Correlative Neuroanatomy Flashcards
(201 cards)
1
Q
the brain weights
A
1.4 kg
2
Q
2 substances important for energy metabolism in the brain
A
glucose and oxygen
3
Q
the embryo is composed of 3 germ layers
A
ectoderm, mesoderm, endoderm
4
Q
neural tissue appear at __ week of development
A
3rd week
5
Q
neural folds fuse to form
A
neural tube
6
Q
neural folds fusion begins in this region
A
cervical region
7
Q
three primary transverse segments of the brain
A
procencephalon (forebrain)
mesencephalon (midbrain)
rhombencephalon (hindbrain)
8
Q
five secondary segments of the brain
A
telencephalon diencephalon mesencephalon metencephalon myelencephalon
9
Q
gives rise to the cerebral hemispheres
A
telencephalon
10
Q
gives rise to thalamus and hypothalamus
A
diencephalon
11
Q
gives rise to pons and cerebellum
A
metencephalon
12
Q
gives rise to medulla
A
myelencephalon
13
Q
myelination almost completed at
A
2 years
14
Q
Myelin migration completed at
A
5 months
15
Q
beginning of myelination
A
4 weeks
16
Q
neural plate develops at
A
16 days
17
Q
Neural groove and tube develops at
A
18 days
18
Q
Neural tube defects are failure of
A
Dorsal induction
19
Q
Enumerate conditions associated with Failure of dorsal induction
A
Craniorachischisis totalis Anencephaly Myeloschisis Encephalocoele Myelomeningocoele Arnold-Chiari malformation
20
Q
Failure of the neural tube to close spontaneously leads to
A
Neural tube disorders
21
Q
Neural tube closure occurs between
A
3rd and 4th week of gestation
22
Q
Midline defect of vertebral bodies
A
Spina bifida occulta
23
Q
Spina bifida occulta typically involves
A
L5- S1
24
Q
Manifestations of spina bifida occulta
A
Most are asymptomatic Overlying skin manifestations: Hair patch Lipoma Skin discoloration Dermal sinus
25
Protrusion of meningeal sac plus cerebral cortex, cerebellum, or brainstem through midline skull defect
Encephalocele
26
Midline skull defect of encephalocele is called
called cranium bifidum
27
Most common location of encephalocele
Occipital
28
Most common location of encephalocele (Asians)
Frontal or nasofrontal areas
29
2 most common manifestations of spina bifida
Hair patch
| Dermal sinus
30
Most severe form of dysraphism involving the vertebral column
Myelomeningocoele
31
50% risk reduction of myelomeningocoele with
0.4 mg Folic acid or
| 4 mg daily with 1 affected child
32
Myelomeningocoele is common in this region
Lumbosacral region
33
this condition is associated with type II chiari defect (Myelomeningocoele) at 80% incidence
Hydrocephalus
34
This vitamin deficiency is associated with neural tube defects
Folic acid deficiency
35
What drug causes neural tube defects?
Valproic acid
36
Presence of unilateral or bilateral clefts in the cerebral hemispheres
Schizencephaly
37
Agyria, absence of cerebral convolutions, 4 layered cortex
Lissencephaly
38
Presence of cysts or cavities in the brain
Porencephaly
39
Results from the defective cleavage of the prosencephalon
Holoprosencephaly
40
Disorders of myelination
Leukodystrophies
- Alexander’s disease
- Canava’s disease
- Krabbe’s disease
- Metachromatic leukodystrophy
41
Is the cystic dilatation of the 4th ventricle
Agenesis of the cerebellar vermis
Hydrocephalus
Dandy-walker neuropathology
42
2 main division of the nervous system
Central nervous system
| Peripheral nervous system
43
CNS is composed of the
```
Brain (encephalon)
Spinal cord(Myelon)
```
44
PNS is comprised of
Nerves and nerve roots
45
Cerebrum is composed of
Cortex, white matter,
| Basal ganglia
46
All of the structures above the tentorium cerebelli
Supratentorial
47
Most primary brain tumors in adults are usually located
Supratentorial
48
Supratentorial involves the
Cerebrum and diencephalon
49
Brainstem is composed of
Midbrain
Pons
Medulla
50
Infratentorial involves
Brainstem
| Cerebellum
51
Location of primary brain tumors in children
Infratentorial
52
Injury to infratentorial region will have risk of
Compression of brainstem -> cephalocaudal herniation -> neurologc deterioration
53
Is elicited by stroking an object across the sole of the foot beginning from the heel, moving forward toward the small toe, and then arcing medially toward the big toe
Plantar response
54
Normal plantar response
Downward contraction of the toes.
Upgoing big toe
Fanning outward of other toes
55
is a clinical sign in which squeezing the calf muscle elicits an extensor plantar reflex.
Gordon’s technique
56
Gordon’s technique elicits a extensor plantar reflex with lesions in
The pyramidal tract
57
Dorsiflexion of the great toe elicited by irritation downward of the medial side of the tibia
Oppenheim’s sign
58
A clinical sign in which pricking of the dorsum of the foot or toe with a pin causes extension of the great toe
Bing sign
59
Oppenheim sign is seen in
Pyramidal tract lesions
60
Bing’s sign is seen with
UMN lesion of the lower limbs
61
External malleolar sign
Chaddock’s sign
62
Is employed when the patient exhibits significant withdrawal response to plantar stimulation when performing babinski reflex
Chaddock sign
63
Is elicited when stimulating the dorsolateral aspect of the foot from the posterior portion of the skin just beneath the external malleolus anteriorly and along the external edge of the foot
Chaddock’s reflex
64
Pathological chaddock reflex is
extension of the big toe
| Fanning of other toes
65
10 signs alternative to babinski reflex
```
Gordon sign
Oppenheim sign
Stransky sign
Schaeffer sign
Moniz sign
Gonda sign
Throckmorton reflex
Bing reflex
Cornell sign
Chaddock sign
```
66
The examiner vigorously abducting and releasing the little toe
Stransky
67
The examinaer squeezes the achilles tendon
Schaeffer sign
68
The examiner flexes and suddenly releases the fourth toe
Gonda sign
69
The examiner applies pressure to plantar flex the ankle
Moniz sign
70
The examiner percusses over the metatarsophalangeal joint of big toe
Throckmorton reflex
71
The examiner applies multiple pinpricks on the dorsum of the foot
Bing sign
72
The examiner scratches along the inner side of the extensor hallucis longus tendon
Cornell sign
73
An involutary flexion of the movement of the thumb and or index finger when the examiner flicks the fingernail of the middle finger down
The reflexive pathway causes the thumb to flex and adduct quickly
Hoffman sign
74
Hoffman sign can be indicative of
UMN, CST dysfunction likely due to cervical cord compression
75
Major cerebral lobes
Frontal lobe
Parietal lobe
Occipital lobe
Temporal lobe
76
Sulcus that passes between precentral and postcentral gyrus
Central sulcus of rolando
77
Anterior to central sulcus of rolando
Frontal lobe
| Precentral gyrus
78
Posterior to central sulcus of rolando
Postcentral gyrus
| Parietal lobe
79
Precentral gyrus is also known as
Primary motor cortex
80
Postcentral gyrus is also known as
Primary somatosensor cortex
81
Main function of primary motor cortex is
Voluntary movement
82
Parasagittal area of the homonculus corresponds to
Lower extremities (leg, foot)
83
Motor Homonculus sequence
Foot, hip, trunk, arm, hand, face, tongue, larynx
84
Function of somatosensory cortex
Somethetic sensation and proprioception
85
Another structure in CNS aside from somatosensory cortex that functions in proprioception is
Dorsal or posterior columns of the spinal cord
86
Speech understanding
Wernicke’s area
87
Integration of somatosensory and visual input important for complex movements
Posterior parietal cortex
88
Integration of all sensory input; important in language
Parietal-temporal- occipital association cortex
89
Surrounded by higher -order visual cortex (Sight)
Primary visual cortex
90
Sensory aphasia is lesion in
Wernicke’s area
91
Babble incessantly
Do not understand a word
Nonsensical streams of words
Wernicke’s aphasia
| Sensory aphasia
92
Cannot repeat words or phrases
| Substitutes words or changes order
Conductive aphasia
93
Conductive aphasia is lesion in
arcuate fasciculus
94
You can understand other people
| You cannot articulate words properly
Broca’s area
95
Mostly found on inner and bottom surface of temporal lobe, motivation and emotion, memory
Limbic association cortex
96
Surrounded by higher-order auditory cortex (hearing)
Primary auditory cortex
97
Planning for voluntary activity
Decision making
Personality traits
Prefrontal association cortex
98
Lesion in prefrontal association cortex leads to
Major personality changes
99
Coordination of complex movements
Premotor cortex
100
Not a visible area
| Programming of complex movements
Supplementary motor area
101
Connects the right and left cerebral hemisphere
Corpus callosum
102
Superior to the corpus callosum is the
Cingulate cortex
103
Seat of our emotions
Limbic lobe
104
Components of limbic lobe
```
Cingulate and parahippocampal gyri
Subcallosal gyrus
Hippocampal formation
Dentate gyrus
Amygdala and septal area
```
105
Neuroanatomical substrate for drive related and emotional behavior
Limbic lobe
106
Plays an important role in emotion, learning and memory
Hippocampus
107
Plays role in aggression, eating, drinking and sexual behaviors
Amygdala
108
Monitors blood levels of glucose, salt, blood pressure and hormones
Hypothalamus
109
Location of primary auditory cortex
Superior temporal gyrus
110
Primary auditory cortex corresponds to brodmann area
41, 42
111
Transverse temporal gyrus is also known as
Heschl’s gyrus
112
Brodmann 4
Precentral gyrus
Paracentral lobule
Fx: Primary motor area
113
Brodmann 6
Superior, middle frontal gyri
Precentral gyrus
Fx: premotor area
114
Brodmann 8
Superior and middle frontal gyri
| Fx: frontal eye field
115
Brodmann number 44,45
opercular/ triangular part, inferior frontal gyrus
Fx: Broca’s area
116
Brodmann 3,1,2
Post-central gyrus
Paracentral lobule
Fx: primary somatosernsory area
117
Brodmann 5,7
Superior parietal lobule,
postcentral gyrus
Fx: somatosensory association area
118
Brodmann 41
Superior temporal gyrus
Paracentral lobule
Fx: Primary auditory area
Heschl’s gyrus
119
Brodmann 22
Superior temporal gyrus
Wernicke’s area
F: Auditory association area
120
Brodmann 40
Supramarginal gyrus
part of the somatosensory association cortex, which interprets tactile sensory data and is involved in perception of space and limbs location
121
Lesion in Brodmann area 40 will present with
Dyscalculia
Right-left disorientation
Difficulty understanding speech
122
What is Gerstmann syndrome ?
Dyscalculia
Right to left disorientation
Finger agnosia
Agraphia
123
Gerstmann syndrome involves the
Angular gyrus
| Left parietal lobe involvement
124
Brodmann 39
Angular gyrus
125
Lesion in brodmann 39
Dyslexia
| Dysgraphia
126
Reading disorder
| Trouble with reading despite normal intelligence
Dyslexia
127
Located in inferior frontal gyrus
Broca’s area
128
Motor aphasia
Broca’s aphasia
129
Broken speech
Broca’s aphasia
130
Expressive aphasia
Broca’s aphasia
131
Can understand other people
| Cannot articulate properly
Broca’s aphasia
132
Comprehension is intact
Broca’s aphasia
133
Brodmann area 22
Wernicke’s area
134
Superior temporal gyrus
Brodmann 22
| Wernicke’s area
135
Sensory aphasia
Wernicke’s aphasia
136
Lesion here produces conductive aphasia
Arcuate fasciculus
137
Language superhighway
Arcuate fasciculus
138
What produces CSF
```
Choroid plexus (main source)
ependymal lining
```
139
Function of CSF
Physical support for brain
Excretory function - regulates chemical environment
Chemical communication
140
CSF voume total
125 mL
141
CSF volume in ventricles
25 mL
142
CSF volume in subarachnoid space
100 mL
143
CSF production rate
0.35 mL/min or 21-22 mL/ hr or 500 mL/day
144
CSF is renewed
4-5 times a day
145
any impairment in CSF production or absorption
hydrocephalus
146
CSF absorbed
arachnoid villi in dural sinuses
147
CSF circulation
```
Lateral ventricles
Foramina of Monro
3rd ventricle
Sylvian aqueduct
4th ventricle
Foramina of Luschka and Magendie
Subarachnoid space
Venous circulation
```
148
interventricular foramina also known as
foramina of Monro
149
connect the paired lateral ventricle with the third ventricle at the midline of the brain
foramina of Monro
150
connect the 3rd and 4th ventricles at the level of the midbrain
Sylvian aqueduct
151
stenosis of Sylvian aqueduct leading to hydrocephalus
Congenital Aqueductal Stenosis
152
(also called median aperture) is one of the foramina in the ventricular system and links the fourth ventricle and the cisterna magna. It is one of the three sites that cerebrospinal fluid (CSF) can leave the fourth ventricle and enter the subarachnoid space.
Foramen of Magendie
153
The two other openings of the fourth ventricle positioned laterally
foramen of Luschka
154
presentation of increased intracranial pressure (due to hydrocephalus)
Headache/ Vomiting with
a. Papilledema
b. diplopia with internal squint
c. deterioration in the level of consciousness
d. bulging fontanel, separation of sutures, rapid enlarging head size
155
sunsetting eyes is indicative of
hydrocephalus
156
pathways that originate with the pyramidal neurons in the cortex and terminate in the spinal cord (corticospinal) or brainstem (corticobulbar).
the direct( pyramidal) system
157
impulses are sent through the corticospinal tracts and synapse in the anterior horn
The direct/ pyramidal system
158
this pathway regulates fast and fine (skilled) movements
The direct/ pyramidal system
159
Movement of action potential through pyramidal system
primary motor area of cerebral cortex (pyramidal neurons) -> internal capsule -> cerebral peduncle -> cerebellum and pons -> at medulla (pyramid) -> [pyramidal decussation] decussates to lateral corticospinal tract of the opposite side
160
indirect pathway
extrapyramidal system
161
pathway of extrapyramidal system
cerebrum -> Midbrain (red nucleus)-> rubrospinal tract -> cervical spinal cord
162
decorticate posture
flexion
163
Regulates fast and fine skilled movements
the direct pyramidal system
164
lesions above the red nucleus will present with this posture
decorticate / flexion
165
decerebrate posture
extension
166
lesions below the red nucleus will present with this posture
extension/ decerebrate
167
which has poorer prognosis
a. decorticate
b. decerebrate
b.
168
2 spinothalamic tracts
anterior spinothalamic tracts
| lateral spinothalamic tracts
169
main fx: conveys light touch
anterior spinothalamic tract
170
this tract conveys pain and temperature
lateral spinothalamic tract
171
pathway for pain, temperature, crude/ light touch
pain, temperature, crude/ light touch -> DRG dorsal root ganglion -> anterolateral spinothalamic tract -> thalamus (Ventral posterior lateral nucleus)-> primary somatosensory cortex
172
basal ganglia is composed of
caudate nucleus
putamen
globus pallidus
substantia nigra
subthamic nucleus
173
3 important structures of basal ganglia
substantia nigra pars compacta (SNc)
lateral pallidal segment
subthalamic nucleus
174
substantia nigra is rich in this type of neurons
dopaminergic neurons
175
substantia nigra appear darker than neighboring areas due to high levels of
neuromelanin
176
Neuromelanin is found in large quantities in catecholaminergic cells of the
substantia nigra pars compacta and locus coeruleus,
177
lesion in substantia nigra pars compacta produces
Parkinson's disease
178
lesion in lateral pallidal segment
Huntington's disease
179
Lesion in subthalamic nucleus
Ballism
180
2 genes involved in Parkinson's disease
PINK 1
| PARKIN
181
is a presynaptic neuronal protein that is linked genetically and neuropathologically to Parkinson's disease (PD).
α-Synuclein
182
α-Synuclein - its aberrant soluble oligomeric conformations, termed_____. They are the toxic species that mediate disruption of cellular homeostasis and neuronal death through effects on various intracellular targets, including synaptic function.
protofibrils
183
main neuropathological feature of PD
lewy bodies
| -eosinophilic, round cytoplasmic inclusions
184
what is the DOC for PD
levodopa- carbidopa
185
is characterized by small shuffling steps and a general slowness of movement (hypokinesia), or even the total loss of movement (akinesia) in the extreme cases.
Parkinsonian gait
186
a disorder of locomotion associated especially with Parkinson's disease that is marked by a tendency to walk backwards
retropulsion
187
Triad of parkinson's disease
tremors
bradykinesia
rigidity
188
what neurotransmitter is deficient in PD
dopamine
189
what part of brain is affected by PD
substantia nigra pars compacta
190
thalamic functions
processes all sensory information except olfactory
controls level of cortical excitability
influences motivational and emotional responses
191
thalamic pain syndrome
Dejerine Roussy Syndrome
192
main function of cerebellum
balance
| coordination
193
three layers of cerebellar cortex
molecular layer
purkinje cell-
granular layer
194
which layer of cerebellar cortex is most sensitive to ischemia
purkinje cell
195
do cerebellar lesions ever cause paralysis
no
| cerebellum only influences control of our muscles
196
method of walking or running) where the toes of the back foot touch the heel of the front foot at each step.
Tandem gait
197
to check for cerebellar lesion make the patient do
Tandem gait
romberg's test
rapid alternating movements
finger to nose test
198
lesions in cerebellar hemisphere will lead to
ipsilateral limb ataxia
truncal ataxia
gait ataxia
intention tremor
199
lesion of vermis present with
truncal ataxia
200
wide-based "drunken sailor" gait characterised by uncertain starts and stops, lateral deviations and unequal steps. It is an instability of the trunk and often seen during sitting. It is most visible when shifting position or walking heel-to-toe.
Truncal ataxia
201
refers to the inability to perform rapid, alternating movements, such as flipping one's hand from back to front on a flat surface, or screwing in a light bulb
Dysdiadochokinesia
