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(PA school) Neuroanatomy > Quiz 1 > Flashcards

Quiz 1 Flashcards

Some quiz 1 learning objectives + Cassidy's practice Qs

1
Q

Lesions of thalami, or large lesions in the hemispheres above the brainstem can impair consciousness indirectly due to what?

A

Mass effect (putting pressure on brainstem)

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2
Q

What is the area between the midbrain and the pons called?

A

Isthmus

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3
Q

Rupture of a berry aneurysm would most likely cause what kind of injury?

A

Subarachnoid hemorrhage

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4
Q

A subdural hematoma is typically caused by a rupture of what?

A

Bridging veins

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5
Q

A posterior communicating aneurysm can cause what?

A

CN III palsy

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6
Q

85% of Berry aneurysms occur in the __________ circulation

A

anterior

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7
Q

True or false? All information passed between cerebral hemispheres and the spinal cords pass through the brainstem.

A

True

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8
Q

Some of the nuclei in what part of the brain contain neurotransmitters?

A

Brainstem

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9
Q

The back of the brain (where the cerebellum sits) is directionally called what (compared to the rest of the brain)?

A

Caudal

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10
Q

What is the name of the fold between the frontal and parietal lobes?

A

Central sulcus

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11
Q

What is the common excitatory NT in the CNS?

A

Glutamate

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12
Q

What is the significance of GABA?

A

Most common inhibitory NT in the CNS

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13
Q

True or false: histamine, norepinephrine, dopamine, serotonin are all NTs

A

True

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14
Q

True or false: gray matter has local synaptic communications between neurons, white matter is over long distances

A

True

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15
Q

The cerebral cortex is made up of _________ matter and wraps around the cerebral hemispheres

A

Gray

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16
Q

Why does the spinal cord end at L-1, L-2?

A

Bony canal (vertebra) lengthen faster than spinal cord during development.

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17
Q

What condition can be caused by disk herniation, tumors, trauma, epidural abscess below the L1, L2 area?

A

Cauda equina syndrome

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18
Q

What separates the temporal lobe from the frontal lobe?

A

The Sylvian (or lateral) fissure (a deep sulcus)

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19
Q

What divides the motor and sensory cortex?

A

Central sulcus

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20
Q

Where is the primary somatosensory cortex located?

A

Postcentral gyrus

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21
Q

The bumps or ridges in between the sulci are called _________

A

gyri

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22
Q

What lies in precentral gyrus in the frontal lobe?

A

Primary motor cortex

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23
Q

Where is the primary auditory cortex?

A

Transverse gyri of Heschl
(this is 2 fingerlike gyri inside the Sylvian fissure)

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24
Q

The right visual cortex innervates which visual field?

A

Left half of each eye

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25
Q

Lesions above the pyramidal decussation would mostly cause weakness where?

A

Contralaterally

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26
Q

The ______________________ cortex is less lateralized and input from opposite side is slightly stronger, but not clinically detectable

A

primary auditory

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27
Q

_______________________ is the most important motor pathway

A

Corticospinal tract/ “pyramidal tract”

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28
Q

Pyramidal decussation occurs at junction of __________ and spinal cord

A

medulla

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29
Q

The 2 main spinal cord sensory pathways are called what?

A

1) Posterior column pathway
2) Anterolateral pathway

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30
Q

What project from the cortex down to the spinal cord or brainstem?

A

Upper motor neurons

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31
Q

Ataxia, the loss of balance and coordination, can be caused by lesions where?

A

Cerebellum

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32
Q

What is the somatosensory pathway that conveys proprioception, vibration sense, and fine touch?

A

Posterior column pathway

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33
Q

True or false: your ability to sense things would be completely eliminated if the posterior column pathway was severed. Explain your answer.

A

False; anterior column pathway would still be working

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34
Q

Which somatosensory pathway detects when you have really hot coffee spilled on you? Explain why.

A

Anterolateral pathway; it conveys pain, temperature, and crude touch

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35
Q

Which is the only sensory pathway to not go through the thalamus relay center? Why?

A

Olfaction; goes directly to olfactory cortex

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36
Q

What pathway crosses over immediately?

A

Anterolateral

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37
Q

What is located in the center of the brain and receives information about light and dark and secrets melatonin as needed?

A

Pineal gland

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38
Q

True or false? Wernicke’s area is located in the dominant hemisphere area of the brain (usually left) and processes higher order information.

A

True

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39
Q

What controls autonomic functions and the limbic system, among many other things?

A

Hypothalamus

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40
Q

What causes receptive aphasia?

A

Damage to Wernicke’s area

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41
Q

What type of aphasia can damage to Broca’s area cause?

A

Expressive or motor aphasia

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42
Q

What may cause a patient to ignore objects, or even their own body parts, to one side? What is this phenomenon called?

A

Right parietal lesions; hemineglect

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43
Q

Lesions to what area may cause a patient to experience problems with personality (like lack of judgement, inappropriate joking, inhibition) and cognition?

A

Frontal lobe

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44
Q

What may cause inability to recognize faces, colors, or persistence or reappearance of an earlier viewed object?

A

Lesions in the visual cortex (of parieto-occipital lobe)

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45
Q

Seizures in what part of the brain may cause visual hallucinations?

A

Visual cortex (of parieto-occipital lobe)

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46
Q

What arteries directly supply the brain?

A

Internal carotid and vertebral arteries

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47
Q

What forms the basilar artery?

A

The vertebral arteries joining

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48
Q

What supplies the posterior of the brain?

A

Basilar artery

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49
Q

What supplies the anterior of the brain?

A

Internal carotid arteries

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50
Q

The _________________ vein returns the brain’s blood

A

internal jugular

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51
Q

Where does the middle meningeal artery run?

A

Epidural space

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52
Q

List the flow of CSF in order (7 steps)

A

1) Lateral ventricles
2) Foramen of Monro
3) Third ventricle
4) Sylvian aqueduct
5) Fourth ventricle
6) Foramen of Luschka and Magendie
7) Subarachnoid space

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53
Q

Bridging veins are found where?

A

Subdural space

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54
Q

What ventricle is in the diencephalon?

A

3rd ventricle

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55
Q

What ventricle is surrounded by the pons, medulla and cerebellum?

A

Fourth

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56
Q

Normal volume of CSF in an adult is _____cc, the choroid plexi produce about _______ cc/d

A

150cc; 500 cc/d

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57
Q

What houses the cauda equina?

A

Lumbar cistern

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58
Q

What tract controls voluntary movement of distal muscles (hands and limbs) and is involved in fine motor skills?

A

The lateral motor system, aka lateral corticospinal tract

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59
Q

If there’s a lesion in the lateral corticospinal tract of the brain, what would happen?

A

Contralateral hemiparesis, particularly affecting fine motor control

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60
Q

What two tracts originate in the primary motor cortex?

A

Lateral corticospinal tract and anterior corticospinal tract

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61
Q

What are the two divisions of the motor system’s tract?

A

Lateral (lateral corticospinal tract) and medial (anterior corticospinal tract)

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62
Q

Damage of what part of the motor system leads to issues of the trunk like gait disturbances, difficulty maintaining upright posture, or gross motor movement difficulties in Parkinson’s?

A

Medial motor system

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63
Q

What tract controls bending, twisting, and movements of the trunk?

A

Anterior corticospinal tract

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64
Q

What 3 things control the sympathetic and parasympathetic nervous systems?

A

Hypothalamus, brainstem, and amygdala

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65
Q

What can dysfunctions in the ANS lead to?

A

Autonomic neuropathies (nerve disorders) in the axon, myelin sheath, or both.

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66
Q

Neuropathy affecting spinal nerve roots is called _____________

A

radiculopathy

67
Q

1) Burning, tingling pain, that often radiates down a limb or dermatome is called what?
2) What causes this?
3) What is that cause often secondary to?

A

1) Radiculopathy
2) ANS neuropathy affecting spinal nerve roots
3) Diabetes (most common), Lyme disease, HIV, or varicella-zoster (shingles)

68
Q

Gray matter in the spinal cord is surrounded by what?

A

Ascending and descending white matter columns

69
Q

Where do the nerve plexuses of the arms and legs originate?

A

Cervical and lumbosacral enlargements of the spinal cord

70
Q

Vertebral arteries form what besides the basilar artery?

A

Both the anterior and posterior spinal arteries

71
Q

What supplies most of the spinal cord with blood? What part does it not supply?

A

Anterior spinal artery; doesn’t supply dorsal surface

72
Q

Venous return for the spinal cord occurs where?

A

Epidural space

73
Q

Where is the corticospinal tract of the brain?

A

In the posterior limb of the internal capsule

74
Q

A lesion/stroke of the ________________ can cause weakness of the entire contralateral side of the body from face to lower extremity

A

internal capsule

75
Q

What are the 3 long tracks of the spinal cord?

A

1) Posterior column-medial leminiscal system
2) Anterolateral systems (2, includes spinothalamic tract)
3) Corticospinal tract

76
Q

What are the two main somatosensory pathways?

A

1) Posterior column-medial leminiscal system
2) Anterolateral systems (2, includes spinothalamic tract)

77
Q

A lesion of what tract will cause a loss of pain and temp sensation in the contralateral side below the level of the lesion? Why?

A

Spinothalamic tract; mediates pain and temp sense

78
Q

What decussates at anterior commissure of spinal cord?

A

Anterolateral systems (includes spinothalamic tract)

79
Q

What does the spinothalamic tract relay info through and to?

A

Through the thalamus to the primary somatosensory cortex

80
Q

What tract conveys proprioception, vibration sense, and fine touch?

A

Posterior column-medial leminiscal system

81
Q

What long tract decussates in the lower medulla?

A

Posterior column-medial leminiscal system

82
Q

What is the most common cause of spinal cord lesions?

A

External compression from degenerative spinal disease, trauma, and metastatic cancer.

83
Q

Vitamin B12 deficient can affect what part of the CNS?

A

Posterior cord

84
Q

Lesions (trauma, compression, multiple sclerosis) of the ___________________ of the spinal cord causes loss of vibration sense, and proprioception below the level of the lesion. This is called _________________________

A

posterior columns; posterior cord syndrome

85
Q

Anterior spinal artery infarcts can cause what condition that leads to loss of pain and temp sensation below the level of lesion?

A

Anterior cord syndrome

86
Q

The cauda equina consists of nerve roots from ______ to ______ in the coccygeal tail bone end

A

L2 to Co1

87
Q

What is responsible for the motor and sensory innervation to pelvic organs (e.g bladders and bowel), lower limbs, and perineum?

A

The cauda equina

88
Q

What controls voluntary sphincter control and sensory functions in the saddle region?

A

Cauda equina

89
Q

Sensory loss in what region is called saddle anesthesia?

A

S2-S5

90
Q

Impairment of _________ (perianal) can cause bladder dysfunction, constipation, fecal incontinence, and loss of erections and needs immediate treatment

A

S2-S4

91
Q

Is the thalamus made of gray or white matter? What is it shaped like?

A

Gray; like eggs

92
Q

What is the processing center of the brain?

A

Thalamus

93
Q

Define dermatome

A

A peripheral region innervated by sensory fibers from a single nerve root level

94
Q

________________ are organized in a way that allows clinicians to map sensory information to the corresponding spinal nerve, which can be useful in diagnosing certain neurological conditions.

A

Dermatomes

95
Q

What is the T4 dermatome?

A

Nipple line

96
Q

What is the T10 dermatome line?

A

Umbilicus

97
Q

What is the C4 dermatome line?

A

Thumb

98
Q

What is the S5 dermatome?

A

Perianal

99
Q

What supplies the anterior hemispheres of the brain?

A

Internal carotid arteries

100
Q

____________________ supply posterior hemispheres and join forming the basilar artery

A

Vertebral arteries

101
Q

The anterior and posterior blood supplies form the ___________________ from which all major cerebral vessels arise

A

Circle of Willis

102
Q

About __[fraction]_____of general population has a full/complete ring/ circle of willis

A

1/3

103
Q

_______________________ come off the aorta and split into the internal and external carotid arteries

A

Common carotid arteries

104
Q

The main arteries that supply the cerebral hemisphere are what?

A

The anterior, middle, and posterior cerebral arteries (ACA, MCA, and PCA)

105
Q

The anterior and middle cerebral arteries are the termination of what?

A

Internal carotids

106
Q

The ___________ join anteriorly by the anterior communicating artery

A

ACA (anterior cerebral arteries)

107
Q

The anterior and posterior circulations are linked by the ________________________ arteries

A

posterior communicating

108
Q

What two arteries are linked to join anterior and posterior circulation of the brain?

A

Internal carotid and the posterior cerebral arteries

109
Q

What does the anterior cerebral artery (ACA) supply?

A

-The cortex on the anterior medial surface of the brain from frontal to parietal lobe.
-Also includes the medial sensorimotor cortex.

110
Q

The _____________ artery’s branches supply the cortex above and below the Sylvian fissure including the lateral temporal lobe and parts of the parietal lobe. Also includes large parts of the basal ganglia and internal capsule, and the thalamus

A

Middle cerebral artery (MCA)

111
Q

What does the posterior cerebral artery (PCA) supply blood to?

A

The inferior and medial temporal lobes, and the medial occipital cortex

112
Q

Branches of the ____________ supply large regions of the basal ganglia and the internal capsule.

A

MCA

113
Q

In the setting of HTN, what small vessels are prone to narrowing, which can lead to blockages causing lacunar infarctions?

A

MCA branches that supply large regions of the basal ganglia and the internal capsule

114
Q

Define lacunar infarct

A

A blockage of one of the small branches (esp of the MCA) can cause an area to infarct, leaving a hole or depression in that area of the brain known as a lacunar infarct/stroke

115
Q

Lacunar infarction in what area causes contralateral hemiparesis?

A

Posterior limb of the internal capsule (which houses motor pathways of the corticospinal tract) and thalamus

116
Q

What characterizes lacunar infarct syndrome (stroke) (clinical manifestation of lacunar infarct)?

A

Pure motor hemiparesis; contra/unilateral face, arm, and leg weakness. Due to lacunar infarct of posterior limb of internal capsule.

117
Q

What is the most common type of stroke?

A

Lacunar infarct syndrome

118
Q

What strokes are more common, ACA, MCA, or PCA?

A

MCA

119
Q

What type of stroke is characterized by aphasia, hemineglect, hemianopia, face/arm or face/arm/leg sensorimotor loss, and a gaze toward the side of the lesion?

A

MCA stroke

120
Q

Define watershed infarcts

A

The area when the blood supply of 2 adjacent cerebral arteries is compromised, the region between the 2 vessels is at high risk for ischemia or infarction

121
Q

What are two causes of watershed infarcts?

A

Sudden occlusion of the internal carotid or a drop in BP setting of carotid stenosis

122
Q

Where is Broca’s area?

A

Just superior to Sylvian fissure in frontal lobe of left hemisphere

123
Q

What is inferior to the lateral fissure in the temporal lobe?

A

Wernicke’s area

124
Q

1) Define Transient Ischemic Attacks (TIAs)
2) What are their symptoms?
3) What are their causes?

A

1) A neurological deficit caused by cerebral ischemia that lasts <24 hours (usually closer to 10 mins)
2) Motor, sensory, visual, auditory, emotional or cognitive
3) Migraines, seizures, arrhythmias and hypoglycemia

125
Q

_______% of patients with TIAs will have a stroke within ___ months and most of those within the next ______ hours

A

10%; 3 months; 48 hours

126
Q

What is the 5th leading cause of death in the US?

A

Strokes

127
Q

What are the two types of strokes? Define each

A

1) Hemorrhagic: blood vessel ruptures
2) Ischemic: lack of adequate blood supply to the brain for long enough to cause cell death.

128
Q

What are the two main causes of ischemic strokes? Which one happens more suddenly?

A

1) Thrombus and embolus
2) Embolus is more sudden

129
Q

What type of ischemic stroke do emboli cause?

A

Large vessel strokes

130
Q

What are small vessel strokes also called?

A

Lacunar infarcts

131
Q

For ________ strokes, you need to find the source to prevent additional strokes. Why?

A

embolic; emobli are most often blood clots and commonly come from the heart

132
Q

What can cause emboli to come from the heart?

A

Afib or areas of damaged cardiac tissue from previous MI, where slow moving or dead areas of cardiac muscle have stagnant blood flow and create emboli

133
Q

What can form on valve leaflets or artificial valves?

A

Valvular disease thrombi

134
Q

What type of emboli can come from stenotic area of another vessel?

A

Artery to artery emboli

135
Q

_____________ of carotids or vertebral arteries often form thrombi/clot which can embolize to the brain

A

Dissection (tear of the inner wall of an artery)

136
Q

Carotid dissection can cause TIA or infarct in the __________ circulation

A

anterior

137
Q

Vertebral dissection can cause TIA or infarct in the __________ circulation

A

posterior

138
Q

Cortical signs come from _________ strokes

A

lobar

139
Q

What are the cortical signs?

A

Aphasia, neglect, homonymous visual field defects, apraxia, hemiparesis, and sensory loss

140
Q

Headaches occur in about ____ of ischemic stroke patients from the innervation of the blood vessels and meninges.

A

¼

141
Q

Headaches are more commonly seen in ________ strokes and can include _______ pain if carotid or vertebral arteries are involved

A

hemorrhagic; neck

142
Q

Strokes in younger patients are usually from?

A

Dissection/trauma

143
Q

Stroke risk factors include?

A

HTN, DM, hypercholesterolemia, cigarette smoking, (+) family history, prior h/o stroke or vascular disease, Afib

144
Q

Deep and superficial veins drain the brain and dump into __________ sinuses. They ultimately exit via the internal ____________ veins

A

dural sinuses; jugular veins

145
Q

_____________ sinuses lay near the dura and collect deoxygenated blood

A

Cerebral venous sinuses

146
Q

If a pt experiences neck stiffness or nuchal rigidity, along with a sudden horrible headache, what may be occurring?

A

A subarachnoid hemorrhage

147
Q

What are potential symptoms of a subarachnoid hemorrhage other than a headache and nuchal rigidity?

A

Altered mental status, nausea, vomiting, or focal neurological deficit

148
Q

What is the most common cause of subarachnoid hemorrhages?

A

Rupture of an intracranial aneurysm

149
Q

Explain why subarachnoid hemorrhages are associated with thunderclap headaches

A

When there’s an aneurysm rupture at the Circle of Willis, blood fills the subarachnoid space, causing irritation to the meninges, leading to severe headache

150
Q

What are the diagnostic tools for subarachnoid hemorrhages?

A

1) CT scan is the initial diagnostic tool (as shown in the case image)
2) If CT is negative but suspicion is high, lumbar puncture may be performed

151
Q

How are subarachnoid hemorrhages treated?

A

Emergent neurosurgical evaluation; aneurysm may be clipped neurosurgically to prevent recurrent hemorrhage

152
Q

True or false: you can’t recover from a subarachnoid hemorrhage. Explain your answer

A

False; varies depending on the severity of the bleed and promptness of treatment, but full recovery is possible

153
Q

Give 4 differential diagnoses for subarachnoid hemorrhages/ severe headaches

A

1) Cervical artery dissection
2) Cerebral venous sinus thrombosis
3) Pituitary apoplexy
4) Hypertensive emergency

154
Q

True or false: The complaint of “worst headache of my life” should always prompt immediate medical evaluation to rule out life-threatening conditions, particularly subarachnoid hemorrhage. Explain your answer

A

True; if its a subarachnoid hemorrhage their chance of recovery depends on promptness of treatment

155
Q

Where are the spinothalamic tracts of the spinal cord in relation to the anterior gray matter horn?

A

Anterior

156
Q

Where are the corticospinal tracts of the spinal cord in relation to the dorsal horn of the gray matter?

A

Lateral

157
Q

What function does the lateral corticospinal tract control?

A

Movement of extremities

158
Q

Where is the spinal cord the thickest?

A

Cervical area

159
Q

True or false? The lateral corticospinal tract starts in the precentral gyrus and travels down through the spinal cord but crosses at the pyramidal decussation.

A

True

160
Q

What percent of the corticospinal tract continues ipsilaterally after the pyramidal decussation?

A

15%

161
Q

The 85% of the corticospinal tract that crosses over becomes the _____________ corticospinal tract; the 15% that doesn’t becomes the ___________ corticospinal tract.

A

85% becomes lateral corticospinal tracts; 15% becomes anterior corticospinal tract

162
Q

Where does the anterolateral pathway cross the spinal cord?

A

Anterior commissure

163
Q

What tract crosses over in the lower medulla?

A

Posterior column-medial leminiscal pathway

(PA school) Neuroanatomy (22 decks)

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