Neuroanatomy Flashcards
What is the cerebrum divided into?
Frontal lobe
Temporal lobe
Parietal Lobe
Occipital Lobe
What are sulci and gyri?
Sulci: valleys
Gyri: ridges
The heavy foldings of the lobar surfaces
What are the primary (major) sulci?
More invariant in appearance than secondary sulci
What is the central sulcus?
Divides frontal lobe from parietal lobe?
What divides frontal lobe from parietal lobe?
Central sulcus
Where is the precentral gyrus?
Frontal lobe
Where is the primary motor cortex?
Precentral gyrus
Where is the motor homunculus?
Primary motor cortex
Where is the postcentral gyrus?
Parietal lobe
What is the postcentral gyrus?
Primary somatosensory cortex
Where is the sensory homunculus?
Primary somatosensory cortex
What is the Sylvian fissure?
Lateral sulcus
What divides the frontal lobe from the temporal?
Lateral sulcus
What does the Sylvian fissure do?
Divides frontal lobe from temporal.
What is the fifth lobe of the cerebrum?
Insula
Where is in the insula?
Deep in Sylvian fissure
What is the insula?
Seat of the primary gustatory cortex
Where is the middle frontal gyrus?
Between the superior and inferior frontal sulci
What is in the middle frontal gyrus?
Dorsolateral prefrontal cortex
What does the dorsolateral prefrontal cortex do?
Executive functions
Where is the cingulate sulcus?
Medial side of frontal lobe
Where is the seat of motivation?
Anterior position of adjoining cingulate gyrus
Which sulci are on the inferior surface of frontal lobe?
Olfactory and orbital sulci
What does the orbitofrontal cortex do?
Seat of associative learning and decision-making
What does the superior temporal sulcus do?
Primary auditory cortex
What separates the superior and inferior parietal lobes?
Superior temporal sulcus
What does the superior temporal sulcus do?
Seat of primary auditory cortex
What part of the cortex is involved in executive functions?
Dorsolateral prefrontal cortex
Where does decision-making and associative learning occur?
Orbitofrontal cortex
What is the inferior parietal lobe made of?
Angular gyrus
Supramarginal gyrus
What is the inferior parietal lobe important for?
Visuospatial attention
Where does visuospatial attention occur?
Inferior parietal lobe
Where is the primary visual cortex?
Calcarine sulcus in medial occiptal cortex
What is the sulcus in the medial occipital cortex?
Calcarine sulcus
What happens to higher level of associative functions in the hemispheres?
Lateralize to one or other hemisphere
Where is language comprehension?
Localized to left temporal corte
What is prosody?
Tonal modulation of speech
Where is prosody located?
Right hemisphere
Where is the dominant hemisphere?
Contralateral to dominant hant
What does the dominant hemisphere do?
Mediates language and speech functions
How can dominance be tested?
Annette’s handedness scale
Edinburgh handedness inventory
How many right-handed people have a dominant right hemisphere?
10%
How many left-handed people have a right dominant hemisphere?
20%
How many left handed people have left dominant hemisphere?
64%
How many left handed people have bilateral dominance?
16%
Where is the planum temporale?
Upper surface of superior temporal gyrus
Larger on left in 65% of people
What is the planum temporale?
Triangular region, important for language processing.
What is the most asymmetrical structure in the human brain?
Planum temporale
Which asymmetry is reduced or reversed in schizophrenia?
Plaum temporale
Signs in left hemisphere lesions
Aphasia Right-left disorientation Finger agnosia Dysgraphia (aphasic) Dyscaculia (number alexia) Limb aprexia
Signs in right hemisphere lesions
Visuospatial deficits Anosognosia Neglect Dysgraphia (spatial, neglect) Dyscalculia (spatial) Constructional apraxia Dressing apraxia
Which hemisphere lesion leads to face recognition?
Bilateral
What are the subcortical structures?
Limbic system Medial Temporal structures Basal ganglia Thalamus Hypothalamus
Who first described the limbic lobe?
Broca
Who first assigned the function of emotional processing to limbic structures?
Papez, then Maclean
What is the Papez circuit of the limbic system?
Hippocampus Fornix Mamillary bodies Mammillothalamic tract Anterior thalamic nucleus Genu of internal capsule Cingulate gyrus Parahippocampal gyrus Entorhinal cortex Perforant pathway Back to hippocampus
What are the boundaries of the limbic system post-Papez?
Include amygdala, septum, basal forebrain, nucleus accumbens, orbitofrontal cortex
Functions of limbic system?
Mediation of emotional responses via amygdala
Influencing neuroendocrine responses via hypothalamus
Reward system regulation via nucleus accumbens
Function of nucleus accumbens?
Reward system
Function of hypothalamus?
Neuroendocrine response
Function of amygdala?
Mediation of emotional repsonses
Fear conditioning
Emotional regulation
What are the medial temporal structures?
Hippocampus
Amygdala
Entorhinal and parahippocampal cortex
Function of hippocampus?
Memory processes
Continuous production of new neurons in adult life
What is the basal ganglia?
Group of gray matter nuclei
What is the largest subcortical structure?
Basal ganglia
Function of basal ganglia?
Planning and programming of movement
Concerting abstract thought into voluntary action
What is in the basal ganglia?
Striatum: caudate nucleus + putamen
Pallidum: globus pallidus
What are the lentiform nucleus?
Putamen and globus pallidus
What is the striatum in basal ganglia made up of?
Caudate nucleus
Putamen
What structures are functionally related to basal ganglia but not part of structure?
Substantia nigra
Subthalamic nuclei
Where does basal ganglia receive input from?
Glutamatergic corticostriatal projection
Who described the circuits in the basal ganglia?
Alexander
What are the important circuits in the basal ganglia?
Motor Oculomotor Dorsolateral prefrontal (executive) Anterior cingulate (motivation) Lateral orbitofrontal (social intelligence)
Which circuit in the basal ganglia is for social functioning?
Lateral orbitofrontal circuit
Which circuit in the basal ganglia is for motivation?
Anterior cingulate
Which circuit in the basal ganglia is for executive?
Dorsolateral prefrontal circuit
Disorders involving basal ganglia dysfunction
OCD Tourette's Huntington's chorea Wilson's disease CO poisoning Hemiballismus Parkinsonism Fahr's disease
What basal ganglia dysfunction causes OCD?
Volumetric changes + higher blood flow to caudate nuclei.
Increased caudate metabolism reduces after effective treatment.
What is he basal ganglia dysfunction in Tourette’s?
Striatal dopaminergic dysfunction
What is the basal ganglia dysfunction in Huntington’s chorea?
Degeneration of striatum - mainly caudate nucleus - and selective loss of GABAergic neurons
What is the basal ganglia dysfunction in Wilson’s disease?
Copper deposits in lenticular nuclei
What is the basal ganglia dysfunction in CO poisoning?
Acute bilateral anoxic damage to basal ganglia
What is the basal ganglia dysfunction in hemiballismus?
Subthamalic nucleus damage - especially infarction
What is the basal ganglia dysfunction in Parkinsonism?
Depigmentation of substantia nigra - Lewy bodies seen.
Striatal overactivity associated with bradykinesia
What basal ganglia dysfunction is linked with bradykinesia in Parkinsonism?
Striatal overactivity
What basal ganglia dysfunction is linked to Fahr’s diease?
Progressive calcium deposition in basal ganglia.
What is the thalamus?
Oval mass of grey matter nuclei in subcortial region.
What does the thalamus do?
Relays all types of sensory information except olfaction onto cortex.
Filter sensory information in preparation for cortical processing.
Relays cerebellar and basal ganglia inputs to cerebral cortex.
Structure of anterior thalamus
Receives mamillothalami tract and fornix
Connects to cingulate cortex
What does anterior thalamus do?
Relays information from hypothalamus and hippocampus onto frontal cortex
What in the thalamus is associated with visual attention?
Pulvinar
Where are sleep spindles in the thalamus?
Generated in reticular nucleus
Function of hypothalamus
Regulates physiological functions - eating, drinking, sleeping, temperature regulation
Neuroendocrine role
What is the ventromedial hypothalamus?
Satiety centre
Where is the satiety centre?
Ventromedial hypothalamus
Where is the feeding centre?
Lateral hypothalamus
What type of lesion leads to obesity in animals?
Lesion in ventromedial hypothalamus hyperphagia
Where is the inferior olivary nucleus?
Brainstem
What does the inferior olivary nucleus do?
Aids in motor coordination by projecting climbing fibres to contralateral cerebellar cortex via inferior cerebellar peduncle
Signs in inferior olivary nucleus lesions
Appendicular ataxia due to motor incoordination of contralateral arm and leg
Fail finger-nose test
Role of cerebellum
Preparing motor plan
Predicting balance needed between muscle groups to carry out action
Cognitive processes
Signs of cerebellar lesions
Ataxia Coarse intentional tremors Hypotonia Past pointing Pendular knee jerk
Function of cerebellum in schizophrenia
Disrupted cortico-cerebellar circuity can lead to cognitve dysmetria - difficulty in coordinating and monitoring process of receiving, processing and expressing information.
What is the brainstem made up on?
Midbrain
Pons
Medulla
What is the midbrain made up of?
Superior and inferior colliculi
Substantia nigra
Periaqueductal grey matter
What do the superior and inferior colliculi do?
Superior - conjugate gaze control
Inferior - auditory source localization
What does the periaqueductal grey matter do?
Vocalization
Freezing response to threat and pain
Where is the pons?
Beneath cerebeullum
Surrounds upper helf of 4th centricle
Where is the medulla?
Inferior part of 4th ventricle
Continuous with spinal cord
Which part of the brainstem is continuous with the spinal cord?
Medulla
Anatomical feature of Olfactory nerve
Runs on basal surface of frontal cortex w/o passing through thalamus.
Formed as outgrowth of forebrain.
Anatomy of optic nerve
Outgrowth of forebrain.
Relays via thalamus - geniculate body.
Anatomy of oculomotor nerve.
Motor function.
Supplies 4/6 of ocular muscles.
Anatomy of trochlear nerve.
Motor function
Supplies superior oblique.
Anatomy of trigeminal nerve
Sensory + motor.
Transmits facial sensation
Controls jaw muscles
Anatomy of abducens nerve
Motor.
Supplies lateral abducens.
Anatomy of facial nerve.
Sensory + motor.
Transmits taste sensation
Controls facial muscles.
Anatomy of vestibular nerve.
Transmits auditory sensation.
Anatomy of cochlear nerve
Transmits balance sesnation
Anatomy of glossopharyngeal nerve
Motor control of pharynx
Parasympathetic control of parotid gland
Taste from back of tongue
Anatomy of vagus nerve
Motor control of larynx and pharynx.
Parasympathetic control of viscera.
Visceral sensations.
Anatomy of accessory nerve.
Motor control of neck muscles.
Anatomy of hypoglossal
Motor control of tongue muscles
Where is grey matter in the cerebrum?
Outer surface
Where is grey matter in the spinal cord?
Inner surface
What does the white matter form in the spinal cord?
Anterior, lateral and dorsal columns
What does the dorsal column of the spinal cord carry?
Proprioceptive sensory fibres
What is the spinothalamic tract made of?
Anterior and lateral columns
What information does the spinothalamic tract carry?
Touch
Pressure
Pain
Temperature
What secretes CSF?
Choroid plexus in lateral, third and fourth ventricles
Rate at which CSf is produced
300ml/day
Route of CSF
Secreted from choroid plexus From lateral ventricle to interventricular foramina of Monroe Into 3rd ventricle Into Aqueduct of Sylvius 4th ventricle Foramen of Magendie (single) and Foramina of Luschka (two lateral) Subarachnoid space
How does CSF go from lateral to 3rd ventricle?
Interventricular formina of Monroe
How does CSF go from 3rd to 4th ventricle?
Cerebral aqueduct of Sylvius
How does CSF go from 4th ventricle to subarachnoid space?
Foramen of Magendie (single) and
Foramina of Luschka (two lateral)
Where is the body of the lateral ventricle?
Below corpus callosum
What separates the two lateral ventricles?
Septum pellucidum
Where is the third ventricle?
Between thalamus and hpothalamus
Where is the fourth ventricle?
Above pons
Below cerebellum
Where does obstruction to CSF commonly occur?
3rd or 4th ventricle (Foraman of Monroe)
What happens in communicating hypocephalus?
Impairment of CSF reabsorption in subarachnoid space due to partial occlusion of arachnoid villi
What does the internal carotid artery divide into?
Anterior cerebral and middle cerebral artery
What does anterior cerebral artery supply?
Medial and superior strip of lateral aspect of cerebral cortex up to parietal/occipital border
What does the middle cerebral artery supply?
Lateral aspect of cerebral cortex, including Brocas and Wernickes in dominant hemispheres
Which artery supplies Brocas and Wernickes?
Middle cerebral artery
What does the posterior cerebral artery supply?
Inferomedial temporal lobe
Occipital lobe
Which artery supplies the occipital lobe?
Posterior cerebral artery
Where does the posterior cerebral artery arise from?
Basilar artery
What supplies the medulla?
Posterior inferior cerebellar arteries
Anterior spinal branches of vertebral arteries
What supplies the pons?
Basilar artery
Signs of carotid system TIA
Amaurosis fugax Aphasia Hemiparesis Hemisensory loss Hemianopic visual loss
What causes amaurosis fugax?
Blockade of retinal arteries
Signs of vertebrobasilar TIA
Diplopia, vertigo, vomiting Choking, dysarthria Ataxia Ataxia without agraphia Hemisensory loss Hemianopic visual loss Transient global amnesia Tetraparesis LOC
What supplies the premotor cortex?
Anterior cerebral artery
What supplies the cingulum?
Anterior cerebral artery
Bilateral infarct of anterior cerebral artery results in which signs
Quadriparesis (legs weaker than arms) Akinetic mutism (ventromedial or cingulate syndrome)
What supplies the caudate nucleus?
Recurrent artery of Huebner (branch of anterior cerebral artery)
Lesion effect of caudate nucleus
Initially agitated, confused
Evolves to akinesia, abulia with mutism and personality changes
What supplies the lateral prefrontal cortex?
Anterior branches of upper division of middle cerebral artery
Signs of lesion of lateral prefrontal cortex
Planning deficits
Impairment of working memory
Apathy
What supplies the basal forebrain?
Anterior comunicating artery
Signs of lesion in basal forebrain
Akinesia
Personality change - orbitofrontal dysfunction
Confabulatory amnesia
What supplies the lateral medulla?
Posterior inferior cerebellar artey
Lesion effect of lateral medulla or of thrombus in PICA?
Wallenberg’s lateral medullary syndrome.
Acute vertigo with cerebellar signs.
Ipsilateral face numbness, diplopia, nystagmus
Horners syndrome
IX/X nerve palsy with contralateral spinothalamic sensory loss and mild hemiparesis
When does Wallenberg’s lateral medullary syndrome occur?
Thrombus in PICA
Lesion in lateral medulla
Types of white matter pathways
Projection fibres
Association fibres
Commissural fibres
What are projection fibres?
Run vertically, connecting higher and lower centres of the brain
What are association fibres?
Interconnect different regions within same hemisphere of brain
What are commissural fibres?
Interconnect similar regions in opposite hemisphere.
What does the anterior commissure do?
Interconnects olfactory bulbs
What does the posterior commissure do?
Interconnects midbrain pretectal nuclei
What interconnects the posterior dorsal thalamic nuclei?
Hippocampal commissure
Habenular commissure
What supplies anterior aspect and most of the body of the corpus callosum?
Pericallosal artery (from anterior cerebral artery)
Signs of vascular disruption to pericallosal artery?
Left sided apraxia and agnosia
What is the posterior aspect of the corpus callosum called?
Splenium
What supplies the splenium?
Posterior cerebral artery
Signs of vascular disruption to splenium?
Alexia and color anomia
Preserved ability to copy words
Why is there preserved ability to copy words but not color in disruption of vasularity to splenium?
Motor information can be relayed via anterior corpus callosum instead
What is the fornix?
Connects hippocampus to hypothalamus via mamillary bodies
Is fornix white or grey matter?
White
Function of fornix
Relays cortical input to regulate neuroendocrine and autonomic systems
What connects Brocas and Wernickes?
Arcuate fasciculus
What does damage to Arcuate fasciculus result in?
Conduction aphasia
What is the uncinate fasciculus?
Connects orbitofrontal cortex to anterior temporal lobs.
Function of unicate funculus?
Social cognition
Language
Who divided the cortical layers into 47 specialised areas?
Brodmann
What is the neocortex made up of as per Brodmann?
6 Layers
Which layers in the neocortex are mainly afferent?
Layers 2 and 4
Which layers in the neocortex are mainly efferent?
Layers 5 and 6
What makes up cortical neurons?
75% is pyramidal neurons
25% are stellate cells - not in layer 1
What is Layer 1?
Molecular/agranular
Cells in Layer 1?
Glial cells
Dendrites from neurons of deeper layers
Horizontal cells of Cajal
Name of Layer 2?
External Granular layer
Cells in Layer 2
Granule cells
Small pyramidal cells (larger as you go down layers)
Name of Layer 3?
External pyramidal layer
Cells in layer 3?
Small and medium sized pyramidal cells
Name of layer 4?
Internal granular layer
Cells in layer 4?
Some pyramidal cells
Mostly granule cells
Receives thalamocortical inputs
Name of layer 5?
Internal pyramidal layer
Cells in layer 5?
Largest pyramidal cells - particularly motor cortex - betz cells
Name of layer 6?
Multiform layer
Cells in layer 6?
All cells
Spindle cells
Martinotti cells
Major source of corticothalamic fibres
Which layer gives rise to association/commissural and projection fibres?
Layer 6
How is the cerebelar cortex described as per Brodmann?
Three layered
Molecular - basket and stellate cells
Purkinje - Purkinje cells
Granular - granule and golgi cells
What are Purkinje cells?
Class of GABAergic neurons in cerebellar cortex only.
Connect to deep cerebellar nuclei via inhibitory projections.
Function of purkinje cells?
For sole output of all motor coordination in cerebellum.
Where are granule cells?
Granular layer of cerebeullum
Layer 4 of cerebral cortex
Denate gyrus of hippocampus
Olfactory bulb
Where are Betz cells?
Primary motor cortex - fifth layer of grey matter.
What are Betz cells?
Pyramidal cell neurons - largest in CNS.
10% of total pyramidal cell population in layer 5 of primary motor cortex.
Where are stella cells?
Layer 4 of cerebral cortex (from thalamus forward to pyramidal cells)
Cerebeullum
What do glial cells do?
Supportive metabolic functions
Modulate neuronal functions via neurosteroids
Types of glial cells
Astrocytes
Oligodendrocytes
Microglia
Ependymal cells
Which glial cell is most predominant?
Astrocyte
What are astrocytes?
Enable nutrition of neurons
Breakdown of neurotransmitters
Maintain blood-brain barrier
Where are oligodendrocytes?
CNS
What do oligodendrocytes do?
Produce myelin sheaths
What do microglia do?
Scavenger cells that clear neuronal debris following cell death
What do ependymal cells do?
Cover ventricles and facilitate csf circulation via their ciliary processes.
Where is the blood brain barrier located?
In endothelial cells of capillaries in the brain.
How do endothelial cells in brain capillaries form the blood-brain barrier?
Tight junctions with high electrical resistance as barrier against molecules.
How are blood capillaries separated from neurons?
Brain capillaries are in contact with foot processes of astrocytes
What molecules can go through blood-brain barrier?
Lipid soluble (ethanol and caffeine) via lipid membrane of cells
What olecues cannot go through blood brain barrier?
Water-soluble molecules such as Na and K.
What is the name of the brain which does not have a blood brain barrier?
Circumventricular organs
Examples of circum-ventricular organs
Subfornical organ
Area postrema (chemoreceptor trigger zone)
Median eminence
Posterior pituitary
Classification of dopaminergic pathways
Long
Short
Ultrashort
Long dopaminergic pathways
Nigrostriatal
Mesocortical
Mesolimbic
Short dopaminergic pathways
Tuberoinfundibular
Incertohypothalamic
Ultrashort dopaminergic pathways
In amacrine cells in retina and olfactory system
Which dopaminergic pathway is the extrapyramidal pathway?
Nigrostriatal - crucial for motor control
Origin and destination of nigrostriatal pathway
Substantia nigra to striatum and amygdala via medial forebrain bundle
Effect of dopamine blockage in nigrostriatal pathway?
Dopamine deficiency - Parkinsons
Blockade due to antipsychotics can cause extrapyramidal SEs
Origin and destination of mesolimbic pathway?
Ventral tegmental area to nucleus accumbens and hippocampus via medial forebrain bundle
Effect of dopamine blockade on nmesolimbic pathway?
Produces desirable antipsychotic effect by controlling positive psychotic symptoms
Origin and destination of mesocortical pathway?
Ventral tegmental area to cingulate cortex and prefrontal regions via medial forebrain bundle
Effect of dopamine blockade on mesocortical pathway?
Low levels of dopamine in this pathway lead to negative symptoms - alogia, anhedonia, amotivation, apathy
Origin and destination of tuberoinfundibular pathway?
Hypothalamus to pituitary via portal vessels
Effect of dopamine blockade on tuberoinfundibular pathway?
Dopamine acts as prolactin inhibitory hormone. Thus, low dopamine levels will increase prolactin.
Origin and destination of incertohypothalamic pathway?
Internal connections within hypothalamus
Effect of dopamine blockage within incertohypothalamic pathway?
Disturbed thermoregulation and weight gain
What are the cholinergic pathways?
Brainstem
Basal forebrain
What is the brainstem cholinergic pathway?
Forms part of ascending reticular activating system.
Function of brainstem cholinergic pathway?
Maintains wakefulness and REM sleep.
Origination of brainstem cholinergic pathway?
Originates from pedunculopontine and laterdorsal tegmental nuclei.
What does brainstem cholinergic pathway innervate?
Thalamic relay neurons
Reticular nuclei
Where does basal forebrain cholinergic pathway originate and project to?
Originates in nucleus basalis of meynert in basal forebrain
Projects to hippocampus, frontal cortex and amygdala
What does degeneration of basal forebrain cholinergic pathway result in?
Alzheimer’s disease
Where do most serotonergic neurons originate and ascend to?
Midbrain dorsal and median raphe nuclei
Ascend to innervate entire cortex, basal ganglia, thalamus
Descend to spinal cord
Where do noradrenergic pathways priginate and ascend to?
Originate in loculs coeruleus (pons)
Ascend to cortex via medial forebrain bundle
Descend to spinal cord
Most common excitatory neurotransmitter in brain?
GLutamate
What makes up most of the corona radiata?
Cortiofugal fibres
Which tracts are predominantly glutamatergic?
Almost all cortical descending tracts Corticofugal fibres - corona radiata All association and commissural fibres Thalamocorticol Cerebellar output from deep nuclei, subthalamic nuclei to globus pallidus projections Brainstem to spinal cord
What is the primary inhibitory neurotransmitter?
GABA
What is the major transmitter for cerebral interneurons?
GABA
Name two major cortical interneuron subtypes
Parvalbumin-expressing interneurons (40%)
Somatostatin-expressing interneurons (30%) - Martinotti cells
What can reduction in expression of parvalbumin-expressing interneurons lead to?
Schizophrenia
Subtypes of parvalbumin-expressing interneurons?
Basket cells
Chandelier cells
What are basket cells?
Receive direct input from thalamocortical projections.
Form synapses with soma or dendrites of pyramidal neurons
Function of basket cells
Provide excitatory-inhibitory balance to cortex
What are chandelier cells?
Form synapses with proximal axonal hillock of pyramidal neurons.
Function of chandelier cells?
Overall excitatory role by serving to short-circuit the action potential propagation
Which artery supplies the dorsolateral prefrontal circuit?
MCA