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2. Geriatric Psychiatry + Neuroanatomy > Neuroanatomy > Flashcards

Neuroanatomy Flashcards

1
Q

what are the 3 major frontal divisions of the brain

A

primary motor cortex

premotor cortex

prefrontal cortex (LARGEST)

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2
Q

what are the INPUTS of the primary motor cortex

A

thalamus

basal ganglia

sensory area

premotor area

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3
Q

what are the OUTPUTS of the of the primary motor cortex

A

motor fibers–> brainstem and spinal cord

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4
Q

what is the PURPOSE of the of the primary motor cortex

A

execution of movements

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5
Q

what is the result of LESIONS TO the primary motor cortex

A

CONTRALATERAL changes in tone, power, fine coordination

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6
Q

what are the INPUTS to the premotor cortex

A

thalamus

basal ganglia

sensory area

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7
Q

what are the OUTPUTS from the premotor cortex

A

primary motor cortex

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8
Q

what is the FUNCTION of the premotor cortex

A

STORAGE of MOTOR PROGRAMS

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9
Q

what is the result of LESIONS TO the premotor cortex

A

CONTRALATERAL weakness

coarse ATAXIA

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10
Q

the prefrontal cortex is a component of what brain system

A

limbic system

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11
Q

where is broca’s area located in relation to the 3 components of the frontal lobes of the brain

A

behind and under the prefrontal cortex

under the premotor cortex

under and in front of the primary motor cortex

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12
Q

why is the frontal brain called “frontal”

A

its located in FRONT of the CENTRAL SULCUS of the brain

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12
Q

why is the frontal brain called “frontal”

A

its located in FRONT of the CENTRAL SULCUS of the brain

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13
Q

list the components of the frontal lobe from anterior to posterior

A

forehead–> prefrontal cortex –> premotor cortex–> primary motor cortex–> central sulcus

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14
Q

what are the 3 subdivisions of the PREFRONTAL cortex

A

dorsolateral region

dorsomedial region (includes the cingulate gyrus)

orbitofrontal region

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15
Q

what is the FUNCTION of the dorsolateral region of the prefrontal cortex

A

executive cognitive functions

–> develop and execute plans for complex goal directed activities

–> conform behaviour to social contingencies

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16
Q

what are the connections that the the dorsolateral region of the prefrontal cortex makes with the rest of the brain

A

motor and sensory CONEVRGENCE areas

thalamus

basal ganglia –via the caudate (globus pallidus, caudate, substantia nigra)

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17
Q

what is the result of LESIONS to the dorsolateral region of the prefrontal cortex

A

executive dysfunction

disinterest/emotional reactivity

inattention to relevant stimuli

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18
Q

what are the two components of the dorsomedial region of the prefrontal cortex

A

superior frontal gyrus

cingulate gyrus

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19
Q

what is the FUNCTION of the dorsomedial region of the prefrontal cortex

A

motivation

initiation to activity

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19
Q

what is the FUNCTION of the dorsomedial region of the prefrontal cortex

A

motivation

initiation to activity

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20
Q

what is the result of the LESION to the dorsomedial region of the prefrontal cortex

A

apathy

decreased drive and spontaneity of movement

loss of cingulate gyrus input to the supplementary motor cortex “releases” activity
–> diminished awareness
–> at worst, usually if bilateral lesions, then can have akinetic mutism

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21
Q

what CONNECTIONS does the dorsomedial region of the prefrontal cortex make with the rest of the brain

A

anterior cingulate gyrus–> ventral striatum (caudate, putamen)–> globus pallidus and substantia nigra–> thalamus etc (feeds back)

connections to temporal and parietal cortices, cingulate cortex, thalamus, basal ganglia

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22
Q

what are the two components of the basal ganglia

A

caudate

putamen

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23
Q

what are the components and waht is the location of the orbitofrontal region of the prefrontal cortex

A
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24
Q

what is the FUNCTION of the orbitofrontal region of the prefrontal cortex

A

modulation of emotional input

arousal

suppression of distractions

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25
Q

what is the result of a LESION to the orbitofrontal region of the prefrontal cortex

A

emotional lability

disinhibition

distractability

“hyperkinesis”

OCD like

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26
Q

what are the connections the orbitofrontal region of the prefrontal cortex makes with the rest of the brain

A

temporal and parietal cortex

thalamus

basal ganglia

insula

amygdala

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27
Q

which region of the prefrontal cortex connects to motor and sensory convergence areas

A

dorsolateral regions

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28
Q

which region of the prefrontal cortex connects to the temporal and parietal cortices

A

dorsomedial and orbitofrontal

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29
Q

which region of the prefrontal cortex connects to the thalamus and basal ganglia

A

all three of them

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30
Q

which region of the prefrontal cortex connects to the insula and amygdala

A

orbitofrontal region

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31
Q

what are the 3 “frontal syndromes”

A

dorsolateral syndrome–> “executive dysfunction”

dorsomedial syndrome (anterior cingulate syndrome)–> “amotivation syndrome”

orbitofrontal lesion–> “disinhibition syndrome”

*in reality is rare to have isolated syndromes

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32
Q

what is “Witzelsucht”

A

uncontrollable tendency to pun, tell jokes/inappropriate humour

can be seen in frontal syndromes

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33
Q

how do we divide the brain VERTICALLY

A

cortical vs subcortical division

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34
Q

what are 4 functions of the CORTICAL division of the brain

A

ability

language

motor

sensory

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35
Q

what are 4 functions of the SUBCORTICAL division of the brain

A

movement

basic function

emotions

connection to FRONTAL lobes–> relay center

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36
Q

which part of the brain contains GRAY matter

A

cortical

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37
Q

where is the hippocampus located in the brain

A

temporal lobe, edge of the cortex

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38
Q

is the hippocampus cortical or subcortical

A

cortical

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39
Q

is basal ganglia cortical or subcortical

A

subcortical

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40
Q

is the thalamus cortical or subcortical

A

subcortical

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41
Q

is the brain stem cortical or subcortical

A

subcortical

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42
Q

which division of the brain–cortical or subcortical–is responsible for the following function:

language

A

cortical

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43
Q

which division of the brain–cortical or subcortical–is responsible for the following function:

connection to frontal lobes

A

subcortical

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44
Q

which division of the brain–cortical or subcortical–is responsible for the following function:

movement

A

subcortical

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45
Q

which division of the brain–cortical or subcortical–is responsible for the following function:

ability

A

cortical

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46
Q

which division of the brain–cortical or subcortical–is responsible for the following function:

motor

A

cortical

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47
Q

which division of the brain–cortical or subcortical–is responsible for the following function:

basic function

A

subcortical

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48
Q

which division of the brain–cortical or subcortical–is responsible for the following function:

emotions

A

subcortical

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49
Q

which division of the brain–cortical or subcortical–is responsible for the following function:

sensory

A

cortical

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50
Q

what makes up the subcortical brain division

A

white matter prohects and deep gray matter bodies

51
Q

in what brain division is the anterior cingulate cortex (ACC) located

A

frontal–> dorsomedial

52
Q

phineas gage sustained damage to what part of the brain

A

orbitofrontal cortex

53
Q

in which hemisphere is brocas area located

A

left

(in frontal lobe, inferior region)

54
Q

what do lesions in brocas area result in

A

EXPRESSIVE aphasia

NON FLUENT

55
Q

in which hemisphere is wernicke’s area located

A

left hemisphere

in temporal lobe/parietal lobe

56
Q

what do lesions in wernicke’s area cause

A

RECEPTIVE aphasia

FLUENT

57
Q

where does the auditory cortex lie

A

in the temporal lobe, just in front of the wernicke’s area

58
Q

what are the functions of the parietal lobe

A

sense of touch

body position

59
Q

where is the primary somatosensory cortex located

A

in the parietal lobe

60
Q

what is the function of the primary somatosensory cortex

A

integrates somesthetic stimuli for recognition and recall of form, texture and weight

61
Q

what is the function of the posterior-lateral area of the parietal lobe

A

visual-spatial relationships and proprioception

62
Q

where is the lesion that causes Gerstmann syndrome

A

dominant parietal lobe

63
Q

what is Gerstmann syndrome

A

a lesion in the dominant parietal lobe causes:

deficits in writing (agraphia)

deficits in calculating (acalculia)

left right disorientation

abnormalities in finger naming

64
Q

what are the functions of the DOMINANT parietal lobe

A

calculation

writing

left right orientation

finger recognition

65
Q

what happens if you have a lesion to the NONdominant parietal lobe

A

neglect

anosognosia

(a smaller lesion may cause apraxia)

66
Q

what is apraxia

A

spatial-manual deficit

lose the ability to do learned motor tasks–> dressing, other well learned activities

67
Q

a lesion in what area may cause anosognosia

A

non dominant parietal lobe

68
Q

a lesion to what area may cause acalculia

A

dominant parietal lobe

69
Q

what are some of the functions of the temporal lobes

A

comprehension

sound

speech

70
Q

what is the function of the hippocampus

A

memory

71
Q

what area is affected in kluver bucy syndrome

A

anterior temporal lobes

72
Q

list the symptoms of kluver-bucy syndrome

A

amnesia

docility

pica

hyperphagia

hyperorality

hypersexuality

visual agnosia

73
Q

what is the function of the occipital lobe

A

information related to sight

74
Q

what brain structures make up the diencephalon

A

thalamus and hypothalamus

75
Q

what brain structures make up the brain stem

A

thalamus and hypothalamus

midbrain

pons

medulla

76
Q

what brain structures make up the hindbrain

A

cerebellum

pons

medulla

77
Q

what brain structures make up the forebrain

A

cerebral structures (cerebral cortex, white matter, subcortical structures)

thalamus and hypothalamus

78
Q

what brain structures make up the telencephalon

A

cerebral structures (cerebral cortex, white matter, subcortical structures)

79
Q

what brain structures make up the mesencephalon

A

midbrain

80
Q

what brain structures make up the metencelphalon

A

pons

cerebellum

81
Q

what brain structures make up the myelencephalon

A

medulla

82
Q

where is the insula located

A

between the parietal and temporal lobes basically

83
Q

what area is responsible for mental flexibility

A

dorsolateral PFC

(lesions lead to concreteness, inability to set shift, perseveration etc)

84
Q

is brocas area in the dominant or nondominant hemisphere

A

DOMINANT hemisphere

85
Q

where are the cortical association areas located

A

parietal lobe

86
Q

what is the function of the cortical association areas

A

integrates and processes sensory information i.e auditory and visual

87
Q

what is the function of wernickes area in the DOMINANT hemisphere

A

communication

88
Q

what is the function of wernickes area in the NONdominant hemisphere

A

receptive aprodosia

(receptive prosody of speech)

89
Q

where does visual and cognitive processing happen

A

in the occipitotemporal gyri

90
Q

what is the function of the parahippocampal gyri

A

learning and memory

91
Q

what is the function of the insular lobe

A

located internal to the lateral sulcus

responsible for NOCICEPTION and regulation of AUTONOMIC FUNCTION

92
Q

what is the result of damage to the anterior cingulate cortex

A

apathy, amotivation

93
Q

what makes up the limbic lobe

A

ACC

subcallosal gyrus

cingulate gyrus

parahippocampal gyrus (includes the entorhinal cortex which links olfactory system, cingulate gyrus, orbital cortex, amygdala, and temporal cortex to the hippocampus)

94
Q

what are the subcortical structures

A
95
Q

the substantia nigra is in what part of the brain

A

part of midbrain

96
Q

what structures make up the dorsal striatum

A

caudate and putamen

97
Q

where does the dopamine that feeds into the dorsal striatum/ caudate+ putamen originate

A

substantia nigra pars compacta

98
Q

what is the function of the caudate

A

motor function

cognitive function

99
Q

what are the two parts of the ventral striatum

A

nucleus accumbens

olfactory tubercle

100
Q

what part of the brain is a major producer of serotonin

A

raphe nucleus

101
Q

where does the dopamine that feeds into the ventral striatum come from

A

ventral tegmental area

*reward/aversion related cognition
*dopaminergic hyperactivity leads to + symptoms

102
Q

what brain structure produces dopamine for the nigrostriatal pathway

A

substantia nigra pars compacta

103
Q

what is the function of the pons

A

relays signals from forebrain to cerebellum

deals with sleep, respiration, swallowing, bladder control, hearing, equilibrium, taste, eye movement, facial expression and sensation and posture

104
Q

what structure in the brain produces norepinephrine

A

locus ceruleus

105
Q

where is the locus ceruleus located in the brain

A

in the pons

106
Q

what cranial nerves are found in the pons

A

V
VI
VII
VIII

107
Q

what is the function of the medulla

A

control of ventilation via signals from the carotid and aortic bodies

cardiovascular SNS, PNS

vasomotor center

reflex center for vomiting, coughing, swallowing, sneezing

108
Q

what part of the brain is responsible for:

swallowing

A

pons

reflex is in medulla

109
Q

what part of the brain is responsible for:

vomiting reflex

A

medulla

110
Q

what part of the brain is responsible for:

bladder control

A

pons

111
Q

what part of the brain is responsible for:

control of ventilation

A

medulla

112
Q

where is the vasomotor center of the brain

A

medulla

113
Q

what are the structures involved in the mesolimbic dopaminergic pathway

A

ventral tegmental area–> dopamine to ventral striatum (nucleus accumbens and olfactory tubercle)

–> dopamine hyperactivity = + symptoms
–> reward/aversion related cognition

114
Q

what are the structures involved in the mesocortical dopaminergic pathway

A

ventral tegmental area–> dopamine release to prefrontal cortex

–> executive function
–>low dopamine transmission = negative symptoms

115
Q

what are the structures involved in the nigrostriatal dopamine pathway

A

substantia nigra pars compacta–> dopamine to dorsal striatum (caudate and putamen)

–> motor function

116
Q

what are the structures involved in the tuberoinfundibular dopaminergic pathway

A

arcuate nucleus–> dopamine release into median eminence, circulates through hypophyseal portal system, and INHIBITS release of prolactin in pituitary–> prolactin inhibition

117
Q

what brain system is affected in restless leg syndrome

A

hypothalamospinal

118
Q

what brain system is affected in tremor

A

incertohypothalamic

119
Q

what tests should be ordered to work up chorea

A

CBC

TSH

ESR

C3
C4

ANA/ENA

anti-dsDNA

calcium +/- PTH

CT head

serum ceruloplasmin

120
Q

list autoimmune causes of chorea

A

APLAS

NMDA-R

PANDAs

Sydenhams

SLE

chorea gravidarum

121
Q

list congenital causes of chorea

A

perinatal asphixia

kernicterus

122
Q

list drug induced causes of chorea

A

neuroleptics

amphetamines

cocaine

stimulants

adrenergics

l-dopa

direct acting dopamine agonists

phenytoin

OCPs

123
Q

list endocrine causes of chorea

A

hyperthyroidism

hypoparathyroidism

124
Q

list infectious causes of chorea

A

neurosyphillis

HIV encephalitis

125
Q

how do you distinguish huntingtons chorea from tardive dyskinesia

A

huntingtons–> typically both upper and lower face; limbs, gait equally if not more affected; respiratory and diaphragmatic chorea

tardive dyskinesia–> typically lower face, tongue and lips more than extremities; respiratory and diagphragmatic chorea

126
Q

asterixis is associated with what conditions or meds

A

hepatic, uremic encephalopathy (toxic-metabolic)

anticonvulsants (esp. valproic acid)

lithium

clozapine

*may also be seen with midbrain, thalamic or frontal disease

2. Geriatric Psychiatry + Neuroanatomy (14 decks)

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