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Case 13 > Radiological Neuroanatomy > Flashcards

Radiological Neuroanatomy Flashcards

1
Q

When is CT good for?

A
  • Trauma + unstable patients
  • Bleeding + stroke
  • Bony injuries
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2
Q

What is MRI good for?

A
  • Soft tissues

- Fluid dark on T1, bright on T2

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3
Q

Summarise the function and anatomy of the frontal lobe

A
  • Primary motor cortex + neurons associated with STM, attention, planning + motivation
  • In anterior cranial fossa
  • Divided from…
    1. Each other by interhemispheric fissure
    2. Parietal lobes by central sulci
    3. Temporal lobes by sylvian fissures
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4
Q

Summarise the function and anatomy of the parietal lobe

A
  • Primary sensory cortex for touch, pain, temp + proprioception
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5
Q

Summarise the function and anatomy of the occipital lobe

A
  • Visual cortex
  • Divided from…
    1. Parietal lobes anteriorly by parieto-occipital fissure
    2. Cerebellum inferiorly by tentorium cerebelli
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6
Q

Summarise the function and anatomy of the temporal lobe

A
  • In middle cranial fossa
  • Dominant temporal lobe contains primary auditory cortex
  • Involved in formation new memories + interpretation visual stimuli
  • Divided from…
    1. Frontal + parietal lobes by sylvian fissures
    2. Cerebellum by tentorium
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7
Q

Where is Broca’s area and what is its significance?

A
  • Inferior frontal gyrus of dominant hemisphere - concerned with production of speech
  • Problems = dysphasia
  • Located left frontal lobe
  • Left sided stroke = right sided weakness
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8
Q

Where is the precentral gyrus and what does it contain?

A
  • In posterior frontal lobe

- Contains primary motor cortex

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9
Q

Where is the postcentral gyrus and what does it contain?

A
  • Lies within anterior parietal lobe

- Contains primary sensory receptor area for sense of touch

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10
Q

What does the amount of cortex devoted to body part proportional to?

A

Density of sensory nerve endings on body part

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11
Q

Where is Wernicke’s area and what is it’s significance?

A
  • Superior temporal lobe gyri

- Language comprehension

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12
Q

Where is the role of the insular cortex?

A
  • Perceptions, motor control, self-awareness + cognitive functioning
  • One of the first areas visibly affected on imaging when middle cerebral artery stroke
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13
Q

What makes of the basal ganglia?

A
  • Caudate nucleus - memory + learning

- Lentiform nucleus

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14
Q

What is the lentiform nucleus formed of?

A

Putamen

  • linked to substantia nigra
  • role in degenerative neurological disorders e.g. Parkinson’s
  • regulate movements + influence various types of learning

Globus pallidus

  • interna and externa
  • involved in subconscious regulation movement
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15
Q

What is the function of the thalamus?

A
  • Through which signals sent between cerebral cortex + midbrain
  • Regulation sleep + wakefulness
  • Level of awareness + activity + processing
  • Relaying sensory info to parts of cerebral cortex
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16
Q

What is the external capsule?

A

Series of white matter tracts that run lateral to lentiform nucleus + connect diff areas of cortex

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17
Q

What is the internal capsule?

A
  • Series of white matter tracts split anatomically into anterior + posterior limb
  • Connected by genu
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18
Q

What is the corona radiata?

A
  • Extension of internal capsule superiorly

- Carrying same ascending + descending tracts

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19
Q

What is the circle of willis?

A
  • Connect anterior + posterior arterial supply of brain
  • Anterior circulation = anterior + middle cerebral arteries = internal carotid
  • Posterior circulation - posterior cerebral arteries = basilar artery
20
Q

What are the most common areas for intracranial aneurysm?

A
  • Anterior communicating artery
  • Bifurcation of middle cerebral artery
  • Posterior communicating artery
  • Basilar tip
21
Q

What makes up the circle of willis?

A 
ICA 
ACA = anterior cerebral 
MCA= middle cerebral 
PCA = posterior communicating 
PCA = posterior cerebral 
VA = vertebral 
BA
ACA = anterior communicating
22
Q

What does the middle cerebral artery supply?

A

Largest territory
Majority of lateral surface brain
Lentiform nucleus

23
Q

What does the anterior cerebral artery supply?

A

Medial strip of brain anteriorly

24
Q

What does the posterior cerebral artery supply?

A

Most of parietal lobe
Occipital lobe + inferior + medial parts temporal lobe
Thalamus

25
Q

Describe the drainage pathway of the superior sagittal sinus

A

> torcular herophili > transverse sinus > sigmoid sinuses > internal jugular veins

26
Q

Which ventricles are most superior on scanning?

A

Bodies of lateral ventricles

27
Q

What connects the lateral ventricle to 3rd ventricle?

A

Foramina of Monro

28
Q

Why is the size of the temporal horns important?

A

Can be enlarges due to hydrocephalus or appear enlarged due to hippocampal atrophy

29
Q

What connects the 3rd and 4th ventricle?

A

Sylvian aqueduct

30
Q

What arises laterally from 4th ventricle?

A

Foramina of Luschka

31
Q

What joins the 4th ventricle with foramen magnum

A

Foramen of Magendie

32
Q

What is the cerebellum divided into?

A

2 hemispheres

Each contain 3 lobes: anterior, posterior + vestibulocerebellum

33
Q

What are the hemispheres of cerebellum connected by?

A

Vermis

34
Q

What is the role of the cerebellum?

A

Coordination and timing of movements

35
Q

What effect can chronic alcohol intake have on the cerbelellum?

A

Atrophy

36
Q

What is the importance of the cerebellar tonsils?

A

1st structures to be squeezed through foramen magnum when coning occurs due to increased ICP

37
Q

What makes up the brainstem?

A

Midbrain
Pons
Medulla

38
Q

What does the midbrain contain?

A
  • Corticospinal tract runs through cerebral peduncles

- Contains substantia nigra

39
Q

What does the pons contain?

A
  • Tracts that link cerebrum to cerebellum

- Tracts that carry sensory signals to thalamus

40
Q

What is role of the medulla?

A
  • Connects higher levels of brain to spinal cords
  • Autonomic functions - breathing, BP, HR
  • Reflex centres - vomiting, coughing, sneezing + swallowing
41
Q

What are the key features of a extradural/ epidural haemorrhage?

A
  • Acute bleed
  • Trauma, head injury
  • Middle meningeal artery injury
  • Bioconvex shape
  • Does not cross structures
  • Head injury with lucid interval
42
Q

What are the key features of a subdural haemorrhage?

A
  • Variable in age of bleed
  • No definite head trauma history
  • Tearing of bridging cortical veins
  • Crosses sutures but does not enter sulci
  • Crescent shape
  • CT appearance change with time
  • Hyperdense (acute) > Isodense to brain (subacute) > CSF density (chronic)
  • Reduced consciousness
43
Q

What are the key features of a subarachnoid haemorrhage ?

A
  • Acute bleed
  • Traumatic (peripheral pattern)
  • Aneurysmal (central-suprasellar cistern pattern)
  • Blood in sulci and/or cisterns - may extend into ventricles
  • Normal CT does not exclude subarachnoid bleed - LP
  • Thunderclap headache, meningeal irritation signs
44
Q

What are the key features of a parenchymal haemorrhage?

A
  • Acute bleed
  • Hypertensive, haemorrhagic transformation of acute infarct, trauma
  • Remember underlying malignancy
  • Within brain parenchyma, central may extend into ventricles
  • In trauma, contusions where brain impacts skull - peripheral blood
  • Older patient, hypertensive with neurological signs
  • Consider acute infections
45
Q

What is the quickest way to survey cervical spine?

A

Plain films

  1. True lateral
  2. AP view
  3. Open mouth odontoid view
46
Q

What are hagman’s fracture?

A

= fractures through pedicle of axis

  • Mechanism = hyperextension
  • Radiographic feature best seen on lateral view
  • Prevertebral swelling
  • Anterior dislocation of C2 vertebral body
  • Bilateral C2 pedicle fractures
47
Q

What is bilateral facet dislocation?

A

= complete anterior dislocation of vertebral body

  • Associated with high risk of cord damage
  • Mechanism = extreme flexion of head + neck without axial compression
  • Radiographic feature best seen on lateral view
  • Complete dislocation of affected body by half or more of vertebral body AP diameter
  • Bow tie or bat wing appearance of locked/ jumped facets

Case 13 (9 decks)

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