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Neuroanatomy > Gross Neuroanatomy > Flashcards

Gross Neuroanatomy Flashcards

1
Q

What are the major parts of the Central Nervous System?

A
  • Cerebrum (Cerebral Hemispheres)
  • Cerebellum (“little brain”)
  • Brainstem (Midbrain, Pons, Medulla)
  • Spinal Cord and Roots
  • Pre-Ganglionic Autonomic Neurons
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2
Q

Describe the spatial relationship between the different parts of the CNS.

A
  • Anterior to Posterior Cerebrum: Frontal Lobe, Parietal Lobe, Occipital Lobe.
  • Temporal Lobe is lateral to Parietal Lobe.
  • Inferior to Occipital Lobe is the Cerebellum
  • On the inferior side of the brain, the brainstem attaches medially — Superior to Inferior: Midbrain, Pons, Medulla
  • Inferior to Medulla is where the spinal cord and roots begin
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3
Q

What makes up the Cerebrum?

A
  • Lobes of Cerebral Hemisphere
  • Telencephalon (Cerebral Cortex and Subcortical Regions)
  • Diencephalon (Thalamus and Hypothalamus)
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5
Q

What is the deepest part of the CNS?

A

The ventricles

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6
Q

Which CNS region is the lateral ventricle located?

A

Cerebral Hemisphere (Telencephalon)

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7
Q

Which CNS region is the 3rd ventricle located?

A

Within the thalamus and hypothalamus (Diencephalon)

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8
Q

Which CNS region is the 4th ventricle located?

A

Within the pons, medulla, and cerebellum

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9
Q

Explain ventricular space vs. subarachnoid space?

A

Ventricular space is within the ventricles and has choroid plexus secreting cerebrospinal fluid (CSF).

The CSF exits the ventricular space through a pore/foramen and enters the subarachnoid space (area surrounding CNS) to be moved around.

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10
Q

Explain the directional axes in the CNS and how it changes in different regions.

A

When referring to the cerebral hemispheres:

  • Rostal/Caudal = front/back = anterior/posterior
  • Dorsal/Ventral = top/bottom = superior/inferior

When referring to the Cerebellum, Brainstem, and Spinal Cord, the axis gets kinked and turns 90 degrees downward:

  • Ventral/Dorsal = front/back = anterior/posterior
  • Rostal/Caudal = top/bottom = superior/inferior
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11
Q

What are the different dural/CNS compartments?

A
  • Supratentorial
  • Infratentorial
  • Vertebral
  • Peripheral Level
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12
Q

What CNS structures are in the supratentorial compartment?

What key functions are tested in the neurological exam in this compartment?

A

Structures: Telencephalon (Cerebral cortex and subcortical regions) and Diencephalon (Thalamus and Hypothalamus).

Key Functions: Awake and Oriented, Olfactory and Visual systems, Cognition, Language, Emotions and Behavior, Hypothalamic/Pituitary functions

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13
Q

What CNS structures are in the infratentorial compartment?

What key functions are tested in the neurological exam in this compartment?

A

Structures: Brainstem and Cerebellum

Key Functions:

  • Brainstem - Cranial Nerves 3-12
  • Cerebellum - Motor Coordination
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14
Q

What CNS structures are in the vertebral compartment?

What key functions are tested in the neurological exam in this compartment?

A

Structures: Spinal Cord, Dorsal and Ventral Roots

Key Functions: Motor and Somatosensory exams, Reflexes

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15
Q

What structures are in the peripheral level?

What key functions are tested in the neurological exam in this compartment?

A

Structures: Somatic/Visceral Nerves and Autonomics

Key Functions: Reflexes

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16
Q

Describe the effects of herniations on brain tissue and dural partitions

A

Initially, the it is the brain tissues that is displaced and injured.

With the progression of mass effect, dural partitions can be displaced as well.

Mass Effect is the displacement of intracranial structures

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17
Q

What causes herniations?

A

When mass effect is severe enough to push intracranial structures from one compartment into another.

A single type of herniations can result from a local mass. Or a progressive supratentorial mass can eventually cause all 4 herniations.

18
Q

List 4 types of brain herniations.

A
  1. Subfalcine (Under the falx cerebri)
  2. Central (centrally and downward)
  3. Uncal Transtentorial (through tentorial notch)
  4. Tonsillar (on pons, above tonsil of cerebellum)
19
Q

Describe normal and increased intracranial pressure.

What are the symptoms (7) and mechanisms (4)?

A

Normal Pressure: <20 cm H2O or <15 cm Hg
Causes: Hydrocephalus (too much CSF), Brain edema (swelling), Hemorrhage, Tumor
Symptoms: Headache, Nausea and Vomiting, Impaired Consciousness, Bulging Skull (children), Increased systemic BP, Bradycardia (slow heart rate), Papilledema (protrusion of optic disk)

20
Q

What are symptoms (3) and causes (3) of Meningeal Irritation Syndrome?

A
  • Symptoms: Headache/Pain, Nuchal Rigidity (Neck Stiffness), Impairment or Loss of Consciousness with progression of pathology
  • Various Causes: Inflammation, Infection (Meningitis - viral, bacterial, or fungal), Pressure (bleeding or growing intracranial mass)
21
Q

Which ventricular structure is at the deepest part of the midbrain?

What is the purpose of this structure?

A

Cerebral Aqueduct

It is a pathway for CSF between the 3rd and 4th ventricle.

22
Q

What is the ventricular structure that is at the deepest part of the spinal cord?

A

The central canal - it dead ends in sacral spinal cord.

23
Q

How does the lateral ventricle communicate with the 3rd ventricle?

A

Via the interventricular foramen

24
Q

What dural structures form the borders within the brain and between the 4 different dural compartments?

A

Superior Sagittal Sinus:
*Divides the cerebral hemispheres
Falx Cerebi:
*Divides the cerebral hemispheres
Transverse Sinus and Tentorium Cerebelli:
*Divides the supratentorial and infratentorial compartments
*Divides the cerebrum from the cerebellum
Falx Cerebelli:
*Divides the cerebellum
Foramen Magnum:
*Divides the infratentorial and vertebral compartments

25
Q

What is the tentorium notch?

A

The hole in the tentorium cerebelli that allows the brainstem to pass through.

26
Q

Describe in detail the meningeal layers from scalp to brain (12).

A

Scalp - Skull - Epidural - Periosteal layer of Dura Mater - Dural Sinuses - Meningeal layer of Dura Mater - Subdural Space - Arachnoid Mater - Arachnoid Trabeculae - Subarachnoid Space - Pia Mater - Cerebral Cortex

27
Q

What meningeal layer contains pain sensitive fibers?

What nerve(s) supply it?

A

Dura Mater

Mostly trigeminal nerve (5) also Vagus nerve (10) and cervical nerves.

28
Q

Differentiate Epidural, Subdural, and Subarachnoid Hemorrhages

A

Epidural: Bleeding from meningeal arteries accumulates between skull and dura
Subdural: Bleeding from cerebral arteries accumulates between dura and arachnoid; also caused by tear in bridging veins
Subarachnoid: Most commonly caused by aneurysms; diffuse neurological signs; meningeal irritation signs; increased intracranial pressure; detectable by lumbar puncture and neuroimaging.

29
Q

Describe Diffuse vs. Focal Presentation of CNS Infection.

What are the routes of entry (5) for infection?

A

Diffuse: Signs of meningeal irritation or increased intracranial pressure
Focal or Multi-Focal: Not common; Exceptions include abscesses and parasitic cysts

Routes of Entry: Traumatic breech of skull or vertebral compartment, Emissary veins (scalp –> skull –> superior sagittal sinus), Veins from face to Cavernous Sinus, Cribriform Plate, Viral entry via PNS Neurons

Neuroanatomy (2 decks)

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