Week 1 Neurology Intro Sessions Flashcards
What is this?
What is this?
What is this?
What is this?
What is this?
What is this?
What is this?
What is this?
What is this?
What is this?
What is this?
What is this?
Frontal lobe functions
Bonus: specific areas for motor control
5 functions of the parietal lobe
Both the frontal and temporal lobes are involved with speech. Which does what with regards to speech?
Frontal: speech output ( think motor function )
Temporal: speech input
The dominant and non-dominant parietal lodes have slightly different functions, what are these?
Dominant: language
Non-dominant: spatial awareness and orientation
Signs of a parietal lobe lesion
Contralateral hemisensory loss
Dominant: dysphasia, acalculia
Non-dominant: spatial disorientation on contralateral side, construction/ dressing apraxia
6 functions of the temporal lobe
What part of the brain is this virus affecting?
Temporal: we know it’s temporal and not frontal because the eyes can be seen at this level in the scan
7 Effects of a temporal lobe lesion
Functions of the occipital lobe
Signs of a temporal lobe lesion
Visual problems/ hallucinations
Briefly describe the order of the body parts of the homunculus
Foot
Leg
Torso plus head
Arm
Hand
Face
Tongue
Hypothalamus function
Homeostasis
Medulla function
Subconscious breathing
Rough order of the anatomy of the brainstem
Cerebellum function and effect of lesion
- Fine tunes coordination of movement from cortex inc. speech
- involved and planning and learning of skilled movements
Lesions present with incoordination in the same side, an inability to produce rapid and accurate movements, distance of targets misjudged, target accuracy decreases as gets closer, characteristic ataxic gait
How many of each type of spinal chord nerves are there
Describe the life cycle of CSF: production, flow, reabsorption
How much CSF is there?
125ml
How much CSF is produced each day?
500ml
5 Functions of the CSF
- Buoyancy
- Protection
- Perfusion control, amount of CSF is proportional to pressure within the cranium, by decreasing the pressure in the cranium this increases perfusion
- Homeostasis
- Clearing waste
When taking a lumber puncture what normal pressure ranges should you expect?
What are the features and causes of high ICP (intra cranial pressure)
What are the features and causes of low IPC (intra cranial pressure)
A 15-year-old boy is brought into the GP after a strange experience. He reported that he felt an overwhelming sensation of fear, felt sick in his stomach, felt his heart going very fast, and heard a laughing sound. His mother noticed him go very white. He did not lose consciousness or feel dizzy. The episode lasted for a minute and a half, after which he was left confused and with a strange feeling of deja vu.
What is the most likely cause of this experience?
Focal temporal lobe seizure
The correct answer is focal temporal lobe seizure. Temporal lobe seizures are characterised by hallucinations, such as this boy’s perceptions of fear, epigastric discomfort, tachycardia, and hearing laughter. His colour change, noted by his mother, and feeling of confusion and deja vu following the episode, is also characteristic of temporal lobe seizures.
A 68-year-old man attends his general practitioner with a two month history of difficulty with speech. He reports that he has had difficulty in generating speech and often struggles to find words but no difficulty in understanding verbal or written language.
A CT head is performed to determine the aetiology of his symptoms.
What is this called?
Where would you expect to find a lesion given this man’s symptoms?
Broca’s aphasia
Left inferior frontal gyrus
A 22-year-old man is brought to the Emergency Department following a motorcycle accident. He has sustained a severe head injury, and a subsequent CT scan of the head shows a significant midline shift along with a large subdural haematoma. The neurosurgery team indicates that the bleeding exerts pressure on the structure that typically divides the cerebral hemispheres.
What structure is being referred to by the neurosurgery team?
Falx cerebri
The falx cerebri is a prominent, sickle-shaped fold of dura mater that descends within the longitudinal fissure, separating the two cerebral hemispheres.
Where are the arterial territories of the anterior, middle and posterior cerebral arteries
Thinking about arterial territories, what would you need to assess for in an anterior or middle circulation stroke but not in a posterior circulation stroke?
Carotid artery stenosis
Thinking about arterial territories what might you need to assess for if a stroke is in multiple territories including bilaterally?
Cardioembolic stroke
This is where emboli are coming from the heart
This is a CT of ischemia in the brain. What artery is likely occluded and what would the likely symptoms be?
Left middle cerebral artery
Remeber CT is looking from underneith
Like symptoms are right sided hemiplegia and aphasia with the chance of loss of vision in the right sided field
What is going here?
What circulation is occluded?
What are the likely symptoms?
Right cerebellar infarct
This is a posterior circulation infarction (I am not sure which artery but I assume either the right SCA, AICA, PICA or vertebral. If it were the basilar would both sides be affected? The right vertebral could affect the right PICA only)
Ataxia mainly affecting the right side of the body
Fill in the names of the venous drainage of the brain
What structure do the first ones flow down?
The saggital sinuses flow down the falx cerebri
What is this?
What are the likely symtoms?
What is the likely history?
Sagittal sinus thrombosis
The sagittal sinus is clearly occluded
Likely symptoms are a headache. They may also have had focal neurological deficits (e.g. paralysis) and seizures
They likely had risk factors for thrombosis – such as hormonal contraceptive use, pregnancy, or cancer
What are the following sensory nerve endings and what do they do?
Free nerve endings: pain/temperature
Merkel endings: touch/pressure. Hint: Angela merkel was under a lot of pressure as chancellor
Meissner’s corpuscle: fine touch
(especially concentrated in fingertips)
Which root do sensory fibres enter the spinal chord?
Sensory fibres enter the spine via the dorsal roots
Hint: Dolphins are sensitive and have dorsal fins
Describe the acending pathway of pain & temperature nerves
1st order neuron enters the spinal chord via the dorsal root and synapses on entry
Decussates immediately
2nd order neuron ascends in spinothalamic tract
Second synapse in thalamus
3rd order neuron ascends to cortex
Describe the acending pathway of touch, proprioception & vibration nerves
1st order neuron enters cord via the dorsal root
Ascends via ipsilateral dorsal column pathway
Synapse in medulla
Then decussation in medial lemniscus, ascent as 2nd order neuron
Final synapse in thalamus
Ascent to sensory cortex
In what tract do pain and temperature sensory nerves travel up the spinal chord?
Spinothalamic tract
In what tract do touch, proprioception & vibration sensory nerves travel up the spinal chord?
Ipsilateral dorsal column pathway
Which of the cranial nerves are sensory and which are motor?
CN I →XII
Some Say Marry Money But My Brother Says Big Brains Matter Most
S = Sensory, M = Motor, B = Both
What is the difference between the falx cerebri and the longitudinal fissure?
Key Differences Summarized:
Nature:
The falx cerebri is a structure (a membrane) made of dura mater that acts as a channel for the superior and inferior saggital sinuses to flow through.
The longitudinal fissure is a space (a groove).
Relationship:
The falx cerebri sits within the longitudinal fissure.
What is the amygdala and what does it do?
Temporal lobe. Responsible for processing emotions and social stimuli. Part of the limbic system
What is the limbic system?
Where does it sit in the brain?
Which parts of the brain are in it?
Sits medially (inside)
Parts of the brain responsible for emotions and survival behaviours
Hippocampus
Amygdala
Hypothalamus
Cingulate gyrus
