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M5 General Anatomy > Y2: Neuroanatomy > Flashcards

Y2: Neuroanatomy Flashcards

1
Q

Osteology

Skull consists of 2 main regions

A

Neurocranium
Viscerocranium

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2
Q

Osteology

Define Neurocranium

A

“protective case for brain”

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3
Q

Osteology

Define Viscerocranium

A

jaw/facial skeleton

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4
Q

Osteology

Neurocranium is formed by X bones. What are they?

A

8 Bones
Frontal
Parietal
Occipital
Ethmoid
Sphenoid
Temporal

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5
Q

Osteology

The Neurocranium is divided into X zones

A

2 Zones
The Calvaria (skullcap)
The Cranial Base

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6
Q

Osteology

Label the Neurocranium

A
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7
Q

Osteology

Label the Viscerocranium

A
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8
Q

Osteology

The Viscerocranium is made up of X bones, what are they?

A

14 bones
Includes the upper and lower jaw

Some: lacrimal, inferior concha, maxilla, mandible, nasal, zygomatic, palatine, Vomer,

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9
Q

Osteology

The skull has sutures, what does this mean?

A

Joints vetween calvarial membrane bones of skull are known as sutures. Theses are important and needed for the infant’s brain growth and the flexibility of the sutures allows the baby’s head to pass through the birth canal.

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10
Q

Osteology

What are the skull sutures?

A

Coronal, bregma, saggital, lambdoid, lambda, asterion, pterion

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11
Q

Osteology

Sutures meet to form…..

A

Fontanelles

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12
Q

Osteology/ Development

When do the Fontanelles close?

A

Closure of fontanelles
Posterior – 2-3 months
Sphenoidal – 6 months
Mastoid – 6- 18 months
Anterior – 18 months- 2 yrs

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13
Q

Osteology

Label the Fontanelle

A
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14
Q

Osteology

What is the internal cranial cavity divided into?

A

3 Fossa
Anterior
Middle
Posterior

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15
Q

Osteology

Label the Internal Cranial Cavity

A
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16
Q

Osteology

What are foramina?

A

Holes in the internal cranial cavity that allow structures such as nerves and blood vessles to pass through.

In the skull- this is mostly for cranial nerves.

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17
Q

Osteology

Label the skull foramina

A
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18
Q

Osteology

Label the skull foramina

A
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19
Q

What is the cranial fossae?

A

Depression in the skull, relating to key structures of the brain

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20
Q

What structures are related to the cranial fossae?

A

Anterior – Cerebrum (frontal lobe)
Middle - Cerebrum (temporal lobe)
Posterior – Cerebellum

Midline –
Hypophyseal/ pitutitary fossa
Brainstem

Foramen magnum- Medulla, Spinal cord

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21
Q

Neuro- Nerves

Identify the Cranial Nerves:

A
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22
Q

Neuro- nerves

What are each of the cranial nerves?

A

1- Olfactory
2- Optic
3- Oculomotor
4-Trochlear
5- Trigeminal
6- Abducens
7- Facial
8- Vestibulocochlear
9- Glossopharyngeal
10- Vagus
11- Accessory
12- Hypoglossal

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23
Q

Which of the cranial nerves do not integrate with the brain stem

A

1 and 2
Olfactory
Optic

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24
Q

What are the roles of the cranial nerves?

A
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25
Q

What are the layers of the Scalp?

A

S- Skin
C- Cranium
A- Aponeurosis
L- Loose Connx Tissue
P- Periosteum/ Pericranium

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26
Q

What is the meninges?

A

The meninges refers to the membranous structures that surround brain and spinal cord.
There are 3 layers: dura mater, arachnoid mater and pia mater.

Provide a supportive framework for the cerebral and cranial vasculature.
Acting with cerebrospinal fluid to protect the CNS from mechanical damage.

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27
Q

Label the meninges

A
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28
Q

What is the Dura Mater

A

two layered sheets of connective tissue:
Periosteal layer: lines surface of cranium
Meningeal layer: continuous with the dura mater and DEEP

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29
Q

dural venous sinuses are located

A

between the layers of the dura mater
They are responsible for the venous drainage of the cranium

empty into the internal jugular veins.

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30
Q

Dura Mater receives vascular supply from

A

middle meningeal artery and vein.
It is innervated by the trigeminal nerve (V1, V2 and V3).

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31
Q

What are dural reflections?

A

Folds of dura mater that protrude inwards upon itself.

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32
Q

What are the X dural reflections?

A

4 Dural Reflections:

Falx cerebri
Tentorium cerebelli
Falx cerebelli
Diaphagma sellae

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33
Q

What is the arachnoid mater?

A

middle layer of the meninges
lies under the dura mater
Avascular
No innervation
Connx tissue

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34
Q

What is the subarachnoid space?

A

Underneath the arachnoid
CSF
Small projections called arachnoid gradnulations allow CSF to re-enter the circulation

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35
Q

What is the pia mater?

A

Located under the subarachnoid space
Thin
Tightly adhered to brain and spinal cord surface
Follows the brain contours (gyri and fissures)

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36
Q

What is the spinal cord?

*LOB: Describe the anatomy of the spinal cord, its coverings, spinal nerves, and their parts.

A

Is the continuation of the Brainstem into the vertebral column through the Foramen Magnum

T2-weighted sagittal magnetic resonance imaging (MRI) of the cervical spine in the midline, showing the cervical and upper thoracic vertebrae (C. 2–T. 4).

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37
Q

Spinal cord is a continuation of the

*LOB: Describe the anatomy of the spinal cord, its coverings, spinal nerves, and their parts.

A

Continuation of medulla oblongata of the brain stem

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38
Q

Which cranial structure does the spinal cord run through

*LOB: Describe the anatomy of the spinal cord, its coverings, spinal nerves, and their parts.

A

The foramen magnum

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39
Q

The spinal cord terminates at

*LOB: Describe the anatomy of the spinal cord, its coverings, spinal nerves, and their parts.

A

L1

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40
Q

Cauda equina

*LOB: Describe the anatomy of the spinal cord, its coverings, spinal nerves, and their parts.

A

Nerve roots descend below conus medullaris (terminus of cord)

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41
Q

Spinal cord has 2 enlargements of ____ at ____ and ________

*LOB: Describe the anatomy of the spinal cord, its coverings, spinal nerves, and their parts.

A

Spinal cord has 2 enlargements of grey matter at cervical and lumbar
to provide sensory and motor to upper and low limb

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42
Q

Identify the spinal cord in axial view

*LOB: Identify the major landmarks of the spinal cord within the vertebral canal.

A
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43
Q

Identify grey matter

Axial view of spinal cord

*LOB: Identify the major landmarks of the spinal cord within the vertebral canal.

A

Nerve cell bodies and their dendrites and synaptic contacts
Butterfly of H-shaped.

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44
Q

Describe and identify white matter

Axial view of spinal cord

*LOB: Identify the major landmarks of the spinal cord within the vertebral canal.

A

Myelinated axons
Contains ascending and descending nerve fibres
Bundles arranged in columns (funiculi)
Each column consists of subdivisions called tracts
The tracts carry signals from one part of the CNS to another

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45
Q

Label the following:

*LOB: Identify the major landmarks of the spinal cord within the vertebral canal.

A
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46
Q

What are funiculi

Axial view of spinal cord

*LOB: Identify the major landmarks of the spinal cord within the vertebral canal.

A

White matter
Bundles arranged in columns (funiculi)
Each column consists of subdivisions called tracts

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47
Q

The layers of Spinal Cord Meninges are…

*LOB: Describe the anatomical relationships of the meninges to the spinal cord and dorsal and ventral nerve roots, particularly in relation to root compression and the placement of epidural and spinal injections.

A

Duramater
Arachnoid
Piamater

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48
Q

The dura mater extends from _ to __

*LOB: Describe the anatomical relationships of the meninges to the spinal cord and dorsal and ventral nerve roots, particularly in relation to root compression and the placement of epidural and spinal injections.

A

Foramen magnum to S2

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49
Q

The arachnoid extends from _ to __

*LOB: Describe the anatomical relationships of the meninges to the spinal cord and dorsal and ventral nerve roots, particularly in relation to root compression and the placement of epidural and spinal injections.

A

Foramen magnum to S2

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50
Q

The pia mater extends to __

*LOB: Describe the anatomical relationships of the meninges to the spinal cord and dorsal and ventral nerve roots, particularly in relation to root compression and the placement of epidural and spinal injections.

A

the filum terminale till the coccyx

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51
Q

Define Filum terminale

*LOB: Describe the anatomical relationships of the meninges to the spinal cord and dorsal and ventral nerve roots, particularly in relation to root compression and the placement of epidural and spinal injections.

A

thin filament which extends from the narrowed end of the spinal cord (conus medullaris) to the coccyx.

It is composed chiefly of the pia mater surrounding a continuation of the central canal, and some neural elements.

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52
Q

How does the meninges interact with roots?

*LOB: Describe the anatomical relationships of the meninges to the spinal cord and dorsal and ventral nerve roots, particularly in relation to root compression and the placement of epidural and spinal injections.

A

The dura mater forms a separate sheath for each dorsal and ventral root.

Dura extends over the Dorsal root Ganglia posteriorly, and then becomes continuous with the epineurium of the nerve.

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53
Q

What is epineurium

*LOB: Describe the anatomical relationships of the meninges to the spinal cord and dorsal and ventral nerve roots, particularly in relation to root compression and the placement of epidural and spinal injections.

A

The external connective tissue sheet which is continuous with the dura

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54
Q

What is epineurium

*LOB: Describe the anatomical relationships of the meninges to the spinal cord and dorsal and ventral nerve roots, particularly in relation to root compression and the placement of epidural and spinal injections.

A

The external connective tissue sheet which is continuous with the dura

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55
Q

What is Ligamentum denticulatum

*LOB: Describe the anatomical relationships of the meninges to the spinal cord and dorsal and ventral nerve roots, particularly in relation to root compression and the placement of epidural and spinal injections.

A

A thin ridge of pia mater on each side of the spinal cord
Extends from the foramen magnum to the L1 vertebra
Made up of 21 pointed projections of pia mater, extending laterally
Acts to keep the spinal cord movement limited within the duramater

“tooth ligament”

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56
Q

What are the ____ spaces related to the Spinal cord

*LOB: Describe the anatomical relationships of the meninges to the spinal cord and dorsal and ventral nerve roots, particularly in relation to root compression and the placement of epidural and spinal injections.

A

Subarachnoid space: Contains cerebrospinal fluid
Dura-arachnoid interface: subdural (potential) space
Extradural (epidural space): Filled with semiliquid fat and venous plexus

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57
Q

Where does Lumbar Puncture/ Spinal Anaesthesia occur? and why?

*LOB: Describe the anatomical relationships of the meninges to the spinal cord and dorsal and ventral nerve roots, particularly in relation to root compression and the placement of epidural and spinal injections.

A

subarachnoid space contains CSF
To avoid spinal cord- terminal end of the spinal cord
Lower border of L1 vertebra or L1-L2 intervertebral Disc.

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58
Q

Surface landmark for lumbar puncture

*LOB: Describe the anatomical relationships of the meninges to the spinal cord and dorsal and ventral nerve roots, particularly in relation to root compression and the placement of epidural and spinal injections.

A

Surface landmark- Highest point of iliac crest (L4), Insert needle one or two spaces above this level.

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59
Q

What is Radiculopathy

*LOB: Describe the anatomical relationships of the meninges to the spinal cord and dorsal and ventral nerve roots, particularly in relation to root compression and the placement of epidural and spinal injections.

A

Radiculopathy is sensory or motor disturbance caused by pathology of a nerve root.

Such as:
* disc herniation
* presence of osteophytes
* spinal stenosis
* trauma.

T2-weighted sagittal MRI of the cervical spine,
showing intervertebral disc prolapse between C3/C4, C4/C5, and C5/C6 (Yellow arrows) and compression of the dural sac (Red arrows)

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60
Q

Identify the following:
* Posterior ramus
* Anterior / Ventral Root
* Posterior / Dorsal Root
* Spinal Nerve
* Anterior ramus

*LOB: Describe the anatomy of a typical spinal nerve, including its origin from dorsal and ventral spinal roots, its main motor and cutaneous branches and any autonomic component.

A
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61
Q

Anterior / Ventral Root

*LOB: Describe the anatomy of a typical spinal nerve, including its origin from dorsal and ventral spinal roots, its main motor and cutaneous branches and any autonomic component.

A

Motor: Efferent neurons
Somatic – Muscles
Visceral – Organs (Autonomic nerves )

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62
Q

Posterior ramus

*LOB: Describe the anatomy of a typical spinal nerve, including its origin from dorsal and ventral spinal roots, its main motor and cutaneous branches and any autonomic component.

A

Posterior ramus
Somatic motor to intrinsic back muscles
Somatic sensory to skin of back

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63
Q

Posterior / Dorsal Root

*LOB: Describe the anatomy of a typical spinal nerve, including its origin from dorsal and ventral spinal roots, its main motor and cutaneous branches and any autonomic component.

A

Sensory: Afferent neurons
Somatic – Skin
Visceral – Organs (visceralperitoneum)
Cell bodies located in dorsal root ganglia

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64
Q

Spinal Nerve

*LOB: Describe the anatomy of a typical spinal nerve, including its origin from dorsal and ventral spinal roots, its main motor and cutaneous branches and any autonomic component.

A

Contains motor and sensory fibers
Divides into anterior and posterior ramus

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65
Q

Anterior ramus

*LOB: Describe the anatomy of a typical spinal nerve, including its origin from dorsal and ventral spinal roots, its main motor and cutaneous branches and any autonomic component.

A

Somatic motor to muscles of trunk and limbs
Somatic sensory to skin

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66
Q

The spinal cord gives rise to____ pairs of spinal nerves

*LOB: Describe the anatomy of a typical spinal nerve, including its origin from dorsal and ventral spinal roots, its main motor and cutaneous branches and any autonomic component.

A

8 Cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal

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67
Q

Spinal nerves emerge from the________

*LOB: Describe the anatomy of a typical spinal nerve, including its origin from dorsal and ventral spinal roots, its main motor and cutaneous branches and any autonomic component.

A

Spinal nerves emerge from the **intervertebral foramina **

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68
Q

Myotomes and Dermatomes

*LOB: Describe the anatomy of a typical spinal nerve, including its origin from dorsal and ventral spinal roots, its main motor and cutaneous branches and any autonomic component.

A

A skin area supplied by the sensory fibres of a single nerve root is known as a dermatome

A group of muscles primarily innervated by the motor fibres of a single nerve root is known as a myotome

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69
Q

Autonomic component

*LOB: Describe the anatomy of a typical spinal nerve, including its origin from dorsal and ventral spinal roots, its main motor and cutaneous branches and any autonomic component.

A

Afferent fibres synapse at the Lateral horn

**Connected to sympathetic ganglia via
White ramus communicans (Pre-ganglionic)
Grey ramus communicans (Post-ganglionic)
**

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70
Q

What is CSF

*LOB: Describe the ventricular system of CSF Flow and its parts, relations, and relevant clinical anatomy.

A

Ultrafiltrate of blood
* Produced by the choroid plexus
found in the walls of the
ventricles
* 150 ml
* 125 ml is intracranial
* The ventricles contain about 25
ml
* 100 ml is located in the cranial
subarachnoid space
* Secreted at a rate of 0.35–0.40
ml per minute

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71
Q

What is the function of CSF?

*LOB: Describe the ventricular system of CSF Flow and its parts, relations, and relevant clinical anatomy.

A
  • Lubrication
  • Shock absorber
  • Transporter
  • Nutrients
  • Waste products
  • Hormones
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72
Q

How does CSF circulate?

*LOB: Describe the ventricular system of CSF Flow and its parts, relations, and relevant clinical anatomy.

A

Lateral ventricles
Interventricular Foramen
Third Ventricle
Cerebral Aqueduct
Fourth Ventricle
Lateral Aperture, Medial Apeture, Lateral Apeture
Subarachnoid space
Arachnoid Villi
Sup Sagittal Sinus

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73
Q

What are the sub. arachnoid space and cisterns?

*LOB: Describe the ventricular system of CSF Flow and its parts, relations, and relevant clinical anatomy.

A

Spaces and pools of CSF for protection
1) Interpeduncular cistern (midbrain)
2) Pontine cistern (pons)
3) Cisterna Magna (medulla oblongata and cerebellum)

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74
Q

Define Tract

A

A collection of axons in the central
nervous system

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75
Q

Define Nerve

A

A collection of axons in the peripheral
nervous system

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76
Q

Define Nucleus

A

A collection of neuronal bodies in
the central nervous system

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77
Q

Define Ganglion

A

A collection of neuronal bodies in
the peripheral nervous system

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78
Q

What is the extent of the spinal cord?

A

Base of brain to lower border of L1 Vertebra

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79
Q

What are the segments of the spinal cord?

A

C1-8, T1-12, L1-5, S1-5, Co-1

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80
Q

What covers the spinal cord?

A

Inside the vertebral canal
* Enclosed in meninges- Dura, arachnoid and
Pia mater
* Surrounded by Extradural fat, lymphatics and
veins
* Cerebrospinal fluid located in Subarachnoid
space

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81
Q

Where are the tracts present?

A

In white matter

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82
Q

What is the ascending tract?

A

From the spinal cord to cerebral cortex

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83
Q

What is the descending tract?

A

From the cerebral cortex to the spinal cord

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84
Q

Features of the Ascending tract

A

Sensory in nature
* Arranged in the spinal cord
based on modalities they carry
* Orders of neurons- 1st, 2nd and
3rd
* Name gives a clue of
destination

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85
Q

What is the Spinothalamic Ascending tract?

A

Lateral- Pain and temperature
Anterior- crude touch and pressure

Posterior column- 2pt discrimination, vibration, position sense, sterognosis (depth perception), deep pressure

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86
Q

What is the lateral spinothalamic tract?

A
  • Receptors - Free nerve endings
  • First order - dorsal root ganglia
  • Second order- Substantia gelatinosa
    (Dorsal grey horn)
  • Third order - Thalamus
  • Decussation/Intersects - At the same spinal segment or one segment above
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87
Q

The spinothalamic tract in the cerebrum

A
  • 2nd order neurons terminate in the ventral posterolateral (VPL) nucleus of the thalamus
  • 3rd order neurons project to the primary somatosensory cortex via the posterior limb of the internal capsule
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88
Q

What is the anterior spinothalamic tract?

A
  • Modalities - Crude touch, pressure
  • Receptors - Free nerve endings
  • First order- dorsal root ganglia
  • Second order - substantia gelatinosa
  • Third order- Thalamus
  • Decussation/intersects - Some segments above
    the spinal level of entry
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89
Q

What is special about substantia gelatinosa

A

If the tracts are mainly present in white matter, then this 3rd order neurone is present in the grey matter.

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90
Q

How can we clinically test for functioning lateral spinothalamic tracts?

A

Pain test
use steline neurological examination pin and temperature by volatile spray to create a cold sensation.
If present, spinothalamic working.

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91
Q

What is the posterior/dorsal column tracts?

A

is formed by two large fasciculi (bundles of nerve fibers) running through the posterior spinal cord: fasciculus gracilis and fasciculus cuneatus.

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92
Q

Features of the posterior column tract?

A

Modalities carried - Fine touch, vibration,
proprioception
* Receptors - Meissners/merkels/ tendon organs/muscle spindle (mechano and proprio receptors)

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93
Q

What are the roles of Gracile fasciculus and Cuneate fasciculus

A

Gracile fasciculus
* below T6 ascend in the medial part of the dorsal column

Cuneate fasciculus
* above T6 ascend in the lateral part of the dorsal column

Cuneate= wedge and Gracile=slim

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94
Q

The dorsal tract in the brainstem

A
  • 1st order neurons pass through the dorsal column (gracile fasciculus and cuneate fasiculus), to reach the gracile
    and cuneate nuclei in Medulla
  • 2nd order neurons- Form internal arcuate fibres in medulla Cross over to the opposite side
  • Ascend through brainstem as Medial lemniscus
  • Medial lemniscus terminates on the
    ventral posterolateral (VPL) nucleus of
    the thalamus by synapsing to the 3rd
    order neuron
  • 3rd order neuron -> posterior limb of the internal capsule ->primary
    somatosensory cortex
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95
Q

What is the medial lemniscus?

A

Ascending bundle of axons in the brainstem that cross specifically in the medulla oblongata

important for somatosensation from the skin and joints

lesion of the medial lemnisci causes an impairment of vibratory and touch-pressure sense.

Lemniscus means “ribbon”

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96
Q

How to clinically test the dorsal column

A

is concerned with fine, precisely-localised (or discriminative) touch, joint position sense, proprioception and vibration sense.
* It is tested using a high-amplitude, low-frequency (128Hz) tuning fork applied to bony prominences- Vibration

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97
Q

What are the roles of the pre and post central gyrus?

A

Pre-central gyrus- Motor
Post-central gyrus- Sensory

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98
Q

What is the descending tract?

A

*MOTOR
* Cerebral cortex  Spinal cord
* Lower motor neuron (LMN)
* Upper motor neuron (UMN)

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99
Q

What divides the descending pathways?

A

Pyramidal and Extrapyramidal

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100
Q

The pyramidal descending tract is

A

Corticospinal
Voluntary movement
of the contralateral (opposite) limbs/trunk

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101
Q

The extrapyramindal descending tract is…

A
  • Vestibulospinal
  • Reticulospinal
  • Rubrospinal
  • Tectospinal
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102
Q

What is the corticospinal tract?

A
  • Longest continuous white matter pathway in the CNS
  • Control of precision and speed of
    skilled movements
  • Forms visible ridges referred to as
    the ‘pyramids’ on the anterior
    surface of the medulla, so also called the Pyramidal Tract.
  • Origin of upper motor neurones UMN in the cortex precentral gyrus
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103
Q

The corticospinal tract in the cerebrum

A

origin: motor and premotor areas of the frontal lobe

These fibres pass from cebral cotex to enter subcortical white matter
Via the Corona radiata
To the posterior limb of the internal capsule

Corona radiata= radiating crown

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104
Q

The corticospinal tract in the brainstem

A

descends through the anterior part of the brain stem
crus cerebri in midbrain
basilar pons
pyramids of the medulla- located on either side of the midline Crus cerebri

Crus cerebri = brain leg

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105
Q

Where does the corticospinal tract decussate?

decussate/ cross/ intersect

A

lowermost border of the medulla

90% of fibres cross in the caudal medulla at the decussation of the pyramids – Form Lateral corticospinal tract

  • Remaining 10% fibres- Ventral corticospinal tract – Cross at the target spinal segment
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106
Q

The corticospinal tract in the spinal cord

A

Lateral corticospinal tract In the Lateral funiculus

Ventral corticospinal tract In anterior funiculus

Cross at the target spinal level

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107
Q

Considering the corticospinal tract, Lower motor neurones arise

A

Anterior horn cell in the Ventral grey horn of spinal cord at the respective level

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108
Q

How do lower and upper motor neurones interact?

A
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109
Q

What is the effect of a lower motor neuron lesion

A
  • Paralysis/ paresis of specific muscles,
  • loss or reduction of tendon reflex activity
  • reduced muscle tone,
  • fasciculations (small contraction)
  • muscle atrophy
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110
Q

What is the effect of upper motor neurone lesions?

A
  • Paralysis/ paresis of movements
  • increased tendon reflex activity
  • increased muscle tone
  • spasticity
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111
Q

Describe the Dura Mater

A

Tough fibroud outermost covering

2 layers:
Endosteal layer- periosteum over skull bones
Meningeal layer- continuous with the dura mater of the cord

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112
Q

Describe the Arachnoid Mater

A

Consists of arachnoid membrane and the arachnoid trabeculae

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113
Q

Describe the Pia Mater

A

Blood vessels run along the surface of the pia wihtin the subarachnoid space.

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114
Q

What are the two layers of the dura mater?

A

Endosteal- periosteum over skull bones
Meningeal- continuous with the dura mater of the spinal cord. (dura proper)

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115
Q

What are the features of the cranial dura mater

(meningeal layer)

A

Sends inwards four septa
Divides the cranial cavity into freely communicating spaces
Subdivisions of the brain

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116
Q

What is a role of the dura mater?

A

Restrict rotatory displacement of the brain

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117
Q

What are the reflections of the dura mater?

A

Falx cerebri- midline
Diaphragma sellae- passage of infundibulum
Tentorium cereblli- roofs over posterior cranial fossa- suports the occipital lobes
Tentorial notch- passage of mid brain
Falx cereblli- projects forward between cerebellar hemispheres

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118
Q

What is the falx cerebri

A

A reflection of dura mater
lies in the midline
between two cerebral hemispheres

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119
Q

What is the diaphragma sellae?

A

A reflection of dura mater
small circular fold
allows passage of the infudibulum

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120
Q

What is the falx cerebelli

A

A reflection of dura mater than projects forward between cerebllar hemispheres

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121
Q

What is the tentorial notch?

A

a reflection of dura mater
passage of the midbrain

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122
Q

What is the tentorium cerebelli

A

reflection of the dura mater which roofs over the posterior cranial fossa
covers the upper surface of the cerebellum
supports the occipital lobes of the cerebral hemispheres

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123
Q

What sinuses does the falx cerebri contain?

A

Superior Sagittal, Inferior sagittal and Straight Sinus

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124
Q

What are the ends and margins of the falx cerebri?

A

ENDS: anterior and posterior
MARGINS: superior and inferior

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125
Q

What are the margins and ends of the tentorium cerebelli?

A

Attatched margin and free margin
Pulled up by attachment ot falx cerebri

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126
Q

What are the features of the falx cerebelli

A

Small fold along internal occipital crest

Contains occipital sinus

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127
Q

What are the structural features of the diaphragma sellae

A

Circular fold over the hypophyseal fossa

Pierced by infundibular stalk of pituitary

Contains intercavernous sinus

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128
Q

When dura stretches…

A

feel headache

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129
Q

How to name the arachnoid spaces?

A

subdural space above
—-a-r-a-c-h-n-o-i-d—-
subarachnoid space

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130
Q

What are the features of the arachnoid mater?

A

Thin avascular layer between pia and dura
Loosely applied layer with projections
All structures passing to / from brain pass through subarachnoid space

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131
Q

How does CSF interact with the meninges?

A

Subarachnoid space contains cerebrospinal fluid (CSF)
Produced by choroid plexus in brain ventricles
Runs through the ventricular system
Leaves the ventricular system from the fourth ventricle to enter the subarachnoid space.
Gets absorbed back into the dural venous sinuses through arachnoid granulations

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132
Q

What are arachnoid granulations?

A

Projections of the arachnoid that affects the transfer of csf to venous sinuses

at the superior sagittal sinus, the arachnoid pierces the dura as a number of finger-like or cauliflower-shaped projections.

However if no cauliflower head then arachnoid villi

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133
Q

What are the role of arahnoid villi?

A

at top, perforations through which the subarachnoid space communicates with the venous sinus.

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134
Q

What is the Pia mater?

A

Very delicate vascular membrane (nourish)
Closely invests brain following gyri / sulci

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135
Q

What is the function of the pia mater?

A

Function: Vascular membrane for nourishment. Cerebral arteries enter brain carrying sheath of pia mater with them

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136
Q

How does the meninges cover the spinal cord?

A
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137
Q

Extradural Vs. Subdural Haematoma

A

Extradural Haematoma- Almost always arterial, Emergency surgical management- Burr holes or craniotomy to release the pressure on the brain
Subdural Haematoma- Almost always venous, mostly subcortical bridging veins, Treatment depends on size, severity and acute nature.

138
Q

What are the venous sinuses

A

situated between periosteal and meningeal layers of dura

Receive tributaries (river, vessel) from the brain, skull bones, the orbit and the internal ear

139
Q

What are the features of the veins of the brain

A

Very thin walls and they possess no valves.
Emerge from the brain and lie in the subarachnoid space.
Pierce the arachnoid mater and the meningeal layer of the dura and drain into the cranial venous sinuses.

140
Q

What is the superior cerebral vein?

A

External cerebral vein
veins- pass upward over the lateral surface of the cerebral hemisphere and empty into the superior sagittal sinus

141
Q

What is the superficial middle cerebral vein?

A

Superficial middle cerebral vein drains the lateral surface of the cerebral hemisphere. It runs inferiorly in the lateral sulcus and empties into the cavernous sinus

142
Q

What is the deep middle cerebral vein?

A

drains the insula and is joined by the anterior cerebral and striate veins to form the basal vein.

143
Q

What is the great cerebral vein?

A

basal vein joins the great cerebral vein, which in turn drains into the straight sinus

144
Q

Label the dural venous sinuses

A
145
Q

Lable the dural venous sinuses

A
146
Q

What is the cavernous sinus

A

Important sinus in the middle cranial fossa
Related to important structures – Internal carotid artery, Cranial nerves -3,4, 5 (1st and 2nd divisions), 6

147
Q

Where is the primary auditory area?

A

Located on superior temporal gyrus
Reception and interpretation of sound

148
Q

What area is responsible for motor speech?

A

(Broca’s) area
Located just above lateral sulcus, usually on the left side of the brain
Controls movements involved in speech

149
Q

What area is responsible for comprehension of speech?

A

Wernicke’s area
Located in the posterior section of the superior temporal gyrus on the left side of the brain
Comprehension of speech

150
Q

What is the primary visual area?

A

Primary visual area
Located on the posterior pole of the occipital lobe around the calcarine sulcus
Receives visual impressions

Calcarine sulcus in blue

151
Q

What are brodmann’s cortical areas?

A

Important areas
Primary Motor area- 4
Primary Sensory areas- 3,2,1
Primary visual area- 17
Visual association areas- 18,19
Motor speech (Broca’s) area- 44
Sensory speech (Wernicke’s) area- 22
Primary auditory area - 41

152
Q

Brain lesions

CLINICAL ANATOMY

A

Focal lesions of the precentral gyrus- contralateral hemiparesis

Lesions of postcentral gyrus - contralateral hemisensory loss.

Widespread degeneration of the cerebral cortex gives rise to symptoms of dementia.

153
Q

How is the frontal lobe divided?

A

Superior frontal gyrus
Middle frontal gyrus
Inferior frontal gyrus

154
Q

How is the temporal lobe divided?

A

Superior temporal gyrus
Middle temporal gyrus
Inferior temporal gyrus

155
Q

How is the medial surface of the cerebrum divided?

A

Paracentral lobule
Cingulate gyrus and sulcus
Parieto-occipital sulcus
Calcarine sulcus

156
Q

How is the inferior surface of the cerebrum divided?

A

Orbital Sulcus and gyri
Collateral sulcus
Occipitotemporal sulcus
Uncus
Parahippocampal gyrus

157
Q

Brain is supplied arterially by

A

Two internal carotid arteries
Two vertebral arteries

158
Q

Two internal carotid arteries
Two vertebral arteries anastamose to form

A

The circle of willis

159
Q

Internal Carotid Arteries

A

enter through the carotid canal
terminate at Anterior cerebral artery and Middle cerebral artery

160
Q

How does the internal carotid artery run?

A

Runs anteriorly forwards within the Cavernous sinus

161
Q

The vertebral arteries…

A

Ascend in the neck through the foramina in the transverse processes of the upper six cervical vertebrae
Enters cranial cavity through foramen magnum

162
Q

The vertebral arteries join to form

A

the basilar artery
On the ventral surface of pons

163
Q

The circle of willis

A

product of the 4 arteries anastamosing. Not complete in majority of people

164
Q

The circle of willis is formed by:

A

Anterior communicating
Anterior cerebral
Middle cerebral
Internal carotid
Posterior communicating
Posterior cerebral
Basilar

165
Q

What is the function of the circle of willis?

A

Allows for collateral circulation of blood if one or part of the circle becomes blocked or narrowed
Avoids ischemia

166
Q

What area of the brain does the anterior cerebral supply?

A
167
Q

What area of the brain does the middle cerebral supply?

A
168
Q

What area of the brain does the posterior cerebral supply?

A
169
Q

Middle Cerebral artery supplies…

A

a large part of the lateral surface

Lies in the lateral sulcus

170
Q

1.

Anterior Cerebral artery supplies….

A

supplies a large part of medial surface

lies Close to corpus callosum,

171
Q

Midbrain is supplied by

A

posterior cerebral, superior cerebellar, and basilar arteries.

172
Q

Pons is supplied by

A

basilar, Pontine arteries, anterior inferior, and superior cerebellar arteries.

173
Q

Medulla oblongata is supplied by

A

Basilar, vertebral, anterior and posterior spinal, posterior inferior cerebellar.

174
Q

The cerebellum is supplied by

A

superior cerebellar, anterior inferior cerebellar, and posterior inferior cerebellar arteries.

175
Q

Label the basilar artery

A
176
Q

The spinal cord is supplied by…

A

2 posterior spinal arteries
1 anterior spinal artery

reinforced by small segmental arteries arsing from arteries outside the vertebral column

anastomose on the surface of the cord and send branches into the substance of the white and gray matter.

177
Q

Blood loss at the anterior cerebral causes

A

loss of primary motor cortex for lower limb and perineum of contralateral side

incontinence

178
Q

Blood loss/ blockage at the middle cerebral leads to

A

loss of sensatioin and motor function (excludes lower limb and perineum)

Loss of Broca and Wernickes

179
Q

Loss of blood/ blockage at posterior cerebral….

A

leads to damage of primary visual cortex and visual field defects

Loss of hippocampus and memory loss

180
Q

The bony orbit is a ____ structure

A

pyyramidal

181
Q

The Bony Orbit is made of ____ bones, name them.

A

7
1. Sphenoid.
2. Frontal.
3. Zygomatic.
4. Ethmoid.
5. Lacrimal.
6. Maxilla.
7. Palatine.

182
Q

What are the two axis?

A

Visual axis- line of sight

Anatomical axis- an imaginary plane passing
through the centre of the orbital pyramid,
dividing it into symmetrical left and
right halves.

183
Q

Where do the anatomical and visual axes coincide?

A

Eye abducted 23 degrees

184
Q

Where is the anatomical axis of the orbit?

A

22.5 degrees from the midline

185
Q

External anatomy of the eye

A

Sclera
Limbus
Iris
Cornea

186
Q

The eye has 3 coats, they are….

A

Fibrous: sclera and cornea
Vasculae: choroid, cilliary body and iris
Neural: retina

187
Q

What is the fibrous tunic?

A

The sclera and cornea are tough and collagen-rich tissue
continour with the dural sheeth

188
Q

What is the vascular tunic?

A

Vascular tunic - Choroid, ciliary body and iris.
Clinically known as the “uveal tract”.

189
Q

What is choroid?

A

pigmented – melanin –
absorbs light and limits reflection
supplies the outer retina with nutrients, and maintains the temperature and volume of the eye.

190
Q

What is the Nerual layer?

A

Retina
Macula lutea and fovea centralia
Optic disk (blind spot)
Central retina artery and vein (branch in quadrants)

191
Q

What is the macula ?

A

The portion of eye at
the center of the retina that
processes sharp, clear vision

192
Q

What is the fovea?

A

depression at the centre
of the macula that provides
greatest visual acuity

193
Q

What is the refractory media of the eye?

A

Zonule fibres- suspensory ligament
attatched to ciliary muscle (ring)

194
Q

How is far vision produced?

A

Flat lens
Suspensory ligament taught
Ciliary muscle relaxed. (parasympathetic ganglion)

195
Q

How is near vision produced?

A

thick lens
suspensory ligament relaxed
ciliary muscles contract

196
Q

The eye is divided into 2 segments

A

anterior- lens
posterior- inner eye

197
Q

Where is the lens situated?

A

Hyaloid fossa of the vitreous body.

198
Q

What is aqueous humour?

A

Clear watery fluid fills the anterior chamber maintaining shape, nutrients and intraocular pressure.

Produced by the ciliary body of the posterior chamber and flows to the anterioir chamber via the canal of schlemm

199
Q

What are the 7 extraocular muscles?

A

Recti- Lateral, Medial, Superior, Inferior
Obliques- Superior, Inferior
Levator palpebrae superioris

200
Q

What is the nerve supply of the extraocular muscles?

A

LR6 SO4 – Lateral rectus 6 superior rectus 4

201
Q

What is the origin of the rectus muscles?

A

attached to
common tendinous ring of zinn

(surrounds optic nerve)

202
Q

What is the insertion of the rectus muscles?

A

sclera of the eyeball behind limbus

203
Q

What is the origin and insertion of the inferioir oblique muscle?

A

O - The anterior aspect of the orbital floor (maxilla mainly)
I - Sclera of the eye, posterior to the lateral rectus

204
Q

What is the origin and insertion of the superior oblique muscle

A

O – Body of the sphenoid bone
* I – sclera of the eye, posterior to
the superior rectus.

205
Q

Actions of the extraocular muscles

A
206
Q

How is intoirsion of the eye achieved?

A
207
Q

How is extosion of the eye achieved?

A
208
Q

What is the pathway of light?

A

Pathway
* Optic nerve
* LGB
* Pre-tectal nucleus in Mibrain
* RELAY BILATERALLY
* Edinger Westphal nucleus –
Midbrain
* CN III
* Parasympathetic supply- Cilary
muscles
* Constriction of pupil

209
Q

What is the Accommodation reflex?

A

This reflex allows us to focus on
objects as they are brought close to
the face. They rely on the 3Cs.

  1. Constriction of the pupil
    (oculomotor nerve)
  2. Convergence of the eye (medial
    rectus contraction-oculomotor
    nerve)
  3. Contraction (ciliary body
    contracts making the lens thicker)
210
Q

Where is the cerebellum situated?

A

Posterior cranial fossa
below tentorium cerebelli (dural reflection)
Hindbrain
Posterior to fourth ventricle, pons, medulla oblongata

211
Q

What is the function of the cerebelllum

A

posture
voluntary movements
smooth contraction of voluntary muscles,
coordination of actions

212
Q

Cerebellum structure.

A

Highly convoluted folds, called ‘Folia’
Ovoid shape
Two cerebllar hemispheres
Cetnral narrow Vermis

213
Q

Fissures of the cerebellum

A

Primary fissure: wide V-shaped fissure separating
anterior and posterior lobes
* Posterolateral fissure: separates posterior and
flocculonodular lobes
* Horizontal fissure: A deep fissure found along the margin
of the cerebellum separates the superior from the inferior
surfaces (no morphologic or functional significance)

214
Q

Lobes of the cerebellum

A
  • Anterior lobe
  • Posterior lobe
  • Flocculonodular lobe
215
Q

White matter in the cerebellum is shaped

A

like a tree
abor vitae
tree of life

216
Q

Deep nuclei of the cerebellum

A

Dentate
- Globose
- Emboliform
- Fastigial

217
Q

The cerebellar peduncles.

A

t is connected to the posterior aspect
of the brainstem by three symmetrical
bundles of nerve fibers
* Superior cerebellar peduncles
* Middle cerebellar peduncles
* Inferior cerebellar peduncles
Describe the major gross anatomical features of the
cerebellum.

218
Q

Superior cerebellar peduncle-

A

Mainly efferent fibers to thalamus and red nucleus.
* Afferent fibres- Ventral spinothalamic tract.
* General functions are to convey sensation and
proprioception.

219
Q

Middle cerebellar peduncle-

A

Largest among the three cerebellar peduncles.
* Conveys motor information from the cerebral cortex and
pons to the cerebellum via the afferent
corticopontocerebellar pathway.

220
Q

Inferior cerebellar peduncle

A

Carries both efferent and afferent fibers mainly concerned
with integrating proprioceptive sensory information with
motor functions such as balance.
* Integrates proprioceptive sensory information and postural
maintenance via the dorsal spinocerebellar tract (Mossy
fibres).

221
Q

What are the zones of the cerebellum

A

Vermis - In the midline of the
cerebellum is the.
* Intermediate zone- Either side of
the vermis
* Lateral hemispheres- Lateral to
the intermediate zone

222
Q

Cerebrocerebellum (lateral zone) is responsible for

A

Involved in planning movements and motor learning.
* It receives inputs from the cerebral cortex and pontine nuclei
* Sends outputs to the thalamus and red nucleus.
* This area also regulates coordination of muscle activation

223
Q

Spinocerebellum (vermis and intermediate) is responsible for

A

Involved in regulating body movements by allowing for
error correction.
* It also receives proprioceptive information.

224
Q

Vestibulocerebellum (flocconodular lobe) is responsible for

A

Involved in controlling balance and ocular reflexes

  • It receives inputs from the vestibular system and sends outputs
    back to the vestibular nucleus.
225
Q

Signs of cerebellar disease

A

Hypotonia
* Alteration of Gait - The patient assumes a wide base when he or she
stands and is often stiff legged. Gait is lurching and staggering towards
the affected side.
* Ataxia- Disturbance of voluntary movements, intentional tremor, past-
pointing on finger-nose test
* Dysdiadochokinesia- Inability to perform rapid alternating movements
* Dysarthria- difficulty in speech
* Nystagmus

226
Q

What is the brainstem?

A

Stalklike structure within the posterioir cranial fossa of the skull.
It connects the forebrain and spinal cord

Contains: Midbrain, pons and medulla oblongata

227
Q

What are the main functions of the brainstem?

A

Conduit for tracts through the CNS
Houses cranial nerve nuclei III to XII
Locaiton of reflex centres
Respiration, CVS funcitons, Conciousness

228
Q

Label the brainstem:

A
229
Q

Identify the following surface features

A
230
Q

What is the Superior colliculi?

A

Visual pathway

231
Q

What is the inferior colliculi?

A

Auditory pathway

232
Q

What is the superior medullary velum?

A

a thin, transparent lamina of white matter, which stretches between the superior cerebellar peduncles

233
Q

What is the inferioir medullary velum?

A

thin layer of white substance, prolonged from the white center of the cerebellum, above and on either side of the nodule;

234
Q

Identify the surface features

Anterior view

A
235
Q

What are the cerebral peduncles?

A

The cerebral peduncles are the two stalks that attach the cerebrum to the brainstem.[1] They are structures at the front of the midbrain which arise from the ventral pons and contain the large ascending (sensory) and descending (motor) nerve tracts that run to and from the cerebrum from the pons.

Cranial nerve 3 (oculomotor nerve) appears ventrally between the two cerebral peduncles in the interpeduncular fossa. Cranial nerve 4 (trochlear nerve) wraps around the lowest part of the cerebral peduncle.[8]

236
Q

What is the basilar groove?

A
237
Q

What is the ponto-medullary junction?

A
238
Q

What is the olive?

A

INF: involved in cerebellar motor-learning and function
SUP: part of the auditory system, aiding the perception of sound.

239
Q

What is the pyramid?

A

contain motor fibers of the corticospinal and corticobulbar tracts

240
Q

Identify the following surface features

posterior view

A
241
Q

What is the corpora quadrigemina?

A

reflex centers involving vision and hearing.

Remember 2 eyes and 2 ears = 4 (quad)

242
Q

What is the superior colliculus?

A

a paired structure in the rostral midbrain that is involved in incorporating environmental stimuli and coordinating gaze shifts involving both eye and head movements.

243
Q

What is the inferior colliculus?

A

It acts as the channel for almost all auditory signals in the human body. Its primary roles are signal integration, frequency recognition, and pitch discrimination.

244
Q

What is the superior, middle and inferior cerebellar peduncle?

A

Inferior: Balance, conjugate eye movement
Superior and inferioir: posture, coordination, motor correction
Superior and middle: planning and initiate movement, coordination, motor learning, correction of coluntary movements.

245
Q

What is the cuneate tubercle?

A

enlargement at the end of the cuneate fasciculus that is produced by cuneate nucleus.

246
Q

What is the gracile tubercle?

A

part of the dorsal column medial leminiscal sensory neuronal pathway.

247
Q

What is the median sulcus of the brainste,?

A
248
Q

What is the facial colliculus

A

a unique feature located in the pons that houses the abducens nucleus and the facial motor fibers.

249
Q

What is the striae medullares

A

“a part of the epithalamus and forms a bilateral white matter tract of the initial segment of the dorsal diencephalic conduction system (DDCS).”

allowing the forebrain to influence midbrain monoaminergic output.

250
Q

Identify the cranial nerves

A
251
Q

Identify the cranial nerves in the anterior view

A
252
Q

What are the functions of the cranial nerves?

A
253
Q

Cranial nerves

The following mnemonic means…

**Some Say Money Matters, But My Brother Says Big Brains Matter Most (1-12)
**

A

S- sensory M-motor B-both

Sensory: 1, 2, 8
Motor: 3, 4, 6, 11,12
Both: 5,7,9,10

254
Q

What important events occur in the medulla?

A

Decussation of motor fibres of cortico-spinal tract
Decussation of sensory fibres of the posterior column tracts

255
Q

What vessels supply the medulla?

A

Branches of the vertebral artery:

Anterior spinal artery
Posterior spinal arteries
Posterior inferior cerebellar arteries
Direct medullary branches

256
Q

Label the vessels of the medulla

A
257
Q

What is lateral medullary syndrome of wallenberg

A

blockage of inf cerebellar artery

Vestibular symptoms
Ipsilateral cerebellar signs
Ipsilateral loss of pain, temperature- face
Contralateral loss of pain, temperature- trunk, limbs
Ipsilateral laryngeal, pharyngeal, palatal hemiparalysis
Ipsilateral Horner’s syndrome

258
Q

What is medial medullary syndrome?

A

Anterior spinal Artery blocked
Ipsilateral hypoglossal palsy
Contralateral loss of proprioception, discriminative touch, vibration
Contralateral hemiplegia

259
Q

How is the pons seperated?

A

Lower Pons (through CN VII)

Upper Pons (through CN V)

260
Q

What features are visible in the lower pons

A

Nucleus of abducent nerve
Motoro nucleus of facial nerve
Facial nerve
Abducent nerve

261
Q

What features are visible in the upper pons?

A

Motor nucleus of the trigeminal nerve
Main sensory nucleus of trigeminal nerve
Sensory root of trigeminal nerve
Motor root of trigeminal nerve

262
Q

What are the arterial supply of the pons?

A

Pontine branches of basilar artery
Anterior inferior cerebellar artery (AICA)
Superior cerebellar artery

263
Q

What is Millard Gubler syndrome?

A

occulsion of branches of basillar artery

Ipsilateral medial squint
Ipsilateral facial palsy
Contralateral hemiplegia

264
Q

What is pontocerebellar syndrome?

A

·Caused by pressure from acoustic neuroma
Tinnitus, deafness & vertigo
Ipsilateral ataxia
Ipsilateral lower motor neuron type of facial palsy
Contralateral loss of pain & temperature sensation of the face
loss of corneal reflex

265
Q

What are the surface features/parts of the midbrain?

A

Tectum (colliculi)
Tegmentum
Substantia Nigra
Crus cerebri
Cerebral peduncles
Aqueduct

266
Q

The midbrain can be divided by….

A

The level of the inferior colliculus
The level of the superior colliculus

267
Q

What features are present in the Inferior colliculus level of the midbrain?

A

Trochlear nerve
Inferior colliculus
Substantia nigra

268
Q

What features are present in the superior colliculus level of the midbrain?

A

superior colliculus
red nucelus
susbtantia nigra
oculomotor nerve

269
Q

What is the blood supplu of the midbrain?

A

Posterior cerebral artery
Superior cerebellar artery
Posterior communicating A
Anterior choroidal artery

270
Q

What is congential hydrocephalus?

A

blockage of cerebral aqueduct

271
Q

What is Weber’s syndrome?

A

posterior cerebral artery occulusion
Damage to oculomotor nerve and crus cerebri

Ipsilateral Ophthalmoplegia
Contralateral Hemiplegia

272
Q

What is the basal ganglia?

Describe the main parts of the basal ganglia and understand their functional connections.

A

A number of sub-cortical nuclear mases in the inferior cerebral hemisphere, lateral to the thalamus.

273
Q

What are the main parts of the basal ganglia?

Describe the main parts of the basal ganglia and understand their functional connections.

A

1) caudate nucleus
2) putamen
3) globus pallidus
4) substantia nigra
5) subthalamic nuclei
6) Claustrum
7) Technically the amygdala by location but limbic by function

274
Q

What is the corpus striatum for?

Describe the shape of the corpus striatum and how it relates to the cavity of the lateral ventricle and to the internal capsule.

A
  • motor and reward systems;
  • receives glutamatergic and dopaminergic inputs from different sources
  • the primary input to the rest of the basal ganglia
275
Q

What is the structure of the corpus striatum?

Describe the shape of the corpus striatum and how it relates to the cavity of the lateral ventricle and to the internal capsule.

A

Dorsal division contains:
* Caudate nucleus
* Lentiform Nucleus (Putamen and Globus pallidum)

Ventral division contains:
* Nucleus accumbens
* Olfactory tubercle

276
Q

What is the lentiform nucleus?

Describe the shape of the corpus striatum and how it relates to the cavity of the lateral ventricle and to the internal capsule.

A

The area of the corpus striatum containing the putamen and the globus pallidum

277
Q

What is the caudate nucleus?

Describe the main parts of the basal ganglia and understand their functional connections.

A

Parts- Head,Body, Tail
a paired, “C”-shaped subcortical structure which lies deep inside the brain near the thalamus.

278
Q

What is the SUBSTANTIA NIGRA

Describe the main parts of the basal ganglia and understand their functional connections.

A
  • Collection of neurons in the midbrain immediately behind the crus cerebri
  • Pars Compacta- Sends Efferents to the Striatum
  • Pars Reticulata- Recieves Afferents From Corpus Striatum and subthalamic nucleus

Clinical relevance: loss of this = loss of dopamine = parkinsons

279
Q

What is the SUBTHALAMIC NUCLEUS

Describe the main parts of the basal ganglia and understand their functional connections.

A
  • Shaped like a biconvex lens In the subthalamic region
  • Junction of internal capsule and crus cerebri
  • Responsible for integrating and smoothening movements
280
Q

Label the structures of the basal ganglia

A
281
Q

What structures do the corpus striatum interact with?

Describe the shape of the corpus striatum and how it relates to the
cavity of the lateral ventricle and to the internal capsule.

A
  • Corpus Callosum lies above the head and body
  • Thalamus lies medial to most of the body of caudate nucleus
  • Between thalamus and caudate nucleus:
    – Stria Terminalis
    – Thalamostriate Vein

Separated from
Lentiform nucleus by Internal Capsule (Anterior Limb)

282
Q

Label the following

Describe the main parts of basal ganglia ondifferent brain sections as used clinically using CT and MRI scans.

A
283
Q

Label the following

Describe the main parts of basal ganglia ondifferent brain sections as used clinically using CT and MRI scans.

A
284
Q

Label the following

Describe the main parts of basal ganglia ondifferent brain sections as used clinically using CT and MRI scans.

A
285
Q

What is the function of the basal ganglia?

Describe the functions of the basal ganglia to cognition, emotion and behavior.

A

feedback mechanism to the cerebral cortex, modulating and refining cortical activation.
motor refinement, preventing unwanted movements, reducing the excitatory input to the
cerebral cortex. Thus prevents excessive and exaggerated movements.

in modulating cognitive and emotional responses through the Ventral striatum which
receives limbic inputs

control of motor activity by influencing the cerebral cortex of the same side (which influences the opposite
side of the body):

286
Q

What are the BASAL GANGLIA CIRCUITS

Describe the functions of the basal ganglia to cognition, emotion and behavior.

A
  • Motor Loop: Learned Movements (writing, passing a ball)
  • Cognitive Loop: Motor Intentions (preparing for movements)
  • Limbic Loop: Emotional Aspects of movement
  • Oculomotor Loop: Voluntary Saccades (using the eye muscles to look at an object)
287
Q

What are the BASAL GANGLIA direct motor loop?

Describe the functions of the basal ganglia to cognition, emotion and behavior.

A
288
Q

What os the BASAL GANGLIA indirect motor loops?

Describe the functions of the basal ganglia to cognition, emotion and behavior.

A
289
Q

What is the role of dopamine in the basal ganglia motor loop?

Describe the functions of the basal ganglia to cognition, emotion and behavior.

A

Dopamine stimulates direct pathway
inhibits indirect pathway and so increases motor activity

290
Q

What is the limbic loops?

Describe the functions of the basal ganglia to cognition, emotion and behavior.

A
  • Involved in giving motor expression to emotions (through smiling, gestering etc)
  • The loop is rich in dopaminergic nerve endings
  • Their decline may account for mask-like facies in Parkinson’s disease
291
Q

Clinical Anatomy

What is dyskenesia

Describe the functions of the basal ganglia to
cognition, emotion and behavior.

A

Hyperkinesia - tremors, athetosis, chorea, ballism
Hypokinesia– Parkinson’s disease
▪ Disturbance of muscle tone (rigidity)

292
Q

Clinical Anatomy

What is tremor?

Describe the functions of the basal ganglia to
cognition, emotion and behavior.

A

Is a rhythmical, alternating abnormal involuntary activity having a
relatively regular frequency and amplitude

293
Q

Clinical Anatomy

What is Athetosis?

Describe the functions of the basal ganglia to
cognition, emotion and behavior.

A

Is characterised by movements that are involuntary,
slow and writhing involving particularly the distal
muscles of the extremities

294
Q

Clinical Anatomy

What is Chorea?

Describe the functions of the basal ganglia to
cognition, emotion and behavior.

A

Quick, jerky, irregular involuntary movements that are non repetitive
**Sydenham’s chorea
**❖ disease of childhood
❖ associated with rheumatic heart
**Huntington’s chorea
**autosomal dominant
* Dopa secreting neurones of SN
overactivated
* nigrostriatal pathway inhibits the
caudate nucleus and putamen
* CT shows enlarged lateral ventricle due
to degeneration of caudate nucleus

295
Q

Clinical Anatomy

What is Hemiballismus?

Describe the functions of the basal ganglia to
cognition, emotion and behavior.

A

Violent, forceful movement confined to one side of the body. It
involves the proximal extremity musculature i.e., muscles of
shoulder and pelvic girdle.

Lesion- subthalamic nucleus, due to thrombosis in the branch of
Posterior Cerebral Artery supplying subthalamus

296
Q

Clinical Anatomy

What is Parkinsonism?

Describe the functions of the basal ganglia to
cognition, emotion and behavior.

A

Impairment of voluntary movement
(hypokinesis– delay in initiation of
movements, paucity and lack of
precision of movement)
b. Rigidity– cog wheel
c. Tremor at rest
d. Expressionless face
e. Stooped posture

Caused by
Lesion in the substantia nigra and
damage to nigrostriatal pathway which
uses dopamine as neurotransmitter
Pathology: Cellular loss and
depigmentation of substantia nigra

297
Q

What is the thalamus

Identify the main parts of thalamus and understand their
functional connections

A
  • Large, egg-shaped mass of gray matter
  • Forms major part of the diencephalon
    • 4x 1.5x 1.5 cm
    • 2 thalami- situated on each side of the third ventricle
298
Q

What does the thalamus interact with?

Identify the main parts of thalamus and understand their functional connections

A

Anterior end
narrow and rounded

Posterior end
expanded to form the pulvinar

Medial
forms part of the lateral wall of the third
ventricle
connected to the opposite thalamus by a band of gray matter - interthalamic adhesion

Lateral
internal capsule

Inferior
continuous with the tegmentum of the midbrain
Superior
(Lateral to medial)- caudate nucleus, stria terminalis, thalamostriate vein, fornix

299
Q

Related white matter to the thalamus

Identify the main parts of thalamus and understand their functional connections

A

Internal medullary lamina-
Vertical sheet of white matter
dividing gray matter of the
thalamus into medial and
lateral halves
* the internal medullary lamina
splits, resembling a Y shape

300
Q

The thalamus is subdivided into ____ parts

Identify the main parts of thalamus and understand their functional connections

A

3 parts:
anterior part
– medial part
– lateral part

And Smaller nuclear groups
– within the internal medullary
lamina,
– Some on the medial and lateral
surfaces of the thalamus.

301
Q

Anterior part of the thalamus

Identify the main parts of thalamus and understand their functional connections

A

Contains the anterior thalamic nuclei
* Afferent- mammillothalamic tract
* Reciprocal connections with the cingulate gyrus and
hypothalamus.
* Function - emotional tone and recent memory.

302
Q

Medial Part of the thalamus

Identify the main parts of thalamus and understand their functional connections

A

Dorsomedial nucleus

Connection (afferents) from Amygdala

Connect to (reciprocal)
- prefrontal cortex
- hypothalamic nuclei.
- interconnected with all other thalamic nuclei

.Function: integration of sensory information, including somatic, visceral, and olfactory information, and the relation of this to emotion and subjective states.

303
Q

Lateral Part of Thalamus: Dorsal Tier of Nuclei

Identify the main parts of thalamus and understand their functional connections

A

Dorsal Tier of nuclei
– Lateral dorsal nucleus
– Lateral posterior nucleus
– Pulvinar.
* interconnections with –
* other thalamic nuclei and with the
* parietal lobe,
* cingulate gyrus,
* and occipital and temporal lobes.

304
Q

Label the Thalamus

Identify the main parts of thalamus and understand their functional connections

A

Anterior (at the front)
Pulvinar (at the back)
Medial (at the top)
Lateral
Ventral

Lateral divided into dorsal and posterior
Ventral divided into anterior, lateral, venterolateral, posteromedial

305
Q

Lateral Part of Thalamus: Ventral Tier of Nuclei:

Ventral anterior and Ventral lateral nuclei

Identify the main parts of thalamus and understand their functional connections

A
  • Afferents
    – substantia nigra
    – Globus pallidus
    – Dentate nucleus (VL)
  • Efferents
    – premotor cortex – Area 4,6
  • Influences the activities of the
    motor cortex.
306
Q

Lateral Part of Thalamus: Ventral Tier of Nuclei:

Ventral Posterior Nuclei

Identify the main parts of thalamus and understand their functional connections

A

Contains the
* VPM
* VPL

307
Q

What is the VPL

Identify the main parts of thalamus and understand their functional connections

A

Afferents
– Medial lemniscus
– Spinal lemniscus
Efferents
– Parietal lobe
– Post central gyrus
* Function: Relay station for touch, pain, temperature and proprioceptive sensations from contralateral body except face

308
Q

What is the VPM

Identify the main parts of thalamus and understand their functional connections

A

Afferents
– Trigeminal lemniscus
– Solitary nucleus
* Efferents
– Parietal lobe
– Post central gyrus through superior thalamic radiation
* Function: Relay station for touch, pain, temperature and proprioception from contralateral face and for taste

309
Q

What are the Geniculate bodies

Identify the main parts of thalamus and understand their functional connections

A

Medial geniculate body*
A swelling on the posterior surface of the thalamus beneath the pulvinar
* part of the auditory pathway
* Afferent - inferior brachium from the inferior colliculus
* Efferent - auditory radiation to the auditory cortex of the superior temporal gyrus (41,42)

Lateral geniculate body
Part of visual pathway
* Swelling on the undersurface of the pulvinar of the thalamus
* 6 layers of nerve cells
* Afferents- optic tract
* Efferent - Optic radiation, which passes to the visual cortex of the occipital lobe.

310
Q

What is the blood supply to the thalamus?

Identify the main parts of thalamus and understand their functional connections

A

Blood supply:
* Posterior communicating arteries
* Basilar artery
* Posterior cerebral arteries

311
Q

Clinical Anatomy

2 important considerations for the thalamus

Identify the main parts of thalamus and understand their functional connections

A

1) thalamic nuclei are small so that lesions producing highly
specific effects are uncommon

2) Thalamic lesions frequently are accompanied by symptoms
from damage to closely related internal capsule, caudate
nucleus and lentiform nucleus

312
Q

Clinical Anatomy

What is Thalamic syndrome

Identify the main parts of thalamus and understand their functional connections

A

Contralateral hemianesthesia
* Due to damage to VPL and VPM
* Typically, all somatic sensory modalities are affected: light
touch, conscious proprioception, 2-point discrimination &
vibration, and pain & temperature.

Hyperalgesia or causalgia
(spontaneous pain with no apparent
stimulation) - seen after a period of recovery from damage to
VPL and VPM (days to months)
* Pain can be severe and intractable.

Contralateral homonymous hemianopia
LGB affected

Movement disorders
damage of VA/VL nuclei (cerebellum
and basal ganglia project to VA and VL)
* contralateral to the side of the lesion.

313
Q

General arrangement in the cerebrum

Describe the white matter of cerebrum and its organisation.
Describe Internal capsule, its parts and related clinical anatomy.

A
314
Q

What are the key White Matter of Cerebral hemisphere

Describe the white matter of cerebrum and its organisation.
Describe Internal capsule, its parts and related clinical anatomy.

A

Commissural fibres– connect corresponding gyri of the two hemispheres:
1) corpus callosum
2) anterior commissure

Association fibres-connect one gyrus to another in the same hemisphere

Projection fibres– connect more or less vertically

315
Q

What are the Commisures

Describe the white matter of cerebrum and its organisation.
Describe Internal capsule, its parts and related clinical anatomy.

A

Commissural fibres– connect corresponding gyri of the two hemispheres:

  • Corpus callosum
  • Anterior commisure
  • Posterior commisure
  • Commisure of the fornix
  • Habenular commisure
316
Q

What are the Internal Capsule

Describe the white matter of cerebrum and its organisation.
Describe Internal capsule, its parts and related clinical anatomy.

A
  • Projection fibres (white matter) between
  • caudate nucleus and thalamus medially
  • lentiform nucleus laterally
317
Q

What are the Internal Capsule

Describe the white matter of cerebrum and its organisation.
Describe Internal capsule, its parts and related clinical anatomy.

A
  • Projection fibres (white matter) between
  • caudate nucleus and thalamus medially
  • lentiform nucleus laterally
318
Q

What is the structure of the internal capsule

label this from memory sometime

Describe the white matter of cerebrum and its organisation.
Describe Internal capsule, its parts and related clinical anatomy.

A
319
Q

What are the Fibres in internal capsule

label this from memory sometime

A
320
Q

What is the limbic system

A

Set of interconnected cortical and subcortical stuctures that form a border (a limbus) **around brain stem **

321
Q

What is the limbic lobe?

A

The rim of the cerebral cortex
Grey Matter
adjacent to the corpus callosum and diencephalon

322
Q

What does the limbic system contain?

A

The limbic cortex, and subcortical nuclei that are relevant

323
Q

What are the functions of the limbic system?

A

Remember HOME
H- Homeostatic (autonomic and endocrine)
O- Olfaction
M- Memory
E- Emotions and Drives

324
Q

What is the Papez circuit?

A

1937 -
- identify emotion is 4 structures: Hyppocampal, Mamillary body, Ant Nuclei of Thalamus, Gyrus Cinguli

1970
- revised, called limbic added: prefrontal gyrus, subcortical structures amygdala, thalamic nuclei etc.

325
Q

What are the components of the Limbic System?

A

Limbic Cortex
parahippocampal gyrus, cingulate gyrus, medial orbitofrontal cortex
Hippocampal formation
dentate gyrus, hippocampus
Amygdala
Olfactory cortex
Diencephalon
hypothalamus, thalamus (ant. nucleus, mediodorsal nucelus
** Basal Ganglia**
ventral striatum (nucelus accumbens, caudate, putamen)
Basal forebrain
Septal nuclei
Tracts that link

326
Q

The cerebral cortex has ____ arcs

A

3 Arcs:
Limbic lobe (subcallosal area, cingulate gyrus, parahippocampal gyrus)
Hippocampal formation (dentate gyrsu, hippocampus, inusium griseum)
Amygdala, fibria and fornix

Connections
stria terminalis, Medial forebrain bundle, Mammillothalamic tract
Nuclei
Amagdyla, Septal nuclei, Mammillary Body, Anterior nucleus of thalamus

327
Q

What is the cingulate gyrus?

A
  • Emotional response to pain,
  • Assigns emotion to stimuli
  • Vocalizing internal states (express emotion)

Damage can result in behaviours such as aggression, shyness and reduced affect.

328
Q

Damage to the cingulate cortex…

A

can result in behaviours such as aggression, shyness and reduced affect.

Linked to:
early Alzheimer’s disease
schizophrenia
obsessive-compulsive disorder
depression
bipolar disorder
addiction

329
Q

Whats the Indusium griseum

A

Sheet of grey matter
extends from the paraterminal gyrus via the gyrus fasciolaris to the dentate gyrus

330
Q

What is the Dentate gyrus?

A

Band of grey matter
lies between fimbria of hippocampus and the parahippocampal gyrus
Seperated by the hippocampal sulcus

331
Q

What is the Hippocampus?

A

Elongated prominent elevation situated along the floor of the inferior horn of the lateral ventricle
Situated above the dentate gyrus
Anterior end presents a bulbous extremity marked by ridges - ‘pes hippocampi’

332
Q

What are the connections of the Hippocampus?

A

Papez ciruit:

333
Q

What is the role of the hippocampal formation?

A

Making new memories & consolidating information from short term to long term memory

334
Q

What happens if teh hippocampal formation is damaged?

A

Involved in severe mental illness
– Reduced volume in schizophrenia, PTSD, depression
Affected in Alzeimer’s disease

335
Q

What is the fornix?

A

efferent projection fibres of the hippocampus

(begins as alveus the efferent fibres from pyramidal cells of hippocampus)

336
Q

What is the structure of the Fornix?

A

The fibres of alveus pass medially on the surface of the hippocampus to form the Fimbria

The fimbria continue as the crura

The crura fuse to form the ‘Body

The body then splits to form columns of the fornix

FIBRES
Pre-commissural fibres → septal area
Post-commissural fibres → mamillary body, anterior nucleus of thalamus

337
Q

What is the amygdaloid body?

A

Ovoid Grey matter
Situated in the roof of the inferior horn of lateral ventricle

Input : from lateral olfactory stria, parahippocampal gyrus
(Visual, auditory, tactile and taste sensory input)
Output :
stria terminalis
Supracommisural – septal nuclei
Commisural
Subcommisural – preoptic and anterior nuclei of hypothalamus, anterior perforated substance

338
Q

What is the function of the amygdala?

A

Essential in the control of: love, friendliness, affection, fear, rage, aggression

Electrical stimulation of amygdala can lead to emotional attacks (rage)

339
Q

Damage to the amygdala….

A

Rabies virus (especially attacks the temporal lobe) leads to violent behavior

Lesions of the amygdala causes reduced ability to identify motivational and emotional significance of events

340
Q

What is the olfactory pathway?

A

Olfactory nerves
Olfactory bulb
Olfactory tract
Olfactory stria
Prepyriform cortex
Primary olfactory cortex

341
Q

Essential structure of the olfactory tract

A

Medial olfactory stria
-Paraterminal gyrus
-Opposite anterior olfactory nucleus
Lateral olfactory stria
-1’ olfactory area
-Prepiriform cortex
-Amygdaloid body
-Nuclei of anterior perforated substance

342
Q
A

M5 General Anatomy (11 decks)

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