Neuroanatomy Flashcards
A 60yo R-handed M, frequently gets lost and only writes on the right side of the paper. Noted to have L-sided hemi-neglect.
Where is the lesion?
Right parietal lobe
A 66yo w/ HTN develops vertigo, diplopia, N/V, hiccups, L face numbness, nystagmus, hoarseness, ataxia of limbs, staggering gait, and tendency to fall to the left.
What is the diagnosis?
Lateral medullary stroke
A 26yo w/ HA and R-hand clumsiness for weeks. Exam shows difficulty w/ rapid alternating movements of the hand, overt intention tremor on finger-to-nose, and mildly dysmetric finger tamping. CNS intact and no papilledema.
Where will damage show on MRI?
Cerebellum
A78yo s/p ischemic stroke w/ residual mild hemiplegia. Pt appeared unaware that there was a problem of weakness on one side of his body. When asked to raise the weak arm, the patient raised his normal arm. When the failure to raise his paralyzed arm was pointed out, he admitted that the arm was slightly weak. He also neglects the side of the body when dressing and grooming. Pt did not shave one side of his face and had difficulty putting on a shirt when it was turned inside out.
What area of the brain was likely affected by a stroke?
Right parietal lobe
Adult neurogenesis happens in which area of the brain?
Hippocampus
MRI scan of the head reveals an infarct in the distribution of the left anterior cerebral artery.
What symptoms is the patient likely to exhibit?
- Weakness of contralateral foot and leg w/ sparing of face and arm
- Abulia (absence of willpower or inability to act decisively)
A previously pleasant mom becomes profane and irresponsible over 6 months.
Where is the pathology most likely located?
Frontal lobe
Rapid onset of R facial weakness, left limb weakness, and diplopia.
What is the diagnosis?
Brain stem infarction
In addiction, dopaminergic neurons project to the nucleus accumbens.
Cell bodies of these neurons reside in which area of the brain?
Ventral tegmental area
Orexin is made in what part of the brain?
Lateral hypothalamic nuclei
What brain area is activated by subliminal presentations of emotional faces?
Amygdala
Where does histamine synthesis happen?
Hypothalamus
Which dopaminergic pathway includes the nucleus accumbens and also mediates addiction and associated reinforcing behaviors?
Mesolimbic
Neural plasticity is largely mediated through the capacity to rapidly change in number and morphology of what cell structure?
Dendritic spines
Which brain region does leptin work at?
Hypothalamus
Oxytocin suppresses which brain region?
Amygdala
What area of the the hypothalamus is responsible for maternal behavior?
Pre-optic
What cranial nerve is responsible for the gag reflex and palette elevation?
Vagus nerve (CN X)
Which of the following statements regarding the development of the CNS in the first two years of life is true?
Motor cortex develops before sensory cortex
Which of the following cortical regions is a key component of the salience network?
Anterior cingulate cortex
Where is the primary taste cortex in humans located?
Anterior insular
The initial learning phase of skilled motor sequence requires the corticostriatal system and whatother system?
Corticocerebellar
Reduced hippocampal volume causes what type of memory impairment?
Declarative
Histaminergic neurons that regulate sleep originate in which brain nuclei?
Tuberomammillary
A patient receives neck manipulation and now has dysarthric speech, gait ataxia, numbness on the R side of their body, and neck pain.
What is the diagnosis?
Vertebral artery dissection
Which areas are connected by the stria terminalis?
Amygdala to the septal area and the hypothalamus
Wakefulness depends on which brain area?
Ascending reticular activating system
What forms the neural tube?
Ectoderm
rTMS for MDD targets which brain region?
Dorsolateral prefrontal cortex
Neurogenesis in the adult brain is restricted to which region of the brain?
Dentate gyrus
Which of the following is part of the hippocampal formation?
- Amygdala
- Septal area
- Dentate gyrus
- Cingulate gyrus
- Mammillary bodies
Dentate gyrus
Bipolar has decreased connectivity in which brain regions?
Amygdala and prefrontal cortex
Which biogenic amine is made in the locus coeruleus?
Norepinephrine
CNS response to fear is mediated by what structure?
Central nucleus of the amygdala
Behavioral and visceral responses in fear come from projections to the brainstem and hypothalamic nuclei from which of the following?
Centromedial nuclei of the amygdala
What CNS region containing dopaminergic neurons projects to the caudate and the putamen?
Substantia nigra
What area of the brain is responsible for face recognition?
Fusiform gyrus
What area of the brain would allow you to remember a phone number?
Dorsolateral prefrontal cortex
Which part of the cortical-striatal-pallidal-thalamic cortical circuit evaluates painful stimuli?
Lateral orbitofrontal
Which circuit mediates the ability to resist responding to aggravating situations with hositlity?
Orbitofrontal
What 3 brain regions are part of a loop circuit that produces worry and obsessive symptoms?
- Dorsolateral prefrontal cortex
- Striatum
- Thalamus
Hyperactivity of the orbitofrontal cortex, basal ganglia, and thalamus are seen in what disorder?
OCD
The blood-brain barrier is made up of what kind of cells?
Endothelial
Dopaminergic neurons in which system are primarily implicated in tasks related to cognitive processing?
Mesocortical
Development of brain gray matter volume peaks at what age?
Late childhood
In a patient with hippocampal damage, what allows them to still learn new skills like playing tennis?
Basal ganglia
Where are the stem cells in the hippocampus in adult brains?
Subgranular zone
A 65yo pt has a stroke that causes him to fall. On exam, he has weakness of the R leg w/ only minor weakness of the R hand, no weakness of the face, and no sensory deficit. Speech is not affected, but the patient seems unusually quiet and passive.
The stroke most likely involved which brain structure?
L anterior cerebral artery
A pt has hemisensory loss followed by pain and hyperathia involving all modalities, which reaches the midline of the trunk and head.
This is most consistent with ischemia in the distribution of which of the following arteries?
Posterior cerebral
R-sided palsy w/ equal involvement of the face, arm, and leg, combined w/ 3rd nerve palsy is most likely due to occlusion of a branch of which artery?
Posterior cerebral
BLE weakness, abulia, mutism, and urinary incontinence are most likely to result from occlusion of which artery?
Anterior cerebral
Pure sensory deficit extending to midline and involving the face, arm, trunk, and leg are most likely caused by a lacunar infarct in which brain region?
Lateral thalamus
Blocking the R posterior cerebral artery causes which visual disturbance?
L homonymous amianopsia
Occlusion of the cortical branch of the posterior cerebral artery would result in which of the following?
Homonymous hemianopsia w/ alexia w/o agraphia
A 28yo cocaine user complains of low back pain, numbness in b/l legs, feet, thighs, buttocks, and abdomen and says that his R leg is weak and clumsy and that his L leg is tired. He has urinary incontinence and difficulty walking.
On exam he has decreased sensation to light tough, pinprick, and temperature. Normal vibration and proprioception. DTRs are difficult to elicit. Muscle tone is normal. Strength is decreased b/l, but worse on the R.
What is the diagnosis?
Anterior spinal artery infarction
A patient has intact sensation for light touch, pressure, temperature, pain, vibration, and proprioception but cannot recognize objects based on touch.
What brain region is affected?
Posterior parietal lobe
Loss of the ability to execute previously learned motor activities (not d/t weakness, ataxia, or sensory loss) is associated with lesions of what brain region?
L parietal cortex
A patient has a normal Romberg w/ eyes open but loses balance with eyes closed.
Where is the lesion?
Cerebellar vermis
Motor speech paradigm activation task on fMRI shows hyperactivity in the R temporal lobe.
Where is the lesion?
Calcarine fissure
Aphasia w/ effortful fragmented, non-fluent, telegraphic speech is seen in a lesion where?
Posterior frontal lobe
A pituitary tumor that protrudes through the diaphragmatic sella is most likely to cause what?
Bitemporal hemianopsia
Conduction aphasia often occurs as a result of damage to which structure?
Arcuate fasciculus
Unilateral hearing loss, vertigo, unsteadiness, falls, HA, mild facial weakness, and ipsilateral limb ataxia are most commonly associated with tumors in what locations?
Cerebellopontine angle
A 20yo w/ 1yr hx of bitemporal headach, polydipsia, polyuria, and bulimia, as well as a 2mo hx of emotional outbursts, aggression, and transient confusion. Neuro exam is normal.
What will MRI brain show?
Hypothalamic tumor
A 34yo M is referred for psych eval 5 years after sustaining a head injury at work. Prior to the accident he was a stable, married man. Since the accident, he has been described as overly talkative and restless. His wife divorced him because he was acting irresponsibly, which also resulted in termination from his job. Psychometric testing reveals that the man has average intelligence and no detectable memory deficits.
This clinical presentation is most consistent with damage to which brain area?
Frontal lobe
Patient reports HA and peripheral vision loss. Visual field defects involving the temporal fields of both eyes are detected.
What is the most likely MRI finding?
A mass in the sella turcica
Unconsciousness can be induced by a small area of damage to what brain region?
Reticular formation
A pt has acute onset of hemiballismus of LUE and LLE.
MRI is most likely to show a lesion in what area?
Subthalamic nucleus
Akinetic mutism can result from b/l infarctions of which of the following structures?
Anterior cingulate gyrus
Which lesion causes b/l vertical and horizontal nystagmus that worsens w/ visual fixation?
Brainstem
A 32yo pt w/ a 1mo hx of worsening headache, episodic mood swings, and occasional hallucinations w/ visual, tactile, and auditory content.
Where is the most likely location of a tumor on CT?
Temporal lobe
What does the cerebellum do in the human adult brain?
Diverse roles in movement, behavior, and learning
A pt presents w/ a syndrome characterized by fluent speech, preserved comprehension, and inability to repeat, w/o associated signs.
Where is the lesion?
Supramarginal gyrus or insula
Lesions in the mammillary bodies will produce what symptoms?
Amnesia, confabulation, and lack of insight
A 62yo w/ progressive personality changes has dull emotions, lack of initiative, and apathy. An autopsy is likely to show atrophy of what region?
Frontal lobe
Implantation of deep brain stimulation electrodes is an effective treatment for Parkinson’s. What is the optimal location for the electrodes?
Subthalamic nucleus
Deep brain stimulation of what brain structure is a useful treatment for primary generalized dystonia?
Globus pallidus
The mesolimbic DA pathway involves which structure?
Ventral striatum
How do cortical brain areas connect between the cerebral hemispheres?
Commissural fibers
The uncinated fasciculus connects which of the following brain areas?
Anterior temporal and ventral prefrontal regions
What are the cortical columns?
Functional units for information processing
Abnormal emotional expression, such as pathological laughter or crying is caused by lesions affecting the cortical-subcortical circuits connecting what 3 brain structures?
- Frontal cortex
- Pons
- Cerebellum
Exposure to light affects which brain structure?
Suprachiasmatic nucleus
What part of the brain controls circadian rhythm?
Suprachiasmatic nucleus
At what age does synaptogenesis peak?
4 years old
Why does the brain rapidly increase in size from birth to 2yo?
Synaptogenesis of neurons
Where does neuron morphology in the brain change the most?
Prefrontal cortex
Threatening objects can produce a startle response prior to a person becoming consciously aware. This is due to a connection in what brain structures?
Thalamus and amygdala
Huntington’s disease is characterized by a loss of neurons that produce which NT?
GABA
A 17yo is evaluated for binge eating associated with a 60lb weight gain over the past 4mos.
CT shows a craniopharyngioma that likely disrupts which structure?
Ventromedial hypothalamus
What is an accurate statement about the brain’s default mode network?
It is involved in reprocessing previously experienced stimuli
What is the most likely reason that adults are superior to adolescents when it comes to abstract thinking?
The brain undergoes synaptic pruning
The dorsolateral prefrontal cortex plays an important role in what activity?
Working memory
Drug abuse activates neuronal circuits, generating signals in the ventral tegmental area to where?
Dopamine in the nucleus accumbens
95% of R-handed people develop L hemispheric dominance for language. What percentage of L-handed people develop L hemispheric dominance for language?
75%
What is the neural pathway that mediates reactive aggression?
Amygdala –> hypothalamus –> periaqueductal gray
What area of the frontal cortex is activated in the Wisconsin Card Sorting Test during the shifting of cognitive sets?
Dorsolateral
After middle age, which region of the brain has decreasing sleep spindle density?
Frontal and occipital lobes
What neurodevelopmental process predominantly occurs during adolescence and young adulthood?
Synaptic pruning
Circadian rhythms related to sleep behavior are set and maintained in what area of the brain?
Suprachiasmatic nucleus
What sensation is transmitted through the spinothalamic tract?
Pain
What term describes the ability to temporarily store and manipulate information such as mental arithemetic?
Working memory
The neural circuit connecting the anterolateral orbitofrontal cortex, anterior putamen, and the thalamus is involved in what cognitive function?
Affective processing
What type of glial cells from myelin sheaths in the PNS?
Schwann cells
What region of the brain is most closely associated with cortical processing of faces?
L parietal lobe
What hypothalamic nuclei is key to integration of neural and nutrient signals, with input from hormonal signals from the small intestine, pancreas, liver, adipose tissue, and brainstem?
Arcuate nucleus
What hormone is synthesized in the arcuate nucleus of the hypothalamus?
Neuropeptide Y
What region of the brain is connected to the anterior medial frontal cortex during recognition of affective behavior by the motor neuron system?
Insula
Corticotropin-releasing hormone is released from which brain region during periods of stress?
Paraventricular nucleus
Individuals w/ PTSD demonstrate low responses on fMRI in what brain structures?
Ventromedial prefrontal cortex
Thiamine deficiency is associated w/ changes in what brain structure?
Mammillary bodies
The diencephalon is a precursor to which brain structure?
Thalamus
Poor strategies for solving visuospatial problems such as following illustrations for assembling furniture involves what circuit?
Dorsolateral prefrontal circuit
Which hypothalamic nuclei affect puberty via pulsatile GnRH secretion?
Infundibular
Which of the following is a key part of the default mode network:
- Medial prefrontal
- Anterior cingulate
- Dorsolateral prefrontal
- Ventromedial prefrontal
- Lateral posterior parietal
Medial prefrontal
What brain structure is implicated in maternal attachment?
Amygdala
What pathway is implicated in tardive dyskinesia?
Nigrostriatal
Corticobulbar fibers run through which part of the internal capsule?
Genu
What brain region contains the cell bodies of noradrenergic neurons?
Locus coeruleus
Patients w/ PTSD have reduced brain volume in this region on MRI:
Hippocampus
A 26yo M w/ clumsiness and dizziness presents for HA, difficulty w/ rapid alternating movements of the R hand, and overt intention tremor w/ finger-to-nose. What structure is most likely to be damaged on MRI?
Cerebellum
What brain lobe is responsible for initial detection of shape, form, and color?
Temporal
Where are dopamine cell bodies located?
- Substantia nigra
- Ventral tegmental area
Pre-natal exposure to VPA causes defects in which stage of development of the nervous system?
Neurulation
What brain region is involved in working memory?
Prefrontal cortex
What brain area is inhibited during wakeful periods?
Ventral lateral preoptic nucleus
Drugs of abuse that lead to addictive behavior activate which dopamine pathway(s)?
Mesoaccumbens
What brainstem area causes defensive behavior in response to a threat?
Dorsal periaqueductal gray
What is a brain region where adult neurogenesis occurs?
Lateral ventricle
Are hyperactive DTRs a sign of upper or lower motor neuron injury?
Upper
