Lecture #2 Neuroanatomy

Question 1

What are the three main long tracts of the nervous system? Their function? Their decussation points

Answer 1

1. Lateral corticospinal tract -Motor -pyramidal decussation (cervivomedullary juntion 2. Anterolateral spinal tract - Sensory ( pain temperature crude touch) - anterior comissure 3. Posterior column or medial lemniscal - Sensory ( vibration proprioception fine touch) -internal arcuate fibers ( lower medulla)

Question 2

Is the gracile nucleus responsible for lower or upper limb sensory info? Is the cuneate nucleus responsible for lower or upper limb sensory info?

Answer 2

Gracile nucleus = lower limb ( vibration proprioception fine touch) Cuneate = upper limb ( vibration proprioception fine touch)

Question 3

If we cut at the ventral root, spinal nerve, or dorsal root?

Answer 3

ventral = no motor spinal = no motor or sensory dorsal = no sensory

Question 4

Intermediolateral cell column =

Answer 4

preganglionic sympathetics

Question 5

Lumbar punctures in adults are usually performed

Answer 5

between L3–L5 (cauda equina level) in order to avoid damage to the spinal cord.

Question 6

grey rami communicates to…

Answer 6

all spinal nerves

Question 7

white rami carries what? starts and ends?

Answer 7

presynaptic sym. fibers from ventral primary rami to sym. trunk and exists only between T1-L2

Question 8

WIll you find white rami in the neck or past L2?

Answer 8

no exists only between T1-L2

Question 9

Dermatome definition? what are landmarks for clavicle, nipples, & knee?

Answer 9

A dermatome is an area of skin that is served by a single spinal nerve; C4 T4 & L3

Question 10

CN I, test, & cranial exit

Answer 10

Olfactory, sniff coffee, foramina in the cribriform plate of ethmoid

Question 11

CN II, test, & cranial exit

Answer 11

Optic, shine light for pupil for sensory part, optic cranial

Question 12

CN III, test, & cranial exit

Answer 12

Occulomotor, is pupil blown?, superior orbital fissure.

Question 13

CN IV, test, & cranial exit

Answer 13

Trochlear, follow your finger while you move it down toward his nose, superior orbital fissure

Question 14

CN V ( V1 V2 V3), test, and cranial exit

Answer 14

Trigeminal (Ophthalmic, maxillary, mandibular), touch face three times, (Ophthalmic = superior orbital fissure, maxillary= formen rotundum, mandibular=foramen ovale)

Question 15

CN VI, test, and cranial exit

Answer 15

abducens, look toward each ear, superior orbital fissure

Question 16

CN VII, test, and cranial exit

Answer 16

Facial, smile, internal acoustic meatus

Question 17

CN VIII, test, and cranial exit

Answer 17

Vestibulocochlear, rub fingers near ears, internal auditory meatus

Question 18

CN IX, test, and cranial exit

Answer 18

Glossopharyngeal, gag or pallate elevation, jugular foramen

Question 19

CN X, test, and cranial exit

Answer 19

Vagus, say AHHH, Jugular foramen

Question 20

CN XI, test, and cranial exit

Answer 20

Spinal acessory, shoulder shrug, jugular foramen

Question 21

CN XII, test, and cranial exit

Answer 21

Hypoglossal, tongue side to side, hypoglossal canal

Question 22

CN 2 and 12 have own canal

Answer 22

optic canal and hypoglossal canal

Question 23

Rule of 4s

Answer 23

4 midline structures that start with M 4 side structures that begin with S 4 CN in medulla, 4 in pons, 4 above pons 4 motor nuclei that are midline and divide equally into 12( 3,4,6,12), lateral are the rest

Question 24

4 midline structures that begin with M

Answer 24

1. Motor pathway 2. Medial lemniscus 3. Medial longitudinal fasiculus 4. Motor nucleus and nerve

Question 25

4 side structures that begin with S

Answer 25

1. Spinocerebellar pathway 2. Spinothalamic pathway 3. Sensory nucleus of the 5th 4. sympathetic pathway

Question 26

4 Medulla CN

Answer 26

9-12

Question 27

4 PONS CN

Answer 27

5-8

Question 28

4 above pons CN

Answer 28

3&4 (midbrain) 1&2 (above brainstem)

Question 29

Blood supply midbrain (CN 3 &4)

Answer 29

Posterior cerebellar artery (PCA)

Question 30

Blood supply Pons

Answer 30

medial(6)=basilar, Lateral (5-8)= Anterior inferior cerebellar artery

Question 31

Blood supply medulla

Answer 31

medial(12)=Anterior spinal artery, Lateral (9-11)= Posterior inferior cerebellar artery

Question 32

Identify the four cortices of the brain in the color diagram below.

Answer 32

1. ) purple: primary motor or sensory cortex
2. ) red: unimodal association cortex
3. ) yellow: heteromodal association cortex
4. ) light blue: Limbic Cortex

Question 33

___ are responsible for collecting used cerebrospinal fluid as it gets recycled into here through arachnoid granulations

Answer 33

dura sinuses

Question 34

Dural sinuses eventually drain into the _____ and exit the skull via the ____.

Answer 34

internal jugular vein; jugular foramen

Question 35

the internal and external jugular vein drain directly into ___.

Answer 35

subclavian veins

Question 36

A 27-year-old male has a spinal cord injury in a skiing accident. When his motor and sensory systems are tested, it is found that his sensory systems are intact, but that he has hypertonia, increased deep tendon reflexes, and a positive Babinski sign. These signs suggest a lesion in the:

a) upper motor axons of the medial lemniscus
b) lower motor axons of the medial lemniscus
c) upper motor axons of the corticospinal tract
d) lower motor axons of the corticospinal tract
e) lower motor axons of the corticobulbar tract

Answer 36

c; upper motor axons of the corticospinal tract

Question 37

A 24-year-old female severs her spinal cord while diving into a shallow muddy river. After transfer to the emergency room and examination, it is found that she has lost skeletal motor control, along with fine touch and proprioception on her left side below T4. She has also lost pain and temperature sensation on her right side below T5. She has:

a) hemisected her spinal cord on the right side at T4
b) hemisected her spinal cord on the left side at T4
c) fully transected her spinal cord at T4
d) lost the posterior columns of her spinal cord at T4
e) lost the anterior columns of her spinal cord at T4
f) lost the lateral columns of her spinal cord at T4

Answer 37

b; hemisected her spinal cord on the left side at T4

Question 38

3. A 38-year-old female patient arrives at her physician’s office complaining about injuring her hands quite frequently, since she does not notice hurting them. She realizes that she has lost her ability to sense pain from her hands and forearms. Upon further testing, it is found that she has diminished pain and temperature sensation over her shoulders, upper back, and upper extremities, with no loss of these sensations over the rest of her body. She also has intact fine touch, proprioception, and skeletal motor control. These symptoms could be due to compression of which part of the cervical region of the spinal cord?
   a) posterior columns
   b) lateral columns
   c) anterior columns
   d) anterior horn
   e) anterior white commissure

Answer 38

e; anterior white commissure

Question 39

4. A 47-year-old female patient has a small stroke that impacts her facial musculature. She cannot close her left eye tightly (which produces difficulty keeping her eye moist) and she drools from the left side of her mouth, with no ability to smile or frown on the left side of her face. Interestingly, she can raise her eyelids and wrinkle the skin on her forehead on both sides. Given these findings, her physician concludes that there is a:
   a) left upper motor neuron lesion controlling her facial muscles
   b) right upper motor neuron lesion controlling her facial muscles
   c) left lower motor neuron lesion controlling her facial muscles
   d) right lower motor neuron lesion controlling her facial muscles

Answer 39

b; right upper motor neuron lesion controlling her facial muscles

Question 40

neural tract that connects Broca’s area with with Wernicke’s area and regulates fluent speech is the ___.

Answer 40

arcuate fasciculus

Question 41

Identify the starred structure

Answer 41

dorsal/posterior horn

Question 42

Identify the starred structure

Answer 42

ventral/anterior horn

Question 43

3 types of spian lreflexes

Answer 43

1. reciprocal inhibition
2. flexor reflex
3. crossed-extensor reflex

Question 44

spinal reflex when activation of extensor muscles and inhibition of flexors on opposite side

Answer 44

crossed-extensor reflex

Question 45

complex reflex arc used to withdraw limb from aversive stimulus

Answer 45

flexor reflex

Question 46

contraction of one muscle set accompanied by relaxation of antagonist muscle

Answer 46

reciprocal inhibition