Neuroanatomy Flashcards
what cell layer forms primitive nervous system?
ectoderm
cells from which part of primitive nervous system form melanocytes, odontoblasts, and Schwann cells?
Neural crest
What folds and forms to form neural tube and neural crest?
neuroepithelium folds and fuses
When does neural tube close in development?
Anterior vs posterior and dz caused
4 weeks.
Anterior first at day 25 (failure encephalocele, anencephaly)
Posterior at day 27 (failure: Myelo)
Anterior closes then posterior closes
What induces ectoderm to form primitive nervous system?
notochord
Prosencephalon forms what? which in turn forms what?
telencephalon and diencephalon
- telencephalon then forms hemispheres and lateral ventricles
- diencephalon then forms thalamus and 3rd vent
Mesencephalon forms what which in turn forms what?
mensencephalon (itself) to form midbrain and aqueduct
Rhombencephalon forms what which in turn forms what?
Metencephalon and Myelencephalon which form:
Metencephalon: pons, cerebellum, upper 4th vent
Myelencephalon: medulla and lower 4th vent
How many neurons and glial cells *(name three types) in general?
neurons: 15 billion
Glial cells: 50 billion: oligodendrocytes, astrocytes, microglia
what makes up allocortex and what does it form?
Archicortex –> 3 layered hippocampus
Paleocortex –> olfactory cortex
Name 6 cortex layers in neocortex
Molecular External granular External pyramidal Internal granular Internal pyramidal Polymorphic
role of astrocytes (4) and what they use for these
- anchors neurons to vessels
- vasoregulation via arachidonic acid
- removes K+ and nts from synaptic cleft
- modulates conduction by propagating calcium waves and releasing calcium
Role of oligodendrocytes
myelin production for saltatory conduction
What are the CNS immune cells?
microglia
Components of BBB?
tight junctions of vascular epithelial cells
Basement membrane
where is the operculum?
portion of inferior frontal gyrus: Broca’s
What is Gerstmann syndrome and where is the lesion?
- r/l confusion
- finger agnosia
- agraphia
- acalculia
DOMINANT parietal
Right way eyes:
seizure vs stroke
Eyes point to lesion in stroke and away from lesion in seizure
Applies to frontal eye fields only
(think of paddling ore and which way boat turns)
Damage to what frontal area causes executive function deficits?
dorsolateral frontal cortex
what area of frontal lobe causes akinetic mutism?
supplemental motor area and anterior cingulate gyrus
what area of frontal lobe causes disinhibition?
orbitofrontal
Visual WHERE system is in what lobe?
parietal lobe: spatial body and environment map
what causes constructional apraxia, dressing apraxia, anosognosia (denial of deficits)
Non dominant parietal
What is Balint’s and what causes it?
- optic ataxia: can’t guide hand to spot in space visually
- oculomotor apraxia: can’t direct eyes in space
- simultagnosia
B/l parieto-occipital damage
what is responsible for visual “what”
ventral pathway visual recognition in the temporal lobe
what causes prosopagnosia?
temporal lobe damage
what syndrome and what causes:
hyperphagia, hypersexuality, visual agnosia
Kluver bucy: bilateral temporal lobe damage
Where is the olfactory cortex?
When you get anosmia, what should you think about?
dementia, affects temporal lobes so may be presenting sign
What is Anton syndrome and what causes it?
cortical blindness w/ denial and confabulation caused by bilateral occipital lobe damage
what causes alexia without agraphia
lesion of left occipital lobe and splenium of corpus callosum.
Visual input can’t reach the left language center, but motor can reach it so can write (disconnection syndrome)
What is Foster Kennedy syndrome? What causes it?
Classic presentation of frontal lobe tumor
- compression of one optic nerve w/ VF loss
- compressed CN1: ipsilat anosmia
- incr ICP so papilledema in opposite eye
5 part path of olfactory nerve?
receptor –> bulb –> tract –> cortex –> amygdala
periphery of CN 3 carries what fibers?
the parasympathetics, so with compression, iris sphincter and ciliary muscle are impaired first: blown pupil!
Edinger Westphal nucleus is for what?
CN 3 parasympathetics: pupil constriction (miosis)
CN in back of midbrain?
trochlear CN 4
CN 4 and 6 makes eyes looks where
4: to nose (SO4)
6: to ears (LR6)
most common isolated nerve palsy?
CN 6 due to very long course
pupil sparing CN 3 palsy is likely what?
diabetic, atherosclerotic, vasculitic (inner fibers first damaged)
What is Mobius syndrome?
underdevelopment of CN VI and VII causing facial and eye paralysis
What is Duane syndrome?
congenital absence of CN VI
Localize: 3rd nerve palsy and contralat hemiparesis
Midbrain infarct: gets CN3 and CST in cerebral peduncle
In CN 4 palsy, explain head tilt
down (chin tucked) and away from lesion to abduct affected eye
Localize: CN 6 palsy with contralat hemiparesis
Pontine infarct: gets CN 6 and CST passing through
Horners: PNS or SNS
Fibers travel with what?
SNS!!! Sympathetic NS! fibers travel with ICA
Parasympathetic does what to eyes?
constricts: causes miosis
What is light-near dissociation?
What is the syndrome and what causes it?
accomodate but don’t react to light (Argyll Robertson)
-neurosyphilis
What is Adie’s myotonic pupil?
Mid-dilated pupil poorly reactive to light caused by degeneration of ciliary ganglion or post-ganglionic neurons
What is Parinaud’s (4)? What causes it?
- sunsetting (upgaze paralysis)
- light-near dissoc
- convergence-retraction nystagmus
- eyelid retraction (Colliers)
Dorsal midbrain syndrome
What is the ciliospinal reflex?
pinching side of neck causes ipsilat sympathetic activation –> pupil dilation
Horners? (3)
- anhidrosis
- miosis (small pupil)
- ptosis
what causes hypo-acusis?
Lesion of V3 (tensor tympani)
Which way does jaw deviation go in lateral pterygoid (CN 5) weakness?
jaw deviates to weak side
what causes hyperacusis?
stapedius muscle weakness (CN VII)
Auditory 4 step pathway?
- receptors to cochlear nerve to cochlear nuclei (ventral and dorsal)
- inferior olivary nuclear complex
- inferior colliculi
- medial geniculate body
What is MLF important for?
for vestibulo ocular reflex
cold calorics rule?
COWS: cold pushes eyes to opposite side with fast nystagmus away
Warm pushes eyes to same side with fast nystagmus toward
Sensation of external ear and auditory meatus?
CN IX
Taste posterior 1/3 tongue
CN IX
Ipsilateral scapular winging and can’t turn head to opposite side?
Trapezius and SCM weakness from CN XI lesion
The only facial nuclei that when hit will cause a paralysis instead of weakness (not bilaterally innervated)
Hypoglossal and facial
What is in the cavernous sinus?
3, 4, 5 (V1 and V1), 6, and Carotid artery
what CN is not in the WALL but the lumen of the cavernous sinus?
6 - not protected
What is talosa hunt?
granulomatous inflammation of cavernous sinus OR superior orbital fissure
What makes up the striatum?
caudate and Putamen
4 components of PD
Pathophys?
TRAP: 1. Tremor, 2. rigidity, 3. Akinesia (bradykinesia), 4. postural instability
Loss of DA in substantia nigra
Pathophys of Huntington?
caudate degeneration
Pathophys of hemiballismus?
Subthalamic nucleus damage
What are the interposed nuclei? Where are they?
The emboliform and globose cerebellar nuclei:
Location is lateral to medial: DEGF (DIF): Dentate, Interposed, Fastigial
Which nucleus in cerebellum is involved in motor planning, timing, cognition?
Dentate: most lateral w/ lateral hemispheres
Type of tremor with cerebellar lesion?
intention overflow tremor
Sensory Dorsal Column: What two sections and which is more medial?
Cuneate (lateral)
Gracile (medial)
Dorsal column pathway and spinothalamic pathway synapse where in the thalamus?
VPL
TAbes dorsalis from what and what does in effect?
syphilis
Posterior columns
Subacute combined degeneration - from what and what does it affect?
Vit B12 def, affects lateral CST AND posterior columns: motor and sensory
Ventral artery occlusion spares what part of the SC?
posterior columns
Anterior vs posterior hypothalamus and autonomic functions?
Anterior: parasympathetic: excitatory
Posterior: sympathetic: excitatory
Trigeminothalamic input and taste relay to what thalamic nuclei?
VPM
LGN vs MGN of thalamus?
LGN: visual
MGN: auditory
VL nucleus of thalamus is for what? Projections and purpose?
Cerebellum and BG input to motor/supplementary motor for smooth precise movements
VA thalamic nucleus is for what?
Input from GP and SN to prefrontal and premotor cortex
What is pulvinar for in thalamus?
integrates visual, auditory, somatosensory input
What is Dorsomedial thalamic nuclei for?
limbic, affected in Wernicke Korsakoff
What is anterior thalamic nuclei for?
hypothalamic input to cingulate and to limbic (emotion)
Centromedian thalamic nuclei is for what?
basal ganglia relay to cortex
Relationship between dopamine and prolactin?
dopamine inhibits prolactin
What does somatostatin do?
inhibition of GH and TSH release from hypothal to pituitary
What makes up the choroid plexus?
invagination of vascular pia and ependymal cells
CSF flow path:
Lateral ventricles Foramen of monro 3rd V aqueduct 4th v Foramen of Magendie (medial) and Luschka (lateral) subarachnoid space arachnoid granulations --> dural sinus
CSF volume
CSF pressure
CSF production
volume: about 200mL
Pressure: 100-180 supine, to 300 sitting
Production: 12-40cc/hr
Name the 4 herniation syndromes:
- cingulate (subfalcine)
- Central from b/l uncal
- transtentorial w/ posterior fossa
- cerebellar tonsillar
subdural hemorrhage from?
bridging veins
What is arterial supply of basal ganglia?
Anterior choroidal off of the ICA
Nerve for sensation of posterior cutaneous nerve of arm/forearm and dorsum of first three digits?
Radial
SNS and PNS for penile erection/ejaculation
Erection: PNS
Ejaculation: SNS
GEneral rules about CN and brainstem part:
Midbrain
Pons
Medulla
MB: 1-4
Pons: 5-8
Medulla: 9-12
muscle and nerve responsible for the first 15 degrees of shoulder abduction and the rest of the abduction
supraspinatus nerve innervates suprascapular muscle : C5 and C6
Deltoids then take over