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surface anatomy 2 - Central Region Flashcards

1
Q

Where is the motor strip located?

A

Precentral Gyrus

have motor homunculus here

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2
Q

Where is the sensory homunculus located?

A

post-central Gyrus

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3
Q

What are examples of Motor Sequence?

A
  1. Toes
  2. Ankle
  3. Knee
  4. Hip
  5. Trunk
  6. Shoulder
  7. Elbow
  8. Wrist
  9. Hand
  10. Little Ring Middle Index
  11. Thumb
  12. Neck
  13. Brow
  14. Eyelid and eyeball
  15. Face
  16. Lips
  17. Vocalisation
  18. Jaw
  19. Tongue
  20. Swallowing
  21. Mastication
  22. Salivation
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4
Q

What are examples of sensory sequence?

A
  1. Toes
  2. Foot
  3. Leg
  4. Hip
  5. Trunk
  6. Neck
  7. Head
  8. Shoulder Arm Elbow
  9. Wrist Hand
  10. Little Ring Middle index
  11. Thumb
  12. Eye
  13. Nose
  14. Face
  15. Upper lip
  16. Lips
  17. Lower lip
  18. Teeth, Gums and Jaw
  19. Tongue
  20. Throat, inside of mouth
  21. Intra-abdominant
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5
Q

What is superificial grey matter?

A

Cortex

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6
Q

What is deep grey matter?

A

Basal Ganglia and the thalamus

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7
Q

What was the naming of the central sulcus?

A
  1. Rolandic Sulcus

2. Central Sulcus

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8
Q

Rolandic sulcus

A

Named after Italian anatomist - Luigi Rolando

F. Leuret (1839)

Observed the precentral and postcentral gyrus on either side of great central fissure

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9
Q

Central Sulcus

A

Theory: animals have some anterior sulci which will form a radius, CS cuts through these radius

He thought central sulcus subdivides sylvian fissure into 2 areas within the circle

E. Huschke (1854)

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10
Q

How was the central sulcus observed?

A

Not the centre of the brain, it is anterior as the frontal lobe is much smaller

Frontal lobe is so developed, it looks more posterior

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11
Q

What can the central region be thought of as?

A

Ellipsoid of tissues

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12
Q

What are the components of the central region?

A
  1. Precentral Gyrus
  2. Postcentral Gyrus
  3. Paracentral Lobule
  4. Subcentral Gyrus
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13
Q

What was the anatomic subdivisions of the Central Sulcus?

A

3 Genu Broca (1878)
Dejerine (1895)

2 Genu Eberstaller (1890)
Cunningham (1892)

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14
Q

How can the Central Sulcus be identified?

A
  1. Anatomic methods
    MR - CT - DSA
  2. Functional Imaging
    fMRI-MEG-PET
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15
Q

What are 2 types of anatomic methods?

A
  1. Extracerebral Landmark
    - Coronal suture
2. Cerebral Landmark
Deep Cortical (AC-PC)
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16
Q

What is a suture?

A

Where 2 bones come together

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17
Q

What is coronal suture?

A

1 and 1/2cm anterior to the central sulcus

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18
Q

Deep (AC:PC) Talairach

A

2 points which are constant to make a line

AC:PC becomes the basis for mathematical orientation

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19
Q

How can you divide the whole brain into rectangles?

A

Do lines which are perpendicular and parallel

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20
Q

What is anterior commissure?

A

White matter tract connecting the 2 temporal lobes of the cerebral hemisphere across the midline

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21
Q

What is Digital substraction angiography?

A

Visualise blood vessels in a bony or dense soft tissue environment

  1. place needle in vessel
  2. Inject dye
  3. Substraction

Picture of bone with and without a dye and make a substraction

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22
Q

What is Angiography?

A

Injection of a constrast medium inside vessels, outline cerebral vessels

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23
Q

Connection IHF

A

Midline S sign

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24
Q

What does the central sulcus not reach?

25
Q

What is the percentage that Central sulcus does reach the interhemispheric fissure (IHF)?

A

37%

1/3rd of the patients

26
Q

What are the midline sulcus sign?

A
  1. CS doesn’t rich IHF
    (28-44%)
  2. PreCS reaches IHF
    (8-20%)
  3. PoCS reaches IHF
    (20-40%)
  4. IPS (infratemporal fossa ) reaches IHF
    (20-40%)
27
Q

What are the Cerebral Landmarks?

A
  1. Axial

2. Sagittal

28
Q

What are example of Axial cerebral landmarks?

A
  1. L-sign
  2. Knob/omega/epsilon
  3. PrCG/Cortex Thickness
  4. Bracket-Moustache
29
Q

What are examples of Sagittal cerebral landmarks?

A
  1. Medial Sagittal
  2. Knob/Hook
  3. Lateral Sagittal
30
Q

L sign

A
  1. IHF
  2. Superior Frontal Sulcus
  3. SFS - PreCS
  4. Central Sulcus is behind PreCS
31
Q

Why do all methods have drawback?

A

Brain surface is variable

32
Q

What is another sulcus found between IHF and SFS?

33
Q

What are the limitations of L sign?

A

Medial FS
present: 64-72%

SFS
Classic: 32-40%
Connected with CS: 12-28%

Connection absent: 8%
preCS doubled: 4%

34
Q

Knob/omega/epsilon sign

A 
MHA is located in the middle genu 
Genu medius (96%)

Protrusion of precentral gyrus

35
Q

Where is the inverted omega located?

A

Opposite SFS + PreCS

36
Q

When Omega is doubled, what is it called?

37
Q

Functional loss from medial side

A

Ulnar Pareses

38
Q

Motor-Hand Knob

A 
Axial		Omega (90%)   Epsilon  (10%)
At SFS-PreCS junction
				(100% – path; 96% + path)
Sagittal	Hook (91%  pathology)
Neurosurgical landmark
39
Q

Knob

A

PoCG 9%

Knob bridges SC 4%

40
Q

What is observed in MHA?

A

Less somatotopy

41
Q

What is central sulcus interrupted by?

A

Connection between pre- and postcental gyrus

42
Q

Sensory Hand Area

A

Postcentral Gyrus may have similar appearance to precentral gyrus

43
Q

Infarction in SHA

A

Sensory loss

Pseudo-ulnar sensory loss

44
Q

Thickness: Gyrus, Cortex

A

Gyral thickness (Naidich)

PreCG > PostCG (98%)

45
Q

Gyral thickness

A

PreCG = PoCG 2%

PreCG < PoCG (6%-CT)

46
Q

Cortical Thickness

A

GPrec > GPostC

Meyer 96

47
Q

Cortical SI

A

CS < Frontal

48
Q

Bracket/Moustache

(Medial axial) - Naidich

A

Sulcus that goes into bracket is central sulcus

CS into Pb in 87%

49
Q

What is ramus marginalis?

A

Posterior border of the paracental lobule

50
Q

1st Sagittal Landmark

A

Medial sagittal
CS anterior PM
Notch in paracentral lobule

51
Q

Medial Sagittal

A
  1. Corpus Callosum
  2. Subcullosal Sulcus
  3. Cingulate Gyrus
  4. Cingulate sulcus
  5. Ramus Marginalis (pars bracket)
  6. Anterior - Central sulcus
52
Q

2nd Sagittal Landmark

A

fMRI of hand
Level of Insula
HOOK (in a cup)

53
Q

What has less variation than parietal lobule?

54
Q

What are the 3 components of the Inferior Frontal Gyrus?

A
  1. Pars Orbitalis
  2. Triangularis
  3. Opercularis
55
Q

What does Opercularis do?

A

Covers the Insula

56
Q

Opercularis

A

Speech area

57
Q

3rd Sagittal Landmark

A 
Sylvian Fissure
Ant horizontal R
Ant asc R
IFS
IFG (M)
precentral sulcus
CS
58
Q

problems with lateral sagittal

A 
Ant asc ramus
		IFS connection
Diagonal S
		Present
IFS
		Interrupted

C1 Modules (20 decks)

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