Neuro- Basic Neuroanatomy Flashcards
(78 cards)
1
Q
What is the final part of the spinal cord called?
A
Conus medullaris
2
Q
Broca’s area controls what?
A
Speech production
3
Q
Wernicke’s area controls what?
A
Speech comprehension
4
Q
Where does the spinal cord normally end?
A
L1
5
Q
The anterior (ventral) nerve root allows efferent _______ neurons to _________ the spinal cord.
A
Motor
Exit
6
Q
The posterior (dorsal) nerve root allows afferent _______ neurons to _________ the spinal cord.
A
Sensory
Enter
7
Q
What are the classical UMN lesion signs?
A
- Hyper-reflexia (brisk)
- Hyper-tonia
- Clonus
- Upgoing plantars
- Muscle weakness with NO muscle wasting (Spastic paralysis)
8
Q
What are the classical LMN signs?
A
- Hypo-reflexia
- Hypotonia
- Fasciculations
- Muscle weakness with wasting (atrophy)
- Normal downgoing plantars
9
Q
UMN lesions usually cause the arm _______ and leg __________ to become weak.
A
Arm extensors
Leg flexors
10
Q
Where does the corticospinal tract decussate?
A
Medulla
11
Q
Where does the dorsal column decussate?
A
Medulla
12
Q
Where does the spinothalamic tract decussate?
A
Spinal level of entry
13
Q
Which tract is affected by syringomelia?
A
Spinothalamic
because it decussates at the spinal level
14
Q
Which spinal nerve roots are involved in the biceps reflex?
A
C5/6
15
Q
Which spinal nerve roots are involved in the triceps reflex?
A
C7/8
16
Q
Which spinal nerve roots are involved in the knee reflex?
A
L3/4
17
Q
Which spinal nerve roots are involved in the ankle/achilles reflex?
A
S1/2
18
Q
What is grade 0 in the MRC Classification of muscle power?
A
0= No visible contraction
19
Q
What is grade 1 in the MRC Classification of muscle power?
A
1= Flicker of movement
20
Q
What is grade 2 in the MRC Classification of muscle power?
A
2= Movement with gravity
21
Q
What is grade 3 in the MRC Classification of muscle power?
A
3= Active movement against gravity
22
Q
What is grade 4 in the MRC Classification of muscle power?
A
4= Active movement against resistance
23
Q
What is grade 5 in the MRC Classification of muscle power?
A
5= Normal power
24
Q
EMG studies are useful for which types of disorders?
A
Neuromuscular disorders eg. Myasthenia gravis, MND
25
Where is Broca's area?
Inferior frontal gyrus
| In the dominant hemisphere (left in most people)
26
Where is Wernicke's area?
Superior temporal gyrus
27
Non-fluent dysphasia is ....
Broca's aphasia
| Due to motor dysfunction; difficulty producing speech
28
Fluent dysphasia is ........
Wernicke's aphasia
| Due to comprehension dysfunction
29
If the arcuate fasciculus is damaged, how does this affect speech?
Difficulty with repetition; conduction aphasia
As the arcuate fasciculus connects the Broca's and Wernicke's areas
30
What are the 2 fibres of CN2?
1. Temporal fibre= looks at nasal part of visual field
| 2. Nasal fibre= looks at temporal part of visual field
31
What are the 3 different types of disorders of the optic nerve (CN2)?
1. Pupil abnormalities
2. Visual field defects
3. Optic disc defects
32
The afferent aspect of the pupil reflex travels via CN _____ and the efferent part travels via CN _____ .
```
Afferent = CN2 Optic
Efferent = CN3 Occulomotor
```
33
In Relative Afferent Pupillary Defect (RAPD), what happens to the pupils in the swinging light test?
Pupils dilate or constrict less when exposed to light.
34
In ipsilateral monocular blindness, which optic nerve fibres are damaged?
Both temporal and nasal fibres of CN2 on one side
35
In bitemporal hemianopia where is the lesion?
Lesion in the optic chiasm (where nasal fibres cross)
| Leads to loss of temporal vision on both sides
36
Ipsilateral monocular blindness is caused by disease in which areas of the eye?
Retina
| Optic nerve
37
What can cause bitemporal hemianopia?
Optic chiasm lesions:
1. Pituitary adenoma
2. Craniopharyngioma
3. Internal carotid artery aneurysm
4. Meningioma
38
What is the primary cause of bitemporal hemianopia in children?
Craniopharygngioma
39
In optic atrophy, the optic disc is ___ in colour and the margins are _____
Pale optic disc
| Sharp margins
40
What are the primary causes of optic disc atrophy?
```
MS
Optic nerve compression
Nutrient deficiency- B1 and B12
Tobacco/ alcohol
Ischemia
```
41
Which muscles does the Occulomotor nerve innervate?
Superior, Inferior and Medial rectus muscles
| Inferior oblique
42
Which muscle does the Trochlear nerve innervate?
Superior oblique
43
Which muscle does the Abducens nerve innervate?
Lateral rectus
44
The superior rectus muscle moves the eyeball ____ and ____-
Up and out
45
The superior oblique moves the eyeball _____ and _________
Down and in
46
What are the key clinical features of a CN3 nerve palsy?
1. Eye moves down and out (Abducted)
2. Ptosis (partial or complete)
3. Impaired accommodation and pupil reflex
4. Painful or painless
47
What are the potential causes of a CN3 nerve palsy?
Ischemia (most common)
Brainstem lesion (midbrain)- tumour, demyelination
Cavernous sinus lesion
Surgical CNIII Palsy (Posterior Communicating Artery Aneurysm)
Tentorial herniation and coning
48
What are the key clinical features of a CN6 Palsy?
Eye moves medially
49
What is the most common cause of both occulomotor and abducens nerve palsies?
Ischemia
Due to diabetes and HTN
50
What is the key clinical sign of a CN4 palsy?
```
Vertical diplopia (up and down double vision)
Patient tilts head towards opposite shoulder
```
51
Which branches of the trigeminal nerve pass through the cavernous sinus?
V1 (Ophthalmic) and V2 (Maxillary)
52
Where is the nucleus of the trigeminal nerve?
Pons
53
Which 2 cranial nerves pass through the internal acoustic meatus?
CN VII- Facial
| CN VIII- Vestibulocochlear
54
Forehead sparing facial palsies are caused by lesions where?
UMN lesion (supranuclear)
Caused by stroke
55
Ramsay hunt syndrome affects which cranial nerve?
CN7 = Facial nerve
56
Ramsay Hunt syndrome is a complication of which virus?
Shingles (Herpes Zoster Oticus)
57
What are the clinical features of Bell's Palsy?
1. Abrupt onset unilateral facial weakness
2. Numbness around ear
3. Sound hypersensitivity
4. Decreased taste
58
What are the functions of CN 9?
Glossopharyngeal nerve:
1. Motor- pharynx and palate
2. Sensory- taste of posterior 1/3 of tongue, chemoreceptors (carotid body), middle ear, oropharynx
59
What are the causes of bulbar palsy?
1. GBS
| 2. Brainstem lesions: Tumours, meningoencephalitis, MND
60
What happens to the tongue, speech and reflexes in bulbar palsy?
Tongue- flaccid, wasted, fasciculations
Speech- Quiet, breathy, nasal
Jaw reflex- absent
Gag reflex- normal
61
Is bulbar palsy caused by an UMN or LMN lesion?
LMN lesion (CN9-12)
62
What is pseudobulbar palsy caused by?
UMN lesion in corticobulbar tract:
Stroke
MND
63
What happens to the tongue, speech and reflexes in pseudobulbar palsy?
Tongue- spastic, slow moving, No fasciculations or wasting
Speech- heavy, slurred
Jaw reflex- increased/ brisk
Gag reflex- increased/ brisk
64
Which nerves innervate the pharynx to control swallow?
CN9- Glossopharyngeal
| CN10- Vagus
65
Which disease can cause a mixture of bulbar and pseudobulbar palsy?
MND
66
What happens to the uvula in CNX lesion?
Vagus nerve lesion.. uvula deviates away from the side of the lesion.
67
What are the features of a CNXII nerve lesion?
Hypoglossal nerve lesion... tongue deviates towards the side of the lesion
Tongue fasciculates and wastes
68
What are the afferent and efferent nerves involved in the gag reflex?
Afferent- CN9 Glossopharyngeal
| Efferent- CN10 Vagus
69
Where does the Vestibulocochlear nerve exit?
Cerebellopontine angle
70
What are the causes of vestibulocochlear nerve palsy?
Benign positional vertigo (BPV)
Acute labyrinthitis
Meniere's disease
Brainstem pathology eg. MS demyleination
71
Which condition is most likely to cause short lived episodes of vertigo and nystagmus on head movement, which usually resolve spontaneously?
Benign paroxysmal positional vertigo
72
What are the symptoms of acute labyrinthitis?
Abrupt onset severe vertigo and loss of balance
Vomiting
NO tinnitus
Symptoms resolve in days-weeks
73
What are the symptoms of Meniere's disease?
```
Unilateral inner ear disease
Vertigo
Tinnitus
Deafness
Vomiting
```
74
If a patient presents with weakness in turning their head. shrugging shoulders, uvula deviation, and poor movement of the soft palate, what syndrome do they likely have?
Jugular foramen syndrome.
Unilateral lower CN palsy
75
What are the clinical features of Horner's syndrome?
Unilateral incomplete ptosis
Miosis
Anhydrosis
Enophthalmos (posterior eyeball displacement)
Normal pupil reflex and accommodation
76
Internuclear Ophthalmoplegia is caused by a lesion where?
Medial longitudinal fasciculus- the heavily myelinated tract which allows conjugate eye movement and communication between CN3 and 6.
77
What are the symptoms of INO?
Failure of affected eye to abduct
| Nystagmus in other eye
78
What are the 2 main causes of INO?
MS
| Stroke
