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Flashcards in INBR 7 - Neuroanatomy Deck (175)
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1

1. Daerah-daerah otak yang tidak memiliki sawar darah-otak meliputi semua hal di bawah ini, kecuali:
A. Pineal body
B. Organ subfornikal
C. Organum vaskulosum dari lamina terminalis
D. Eminensi mediana dari hipotalamus
E. Nukleus habenulare

(E) The pineal body, subfornical organ, organum vasculosum of the lamina terminalis, median eminence of the hypothalamus, neurohypophysis, subcommissural organ, and the area postrema are devoid of a blood-brain barrier and are commonly referred to as circumventricular organs. The habenular nucleus is not a circumventricular organ (Carpenter, pp. 18-20; Kandel, p. 1293).

2

2. Manakah diantara hal-hal di bawah ini yang merupakan jaras keluar utama dari ganglia basalis
A. Fasikulus lentikularis (H2 dari Forel)
B. Ansa Lentikularis
C. Faskikulus talamikus (H1 dari Forel)
D. Ansa Retikularis
E. Traktus mammillotalamikus

(A) The major fibers projecting from the basal ganglia originate in the medial globus pallidus as a fiber tract known as the lenticular fasciculus, or Forel's field I-12 . Another tract, known as ansa lenticularis, loops around the internal capsule, merges with the lenticular fasciculus in Forel's field H, and continues with the dentatorubrothalamic tract as the thalamic fasciculus (Forel's field H 1 ) . These fibers then synapse in the centromedian (CM), ventrolateral (VL), and ventroanterior (VA) nuclei of the thalamus before being relayed to the cerebral cortex. Three other efferent tracts of the basal ganglia include the pallidosubthalamic, pallidohabenular (via the stria medullaris), and pallidotegmental, which terminate in the subthalamic nucleus, habenular nucleus, and midbrain tegmentum, respectively (Carpenter, pp. 341-344).

3

3. Cedera pada Segitiga GUILLAIN-MOLLARET dapat menyebabkan
A. Tremor pada lengan
B. Torsional nistagmus
C. Hipotonia
D. Tuli
E. Mioklonus

(E) Guillain-Mollaret's triangle is a physiologic connection between the red nucleus, inferior olives, and dentate nucleus of the cerebellum. Injury to this pathway has been !mown to result in palatal myoclonus. This occurs mainly from hypertrophic degeneration of the inferior olive secondary to either red or dentate nucleus damage. Other muscles of branchial origin (face, tongue, vocal cords, and diaphragm) may also be affected. Vascular lesions and multiple sclerosis are common causes of secondary palatal myoclonus that persists during sleep. The etiology of primary myoclonus is unclear and is often associated with bothersome clicking sounds i n the ear caused by contractions of the tensor veli palatini (CN V) muscles, which open the eustachian tubes. Primary myoclonus disappears during sleep (Merritt, pp. 666-667; Wilkins, p. 149 ) .

4

4. Melalui struktur manakah serabut dari olive inferior mencapai serebelum?
A. Pedunkulus serebelaris superior
B. Pedunkulus serebelaris inferior
C. Pedunkulus serebelaris medius
D. Nukleus vestibularis
E. Lobe flokulonodularis

(B) The fibers exiting the inferior olive are climbing fibers and reach the cerebellum through the inferior cerebellar peduncle. Climbing fibers are excitatory and synapse with Purkinje cells in a distinctive morphologic fashion. They wrap around the cell body and dendrites of Purkinje cells, where numerous synaptic contacts are made. Each climbing fiber contacts 1 to 10 Purkinje cells, and each Purkinje cell receives input from only a single climbing fiber. The response elicited by the interaction between climbing fibers and Purkinje cells is believed to be the most powerful in the CNS and results in a large action potential (complex spike) secondary to Ca2+ influx into the Purkinje cell. The other major afferent fibers reaching the cerebellum are mossy fibers, which influence Purkinje cells indirectly through synapses with granule cells (Carpenter, pp. 230-234) .

5

5. Semua di bawah ini adalah serabut asosiasi, KECUALI
A. Faskikulus longitudinal superior
B. Faskikulus arkuatus
C. Fascikulus unsinatus
D.Corona radiata
E.Singulum

(D) The corona radiata is made u p of projection fibers conveying impulses to subcortical structures including the thalamus, basal ganglia, brainstem, and spinal cord. The superior and inferior longitudinal fasciculus, arcuate fasciculus, uncinate fasciculus, external capsule, and cingulum are six of the more notable association fibers that connect different lobes within the same hemisphere. Commissural fibers connect corresponding regions of the two hemispheres, which include the corpus callosum, anterior commissure, and hippocampal commissure (Carpenter, pp. 33-3 7 ) .

6

6. Neuron ordo pertama untuk dilatasi pupil berasal dari struktur yang mana?
A. Thalamus
B. Hipothalamus
C. Kolukulus superior
D. Ganglion servikalis superior
E. Nukleus EDINGER-WESTPHAL

(B) First-order neurons involved with pupillary dilation originate in the hypothalamus and descend through the brainstem and cervical spinal cord to the T 1-T2 level of the spinal cord. They then synapse on ipsilateral preganglionic sympathetic fibers, exit the cord, travel with the sympathetic fibers as second-order neurons,. and synapse on postganglionic sympathetic fibers. The third-order neurons travel with the internal carotid artery to the orbit and innervate the radial smooth muscle of the iris ( Kandel, p. 905).

7

7. Nukleus basalis (dari MEYNERT) mengandung jenis neuron yang mana?
A. Kolinergik
B. Adrenergik
C. Serotonergik
D. Dopaminergik
E. Noradrenergik

(A) The basal nucleus (of Meynert) contains neurons with acetylcholine that project to the cingulate gyrus, septal nuclei, and the nucleus of the diagonal band of Broca. Dopaminergic fibers are located mainly in the substantia nigra and ventral tegmental area, w

8

8. Awal insisi untuk graf krista iliaka anterior pada sekitar 3 cm lateral dari spina iliaka anterior adalah upaya untuk mencegah kerusakan struktur berikut :
1. Muskulus Sartorius
2. Nervus kutaneus femoralis lateralis
3. Ligamen ilio-inguinal
4. Muskulus iliakus

(A) Beginning the incision for an anterior iliac crest graft approximately 3 em lateral to the anterior iliac spine av()ids the attachments of the sartorius muscle and ilioinguinal ligament. The lateral femoral cutaneous nerve courses through this region_ and is also vulnerable to injury with this approach, but it does not attach to or originate from the iliac crest (Connolly, pp. 818-819).

9

9. Serabut mossy yang berasal dari girus dentatus akan berakhir di sini.
A. CA1
B. CA2
C. CA3
D. CA4
E. Griseum indusium
F. Girus dentate
G. Bukan, A-F

(C) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .

10

10. Sangat rentan terhadap hipoksia.
A. CA1
B. CA2
C. CA3
D. CA4
E. Griseum indusium
F. Girus dentate
G. Bukan, A-F

(A) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .

11

11. Kolateral-kolateral SCHAFFER berproyeksi pada neuron piramidial dari sub-lapisan ini
A. CA1
B. CA2
C. CA3
D. CA4
E. Griseum indusium
F. Girus dentate
G. Bukan, A-F

(A) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .

12

12. Terletak pada konkavitas girus dentatus.
A. CA1
B. CA2
C. CA3
D. CA4
E. Griseum indusium
F. Girus dentate
G. Bukan, A-F

(D) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .

13

13. Sisa vestigial dari pembentukan hipokampus
A. CA1
B. CA2
C. CA3
D. CA4
E. Griseum indusium
F. Girus dentate
G. Bukan, A-F

(E) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .

14

14. Cedera pada sektor ini bisa menyebabkan masalah memori yang lalu.
A. CA1
B. CA2
C. CA3
D. CA4
E. Griseum indusium
F. Girus dentate
G. Bukan, A-F

(G) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .

15

15. Sektor yang paling besar
A. CA1
B. CA2
C. CA3
D. CA4
E. Griseum indusium
F. Girus dentate
G. Bukan, A-F

(A) The hippocampal formation includes the hippocampus, dentate gyrus, and subiculum. The hippocampus and dentate gyrus form interlocking C-shaped structures when viewed in transverse section. Both structures also contain three cortical layers, which is characteristic of the archicortex. The hippocampus is found in the floor of the temporal horn and is composed of the molecular, pyramidal, and poly- morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. morphic layers. The neurons of the hippocampus reside in the pyramidal layer and have extensive apical dendrites that project to the molecular layer. Terminal axons from several sources, including the dentate gyrus and entorhinal cortex, synapse with pyramidal cell dendrites in the molecular layer. The polymorphic layer contains basal dendrites and axons of pyramidal cells. The axons of hippocampal pyramidal cells have extensive collateral branching patterns. The hippocampus can be further subdivided into four regions, namely CAl , CA2, CA3, and CA4. CAl is the largest sector and is continuous with the subiculum, which is located in the parahippocampal gyrus and joins the hippocampal formation to the entorhinal cortex. CAl is also called Sommer's sector and is extremely vulnerable to hypoxia. The CA2 subfield is a short transitional region between the more extensive CA3 and CAl subfields. CA3 (harbors largest pyramidal cells of hippocampus) is located at the genu and enters the dentate gyrus and is relatively resistant to hypoxia. CA4 lies in the concavity of the dentate gyrus, and represents the transition zone into this structure. The dentate gyrus also consists of three layers: the molecular, granular, and polymorphic. The granule cells (of the granular layer) have dendritic trees that extend into .the molecular layer and axons within the polymorphic layer. The subiculum is located in the superior part of the parahippocampal gyrus and is buried in the ventral bank of the hippocampal fissure. The subiculum forms the transition between the trilaminar hippocampus and the six layers of the entorhinal cortex (area 28); like the dentate gyrus and hippocampus, it also contains three cortical layers: a superficial molecular layer, a deeper polymorphic layer, and a pyramidal layer which lies in between them . The hippocampus contains three major intrinsic pathways, including the perforant pathway, Schaffer collateral pathway, and mossy fiber pathway. The serial flow of information begins in the entorhinal cortex, which is believed to be the first leg of a multisynaptic loop that flows through the hippocampal formation. Information from the entorhinal cortex (area 28) is first projected to the granule cells of the dentate gyrus via the perforant pathway. It is called the perforant pathway because the fibers perforate the hippocampal formation before reaching the granular cell dendrites of the dentate gyrus (located in the molecular layer). The granule cells of the dentate gyrus, in turn, send a dense projection of axons, or mossy fibers, to the molecular layer of the CAJ subfield, where they synapse on the apical dendrites of pyramidal neurons. Axons from CAJ then bifurcate into two pathways. One pathway enters the alveus to exit the hippocampus in the fibers of the fornix; the other includes Schaffer collaterals, which project to the pyramidal neurons of CAl, which, in turn, project back to the subiculum. Finally, neurons from the subiculum complete this multisynaptic loop through the hippocampal formation by sending axons back to the entorhinal cortex. These pathways form the intrinsic connections within the hippocampal formation that are involved in long-term potentiation. With long-term potentiation, small stimuli result in increased and prolonged postsynaptic potentials of target neurons (facilitation) , and this often involves the NMOA receptor. Long-term potentiation involves depolarization and activation of NMOA receptors and/or voltage dependent calcium channels as well as release of calcium from intracellular stores. This increase in intracellular calcium results in activation of specific intracellular transduction cascades, including gene transduction, resulting in long-lasting modifications of synaptic integrity. The fornix represents the primary efferent projections of the hippocampal formation (subiculum and hippocampus) . The fornix passes under the splenium of the corpus callosum (crura) , after which the crura join to form the body of the fornix, which curves around to the rostral thalamus. The body of the fornix then divides into the anterior columns of the fornix that curve ventrally to the foramina of 1vlonro. The fornix then divides into precommissural and postcommissural fibers at the anterior commissure. Precommissural CHAPTER 2 Neuroanatomy Answers 37 fibers project to the septal nuclei. Postcommissural fibers project to the mammillary body, hypothalamus, septal region, medial frontal cortex, and anterior thalamus. A small number of postcommissural fibers project to the midbrain tegmentum. Collateral projections also exit the fornix at various points along its course and project to neocortical association areas. The majority of fibers that enter the fornix originate in the subiculum, which in turn receives extensive input from the hippocampus and dentate gyrus. The anterior hippocampus also has direct efferent projections to the amygdala. Vestigial remnants of the hippocampal formation include the indusium griseum (supracallosal gyrus), which connects to the dentate gyrus via the fasciolar gyrus. The hippocampus is involved with recent memory and encoding of new memories into long-term storage. Bilateral hippocampal lesions result in marked deficits in short term memory, inability to acquire new information and skills, and mild behavioral changes, while memory for remote events is usually unaffected (Carpenter, pp. 369-3 76; Kandel, pp. 1259-1260; Pritchard , pp. 3 7 7-380 ) .

16

16. Pada orang normal, sirkuit langsung dan tidak langsung dari ganglia basal diseimbangkan oleh
A. Aksi-aksi perlawanan dari proyeksi-proyeksi nigrostriatal dopaminergik pada sub-tipe-sub-tipe reseptor D1 dan D2 pada putamen
B. Aktivitas penghambatan dari nukleus subthalamik pada globus pallidus interna.
C. Meningkatnya aktivitas neuron-neuron GABAergik pada segmen bagian dalam dari globus pallidus ileh jalur langsung
D. Serat-serat dopaminergik yang semakin naik dab berasal dari tegmentum bagian
tengah otak dari substantia nigra ( yang mempengaruhi reseptor-reseptor D1 dan D2 dari globus pallidus).
E. A, B, C dan D semuanya benar

(A) . T h e dopaminergic projections o f t h e SNc t o t h e striatum facilitate movements by influencing the direct and indirect pathways. The nigrostriatal projections to the spiny neurons of the direct pathway ( 0 1 receptors) are excitatory, while the nigrostriatal projections to the spiny neurons of the indirect pathway (02 receptors) are inhibitory. In normal individuals, the direct and indirect circuits of the basal ganglia are balanced by the opposing actions of these projections on these receptors. The loss of SNc dopaminergic projections to the striatum results in increased activity of the indirect circuit (and decreased activity of the direct circuit), which accounts for the hypokinetic aspects of Parkinson's disease. It is important to realize, however, that the segregation of the 0 1 and 02 receptors between the direct and indirect pathways is probably not as strict as described above, but it still serves as a nice framework to explain the differential action of dopamine on striatal output. The subthalamic nucleus has an excitatory effect on the internal segment of the globus pallidus via the indirect pathway. In normal individuals, the activation of striatal GABAergic neurons inhibits GABAergic neurons within the internal segment of the globus pallidus instead of activating them. The ascending dopaminergic activating system originates in the brainstem reticular

17

17. Lesi visual yang menyebabkan defek sentral pada satu lapang pandang dengan defek temporo-superior sisi berlawanan, kemungkinan berasal dari lokasi yang mana?
A. Kiasm depan
B. Lobe okipital
C. Lobe temporal
D. Saraf optik
E. Lobe parietal inferior

(A) A visual lesion producing a central defect i n one field with a superior temporal defect in the opposite field s uggests 38 Intensive Neurosurgery Board Review a lesion near the anterior optic chiasm. This is likely the result of damage to the ipsilateral optic nerve and the fibers that loop forward from the inferonasal retina of the opposite eye (Wille brand'$ knee). (Brazis, p. 136, Kline, pp. 3 , 9).

18

18. Serat-serat dari medan-medan mata frontal lewat melalui genu dari kapsul bagian dalam, melakukan dekusasi di dalam pons, dan bersinapse di dalam struktur yang terlibat dengan sakkades yang mana?
A. Faskikulus longitudinal medial (MLF)
B. Kolikulus inferior
C. Nukleus Edinger-Westphal
D. Nukleus soliteris
E. Formasi retikular pontin paramedian (PPRF)

(E) Fibers controlling saccades originate in the contralateral frontal eye fields (Brodmann's area 8), pass through the internal capsule, decussate in the pons, and synapse in the paramedian pontine reticular formation (PPRF) . Efferent fibers from the PPRF project to the ipsilateral abducens nucleus (VI) and contralateral oculomotor nucleus (III) via the medial longitudinal fasciculus (MLF) , which results in saccadic eye movements. Saccades that are organized in the PPRF are usually under the control of the superior colliculus, although some saccadic eye movements occur independently, without collicular influence (Kandel, pp. 789-792 ) .

19

19. Oklusi dari pembuluh ini merupakan penyebab yang paling lazim dari sindroma medularis lateral (Wallenberg) .

(E) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer\'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner's syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)' occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and 'tract), ipsilateral Horner's syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner's syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a "fetal" PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .

20

20. Memasok piramis, tuber, flokulus, dan bagian-bagian kaudal dari tegmentum pontin

(C) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer\'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner's syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)' occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and 'tract), ipsilateral Horner's syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner's syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a "fetal" PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .

21

21. Oklusi dapat menyebabkan gangguan pendengaran kontra-lateral.

(B) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer\'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner's syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)' occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and 'tract), ipsilateral Horner's syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner's syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a "fetal" PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .

22

22. Pembuluh yang lazim berasosiasi dengan neuralgia trigeminal .

(B) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer\'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner's syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)' occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and 'tract), ipsilateral Horner's syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner's syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a "fetal" PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .

23

23. Pembuluh yang paling berisiko cedera selama dekompresi Chiari.

(D) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer\'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner's syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)' occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and 'tract), ipsilateral Horner's syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner's syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a "fetal" PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .

24

24. Nukleus dentate biasanya dipasok oleh pembuluh ini.

(B) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer\'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner's syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)' occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and 'tract), ipsilateral Horner's syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner's syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a "fetal" PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .

25

25. Memasok pedunkel serebelar tengah.

(C) The vertebral artery (VA) is generally the l argest branch of the subclavian artery; as a variant, the left VA arises from the aortic arch about 4% of the time. There are four segments of the vertebral artery (E). The first courses superiorly and posteriorly to enter the transverse foramen of the sixth cer\'ical vertebral body. The second segment ascends vertically within the transverse foramina, accompanied by a network of sympathetic fibers from the stellate ganglion and a venous plexus. I t turns laterally within the transverse process of the axis. The third segment exits the foramen of the axis and curves posteriorly and medially in a groove on the upper surface of the atlas to enter the foramen magnum. The fourth and last segment pierces the dura and joins the opposite VA near the lower pontine border. Branches of the V-A include the anterior meningeal artery, which may occasionally feed meningiomas or clival chordomas; the posterior meningeal arfery; posterior spinal artery; posterior inferior cerebellar artery (PICA) (D), and the anterior spinal artery. Occlusion of PICA (D) or the vertebral artery (E) may produce the lateral medullary (Wallenberg) syndrome, which is characterized by ipsilateral facial numbness; contralateral trunk numbness; ipsilateral palatal, pharyngeal, and vocal cord paralysis (nucleus ambiguus ) ; ipsilateral Horner's syndrome; vertigo; nausea; vomiting; ipsilateral cerebellar signs; and occasionally hiccups. The most common cause of Wallenberg syndrome is VA occlusion ; however, it has classically been described in the literature after PICA occlusion. The PICA vessels are at risk for injury during a Chiari decompression, as they loop around the tonsils. The characteristic picture of anterior inferior cerebellar artery (AICA) (C)' occlusion includes vertigo, nystagmus, nausea and vomiting (vestibular nuclei involvement), ipsilateral facial numbness (trigeminal spinal nucleus and 'tract), ipsilateral Horner's syndrome (descending sympathetic fibers), contralateral limb numbness (lateral spinothalamic tract), ipsilateral ataxia (middle cerebellar peduncle) , and ipsilateral deafness and facial paralysis (lateral pontomedullary tegmentum). It supplies the middle and inferior lateral pontine regions and the anterolateral parts of the cerebellum, which includes the middle cerebellar peduncle, flocculus, pyramis, and tuber. It is the most common vessel compressing the seventh cranial nerve during hemifacial spasm, which occasionally requires surgical decompression. Occlusion of the SCA (B) is the least common cause of cerebellar infarction, which is characterized by nausea, vomiting, vertigo, nystagmus, ipsilateral Horner's syndrome, ataxia, ipsilateral intention tremor (superior cerebellar peduncle), contralateral limb numbness, contralateral hearing loss (crossed fibers of the lateral lemniscus), and possibly a fourth nerve palsy (pontine tectum) . The SCA is the most common nerve compressing the trigeminal nerve i n trigeminal neuralgia. The posterior cerebral arteries (A) are joined by the posterior communicating arteries (PComA) about 1 em from their origin . The PComA is the major origin of the PCA 15 to 20% of the time and is termed a "fetal" PCA. The PCA comprises the P1 (peduncular), P2 (ambient) , P3 (quadrigeminal) , and P4 (distal or cortical) segments and their respective branches . Major branches of the PCA include the medial and lateral posterior choroidal arteries; anterior, middle, and posterior temporal arteries; parieto-occipital artery; calcarine artery; as well as the smaller thalamoperforating and thalamogeniculate arteries. The origin of the PComA is the first or second most common location for aneurysm formation, along with the anterior communicating artery ( Brazis, p p . 37 4-3 7 7 ; Kaye and Black, pp. 1603, 1734; Osborn DCA, p p . 153-193; Greenberg, pp. 107-108) .

26

26. Serat-serat yang lewat dari amigdala ke hypothalamus bisa berjalan pada bundel serat yang mana?
A. Stria medullaris
B. Forniks
C. Terminal-terminal stria
D. Bundel otak depan tengah
E. Singulum

(C) Afferent connections into the hypothalamus are umerous and complex. Seven of the main pathways are described below. 1. Amygdalohypothalamic fibers pass from the amygdala to the hypothalamus by two pathways: the stria terminalis and a pathway under the lentiform nucleus (ventral amygdalofugal fibers). The stria terminalis arises mainly from the corticomedial part of the amygdala and distributes fibers to the medial preoptic nucleus, anterior hypothalamic nucleus , and ventromedial and arcuate nuclei. Ventral amygdalofugal fibers arise from the basolateral amygdala and pyriform cortex and spread medially and rostrally under the lentiform nucleus to reach the lateral hypothalamus and medial forebrain bundle. 2. Visceral and somatic fibers reach the hypothalamus through collateral branches of the lemniscal tracts and reticular formation. 3. Basal olfactory, septal nuclei, periamygdaloid, and subiculum fibers reach the lateral and preoptic hypothalamic regions via the medial forebrain bundle . 4. Cortical fibers to the hypothalamus arise mainly from the frontal lobe. 5. Hippocampohypothalamic fibers travel through the fornix to the mammillary body. 6. Thalamohypothalamic fibers arise from the dorsomedial and midline thalamic nuclei. 7. Brainstem fibers to the hypothalamus arise from the raphe nuclei of the midbrain, the lateral parabrachial nuclei of the pons, and the locus ceruleus. Brainstem reticular fibers also ascend to the hypothalamus by the mammillary pedicle and dorsal longitudinal fasciculus (Carpenter, pp. 304-307 ; Kandel, pp. 972-981 , 992-993 ) .

27

27. Sebuah glomerulus serebelar terdiri dari semua hal di bawah ini, KECUALI
A. Serat-serat mendaki
B. Kapsul glial
C. Dendrit neuron-neuron granula
D. Akson & dendrite dari neuron-neuron Golgi Tipe-II
E. Serat-serat Mossy

(A) The cerebellar glomeruli have synaptic connections consisting of mossy fiber rosettes, axons of Golgi type II neurons, and dendrites of granule cells. A glial capsule surrounds this conglomeration. The axons of the granule neurons, which enter the molecular layer, provide the output from the glomerulus. Climbing fibers bypass the glomeruli to synapse directly on Purkinje cells (Carpenter, pp. 224-234). 2 8 .

28

28. Situs utama proliferasi neuroblas pada Sistem Saraf Pusat adalah
A. Lapisan III dari korteks serebral
B. Daerah ependimal periventrikular
C. Zat putih
D. Spinal cord
E. Lapisan araknoid

(B) The major site of neuroblast proliferation in the CNS is the periventricular ependymal surface. After undergoing mitosis, these young neural cells migrate away from the ependyma ( El liso n , p. 7 1 ) .

29

29. Diantara sel-sel di bawah ini, sel manakah yang hanya mewakili keluaran dari korteks serebelar?
A. Sel granula
B. Sel Golgi
C. Sel Stellate
D. Sel Purkinje
E. Sel horisontal

(D) The cerebellar cortex consists of a molecular layer, Purkinje cell layer, and granular layer. The granular layer is deepest and lies just above the central medullary white matter. This layer contains the granule cells, which utilize glutamate as their neurotransmitter and are the only excitatory cells of the cerebellar cortex. Granule cell dendrites terminate in glomeruli, and their axons ascend to the molecular layer of the cerebellum as parallel fibers, which synapse with Purkinje cell dendrites. Golgi type II cells also reside in the granular layer of the cerebellar cortex. These cells are inhibitory (GABA) interneurons; their dendrites contact parallel fibers while their axons terminate in glomeruli. Each glomerulus consists of granule cell dendrites, Golgi cell axons , and a mossy fiber rosette. The Purkinje cells reside in the middle layer of the cerebellar cortex; they are large cells that project inhibitory fibers (GABA) to the deep cerebellar nuclei and the vestibular nuclei. The Purkinje cell represents the only output of the cerebellar cortex, which is inhibitory. Purkinje cells have extensive dendritic arborizations that extend into the molecular layer and are stimulated by parallel fibers and climbing fibers. Specialized astrocytes, called Bergman cells (Golgi epithelial cells) , surround Purkinje cells within the Purkinje cell layer and provide supportive functions. The molecular layer is the most superficial layer of the cerebellar cortex; it contains stellate cells, basket cell . Purkinje dendrites, and pqrallel fibers (from granule cells). Stellate cells make synaptic contacts with Purkinje cell dendrites, while basket cells form synapses on Purkinje cell bodies. Both stellate and basket cells are inhibitory and utilize GABA as their neurotransmitter. Cerebellar cortical input occurs via climbing fibers an • mossy fibers. Climbing fibers originate in the inferior oli,•e (olivocerebellars) ; they ascend to the molecular layer. "'•h;:re they directly stimulate the dendrites of small numb rs u

30

30. Struktur-struktur manakah yang melewati annulus tendineus ( dari Zinn)?
1. Ophthalmic vein
2. Muskulus rektus lateral
3. Cabang lakrimal dari saraf optalmik
4. Pencabangan inferior saraf okulomotor

(C) The annulus tendineus (of Zinn) lies at the apes the periorbita and gives rise to four rectus muscles. The o