Neuroanatomy

Question 1

what are the 3 major frontal divisions of the brain

Answer 1

primary motor cortex

premotor cortex

prefrontal cortex (LARGEST)

Question 2

what are the INPUTS of the primary motor cortex

Answer 2

thalamus

basal ganglia

sensory area

premotor area

Question 3

what are the OUTPUTS of the of the primary motor cortex

Answer 3

motor fibers–> brainstem and spinal cord

Question 4

what is the PURPOSE of the of the primary motor cortex

Answer 4

execution of movements

Question 5

what is the result of LESIONS TO the primary motor cortex

Answer 5

CONTRALATERAL changes in tone, power, fine coordination

Question 6

what are the INPUTS to the premotor cortex

Answer 6

thalamus

basal ganglia

sensory area

Question 7

what are the OUTPUTS from the premotor cortex

Answer 7

primary motor cortex

Question 8

what is the FUNCTION of the premotor cortex

Answer 8

STORAGE of MOTOR PROGRAMS

Question 9

what is the result of LESIONS TO the premotor cortex

Answer 9

CONTRALATERAL weakness

coarse ATAXIA

Question 10

the prefrontal cortex is a component of what brain system

Answer 10

limbic system

Question 11

where is broca’s area located in relation to the 3 components of the frontal lobes of the brain

Answer 11

behind and under the prefrontal cortex

under the premotor cortex

under and in front of the primary motor cortex

Question 12

why is the frontal brain called “frontal”

Answer 12

its located in FRONT of the CENTRAL SULCUS of the brain

Question 12

why is the frontal brain called “frontal”

Answer 12

its located in FRONT of the CENTRAL SULCUS of the brain

Question 13

list the components of the frontal lobe from anterior to posterior

Answer 13

forehead–> prefrontal cortex –> premotor cortex–> primary motor cortex–> central sulcus

Question 14

what are the 3 subdivisions of the PREFRONTAL cortex

Answer 14

dorsolateral region

dorsomedial region (includes the cingulate gyrus)

orbitofrontal region

Question 15

what is the FUNCTION of the dorsolateral region of the prefrontal cortex

Answer 15

executive cognitive functions

–> develop and execute plans for complex goal directed activities

–> conform behaviour to social contingencies

Question 16

what are the connections that the the dorsolateral region of the prefrontal cortex makes with the rest of the brain

Answer 16

motor and sensory CONEVRGENCE areas

thalamus

basal ganglia –via the caudate (globus pallidus, caudate, substantia nigra)

Question 17

what is the result of LESIONS to the dorsolateral region of the prefrontal cortex

Answer 17

executive dysfunction

disinterest/emotional reactivity

inattention to relevant stimuli

Question 18

what are the two components of the dorsomedial region of the prefrontal cortex

Answer 18

superior frontal gyrus

cingulate gyrus

Question 19

what is the FUNCTION of the dorsomedial region of the prefrontal cortex

Answer 19

motivation

initiation to activity

Question 19

what is the FUNCTION of the dorsomedial region of the prefrontal cortex

Answer 19

motivation

initiation to activity

Question 20

what is the result of the LESION to the dorsomedial region of the prefrontal cortex

Answer 20

apathy

decreased drive and spontaneity of movement

loss of cingulate gyrus input to the supplementary motor cortex “releases” activity
–> diminished awareness
–> at worst, usually if bilateral lesions, then can have akinetic mutism

Question 21

what CONNECTIONS does the dorsomedial region of the prefrontal cortex make with the rest of the brain

Answer 21

anterior cingulate gyrus–> ventral striatum (caudate, putamen)–> globus pallidus and substantia nigra–> thalamus etc (feeds back)

connections to temporal and parietal cortices, cingulate cortex, thalamus, basal ganglia

Question 22

what are the two components of the basal ganglia

Answer 22

caudate

putamen

Question 23

what are the components and waht is the location of the orbitofrontal region of the prefrontal cortex

Answer 23

Question 24

what is the FUNCTION of the orbitofrontal region of the prefrontal cortex

Answer 24

modulation of emotional input arousal suppression of distractions

Question 25

what is the result of a LESION to the orbitofrontal region of the prefrontal cortex

Answer 25

emotional lability disinhibition distractability "hyperkinesis" OCD like

Question 26

what are the connections the orbitofrontal region of the prefrontal cortex makes with the rest of the brain

Answer 26

temporal and parietal cortex thalamus basal ganglia insula amygdala

Question 27

which region of the prefrontal cortex connects to motor and sensory convergence areas

Answer 27

dorsolateral regions

Question 28

which region of the prefrontal cortex connects to the temporal and parietal cortices

Answer 28

dorsomedial and orbitofrontal

Question 29

which region of the prefrontal cortex connects to the thalamus and basal ganglia

Answer 29

all three of them

Question 30

which region of the prefrontal cortex connects to the insula and amygdala

Answer 30

orbitofrontal region

Question 31

what are the 3 "frontal syndromes"

Answer 31

dorsolateral syndrome--> "executive dysfunction" dorsomedial syndrome (anterior cingulate syndrome)--> "amotivation syndrome" orbitofrontal lesion--> "disinhibition syndrome" *in reality is rare to have isolated syndromes

Question 32

what is "Witzelsucht"

Answer 32

uncontrollable tendency to pun, tell jokes/inappropriate humour can be seen in frontal syndromes

Question 33

how do we divide the brain VERTICALLY

Answer 33

cortical vs subcortical division

Question 34

what are 4 functions of the CORTICAL division of the brain

Answer 34

ability language motor sensory

Question 35

what are 4 functions of the SUBCORTICAL division of the brain

Answer 35

movement basic function emotions connection to FRONTAL lobes--> relay center

Question 36

which part of the brain contains GRAY matter

Answer 36

cortical

Question 37

where is the hippocampus located in the brain

Answer 37

temporal lobe, edge of the cortex

Question 38

is the hippocampus cortical or subcortical

Answer 38

cortical

Question 39

is basal ganglia cortical or subcortical

Answer 39

subcortical

Question 40

is the thalamus cortical or subcortical

Answer 40

subcortical

Question 41

is the brain stem cortical or subcortical

Answer 41

subcortical

Question 42

which division of the brain--cortical or subcortical--is responsible for the following function: language

Answer 42

cortical

Question 43

which division of the brain--cortical or subcortical--is responsible for the following function: connection to frontal lobes

Answer 43

subcortical

Question 44

which division of the brain--cortical or subcortical--is responsible for the following function: movement

Answer 44

subcortical

Question 45

which division of the brain--cortical or subcortical--is responsible for the following function: ability

Answer 45

cortical

Question 46

which division of the brain--cortical or subcortical--is responsible for the following function: motor

Answer 46

cortical

Question 47

which division of the brain--cortical or subcortical--is responsible for the following function: basic function

Answer 47

subcortical

Question 48

which division of the brain--cortical or subcortical--is responsible for the following function: emotions

Answer 48

subcortical

Question 49

which division of the brain--cortical or subcortical--is responsible for the following function: sensory

Answer 49

cortical

Question 50

what makes up the subcortical brain division

Answer 50

white matter prohects and deep gray matter bodies

Question 51

in what brain division is the anterior cingulate cortex (ACC) located

Answer 51

frontal--> dorsomedial

Question 52

phineas gage sustained damage to what part of the brain

Answer 52

orbitofrontal cortex

Question 53

in which hemisphere is brocas area located

Answer 53

left (in frontal lobe, inferior region)

Question 54

what do lesions in brocas area result in

Answer 54

EXPRESSIVE aphasia NON FLUENT

Question 55

in which hemisphere is wernicke's area located

Answer 55

left hemisphere in temporal lobe/parietal lobe

Question 56

what do lesions in wernicke's area cause

Answer 56

RECEPTIVE aphasia FLUENT

Question 57

where does the auditory cortex lie

Answer 57

in the temporal lobe, just in front of the wernicke's area

Question 58

what are the functions of the parietal lobe

Answer 58

sense of touch body position

Question 59

where is the primary somatosensory cortex located

Answer 59

in the parietal lobe

Question 60

what is the function of the primary somatosensory cortex

Answer 60

integrates somesthetic stimuli for recognition and recall of form, texture and weight

Question 61

what is the function of the posterior-lateral area of the parietal lobe

Answer 61

visual-spatial relationships and proprioception

Question 62

where is the lesion that causes Gerstmann syndrome

Answer 62

dominant parietal lobe

Question 63

what is Gerstmann syndrome

Answer 63

a lesion in the dominant parietal lobe causes: deficits in writing (agraphia) deficits in calculating (acalculia) left right disorientation abnormalities in finger naming

Question 64

what are the functions of the DOMINANT parietal lobe

Answer 64

calculation writing left right orientation finger recognition

Question 65

what happens if you have a lesion to the NONdominant parietal lobe

Answer 65

neglect anosognosia (a smaller lesion may cause apraxia)

Question 66

what is apraxia

Answer 66

spatial-manual deficit lose the ability to do learned motor tasks--> dressing, other well learned activities

Question 67

a lesion in what area may cause anosognosia

Answer 67

non dominant parietal lobe

Question 68

a lesion to what area may cause acalculia

Answer 68

dominant parietal lobe

Question 69

what are some of the functions of the temporal lobes

Answer 69

comprehension sound speech

Question 70

what is the function of the hippocampus

Answer 70

memory

Question 71

what area is affected in kluver bucy syndrome

Answer 71

anterior temporal lobes

Question 72

list the symptoms of kluver-bucy syndrome

Answer 72

amnesia docility pica hyperphagia hyperorality hypersexuality visual agnosia

Question 73

what is the function of the occipital lobe

Answer 73

information related to sight

Question 74

what brain structures make up the diencephalon

Answer 74

thalamus and hypothalamus

Question 75

what brain structures make up the brain stem

Answer 75

thalamus and hypothalamus midbrain pons medulla

Question 76

what brain structures make up the hindbrain

Answer 76

cerebellum pons medulla

Question 77

what brain structures make up the forebrain

Answer 77

cerebral structures (cerebral cortex, white matter, subcortical structures) thalamus and hypothalamus

Question 78

what brain structures make up the telencephalon

Answer 78

cerebral structures (cerebral cortex, white matter, subcortical structures)

Question 79

what brain structures make up the mesencephalon

Answer 79

midbrain

Question 80

what brain structures make up the metencelphalon

Answer 80

pons cerebellum

Question 81

what brain structures make up the myelencephalon

Answer 81

medulla

Question 82

where is the insula located

Answer 82

between the parietal and temporal lobes basically

Question 83

what area is responsible for mental flexibility

Answer 83

dorsolateral PFC (lesions lead to concreteness, inability to set shift, perseveration etc)

Question 84

is brocas area in the dominant or nondominant hemisphere

Answer 84

DOMINANT hemisphere

Question 85

where are the cortical association areas located

Answer 85

parietal lobe

Question 86

what is the function of the cortical association areas

Answer 86

integrates and processes sensory information i.e auditory and visual

Question 87

what is the function of wernickes area in the DOMINANT hemisphere

Answer 87

communication

Question 88

what is the function of wernickes area in the NONdominant hemisphere

Answer 88

receptive aprodosia (receptive prosody of speech)

Question 89

where does visual and cognitive processing happen

Answer 89

in the occipitotemporal gyri

Question 90

what is the function of the parahippocampal gyri

Answer 90

learning and memory

Question 91

what is the function of the insular lobe

Answer 91

located internal to the lateral sulcus responsible for NOCICEPTION and regulation of AUTONOMIC FUNCTION

Question 92

what is the result of damage to the anterior cingulate cortex

Answer 92

apathy, amotivation

Question 93

what makes up the limbic lobe

Answer 93

ACC subcallosal gyrus cingulate gyrus parahippocampal gyrus (includes the entorhinal cortex which links olfactory system, cingulate gyrus, orbital cortex, amygdala, and temporal cortex to the hippocampus)

Question 94

what are the subcortical structures

Answer 94

Question 95

the substantia nigra is in what part of the brain

Answer 95

part of midbrain

Question 96

what structures make up the dorsal striatum

Answer 96

caudate and putamen

Question 97

where does the dopamine that feeds into the dorsal striatum/ caudate+ putamen originate

Answer 97

substantia nigra pars compacta

Question 98

what is the function of the caudate

Answer 98

motor function cognitive function

Question 99

what are the two parts of the ventral striatum

Answer 99

nucleus accumbens olfactory tubercle

Question 100

what part of the brain is a major producer of serotonin

Answer 100

raphe nucleus

Question 101

where does the dopamine that feeds into the ventral striatum come from

Answer 101

ventral tegmental area *reward/aversion related cognition *dopaminergic hyperactivity leads to + symptoms

Question 102

what brain structure produces dopamine for the nigrostriatal pathway

Answer 102

substantia nigra pars compacta

Question 103

what is the function of the pons

Answer 103

relays signals from forebrain to cerebellum deals with sleep, respiration, swallowing, bladder control, hearing, equilibrium, taste, eye movement, facial expression and sensation and posture

Question 104

what structure in the brain produces norepinephrine

Answer 104

locus ceruleus

Question 105

where is the locus ceruleus located in the brain

Answer 105

in the pons

Question 106

what cranial nerves are found in the pons

Answer 106

V VI VII VIII

Question 107

what is the function of the medulla

Answer 107

control of ventilation via signals from the carotid and aortic bodies cardiovascular SNS, PNS vasomotor center reflex center for vomiting, coughing, swallowing, sneezing

Question 108

what part of the brain is responsible for: swallowing

Answer 108

pons reflex is in medulla

Question 109

what part of the brain is responsible for: vomiting reflex

Answer 109

medulla

Question 110

what part of the brain is responsible for: bladder control

Answer 110

pons

Question 111

what part of the brain is responsible for: control of ventilation

Answer 111

medulla

Question 112

where is the vasomotor center of the brain

Answer 112

medulla

Question 113

what are the structures involved in the mesolimbic dopaminergic pathway

Answer 113

ventral tegmental area--> dopamine to ventral striatum (nucleus accumbens and olfactory tubercle) --> dopamine hyperactivity = + symptoms --> reward/aversion related cognition

Question 114

what are the structures involved in the mesocortical dopaminergic pathway

Answer 114

ventral tegmental area--> dopamine release to prefrontal cortex --> executive function -->low dopamine transmission = negative symptoms

Question 115

what are the structures involved in the nigrostriatal dopamine pathway

Answer 115

substantia nigra pars compacta--> dopamine to dorsal striatum (caudate and putamen) --> motor function

Question 116

what are the structures involved in the tuberoinfundibular dopaminergic pathway

Answer 116

arcuate nucleus--> dopamine release into median eminence, circulates through hypophyseal portal system, and INHIBITS release of prolactin in pituitary--> prolactin inhibition

Question 117

what brain system is affected in restless leg syndrome

Answer 117

hypothalamospinal

Question 118

what brain system is affected in tremor

Answer 118

incertohypothalamic

Question 119

what tests should be ordered to work up chorea

Answer 119

CBC TSH ESR C3 C4 ANA/ENA anti-dsDNA calcium +/- PTH CT head serum ceruloplasmin

Question 120

list autoimmune causes of chorea

Answer 120

APLAS NMDA-R PANDAs Sydenhams SLE chorea gravidarum

Question 121

list congenital causes of chorea

Answer 121

perinatal asphixia kernicterus

Question 122

list drug induced causes of chorea

Answer 122

neuroleptics amphetamines cocaine stimulants adrenergics l-dopa direct acting dopamine agonists phenytoin OCPs

Question 123

list endocrine causes of chorea

Answer 123

hyperthyroidism hypoparathyroidism

Question 124

list infectious causes of chorea

Answer 124

neurosyphillis HIV encephalitis

Question 125

how do you distinguish huntingtons chorea from tardive dyskinesia

Answer 125

huntingtons--> typically both upper and lower face; limbs, gait equally if not more affected; respiratory and diaphragmatic chorea tardive dyskinesia--> typically lower face, tongue and lips more than extremities; respiratory and diagphragmatic chorea

Question 126

asterixis is associated with what conditions or meds

Answer 126

hepatic, uremic encephalopathy (toxic-metabolic) anticonvulsants (esp. valproic acid) lithium clozapine *may also be seen with midbrain, thalamic or frontal disease