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Neuro- Basic Neuroanatomy Flashcards

1
Q

What is the final part of the spinal cord called?

A

Conus medullaris

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2
Q

Broca’s area controls what?

A

Speech production

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3
Q

Wernicke’s area controls what?

A

Speech comprehension

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4
Q

Where does the spinal cord normally end?

A

L1

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5
Q

The anterior (ventral) nerve root allows efferent _______ neurons to _________ the spinal cord.

A

Motor

Exit

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6
Q

The posterior (dorsal) nerve root allows afferent _______ neurons to _________ the spinal cord.

A

Sensory

Enter

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7
Q

What are the classical UMN lesion signs?

A
  1. Hyper-reflexia (brisk)
  2. Hyper-tonia
  3. Clonus
  4. Upgoing plantars
  5. Muscle weakness with NO muscle wasting (Spastic paralysis)
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8
Q

What are the classical LMN signs?

A
  1. Hypo-reflexia
  2. Hypotonia
  3. Fasciculations
  4. Muscle weakness with wasting (atrophy)
  5. Normal downgoing plantars
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9
Q

UMN lesions usually cause the arm _______ and leg __________ to become weak.

A

Arm extensors

Leg flexors

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10
Q

Where does the corticospinal tract decussate?

A

Medulla

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11
Q

Where does the dorsal column decussate?

A

Medulla

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12
Q

Where does the spinothalamic tract decussate?

A

Spinal level of entry

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13
Q

Which tract is affected by syringomelia?

A

Spinothalamic

because it decussates at the spinal level

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14
Q

Which spinal nerve roots are involved in the biceps reflex?

A

C5/6

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15
Q

Which spinal nerve roots are involved in the triceps reflex?

A

C7/8

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16
Q

Which spinal nerve roots are involved in the knee reflex?

A

L3/4

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17
Q

Which spinal nerve roots are involved in the ankle/achilles reflex?

A

S1/2

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18
Q

What is grade 0 in the MRC Classification of muscle power?

A

0= No visible contraction

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19
Q

What is grade 1 in the MRC Classification of muscle power?

A

1= Flicker of movement

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20
Q

What is grade 2 in the MRC Classification of muscle power?

A

2= Movement with gravity

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21
Q

What is grade 3 in the MRC Classification of muscle power?

A

3= Active movement against gravity

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22
Q

What is grade 4 in the MRC Classification of muscle power?

A

4= Active movement against resistance

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23
Q

What is grade 5 in the MRC Classification of muscle power?

A

5= Normal power

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24
Q

EMG studies are useful for which types of disorders?

A

Neuromuscular disorders eg. Myasthenia gravis, MND

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25
Q

Where is Broca’s area?

A

Inferior frontal gyrus

In the dominant hemisphere (left in most people)

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26
Q

Where is Wernicke’s area?

A

Superior temporal gyrus

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27
Q

Non-fluent dysphasia is ….

A

Broca’s aphasia

Due to motor dysfunction; difficulty producing speech

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28
Q

Fluent dysphasia is ……..

A

Wernicke’s aphasia

Due to comprehension dysfunction

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29
Q

If the arcuate fasciculus is damaged, how does this affect speech?

A

Difficulty with repetition; conduction aphasia

As the arcuate fasciculus connects the Broca’s and Wernicke’s areas

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30
Q

What are the 2 fibres of CN2?

A
  1. Temporal fibre= looks at nasal part of visual field

2. Nasal fibre= looks at temporal part of visual field

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31
Q

What are the 3 different types of disorders of the optic nerve (CN2)?

A
  1. Pupil abnormalities
  2. Visual field defects
  3. Optic disc defects
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32
Q

The afferent aspect of the pupil reflex travels via CN _____ and the efferent part travels via CN _____ .

A 
Afferent = CN2 Optic
Efferent = CN3 Occulomotor
33
Q

In Relative Afferent Pupillary Defect (RAPD), what happens to the pupils in the swinging light test?

A

Pupils dilate or constrict less when exposed to light.

34
Q

In ipsilateral monocular blindness, which optic nerve fibres are damaged?

A

Both temporal and nasal fibres of CN2 on one side

35
Q

In bitemporal hemianopia where is the lesion?

A

Lesion in the optic chiasm (where nasal fibres cross)

Leads to loss of temporal vision on both sides

36
Q

Ipsilateral monocular blindness is caused by disease in which areas of the eye?

A

Retina

Optic nerve

37
Q

What can cause bitemporal hemianopia?

A

Optic chiasm lesions:

  1. Pituitary adenoma
  2. Craniopharyngioma
  3. Internal carotid artery aneurysm
  4. Meningioma
38
Q

What is the primary cause of bitemporal hemianopia in children?

A

Craniopharygngioma

39
Q

In optic atrophy, the optic disc is ___ in colour and the margins are _____

A

Pale optic disc

Sharp margins

40
Q

What are the primary causes of optic disc atrophy?

A 
MS
Optic nerve compression
Nutrient deficiency- B1 and B12
Tobacco/ alcohol
Ischemia
41
Q

Which muscles does the Occulomotor nerve innervate?

A

Superior, Inferior and Medial rectus muscles

Inferior oblique

42
Q

Which muscle does the Trochlear nerve innervate?

A

Superior oblique

43
Q

Which muscle does the Abducens nerve innervate?

A

Lateral rectus

44
Q

The superior rectus muscle moves the eyeball ____ and ____-

A

Up and out

45
Q

The superior oblique moves the eyeball _____ and _________

A

Down and in

46
Q

What are the key clinical features of a CN3 nerve palsy?

A
  1. Eye moves down and out (Abducted)
  2. Ptosis (partial or complete)
  3. Impaired accommodation and pupil reflex
  4. Painful or painless
47
Q

What are the potential causes of a CN3 nerve palsy?

A

Ischemia (most common)
Brainstem lesion (midbrain)- tumour, demyelination
Cavernous sinus lesion
Surgical CNIII Palsy (Posterior Communicating Artery Aneurysm)
Tentorial herniation and coning

48
Q

What are the key clinical features of a CN6 Palsy?

A

Eye moves medially

49
Q

What is the most common cause of both occulomotor and abducens nerve palsies?

A

Ischemia

Due to diabetes and HTN

50
Q

What is the key clinical sign of a CN4 palsy?

A 
Vertical diplopia (up and down double vision)
Patient tilts head towards opposite shoulder
51
Q

Which branches of the trigeminal nerve pass through the cavernous sinus?

A

V1 (Ophthalmic) and V2 (Maxillary)

52
Q

Where is the nucleus of the trigeminal nerve?

53
Q

Which 2 cranial nerves pass through the internal acoustic meatus?

A

CN VII- Facial

CN VIII- Vestibulocochlear

54
Q

Forehead sparing facial palsies are caused by lesions where?

A

UMN lesion (supranuclear)

Caused by stroke

55
Q

Ramsay hunt syndrome affects which cranial nerve?

A

CN7 = Facial nerve

56
Q

Ramsay Hunt syndrome is a complication of which virus?

A

Shingles (Herpes Zoster Oticus)

57
Q

What are the clinical features of Bell’s Palsy?

A
  1. Abrupt onset unilateral facial weakness
  2. Numbness around ear
  3. Sound hypersensitivity
  4. Decreased taste
58
Q

What are the functions of CN 9?

A

Glossopharyngeal nerve:

  1. Motor- pharynx and palate
  2. Sensory- taste of posterior 1/3 of tongue, chemoreceptors (carotid body), middle ear, oropharynx
59
Q

What are the causes of bulbar palsy?

A
  1. GBS

2. Brainstem lesions: Tumours, meningoencephalitis, MND

60
Q

What happens to the tongue, speech and reflexes in bulbar palsy?

A

Tongue- flaccid, wasted, fasciculations
Speech- Quiet, breathy, nasal
Jaw reflex- absent
Gag reflex- normal

61
Q

Is bulbar palsy caused by an UMN or LMN lesion?

A

LMN lesion (CN9-12)

62
Q

What is pseudobulbar palsy caused by?

A

UMN lesion in corticobulbar tract:
Stroke
MND

63
Q

What happens to the tongue, speech and reflexes in pseudobulbar palsy?

A

Tongue- spastic, slow moving, No fasciculations or wasting
Speech- heavy, slurred
Jaw reflex- increased/ brisk
Gag reflex- increased/ brisk

64
Q

Which nerves innervate the pharynx to control swallow?

A

CN9- Glossopharyngeal

CN10- Vagus

65
Q

Which disease can cause a mixture of bulbar and pseudobulbar palsy?

66
Q

What happens to the uvula in CNX lesion?

A

Vagus nerve lesion.. uvula deviates away from the side of the lesion.

67
Q

What are the features of a CNXII nerve lesion?

A

Hypoglossal nerve lesion… tongue deviates towards the side of the lesion
Tongue fasciculates and wastes

68
Q

What are the afferent and efferent nerves involved in the gag reflex?

A

Afferent- CN9 Glossopharyngeal

Efferent- CN10 Vagus

69
Q

Where does the Vestibulocochlear nerve exit?

A

Cerebellopontine angle

70
Q

What are the causes of vestibulocochlear nerve palsy?

A

Benign positional vertigo (BPV)
Acute labyrinthitis
Meniere’s disease
Brainstem pathology eg. MS demyleination

71
Q

Which condition is most likely to cause short lived episodes of vertigo and nystagmus on head movement, which usually resolve spontaneously?

A

Benign paroxysmal positional vertigo

72
Q

What are the symptoms of acute labyrinthitis?

A

Abrupt onset severe vertigo and loss of balance
Vomiting
NO tinnitus

Symptoms resolve in days-weeks

73
Q

What are the symptoms of Meniere’s disease?

A 
Unilateral inner ear disease
Vertigo
Tinnitus
Deafness
Vomiting
74
Q

If a patient presents with weakness in turning their head. shrugging shoulders, uvula deviation, and poor movement of the soft palate, what syndrome do they likely have?

A

Jugular foramen syndrome.

Unilateral lower CN palsy

75
Q

What are the clinical features of Horner’s syndrome?

A

Unilateral incomplete ptosis
Miosis
Anhydrosis
Enophthalmos (posterior eyeball displacement)

Normal pupil reflex and accommodation

76
Q

Internuclear Ophthalmoplegia is caused by a lesion where?

A

Medial longitudinal fasciculus- the heavily myelinated tract which allows conjugate eye movement and communication between CN3 and 6.

77
Q

What are the symptoms of INO?

A

Failure of affected eye to abduct

Nystagmus in other eye

78
Q

What are the 2 main causes of INO?

Psychiatry and Neurology (9 decks)

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