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CNS Exam 1
Quetion | Answer |
---|---|
The midbrain and the cerebellar are connected by the | superior cerebellar peduncle |
name the group of fibers which connect the pons and cerebellum | Middle cerebellar peduncle |
Name the group of fibers which connect the medulla to cerebellum | Inferior cerebellar peduncle |
Name the sources of afferents to the reticular nuclei which are most important for stimulation of the lower motor neuron | Cerebellum and wide areas of cerebral cortex |
The ________ nucleus is located on the wall of the lateral ventricle | Caudate |
Substantia nigra is located _________ | Tegmentum of midbrain and Subthalamus of diencephalon |
The motor speech (Broca's) area is located in the __________ lobe. | Frontal (Broca's = 44,45) |
In the continuous regulation of muscle tone, descending fibers terminate on ______________ in the ventral horn | Gamma motor neurons |
Areas 5 & 7 are located in the ___________ lobe. | parietal |
The dural sac ends (inferiorly) at the __________ vertebral level | S2 |
The Spinal dura terminates at the __________ vertebral level | S2 |
The concentration of what substance is notably lower in the cerebrospinal fluid that in the blood serum | Protein |
What is the normal amount of CSF | 100 ml |
What congenital malformation causes hydrocephalus in Dandy-Walker syndrome? | Lack of medial and lateral apertures |
Dandy-Walker syndrome | Absence of lateral and medial apertures |
Spina Bifida Occulta | Failure of the posterior neuropore to close and the neural arch to form |
Arnold-Chiari syndrome | Cerebellum and Medulla are pulled through foramen magnum |
Enncephalocele | Failure of the anterior neuropore to close |
The red Nucleus is located in the | Tegmentum of midbrain and subthalamus of diencephalon |
Fasciculi gracilis and cuneatus are located in the __________ of the spinal cord | Posterior Funiculus |
Define - Spinal cord segment | Area of spinal cord to which spinal nerve attaches |
Why does papilledema occur with increased intracranial pressure | Decrease venous return in the central vein of the retina and bulging of optic disc (swelling inhibits venous return) |
Irritation of the meninges in the posterior cranial fossa would cause headache referred to __________ | Back of head and neck Above tentorium - forehead and face (trigeminal N) Below tentorium - back of head and neck (upper C1-C3 nerves) |
What type of head injury would likely result in a subdural hemorrhage? | Blow to front/back of head causing superior cerebral vein to tear at superior saggital sinus |
An occlusion of which cerebral artery would result in loss of all general sensation in the lower extremity? | Anterior Cerebral Artery |
The pyramids receive blood supply from the ____________ artery | Anterior spinal |
Anterior spinal artery supplies ______ | Medulla - hypoglossal and pyramids Spinal core - anterior 2/3 |
The posterior lateral open medulla receives blood supply from the ______ artery | Posterior inferior cerebellar |
Below the cervical cord, the anterior spinal artery receives blood from the _______ artery | Anterior radicular artery |
What is the most common site of congenital aneurysm? | Circle of Willis |
Choroid plexus located in __________ may become calcified with age | Telencephalon (lateral ventricle |
Which structure of the diencephalon may become calcified with age? | pineal body telencephalon = choroid plexus |
In what area of the spinal cord is fasciculus cuneatus located? | Posterior lateral just lateral to fasciculus gracilus |
The posterior limb of the internal capsule is located between which two structures? | Lentiform nucleus and thalamus |
What are symptoms of increased intracranial pressure? | Headache, change in consciousness, drowsiness, lethargy. stupor, coma, nausea, vomiting, behavioral change, bradycardia, increased BP, papilledemia, infants- bulging fontanelles and seperating sutures |
Epidural hemorrhage | results from tearing a meningeal artery |
Subdural hemorrhage | results from tearing the superior cervical vein as it empties in the superior sagittal sinus |
Subarachnoid Hemorrhage | results from blood or bilirubin in the CSF |
Contains substantia nigra and red nuclues | subthalamus |
Contains pineal gland and habenular nuclei | epithalamus |
Contains mamillary nucleus, paraventricular, and supraoptic nucleus | hypothalamus |
Which thalamic group of nuclei receive afferents form both the paleospinothalamic tract and the reticular nuclei of the brainstem? | nonspecific |
What thalamic nucleus projects to areas 3,1,2 laterally? | Ventral posterior medial nucleus (VPMN) |
Name source of afferents to areas left 5 & 7 Short association fibers from ______________ | same side (ipsilateral) Left cerebral cortex 3,1,2 primary sensory area |
Name source of afferents to areas left 5 & 7 Commissural fibers from | opposite side Right cerebral cortex 5&7 |
Name source of afferents to areas left 5 & 7 Projection fibers from | Non-specific nuclei of thalamus and integrative |
In general, reticular nuclei which are part of the ascending reticular activation system (ARAS) receive input from which 2 sources | Cerebral cortex & sensation |
Which brainstem nuclei send information into the cerebellum | Lateral Cuneate N. Mesocephalic N. Reticular N. |
Person in a persistent vegetative state | Has normal sleep/wake cycles Makes spontaneous eye movement Has an intact reticular activating system |
What areas will have deficit in pain from a right hemidissection of the C2 spinal cord? | Left arm, Left leg, and Right forehead |
What areas will have deficit in discriminating touch from a right hemidissection of the C2 spinal cord? | Right arm and Right leg |
What deficits are expected in the Right C2 dermatome? | Pain Crude Touch Vibration Discriminating Touch |
What areas will have deficit in pain from an occlusion of the anterior spinal artery at the T3 spinal cord? | Right Leg and Left leg |
What areas will have deficit in discriminating touch from an occlusion of the anterior spinal artery at the T3 spinal cord? | None |
Consider a lesion in the genu of the right internal capsule What sensory deficits are expected in the arms? | None |
Consider a lesion in the genu of the right internal capsule What sensory deficits are expected in the face? | All on the left side |
The right neospinothalamic tract originates in the _____________ and terminates on the ______________ | Left nucleus proprius VPLN |
Which tract carries proprioception from the lower extremity integrated with the state of excitation of the lower motor neuron? | Ventral Spinocerebellar |
Fibers in the right ventral triginothalamic tract originate from _______ nuclei | Left chief (sensory nucleus of V) Left nucleus of the spinotrigeminal tract |
The superior colliculi are located ____________ | tectum of midbrain |
What portion of the ventricular system is located in the diencephalon? | 3rd Ventricle |
Levels of gamma globulins are elevated in the cerebrospinal fluid in what disease? | multiple sclerosis |
Stimulation of the golgi tendon organ results in inhibition of the _______ supplying the homologous muscle | alpha motor neurons |
Located in the closed medulla | Nucleus gracilis Medial lemniscus Paliospinothalamic tract |
What is significantly higher in cerebrospinal fluid than in the serum | Na+ |
The anterior choroidal artery is prone to thromobosis. Which structures does it supply that are especially sensitive to ischemia | hippocampus and globus pallidus |
What type of hemorrhage would be associated with congenital aneurysm, yellow cerebrospinal fluid, and severe fluid? | Subarachnoid |
A person sustains a blow to the temporal region of the head which results in an epidural hemorrhage. Which vessel was likely torn? | Middle meningeal artery |
The ventral posterior lateral nucleus of the thalamus belongs to the ________ group of thalamic nuclei | specific |
The ventral posterior medial nucleus of the thalamus projects to ________ | Lateral 3,1,2 |
The pineal gland belongs to which region of the diencephalon? | epithalamus |
What information passes through the genu of the internal capsule? | General sensation from the head = discriminating touch, vibration, conscious proprioception, pain, temperature, crude touch, pressure |
Which nuclei send proprioceptive information from the head to the cerebellum? | Reticular nucleus |
In the persistent vegetative state the ________ intact but the ________ in not intact | ARAS Cerebral Cortex |
In general the reticular nuclei of the brainstem receive input from all sensation, the cerebral cortex the ________ and the __________ | Hypothalamus Cerebellum |
Name the brainstem nuclei whose fibers terminate on the non-specific group of the thalamus? | Reticular N Chief sensory nucleus of V Nucleus of Spinothalamic/trigeminal tract |
Give the terminations of the left lateral corticospinal tract | dorsal horn LMN = lamina IX Association neurons lamina VII & VIII |
Give the location of the nerve cell bodies whose fibers from the right fasciculus gracilis | Right dorsal root ganglion of T6 and belos |
Give the location of the nerve cell bodies whose fibers from the Left neospinothalamic tract | Right nucleus proprius |
Fibers of the neospinothalamic tract terminate on the ___________ | Ventral Posterior Lateral Nucleus of the thalamus |
What modalities are carried in the right ventral trigeminothalamic tract at the level of the closed medulla? | Left side Pain, temperature, crude touch, and pressure to the head |
Hemidissection of the right T3 spinal cord would cause pain deficits in the ___________ | Left Leg |
Hemidissection of the right T3 spinal cord would cause discriminating touch deficits in the ___________ | Right Leg |
Hemidissection of the right T3 spinal cord would cause voluntary motor control deficits in the ________________ | Right Leg |
The S5 spinal segment is located approximately at the level of the _____ vertebra | L1-L2 |
Yellow colored cerebrospinal fluid is caused by the breakdown of _______ in the CSF. This is a sign of a __________ hemorrhage. | Hemoglobins Subarachnoid |
The fibers connecting the left and right sides of the spinal cord form the __________ | Anterior Commisure |
A person is unable to interpret the meaning of spoken language. An occlusion of which artery would cause this deficit? | Left Middle cerebral artery |
An expanding aortic aneurysm may result in deficits due to occlusion of the _________ arteries | Segmental (Spinal) |
Which blood vessels supplies the posterior lateral aspect of the open medulla? | Posterior inferior cerebellar artery |
What can produce cerebral ischemia? | Hemorrhage Emboli Increased intracranial pressure |
A person presents with abnormal ocular movements and complaints of visual deficits which have developed over the last 2 days. You suspect a slow bleeding aneurysm located _____________ | opthalamic artery or any part of the circle of willis |
What is the general function of the nuclei of the subthalamus | Motor function |
Give the Afferents to area 5 and 7 on the left 1. With general sensation from the body 2. With general sensation from the head 3. In the pathway for reticular activation (name the nuclei which project to the thalamus or name the fibers) | 1. Paleospinothalamic tract 2. ventral trigeminothalamic tract 3. Reticular nuclei of brainstem |
Via which group of fibers do the motor speech and sensory language areas communicate? | Superior longitudinal fasciculus |
Consider an anterior cavitation of the central canal in the T5-8 spinal cord. 1. What areas of the body have pain deficits? 2. What areas of the body have a discriminating touch deficit? | 1. Bilateral pain deficit for dermatomes T5-8 2. NONE |