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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
What is the percentage that Central sulcus does reach the interhemispheric fissure (IHF)?
37% | 1/3rd of the patients
26
What are the midline sulcus sign?
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
What are the Cerebral Landmarks?
1. Axial | 2. Sagittal
28
What are example of Axial cerebral landmarks?
1. L-sign 2. Knob/omega/epsilon 3. PrCG/Cortex Thickness 4. Bracket-Moustache
29
What are examples of Sagittal cerebral landmarks?
1. Medial Sagittal 2. Knob/Hook 3. Lateral Sagittal
30
L sign
1. IHF 2. Superior Frontal Sulcus 3. SFS - PreCS 4. Central Sulcus is behind PreCS
31
Why do all methods have drawback?
Brain surface is variable
32
What is another sulcus found between IHF and SFS?
Medial FS
33
What are the limitations of L sign?
Medial FS present: 64-72% SFS Classic: 32-40% Connected with CS: 12-28% Connection absent: 8% preCS doubled: 4%
34
Knob/omega/epsilon sign
``` MHA is located in the middle genu Genu medius (96%) ``` Protrusion of precentral gyrus
35
Where is the inverted omega located?
Opposite SFS + PreCS
36
When Omega is doubled, what is it called?
Epsilon
37
Functional loss from medial side
Ulnar Pareses
38
Motor-Hand Knob
``` Axial Omega (90%) Epsilon (10%) At SFS-PreCS junction (100% – path; 96% + path) Sagittal Hook (91%  pathology) Neurosurgical landmark ```
39
Knob
PoCG 9% | Knob bridges SC 4%
40
What is observed in MHA?
Less somatotopy
41
What is central sulcus interrupted by?
Connection between pre- and postcental gyrus
42
Sensory Hand Area
Postcentral Gyrus may have similar appearance to precentral gyrus
43
Infarction in SHA
Sensory loss | Pseudo-ulnar sensory loss
44
Thickness: Gyrus, Cortex
Gyral thickness (Naidich) PreCG > PostCG (98%)
45
Gyral thickness
PreCG = PoCG 2% | PreCG < PoCG (6%-CT)
46
Cortical Thickness
GPrec > GPostC | Meyer 96
47
Cortical SI
CS < Frontal
48
Bracket/Moustache | (Medial axial) - Naidich
Sulcus that goes into bracket is central sulcus CS into Pb in 87%
49
What is ramus marginalis?
Posterior border of the paracental lobule
50
1st Sagittal Landmark
Medial sagittal CS anterior PM Notch in paracentral lobule
51
Medial Sagittal
1. Corpus Callosum 2. Subcullosal Sulcus 3. Cingulate Gyrus 4. Cingulate sulcus 5. Ramus Marginalis (pars bracket) 6. Anterior - Central sulcus
52
2nd Sagittal Landmark
fMRI of hand Level of Insula HOOK (in a cup)
53
What has less variation than parietal lobule?
Frontal
54
What are the 3 components of the Inferior Frontal Gyrus?
1. Pars Orbitalis 2. Triangularis 3. Opercularis
55
What does Opercularis do?
Covers the Insula
56
Opercularis
Speech area
57
3rd Sagittal Landmark
``` Sylvian Fissure Ant horizontal R Ant asc R IFS IFG (M) precentral sulcus CS ```
58
problems with lateral sagittal
``` Ant asc ramus IFS connection Diagonal S Present IFS Interrupted ```

C1 Modules (20 decks)

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