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MRCS Anatomy > Raftery Neuroanatomy > Flashcards

Raftery Neuroanatomy Flashcards

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1
Q

What separates the 2 cerebral hemispheres?

A

Longitudinal fissure

Filled by falx cerebri (
dura mater)

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2
Q

What is the cerebrum derived from embryologically?

A

Prosencephalon

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3
Q

Which parts of the cranial fossae does the cerebrum fill?

A

Anterior and middle cranial fossae

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4
Q

What structure is the cerebrum located above inferoposteriorly?

A

Tentorium cerebelli

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5
Q

Major subdivisions of the brain

A

Forebrain
Midbrain
Hindbrain

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6
Q

Parts of the forebrain

A

Cerebral hemisphere or telencephalon (lateral ventricle)

Diencephalon - contains thalamus and hypothalamus (third ventricle)

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7
Q

Parts of midbrain

A

Mesencephalon (cerebral aqueduct)

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8
Q

Parts of hindbrain

A

Pons
Medulla
Cerebellum (fourth ventricle)

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9
Q

Which fossa does the frontal lobe lie in?

A

Anterior cranial fossa

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10
Q

Which fossa does the temporal lobe lie in?

A

Middle cranial fossa

Temporal pole at anterior extremity
Uncus on medial surface

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11
Q

2 types of tissue making up the cerebrum

A

Grey matter

White matter

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12
Q

What is grey matter?

A

Forms the external surface of each cerebral hemisphere (aka cerebral cortex)

Associated with processing and cognition

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13
Q

What is white matter?

A

Forms bulk of deeper parts of brain

Consists of glial cells and myelinated axons connecting various grey matter areas

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14
Q

What causes the convoluted external appearance of cerebrum?

A

Sulci (grooves/depressions)

Gyri (ridges/elevations)

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15
Q

What connects the 2 cerebral hemispheres?

A

Corpus callosum (white matter)

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16
Q

What separates the frontal and parietal lobes?

or the precentral (motor) from postcentral (sensory) gyrus?

A

Central sulcus

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17
Q

What separates the temporal from frontal and parietal lobes?

A

Lateral sulcus

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18
Q

What separates the occipital from parietal lobe?

A

Parieto-occipital sulcus on medial surface of hemisphere

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19
Q

What is the lunate sulcus?

A

A groove located in the occipital cortex

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20
Q

What are the calcarine and postcalcarine sulci?

A

Concerned with visual centres

Lie on medial aspect of occipital lobe

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21
Q

What is the superior temporal gyrus?

A

Ridge located below the lateral sulcus

For receiving and processing sound

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22
Q

Important areas of frontal lobe

A

Motor cortex in precentral gyrus
Broca’s area
Frontal cortex

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23
Q

What are the association areas of the frontal lobe responsible for?

A 
Higher intellect
Personality
Mood
Social conduct
Language (dominant hemisphere side only)
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24
Q

Fibres of motor cortex

A

Afferents from thalamus and cerebellum

Pass through internal capsule

To motor nuclei and cranial and spinal nerves

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25
Location of Broca's area
Posterior part of inferior frontal gyrus of dominant hemisphere
26
Functions of frontal cortex
Lateral - intellect Medial and orbital - affective behaviour
27
Important areas of parietal lobe
Sensory cortex in postcentral gyrus Parietal association cortex
28
What are the association areas of the parietal lobe responsible for?
Language and calculation (dominant) Visuospatial functions (non-dominant)
29
Important areas of temporal lobe
Auditory cortex Temporal association cortex Uncus
30
Fibres of auditory cortex
Afferents from medial geniculate body
31
Location and function of temporal association cortex
Surrounds auditory cortex Perceiving auditory stimuli and their integration with other sensory modalities
32
Function of uncus
Olfactory stimuli
33
Important areas of occipital lobe
Visual cortex Occipital association cortex
34
Location and function of visual cortex
Surround calcarine and postcalcarine sulci Vision of opposite half-field of sight
35
What happens if there is damage to frontal lobe?
Impairment of emotions and intellect
36
What happens if there is damage to motor cortex?
Weakness in contralateral side of body
37
What does the basal ganglia consist of?
Subcortical nuclei grouped functionally rather than anatomically
38
Why is anatomy of the basal ganglia complex?
It is spread throughout the forebrain
39
Parts of basal ganglia
Corpus striatum (caudate nucleus, putamen, globus pallidus) Claustrum Amygdaloid nucleus Thalamus
40
How can the components of the basal ganglia be divided?
Input nuclei Intrinsic nuclei Output nuclei
41
What forms the input nuclei of basal ganglia?
Caudate nucleus | Putamen (neostriatum)
42
What forms the intrinsic nuclei of basal ganglia?
External globus pallidus Subthalamic nucleus Pars compacta of substantia nigra
43
What forms the output nuclei of basal ganglia?
Internal globus pallidus | Pars reticulata of substantia nigra
44
What is the most rostral aspect of the neostriatum called?
Nucleus accumbens (Acb) - part of functionally separate domain called ventral striatum Where caudate nucleus and putamen join together
45
Where does the subthalamic nucleus lie?
In diencephalon
46
Where does the substantia nigra lie?
In mesencephalon
47
2 parts of substantia nigra
``` Pars reticulata (anterior) Pars compacta (posterior) ```
48
Location of caudate nucleus
Collection of gray matter forming lateral wall of lateral ventricle Follows telencephalic expansion during development
49
What separates the caudate nucleus from putamen during development?
Descending white matter fibres Aka internal capsule
50
What does the lentiform nucleus consist of?
Globus pallidus Putamen Anatomically related but no functional relationship
51
Location of putamen with respect to lentiform nucleus
Lateral aspect of lentiform nucleus
52
Location of globus pallidus with respect to lentiform nucleus
External globus pallidus lies on the concave inner surface of lentiform nucleus
53
What separates the putamen from GPe?
Lateral medullary lamina
54
What separates the GPe from GPi?
Medial medullary lamina
55
What is the collection of WM fibres lateral to the putamen called?
External capsule
56
What is the thin bundle of grey matter lateral to the external capsule called?
Claustrum
57
What lies lateral to the claustrum?
Extreme capsule (WM tracts separating claustrum from neocortical insula)
58
What causes the dark appearance of substantia nigra?
Neuromelanin produced by cells of SNc
59
Location of subthalamic nucleus
Below the thalamus, above substantia nigra
60
Function of basal ganglia
Feedback mechanism to cerebral cortex Motor refinement - prevent unwanted/exaggeratedmovements to start, reduce excitatory input to cortex Modulate cognitive and emotional responses
61
Inputs and projections of putamen
Inputs from motor and somatosensory cortices Project back to motor areas Hence related to motor loop
62
Inputs and projections of caudate nucleus
Input from cortical association areas Project to prefrontal areas
63
Inputs and projections of ventrial striatum (including nucleus accumbens)
Limbic inputs Hence related to emotions
64
Arterial supply to basal ganglia
Mainly MCA Main artery - lenticulostriate artery (most circulation to striatum and lenticular nucleus)
65
Minor arterial supply to basal ganglia
ACA Anterior choroidal artery Both are branches of ICA Supply more anterior aspect of ganglia (i.e. head of caudate nucleus and nucleus accumbens) Esp large artery - medial striate artery (of Heubner)
66
Arterial supply of substantia nigra and subthalamic nucleus
PCA Posterior communicating arteries (as location more posterior)
67
Venous drainage of basal ganglia
Striate branches of internal cerebral vein Drain into great cerebral vein
68
Types of cells in pineal gland
Pinealocytes = secrete hormones Glial cells = support cells
69
What happens to the pineal gland as we age?
Accumulation of calcified material called brain sand Can be identified on XR/CT head
70
Attachment of pineal gland
To diencephalon by pineal stalk
71
What is the base of the pineal stalk continuous with?
Posterior wall of third ventricle
72
What is contained in the superior and inferior parts of the base of pineal stalk?
Superior = habenular commissure Inferior = posterior commissure
73
Which structure is in close proximity to the pineal gland?
Superior colliculi of the midbrain
74
What does the pineal gland possess?
Adrenergic sympathetic fibres from superior cervical sympathetic ganglia No nerve cells
75
Arterial supply to pineal gland
Posterior choroidal arteries (set of 10 branches from PCA)
76
Venous drainage of pineal gland
Internal cerebral veins
77
Commonest type of pineal gland tumour
Germ cell tumour
78
What syndrome can a pineal gland tumour cause?
Parinaud syndrome = inability to move eyes upwards due to compression of superior colliculi Hydrocephalus = obstruction of cerebral aqueduct
79
What can happen in children with pineal gland tumours?
Accelerated onset of puberty | as function is to inhibit sexual development
80
Does the pineal gland contain a BBB?
No
81
Nervous pathway from retina to pineal gland
Retina to Suprachiasmatic nucleus of hypothalamus to Tegmentum of midbrain to Pineal gland Latter part may involve reticulospinal tract
82
Which hormone is produced by the pineal gland?
Melatonin
83
What happens to melatonin after they are produced by pineal gland?
Released into blood/CSF to Anterior lobe of pituitary gland to Inhibit release of gonadotrophic hormone
84
What is the smallest region of the brainstem?
Midbrain (2cm in length)
85
As the midbrain ascends, where does it travel through?
Tentorium cerebelli
86
2 main parts of midbrain
Tectum = posterior to cerebral aqueduct Paired cerebral peduncles = located anteriorly and laterally
87
Internally, what are the cerebral peduncles further separated by?
Substantia nigra Into crus cerebri (anterior) and tegmentum (posterior)
88
What does the tectum contain?
2x superior colliculi 2x inferior colliculi (collectively called corpora quadrigemina)
89
What are the colliculi separated by?
Cruciform sulcus
90
What structure is superior to the colliculi?
Pineal gland
91
What extends laterally from each colliculi?
Quadrigeminal brachium
92
What emerges inferior to the colliculi?
Trochlear (CN IV) nerve before sweeping across to anterior surface
93
Pathways of superior and inferior quadrigeminal brachium
Superior = between superior colliculus and retina of eye Inferior = from lateral lemniscus and inferior colliculus to medial geniculate body
94
What structures does the midbrain contain?
Cerebral peduncles (corticobulbar and corticospinal tract) Red nucleus Substantia nigra Nuclei of CN III and IV Portion of sensory nucleus of CN V
95
What are the cerebral peduncles separated anteriorly in the midline by?
Interpeduncular fossa
96
What is the floor of interpeduncular fossa called?
Posterior perforated substance | as many perforating blood vessels can be identified
97
What is seen exiting from between the peduncles?
Oculomotor (CN III) nerve
98
What runs around the superior border of midbrain?
Optic tract
99
What is found in the anterolateral surface of the midbrain at the level of inferior colliculus?
Paired crus cerebri
100
What fibre tracts run within the crus cerebri?
Frontopontine fibres = most medially Corticospinal fibres and corticobulbar tracts = motor fibres from primary motor cortex Temporopontine fibres = posterolaterally
101
What structure separates the 2 regions of the cerebral peduncles?
Substantia nigra (pigmented nucleus)
102
What structure is located posterior to substantia nigra?
Tegmentum (continuous in that found in pons by the same name) Note: continuous at midline unlike crus cerebri
103
What is the cerebral aqueduct surrounded by?
Periaqueductal gray matter
104
What lies within the periaqueductal gray matter?
Mesencephalic nucleus of trigeminal nerve Trochlear nucleus (fibres continue around gray matter to exit the midbrain)
105
What can be seen anterior to the fibres of the trochlear nucleus?
Medial longitudinal fasciculus
106
What lies between the central gray matter and substantia nigra in the midbrain?
4 lemnisci | anterior to posterior: medial, spinal, trigeminal, lateral
107
What can be found at the very posterior pole of the midbrain?
Tectum containing the inferior collliculus
108
What occupies the central portion of the midbrain at the level of inferior colliculus?
Decussation of superior cerebellar peduncles
109
What occupies the central portion of midbrain at the level of superior colliculus that used to contain decussation of cerebellar peduncles?
Large paired red nuclei with some decussation of rubrospinal tract anterior to it
110
What is the trochlear nucleus replaced by at the level of superior colliculus?
Oculomotor nucleus
111
Arterial supply of midbrain
Interpeduncular branches of basilar artery PCA and its peduncular branches Superior cerebellar artery Posterior choroidal artery
112
What does the pons develop from?
Embryonic metencephalon (part of hindbrain, developed from rhombencephalon) alongside cerebellum
113
Where is the pons located?
Anterior part of posterior cranial fossa
114
Anatomical relations of pons
``` Superior = midbrain Inferior = medulla oblongata ``` Posterior = cerebellum, separated by the fourth ventricle
115
How is the pons connected to the cerebellum?
By the middle cerebellar peduncle
116
What forms the floor of the fourth ventricle?
Dorsal surface of lower pons
117
What is the anterior (ventral) surface of the pons marked by?
Transverse pontocerebellar fibres wrapping around brainstem Measures ~2.5cm in adults
118
What demarcates the midline of ventral surface of pons?
Basilar groove where basilar artery is located
119
What is an important anatomical landmark defined by the angle between the lower border of pons and superior border of medulla?
Pontomedullary junction
120
Which CNs originate from ventral surface of pons?
Trigeminal (CN V) = from lateral aspect of mid pons Abducens (CN VI) = from pontomedullary junction, close to midline Facial (CN VII) = from cerebellopontine angle, more lateral aspect of pontomedullary junction Vestibulocochlear (CN VIII) = lateral to facial nerve
121
Which nuclei does the pons contain?
Nuclei of CN 6-8 Motor nucleus of CN 5
122
Relationship between pons and sensory nucleus of CN 5
Sensory nucleus of CN V extends from midbrain through pons and medulla to upper cervical cord
123
Which tracts cross in lower pons?
Corticospinal tracts
124
Important anatomical landmarks in floor of fourth ventricle
Medial eminence Facial colliculus Stria medullaris
125
What does the medial eminence in the pons denote?
Midline of floor of fourth ventricle
126
What is the facial colliculus in the pons formed by?
Bulging formed by fibres of the facial nerve looping around abducens nucleus
127
What is the stria medullaris of fourth ventricle?
Bundle of nerve fibres crossing transversely from lateral aspect into the midline They mark the posterior border between the pons and medulla
128
What is the angle formed at the junction of the pons, medulla and cerebellum?
Cerebellopontine angle Here, the cerebellar flocculus, ventricular choroid plexus and emerging CN 7 and 8 surround the lateral apertures of the fourth ventricle (foramen of Luschka)
129
2 major components of pons
Ventral pons Tegmentum
130
What does the ventral pons contain?
Pontine nuclei = coordinate movement Fibres from pontine nuclei cross the midline and form the middle cerebellar peduncles on their way to cerebellum
131
What is the tegmentum?
Evolutionarily older part of pons Forms part of reticular formation (set of nuclei found throughout brainstem that are responsible for arousal and attentiveness)
132
Which tracts make up the pons?
Descending = corticospinal (body) and corticobulbar (voluntary motor control of face, H&N) Ascending = medial lemniscus (fine touch, vibration, proprioception) and spinothalamic tracts (pain, temp)
133
Nuclei receiving sensory information from trigeminal nerve
Trigeminal sensory nucleus Spinal trigeminal nucleus Mesencephalic nucleus
134
Arterial supply of pons
Branches of vertebrobasilar system Most by pontine arteries (branches of basilar artery) Smaller part = anterior inferior cerebellar artery, superior cerebellar artery
135
Venous drainage of pons
Anterior pontomesencephalic vein Drains superiorly: basal veins --> cerebral veins Inferiorly: inferior petrosal sinus --> internal jugular veins
136
Symptoms of cerebellopontine angle (majority due to vestibular schwannomas)
Ipsilateral hearing loss + tinnitus (compression of cochlear component of CN 8) Dysequilibrium + vertigo (more rarely, compression of vestibular component of CN 8) Nystagmus (compression of cerebellar flocculus) ``` More serious Cx: Facial paralysis (CN 7 compression) Reduced corneal reflex (CN 5 and 7) Trigeminal palsy (CN 5) Ipsilateral cerebellar signs ```
137
How is the medulla connected to the cerebellum?
By the inferior cerebellar peduncle
138
What is the inferior margin of the medulla marked by?
Origin of first pair of cervical spinal nerves just as the medulla exits the skull through the foramen magnum
139
Structures visible on anterior surface of medulla
3 fissues/sulci Pyramids Olives 5 cranial nerves
140
What lies in the midline of the anterior surface of the medulla?
Anterior median fissure continuous along length of spinal cord, but interrupted temporarily by decussation of pyramids
141
As move away from midline of medulla, what structures are visible?
Ventrolateral and posterolateral sulci
142
What structure arises from the junction between pons and medulla?
Abducens nerve
143
What structure extends out of the ventrolateral sulcus?
Hypoglossal nerve (CN 12)
144
Which nerves join the medulla at the posterolateral sulcus?
Glossopharyngeal Vagus Accessory (CN 9-11)
145
What lies in the midline of the posterior surface of the medulla?
Posterior median sulcus
146
What structures lie lateral to the posterior median sulcus of medulla?
Fasciculus gracilis Fasciculus cuneatus separated by posterior intermediate sulcus
147
2 regions of medulla
Open and closed difference based on whether CSF-containing cavities are surrounded by medulla (closed) or not (open)
148
When does the medulla become open?
When the central canal opens into the fourth ventricle
149
What runs from the nucleus gracilis and cuneatus around and anterior to the central gray matter to form the medial lemniscus?
Internal arcuate fibres
150
What structures are found lateral to the medial lemniscus?
Trigeminal nucleus and spinal tract Spinocerebellar tracts Lateral spinothalamic tract
151
At the level of decussation of medial lemniscus, what structures can be seen in the centre of the medulla?
Hypoglossal nucleus Medial longitudinal fasciculus Nucleus ambiguus (more lateral)
152
What structure is found between the nucleus ambiguus and pyramids?
Inferior olivary nucleus
153
What nuclei does the medulla contain?
Nucleus ambiguus (motor to CN 9-10) Nucleus of tractus solitarius (sensory for CN 8-10) Nuclei of CN 9-12
154
Arterial supply of medulla
Complex: depends on level viewed Anterior and posterior spinal arteries Anteiror and posterior inferior cerebellar arteries Vertebral arteries
155
Which embryonic structure does the cerebellum arise form?
Metencephalon (superior division) of hindbrain (rhombencephalon) Inferior division is called myencephalon
156
What separates the cerebellum from the temporal and occipital lobes?
Tentorium cerebelli
157
What separates the cerebellum from the pons?
Fourth ventricle | lies on same level of and posterior to pons
158
What is embedded in the white matter of cerebellum?
4 cerebellar nuclei - dentate - emboliform - fastigi - globose
159
3 ways of dividing the cerebellum
Anatomical lobes Zones Functional divisions
160
3 anatomical lobes of cerebellum
``` Anterior (primary fissure) Posterior (posterolateral fissure) Flocculonodular ```
161
3 cerebellar zones
Vermis = midline Intermediate zone = lateral to vermis 2 lateral hemispheres = lateral to intermediate zone
162
3 functional areas of cerebellum
Cerebrocerebellum Spinocerebellum Vestibulocerebellum
163
Cerebellar tonsil
Bulge of lateral lobe that projects inferiorly posterolateral to medulla
164
What is the cerebrocerebellum?
Largest division of cerebellum Formed by lateral hemispheres Functions = planning movements, motor learning, coordinating muscle activation Inputs from cerebral cortex and pontine nuclei Outputs to thalamus and red nucleus
165
What is the spinocerebellum?
Comprises vermis and intermediate zone Functions = regulate body movements by allowing for error correction, receives proprioceptive information
166
What is the vestibulocerebellum?
Functional equivalent to flocculonodular lobe Functions = control balance and ocular reflexes, mainly fixation on a target Inputs from vestibular system Outputs to vestibular nuclei
167
Arterial supply of cerebellum
3 paired of arteries: Superior cerebellar (from basilar) Anterior inferior cerebellar (from basilar) Posterior inferior cerebellar (from vertebral)
168
Venous drainage of cerebellum
Superior and inferior cerebellar veins Drain into superior petrosal, transverse and straight dural venous sinuses
169
What happens to the cerebellum when there is raised ICP?
The tonsil can herniate into the foramen magnum and compress the medulla oblongata e.g. after LP
170
Manifestations of cerebellar dysfunction (DANISH)
``` Dysdiadochokinesia Ataxia Nystagmus Intention tremor Scanning speech Hypotonia ```

MRCS Anatomy (9 decks)

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