* Neuroanatomy Chapter 6

Front 1

Anterior spinal artery arises from?

Back 1

Vertebral arteries

Front 2

Posterior spinal arteries arise from?

Back 2

vertebral or posterior inferior cerebellar arteries

Front 3

Great radicular artery of Adamkiewicz usually arises where? Supplies what?

Back 3

Usually T9-T12 and provides blood supply to lumbar and sacral cord

Front 4

Most susceptible to infarction with decreased aortic pressure?

Back 4

T4-T8

Front 5

Venous return from the spinal cord?

Back 5

Epidural veins called Batson's plexus. Has no valves

Front 6

Lesions of association cortex can lead to?

Back 6

Apraxia (deficit in higher-order motor planning and execution despite normal strength)

Front 7

Site of decussation of lateral corticospinal tract?

Back 7

Pyramidal decussation at the cervicomedullary junction

Front 8

Levels of termination and function of anterior corticospinal tract? medial or lateral?

Back 8

Terminates in cervical and upper thoracic cord; controls bilateral axial and girdle muscles. Medial

Front 9

site of origin, level of termination and function of reticulospinal tracts? Medial or lateral?

Back 9

Site or origin is pontine and medullary reticular formation, terminates throughout entire cord and does automatic posture and gait related movements. Medial

Front 10

2 lateral motor tracts?
4 medial motor tracts?

Back 10

Lateral motor tracts: lateral corticospinal & rubrospinal
Medial motor tracts: Anterior corticospinal, vestibulospinal, reticulospinal, tectospinal

Front 11

Unilateral lesions of the medial motor system produces?

Back 11

No obvious deficits

Front 12

Signs of lower motor neuron lesions

Back 12

muscle weakness, atrophy, fasciculations, decreased tone, hypOreflexia

Front 13

Signs of upper motor neuron lesion

Back 13

Muscle weakness, increased tone, hyperreflexia (spasticity), Babinski's sign

Front 14

Oligoclonal Bands

Back 14

In CSF of MS patients. Result from synthesis of large amounts of relatively homogeneous immunoglobin by individual plasma cell clones in the CSF

Front 15

The arms are medial to the legs with what 2 exceptions?

Back 15

Primary sensorimotor cortices and posterior columns

Front 16

The corticospinal tract lies in the ___________ of the internal capsule?

Back 16

Posterior limb

Front 17

Lesion of the internal capsule often produce?

Back 17

Weakness of the entire contalateral body

Front 18

The cervicomedullary junction is at what level and what occurs there?

Back 18

Is at the foramen magnum, and 85% of the pyramidal tract fibers cross over in the pyramidal decussation

Front 19

Autonomic system consists only of _______ pathways

Back 19

efferent

Front 20

Preganglionic neurons of the sympathetic division are located in what cell column in what lamina?

Back 20

Intermediolateral cell column in lamina VII

Front 21

Preganglionic neurons in both sympathetic and parasympathetic ganglia release _______ activating ____________________

Back 21

sympathetic and parasympathetic ganglia release ACETYLCHOLINE activating NICOTINIC CHOLINERGIC RECEPTORS

Front 22

Hemiplegia with no associated sensory defects

Back 22

Corticospinal and corticobulbar tracts between the medulla and cortex: corona radiata, posterior limb of internal capsule, basis potin, or middle third of the cerebral peduncle. All contralateral to weakness.

Front 23

Hemiplegia with associated somatosensory, ocuolomotor, visual, or higher cortical deficits

Back 23

Entire primary motor cortex, corticospinal and corticobulbar tracts above the medulla. Can be more localized with more info

Front 24

Hemiplegia sparing the face

Back 24

Arm and leg area of motor cortex; corticospinal tract from lower medulla to C5

Front 25

Unilateral face and arm weakness

Back 25

Face and arm area of the primary motor cortex over the lateral frontal convexity. Cause?

Hint 25

Middle cerebral artrey superior division infarct

Front 26

Unilateral arm weakness or paralysis

Back 26

Arm area of primary motor cortex or peripheral nerve supplying the arm.
Cause?

Hint 26

Motorcortex: infarct of small cortical branch of middle cerebral artery
Peripheral: Compression injury, diabetic neuropathy

Front 27

Unilateral leg weakness or paralysis

Back 27

Leg area of primary motor cortex along medial surface of frontal lobe
Lateral coritcospinal tract below T1 or peripheral nerves suppling the leg
Cause?

Hint 27

Motor cortex: Infarct in the anterior cerebral artery territory
Spinal cord: Unilateral cord trauma, compression
Peripheral: Compression, diabetic neuropathy

Front 28

Unilateral facial weakness

Back 28

CN VII
Cause?

Hint 28

Bell's palsy, trauma, surgery

Front 29

Bilateral arm weakness of paralysis

Back 29

Medial fibers of both lateral corticospinal tracts; bilateral ventral horn cells
Causes?

Hint 29

Central cord syndrome: syringomyelia, intrinsic spinal cord tumor, myelitis
Anterior cord syndrome: anterior artery infarct, trauma, myelitis

Front 30

Bilateral leg weakness or paralysis

Back 30

Bilateral leg areas of the primary motor cortex; lateral corticospinal tracts below T1; cauda equina syndrome
Causes?

Hint 30

Bilateral medial frontal lesions: parasagittal meningioma, cerebral palsy

Front 31

Quadriparesis or quadriplegia

Back 31

Bilateral arm and leg areas of motor cortex; bilateral lesion of corticospinal tracs between medulla and C5
Cause?

Hint 31

Bilateral motor cortex: Watershed infarcts, affect proximal more than distal musccles

Front 32

Corticospinal damage generally spares _______ relative to ________

Back 32

corticospinal damage generally spares flexors relative to extensors

Front 33

Spastic gait

Back 33

Stiff-legged, circumduction, decreased arm swing, fall toward side of greater spasticity
Location? Cause?

Hint 33

Corticospinal tract(s)
Brain infarct affecting upper motor neuron pathways, cerebral palsy, ms

Front 34

Ataxic gait

Back 34

Wide based, unsteady, staggering side to side
Location? Cause?

Hint 34

Cerebellar vermis or other midline cerebellar structures.
Alcohol or infarct or ischemia of cerebellar pathways

Front 35

Frontal gait

Back 35

Slow, shuffling, "magnetic", unsteady
Location? Cause?

Hint 35

Frontal lobes or frontal subcortical white matter.
Hydrocephalus; frontal tumors, bilateral anterior cerebral artery infarcts

Front 36

Tabetic gait

Back 36

High stepping, foot flapping gait, difficulties walking in dark or on uneven surfaces
Location? Cause?

Hint 36

Posterior columns or sensory nerve fibers.
Posterior cord syndrome

Front 37

Cause of multiple sclerosis?

Back 37

T lymphocytes are triggered by a combo of genetic and environmental factors to react against oligodendroglial (CNS) myelin.
Worse symptoms when warm

Front 38

Sudden onset of right hand weakness
- Afib

Back 38

Left precentral gyrus, primary motor cortex, hand area
cause?

Hint 38

Embolic infarct, small cortical branch of the left middle cerebral artery, superior division

Front 39

Sudden onset of left foot weakness and right frontal headache
-Diabetes/hypertension

Back 39

Right precentral gyrus, primary motor cortex, leg area

Hint 39

Embolic infarct of a cortical branch of the right anterior cerebral artery

Front 40

Sudden onset of right face weakness, trace curling of right fingertips
-Diabetes

Back 40

Lesion in the left motor cortex face area

Hint 40

Embolic infarct of a cortical branch of the left middle cerebral artery

Front 41

Pure Motor Hemiparesis
- woman in 30s with no vascular risk
-Gets worse when warm

Back 41

Right corticobulbar and corticospinal tracts in the posterior limb of the internal capsule or ventral pons

Hint 41

Motor hemiparesis is usually caused by lacunar infarct of contralateral internal capsule or pons.
Given her lack of vascular risk and it getting worse when warm, probably ms

Front 42

Pure right sided motor hemiparesis
- decreased right palate movement, rightward tongue deviation

Back 42

Left corticobulbar and corticospinal tracts in the posterior limb of the internal capsule or ventral pons

Hint 42

Lacunar infarction of contralateral internal capsule or pons

Front 43

Progressive weakness, muscle fasciculations and cramps
-atrophy
-Babinsky's sign

Back 43

Amyotrophic lateral sclerosis
Treat with?

Hint 43

Riluzole

Front 44

Lateral corticospinal tract

Back 44

Precentral gyrus -- posterior limb of the internal capsule -- cerebral peduncle in midbrain -- ventral pons --- crosses at pyramidal decussation -- lateral spinal cord -- anterior horn

Front 45

Lateral motor systems control what? Medial motor systems control what?

Back 45

Lateral motor systems are involved in limb control
Medial motor systems control proximal trunk muscles