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Neurology > Neuro anatomy > Flashcards

Neuro anatomy Flashcards

1
Q

surface anatomy

A

bulges= gyri

indentations: sulci and fissures

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2
Q

CNS includes

A
  • cerebrum
  • cerebellum
  • brain stem
  • spinal cord (tracts)
  • diencephalon: thalamus, hypothalamus, epithalamus, subthalamus
  • basal ganglia: caudate nucleus, globus pallidus, putamen, claustrum, and amygdala
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3
Q

PNS includes:

A
  • 31 pairs of spinal nerves
  • 12 pairs of CN
  • anterior horn cells (in SC gray matter)
  • peripheral/terminal nerves
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4
Q

UMN vs LMN

A

UMN:
•structures: cerebrum, basal ganglia, brainstem, SC-corticospinal tract pathway through CNS
•tone: increased/hypertonic, spasticity or rigidity
•reflexes: DTR=3 (maybe) 4 (definitely), (+) Babinski
•Atrophy: no significant, disuse only
• Fasiculations and fibrillations: not present

LMN:
•structures: CN, anterior horn cells, nerve roots, spinal nerves, peripheral nerves, musculoskeletal junction
•tone: decreased/hypotonic to flaccid
•reflexes: decreased=hyporeflexive to arreflexive, DTR’s=0 to 1, Babinski not present
• atrophy: significant atrophy, fasiculations and fibrillations present

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5
Q

Babinski reflex

A
  • stroke lateral aspect of patient’s foot
  • normally this elicits flexion of all toes (a negative babinski
  • with a (+) Babinski reflex, the great toe dorsiflexesand the other toes fan out
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6
Q

Cerebrum

A
  • paired (R) and (L) hemispheres, each governing actions on the opposite side of the body
  • outer layer: gray matter=collections of nerve cells, called cerebral cortex
  • inner layer: white matter, mainly axons, tracts
  • divided into four main lobes= Frontal, Parietal, Temporal, Occipital
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7
Q

Central sulcus

A

divides frontal from parietal lobe

•precentral gyrus anterior to central sulcus, and postcentral gyrus posterior to central sulcus

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8
Q

Lateral or Sylvian fissure

A

• divides the temporal lobe from frontal and parietal

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9
Q

Longitudinal/interhemispheric fissure

A

divides (L) and (R) hemispheres

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10
Q

Frontal lobe

A
  • motor
  • primary motor cortex (in the precentral gyrus)
  • premotor cortex (anterior to the primary motor cortex
  • Broca’s area
  • prefronal area
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11
Q

Primary motor cortex

A
  • located in the precentral gyrus anterior to the central sulcus
  • responsible for all fine motor movement commands -> tracts -> nerves -> muscles
  • if there was a stroke in this area you would see flaccid paralysis initially, which usually turns into spastic paralysis within 2 to 6 weeks, and weakness, hypereflexia, increased tone, and (+) Babinski sign on the opposite side of the body
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12
Q

Premotor cortex

A
  • anterior to the primary motor cortex
  • functions to initiate coordinated movements, instead of individual muscle movement
  • Learned, skilled, integrated movement
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13
Q

Broca’s Area

A
  • expressive aphasia/ non-fluent aphasia/motor aphasia
  • when the dominant hemisphere (usually L) is involved the patient understands and knows what they want to say but speech is slow, deleting many prepositions and nouns
  • motor ability of speech affected
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14
Q

Prefrontal area

A
  • (L) side responsible for logic, judgement, analysis
  • (R) side responsible for creativity, emotion, intuition
  • if prefrontal area is affected may see apathy, uncaring about appearance, surroundings, decreased awareness of social consequence of actions, dementia-Alzheimers
  • complex cerebral motor disabilities= apraxias i.e. ideamotor and ideational
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15
Q

Apraxia

A

difficulty planning + executing purposeful movements

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16
Q

Ideational apraxia

A

inability of the patient to produce movement either on command or automatically and represents complete breakdown in the conceptualization of a task. The pt has no idea how to do the movement and thus cannot formulate the required motor programs.

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17
Q

Ideamotor apraxia

A

the patient is unable to produce a movement on command but is able to move automatically

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18
Q

Left brain vs. Right brain

A 
Left brain: usability/analytic
•analytic thought
•logic
•language
•science and math
•sequential 
•detail
•thinks according to rules and patterns
• sense of time
•planned
•short term (auditory) memory
•fine motor
•controls R side of the body 
Right brain: design/creative
•holistic thought
•intuition 
•creativity
•art and music
•no sense of time 
•spontaneous
•long term (visual) memory
•big picture 
•illustrations
•simultaneous
•gross motor
•controls L side of the body
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19
Q

Parietal lobe

A
  • sensation lobe
  • primary sensory cortex
  • sensory association area/secondary somesthetic sensory area
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20
Q

Primary sensory cortex

A
  • located in the postcentral gyrus

* receives impulses from the sensory receptors for pain, temperature, pressure, touch, proprioception, and vibration

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21
Q

Secondary association are/ somatosensory area

A
  • posterior to the primary sensory cortex: higher order sensory discrimination which requires integration of information and memory
  • 2 point discrimination, stereognosis, graphesthesia, barognosis
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22
Q

graphesthesia

A

Graphesthesia is the ability to recognize writing on the skin purely by the sensation of touch

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23
Q

barognosis

A

the ability to evaluate the weight of objects, or to differentiate objects of different weights, by holding or lifting them

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24
Q

stereognosis

A

ability to recognize an object by touch

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25
Q

agnosia

A

Agnosia is the inability to process sensory information. Often there is a loss of ability to recognize objects, persons, sounds, shapes, or smells while the specific sense is not defective nor is there any significant memory loss

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26
Q

anasognosia

A

impairs a person’s ability to understand and perceive his or her illness

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27
Q

Homonculus

A
  • representation of areas of the body on the precentral (primary motor cortex) and postcentral gyrus (primary sensory cortex), amount of representation on the surface depends on complexity of movement and sensitivity of area
  • legs and feet are located medially while arms and trunk are lateral
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28
Q

Temporal lobe

A
  • auditory lobe
  • primary auditory cortex
  • auditory association area
  • Wernike’s area
  • storage for long term memories
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29
Q

Primary auditory cortex

A

•receives auditory impulses from auditory receptors of inner ears (hears sounds)

30
Q

auditory association area

A

•surrounds primary auditory cortex- interprets sounds, integrative. If this area is affected produces auditory aphasia

31
Q

Wernike’s aphasia

A
  • sensory aphasia/receptive aphasia/fluent aphasia

* the patient hears but makes mistakes unknowingly due to inability to understand their own words

32
Q

Occipital lobe

A
  • primary visual cortex

* secondary visual cortex/visual association area

33
Q

Primary visual cortex

A

recieves projection of images from contralateral visual fields. If the area is affected would result in contralateral blindness

34
Q

Secondary visual cortex/ visual association area

A

•recognizes and identifies objects- if area was affected it would not result in blindness but the pt would see images and not recognize the object (visual agnosia)

35
Q

Meninges

A

3 layers of CT found inside the skull and vertebral canal
The meninges are the membranes covering the brain and SC
•Pia mater
•Arachnoid
•Dura

36
Q

Pia mater

A

innermost layer on the brain itself, thin and vascular

* circle of Willis lives here

37
Q

Arachnoid

A

between pia and dura, like a spider web, avascular

38
Q

Dura mater

A

lies against the bone, is thick and durable, contains double layer of CT- outerlayer is periosteum, has thick venous channels (sinuses) between the two layers-where venous blood and CSF drain. (a subdural hemorrhage results from tearing of the bridging veins that connect the brain and dural tissues. Epidural hemorrhages result from tearing of arteries these usually coincide with skull fractures.

39
Q

Ventricular system and CSF

A
  • CSF= found in the subarachnoid space (space between arachnoid and pia mater, including in the SC) and exits into the superior sagittal sinus
  • obstruction of CSF anywhere in its pathway: ventricles -> interventricular faramina -> third ventricle -> aqueduct of sylvius -> fourth ventricle -> foramen of magendie and foramens of Lyschuka -> subarachnoid space. Leads to dilation/expansion of lateral ventricles and HYDROCEPHALUS.
40
Q

Normal pressure hydrocephalus

A

hallmark triad of NPH:
1)altered mental status (confusion)
2)altered gait (usually wide BOS and shuffling with difficulty initiating ambulation with difficulty initiating ambulation
3) urinary incontinence
• recent studies have shown up to a 90% success rate in shunt placement in patients who showed improvement after lumbar puncture (removal of excessive CSF)

41
Q

Corpus collosum

A
  • wide band of nerve fibers on medial cerebrum

* interconnects the two cerebral hemispheres and transfers information between them

42
Q

internal capsule

A
  • narrow zone of a funnel of motor and sensory fibers that converge upon the brainstem and cerebral cortex (bringing motor info and sensory info to the brain)
  • there is one on each side situated deep just behind the Circle of Willis
  • the anterior choroidal artery and striate arteries supply the internal capsule and may hemmorhage in situations of hypertension or arterioclerosis, causing great damage from a tiny lesion
43
Q

Brainstem

A
  • connecting link between cerebrum and SC and cerebellum
  • provides face and neck with sensory and motor functions via cranial nerves and several visceral functions i.e. heart and respiratory rates
  • reticular formation: sleeping and waking
44
Q

Brainstem

A
  • Diencephalon: hypothalamus and thalamus
  • midbrain
  • pons
  • medulla oblongata
45
Q

Diencephalon

A

contains the thalamus, hypothalamus, and CN I and II

46
Q

Thalamus

A

serves as a relay station for all sensory fibers entering the cerebrum

47
Q

Hypothalamus

A

•primary center for homeostasis: control of:
- body temp
- appetite
- water excretion
•center for fight or flight impulse/controls the autonomic nervous system- regulating BP and blood flow
•exerts control over pituitary (hormonal system)- links nervous and endocrine system
•CN I- olfactory and CN II- optic

48
Q

pituitary gland

A

the hypothalamus and the pituitary in the brain control the normal secretion of thyroid hormones which in turn controls metabolism

49
Q

Midbrain

A
  • responsible for reticular formation (controls state of wakefullness- most long term commas traced to this region)
  • contains CN III and IV
50
Q

Pons

A

•contains CN V, VI, VII, VIII

51
Q

Medulla oblongata

A
  • respiratory and cardiovascular control center
  • CN IX, X, XI, XII
  • continuation of SC, where many of the tracts cross to the other side as they ascend/descend
  • center that coordinates swallowing, nausea, and vomiting
52
Q

CN

A 
I. Olfactory
II. Optic
III. Occulomotor
IV. Trochlear
V. Trigeminal
VI. Abducens
VII. Facial
VIII. Vestibulocochlear
IX. Glossopharyngeal
X. Vagus
XI. Spinal accessory 
XII. Hypoglossal
53
Q

CN I

A

Olfactory: sensory

•smell

54
Q

CN II

A

Optic: sensory

•sight

55
Q

CN III

A

Oculomotor: motor
•levator palpebrae (dysfunction results in ptosis- drooping eyelid), inferior oblique, pupillary sphincter (constricts pupil- parasympathetic action) superior, inferior, and medial rectus (moves eyeball up, down, and medially)

56
Q

CN IV

A

Trochlear: motor

• superior oblique of the eye

57
Q

CN V

A

Trigeminal: both
•motor: muscles of mastication (chewing)- masseter and temporalis
•sensory: face

58
Q

CN VI

A

Abducens: motor

•lateral rectus- moves eye laterally

59
Q

CN VII

A

Facial: both
• sensory: taste- anterior 2/3 of the tongue
• motor: facial expressions
*parasympathetic motor function lacrimal gland (tears), and submaxillary and sublingual (saliva)

60
Q

CN VIII

A

Vestibulocochlear: sensory

•hearing and balance (equilibrium)

61
Q

CN IX

A

Glossopharyngeal: both
•sensory: taste posterior 1/3 of the tongue
•motor: swallowing

62
Q

CN X

A

Vagus: both
•sensory: sensation to organs
•motor: swallowing, larynx- hoarseness
*parasympathetic function: decreases HR and BP
*stimulates peristalsis and secretion in the GI, as well as bile in the pancreas
*contricts bronchi

63
Q

CN XI

A

Spinal accessory: motor

•SCM and traps

64
Q

CN XII

A

Hypoglossal: motor

• tongue movement

65
Q

SC tract anatomy

A

slides 91 and 92 neuroanatomy power point

66
Q

Functions of the autonomic nervous system

A
  • autonomic nervous system regulates automatic body functions, in contrast to the somatic, which is the part of the peripheral nervous system that transmits signals to and from the CNS
  • Autonomic nervous system is split into sympathetic and parasympathetic branches
67
Q

Autonomic nervous system: Sympathetic

A

Heart
•increases HR
•increases force of contraction

Blood vessels
•constriction (which increases BP)

Lungs
•bronchodilation

GI
•decreases motility
•sphincter contraction
•decreased secretions

68
Q

Autonomic nervous system: Parasympathetic

A

Heart
•decreased HR
•decreased force of contraction

Blood vessels
•no effect

Lungs
•bronchoconstriction

GI
•increased motility
•sphincter relaxation
•increased secretions

69
Q

Conus medularis

A

tapered lower end of the spinal cord that terminates into the cauda equina at approx. L1 or L2

70
Q

Cauda equina

A

collection of nerves at the end of the spinal cord

71
Q

Cauda equina syndrome

A
  • Low back pain
  • Unilateral or bilateral sciatica.
  • Saddle and perineal hypoesthesia or anesthesia.
  • Bowel and bladder disturbances.
  • Lower extremity motor weakness and sensory deficits.
  • Reduced or absent lower extremity reflexes.

Neurology (9 decks)

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