NeuroAnatomy Flashcards by Kalee Woody

60 yo right handed M, getting lost, only writes on right half of paper, left sided hemi-neglect. Where is the lesion?

right parietal lobe

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Frontal lobe functions

-Primary motor cortex (precentral Gyrus)
-impulse control (orbitofrontal cortex)
-socialization
-executive functioning
-working memory
-language production (Broca’s area)

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Parietal lobe functions

-primary sensory cortex (post-central gyrus)
-knowledge of numbers
-visuospatial processing
-R-L orientation

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Temporal lobe functions

-primary auditory cortex
-contains hippocampus (memory)
-Wernicke’s area (understanding language)
-comprehension/naming
-recognition of faces
-visual processing

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Occipital lobe functions

-primary visual cortex
-lesions=visual field abnormalities

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Cerebellum functions

-sensory perception
-motor coordination/learning
-proprioception
-equilibrium
-posture

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Basal Ganglia functions

-Is associated with coordination of movement

-composed of:
1: striatum (putamen/caudate/nuc accubens)
2: globus pallidus
3: subthalamic nucleus
4: substantia nigra

-motor tracts go through striatum

-abnormalities of basal ganglia include parkinson’s disease, tourettes, cerebral palsy, dystonia, OCD, and tardive dyskinesia

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MoCA Modified Trail Marking tests _?

-tests language skills (Broca’s and Wernickes’)
-Must be able to understand the instructions, know what the letters and numbers mean

-tests executive functioning (frontal lobe)
-must be able to switch back and forth between letters and numbers

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Impairment in trail making on the MoCA indicates which possible pathology?

-Alzheimer’s
-frontal subcortical vascular disease
-frontotemporal dementia
-lewy body dementia

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MoCA Copy of the Cube tests _?

-visuomotor and visuo-perceptual skills (parieto-occipital lobe)
-planning (frontal lobe and frontal cortical subcortical circuits)
-fine motor ability (fronto-parieto-occipital cortices)

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MoCA Clock Drawing tests _?

-visual-spatial functions (right parietal lobe)
-executive function (frontal lobe and frontal subcortical circuits)
-

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MoCa Naming animals exercise tests_?

-perceptual visual function (right parietal and bilateral occipital lobes)
-semantic memory used to identify and name animal (medial temporal lobes)
-Language production (left temporal-parietal lobe and left frontal lobe AKA Broca’s region in right handed individuals)

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MoCa “recite this list of numbers back to me” exercise tests_?

-retention of auditory stimuli and articulatory rehearsal (understanding and speaking language=Left sylvian valley)
-attention and immediate memory (dorsolateral prefrontal cortex)

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MoCa “Letter A Tapping Test” exercise tests_?

-concentration (frontal lobe and frontal subcortical circuits)
-Inhibition of tapping (orbitofrontal cotex)

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MoCa “serial 7’s” exercise tests_?

-concentration (frontal lobe and frontal subcortical circuits)
-working memory (dorsolateral prefrontal cortex)
-calculation (left parietal lobe)

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MoCa “Sentence Repeating” exercise tests_?

-language skills (left temporo-parietal-frontal circuit ‘left sylvian valley’ for understanding and reproducing language)
-working memory and attention (dorsolateral prefrontal cortex)
-concentration (frontal lobe and frontal subcortical circuits)

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MoCA exercise of “naming things that start with F” tests_?

-set shifting and concentration (left frontal lobe and frontal subcortical circuits)
-working memory (dorsolateral prefrontal cortex)

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MoCA “abstraction” exercise tests?

-semantic memory (medial temporal lobes)
-knowledge of categories and concepts (left temporal lobe and left angular gyrus)
-abstract thinking (frontal subcortical circuits)

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MoCA exercise of “delayed recall” tests_?

-memory retrieval (frontal lobe or frontal subcortical areas adn the hippocampal-parieto-frontal networks)
-encoding memory (Left papez circuit=hippocampus, fornix, mammillary bodies, and thalamus)

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MoCA testing of “orietation” tests_?

recent memory (papez circuit= hippocampus, fornix, mammillary bodies, and thalamus)

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66yo with HTN develops vertigo, diplopia, nausea, vomiting, hiccups, L face numbness, nystagmus, hoarseness, ataxia of limbs, staggering gait, and tendency to fall to the left. Dx?

left medullary stroke (aka wallenberg’s syndrome or posterior inferior cerebellar artery (PICA) occlusion)

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left sided hemineglect is cause by a lesion in which area?

right parietal lobe

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adult neurogenesis happens in which area of the brain?

hippocampus

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MRI Scan of the head reveals infarct in distribution of left anterior cerebral artery. Signs?

weakness of contralateral foot and leg, sparing of face and arm, with abulia

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previously pleasant mom becomes profane and irresponsible over 6 months. Where is the pathology?

frontal lobe

Rapid onset of right facial weakness, left limb weakness, diplopia. Where is the infarct?

brain stem

In addiction, dopaminergic neurons project to nucleus accumbens. Cell bodies of these neurons reside in which area of the brain?

ventral tegmental area

orexin is made in which part of the brain?

lateral hypothalamic nuclei

Brain area activated by subliminal presentations of emotional faces is ___.

amygdala

Where does histamine synthesis happen?

hypothalamus

which dopaminergic pathway includes the nucleus accumbens and also mediates addiction and associated behaviors/reinforcing?

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?

hypothalamus

oxytocin suppresses which brain region?

amygdala

hypothalamus area for maternal behavior?

pre-optic

cranial nerve for gag reflex and palete elevation?

vagal nerve

whicch of the following statements regarding the development of the CNS in the first 2 years of life is correct?

motor cortex develops before sensory cortex

which of the following cortical regions is a key component of the salience network?

anterior cingulate gyrus

primary taste cortex in humans is located in which cortical area?

anterior insular

initial learning phase of skilled motor sequence requires the corticostriatal system and what other system?

corticocerebellar

reduced hippocampal volume causes what type of memory impairment?

declarative

histaminergic neurons that regulate sleep originate in which brain nuclei?

tuberomammilary

Pt receives neck manipulation, now has dysarthric speech, gait ataxia, numbness right body, neck pain, dx?

vetebral 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 what 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 here

amygdala and prefrontal cortex

biogenic amine made in locus coeruleus:

norepinephrine

CNS response to fear is mediated by what structure?

centromedial nuclei of amygdala

CNS region containing dopaminergic neurons projecting to caudate and putamen:

substantia nigra

area of brain responsible for facial recognition

fusiform gyrus

area of brain to remember a number to make a phone call

dorsolateral prefrontal cortex

which part of the cortical-striatal-pallidal-thalamic cortical circuit evaluates painful stimuli?

lateral orbitofrontal

which circuit mediates ability to resist responding to aggravating situations with hostility?

orbitofrontal

the dorsolateral prefrontal cortex, striatum, and ___ are part of a loop circuit that produces worry and obsessive symptoms.

thalamus

hyperactivity of the orbitofrontal cortex, basal ganglia, and thalamus is what disorder?

OCD

the blood brain barrier is made up of what kind of cells?

endothelial

dopamine neurons in what system are primarily implicated in tasks related to cognitive processing?

mesocortical

development of brain gray matter volume peaks at what stage?

late childhood

in a patient with hippocampus damage, what allows them to still learn new skills like playing tennis?

basal ganglia

where are stme cells in the hippocampus for adult brains?

subgranular zone

where is the stroke: weakness of right leg, with only minor weakness of the right hand, no weakness of face, no sensory deficit, no speech deficit, patient is unusually quiet and passive

left anterior cerebral artery

which artery is the stroke? hemisensory loss followed by pain and hyperpathia involving all modalities and reaching the midline of the trunk and head

posterior cerebral

which artery is the stroke? right side palsy with equal involvement of the face, arm, and leg, combined with 3rd nerve palsy

posterior cerebral artery

which artery is the stroke? bilateral lower extremity weakness, abulia, mutism, urinary incontinence

anterior cerebral

where is the stroke? pure sensory deficit extending to midline and involving face, arm, trunk, and leg caused by a lacunar infarct where?

lateral thalamus

Blocking right posterior cerebral artery causes which visual disturbance?

left homonymous hemianopsia

the clinical syndrome associated with occlusion of the cortical branch of the posterior cerebral artery would result in which of the following?

homonymous hemianopia with alexia without agraphia

signs of anterior spinal artery infarction

-acute back pain at level of injury -bilateral flaccid para/quadraparesis, -loss of pain and temperature -preservation of proprioception, vibratory sense, fine touch, and 2-pt discrimination -autonomic dysfunction with hypotension, bradycardia, and impaired temperature regulation

intact somatosensory functioning for light touch, pressure, temperature, pain, vibration, and proprioception but patient cannot recognize objects based on touch. what brain region is affected?

posterior parietal lobe

loss of ability to execute previously learned motor activities (which is the result of demonstrable weakness, ataxia, or sensory loss) is associated with lesions of?

left parietal cortex

normal romberg w/ eyes open but loses balance with eyes closed. where is the lesion?

cerebellar vermis

motor speech paradigm activation task on fMRI--hyperactivity in right temporal lobe.

calcarine fissure

aphasia with effortful fragmented, non-fluent, telegraphic speech is seen in a lesion where?

posterior frontal lobe (broca's area)

a pituitary tumor that protrudes through the diaphragmatic sella is most likely to cause?

bitemporal hemianopsia

conduction aphasia often occurs as a result of damage to which structure?

arcuate fasciculus

unilateral hearing loss, vertigo, unsteadiness, falls, headaches, mild facial weakness, and ipsilateral limb ataxia is most commonly associated with at tumor whrere?

cerebellopontine angle

20 yo with 1 year h/o bitemporal headaches, polydipsia, polyuria, and bullimia, + 2 months h/o emotional outbursts aggression, and transient confusion.Where is the tumor?

hypothalamic tumor

personality change with impulsivity is a problem where?

frontal lobe

headaches, peripheral vision loss involving temporal fields of both eyes. where is the mass

sella turcica

unconsciousness can be induced by a small area of damage where?

reticular formation

Acute onset of hemiballismus of LUE and LLE. MRI shows lesion where?

subthalamic nucleus

akinetic mutism can result from bilateral infarctions of which of the following structures?

anterior cingulate gyrus

which lesion causes bilateral coarse nystagmus worsening with visual fixation and present with horizontal and vertical gaze?

brainstem

32 yo patient with 1 month h/ of worsening headaches, episodic mood swings, and occasional hallucinations with visual, tactile, and auditory content. Where is tumor?

temporal lobe

syndrome characterized by fluent speech, preserved comprehension, inability to repeat, w/o associated signs. Location of lesion in the brain?

supramarginal gyrus or insula

lesions in mammillary bodies will have what sx?

amnesia, confabulation, lack of insight

old person with progressive personality changes, dull emotions, lack of initiative, and apathy with show atrophy of what on autopsy?

frontal lobe

optimal positioning of deep brain stimulator for parkinsons?

subthalamic nucleus

optimal position of deep brain stimulator for primary generalized dystonia?

globus pallidus

mesolimbic dopamine pathway includes which structure?

ventral striatum

how do coritcal brain areas connect between the cerebral hemispheres?

commissural fibers (commissure)

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 expressions such as pathological laughter or crying caused by lesions affecting cortical subcortical circuits linking frontal cortex, pons, and what?

cerebellum

exposure to light affects which brain structure?

suprachiasmatic nucleus

what part of the brain makes circadian rhythms?

suprachiasmatic nucleus

when does synaptogenesis peak?

first 4 years of life

why does the brain rapidly increase in size from birth to 2 years old?

synaptogenesis of neurons

where does the neuron morphology in the brain change the most?

prefrontal cortex

threatening objects produce startle response prior to person becoming consciously aware. Connection of thalamus to what?

amygdala

huntingtons disease characterized by loss of neurons producing which neurotransmitter?

GABA

17 yo is evaluated for binge eating associated with a 60lb weight gain over last 4 months. CT shows a craniopharyngioma that likely disrupts what structure?

ventromedial hypothalamus

what is an accurate statement about the brains default mode network?

is involved in reprocessing previously experienced stimuli

the most likely reason that adults are superior to adolescents in abstract thinking is due to the brain undergoing____

synaptic pruning

dorso-lateral-prefrontal cortex plays an important role in which activity?

working memory

drug abuse activates these neuro circuits, generating signals in the ventral tegmental area to where?

dopamine into the nucleus accumbens

95% of R handed people develop L hemispheric dominance for language. What percentage of L handed people develop left hemispheric dominance for language?

75%

neural pathway mediating reactive aggression?

amygdala-hypothalamus-periaqueductal gray

area of frontal cortex activated in Wisconsin Card Sorting Test during shifting of cognitive sets?

dorsolateral

after middle age, what 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

where in the brain are circadian rhythms related to sleep behavior set and maintained?

suprachiasmatic nucleus

what sensation is transmitted through spinothalamic tract?

pain

ability to temporarily store and manipulate information such as in mental arithmetic?

working memory

neural circuit that connects anterolateral orbitofrontal cortex, anterior part of the putamen, and the thalamus is involved in what cognitive function?

affective processing

what type of glial cells form myelin sheaths in the PNS?

schwann

region of the brain most closely associated with cortical processing of faces:

left parietal

this hypothalamic nuclei is key to integration of neural and nutrient signals with 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

Region of the brain connected with the anterior medial frontal cortex during recognition of affective behavior by mirror neuron system:

insula

Corticotropin releasing hormone is released from which brain region during stress?

paraventricular nucleus

individuals with PTSD demonstrated low responses in what structures on functional imaging?

ventromedial prefrontal cortex

thiamine deficiency is associated with changes in what structure?

mammillary bodies

diencephalon is a precursor to which brain structure?

thalamus

poor strategies for solving visuospatial problems such as following illustrations for assembling furniture involves which circuit?

dorsolateral prefrontal circuit

which hypothalamic nuclei affect puberty by pulsatile GnRH secretion?

infundibullar

which of the following is a key part of the default mode network:

medial prefrontal

brains structure implicated in maternal attachment:

amygdala

pathway implicated by tardive dyskinesia

nigrostriatal

corticobulbar fibers run through which part of the internal capsule?

genu

area that contains cell bodies of noradrenergic neurons:

locus coeruleus

PTSD reduces brain volume in this region on MRI

hippocampus

26 yo M with clumsiness, dizziness, headache, difficulty with rapid alternating movements of R hand, and intentional tremor with finger to nose. what area of brain is damaged?

cerebellum

which brain lobe is responsible for initial detection of shape, form, and color?

temporal

dopamine cell bodies are located where?

substantia nigra and ventral tegmental area

prenatal exposure to valproic acid causes deficits in which stages of development of the nervous system?

neurulation

brain region involved in working memory

prefrontal cortex

brain area inhibited in wakefulness

ventral lateral preoptic nucleus

drugs of abuse that lead to addictive behavior activate which dopamine pathways?

mesoaccumbens

what brainstem area causes defensive behavior in response to threat?

dorsal periaqueductal gray

a brain region where adult neurogenesis occurs

lateral ventricle

hyperactive DTRs are a sign of upper or lower motor neuron injury?

upper