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108 Cards in this Set
- Front
- Back
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lesion of occulomotor nerve
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stuck down and out
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what inhibits the parasymp system to allow you to keep eyes dilated?
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Ach
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what is the best landmark for the motor nucleus of the trigeminal nerve?
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presecnce of trigeminal nerve fibers streaking through middle cerebellar peduncles
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which nucleus is the secretomotor parasymp nucleus?
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dorsal nucleus of the vagus
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Anosmia
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loss of smell, usually unilateral
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CN 3 damage
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ptsosis, loss of pupillary reflex, dilation of pupil, loss of accomodation, adbducted and inferior (down and out)
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CN 4 damage
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writing reflex, out rotation of eye, tilt head down and toward contralateral shoulder, diplopia (down and in)
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Path of V2 (bone wise)
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foramen rotundum-pterygopalatine fossa- infraorbital foramen
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Path of V3 (bone wise)
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foramen ovale- mental foramen
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Branches of the opthalmic v1
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frontal (supraorbital, supratrochlear) nasociliary (long and short ciliary, nasal, ethmoidal) lacrimal
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branches of maxillary v2
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infraorbital (zygomaticofacial, zygomaticotemporal), posterior superior alveolar, palatine (lesser and greater), nasopalatine
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CN V2 damage
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trigeminal neuralgia (tic douloureux)
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what artery exits the foramen spinosum
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middle meningeal artery
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branches of mandibular v3
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lingual, buccal, auriculotemporal, inferior alveolar (mental, mylohyoid)
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CN 6 damage
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medial strabismus (convergent squint), diplopia
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what does CN 7 innervate? From the stylomastoid foramen
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stapedius, stylohyoid, posterior belly of digastric
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what innervated the anterior belly of the digastric
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V3, mandibular
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CN 7 damage
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bells palsy, loss of taste in anterior 2/3, tongue to one side, and decreased salvation
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CN 8 damage
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tinnitus, impairment or loss of hearing, loss of balance, acoustic neromas
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CN 9 damage
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loss of gag reflex, reduced salvation,
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CN 10 damage
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paralysis of palate and larynx, hoarseness, deviation of uvula, palpitation of heart, tachycardia, slow respiration and sensation of suffocation
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CN 12 damage
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unilateral paralysis of the tongue
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unilateral pyramidal tract lesions about pt of decussation will result in?
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paralysis of the muscles on the opposite side of the body
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fibers of pyramidal tract synapse with cranial nerves to form what tract?
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corticobulbar
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where do corticobulbar axons descend?
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within genu, or bend of the internal capsule
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lesions of cranial nerve NUCLEI located in brainstem are called
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bulbar lesions, paralysis is called bublar paralysis
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lesions to the AXONS of cranial nerves are called?
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peripheral lesions
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lesion of right nucleus of trigeminal cranial nerve and right side of pyramidal tract would cause?
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paralysis of right side of jaw and left arm or leg
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Sensory area 3,1,2 and associated receptors
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3- Ruffini (slow) 1-Pacinian (fast) 2-deep receptors of the joints
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Wernickes aphasia characteristics
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paraphasia- substitution and neologisms- insertion of meaningless words and jargon aphasia- stringing or words and phrases
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Parietal lobe syndromes
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difficulty with spatial orientation
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Damage to temporal lobe
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AGNOSIA- difficulty recognizing, identifying and naming different categories of objects 'not knowing'
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apraxia
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loss to perform coordinated movements or manipulate objects. Absence of motor or sensory impairment
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aphasia
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loss to articulate ideas or comprehend spoken or written language
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A-beta fibers
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Discriminitive touch- Meissners. Pacinian, Merkel, Ruffini
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A-delta fibers and C
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Pain and Temperature- free nerve endings
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A-alpha fibers
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Proprioception- muscle spindles, golgi tendon organs, joint afferents
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Stereogenesis
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ability to recognize objects from touch alone using size, shape, texture weight
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Graphesthesia
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ability to recognize numbers to letters drawn on the skin
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What is rombergs sign? And the spinal tract involved
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absence of position sense because patient cannot stand with eyes closed. Tract is spinocerebellar (proprioception, clarkes nucleus)
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Discriminitive touch
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1- DRG 2- nucleus gracilis/cuneatus 3- VPL thalamus 4- somatosensory cortex, BA 3,1,2, post central gyrus. Tract= posterior column
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where is the crossing for Discr. Touch?
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crosses high, at the internal arcuate fibers, when it crosses becomes the medial lemniscal tract
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The pathway of discriminitive touch after synapsing in the thalamus
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VPL- internal capsule- corona radiata- parieatal lobe- post central gyrus - BA 3 1 2 somatosensory 1
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blood supply to the legs?
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anterior cerebral artery
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blood supply to the trunks and up
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middle cerebral artery
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What afferents travel through the internal capsule to get to the primary somatosensory cortex?
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thalamocortical afferents
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lesion of the left fasciculus gracilis
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left leg and lower left trunk
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lesion of left dorsal columns
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left side of the body below the level of the cut
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lesion of right medial lemniscus in medulla
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the entire left body, from the neck down
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lesion at the left internal capsule
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the entire right body (including the face)
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speed of A alpha
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80-120
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speed of A beta
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35-75
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speed of A delta
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5 35
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speed of C
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.5-2
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Rexed laminas and the dorsal horn?
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posterior marginalis- 1, substantia gelatinosa- 2, nucleus proprius- 3, 4, 5
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Pain and temperature A alpha fibers
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1- DRG 2- enter posterior marginalis and nucleus proprius. Rexed lamina 7. 3- VPL. Spinothalamic tract (lateral faniculus) **synapse on secondary afferents
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crossing of pain and temp
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cross low at anterior white commisure
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Pain and temp C fibers
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1- DRG 2- enter substantia gelatinosa and ***synapse on interneursons then they carry to post. Marginalis and nuc proprius. Rexed lamina 7 3-VPL. Spinothalamic tract
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what two tracts enter VPL thalamus together?
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spinothalamic and medial lemniscus
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crossing of proprioception?
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they don’t!!!
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Proprioception
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1-DRG 2- Clarkes or external cuneate nucleus (rexed lamina 7) 3- Cerebellum. Spinocerebellar tract
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what makes up the inferior cerebellar peduncle?
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projections from the inferior olive and spinocerebellar tract (traveling on the lateral margin of the brainstem)
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divisions of spinal nucleus V
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subnucleus: oralis, interpolaris, caudalis
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mesencephalic nuclie is essentially a?
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primary afferent/ganglia
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LD nuclei
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Relay, hippocampus, cingulate gyrus
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LP nuclei
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Parietal lobe
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Which ventricle does the diencephalon contain?
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third ventricle
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What does the epithalamus include?
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Pineal gland and habenular nuclei
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closure of cerebral aqueduct leads to what disease?
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hydrocephalus
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damage of pineal gland/epithalamus?
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change in sexual function, mood and depression
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How is the pineal gland attached to the diencephalon?
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by a stalk
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What is the rostral swelling on the pineal gland?
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habenula
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the two habenular nuclei are interconnected by?
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habenular commissure
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What part of the midbrain continues into the diencephalon?
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the tegmentum continues as the subthalamus
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What is the zona incerta?
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small mass of gray matter intervening between the subthalamic nucleus and the thalamus
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What are the diviosns of the hypothalamus?
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supraoptic, tuberal, mamillary
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fusion of right and left thamalic?
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across third ventricle, interthalamic adheison or massa intermedia
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What nuclei does the habenulointerpeduncular tract pass through?
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parafascicular nuclei
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what intervenes between the internal and external medullary lamina?
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thalamic reticular nuclear
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what nuclei covers the ventricular surface of the thalamus at the third ventricle?
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midline nuclei
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what is the special role of the intralaminar and midline nuclei?
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involved in the function of the basal ganglia and limbic systems
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what neurotransmitter results in increased input activity and causes faster firing?
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glutamate
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mammilothalamic…think?
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cingulate gyrus
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what does the telencephalon consist of?
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cerebral cortex, basal ganglia (gray matter)
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what is the site of fusion of telecephalon and diencephalon during embryological development?
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Insula
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Function of Temporal lobe
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emotional responses, hearing, memory, speech
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Function of parietal lobe
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cognition, information processing, pain and touch sensation, spatial orientation, speech, visual perception
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Function of occipital lobe
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controls vision, color recognition
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Function of insular lobe
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associated with visceral functions, integrates autonomic information
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Layers 2 to 5 are dominated by what type of cells?
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large pyramidal cells and small stellate cells--known as granular cortex
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what is agranular?
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lack of stellate cells
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what are the two key areas of association cortex?
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prefrontal cortex and the parietal-occipital-temporal association cortex
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what cells do the commissural fibers arise from?
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pyramidal cells
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all cortical areas receive commisural fibers except?
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hand area of somatosensory cortex and the all of area 17 (occipital area)
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What are the 4 most prominent bundles of association fibers?
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superior longitudinal fasciculus, superior occipitofrontal fasciculus, inferior occipitofrontal fasciculus, cingulum
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What is the arcuate fasciculus?
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the superior longitudinal fasciculus
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What is the subcallosal bundle?
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the superior occipitofrontal fasciculus
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What is the uncinate fasciculus?
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the inferior occipitofrontal fasciculus
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broadman area 4
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precentral gyrus, paracentral lobe- primary motor area
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BA 6
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superior and middle frontal gyri; precentral gyrus- premotor area, supplementary motor area
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BA 8
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superior and middle frontal gyri
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BA 44, 45
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opercular and triangular parts of inferior frontal gyrus- Broca's area
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what is in the pars triangular
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brocas area
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BA 17
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banks of calcarine sulcus- primary visual cortex V1
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BA 18,19
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surrounding 17- visual association v2, v3, v4, v5
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BA 41
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superior temporal gyrus- primary auditory a1
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BA 42
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superior temporal gyrus- auditory asssociation area a2
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BA 22
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superior temporal gyrus- Wernicke
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