Neuroanatomy
Terms
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- arteries of stroke
- -lateral striate arteries -arise from MCA -supply internal capsule, caudate, putamen, globus pallidus
- most common site of berry aneurysms
- anterior communicating artery
- The vertebral artery arises from _______ and gives off ________ and ________.
- -subclavian artery -anterior spinal artery -PICA
- The basilar artery gives rise to...
- -paramedian pontine arteries -AICA -superior cerebellar artery -PCA -labyrinthine artery (15% of people)
- major blood supply to the midbrain
- PCA
- supplies thalamus, LGN and MGN, occipital lobe; occlusion results in CL hemianopia with macular sparing
- PCA
- blood supply of internal capsule
- lateral striate arteries, anterior choroidal artery
- hypothalamus and thalamus
- posterior communicating artery
- CN III palsy
- posterior communicating artery
- anterior choroidal artery
- -NOT part of circle of Willis -arises from internal carotid -supplies LGN, GP, posterior limb of internal capsule
- leg-foot area of motor and sensory cortices
- ACA
- bitemporal lower quadrantopia
- anterior communicating artery
- The medial striate arteries arise from ________ and supply ________.
- -ACA -anterior putamen and caudate nucleus and anteroinferior internal capsule
- middle cerebral artery
- -Broca's and Wernicke's areas -face and arm areas of motor and sensory cortices -FEF
- dorsolateral quadrant of medulla
- -supplied by PICA -contains nucleus ambiguus (CN IX, X, XI) and inferior cerebellum
- AICA
- caudal lateral pontine tegmentum, including CN VII, the spinal trigeminal tract of CN V, and the inferior surface of the cerebellum
- superior cerebellar artery
- dorsolateral tegmentum of rostral pons, SCP, superior cerebellum and cerebellar nuclei, cochlear nuclei
- risk factors for berry aneurysms
- -APKD -Ehlers-Danlos -Marfan's -advanced age -HTN -smoking -race (blacks)
- Charcot-Bouchard microaneurysms
- -chronic HTN -affects small vessels in basal ganglia, thalamus
- Wallenberg's syndrome
- -PICA infarct -nystagmus -ipsil ataxia -N/V -Horner's
- watershed zones
- -upper arm/upper leg weakness -defects in higher-order visual processing
- stroke of anterior circle
- -general sensory and motor dysfct -aphasia
- stroke of posterior circle
- -CN deficits (vertigo, visual deficits) -coma -cerebellar deficits
- fall toward side of lesion
- cerebellar hemispheric lesion
- eyes look AWAY from side of lesion
- PPRF (paramedian pontine reticular formation)
- eyes look TOWARD lesion
- FEF
- rupture of middle meningeal artery, often secondary to fracture of temporal bone
- epidural hematoma
- lucid interval
- epidural hematoma
- rupture of bridging veins
- subdural hematoma
- biconvex disk that can cross falx and tentorium (NOT suture lines)
- epidural hematoma
- elderly, alcoholics, blunt trauma, shaken baby
- subdural hematoma
- bloody or xanthochromic spinal tap
- subarachnoid hemorrhage
- risk of vasospasm 2-3 days afterward
- subarachnoid hemorrhage
- -caused by HTN, amyloid angiopathy, DM, tumor -usu in basal ganglia, internal capsule
- parenchymal hemorrhage
- exits midbrain from interpeduncular fossa
- CN III in addition to moving the eye and elevating the eyelid, sends preganglionic parasym fibers to ciliary ganglion, which projects to sphincter pupillae (miosis) and ciliary muscle (accomodation)
- exits from dorsal aspect of brain stem
- CN IV
- conditions assoc with CN III impairment
- -transtentorial (uncal) herniation - sphincter pupillae muscles are affected first (dilated pupil), then somatic efferent fibers (external strabismus) -aneurysms of carotid and posterior communicating arteries - compress CN III within cavernous sinus or interpeduncular cistern -diabetes oculomotor palsy - damages central fibers and spares sphincter pupillae fibers
- exits from cerebellopontine angle
- CN VII, VIII
- exits skull through jugular foramen
- CN IX, X, XI
- LMN lesion of CN VII
- Bell's palsy face area of motor ctx projects to facial nucleus of pons
- superior salivatory nucleus of caudal pons
- contains pregang parasym neurons that project to lacrimal, submandibular, sublingual glands
- lacrimal pathway of CN VII
- sup salivatory nuc --> intermediate and greater petrosal nerves --> pterygopalatine ganglion --> lacrimal gland
- submandibular pathway of CN VII
- sup salivatory nuc --> intermediate nerve and chorda tympani --> submandibular ganglion --> glands
- nucleus Solitarius
- visceral Sensory taste, baroreceptors, gut distention CN VII, IX, X
- nucleus aMbiguus
- Motor innervation of pharynx, larynx and upper esophagus (swallowing, palate elevation) CN IX, X, XI
- dorsal motor nucleus
- parasym fibers to heart, lungs, upper GI
- superior orbital fissure
- CN III, IV, V1, VI, ophthalmic vein
- foramen rotundum
- CN V2
- foramen ovale
- CN V3
- foramen spinosum
- middle meningeal artery
- foramen magnum
- spinal roots of CN XI, brain stem, vertebral arteries
- muscles that close the jaw
- masseter, temporalis, medial pterygoid
- A
- A
- foci of necrosis surrounded by palisading (tumor)
- glioblastoma multiforme
- small round blue cell tumors
- Lymphoma Ewing sarcoma ALL Retinoblastoma Rhabdomyosarcoma Neuroblastoma Neuroepithelioma Medulloblastoma
- 3 tumors with psammoma bodies
- -meningioma -papillary carcinoma of the thyroid -papillary serous cystadenocarcinoma of the ovaries
- all muscles with "glossus" except _____ are innervated by the hypoglossal nerve
- palatoglossus (vagus)
- all muscles with "palat" except _____ are innervated by the vagus nerve
- tensor veli palatini (CN V3)
- -usually low grade but occasionally anaplastic -resemble astrocytomas in most respects but grow more slowly and are more sensitive to chemo -calcification in 90% of cases
- oligodendroglioma
- Homer-Wright pseudorosettes, neurosecretory granules
- neuroblastoma -kids<5 -presents as abd mass (adrenal medulla) -Hutchinson neuroblastoma: skull and orbital mets that produce exophthalmos; mets to LN, liver, lung, bone
- pseudobulbar palsy
- -dysphagia -dysarthria ("donald duck" -hyperactive gag reflexes -spontaneous crying or laughter -causes: bilateral CVA involving internal capsule, motor neuron dz, MS
- -acute onset -recurrent attacks of vertigo -N/V -diminished hearing, tinnitus -endolymphatic hydrops
- Meneire disease