Week 1 Labs Flashcards

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1
Q

Tracts

A

ascending and descending systems which connect the spinal cord and brainstem ot hte cerebrum

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2
Q

Cerebellar peduncles

A

three pairs of axon bundles that relay connections to and from the cerebellum

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3
Q

Three divisions of the brainstem

A

midbrain, pons, medulla

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4
Q

4-4-4 rule

A

4 cranial nerves emerge from each: medulla, pons, midbrain and higher

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5
Q

Cranial nerves arising from the medulla

A

Glossopharyngeal - IX
Vagus - X
Spinal Accessory - XI
Hypoglossal - XII

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6
Q

Cranial nerves arising from the pons

A

Trigeminal - V
Abducens - VI
Facial - VII
Vestibulocochlear - VIII

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7
Q

Cranial nerves arising from the midbrain or higher

A

Midbrain:
Ocular Motor - III
Trochlear - IV

Above:
Optic nerve - II

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8
Q

Only sensory modality where in-coming information bypasses thalamus and is carried directly to central cortical structures.

A

Smell

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9
Q

Where are the sensory/motor cell bodies of all the cranial nerves except I, II, XI?

A

Sensory - ganglia lying outside the CNS similar to the dorsal roots of spinal nerves
Motor - within the CNS collected into nuclei serving well-defined muscle groups

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10
Q

Role of cerebellum

A
  1. coordinating center for the control of movement by modulating the force, speed, and pattern of muscular contraction –> modulates upper motor neurons
  2. learning motor skills and detecting errors between intended/actual movements
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11
Q

Lower motor neurons

A

neurons whose axons directly synapse on muscle

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12
Q

Upper motor neurons

A

neurons whos axons synapse on lower motor neurons and are found in the motor cortices

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13
Q

T/F The cerebellum resides on major sensory and motor pathways.

A

F

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14
Q

Where does the cerebellum receive information from?

A

Cerebral cortex, spinal cord, and CN 8.

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15
Q

Three components of cerebellum

A
  1. cerebellar cortex
  2. deep cerebellar nuclei (pair)
  3. 3 cerebellar peduncles (pairs)
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16
Q

Functional part of the cerebellum that conducts neuronal calculations on in-coming signals

A

cerebellar cortex

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17
Q

The circuitry of the cerebellar cortex is the same throughout the cerebellum but is divided into functional units based on _______.

A

the anatomical source of their inputs and targets of their outputs

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18
Q

Three functional units of cerebellar cortex

A
  1. corticocerebellum (hemispheres)
  2. spinocerebellum (vermis and paravermis)
  3. vestibulocerebellum (flocculonodular lobe)
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19
Q

The spino and vestibulocerebellum receive input from the spinal cord and CN8 via ______.

A

inferior cerebellar peduncle

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20
Q

The corticocerebellum receives input by means of the ________.

A

middle cerebellar peduncle

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21
Q

The superior cerebellar peduncle carries ______ signals to the ________ and part of the ______ which projects to the _______.

A

output; midbrain; thalamus; motor cortices

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22
Q

Blood is supplied to the brain via which two major arteries?

A

Internal carotid and vertebral arteries.

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23
Q

The vertebral arteries form the ________.

A

Basilar artery

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24
Q

The Circle of Willis is supplied by which arteries?

A

Basilar artery and internal carotid artery

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25
Q

The Circle of Willis distributes blood to which principal vessels?

A

Anterior, middle, and posterior cerebral arteries (also includes posterior and anterior communicating arteries)

*also smaller arteries to the cerebellum, brainstem, and cerebrum

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26
Q

Cerebral veins drain into what structures?

A

Dural sinuses

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27
Q

In what major vessel does cerebral venous blood return to the heart?

A

jugular veins

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28
Q

Three brain membranes/meninges

A

dura, arachnoid, pia

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29
Q

Pia mater

A

thin layer that covers the contours of the brain –> encloses all but he largest blood vessels

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30
Q

Which structures lie in the subarachnoid space?

A

in addition to CFS, large cerebral blood vessels and their major branches

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31
Q

What structure produces CSF?

A

choroid plexus - specialized secretory epithelia located in each ventricle

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32
Q

What structure connects the lateral and third ventricles?

A

foramen of monro

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33
Q

What structure connects the 3rd and 4th ventricles?

A

cerebral aqueduct

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34
Q

How does CSF normally escape the ventricular system?

A
  1. arachnoid granulations into dural sinuses

2. three apertures in the walls of the fourth ventricle into the subarachnoid space

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35
Q

Epidural hematomas are between what layers?

A

dura and skull

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36
Q

Subdural hematomas are between what layers?

A

arachnoid and dura

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37
Q

Arachnoid hematomas are between what layers?

A

pia and arachnoid

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38
Q

Four major brain lobes

A

Parietal
Frontal
Temporal
Occipital

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39
Q

Lateral sulcus/Sylvian fissure divides

A

temporal lobe from the frontal and parietal lobes

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40
Q

Falx cerebri

A

vertically oriented, midline sheet of dura that separates the brain into two hemispheres

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41
Q

Tentorium cerebelli

A

two horizontal sheets of dura that originate from the lateral dura; forms the posterior compartment and separates the cerebellum from the rest of the cerebrum

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42
Q

Superior and inferior sagittal sinus

A

major venous drainages of the brain; superior also has connections with the arachnoid via the arachnoid granulations

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43
Q

Arachnoid mater

A

middle meningeal layer; delicate, translucent membrane that encloses the entire CNS including the spine

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44
Q

Subarachnoid space

A

contains CSF; has large pockets known as cisterns

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45
Q

3 cisterns

A

Cisterna magna
Superior cistern
Interpeduncular cistern

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46
Q

Telencephalon

A

major portion of the brain specimen covered with sulci and gyri that increase surface area; contains basal ganglia which have motor and cognitive functiosn

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47
Q

Thalamus

A

large mass consisting of many individual nuclei and is the route by which ascending information reaches the cerebral cortex

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48
Q

Third ventricle geometry

A

between two thalami; floor is the hypothalamus

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49
Q

Epithalamus

A

consists of the pineal gland and the posterior commissure

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50
Q

Subthalamus

A

transitional region between thalamus and midbrain

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51
Q

Pons

A

contains nuclei for input into the cerebellum as well as brainstem nuclei

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52
Q

Cerebellum

A

important for balance, coordination, and planning and executing movements

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53
Q

Medulla

A

contains multiple cranial nerve nuclei and part of the reticular formation

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54
Q

Components of the lateral ventricle

A

frontal horn, body, occipital horn, temporal horn

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55
Q

Two important apertures

A

Midline (Foramen of Magendie)

Lateral (Foramen of Luschka)

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56
Q

Longitudinal fissure

A

midline fissure separates the right and left hemisphere

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57
Q

Corpus callosum

A

joins the two hemispheres together: rostrum, genu, body, splenium

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58
Q

Frontal lobe

A

contains the prefrontal cortex –> personality, decision-making, future planning, and other complex concepts;
caudal part –>motor cortex-eye movements, motor memory, and the motor output of speech

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59
Q

Parietal lobe

A

posterior to central sulcus –> sensory processing and integration + primary somatosensory cortex + integrations of spatial, visual, and auditory

60
Q

Pre-occipital notch

A

small sulcus that separates the temporal and parietal lobes from the occipital lobe

61
Q

Temporal lobe

A

found ventral to the Sylvian fissure –> memory, language, smell, audition, visual object/facial recognition

62
Q

Insular lobe

A

deep plane of cortex that runs parallel to outer cerebral cortex –> primitive (e.g. taste)

63
Q

Orbitofrontal cortex

A

above the orbits –> one of three major divisions of prefrontal cortex –> novel decisions + linked to limbic system

64
Q

Infundibulum

A

pituitary stalk –> protuberance behind optic chiasm (connects hypothalamus to pituitary)

65
Q

Mammillary bodies

A

two small bumps posterior to infundibulum –> memory

66
Q

Uncus

A

most medial part of temporal lobe –> herniation from intracrainal pressure (accompanied by CN3 palsy)

67
Q

Segments of the corpus callosum

A

Rostrum, Genu, Body, Splenium

68
Q

Anterior commissure

A

“white dot” –> connects medial regions of the temporal lobes (uncus’)

69
Q

Calcarine fissure

A

in medial occipital lobe –> cortex on upper/lower banks = primary visual cortex

70
Q

Cingulate gyrus

A

cortical area important for memory consolidation

71
Q

Massa intermedia (interthalamic adhesion)

A

midline within the third ventricle connecting the two thalami

72
Q

Hypothalamic sulcus

A

divides the hypothalamus and epithalamus from the thalamus and subthalamus

73
Q

Pineal gland

A

region of the epithalamus –> under splenium –> produces melatonin

74
Q

Posterior commissure

A

region of the epithalamus –> between pineal gland and anterior portion of cerebral aqueduct –> axons that connect the midbrain nuclei –> pupillary reflex to light

75
Q

Primary motor cortex

A

anterior to central sulcus –> movement

76
Q

Supplementary/premotor cortex

A

anterior to primary motor cortex –> modulate and plan movements –> movement quality

77
Q

Frontal eye fields

A

Brodmann area 8 anterior to premotor cortex –> produces fast eye movements (saccades)

78
Q

Prefrontal cortex

A
  1. lateral = plan formation

2. orbitofrontal = plans based on ethics and morals (ventral)

79
Q

Broca’s area

A

ventral frontal cortex –> speech production (language tends to be in the left brain)

80
Q

Primary somatosensory cortex

A

posterior to central sulcus –> sensory information from thalamus

81
Q

Somatosensory and visual association cortex

A

Posterior to primary somatosensory cortex –> synthesize visual and somatosensory information

82
Q

Supramarginal gyrus

A

important for language comprehension and processing

83
Q

Angular gyrus

A

language comprehension

84
Q

Visual association cortex

A

superior and inferior to the primary visual cortex around the calcarine fissure –> refining the neural representation of visual scenes

85
Q

Superior temporal gyrus

A

first gyrus ventral to Sylvian fissure –> auditory processing

86
Q

Middle and inferior temporal gyri

A

ventral to superior temporal gyrus –> visual association areas –> refine “what” an object is

87
Q

Fusiform/inferior temporal gyrus/cortex

A

multiple gyri between inferior temporal gyrus and parahippocampal gyrus on ventral temporal lobe –> visual association

88
Q

Parahippocampal gyrus

A

ventromedial temporal lobe –> memory formation and storage

89
Q

Wernicke’s area

A

posterior superior temporal gyrus –> language comprehension

90
Q

Heschl’s gyrus

A

primary auditory cortex

91
Q

Oculomotor nerve (CN3)

A

exits brainstem from interpeduncular cistern –> controls six extraocular muscles, levator palpebrae, and parasympathetic control of pupil

92
Q

What is a CN consequence of uncal herniation and how does this present?

A

CN3 compression –> oculomotor nerve palsy (down and out) + ptosis + dilated pupil

93
Q

Colliculi

A

two pairs of bumps on the dorsal surface of midbrain –> along with CN4

94
Q

Superior colliculus

A

involved in reflexive head and eye movements in response to stimuli –> receives ascending auditory and somatosensory + retina

95
Q

Inferior colliculus

A

obligatory relay nucleus in audition –> sends axons to thalamus//primary auditory cotex and to the superior colliculus

96
Q

What is the only nerve to emerge from the dorsal surface of the brainstem?

A

CN4/Trochlear –> caudal to inferior colliculus –> long and tortuous course around cerebral peduncle to posterior region of cavernous sinus –> prone to damage

97
Q

Divisions of the pons

A

pontinetegmentum (inner) and the basis pontis (outer)

98
Q

What nerve emerges from the lateral pons?

A

CN5/Trigeminal –> exits pons and pierces middle cerebellar penduncle at right angle

99
Q

Components of the vestibulocerebellum

A

regulates postural muscles and stability of gaze

  1. flocculus– tongue-like lateral appendages
  2. nodulus - internal part of the vermis in the fourth ventricle
100
Q

Spinocerebellum

A

modulates movements of large distal muscles –> paravermis

axial muscles –> vermis

101
Q

Tonsils

A

bulges of paravermis –> herniation through the foramen magnum can be caused by intracranial pressure

102
Q

Cerebellar peduncles

A
  1. superior = dive into brainstem and form roof of rostral half of 4th ventricle –> mostly output
  2. middle = input from motor cortex
  3. inferior = input/output from brainstem and cord
103
Q

Pyramids

A

two elevations extending entire length of medulla –> contains axons from the motor cortex/UMN that will terminate with spinal cord for voluntary movement

104
Q

Inferior Olives

A

elevations on medulla lateral to pyramids –> major input to the cerebellum

105
Q

Lenticulostriate arteries

A

small penetrating branches of the MCA that supply the putamen, globus pallidus, and internal capsule –> sensitive to blood pressure changes and can cause hemorrhagic stroke (no collateral circulation can cause paresis easily)

106
Q

Posterior inferior cerebellar artery

A

first major branch of vertebral arteries and supplies choroid plexus, inferior surface of cerebellum, and lateral medulla

107
Q

Anterior inferior cerebellar arteries

A

branches of the basilar that supply the anterior/inferior portion of cerebellum and lateral pons

108
Q

Caudal arteries of the basilar

A
  1. superior cerebellar = superior and dorsal cerebellum
  2. posterior cerebral = rostral supply to occiptal lobe (runs above tentorium cerebelli)
    * both supply lateral midbrain
109
Q

Thalamoperferators

A

small vessels from tip of basilar and beginning of posterior cerebral arteries that enter the brain via the interpeduncular fossa and supply thalamus/subthalamus

110
Q

Great Vein of Galen/Great Cerebral Vein

A

found under splenium –> main draining area of internal cerebrum –> drains into straight sinus

111
Q

Where do superficial cerebral veins drain into?

A

superior and inferior sagittal sinuses

112
Q

The merging of what vessels creates the straight sinus?

A

inferior sagittal sinus + Great Vein of Galen

113
Q

Where does the straight sinus drain into?

A

confluens of sinuses

114
Q

What vessels arise from the confluens of sinuses?

A

two transverse sinuses

115
Q

What neurons are in the intermediolateral cell column?

A

lateral horn in T1-L2 segments –> preganglionic sympathetics

116
Q

In what tract do Clarke’s nucleus axons ascned the spinal cord

A

dorsal spinocerebellar tract –> nuclei between T1-L2 –> proprioceptive input to cerebellum

117
Q

Where are neurons that act as central pattern generators for locomotion found?

A

intermediate zone of lumbosacral enlargements

118
Q

Which nerves are classified by roman numerals?

A

dorsal roots of muscular nerves are classified by conduction vessels via roman numerals

119
Q

Which nerves are classified alphabetically?

A

dorsal roots of cutaneous nerves are classified by fiber diameter alphabetically

120
Q

Where do Ia and Ib fibers arise?

A

muscle spindles and golgi tendon organs

121
Q

Where do II fibers arise?

A

muscle spindles

122
Q

What do A-beta fibers innervate?

A

skin mechanoreceptors

123
Q

What do A-delta fibers respond to?

A

sharp pain/cold (free nerve endings)

124
Q

What do C-fibers respond to?

A

dull pain/warmth (free nerve endings)

125
Q

What 3 kinds of axons can exit the spinal cord in a ventral root?

A
  1. axons of alpha or LMN for extrafusal muscle fibers
  2. gamma motor neurons for intrafusal fibers (spindles and golgi)
  3. preganglionic autonomics (T-L2 and S2-S4)
126
Q

Role of Renshaw cells

A

recurrent inhibition limits the firing of alpha motor neurons –> feedback inhibition/sensitivity of alpha motor neurons

127
Q

Clinical consequence of blocking Renshaw cells

A

e.g. tetanus –> sustained contractions and spasms of axial and limb muscles

128
Q

2 lateral system motor tracts

A
  1. corticospinal = internal capsule –> decussation of pyramids –> contralateral skilled limb movement
  2. rubrospinal = red nucleus –> cross below red nucleus –> parallel to corticospinal –> contralateral upper limb flexion
129
Q

2 medial system motor tracts

A

reticulospinal and vestibulospinal tracts –> postural control (bilateral)

130
Q

Which reflex utilizes C5-C6?

A

biceps brachii

131
Q

Which reflex utilizes C7-C8?

A

triceps brachii

132
Q

Which reflex utilizes L3-L4?

A

quadriceps/patellar

133
Q

Which reflex utilizes S1-S2?

A

gastroc-soleus/ankle jerk

134
Q

What kind of lesions result in an ipsilateral flaccid paralysis at the level of the lesion?

A

LMN

135
Q

What kind of lesions result in an ipsilateral or contralateral spastic paralysis below the level of the lesion?

A

UMN

136
Q

Horner’s syndrome

A

lesion of descending hypothalamic axons between hypothalamus and preganglionic sympathetics in cord –> miosis, ptosis, anhidrosis ipsilaterally (also orthostatic hypotension)

137
Q

3 P’s of tabes dorsalis

A
  1. parasthesia
  2. pain - hypersensitivity of small diameter axons
  3. polyuria - loss of large diameter sensory neurons that mediate bladder fullness
138
Q

A unilateral lesion of the crossed axons of the spinothalamic tract in the spinal cord or brainstem results in a loss of pain and temperature where?

A

contralateral and below the lesion

139
Q

If the spinothalamic tract is lesioned in the spinal cord, where is the loss of temperature and pain?

A

contralateral and begins 1-2 segments below the level of the lesion

140
Q

Where does the dorsal spinocerebellar tract arise?

A

Clarke’s nucleus from T1-L2 –> carries proprioceptive input from stretch/golgi in lower limb and lower trunk

141
Q

Where do 2nd order axons from clarke’s nucleus extend?

A

they enter the dorsal spinocerebellar track and enter cerebellum via inferior peduncle

142
Q

Where does the cuneocerebellar tract arise?

A

primary upper limb spindles/golgi synapse in the external cuneate nucleus (brainstem) and secondary axons form the cuneocerebellar tract that run into the cerebellum via the inferior peduncle

143
Q

The dorsal roots that synapse in the superficial layers of the dorsal horn are mainly those carrying ___________.

A

Pain and temperature

144
Q

Where are primary cell bodies of the corticospinal tract?

A

contralateral motor cortex

145
Q

Where are primary cell bodies of the rubrospinal tract?

A

red nucleus in midbrain

146
Q

Where are primary cell bodies of the lateral vestibulospinal tract?

A

ipsilateral lateral vestibular nucleus in medulla

147
Q

Where are primary cell bodies of the reticulospinal tract?

A

pons and medulla