Neuroanatomy and Imaging Flashcards

1
Q

The Foramen of Munro connects

A

also known as the interventricular foramen
connection between the third ventricle and the lateral ventricles.

if blocked or effaced, causes reduction in CSF flow from the lateral ventricles despite no associated reduction in CSF production from the choroid plexus.

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2
Q
Question 3.
The ventral tegmental area is located in which part of the brain?
Medulla
Midbrain
Occipital lobe
Pons
Temporal lobe
A

group of dopaminergic cells, origin of the mesolimbic dopamine pathway that is highly significant in reward and sensations of pleasure.

located on the midbrain.

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3
Q

Question 4.

Hippocampus is supplied by

A

The hippocambal arteries mainly arise from posterior cerebral artery
and to a lesser extent from anterior choroidal artery.

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4
Q

What is Papez circuit?

A

The limbic system - James Papez in 1937

Hippocampal formation (Subiculum) → fornix → mammillary bodies →  mammillothalamic tract → 
anterior thalamic nucleus → genu of the internal capsule → cingulate gyrus → Parahippocampal gyrus → 
entorhinal cortex → perforant pathway → hippocampus

Functions:
 Mediating emotional response (amygdalar connections)
 Influencing endocrine autonomic via hypothalamus
 Hippocampus- recalling previously learning
 Reward system regulation via nucleus accumberns
 Motivational circuitry (cingulate and DLPFC)

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5
Q
Question 7.
Which of the following nuclei of basal ganglia contains melanin pigment?
Caudate nucleus
Globus pallidus
Putamen
Substantia nigra
Subthalamic nuclei
A

Substantia nigra appears black because of melanin pigment.

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6
Q

Major components of the basal ganglia

A

= collection of grey matter nuclear masses in the subcortical area.

=caudate nucleus, putamun, globus pallidus

also corpus striatum. control posture and movement

lenticular/lentiform nucleus= putamen and globus
striatum = putamen and caudate

**The subthalamic nuclei and the substantia nigra are both functionally related to the basal ganglia, but are NOT considered to be part of that structure.

The nucleus accumbens (located where the head of the caudate and the anterior portion of the putamen meet just lateral to the septum pellucidum) and the olfactory tubercle collectively form the VENTRAL STRIATUM,, which is part of the basal ganglia.

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7
Q

Five important circuits are described ( Alexander) and functions

A
motor
oculomotor
DLFC (executive)
Anterior cingulate circuit (motivation) 
Lateral orbitofrontal circuit (social intelligence)
  1. planning movement
  2. abstract thought to action
  3. cognitive processes (caudate)
  4. Lesions of the caudate disrupt performance on tests involving object reversal and delayed alternation.
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8
Q

Prosencephalon  differentiates into the

A

Telencephalon (cerebrum, striatum and pallidum)

Diencephalon (thalamus, subthalamus, hypothalamus
and epithalamus= habenacular nucleus and pineal gland)

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9
Q

Mesencephalon (midbrain)

A

Tectum - corpora quadrigemina, made up of the superior and inferior colliculi

Basis pedunculi

Tegmentum containing the red nucleus + periaqueductal grey matter.

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10
Q

Rhombencephalon  differentiates into

A

Metencephalon - pons, rostral medulla (oral part) and
cerebellum.

Myelencephalon – caudal part medulla oblongata.

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11
Q

The internal capsule is supplied by the;

A

Internal capsule contains traversing corticospinal tract and receives blood supply from different parts of the circle of Willis.

The anterior limb is supplied by lenticulostriate branches of middle cerebral artery (superior half) & recurrent artery of Heubner off of the anterior cerebral artery (inferior half).

The genu receives supply from lenticulostriate branches of middle cerebral artery,
posterior limb is supplied by the lenticulostriate branches of middle cerebral artery (superior half) &
anterior choroidal artery off of the internal carotid artery (inferior half).

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12
Q
Question 11.
Which structure separates the two lateral ventricles in human brain?
Aqueduct of sylvius
Corpus callosum
Pons
Septum pallidum
Septum pellucidum
A

The body of the lateral ventricle lies immediately below the corpus callosum and they are separated by septum pellucidum.

An anomalous splitting of the septum pellucidum may be more common in schizophrenia than in general population (cavum septum pellucidum).

The third ventricle lies between thalamus and hypothalamus.

The fourth ventricle lies above the pons and just below the cerebellum. The Aqueduct of Sylvius links the third and fourth ventricles.

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13
Q

Circulation of CSF

A
  1. From lateral ventricle to 3rd ventricle- via Interventricular foramina of monro
  2. From 3rd to 4th Ventricle- via cerebral aqueduct of sylvius
  3. From 4th ventricle to subarachnoid space-via Foramen of Magendie (single medial) and Foramen of Luschka (two, lateral foramina)
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14
Q
Question 14.
Which one of the following structures is involved in the visual pathway?
Heschl's gyrus
Inferior Colliculus
Lateral geniculate body
Medical geniculate body
Tegmentum
A

The medial fibres of the optic nerve cross in the optic chiasma to join the contralateral optic tract. The lateral fibres of the optic nerve pass through the ipsilateral optic tract.

The fibres synapse in the lateral geniculate body of the thalamus.

From here the optic radiation runs within the posterior part of the internal capsule and terminates in the visual cortex.

Myers loop (damage leads to temporal HH) is part of the optic radiation, which loops anteriorly from the lateral geniculate ganglion into the temporal lobe before travelling posteriorly in the occipital cortex

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15
Q

Forced utilization behaviour

A

If the frontal lobe superior to the eye (orbitofrontal) is damaged, forced utilization can be seen. Here when objects are placed in front of the subject, an object will be picked up and used appropriately, even when the subject is told not to do so.

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16
Q
Question 18.
In what percentage of left-handed people is the left hemisphere dominant?
0.1
0.16
0.2
0.64
0.9
A

dominant hemisphere mediates language and speech functions.

10% of right-handed people the right hemisphere is dominant.

In left handed people only about 20% are right hemisphere dominant as expected, with 64% left hemisphere dominant and 16% showing bilateral dominance.

Generally, apraxia results from dysfunction in the dominant hemisphere and
agnosia results from dysfunction in the non-dominant hemisphere.

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17
Q

Movement disorders and their leisions:

A

Lesions in the corpus striatum are associated with dystonia, athetosis and chorea.

Lesions in the sub thalamic nucleus:
Hemiballismus.

Lesions in the substantia nigra: Parkinson’s disease.

18
Q

R vs L hemisphere leisions:

A
Left hemisphere lesions may produce 
alexia, agraphia, acalculia, 
colour anomia without aphasia, 
Broca's aphasia, Wernicke's aphasia 
Gerstmann syndrome. 

Right hemisphere lesions may produce
constructional apraxia,
Prospagnosia, Autotopagnosia,
Visual spatial Agnosia (visualpercep), anosognosia (insight)
receptive amusia, and contralateral neglect.

19
Q

where are the primary sensory and motor areas located?

A

Brodmann areas 3, 1 and 2 comprise the primary somatosensory cortex of the human brain (or S1) - most of which is located on postcentral gyrus.

Lesions affecting the primary somatosensory cortex produce characteristic symptoms including: agraphesthesia, astereognosia, loss of vibration, proprioception and fine touch.

The primary motor cortex (or M1) is a brain region that in humans is located in the posterior portion of the frontal lobe. It works in association with pre-motor areas to plan and execute movements. M1 is located on precentral gyrus.

20
Q

2 parts of hypothalamus feeding functions

A

Ventromedial hypothalamus acts as satiety centre;
leision–> hyperphagia, obesity in animals

lateral hypothalamus as feeding centre.

21
Q

Question 28.

Which artery supplies most part of the corpus callosum?

A

Infarcts of the corpus callosum are not common due likely to a rich blood supply from the main arterial systems, specifically the anterior cerebral and anterior communicating, but also from posterior cerebral arteries.

22
Q

Which sides account for verbal memory and pictorial memory?

A

Disorders of verbal and of pictorial memory are commonly dissociated by brain injury with verbal memory being affected in left and picture memory predominantly by right brain injury;

However, this is disputed as many subjects use verbal encoding when remembering pictures.

23
Q

function of angular gyrus?

A

inferior parietal lobe of the brain that is involved in the processing of auditory and visual input and in the comprehension of language.

is Brodmann area 39

Lesions are associated with anomia.

24
Q

What are mirror neurons and where are they found

A

Brain imaging experiments using functional magnetic resonance imaging (fMRI) have shown that the human inferior frontal cortex and superior parietal lobe is active

when the person performs an action and also when the person sees another individual performing an action.

It has been suggested that these brain regions contain mirror neurons, and they have been defined as the human mirror neuron system. Mirror neurons help us to understand why we contantly ‘act-out’ and imitate activity that we are observing.

25
Q

difference between Non comm hydrocep and comm hydrocep

A

The commonest site of block in non-communicating hydrocephalus is foramen of Monroe. Other sites include;
Third ventricle, Aqueduct of Sylvius,
Fourth ventricle, Foramen of Luschka and Foramen of Magendie.

Impaired CSF absorption may cause communicating hydrocephalus. The apparent mechanism is partial occlusion of the arachnoid villi in this case.

26
Q

OCD is associated with abnormality in which part of the brain?

A

Putamen and globus pallidus together form the lenticular/lentiform nuclei.

Neuroimaging studies with PET scan suggest the involvement of both caudate (change in volumes and higher blood flow) and lentiform nuclei dysfunction in patients with OCD.

27
Q

anterograde amnesia…where is the leision

A

The regions involved are certain sites in the temporal cortex, especially in the hippocampus and nearby subcortical regions.

28
Q

Alzheimer’s disease where is affected first?

A

temporal lobes, especially the hippocampal areas in them, are affected early in Alzheimer’s disease.

Medial temporal lobe atrophy and loss of hippocambal volume is one of the earliest findings seen in patients with Alzheimer’s disease.

29
Q

Huntington’s disease is caused due to degeneration of

A

Huntington’s disease is caused due to degeneration of the striatum (mainly caudate nucleus) and selective loss of GABA-ergic neurons.

30
Q

Localisation:

Tourettes

Wilsons

CO poisoning

Farhs disease

A
  1. striatal dopaminergic dysfunction
  2. deposits in lenticular nuclei = pp
  3. Basal ganglia
  4. calcium deposition in BG
    early onset- schizophreniform and catatonic
    late- dementia and choreoathetosish
31
Q

Frontal lobe leisions

unilateral

right

left

bilateral

A

Effects of unilateral frontal disease, either left or right
A. Contralateral spastic hemiplegia
B. Slight elevation of mood, increased talkativeness, tendency to joke, loss of initiative
C. If entirely prefrontal, no hemiplegia; grasp and suck reflexes or instinctive
grasping may be released
D. Anosmia with involvement of orbital parts

II. Effects of right frontal disease
A. Left hemiplegia
B. Changes as in I.B, C, and D

III. Effects of left frontal disease
A. Right hemiplegia
B. Motor speech disorder with agraphia, with or without oro-buccal apraxia
C. Sympathetic apraxia of left hand
D. Loss of verbal associative fluency; perseveration
E. Changes as in I.B, C, and D

IV. Effects of bifrontal disease
A. Bilateral hemiplegia
B. Spastic bulbar (pseudobulbar) palsy
C. If prefrontal, abulia or akinetic mutism, attention and solve complex problems, rigidity of thinking, bland affect, nticipate, labile mood, and varying combinations of grasping, sucking, obligate imitative movements, utilization behavior.

D. Decomposition of gait and sphincter incontinence

32
Q

Temporal lobe leision

unilateral

right

left

bilateral

A

Effects of unilateral disease of the dominant temporal lobe
A. Homonymous upper quadrantanopia
B. Wernicke’s aphasia (word-deafness—auditory verbal agnosia)
C. Amusia (some types)
D. Impairment in tests of verbal material presented through the auditory sense
E. Dysnomia
F. Visual agnosia
G. Occasionally amnesic (Korsakoff) syndrome

II. Effects of unilateral disease of the nondominant temporal lobe
A. Homonymous upper quadrantanopia
B. judge spatial relationships
C. Impairment of visually presented nonverbal material
D. Agnosia for sounds and some music

III. Effects of disease of either temporal lobe
A. Auditory, visual, olfactory, and gustatory hallucinations
B. Dreamy states with uncinate seizures
C. Emotional and behavioural changes
D. time perception

IV. Effects of bilateral disease
A. Korsakoff amnesic defect (hippocampal formations)
B. Apathy and placidity
C. Hypermetamorphopsia (compulsion to attend to all visual stimuli), hyperorality, hypersexuality, blunted emotional reactivity (Kluver-Bucy syndrome; the full syndrome is rarely seen in humans)

33
Q

Parietal leisons

unilateral

left

bilateral

A

I. Effects of unilateral disease of the parietal lobe,
A. Corticosensory syndrome and sensory extinction
B. Mild hemiparesis
C. Homonymous hemianopia or inferior quadrantanopia (incongruent or congruent) or visual inattention
D. Neglect of the opposite side of external space (more prominent with right parietal lobe)

II. Effects of unilateral disease of the dominant (left) parietal lobe (in right-handed and most left-handed patients)—additional phenomena include
A. Disorders of language (especially alexia)
B. Gerstmann syndrome (dysgraphia, dyscalculia, finger agnosia, right-left confusion)
C. Tactile agnosia (bimanual astereognosis)
D. Bilateral ideomotor and ideational apraxia

III. Effects of unilateral disease of the nondominant (right) parietal lobe
A. Visuospatial disorders
B. Topographic memory loss
C. Anosognosia, dressing and constructional apraxias more frequently and greater severity with non-dom)
IV. Effects of bilateral disease of the parietal lobes
A. Visual spatial imperception, spatial disorientation, and complete or partial Balint syndrome (parieto-occipital) =

simltagnosia, oculomotor apraxia, optic ataxia

34
Q

Occipital leisions

unilateral

left/right

bilateral

A

OCCIPITAL LESIONS:
I. Effects of unilateral disease
A. Contralateral (congruent) homonymous hemianopia, which may be central (splitting the macula) or peripheral; also homonymous hemiachromatopsia
B. Elementary hallucinations—usually due to irritative lesions

II. Effects of left occipital disease
A. Right homonymous hemianopia
B. If deep white matter or splenium of corpus callosum is involved, alexia and color-naming defect
C. object agnosia

III. Effects of right occipital disease
A. Left homonymous hemianopia
B. With more extensive lesions, visual illusions (metamorphopsias) and hallucinations (more right sided than left-sided)
C. Loss of topographic memory and visual orientation

IV. Bilateral occipital disease
A. Cortical blindness (pupils reactive)
B. Anton syndrome (visual anosognosia, denial of cortical blindness)
C. Loss of perception of color (achromatopsia)
D. Prosopagnosia (temporo-occipital), simultanagnosia (parieto-occipital)
E. Balint syndrome (parieto-occipital)

35
Q

testing dominance

A

annettes handedness scale and edinburgh handedness inventory.

36
Q

dostoevskys epilepsy

A

ecstatic content in aura

37
Q

geschwind syndrome

A

personality change in epilepsy
hypergraphia, religiousness
circumstantiality
hyposexuality

38
Q

Olivary nucleus

A

iferior olive axons–> infe cerebellar peduncle –>contralateral

damage- appendicular ataxia. test finger nose test. in contralateral limb

39
Q

lateral medullary syndrome

A

PICA thrombosis
wallenbergs synd
= brain stem infarction–> vertigo and cerebellar signs

contra- spinothalmic sensory loss and hemiparesis
ipsi- facian numb, diplopia, nystag, ataxia, horners, 9-10CN leision

40
Q

FLAIR

A

fluid attenuated inversion recovery

T1 inverted and added to T2
double contrast
useful for sclerosis of hippo (TLE)
and for localising abnormal metabolism in degen neuro