BRAIN & SPINE Flashcards by Hanna Mercado

Contralateral paralysis and sensory loss (LE >UE) , Urinary Incontinence.

Anterior Cerebral Artery

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-Contralateral paralysis and sensory loss (Face & UE > LE)
-Aphasia in dominant (usually L) hemisphere
-Hemineglect in non dominant (usually R) hemisphere

Middle Cerebral Artery

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Wernicke aphasia associated with right superior quadrant visual field defect due to temporal lobe involvement.

Middle Cerebral Artery

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▪️Contralateral paralysis
▪️Pure motor stroke
▪️Absence of cortical signs

Lenticulostriate artery

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▪️Contralateral hemianopia with macular sparing
▪️ Alexia without agraphia (dominant hemisphere)
▪️ Prosopagnosia (nondominant hemisphere)

Posterior Cerebral Artery

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▪️Quadriplegia , loss of voluntary facial, mouth and tongue movements.
▪️Loss of horizontal, but not vertical, eye movements .

Basilar Artery (Locked-in Syndrome)

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▪️Paralysis of face , decreased lacrimation, decreased salivation, decreased taste from anterior 2/3 of tongue.
▪️Vomiting, vertigo, nystagmus
▪️Decreased pain and temperature sensation from ipsilateral face & contralateral body

Anterior Inferior Cerebellar Artery

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▪️Ipsilateral Horner Syndrome
▪️Ipsilateral ataxia, dysmetria
▪️Ipsilateral sensorineural deafness, vertigo

Anterior Inferior Cerebellar Artery

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▪️Good fluency
▪️Good comprehension
▪️Poor repetition
▪️Poor naming

Conduction Aphasia

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Aphasia where patient can comprehend and is fluent but has difficulty repeating words.

Conduction Aphasia

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Most common type of neuron according to number of processes.

Multipolar

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Cerebellum is a derivative of what secondary brain vesicle.

Metencephalon

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Function of Broca’s area. (3)

▪️Motor Speech area
▪️For speech production
▪️Regulates breathing patterns while speaking and vocalizations required for normal speech

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▪️Dysphagia, hoarseness, Decreased gag reflex, hiccups
▪️Vomiting, vertigo, nystagmus
▪️Decreased pain and temperature sensation from ipsilateral face and contralateral body
▪️Ipsilateral Horner Syndrome
▪️Ispilateral ataxia, dysmetria

Posterior Inferior Cerebellar Artery ( Wallenburg Syndrome)

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Ipsilateral ptosis, meiosis, anhidrosis. Da,age along oculosymphathetic pathway.

Horner Syndrome

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What are the watershed zones? (2)

Cortical border zones: ACA/MCA , MCA/PCA
Internal border zones: Between LCA & MCA

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Brodmann area 4

Primary motor (moves all four)

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Brodmann area 1,2,3

Primary Somatosensory (Sensor 3)

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Brodmann area 17

seVenteen = Visual

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What is Heschl gyrus ?

Temporal gyrus for hearing = Primary Auditory Cortex

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Brodmann area 41, 42

Horton Hears a who? = Hearing

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Brodmann area 44, 45

Broca = Broc45 area

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Brodmann area 22

Two U’s for a W= Wernicke

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Only 2 nerves that are supratentorial.

CN I & II

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▪️Contralateral paralysis ▪️Decreased contralateral propioception ▪️Ipsilateral hypoglossal dysfunction (ipsilateral tongue deviation)

Anterior Spinal Artery

▪️No pupillary involvement ▪️Consciousness often preserved ▪️ ACA compression -> contralateral LE weakness

Subfalcine herniation

▪️Ipsilateral CN III compression -> Ipsilateral dilated and fixed pupil ▪️Early : Ipsilateral cerebral peduncle compression -> contralateral hemiparesis ▪️Late: Contralateral cerebral peduncle compression -> ipsilateral hemiparesis

Uncal herniation / Lateral DTH

▪️Bilateral mid position and fixed pupils (loss of symphathetic and parasympathetic innervation) ▪️Decorticate -> Decerebrate posturing

Central Transtentorial Herniation

Brainstem compression -> coma , loss of CN reflexes, flaccid paralysis, respiratory arrest.

Tonsillar Herniation

Neural Tube Defects associated with elevated AFP. (5)

1. Gastrochisis 2. Anencephaly 3. Conjoined twins 4. Omphalocele 5. Spina bifida (GACOS)

With lucid interval , CT scan appearance is lemon shaped or convex shaped. Caused by injury to the middle meningeal artery.

Extradural Hemorrhage

What are the 2 layers of dura mater?

1. Endosteal layer 2. Meningeal layer

What are the 2 unpaired facial bones?

1. Vomer 2. Mandible

What are the 2 paired cranial bones?

1. Parietal 2. Temporal

Tearing of bridging veins, CT scan appearance is banana shaped or concave crescent shaped.

Subdural Hematoma

Parts of the brain that doesn’t have blood brain barrier? (8)

1. Subcommisural organ 2. Subfornical organ 3. Habenula 4. Organosum vaculosm of lamina terminalis 5. Pineal body 6. Median eminence 7. Area of postrema 8. Neurohypophysis SSHOP lifter MAN has no barrier

Point of meeting and articulation of frontal , parietal, squamous temporal and great wing sphenoid.

Pterion

Weakest part of the skull.

Pterion

Location of gray and white matter in the CNS.

1. Brain: Inside - White matter, Outside- gray matter (BIWOG) 2. Spinal cord: Inside- Gray matter, Outside- White matter (SIGOW)

Weight of Pineal gland?

172mg

What is the derivative of notochord?

Nucleus pulposus

Absent in baby hair.

Medulla

Formation of the three primary brain vesicles occurs how many weeks of conception?

Primary - 4 weeks AOG Secondary - 5 weeks AOG

Myelencephalon derivatives. (2)

1. Medulla oblongata 2. Spinal cord

The dangerous area of the face.

Root of the nose and two angles of the mouth.

Actions of the inferior oblique muscle. (3)

1. Extorsion 2. Elevation 3. Abduction (ExEl Abd)

Actions of the superior oblique muscle. (3)

1. Intorsion 2. Depression 3. Abdsuction (SIDAb)

Location of venous sinuses of the brain?

Between the periosteal and meningeal layers of the dura mater.

Pituitary gland blood supply are branches of ___________?

Internal carotid artery

Visual field defect associated with pituitary adenoma.

Bitemporal hemianopia

Releases vasopressin and oxytocin .

Posterior pituitary gland

Compression of the pituitary gland by tumors expanding superiorly can cause ___________.

Bitemporal hemianopsia

Patient with hemilateral sensory loss and hemilateral pain with hypersensitivity of affected side without weakness of contralateral side.

Dejerine-Roussy Syndrome

CSF FLOW (10)

Mnemonic: Come Lets Meet Tita Sylvia For Lunch Mamaya sa Aristocrat 1. Choroid 2. Lateral ventricle 3. Foramen of Monroe 4. Third ventricle 5. Aqueduct of Sylvius 6. Fourth ventricle 7. Luschka 8. Magendie 9. Subarachnoid 10. Arachnoid

Subdivision of cerebellum responsible for coordination of voluntary movements.

Posterior lobe (Nocerebellum or Cerebrocerebellum)

Inability to perform rapid alternating movements.

Dysdiadochokinesia

Foramen that transmits the middle meningeal artery and vein.

Foramen spinosum

CSF is produced by ____________.

Ependymal cells

Total volume of CSF.

130-150ml

Cranial nerves with parasympathetic component.

CN III, VII, IX, X (1973)

Papez circuit. (4)

1. Mammillary bodies 2. Anterior thalamic nuclei 3. Cingulate gyrus 4. Hippocampus

Part of the brain that maintains coordination of limb movements and regulation of muscle tone.

Spinocerebellum / Anterior Lobe/ Paleocerebellum

Part of the brain that controls coordination of paraxial muscles associated with equilibrium.

Vestibulocerebellum / Flocculonodular lobe/ Archiecerebellum

Area affected in patients with ataxia, dysmetria, dysdiadokinesia, intention tremor.

Cerebrocerebellum / Posterior lobe/ Neocerebellum

Blockage of this artery can result to contralateral hemianopia with macular sparing.

Posterior cerebral artery

Characteristic of UMN lesion. (6)

1. Spastic paralysis 2. Atrophy (-) 3. Fasciculation (-) 4. Pathologic reflex (+) 5. Clonus (+) 6. Increased muscle tone

Fracture of C2 (axis) vertebra.

Hangman’s fracture

Fracture of C1 (atlas).

Jefferson Burst Fracture

Atlanto-axial (C1-C2) joint movement.

Rotation

Atlanto-occipital joint movements.

Flexion-extension Lateral flexion

Blood supply of the Pituitary gland.

Superior hypophyseal artery which is a branch of Internal carotid artery.

Lobes of the pituitary gland. (2)

1. Anterior: - Pars distalis - Pars intermedia - Pars tuberalis 2. Posterior: - Pars nervosa

Calcified secretions of the pineal gland, also known as Brain Sands.

Corpora Arenacea

Epidural hemorrhage most commonly injured artery?

Anterior division of the Middle Meningeal Artery

Subdural hemorrhage most commonly injured artery?

Tearing or Bridging / Superior Cerebral Veins

Subarachnoid hemorrhage most commonly injured artery?

Rupture of Congenital Aneurysm in the Circle of Willis - Posterior Cerebral - Posterior communicating - Internal Carotid - Anterior cerebral - Anterior communicating

Intracerebral hemorrhage most commonly injured artery?

Most common in hypertensive patients from rupture of Lenticulostriate Arteries.