Neuroanatomy (NCS)
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| What is in the frontal lobe and what does each area do? (3) | Primary motor cortex: contralateral motor function; prefrontal cortex: personality, executive functions, behaviors, judgment; Broca's area: language output
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| What is in the temporal lobe? | Primary auditory cortex, Wernicke's area: language comprehension; memory; identification of objects
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| What is in the parietal lobe? | primary sensory cortex: contralateral side of the body; perception and integration, visual and auditory processing
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| Which cortices are in the occipital lobe? | Primary visual cortex; visual association cortex
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| Which area of the brain controls voluntary movements? | Primary motor cortex (Brodmann's area 4); frontal lobe
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| Which area of the brain controls trunk and girdle muscles, anticipatory postural adjustments, externally guided? | Premotor cortex (frontal lobe) (brodmann's area 6 lateral)
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| Which area of the brain controls planning of movements, initiation of movement, bimanual and sequential movements, internally guided? | supplementary motor area (brodmann's area 6 superomedial); frontal lobe
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| Which area of the brain controls motor planning of speech? | Broca's area, Brodmann's area 44 and part of 45; frontal lobe; usually L hemisphere
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| Which area of the brain controls planning nonverbal communication (gestures, tone of voice, etc? | area analagous to Broca's area; frontal lobe of opposite hemisphere to Broca's; Brodmann's 44 and part of 45
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| Which area of the brain discriminates shape, texture, or size of objects? | Parietal lobe; postcentral gyrus, primary somatosensory cortex; Brodmann's area 3, 1, 2
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| Which area controls conscious processing of sounds? | Temporal lobe, Primary auditory cortex, Brodmann's area 41
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| Which area of the brain distinguishes light, dark, shape, size, location and movement of objects? | occipital lobe, primary visual cortex, Brodmann's area 17
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| Which area of the brain processes info regarding head position and head movements? | Parietal lobe, Primary vestibular cortex, Brodmann's area 40-anterior
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| Which area of the brain controls stereognosis and memory of tactile and spatial environment? | parietal lobe, somatosensory association area, Brodmann's area 5 and 7
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| Which area of the brain processes analysis of colors and motion, visual fixation? | occipital lobe and temporal lobe, visual association area, Brodmann's 18-21
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| Which area of the brain controls classification of sounds (language, music, noise)? | temporal lobe, auditory association area, Brodmann's 22, 42
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| What do you call the nerve fibers connecting the L and R cerebral hemispheres? | corpus callosum
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| What do you call the cavities in the brain containing CSF? How many are there | ventricles (4) (2-lateral, 3rd, 4th)
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| CSF is produced by what? and which space does it fill? | The choroid plexus; the subarachnoid space
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| How does CSF flow from the ventricles to the blood stream? | lateral ventricles>intraventricular foramen>3rd ventricle>cerebral aqueduct>4th ventricle>subarachnoid space>dural venous sinuses>blood stream
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| Name the components of the limbic system (5) | Amygdala
Hippocampus
hypothalamus
anterior and medial nuclei of the thalamus
limbic cortex (cingulate gyrus, parahippocampal gyrus, uncus)
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| Which area of the brain control emotions and also instincts, initiation, motivation, and aggression? | Amygdala
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| Which part of the brain controls memory? | hippocampus
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| Name the parts of the diencephalon. | Thalamus
epithalamus
hypothalamus
subthalamus
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| What do you call the collection of nuclei located above the brainstem that functions to relay sensory and motor signals to the cerebral cortex, also regulates consciousness, arousal, and attention and assists in integration of visceral and somatic functio | Thalamus
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| The thalamus relays all sensory signals to the cerebral cortex except_________? | olfactory
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| What is located below the thalamus that functions to maintain homeostasis, regulate circadian rhythm, regulates emotional expressions (pleasure, fear, anger) and involved in the autonomic nervous system,s trongly connected to the endocrine system and the | hypothalamus
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| What is located above the thalamus, has a major component the pineal gland, and functions to secrete hormones that influence the pituitary gland and regulate circadian rhythm? | epithalamus
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| What is part of the basal ganglia that is located below the thalamus and is involved in control of movement? | subthalamus
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| What do you call the axons connecting the cerebral cortex and subcortical structures; fiber tracts separate the thalamus and basal ganglia | internal capsule
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| Name the components of the basal ganglia (5) | caudate, putamen, globus pallidus, subthalamic nucleus, substantia nigra
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| The globus pallidus and putamen are called the? | lentiform nucleus
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| The caudate and the putamen are called the? | striatum
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| What does the basal ganglia control? | regulates movement via control of sequencing, muscle tone, muscle force; communicates with motor planning areas of the cerebral cortex via the thalamus;
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| Name the lobes of the cerebellum (3) | anterior, posterior, flocculonodular
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| Name the deep cerebellar nuclei (4) | fastigial, globose, emboliform, dentate
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| What are the 3 functional regions of the cerebellum? | vestibulocerebellum (flocculonodular lobe)
spinocerebellum (vermis and paravermal hemispheres)
cerebrocerebellum (lateral hemispheres)
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| Where does each cerebellar peduncle attach? and what type of fibers does it contain? | Sup. cerebellar peduncle: midbrain: efferent
Mid. cerebellar peduncle: pons: afferent from the cerebral cortex
Inf. cerebellar peduncle: medulla: affarent from the brainstem/spinal cord & efferent to the vestibular and reticular nuclei in the brainstem
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| Does the cerebellum have ipsilateral or bilateral control? | mostly ipsilateral; vestibulocerebellum includes some bilateral control
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| Which area of the brain's primary function is to compare actual movement to intended movement and make adjustments? postural adjustment (anticipatory and reactive); and coordination of movement? | cerebellum
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| which fibers of the cerebellum are for input (2) and output (1)? | Input: mossy fibers (information) and climbing fibers (timing); purkinje cells (output)
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| Which area of the cerebellum regulates equilibrium? and what are the inputs/outputs? Which nucleus? | vestibulocerebellum
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| What are the inputs/outputs of the vestibulocerebellum? | inputs: vestibular nuclei and superior colliculus (eye and head position/movement)
outputs: medial vestibular nucleus (VOR, eye-head coordination) and lateral vestibular nucleus, reticulospinal system, primary motor cortex (postural reactions)
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| Which deep cerebellar nucleus is involved with the vestibulocerebellum? | fastigial
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| Which area of the cerebellum regulate gross limb movments? | spinocerebellum
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| What are the inputs/outputs of the spinocerebellum? | inputs: spinocerebellar tracts
outputs: vestibulospinal and reticulospinal tracts, motor cortex and red nucleus
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| Which nuclei are involved with the spinocerebellum? | emboliform and globose
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| Which area of the cerebellum reulates istal limb voluntary movements, motor planning, timing, and rhythm? | cerebrocerebellum
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| What are the inputs and outputs of the cerebrocerebellum? | inputs: cerebral cortex via pontine nuclei; outputs: motor and premotor cortices via the thalamus, red nucleus to activate the rubrospinal tract
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| which deep cerebellar nucleus is involved with the cerebrocerebellum? | dentate
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| What are the 3 components of the brainstem? | midbrain, pons, and medulla
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| The brainstem is the origin of all descending pathways except______? | the corticospinal tract
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| Which cranial nerve nuclei are located on the brainstem? | CN 3-12
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| What do you call the parts of the brain that regulate cardiovascular, respiratory, and visceral activity as well as arousal and awareness through the ascending reticular activating system? | Brainstem
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| What structures are in the midbrain and which cranial nerves are located there? | cerebral peduncles (descending tracts from the cerebral cortex), substantia nigra (part of the basal ganglia) red nucleus, superior colliculus (reflexive eye-head movements, inferior colliculus (relays auditory info), CN 3, 4,5
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| Which cranial nerves attach to the pons? | 5,6,7
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| Which cranial nerves attach to the medulla, which tracts, and what decussates here? | decussation of the corticospinal tract and dorsal column-medial lemniscus tract; cranial nerves 7-12
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| The spinal cord extends from what to what? | medulla to L1/L2 vertebral level
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| What do you call the termination of the spinal cord and what level does it terminate at? | conus medullaris: L2
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| What does the dorsal column medial lemniscus tract sense? | discriminative touch, conscious proprioception
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| What does the spinothalamic tract sense? | pain and temperature
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| Describe the first, second, and third order neurons for the dorsal column medial lemniscus tract. | ascends peripheral receptor to medulla (1) via the dorsal spinal cord, medulla to the thalamus (synapses in the nucleus gracilis or cuneatus and decussates here), travels from the thalamus to the primary somatosensory cortex via the internal capsule
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| How does the spinothalamic tract travel up? | peripheral receptor to spinal cord, synapses here, then to the thalamus (decussating in the anterior white commisure) then ascends contralaterally to the cerebral cortex, and travels up through the internal capsule to the primary somatosensory cortex
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| Which pathways relay slow pain? | divergent
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| What does the spinomesencephalic tract do? | turns eyes toward source of pain
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| What does the spinoreticular tract do? | relays arousal, withdrawal, and autonomic responses to pain
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| What does the spinolimbic tract do? | controls affective responses to pain
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| Name the descending motor tracts (8) | corticospinal, rubrospinal, reticulospinal, lateral vestibulospinal tracts, tectospinal and medial vestibulospinal; ceruleospinal, raphespinal
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| Which 2 descending tracts control head and neck control? | tectospinal and medial vestibulospinal
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| Where does the lateral corticospinal tract decussate? and what is its function | lower medulla; fractionated movement: ability to activate individual muscles independently of other muscles (contralateral)
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| What does the medial corticospinal tract do? | controls signals to neck, shoulder, trunk and prepares the postural system for intended movements; mainly ipsilateral
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| What does the reticulospinal tract control? | postural muscles and limb extensors; ipsilateral
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| What does the lateral vestibulospinal tract do? | facilitates extensors and inhibits flexors for balance reactions; ipsilateral
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| What area does the medial vestibulospinal tract control? | neck and upper back musculature; bilateral
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| Where does the tectospinal tract decussate?and what is its function? | midbrain; turns head towards visual and auditory stimuli; contralateral
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| What do the ceruleospinal and raphespinal tracts do? | enhance activity of interneurons and motor neurons
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| What is cranial nerve 1 and how do you assess it? | olfactory; identify distinctive smells: coffee or lemon; projects directly to the temporal lobe, bypassing the thalamus
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| What is cranial nerve 2 and how do you assess it? | optic nerve; confrontation or the snellen chart; R eye L cortex and vice versa
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| What is cranial nerve 3 and how do you assess it? | occulomotor; smooth pursuits
innervates the superior rectus, medial rectus, inferior rectus, inferior oblique
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| What is cranial nerve 4 and how do you assess it? | trochlear: smooth pursuits (innervates the superior oblique muscle-inferior and medial eye movement); only CN to emerge from the dorsal brainstem
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| What is cranial nerve 5 and how do you assess it? | trigeminal: light touch to face, palpate temporalis and masseter as patient clenches teeth; sensory (face and TMJ) and motor function (muscles of mastication); jaw jerk reflex
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| What are the 3 branches of the trigeminal nerve (CN5)? | opthalmic-sensory
maxillary-sensory
mandibular-sensory and motor
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| What is the significance of the jaw jerk reflex? | if it is hyperreflexive, it indicates pathology above the foramen magnum; if the test is negative, leads to diagnosis of cervical spondylotic myelopathy not ALS or MS
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| What is cranial nerve 6 and what does it innervate? | abducens; lateral rectus; smooth pursuits; if impaired, eye will deviate towards the nose
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| What is cranial nerve 7? what does it do? how do we assess it? | facial nerve; motor to muscles of facial expression and sensory: taste of anterior 2/3 of tongue and salivation; observe for facial symmetry: eyebrow elevation, puff cheeks, close eyes, smile
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| What are the 5 branches of the facial nerve? | temporal, zygomatic, buccal, mandibular, cervical
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| What is cranial nerve 8? what does it do? how do you assess it? | vestibulocochlear, hearing and vestibular function, finger rub beside ears, vestibular screen
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| What is cranial nerve 9 and how do you assess it? | glossopharyngeal; taste of posterior 1/3 of the tongue, salivation, swallowing (sensation from soft palate and pharynx); gag reflex sensory portion
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| What is cranial nerve 10 and how do you assess it? | vagus; speech, swallowing, thoracic and abdominal viscera, heart; gag reflex ("say ahh", observe palate elevation, uvula deviation away from the affected side); motor portion of the gag reflex
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| What is cranial nerve 11 and how do you assess it? | spinal accessory; innervates the SCM and upper trapezius; turn head and shrug shoulders
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| What is cranial nerve 12 and how do you assess it? | hypoglossal; tongue movement; tongue deviates towards affected side
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| What are the 3 types of connective tissue in peripheral nerves and what do they each cover? | epineurium: entire nerve trunk
perineurium: bundles of axons
endoneurium: individual axons
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| What are the 2 types of lower motor neurons? | Gamma (medium)-myelinated)
Alpha (large-myelinated)
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| Which type of motor unit contains larger diameter, faster, alpha motor neurons? | fast twitch
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| Which type of motor unit contains smaller diameter, slower alpha motor neurons? | slow twitch
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| What is Henneman's size principle? | Slower twitch motor units are recruited first, followed by fast twitch (e-stim is the opposite)
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| Name the myotomes and muscles tested because they are innervated by a single spinal nerve. | C5 elbow flex C6 wrist ext; C7 elbow ext; C8 finger abd; T1 deep finger abd, L2 hip flex, L3 knee ext, L4 ankle DF, L5 great toe ext; S1 ankle PF
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| What is cranial nerve 9 and how do you assess it? | glossopharyngeal; taste of posterior 1/3 of the tongue, salivation, swallowing (sensation from soft palate and pharynx); gag reflex sensory portion
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| What is cranial nerve 10 and how do you assess it? | vagus; speech, swallowing, thoracic and abdominal viscera, heart; gag reflex ("say ahh", observe palate elevation, uvula deviation away from the affected side); motor portion of the gag reflex
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| What is cranial nerve 11 and how do you assess it? | spinal accessory; innervates the SCM and upper trapezius; turn head and shrug shoulders
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| What is cranial nerve 12 and how do you assess it? | hypoglossal; tongue movement; tongue deviates towards affected side
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| What are the 3 types of connective tissue in peripheral nerves and what do they each cover? | epineurium: entire nerve trunk
perineurium: bundles of axons
endoneurium: individual axons
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| What are the 2 types of lower motor neurons? | Gamma (medium)-myelinated)
Alpha (large-myelinated)
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| Which type of motor unit contains larger diameter, faster, alpha motor neurons? | fast twitch
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| Which type of motor unit contains smaller diameter, slower alpha motor neurons? | slow twitch
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| What is Henneman's size principle? | Slower twitch motor units are recruited first, followed by fast twitch (e-stim is the opposite)
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| Name the myotomes and muscles tested because they are innervated by a single spinal nerve. | C5 elbow flex C6 wrist ext; C7 elbow ext; C8 finger abd; T1 deep finger abd, L2 hip flex, L3 knee ext, L4 ankle DF, L5 great toe ext; S1 ankle PF
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| What system is responsible for maintaining homeostasis, regulating the cardiovascular system, GI system, GU system, body temp, metabolism, pupillary adjustments, and reproduction | autonomic nervous system
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| what cranial nerves are associated with the Autonomic nervous system? | vagus X, VII facial, IX hypoglossal
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| Name the visceral receptors and what they sense changes in. | mechanoreceptors-pressure
chemoreceptors-chemical changes specifically the aortic body which detects O2 or CO2 in blood and the carotid body which detects that plus changes in pH
thermoreceptors-temp changes
nociceptors-pain
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| What is cranial nerve 9 and how do you assess it? | glossopharyngeal; taste of posterior 1/3 of the tongue, salivation, swallowing (sensation from soft palate and pharynx); gag reflex sensory portion
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| What is cranial nerve 10 and how do you assess it? | vagus; speech, swallowing, thoracic and abdominal viscera, heart; gag reflex ("say ahh", observe palate elevation, uvula deviation away from the affected side); motor portion of the gag reflex
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| What is cranial nerve 11 and how do you assess it? | spinal accessory; innervates the SCM and upper trapezius; turn head and shrug shoulders
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| What is cranial nerve 12 and how do you assess it? | hypoglossal; tongue movement; tongue deviates towards affected side
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| What are the 3 types of connective tissue in peripheral nerves and what do they each cover? | epineurium: entire nerve trunk
perineurium: bundles of axons
endoneurium: individual axons
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| What are the 2 types of lower motor neurons? | Gamma (medium)-myelinated)
Alpha (large-myelinated)
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| Which type of motor unit contains larger diameter, faster, alpha motor neurons? | fast twitch
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| Which type of motor unit contains smaller diameter, slower alpha motor neurons? | slow twitch
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| What is Henneman's size principle? | Slower twitch motor units are recruited first, followed by fast twitch (e-stim is the opposite)
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| Name the myotomes and muscles tested because they are innervated by a single spinal nerve. | C5 elbow flex C6 wrist ext; C7 elbow ext; C8 finger abd; T1 deep finger abd, L2 hip flex, L3 knee ext, L4 ankle DF, L5 great toe ext; S1 ankle PF
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| What system is responsible for maintaining homeostasis, regulating the cardiovascular system, GI system, GU system, body temp, metabolism, pupillary adjustments, and reproduction | autonomic nervous system
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| what cranial nerves are associated with the Autonomic nervous system? | vagus X, VII facial, IX hypoglossal
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| Name the visceral receptors and what they sense changes in. | mechanoreceptors-pressure
chemoreceptors-chemical changes specifically the aortic body which detects O2 or CO2 in blood and the carotid body which detects that plus changes in pH
thermoreceptors-temp changes
nociceptors-pain
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| What is the sympathetic nervous system characterized by, where are the cell bodies located and where do they synapse? | fight or flight; preganglionic-spinal levels T1-L2; @sympathetic chain ganglia
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| What is the parasympathetic nervous system characterized by? Where are the cell bodies located? Where do they synapse? | rest and digest; brainstem and sacral spinal cord; and near target organs
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| What does the anterior cerebral artery supply? | frontal lobe
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| What does the middle cerebral artery supply? | frontal lobe, lateral surface of temporal and parietal lobes
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| What does the posterior cerebral artery supply? | portion of temporal and occipital lobes and deep subcortical structures including the thalamus
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| What arteries supply the cerebellum? | vertebral arteries: posterior inferior cerebellar artery and posterior spinal artery
Basilar artery: superior cerebellar artery and anterior inferior cerebellar artery
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| what arteries supply the midbrain? | basilar: paramedian aa; short circumferential aa, long circumferential aa
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