Neuroanatomy

Question 1

What is the clivus?

Answer 1

Bone where pons rests against

Question 2

Blockage of internal carotid causes what?

Answer 2

weakness and loss of sensation- supplies anterior portion of brain

Question 3

Blockage of vertebral artery causes what?

Answer 3

Vision, balance, brainstem lesions

Question 4

What sinus can be involved in ear infections?

Answer 4

Transverse sinus

Question 5

What sinus is the easiest way for infections to spread to the brain? Why?

Answer 5

Cavernous sinus- venous blood drains from face and eye into it

Question 6

What sinus drains CSF?

Answer 6

Superior saggital sinus

Question 7

What arteries supply the internal capsule?

Answer 7

Choroidal and striate- if occluded can cause major deficits

Question 8

What is the difference between cerebellar and cerebral lesions?

Answer 8

Cerebellar typically produce ipsilateral effects- pathways do not cross over (ex spinocerebellar)
Cerebral typically produce contralateral effects

Question 9

Where does tertiary syphilis typically affect? What does it cause?

Answer 9

Posterior columns- causes proprioceptive and pain loss

Question 10

Where does pernicious anemia affect? Causes?

Answer 10

Posterior columns causing proprioceptive loss and corticospinal tract- causing UMN lesions

Question 11

Where does ALS affect? Causes?

Answer 11

Anterior horn cells causing LMN and corticospinal tracts causing UMN

Question 12

Where does Guillain Barre affect? Causes?

Answer 12

Peripheral nerves- causes sensory and LMN lesion

Question 13

What syndrome looks like Parkinson’s but has autonomic instability (fainting, loss of bladder control, impotence)?

Answer 13

Shy-Drager syndrome or multiple system atrophy

Question 14

Lesion to angular gyrus

Answer 14

Causes alexia and agraphia

Question 15

Lesion to supra marginal gyrus

Answer 15

Tactile and proprioceptive agnosia- confusion of left to right discrimination

Question 16

Basal nucleus of Meynert

Answer 16

Dementia in Alzheimer’s

Question 17

Find the lesion: left sided weakness and decrease in all sensation in leg, hyperreflexia

Answer 17

Right ACA

Question 18

Find the lesion: Left weakness and decrease in sensation in arm and face, hyperreflexia

Answer 18

Right MCA

Question 19

Find the lesion: Bilateral muscle atrophy, fasciculations, and hyperreflexia in arms legs and face

Answer 19

ALS

Question 20

Find the lesion: bilateral weakness, hyporeflexia, and decreased sensation in hands and feet

Answer 20

Peripheral neuropathy- think diabetes or alcoholism

Question 21

Find the lesion: bilateral decreased proprioception and sharp pains in legs and positive Romberg sign

Answer 21

Tertiary syphilis- lesion in posterior columns of white matter
Look for argyll Robertson pupil- accommodates but does not react

Question 22

Find the lesion: bilateral spastic paralysis, decreased proprioception, hyperreflexia, decreased pain and temp sensation in legs

Answer 22

Hemisection of spinal cord at T11- Brown sequard

Question 23

Find the lesion: R arm radicular pain, more lateral

Answer 23

Cervical roots C5-6

Question 24

Find the lesion: bilateral decreased pain and temp sensation on trunk and arms with muscle atrophy in hands. Light touch and proprioception intact

Answer 24

Syringomyelia- demyelination affecting crossing pain and temp fibers

Question 25

Find the lesion: bilateral spastic paralysis and loss of all sensation and hyperreflexia in legs

Answer 25

Total transaction of spinal cord

Question 26

Find the lesion: bilateral loss of proprioception, paresis, hyperreflexia, and babinski's sign in legs.

Answer 26

Pernicious anemia- lesions of posterior columns and corticospinal tract

Question 27

Find the lesion: bilateral acute flaccid paralysis and loss of all sensation in legs

Answer 27

Guillain Barre

Question 28

Find the lesion: unilateral paralysis, muscle atrophy and hyporeflexia of L leg

Answer 28

Polio

Question 29

Find the lesion: unilateral weakness of elbow and wrist extension, numbness of dorsum of hand, decreased triceps reflex

Answer 29

Radial nerve

Question 30

Find the lesion: unilateral weakness of wrist flexion, thumb opposition, atrophy of the air eminence, pain along fingers

Answer 30

Median nerve above wrist! Carpal tunnel does not affect wrist flexion

Question 31

Find the lesion: unilateral claw hand, numbness of pinky, atrophy of pinky

Answer 31

Ulnar nerve

Question 32

Find the lesion: decreased sensation in buttocks, atrophy, and impotence

Answer 32

Caudal equina syndrome - S2-4

Question 33

Find the lesion: Right sided spastic paralysis, hyperreflexia, decreased proprioception. Left sided tongue weakness and atrophy

Answer 33

Left medulla- left medial lemniscus, left pyramid, left CN XII

Question 34

Find the lesion: Right decreased taste and pain/temp in face, ataxia. L sided decreased pain/temp below face. Hoarseness and difficulty swallowing

Answer 34

PICA syndrome- spinocerebellar tract--> ataxia Right Spinothalamic tract and nucleus of right CNV--> loss of left extremity pain/temp and loss of facial pain/temp Hoarseness and difficulty swallowing- R nucleus ambiguus Decreased taste- R nucleus solitarius

Question 35

Find the lesion: L spastic paralysis and decreased proprioception in arms and legs. Right facial paralysis and eye cannot abduct

Answer 35

Right caudal pons- corticospinal tract, CNVI, right medial Lemniscus (proprioception), CN7(facial paralysis)

Question 36

Find the lesion: Right foot drop, weakness, and numbness

Answer 36

Common peroneal nerve

Question 37

Find the lesion: Right decreased vision, babinski's sign. Left facial weakness. Ataxia, nystagmus, inter nuclear opthalmoplegia

Answer 37

MS- no single lesion possible!!!

Question 38

Find the lesion: Right masseter weakness, facial anesthesia. Left arm, leg weakness

Answer 38

Right pons- CN5, CN7, corticospinal tract

Question 39

Find the lesion: Left ptosis, dilated pupil, difficulty addicting eye. Right lower facial paralysis and spastic paralysis of arms and legs.

Answer 39

Left midbrain