Neuroanatomy (Exam #3)

Question 1

What are the three layers of meninges and in what order (closest to brain → closest to skull)?

Answer 1

1. Pia (closest to brain)
2. Arachnoid
3. Dura (closest to skull)

Question 2

What vessel(s) are affected with an Epidural Hematoma, and how does this appear on imaging?

Answer 2

• Middle Meningeal a.

- Lens-shaped on imaging

Question 3

What vessel(s) are affected with an Subdural Hematoma, and how does this appear on imaging?

Answer 3

• Bridging veins

- Crescent-shaped on imaging

Question 4

What occurs an Subarachnoid Hemorrhage, and how does this appear on imaging?

Answer 4

Aneurysm

- Crab-shaped on imaging

Question 5

With ANTERIOR circulation in the brain, how does the R side differ from the L side?

Answer 5

• R = Aorta → Brachiocephalic a. → R Common Carotid a.

- L = Aorta → L Common Carotid a.

Question 6

What are the primary vessels of the POSTERIOR circulation in the brain?

Answer 6

Vertebral aa. (L and R)

Question 7

What four nerves and which artery runs through the Cavernous Sinus?

Answer 7

• CN III
• CN IV
• CN VI
• CN V (1 and 2)
• Internal Carotid a.

Question 8

What two deficits may be seen if the Cavernous Sinus is compromised?

Answer 8

• Ophthalmoplegia (decreased EOMs)

- Decreased facial sensation

Question 9

What function is primarily seen with the frontal lobe? Which cortex is included in the frontal lobe, and what is its function?

Answer 9

Motor (voluntary)

- Motor cortex = movement

Question 10

What function is primarily seen with the parietal lobe? Which cortex is included in the parietal lobe, and what is its function?

Answer 10

Perception (temperature, taste, touch, movement)

- Sensory cortex = sensation

Question 11

What function is primarily seen with the occipital lobe?

Answer 11

Vision

Question 12

What function is primarily seen with the temporal lobe?

Answer 12

Language

- Also memory and auditory processing

Question 13

What are the three sections of the Brainstem, and what CN are seen in each (3, 3, 4)?

Which CN is seen at a junction and what is this junction called?

Answer 13

• Midbrain: II, III, IV
• Pons: V, VI, VII
• Medulla: IX, X, XI, XII

CN VIII is at the Pons/Medulla junction

Question 14

What does “crossed signs” mean and where is this seen?

Answer 14

Brainstem

• Ipsilateral CN deficits
• Contralateral body weakness

Question 15

What is ipsilateral CN deficits and contralateral body weakness?

Answer 15

“Crossed signs”

Question 16

If the Conus Medullaris and/or Cauda Equina are affected, what three sxs/deficits may be seen?

Answer 16

• Pain
• Weakness
• Bladder/bowel dysfunction

Question 17

What are the four components of the Central NS?

Answer 17

• Cortex (UMN)
• Subcortical
• Brainstem
• Cerebellum
• Spinal Cord

Question 18

What are the five components of the Peripheral NS?

Answer 18

• Lower Motor Neuron (LMN)
• Peripheral Nerves
• NMJ
• Muscle

Question 19

When testing motor, what is the correct protocol?

Answer 19

Proximal → distal

Question 20

When testing sensory, what is the correct protocol?

Answer 20

Distal → proximal

Question 21

How does an UMN differ from a LMN in presentation?

Answer 21

UMN:

• Spastic weakness
• Hyperreflexia
• +Babinski

LMN:

• Flaccid weakness
• Hyporeflexia
• Atrophy
• Fasciculations

Question 22

What three signs/sxs are seen with an UMN?

Answer 22

• Spastic weakness
• Hyperreflexia
• +Babinski

Question 23

What four signs/sxs are seen with a LMN?

Answer 23

• Flaccid weakness
• Hyporeflexia
• Atrophy
• Fasciculations

Question 24

Sxs of aphasia, neglect, hemiparesis/hemisensory involving face/arm vs. leg are indicative of dysfunction of which neuro area?

Answer 24

Cortex

Question 25

Sxs of chorea, ballism, tremor, cogwheel), dense hemiplegia are indicative of dysfunction of which neuro area?

Answer 25

Subcortical structures

Question 26

Sxs of ataxia and dysmetria of trunk vs. limbs are indicative of dysfunction of which neuro area?

Answer 26

Cerebellum

Question 27

Sxs of CN palsies, “crossed signs” are indicative of dysfunction of which neuro area?

Answer 27

Brainstem

Question 28

Sxs of sensory level, bladder/bowel involvement, saddle anesthesia are indicative of dysfunction of which neuro area?

Answer 28

Spinal Cord

Question 29

Sxs of fasciculations, NO sensory are indicative of dysfunction of which neuro area?

Answer 29

Motor Neuron

Question 30

Sxs of distal weakness/sensory (stocking-glove distribution), areflexia vs. hyporeflexia are indicative of dysfunction of which neuro area?

Answer 30

Peripheral Neuron

Question 31

Sxs of fatigability, NO sensory are indicative of dysfunction of which neuro area?

Answer 31

NMJ

Question 32

Sxs of proximal weakness (symmetric), NO sensory are indicative of dysfunction of which neuro area?

Answer 32

Muscle

Question 33

With a cortical injury, how can you differentiate injury to MCA vs. ACA?

Answer 33

- MCA: face/arm > leg | - ACA: leg > arm/face

Question 34

What type of injury involves hemisensory = motor def., aphasia, apraxia, agnosia?

Answer 34

Cortex (Cortical)

Question 35

What type of injury involves dense unilateral motor or sensory deficit; movement disorders?

Answer 35

Subcortical

Question 36

If a patient has a lesion of CN XII, how will this present?

Answer 36

"Lick your lesion" | - Tongue will go TOWARDS the same side as the lesion

Question 37

How does Cortical vs. Subcortical presentation differ in terms of body parts affected?

Answer 37

- Cortical: face/arm > leg vs. leg > arm/face | - Subcortical: face, arm and leg affected equally