Neuroanatomy

Front 1

What are three components of the accomodation response?

Back 1

1.) pupil
2.) lens
3.)convergence

Front 2

telencephelon contains

Back 2

cerebral hemispheres,basal ganglia: caudate nucleus, globus polidius,puteman, lateral ventricles, cerebral commissures and the internal capsule

Front 3

Diencephelon contains

Back 3

thalmus, epithalmus, hypothalmus, subthalmus, third ventrical and oculomoter nerve

Front 4

Thalmus

Back 4

is seperated from the hypothalmus by the hypothalamic sulcus..contains the Pulvinar, medial geniculate(auditory), lateral geniculate(visual), and massa intermedia

Front 5

Hypothalmus

Back 5

Optic chiasm, mamillary bodies, infundibulum

Front 6

Epithalmus

Back 6

Pineal body, Habenular trigome, Choriod plexus of third ventricle

Front 7

Subthalmus

Back 7

Subthalamic nucleus, Zona incerta

Front 8

Mesencephelon
(MidBrain)

Back 8

between the diencephelon and pons; contains the cerebral aquaduct. Ventral surface: cerebral peduncle, interpeduncular fossa (CN III). Dorsal surface: Superior colliculus, inferior colliculus, and Trochlear (CN IV)

Front 9

Pons

Back 9

Between midbrain and medulla. Ventral surface: Basilar pons, CN V,VI,VII,VIII, Dorsal surface: Locus ceruleus, facial colliculus,
sulcus limitans,
striae medullares

Front 10

Medulla

Back 10

Extends from C1 to the inferior pontine sulcus. Ventral surface: pyramids, olive, CN IX,X,XI,XII. Dorsal surface: Gracile tubercle, cuneate tubercle, rhomboid fossa.

Front 11

Rhomboid fossa

Back 11

On the dorsal surface of the Medulla includes: striae medullaris, vagal trigone, hypoglossal tricone, sulcus limitans, area postrema (vomiting center)

Front 12

cerebellum

Back 12

located in the posterior cranial fossa, forming the roof of the 4th ventricle, is seperated from the occipital lobe by the tentorium cerebelli. Contains: Two lateral hemispheress which are divided into anterior,posterior and floculonodual lobes; vermis, locculus and vermal nodes, tonsil, superior, middle, and inferior cerebellar peduncles

Front 13

striatum

Back 13

combination of the caudate nucleus and the puteman

Front 14

limbic lobe

Back 14

is a C-shape structure that encircles the corpus collosum; contains: subcallosal area, cingulate gyrus, parahippocampal gyrus, hippocampal formation

Front 15

basal ganglia

Back 15

Part of the telencephelon; contains the caudate, putamen, globus pallidus, and amygdala

Front 16

corpus collosum

Back 16

ant: genu, inf: rostrum, sup: body, post: splenium

Front 17

Ascending Spinal Tracts

Back 17

Six major tracts that convey sensory information from periphery to CNS, usually has 3 chain neuron unit with the first order always in the dorsal root ganglion. 1. Dorsal coulmn-medial lemniscus 2. Ventral spinothalamic tract 3.Lateral spinothalamic tract 4. Dorsal spiocerebellar tract 5. Ventral spinocerebellar tract 6. Cuneocerebellar tract

Front 18

Dorsal column-medial lemniscus

Back 18

tactile discrimination, proprioception... first order neurons are in the Dorsal root ganglia, give rise to cuneate and gracile facicles. Second order bodies are in the caudal medulla in the cuneate and gracile nuclei, and go across the internal arcuate fibers (decasation) to form the medial lemniscus. The medial lemniscus ascends to the VPL. VPL to somatosensory cortex.

Front 19

Name the four somatosensory functions for the vagus nerve:

Back 19

1. GSA- (pain and touch) for ear external acoustic meatus, tympanic membrane, dura
2. SVA-(taste sensation) for epiglottis and pharynx
3. GVA-(sensory input from) the visceral organs of the abd/thorax, also baroreceptors for aortic arch
4. GVE-(information to) parasympathetic supply to the visceral organs,,,para, slows
5. SVE-(motor reflex) input from nuc. Ambiguous- relexes for cough, gag, vomit, allows for palatal bilateral rise. Also speech, swallow.

Front 20

Ventral spinothalamic tract

Back 20

Fine touch...First order neurons are in the dorsal root ganglia, project into the DREZ to second order neurons in the dorsal horn(cell body location). Second order neurons axons travel across the ventral white commissure and ascend inthe the contralateral VPL. Then from VPL to Post. limb of internal capsule and corona radiata to postecentral gyrus areas 3,1,2

Front 21

What are the four major nucleuses involved with the vagus nerve?

Back 21

1. Dorsal motor vagal nucleus (GVE)
2. Solitary nucleus (SVA/GVA)
3. Spinal trigeminal (GSA)
4. Nucleus ambiguous (SVE)

Front 22

Lateral spinothalamic tract

Back 22

Pain and Temp...recieves input from nociceptors (A-delta and C fibers). First order neurons are found in dorsal root ganglia, axons go through the Lissauer tract to the second order neurons in the dorsal horn. Second order neurons give rise to axons that decussate at the ventral white commissure and ascend in the ventral half of the lateral funiculus. They project lateral to the reticular formation and terminate in the VPL. VPL(bodies) to the posterior limb of the internal capsule, to the somatosensory cortex areas 3,1,2

Front 23

Name 2 syndromes associated with the vagus nerve that cause dysphagia and dysarthria?

Back 23

1. Jugular foramen syndrome- causes ipsilateral paresis of pharyngeal/ laryngeal muscles.
2. Lateral medullary syndrome- dorsolateral vascular zone, lower motor neuron loss-palate raises on normal side.

Front 24

dorsal spinocerebellar tract

Back 24

fine coordination and postural control and lower extremity posture adjustments,, it is an uncrossed tract!!... FON-C8 to S3, project through DREZ into Clarkes nucleus. SON-From Clarkes nucleus through the lateral faniculus to inf. cere. peduncle. Terminate on ipsilateraly mossy fibers.

Front 25

Name the somatosensory functions for the CN IX:

Back 25

1. GSA-for ear and tympanic membrane, also post 1/3 of tongue and pharynx
2. GSE- for muscle
3. SVA- for taste
4. GVA- baroreceptors for carotids

Front 26

Ventral spinocerebellar tract

Back 26

Propreoceptive information, coordination and postural control for lower extremities... FON DRG of L1-S2, SON In the ventral horns of L1-S1, decussate on ventral white comissure, ascend lateral to lateral spinothalamic tract in Lat. Faniculus to the superior cerebellar peduncle to terminate on mossy fibers of contralateral side.

Front 27

If a patient describes a stabbing pain in the base of the tongue or below the angle of the jaw, what might this describe as for a neurological syndrome?

Back 27

Glossopharyngeal neuralgia

Front 28

cuneocerebellar tract

Back 28

Is the upper extremity equevelent to the dorsal spinocerebellar tract. FON- projects axons via the cuneat fascicle to the accessory cuneate nucleus. SON- are in the accessory cuneat nucleus of medulla, poject ipsilaterally to the inferior cerebellar peduncle.

Front 29

Descending spinal tracts

Back 29

1.Lateral corico spinal(pyramidal tract) 2.ventral corticospinal tract 3. Rubrospinal tract 4. Vestibulospinal tract 5. Descending autonomic tracts

Front 30

Lateral corticospinal

Back 30

Also known as the pyramidal tract, is the major tract responsible for volentary movement. Fibers flow from the precentral gyrus through the posterior limb of the internal capsule to the middle portion of the basis pedunculi to form the medullar pyramids. They then decussate in the caudal medulla where 90%decussate and travel down the dorsal portion of the lateral fasciculus to the synapse on cells in the ventral horn. 10% that do not decussate are the ventral corticospinal tract.

Front 31

Ventral Corticospinal tract

Back 31

is a small uncrossed trat that decussates at the spinal cord level in the ventral whit commissure, controls the axial muscles.

Front 32

Rubrospinal tract

Back 32

Arises in the contralateral red nucleus of the midbrain, The rubrospinal tract is involved in large movements of proximal musculature of the limbs. It inhibits activity of extensors, and increases activity of flexors

Front 33

Vestibulospinal tract

Back 33

Arises from the giant cells of Deiters in the ipsilateral lateral vestibular nucleus. Plays a role in the control fo the extensor muscle tone

Front 34

Descending autonomic fibers

Back 34

Project to the sympathetic T1-L3 and parasympathetic S2-S4 centers in the spinal cord

Front 35

With diplopia or disconjugate gaze, what pathways may be disturbed?

Back 35

Supra and Infranuclear eye movement pathways.

Front 36

What is a good indicator for a pontine dysfunction?

Back 36

Bilat. Babinski sign
shivering
eye bobbing (fast down, slow to return)

Front 37

What are some indicators for midbrain dysfunction?

Back 37

Uni or bilateral pupil dialation, impaired conscousness, third nerve palsy

Front 38

What are the steps involved with inervation of the parotid gland by IX? hint 7 steps

Back 38

1. CN IX exits cranial cavity via jugular foramen
2. Tympanic branch of CN IX enters middle ear via tympanic canaliculus
3. Tympanic nerve forms tympanic plexus in middle ear
4. Lesser petrosal nerve arises and pentrates root of tympanic cavity to enter middle cranial fossa.
5. Leaves skull through foreman ovale
6. Preganglionic axons synapse on postganglionic neurons in the otic ganglion
7. Postganglionic axons distribute to the parotid gland with branches of auriculotemporal (V3)

Front 39

What does the SVE from CN IX do? And what is their route?

Back 39

Inervates the stylopharyngeus muscle, the cell bodies are located in nucleus ambiguous, fibers exit medulla via post olivary sulcus and go dorsal to olive and ventral to trigeminal tubercle

Front 40

Medial medullary syndrome is caused by what vascularity obstruction and what are its symptoms? What structures are involved?

Back 40

1. paramedian branches of vertebral and anterior spinal artery
2. contralateral extremity weakness, and decrease sense of position and vibration; CN XII ipsilateral tongue weakness
3. pyramidal tracts, medial lemniscus, hypoglossal nucleus

Front 41

What is Wallenburg's syndrom? what are its symptoms, and what structures are effected?

Back 41

Vertebral occlusion more than PICA (Lateral Medullary Syndrome)
1. Effects ICP’s vestibular nuclei, to cause ataxia, vomiting, nystagmous and vertigo
2. Effects Trigeminal nucleus and tract for decrease of pain and temp ipsilaterally on face; with ALS contralateral to body pain/temp
3. Descending hypothalamospinal Fibers to cause ipsilateral Horner’s syndrome (CN X)
4. Nucleus ambiguous for dysphagia, hoarsness
5. Solitary nucleus for ipsilateral taste loss

Front 42

What are the somatosensory processes for CN VIII?

Back 42

1. SSA- hearing from cochlea
a. Primary cell bodies in spiral ganglion in cochlea, end on ventral or dorsal cochlear nuclei
2. SSA- balance and equilibrium- utricle, saccule, & semicircular canal
a. Primary cell bodies in vestibular nucleus (U,S, SCC), terminate on vestibular nuclei., going to vestibulospinal tract and MLF to influence spinal motor neurons and extraocular muscles in coordination with cerebellum connection

Front 43

If examining the right eye, a corneal reflex test is done. If the right eye is stimulated and the response is the only the left eye blinks, then the left eye is stimulated and only the left eye blinks, then the lesion is where?

Back 43

Facial nucleus

Front 44

If examining the left eye for a corneal reflex, and neither eyes blink. Then on examination of the right eye, both eyes blink, then the lesion is where?

Back 44

Pontine trigeminal nucleus

Front 45

Medial inferior Pontine syndrome -

Back 45

blockage of paramedian arteries of the basilar artery
1. Alternating hemiaplegia-
a. Flacid paralysis of contralateral body
b. Tongue points away (upper motor) from lesion, towards side of body effected
c. Ipsilateral paralysis of lateral rectus,, CN VI
d. Can be accompanied by horizontal gaze paralysis ( Abduc. And PPRF), nystagmous (MLF) and others

Front 46

Medial superior Pontine syndrome-

Back 46

- blockage of the paramedian basilar arteries
1. Contralateral hemiaplesia
2. loss of position and vibration
3. intranuclear opthaloplegia (MLF)

Front 47

Millard-Gubler syndrome

Back 47

-Occlusion of paramedian and short circumferential arteries of the medial and lateral zones (excluding tegmentum):
1. Same signs as Medial Inferior Pontine Syndrome + ipsilateral Bell’s palsy

Front 48

Lateral Pontine Syndrome -

Back 48

Occlusion of long circumferential arteries of basilar artery and/or AICA:
1. .Alternating hemiesthesia: loss of contralateral pain and temperature,
2. loss of ipsilateral cutaneous sensation of face.

a. facial nucleus and nerve- facial paralysis
b. trigeminal motor nucleus and nerve- paralysis of muscles of mastication
c. vestibular nucleus- nastagmus, vomiting, vertigo
d. abducens nucleus & PPRF- paralysis of conjugate gaze
e. cochlear nuc- deafness
f. MCP- ataxia

Front 49

Edinger-Westphal nucleus-

Back 49

(GVE) parasympathetic neurons project to ciliary ganglion; Postganglionic neurons in ciliary ganglion via short ciliary nerves that invervate the cilliary muscles and sphincter pupillae of iris, concerned with light reflex response

Front 50

Name areas of the brain that are associated with voluntary eye movement-

Back 50

1. frontal eye fields in the frontal cortex
2. superior colliculus
3. pretectal area
4. oculomotor
5. Trochlear
6. abducens nuclei
7. MLF
8. PPRF

Front 51

Weber's syndrome (Midbrain basis)

Back 51

alternaing hemiplegia-
contralateral hemiparesis, ipsilateral oculomotor palsey, and pupillary dialation

Front 52

Benedict's syndrome (Midbrain basis and tegamentum) alternating hemiaplesia-

Back 52

coltralateral hemiparesis, ipsilateral oculomotor palsy, pupillary dialation, contralateral ataxia, involentary movements

Front 53

Claude's syndrome (midbrain tegmental)

Back 53

ipsilateral oculomotor palsey, pupillary dialation, contralateral ataxia, and involentary movements

Front 54

Midbrain medial zone vascularity Recieves small branches from basilar artery and PCA. Structures supplied are:

Back 54

1.oculomotor,
2. Edinger-Westphal and trochlear nucleus
3. oculomotor nerve fibers

Front 55

Lateral midbrain zone of vascularity

Back 55

Penetrating branches from quadrigeminal artery and branches from anterior chorid artery
Structures in zone:
1. medial lemniscus
2. lateral sub. nigra and crus cerbi

Front 56

Dorsal midbrain vascular zone

Back 56

Recieves branches from quadrigeminal & sperior cerebellar arteries
Structures include:
1. PAGM
2. Sup and inferior colliculus
3. ALS
4. brachium of inferior colliculus

Front 57

Parinaud's syndrome

Back 57

paralysis of upward gaze due to pineal gland tumor

Front 58

Horner's syndrom

Back 58

Disruption of sympathetic inervation to the eye, head and neck
1. Anhydrosis
2. Miosis (dialated pupil)
3. ptosis

Front 59

extropia vs esotropia

Back 59

x is out gaze with one eye
eso is in

Front 60

Painful oculomotor palsy that involves the pupil should be a sign of?

Back 60

Aneurysms in the Pcomm area

Front 61

complete Oculomotor palsy that does not effect the pupil is a indicator of what?

Back 61

Diabetes

Front 62

Partial oculomotor palsy that spares the pupil is a sign of ?

Back 62

partial compression due to aneurysm or tumor

Front 63

give the two main causes for verticle diplopia-

Back 63

Myasthenia gravis and
trochlear nerve palsy

Front 64

Occlusions of PICA can cause?

Back 64

VERTIGO!!! Supply vestibular nuclei

Front 65

Lat, medial and inferior vestibular nuclei receives input from?

Back 65

STATIC control from utricles and saccule
Head tilt or linear acceleration

Front 66

Medial and Superior vestibular nuclei receive info from?

Back 66

Kinetic semicircular canals due to endolymph lag of movement during angluar acceleration

Front 67

Meniere's disease

Back 67

recurrent vertigo, progressive hearing loss, tinnitis, full feeling in ear (incr. endolymph pressure)

Front 68

Give 5 causes for true Vertigo-

Back 68

1. benign paroxysmal positional vertigo
2. vestibular neuritis
3. Meniere's disease
4. central lesions to brainstem
5. central lessions to cerebellum