attention

superior temporal gyrus - BA41/42 is the

primary auditory cortex hesch's gyrus transverse temporal gyri

superior temporal gyrus aka primary auditory cortex/Hesch's gyrus is where.... it receives projections from ....

perception/recognition of complex auditory stimuli (ex. speech) occurs receives projections from the medial geniculate bodu

damage to superior temporal gyrus leads to

auditory verbal agnosia or pure word deafness

in the temporal lobe there is also BA 22 - wernicke's area which is the _______, and it is involved in

auditory association cortex connects via arcuate fasiculus to BA 44/45 recall and interpretation of spoken language

damage to wernicke's causes

difficulty interpreting speech auditory comp impairment

BA 39 - angular gyrus is responsible for

storing symbols for reading, writing, and calculations/arithmetic processes orthographic word forms and abstract word forms receives rich visual projections from visual cortices

damage to the angular gyrus causes

issues w accessing and interpreting symbols needed for reading/writing/math alexia, agraphia, acalculia jargo aphasia (if in conjunction w BA 22) conduction aphasia (if in conjunction w arcuate fasciculus)

Left inferior frontal gyrus linked to ______ (temporal lobe surgery, stroke)

naming deficits

damage to the anterior temporal lobe (BA 20, 21, 38) leads to

impaired semantic knowledge impaired processing of vowl-change verbs (sleep-tight, keep-kept, dive-dove)

damage to the posterior temporal lobe (BA 37) leads to

difficulty accessing phonology impaired phonological form access (eg. hat for cat)

arcuate fasciculus is important bc

it is a projection fibre from temporal to parietal to frontal damage to this will result in issues (ex. repeating someones message) due to connectivity

parietal lobe contains BA 40, the supramarginal gyrus which is responsible for

semantic/syntactic/phonological sentence processing integrates visual and somesthetic input operates in conjunction w BA 22

damage to the supramarginal gyrus in the parietal lobe may lead to

jargon aphasia (Kertesz) constructional apraxia poor gesture use/comp scanning and reading

BA 3, 1, 2 - post central gyrus of the parietal lob is the ______ cortex, and receives ______ afferent info ..... before this info gets here it goes thru the ______

primary somesthetic cortex ipsilateral/contralateral thalamus

BA 5/7 secondary somesthetic area/somesthetic association cortex in the parietal lobe receives input from ...

Primary somesthetic cortex and the dorsal portion of the thalamus

BA 5/7 secondary somesthetic area/somesthetic association cortex in the parietal lobe is responsible for

discriminative touch integration of info about form, position, temporal changes

BA 17 - primary visual cortex in the occipital lobe receives afferent fibers from the _____

lateral geniculate nucleus

in the PVC in occipital lobe - it receives info from the _____ temporal retina and ______ nasal retina

ipsilateral (aka stay on the same side) contralateral (aka cross over at the optic chiasma)

in the PVC - the right half of the visual field goes to

L visual cortex

in the PVC the L half of the visual field goes to the

R visual cortex

right homonymous hemianopia

right being right side of each visual field homonymous = the same hemi = half vision

BA 18, 19 Visual association cortex receives afferent fibres from ____ and _____

PVC Pulvinar of the thalamus

visual association cortex is responsible for

real time integration of past visual experiences w recognition and interpretation of what is received thru visual sensory inputs

damage to visual association cortex leads to

visual agnosia (colour, face, objecy), alexia without agraphia

agnosia is

percept or perception stripped of its meaning due to disconnection bw primary sensory cortex and association cortex OR damage to association cortex can receive and describe the info but can't interpret it ex. may be able to see the characs of the photo but not recognize that it is Donald Trump