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Neurology > Week 1 - A Ton of Neuroanatomy > Flashcards

Week 1 - A Ton of Neuroanatomy Flashcards

1
Q

What component of the neuron is found in the cerebral cortex? What part is in the medulla?

A

All the cell bodies of the neurons of the Cerebrum are found in the cortex {grey matter}. The fibres from these neurons are concentrated in the white matter of the medulla.

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2
Q

What is the transverse fissure and where is it located?

A

The Transverse Fissure is located on the posterior aspect of the brain between the cerebellum and cerebrum.

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3
Q

Which side of the brain is the language centre located in most people.

A

In the majority of people the Language Centres are located within the left hemisphere of the brain.

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4
Q

What two things are contained within the Subarachnoid Space?

A

It contains both the superficial cerebral arteries and the Cerebral Spinal Fluid {CSF}.

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5
Q

What is the major communication structure between the two hemispheres of the brain?

A

The Corpus Callosum {means Hard Body} consists of commissural fibres and allows for communication between the two hemisphere.

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6
Q

What is the bridge between the cerebrum and the cerebellum?

A

The Pons.

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7
Q

Where are the Central Respiratory Control Centres located?

A

The Medulla.

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8
Q

What is the relay station of the brain and what goes through it?

A

The Thalamus is an incoming relay station which processes all incoming information and sends it to the correct portion of the brain. All afferent nerve fibres will go through the Thalamus.

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9
Q

What is the Hypothalamus responsible for?

A

Everything to do with the Viscera of the body.

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10
Q

What two structures are included in the Diencephalon?

A

The Thalamus and the Hypothalamus.

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11
Q

What is the role of the Short Association Fibres?

A

Short Association Fibres {U-Shaped Fibres} interconnect the gyri of the brain allowing them to communicate with each other.

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12
Q

What is the role of the Long Association Fibres?

A

The Long Association Fibres interconnect the different lobes of the brain in each hemisphere. They do not cross over.

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13
Q

What is the role of the Commissural Fibres? What is an example of a structure of these fibres?

A

Commissural Fibres interconnect the hemispheres and allow for communication between the left and right brain. The Corpus Callosum is the largest collection of these fibres.

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14
Q

What is the role of Projection Fibres? What are the Efferent and Afferent Branches of these Projection Fibres?

A

Projection Fibres go from the cortex to peripheral areas of the CNS {Efferent; Corticospinal; usually motor}, or from the peripheral CNS to the cortex {Afferent; Spinothalamic; usually sensory} and cross over to the opposite side of the body.

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15
Q

What is conveyed by the Spinothalamic Fibres?

A

These afferent fibres convey both pain and temperature. {+Itch}

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16
Q

What is the Precentral Gyrus responsible for? What is it part of? What does it form the Sensory-Motor Strip with?

A

The Precentral Gyrus controls movement on the opposite side of the body and is part of the Premotor Cortex. The Primary Central Somatic Gyrus is also called the Postcentral Gyrus. Together these from the Sensory-Motor Strip.

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17
Q

What part of the premotor cortex is involved with the lower limb?

A

Control of the lower limb is in the medial aspect of the premotor cortex. Remember the way Leann acted it out in lab…

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18
Q

What is Functional Localization?

A

Functional Localization is the idea that certain areas of the brain are more involved with particular functions, but never exclusively so.

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19
Q

What is Association?

A

Association is the integration of diverse sensory information for the planning of purposeful action.

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20
Q

What part of the brain is responsible for Proprioception?

A

The Parietal Lobe.

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21
Q

Describe the jobs of the parts of the brain involved with performing a movement.

A

The Premotor Cortex {pMC} plans the muscles movements needed for the desired maneuver.
The Primary Motor Cortex {PMC} performs the action passed onto it from the premotor cortex.
The Supplementary Motor Cortex Area {SMA} programs complex sequences of movements.

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22
Q

What is Apraxia? Lesions in which areas will result in Apraxia?

A

The inability to perform a purposeful motor movement due to brain damage. A lesion of the pMC or SMA will result in apraxia, while lesions of the PMC will result in weakness and paralysis.

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23
Q

What is Broca’s area involved with? What type of aphasia is caused by damage to this area?

A

Broca’s Motor Speech Area is involved in the formulation of speech and is located in the frontal lobe {Motor; Expressive Aphasia}.

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24
Q

What is Wernicke’s area involved with? What type of aphasia is caused by damage to this area?

A

Wernicke’s Sensory Speech Area is involved in language comprehension and is located in the parietal lobe {Sensory; Receptive Aphasia}.

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25
Q

What is Conduction {Associative} Aphasia?

A

A Conduction Aphasia {Associative Aphasia} occurs when there is a disconnect between Broca’s and Wernicke’s resulting in the ability to comprehend, but not to repeat.

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26
Q

How many neurons are involved in the Dorsal Column – Medial Lemniscal Long Tract?
What is this tract for?
At what level do these neurons cross to the contralateral side?

A

The DORSAL COLUMN — MEDIAL LEMNISCAL {3 Neuron} is the main pathway for Tactile Information, Proprioception, Stereognosis, and Discriminative & Light Touch.
These neurons cross contralaterally at the level of the medulla, after synapsing to the 2nd order neuron.

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27
Q

How many neurons are involved in the Corticospinal Long Tract?
What is this tract for?
At what level do these neurons cross to the contralateral side?

A

The CORTICOSPINAL {2 Neuron} is the main Motor pathway involving voluntary skilled motor activity.
Neuron goes from the cortex down to the point where it is about to leave the spinal cord.These will cross over at the level of the medulla and synapse with the Lower Motor Nerve at the level that they leave spinal cord.

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28
Q

How many neurons are involved in the Anterolateral – Spinothalamic Long Tract?
What is this tract for? At what level do these neurons cross to the contralateral side?

A

The ANTEROLATERAL SYSTEM — SPINOTHALAMIC {3 Neuron} is the main pathway for Pain & Temperature {+ Itch}.
These fibres cross over at the same level which they enter the spinal cord after synapsing with the 2nd order neurons.

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29
Q

Which portion of the Dorsal Column receives sensory innervation from the legs? Which one from the arms?

A

The Gracile portion of the DC receives sensory innervation from the lower limb and trunk. The Cuneate DC portion receives sensory innervation from the upper limb and trunk.

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30
Q

What do Oligodendrocytes do?

A

Oligodendrocytes myelinate the axons of the CNS & provide a structural framework to support the neurons.

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31
Q

What do Microglia do?

A

Microglia remove cell debris, wastes, and pathogens by phagocytosis — they are like little janitors.

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32
Q

What do Ependymal Cells do?

A

Ependymal Cells line the ventricles and spinal cord central canal producing CSF.

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33
Q

What do Astrocytes do?

A

Astrocytes maintain the Blood Brain Barrier {BBB}; regulate ion, nutrient, & dissolved gas concentration; absorb and recycle neuro-transmitters; and form Glial Scars after injury.

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34
Q

What do Satellite Cells do?

A

Satellite Cells surround the neuronal cell body and play a supportive role; not much is known about the functions of these cells.

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35
Q

What do Schwann Cells do?

A

Schwann Cells myelinate peripheral axons {sensory and motor}. Each Schwann Cell only myelinates a single segment.

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36
Q

All _______ neurons are myelinated while not all _______ neurons are.

A

Motor; Sensory

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37
Q

What are some features of Autonomic Ganglia?

A

Autonomic Ganglia are the cell bodies of postsynaptic motor neurons. They are Multipolar Neurons with an eccentrically located nucleus. Satellite cells are less apparent.

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38
Q

What are Cephalohematomas?

A

Cephalohematoma are subperiosteal hematoma between the periosteum and the skull. These hematoma are limited in size by the sutures and will be small, only covering one bone.

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39
Q

What are Subgaleal Hematomas?

A

Subgaleal Hematoma are no bounded by the sutures and can become huge, the blood loss resulting from these hematoma can be life threatening.

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40
Q

What colour is blood on CT?

A

White! It is brighter than Grey Matter in the first 10 days; equal to Grey Matter from 10 - 20 days; and darker than Grey Matter > 20 days.

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41
Q

2 - 3 Head CTs will increase the risk of what?

5 - 10 Head CTs will increase the risk of what?

A

Triple the risk of brain cancer;

Triple the risk of leukemia.

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42
Q

How will a Subdural Hematoma present?

A

Subdural Hematoma will present as a crescentic collection that crosses the suture. A mixed density will indicate acute and subacute blood.

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43
Q

What is a Hemorrhagic Infarct and what commonly causes them?

A

Hemorrhagic Infarcts occurs when an ischemic area is reperfused and the blood subsequently leaks out. This is commonly seen with emboli.

44
Q

What is the Corticonuclear {Corticobulbar} tract responsible for? What kind of connections do its nerves form?

A

The CORTICONUCLEAR {Corticobulbar} is responsible for the movements of the head and neck and form bilateral connections to the Cranial Nerve Nuclei.

45
Q

What is special about the facial nerve nucleus compared to the others. How is this clinically significant?

A

The portion of the facial nerve innervating the lower 2/3 of the face only has contralateral input. When someone has a stroke you will not see any CN signs due to bilateral innervation with the exception of the lower 2/3 of the face.

46
Q

What condition is caused by damage to the lower facial motor neuron?

A

Bell’s Palsy

47
Q

What are 5 symptoms associated with upper motor neuron lesions?

A
  1. Spastic Muscle Paralysis
  2. Increased Muscle Tone {Hypertonia}
  3. Exaggerated Deep Tendon Reflexes {Hyperreflexia}*
  4. Abnormal Reflexes {Babinski Sign}
  5. Little or No Muscle Atrophy

*Takes a few while, acute insults may be hyporeflexive.

48
Q

What are 5 symptoms associated with lower motor neuron lesions?

A
  1. Flaccid Muscle Paralysis
  2. Decreased or Absent Muscle Tone {Hypotonia}
  3. Diminished or Absent Deep Tendon Reflexes {Hyporeflexia}
  4. Fasciculations & Fibrillations
  5. Muscle Atrophy with Time

*No Abnormal Reflexes

49
Q

What are 3 Characteristics of Basal Ganglia Disease?

A
  1. Tremor + Involuntary Movement {Dyskinesias}
  2. Change in Muscle Tone and Posture
  3. Poverty of Movement
50
Q

What are the 4 Principal Nuclei of the Basal Ganglia?

A
  1. Striatum {Caudate Nucleus + Putamen}
  2. Globus Pallidus {Pallidus or GPe & GPI}
  3. Substantia Nigra {SNc and SNr} {Parkinson’s}
  4. Subthalamic Nucleus
51
Q

What are the 3 Major Neurotransmitters of the Basal Ganglion?

A
  1. GABA: Inhibitory
  2. Dopamine {SN}: Inhibitory
  3. Acetylcholine {Modulatory: +ve or -ve}

The output of the BG is inhibitory.

52
Q

What is the role of the Basal Ganglia and what is its primary input/output?

A

Plays a major role in the control of normal movement. Its primary input is the cerebral cortex and primary output the prefrontal, premotor, & primary motor cortex as well as the brainstem.

53
Q

What is the major input nucleus of the Basal Ganglia?

A

The Striatum

54
Q

What are the major output nuclei of the Basal Ganglia?

A

The Globus Pallidus & Substantia Nigra

55
Q

What is the only excitatory intrinsic connection of the Basal Ganglia?

A

The Subthalamopallidal Projection

56
Q

What effect does Dopamine have on the pathways of the Basal Ganglia?

A

It excites the direct and inhibits the indirect pathways.

57
Q

What is the effect of Acetylcholine on the Basal Ganglia?

A

It inhibits the direct and excites the indirect pathways.

58
Q

Huntington’s creates a ______tonic state while Parkinson’s creates a ______tonic state.

A

Hyper; Hypo

59
Q

What is Hemiballismus?

A
  • A dyskinesia which causes flailing and throwing of the extremities. Very violent.
  • Self Limiting hyperkinetic condition.
  • Lesion of the Subthalamic Nucleus which inhibits its excitatory effects on the Globus Pallidus; causes a subsequent decrease in inhibitory signals of the Basal Ganglia to the Thalamus.
60
Q

What is missing in Parkinson’s Disease?

A

Dopamine

61
Q

Which parts of the cerebellum control which parts of the body?

A

The hemispheres control the extremities while the middle {Vermis} control the axial muscles.

62
Q

Which part of the Cerebellum sends information out to the cortex?

A

The Deep Nuclei

63
Q

Which 3 arteries supply the Cerebellum?

A

The Superior Cerebellar Artery, and the Anterior & Posterior Inferior Cerebellar Arteries.

{Everything is sets of 3 in the Cerebellum}

64
Q

What is the only sense which bypasses the Thalamus?

A

Olfaction, via CN I.

65
Q

Which ocular muscles are NOT controlled by CNIII {Oculomotor}? Which CN control these?

A

LR6SO4

  • Lateral Rectus by CN VI {Abducens}
  • Superior Oblique by CN IV {Trochlear}
66
Q

All muscles of facial expression are controlled by which CN?

A

CN VII {Facial}

67
Q

A patient presents with facial weakness sparing the upper forehead. Where is the lesion?

A

If there is {droop} facial weakness which spares the forehead it is an Upper Motor Neuron issues.

68
Q

What are two great test which, if positive, indicate upper motor neuron lesions?

A

Pronator Drift and Babinski Reflex

69
Q

Who was Epicanthic Folds?

A

Some people have an Epicanthic Fold, this fold is more prominent in those of oriental ethnicity and children with Downs Syndrome.

70
Q

By how much should the upper eyelid normally cover the iris?

A

It should cover the top 1/6th.

71
Q

What is the proper name for an infected nasolacrimal duct?

A

Darocystitis

72
Q

Which CN give sensation to the Conjunctiva?

A

CN V1 {Nasocilliary n.}. This nerve is also responsible for the blink reflex.

73
Q

What is the Canal of Schlemm? What condition can occur when this duct is blocked?

A

The Canal of Schlemm is the main drainage site of the Aqueous Humour which determines the intraocular pressure. Blockage of the canal of schlemm is obviously bad and will result in a condition called Glaucoma.

74
Q

What is the area of highest visual acuity? What is the blood supply for this area?

A

The Fovea is the site of highest visual acuity, it has its own blood supply, the Foveolar Artery.

75
Q

What is Papilledema and what would it look like?

A

Papilledema occurs when the optic disc has been pushed into the eye creating a crater where the disc has been pushed into the eye. This occurs due to an increase intercranial pressure. It is like a volcano, the edge is raised but the centre is depressed. Usually not associated with any specific visual disturbances as you don’t see through your optic disc anyways.

76
Q

Which CN closes the eyes and which opens them?

A

CN VII {Facial} & CN III {Oculomotor}.

Remember that CN VII is involved with any facial expression, even scrunching your eyes!

77
Q

A stye is an infection of the sebaceous glands of the eyelids {Palpebrae}. What is an internal stye called? An external stye?

A

Chalazion; Hordeolum

78
Q

Usually most symptoms of CNS issues occur on contralateral sides. Which symptoms breaks this rule?

A

Ataxia. Ataxia on the right usually means cerebellar damage on the right.

79
Q

Why don’t you see cranial nerve signs presenting with a stroke?

A

All lower motor neurons {Cranial Nerves} of the Corticonuclear tract receive bilateral innervation. When one side is damaged they still receive the signal from the other side. the only exception is the bottom 2/3 of the facial nerve.

80
Q

What is the Flocculonodular Node involved with? What will you get if it is damaged?

A

The Flocculonodular Node is involved with the inner ear and the functions of balance and equilibrium.

Vertigo

81
Q

What is the major functional cell of the Cerebellum?

A

Purkinje Neuron in the Cerebellar Folium. Results in the inhibitory actions of the cerebellum.

82
Q

What is the major nucleus of the Cerebellum and what is it responsible for?

A

The Dentate Nucleus which is responsible for regulating movement of the extremities.

83
Q

What are the Vermis and Paravermal zones responsible for? What Nuclei are involved with these?

A

Execution of movement and muscle tone of the body and limbs.Fastigial and Interposed Nuclei

84
Q

What it the Lateral zone responsible for and which nucleus does it pass through?

A

Motor planning and evaluation of sensory information; dentate nucleus.

85
Q

What nuclei is the Flocculonodular Lobe connected to? What are they responsible for?

A

The Vestibular Nuclei. They determine the location and acceleration of the head. Head and eye movements as well as balance and equilibrium.

86
Q

What nuclei and neurotransmitter is affected in Parkinson’s.

A

The Substantia Nigra {SNc} of the Basal Ganglia. Dopamine.

87
Q

What nuclei and neurotransmitter is affected in Huntington’s?

A

The Striatum {Caudate Nucleus + Putamen}; GABA.

88
Q

What nuclei and neurotransmitter is affected in Hemiballismus?

A

The Subthalamic Nuclei; Excitatory. {Glutamine or Acetylcholine?}

89
Q

What three questions should you ask when trying to diagnose a neurological problem?

A
  1. What region of the NS is affected?
  2. Is it focal or diffuse?
  3. What is the diagnosis?
90
Q

What symptoms will often be present with spinal cord lesions?

A

Bowel and bladder problems as well as symptoms bilaterally.

91
Q

What 4 things should you examine for the motor portion of a neurological exam?

A
  • Strength
  • Reflexes
  • Tone {Velocity Dependant or Rigid}
  • Bulk
92
Q

Describe the grading scale of the British Research Council strength assessment.

A
  • 5 is full movement against full resistance.
  • 4 is full movement against some resistance.
  • 3 is movement against only gravity.
  • 2 is movement with gravity eliminated.
  • 1 is flicker movements.
  • 0 is no movement.
93
Q

What four “systems” of the nervous system should you start with in investigating a nervous system problem to help with localization?

A
  • Cranial Nerves
  • Motor
  • Sensory
  • Coordination
94
Q

What is a Romberg Sign?

A

A test of the bodies proprioception. You need ⅔ of vision, proprioception, and vestibular function to maintain balance. By closing ones eyes you can see if the other two are functioning. If they start to fall it is likely that their sense of proprioception is failing.

95
Q

What is Dysmetria?

A

A type of ataxia characterized by an inability to judge distances. The individual will consistently under or overshoot objects.

96
Q

What is Dysdiadokokinesis?

A

An inability to perform rapid, alternating, movements due to damage of the cerebral cortex or the cerebellum.

97
Q

What are the criteria for grading reflexes?

A

0: Reflex is absent with distraction.
1: Reflex is present but hyporeflexive with distraction.
2: Reflex is NORMAL.
3: Reflex is hyperreflexive and involves an additional muscle group.
4: Clonus

98
Q

What is the name of the foramen {or apertures} which drain CSF from the 4th ventricle?

A

The Lateral Foramina of Luschka and the Medial Foramen of Magendie.

99
Q

Where does CSF drain into from the fourth ventricle?

A

The Cerebellomedullary Cistern {Cisterna Magna}.

100
Q

What produces CSF?

A

The Choroid Plexuses.

101
Q

Where is CSF reabsorbed and sent into the venous circulation?

A

Superior Sagittal Sinus via Arachnoid Granulations

102
Q

What is the Superior Colliculi?

A

A relay station for the optical system.

103
Q

What is the Inferior Colliculi?

A

A relay system for the auditory system.

104
Q

What are two effective ways of treating hydrocephalus?

A

Ventriculo-Peritoneal Shunts & Transventricular 3rd Ventriculostomy into the Interpeduncular Cistern from the Pre-mammillary Membrane in the floor of the 3rd ventricle.

105
Q

What are the three hallmark symptoms of Normal Pressure Hydrocephalus {NPH}? What condition may develop later on if this is not treated?

A
  • Thinking and Reasoning Problems
  • Difficulty in Walking {Gait Apraxia, Wide, Shuffling Gait}
  • Loss of bladder Control
  • Later On: Dementia.
106
Q

What are the three causes of hydrocephalus?

A
  • Excessive Production
  • Reduced Reabsorption
  • Obstructions to Flow

Neurology (2 decks)

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