5. Anatomy IV p94-111
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Complete list of Terms and Definitions for 5. Anatomy IV p94-111

Terms Definitions
4. Achilles S1
Right Meyer's loop (parietal lesion) Left lower quadrantic anopsia
Functions of Golgi/RER/SER pg. 94
Dural venous sinuses p. 105
What is a consequence of a lesion in:
T or F: Liver sinusoids have basement membranes? C2
T or F: Spleen sinusoids have basement membranes? True -- "barrel hoop" basement membranes line sinusoids
Delineate the flow of processing in the indirect pathway. Putamen (inhibitory) => GPe (inhibitory) => GPi (inhibitory) => Thalamus; induces loss of inhibitory influence on Gpi => inhibition of thalamus
Which cranial nerves pass through the internal auditory meatus? VII, VIII
What is the main secretory product of the medulla Catecholamines
What is the function of the lateral geniculate nucleus? Visual pathway (remember Lateral is needed to Look)
Spinal muscle control (p 110)
This nuclei confers visceral Sensory information (eg: taste, gut distension) Nucleus Solitarius (VII, IX, X)
Vagal nuclei (p 107)
Play this game: Where is the Upper Limb nerve Lesion?? (p110-111)
Delineate the flow of processing in the direct pathway. Putamen (inhibitory) => Gpi (inhibitory) => Thalamus: inhibition of Gpi => activation of thalamus
name organelle of proteoglycan assembly Golgi
Patient's jaw deviates toward the left left CN V
This nucleus sends parasympathetic fibers to the heart, lungs, and upper GI Dorsal motor nucleus
Pancreatic Cell Types pg. 95
What is the primary regulator of the zona fasciculata ACTH (direct) and CRH (indirect)
This is also another common area of aneurysm. aneurysm causes CN III palsy Posterior communicating artery
What is the difference between alpha and gamma motor neurons? alpha fibers participates in the reflex arc and cause extrafusal contraction. Gamma neurons are stimulated by CNS to contract intrafusal fiber to increase sensitivity of reflex arc
Sensation for ____(What part of the body) is generally located superior medially on the primary sensory cortex while ____ is located more laterally Lower limbs, Head and neck
Which nucleus is responsible for satiety? ventromedial nucleus (without which you grow ventrally and medially
Following a blow to his shoulders, the patient presents with limb hanging by side (paralysis of abductors), medially rotated (paralysis of lateral rotators), and protonated forearm (loss of biceps) C5 and C6 roots. Known as Erb-Duchenne palsy
what are the phagocytic cells of the nervous system microglia
In general, in stroke of anterior circle you would see what kind of deficits? Sensory and motor dysfunction, aphasias
Lymph Nodes pg. 96
At what level should one perform a lumbar puncture? Between L4 and L5 (to keep the cord alive, keep the needle between L3 and L5)
Which of the following herniations can cause compression on the brain stem that can result in coma and death? 1. Cingulate herniation 2. Transtentorial herniation 3. Uncal herniation 4. Cerebellar tonsillar herniation 1 herniates under the falx cerebri and does not cause coma and death. 2. Transtectoral, 3. Uncal, and 4. tonsillar herniations can
Homounculus (p 106)
Cavernous sinus p. 102
Describe the primary function fo the basal ganglia. The basal ganglia mediates voluntary movements and postural adjustments
Limbic System pg. 99
Sounds (p 106)
Name the visual field defect associated with a lesion of each of the following structures:
4. Duret hemorrhage Caudal displacement of brain stem
Right optic nerve Right anopsia
Amygdala? Kluver-Bucy syndrome: hyperorality, hypersexuality
Cranial nerves p. 104
name organelle of protein transport Golgi
Thoracic Outlet Syndrome (p111)
Do nonpolar/lipid soluble substances or polar, water-soluble substances pass through the BBB more easily? Nonpolar/lipid soluble
Patient could no longer flex at his elbow joint and supination of his forearm is weakened. Exam shows loss of biceps reflex and variable sensory loss of his forearm musculocutaneous nerve
Cerebral cortex functions p. 101
name organelle of N-oligodsaccharide addition Rough ER
2. Triceps C7
Adrenal Cortex and Medulla pg. 95
Name the cranial nerves that innervate the facial muscles (extraocular muscles excluded). Trigeminal (V): mastication; Facial (VII): facial movement
Where is the primary visual cortex (V1) located? most posterior aspect of occipital lobe
central white commisure and ventral horns Syringomyelia
What is the role of Wernicke's area? Where is it located? superior temporal gyrus; mediates speech comprehension
Which nucleus is responsible for hunger? Lateral nucleus
Which three sinuses combine to form the confluence of sinuses? superior sagittal sinus, straight sinus, occipital sinus
What are the signs of Upper Motor neuron lesion? Upper = everything up (tone, DTRs, toes)
You would ask the patient to say this to test CN X (vagus) Kuh-kuh-kuh
Is a lymph node a primary or secondary lymphoid organ Secondary
name organelle of N-oligodsaccharide modification Golgi
Name the cranial nerves that innervate the eye muscles. Oculomotor (III), Trochlear (IV), and Abducens (VI)
2. Contralateral homonymous hemianopsia Compression of ipsilateral posterior cerebral artery
Cerebellar vermis? Truncal ataxia and dysarthria
At which artery in the circle of willis is the most common place of aneurysm? You often see visual symptoms Anterior communicating artery
Why is L-dopa, not dopamine, the treatment of choice in Parkinson's Disease L-dopa crosses the BBB
Right parietal lobe? spatial neglect syndrome (contralateral)
What is the clinical presentation of chorea? sudden, jerky, purposeful movements; Chorea= dancing, think choreography
Internuclear ophthalmoplegia p. 103
Brain stem anatomy p. 105
Upper motor neuron lesion coming from the facial nucleus result in what? contralateral paralysis of lower quadrant
"La la la" tests which CN? XII - Hypoglossal (innervation of the tongue)
Extraocular muscles and nerves p. 102
What are the functions of the hypothalamus (7) Thirst, Adenohypophysis control, Neurohypophysis hormone synthesis, Hunger, Autonomic regulation (including circadian rhythms), Temperature regulation, Sexual urges (TAN HATS)
What is the characteristic lesion in internuclear ophthalmoplegia? destruction of the medial longitudinal fasciculus (MLF) => medial rectus palsy on attempted lateral gaze
Pupillary light reflex p. 103
What is the Babinski reflex a sign of? When is it normal? UMN lesion, its normal during 1st year of life
What is the main secretory product of Brunner's Glands and where do they reside Secrete alkaline mucus and live in the submucosa of the duodenum
What zona makes cortisol Zona Fasciculata (remember GFR and "The Deeper you go, the sweeter it gets" -- i.e. salt, sugar, sex
Patient's shoulder droop on the left left CN XI lesion
Rigth optic tract Left homonymous hemianopsia
Which cranial nerves exit the brainstem rostral to the pons? Cranial nerves I through V
Clinical Reflexes (p111)
what cells produce myelin in the CNS oligodendricytes
Patient dislocates his shoulder and could no longer use his deltoid. axillary nerve
What are the roles of the direct and indirect pathways? Indirect pathway inhibits movement; Direct pathway facilitates movement.
Brain lesions p. 101
CNS/PNS Supportive Cells pg. 98
Play this game: Where is the Lesion?? (p 107)
Posterior Pituitary pg. 99
name organelle of protein synthesis Rough ER
In thoracic outlet syndrome, when the patient turn his head toward the opposite side, you notice the dissapearance of _____ (what physical finding?) radial pulse
Injury to what nerve causes loss of plantar flexion tibial (L4-S3) (TIP = Tibial Inverts and Plantarflexes; if injured, can't stand on TIPtoes)
Name five structures passing through superior orbital fissure (four nerves, one vessel). CN III, IV, V1, VI; ophthalmic vein
Claw hang Trunk of C8 and T1
T or F: delta cells make somatostatin TRUE
What are the Brodman's Area designations for S1, M1, V1? S1: 3, 1, 2; M1: 4; V1: 17
What is I-Cell Disease Failure of golgi to add mannose-6-phos to lysosome proteins, causing their secretion outside the cell (defect of golgi)
Nerve Injury pg. 97
What muscles would you expect to be atrophied as a result of thoracic outlet syndrome? thenar and hypothenar eminences, innterosseous
Ventral Nuclei (VA/VL) functions? Motor
A patient comes in with facial paralysis and inability to close the eye on one side of the face, suggesting Bell's Palsy. What diseases might you see in him that could have caused his condition? ALexanger Bell with STD: AIDS, Lyme, Sarcoid, Tumors, Diabetes
dorsal column, impairs propioception and causes locomotor ataxia Tabes dorsalis (tertiary syphilis)
Loss of hip adduction? Obturator (L2-L4)
Patient has weakness turning head to the left right CN XI lesion
Zona Glomerulosa makes ________ Aldosterone
The lateral cortical spinal tract carries what type of fibers, and how are they arranged in the spinal cord? motor fibers, arms medially, legs laterally
What is the role of Broca's area? where is it located? inferior aspect of frontal lobe; mediates motor speech (production)
Describe the route of CSF from the superior sagittal sinus to the internal jugular vein. superior sagittal sinus => confluence of sinuses => transverse sinus => sigmoid sinus => internal jugular vein (via jugular foramen)
Foramina: posterior cranial fossa (CN VII-XII) p. 102
Where is the primary sensory cortex (S1) located? anterior aspect of parietal lobe
1. Ipsilateral dilated pupil, ptosis Stretching of CN III
divide the 31 spinal nerves into their divisions 8Cs, 12Ts, 5Ls, 5Ss, 1 coccygeal
Brachial Plexus (p110)
Mostly white matter of Cervical region, lesion are asymmetric and random Multiple sclerosis
Loss of Knee Jerk? Femoral (L2-L4)
What is the function of the medial geniculate nucleus? Auditory pathway (remember Medial is to hear Music)
Arcuate fasciculus? conduction aphasia: poor repetition w/ good comprehension and fluent speech
Uncal herniation can cause the following clinical signs, name their causes (p 107)
Mammillary bodies? Wernicke-Korsakoff's encephalopathy: anterograde amnesia (think alcoholism)
T or F: alpha cells make glucagon True
patient tends to fall toward the left side left lesion of the cerebellum
Mr. Brown-Sequard was struck on the spinal cord that resulted in the hemisection of the spinal cord at T3 level. Give me 4 symptoms that you may find in him 1. Ipsilateral motor paralysis 2. Ipsilateral loss of tactile, vibration, proprioception senses 3. Contralateral pain and temperature loss 4. Ipsilateral loss of ALL sensation at the T3 level
Name five nerves and one vessel that pass through the cavernous sinus. CN III, IV, V1, V2, VI; internal carotid artery
Mucus-secreting goblet cells of small intestine and antibody secreting plasma cells are rich in ______ (organelle) Rough ER
What two areas does the hippocampus project to? the subiculum (mammillary nuclei) and the septal area
Wingled Scapula Long thoracic nerve
Trace the pathway from Mammillary body to hippocampus. Mammillary body, anterior nucleus of thalamus, cyngulate gyrus, entorhinal cortex, hippocampus
List in sequence the nerves, brain structures, and muscles involved in the pupillary light reflex from illumination of one eye to bilateral pupillary constriction. Light => retina => optic nerve => optic chiasm => optic tract => prectectal nuclei (synapse) => Edinger-Westphal nuclei (synapse) => oculomotor nerve => ciliary ganglion (synapse) => pupillary constrictor muscles
everywhere, but spares the dorsal columns Ventral artery occlusion
The dorsal columns have 2 tracts. The Fasciculus ____ carries nerve fibers for _____(part of the body). The fasciculus ____ carries tract from ____ (part of the body) Cuneatus, upper body and extremities. Gracilis, lower body and extremities
Describe the innervation of the extraocular muscles. LR6SO4R3 : Lateral Rectus = CN VI, Superior Oblique = CN IV, and the Rest are CN III
Function of the ventral posterior nucleus, medial part (VPM)? receives facial sensations, including pain
Foramina: middle cranial fossa (CN II-VI) p. 102
in grey matter, affect lower motor neuron only, cause flaccid paralysis Poliomyelitis / Werdnig-Hoffmann disease
Name three other movement disorders associated with basal ganglia processing. Chorea, athetosis, hemiballismus
The paracortex is the home of ____ cells T-cells
Patient has clawed hand. Exam showed that he has imparied wrist flexion and adduction, impaired adduction of thumb and last 2 fingers. He also has lost of sensation over medial palm and pinky finger. What was the injured nerve? ulnar nerve
Patient's uvula deviate to the left right CN X lesion
What are the 5 divisions/parts of the bracial plexus? Roots Trunks Divisions Cords Branches (Randy Travis Drinks Cold Beer)
What zona makes the sex hormones Zona reticularis
Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease (p 108)
Where is the primary motor cortex (M1) located? posterior aspect of frontal lobe
name organelle of steroid synthesis and detoxification of drugs and poisons Smooth ER
What part of the lymph node is the site of B-cell localization and proliferation Follicle
Name the foramina of exit for each division of the trigeminal nerve (CN V). Standing Room Only: V1 = Superior orbital fissure; V2 = foramen Rotundum; V3 = foramen Ovale
Match: B-cells are in the red or white pulp White (within the follicles)
Broca's area? motor (expressive, nonfluent) aphasia; BROca's BROken speech
What are the functions of the limbic system? Feeding, Fighting, Feeling, Flight, and Sex (the five Fs)
T or F: B cells make somatostatin False -- beta cells make insulin
grey matter, and motor tracts: upper and lower motor neuron deficits Amyotrophic Lateral Sclerosis
Islet cells arise from what primordial structure Pancreatic Buds
What is the most common tumor of the adrenal medulla in children Neuroblastoma
Brown Sequard Syndrome, UMN, LMN, Facial Lesions (p108)
Thoracic outlet syndrome leads to loss of the compression of ____ artery and ____ trunk of brachial plexus Subclavian, inferior (C8. T1)
Which nuclei of the hypothalamus project axons into the posterior pituitary? supraoptic nuclei (ADH) and paraventricular nuclei (oxytocin)
What is the anatomical defect in hemiballismus? contralateral subthalamic nucleus lesion
Name four structures passing through the jugular foramen (three nerves, one vessel). CN IX, X, XI; jugular vein
What three structures form the BBB Choroid plexus epithelium, Intracerebral capillary endothelium, Arachnoid (remember CIA)
Which cranial nerves exit the brainstem caudal to the pons? Cranial nerves VI through XII
Reticular activating system? Coma
Which cranial nerves pass through the jugular foramen? IX, X, XI
Which artery supplies the medial surface of the brain, leg-foot area of motor and sensory cortices? Anterior cerebral artery
3. Patella L4
Match: T-cells are in the red or white pulp Red
Name two nerves passing through internal auditory meatus. CN VII, VIII
What structures are pierced? Skin, Ligaments, Epidural space, Dura, Subdural Space, Arachnoid, Subarachnoid (CSF) (NOTE: pia is NOT pierced)
Functions of Thalamic Nuclei pg. 99
This artery comes off of middle cerebral artery and supply internal capsule, caudate, putamen, globus pallidus Lateral Striate
Circle of Willis (p 106)
In adults, where does the spinal cord end? L1-L2
Homunculus is the topographical representation of the body that exists in what 2 areas of the cerebral cortex? Sensory and Motor areas
True or False: Upper motor neuron lesion of the face causes contralateral weakness of lower face only TRUE
True or False: Lower motor neuron lesion of the face causes contralateral weakness of lower face only FALSE: weakness of both upper and lower face seen
Does the posterior hypothalamus control heat conservation? Yes, think no Posterior hypothalamus = poikilotherm (cold blooded snake)
Name three structures passing through optic canal (one nerve, two vessels). CN II, ophthalmic artery, central retinal vein
What tract carries pain and temperature sensation? Where is it located on the spinal cord? Spinal Thalamic tract, ventral part
"Mi mi mi" tests which CN? VII - Facial (innervation of lips)
What cell is responsible for physical support and repair, as well as K+ metabolism astrocytes
Dorsal optic radiation Left hemianopsia with macular sparing
What is the main location of CSF return via the arachnoid granulations? superior sagittal sinus
patient's tongue deviates to the left left CN XII
Patient comes into the ER with trauma injury that broke his humerus bone. Two weeks later when you examined him, you noticed that his wrist is dropped. Neuro exam showed that the triceps and brachioradialis reflexes of the same arm are absent. What was t radial nerve (innervates BEST!) Brachioradialis, Extensors of wrist and fingers, Supinator, and Triceps
Hypothalamus pg. 98
What nerve root do you test for if you illecit the following reflexes?
If you suspect a lesion in both Broca's and Wernecke's areas, a lesion in which artery could be the cause? Middle cerebral artery
Name three characteristic clinical features of internuclear ophthalmoplegia. 1. On attempted lateral gaze, contralateral eye fails to abduct past midline; 2. Contralateral nystagmus on attempted lateral gaze; 3. Normal convergence
Does the anterior hyporthalamus control cooling when hot? Yes, think Anterior Cooling = A/C
What neurologic disease is commonly associated with internuclear ophthalmoplegia (aka MLF syndrome)? multiple sclerosis; think MLF = MS
Where does the subarachnoid space end? S2
Decreased thumb function, Pope's blessing median nerve
how will a stroke of posterior circle will manifest? C2
What is the clinical presentation of hemiballismus? sudden, wild flailing of 1 arm; half ballistic= as in throwing a baseball
Injury to what nerve causes loss of dorsiflexion of foot common peroneal (L4-S2) (PED = Peroneal Everts and Dorsiflexes)
What is the clinical presentation of athetosis? slow, writhing movements, especially of fingers;
Herniation syndromes
What is the name of the syndrome associated with disfunctional paracortex DiGeorge's Syndrome
What tissue is responsible for IgA secretion in the gut? Peyer's patch (Think IgA -- Intra-Gut Antibody) -- Stimulated B-cells from Peyer's secrete IgA into the lumen
What neurological symptoms would you see? sensory deficits of medial side of forearm and hand
What is the function of the medulla Communicate with efferent lymphatics and contain lymphocytes, plasma cells, macs, and reticular cells
Which cranial nerves pass through the superior orbital fissure? III, IV, V1, VI
Wernicke's area? sensory (fluent, receptive) aphasia; Wernicke is Wordy but makes no sense
Liver hepatocytes and steroid producing cells of the adrenal cortex are rich in ______ (organelle) Smooth ER (look at function two questions above)
Name structures passing through foramen magnum. brain stem, vertebral arteries, spinal roots of CN XI
What is the anatomical defect in Parkinson's Dz? Loss of substantia nigra pars compacta (SNc) dopamine output to putamen => activation of indirect pathway and inhibition of direct pathway
What is the primary regulator of the zona glomerulosa Renin-Angiotensin
Classify each cranial nerve (1-12) according to its function as a sensory nerve, a motor nerve, or both. Mnemonic: Some Say Marry Money But My Brother Says Big Brains Matter Most
Lumbar Puncture pg. 97
Patient has lost power of his arm muscles. He could not longer flex his wrist or fingers, and has trouble with thumb movements. History showed that he broke his had a suprecondylar fracture (of the humerus) What was the injured nerve? median nerve
Optic chiasm Bitemporal hemianopsia
Sinusoids pg. 94-95
Right Meyer's loop (temporal lesion) Left upper quadrantic anopsia
Cranial nerves and passageways p. 104
Spleen sinusoids traverse the _______ pulp Red
Which cranial nerves are associated with the cerebellopontine angle? CN VII, VIII, and IX
Visual field deficits p. 104
Name the cranial nerves associated with sight, smell, hearing, and taste. sight: optic (II); smell: olfactory (I); hearing: vestibulocochlear (VIII); taste: facial (VII) for ant. 2/3 of tongue and glossopharyngeal (IX) for post 1/3
3. Ipsilateral paresis Compression of contralateral crus cerebri (Kernohan's notch)
What is the most common tumor of the adrenal medulla in adults Pheochromocytoma
Spinal Cord (p 108)
1. Biceps C5
Cerebellar hemisphere? Limb ataxia and intention tremor
Nucleus aMbiguus confers Motor innervation of what part of the body? pharynx, larynx, and upper esophagus (IX, X, XI)
Function of the ventral posterior nucleus, lateral part (VPL)? receives body senses (proprioception, pressure, pain, touch, vibration)
Lesion at the anterior cerebral artery will canse deficit in sensation or movement in which part of the body? Lower limbs
Blood Brain Barrier pg. 98
what is the primary regulator of the zona reticularis ACTH (direct) and CRH (indirect)
What are the signs of Lower Motor neuron lesion? everything lowered: « muscle mass, « muscle tone, « reflexes, downgoing toes
Basal ganglia p. 100
what cells produce myelin in the PNS Schawnn cells