Neuroanatomy and Clinical Correlation

What is the basic functional unit of the CNS?

Neuron

What is the connection between neurons?

Synapse

What are the 3 main types of Glial cells and what do they do?

Astrocyte - supports neuron structure
Oligodendrocyte - create myelin of neurons
Microglia - scavenger cells

What are 3 common lesions/injuries to a neuron?

Stroke
Acquired Brain Injury
Multiple Sclerosis

What is a Stage IV Glioblastoma Multiforme?

Type of Astrocytoma that has only a 5%, 5 year survival rate

What is the survival rate of an Oligodendroglioma?

80-90%

What produces the myelin of the myelinated axons (2)?

Oligodendrocytes (CNS)
Schwann Cells (PNS)

True or False: Multiple Sclerosis is a lesion of the CNS (Oligodendrocytes)

True

True or False: Guillan Barre is a lesion of the PNS (Schwann Cells)

True

What are the 2 main parts of the CNS?

Brain
Spinal Cord

What are the 3 main parts of the brain?

Cerebrum
Brainstem
Cerebellum

What composes the PNS?

Cranial Nerves (12)
Spinal Nerves (31)

What are the primary brain vesicles at 4 weeks?

Prosencephalon
Mesencephalon
Rhombencephalon

What are the secondary brain vesicles at 5 weeks?

Telencephalon
Diencephalon
Mesencephalon
Metencephalon
Myelencephalon

What does the Prosencephalon divide into at 5 weeks?

Telencephalon
Diencephalon

What does the Mesencephalon divide into at 5 weeks?

Doesn’t; stays as Mesencephalon

What does the Rhombencephalon divide into at 5 weeks?

Metencephalon
Myelencephalon

What arises from the Telencephalon?

Cerebral Cortex (Gray Matter)
Subcortical White Matter
Basal Ganglia
Internal Capsule

What arises from the Diencephalon?

Thalamus
Hypothalamus
Subthalamus
Epithalamus
(aka anything that has the word “thalamus”)

What arises from the Mesencephalon?

Midbrain

What arises from the Metencephalon?

Pons
Cerebellum

What arises from the Myelencephalon?

Medulla Oblongata

What area is considered the “Primary Motor Area”?

Area 4 (aka Orlando)

What is Area 4

Primary Motor Area

Which brain area does all of our movement come from?

Area 4: Primary Motor Area

If an individual has a lesion in Area 4, what could that look like, for both small (irritative) lesion and larger (gross) lesion?

Irritative Lesion - Convulsive seizures
Gross Lesion - contralateral flaccid paralysis, areflexia (no reflexes)

What area is the supplementary motor area and pre-motor area?

Area 6

What is Area 6

Supplementary Motor Area or PreMotor Area

What is Area 6: Supplementary Motor area responsible for?

Motor Activities
Programming
Planning

What is Area 6: Pre-Motor Area responsible for?

Sensorially guided movements or movements activated in response to stimuli
(visual, auditory and somatosensory)

What would a lesion on Area 6: Supplementary Motor Area look like?

Hard to plan/program intended movement

What would a lesion on Area 6: Pre Motor Area look like?

Does not plan the correct movement in response to external stimuli

What are the 3 main blood supplies responsible for cerebral circulation?

Anterior Cerebral Artery (ACA)
Middle Cerebral Artery (MCA)
Posterior Cerebral Artery (PCA)

What would a lesion of the ACA look like?

Typically affects the LE more, both motor and sensory
(Note: Could also affect UE + face due to MCA coming from ACA)

What would a lesion of the MCA look like?

UE, hands and face

What would a lesion of the PCA look like?

Vision changes

What Area of the brain is associated with Frontal Eye Field?

Area 8

What is Area 8 responsible for?

Voluntary Eye Movement
- saccades (contralateral)
- smooth pursuit (ipsilateral)
- optokinetic nystagmus (ipsilateral)

What would a lesion of Area 8: Frontal Eye Field look like?

Voluntary contraversive horizontal gaze deficit
Ipsiversive gaze preference

What brain Areas make up the prefrontal cortex?

Area 9, 10, 11, 12

What is Areas 9, 10, 11, 12

Prefrontal Cortex

What is brain Areas 9, 10, 11, 12: Prefrontal Cortex essential for?

Abstract Thinking
Foresight
Judgment
Cognitive Function

What would a lesion in brain Areas 9, 10, 11, 12 look like?

Behavioral and cognitive changes

What Brain Areas are considered Broca’s Area?

44, 45

What is Area 44, 45

Brocas Area

What is the purpose of Area 44, 45: Broca’s Area?

Motor Speech Area
Speech Production
Language

What would a lesion in Area 44, 45: Broca’s Area look like?

Extreme difficulty in expressing words or phrases
Expressive Aphasia
BEMAN = Broca’s, Expressive, Motor, Anterior, Non-Fluent
(aka they understand what you are saying, but have a hard time responding/expressing their thoughts)

True or False: Individuals with Broca’s Aphasia are often very frustrated

True

What are all the Brain Area’s that are located in the Frontal Lobe of the Cerebral Cortex?

Area 4: Primary Motor Area (President)
Area 6: Supplementary Motor Area (Vice President)
Area 6: Pre-Motor Area (Vice President)
Area 8: Frontal Eye Field (Vice President)
Area 9, 10, 11, 12: Prefrontal Cortex (President)
Area 44, 45: Broca’s Area (President)

What brain Areas is the Primary Somatosensory Area?

Area 3, 2, 1

What is Area 3,2,1

Primary Somatosensory Area

What is Area 3, 2, 1 responsible for?

Receives and process sensation - I can feel but what is this
Touch localization
Detect type of sensory modality (pain, touch, temperature)

What would a lesion in Area 3, 2, 1 look like?

Contralateral paresthesia (numbness)
Impaired sensation

What brain Areas is responsible for somastosensory association area?

Area 5, 7 (Vice President to Area 3, 2, 1)

What is Area 5,7

Somatosensory Association Area

What is Area 5, 7 responsible for?

Sensory Input - Giving the feeling meaning
Stereognosis
Bimanual Manipulation
(Note: Area 3, 2,1 says we feel something, then Area 5, 7 remembers it and puts a name to it)

What would a lesion in Area 5, 7 look like?

Astereognosis (contralateral; can feel not identify object)
Sensory Neglect (damage in nondominant hemisphere)

What Brain Area is the Angular Gyrus / Posterior Speech Area?

Area 39

What is Area 39

Angular Gyrus

What is Area 39 responsible for?

Language and number processing
Reading
Writing
Speech Fluency

What would a lesion to Area 39 look like?

Alexia (hard read)
Agraphia (hard write)

True or False: Area 39 is considered the “bridge” of Broca’s Area and the Visual Area of the brain

True (connects the language and visual portion)

What Brain Area is the Supramarginal Gyrus / Posterior Speech Area?

Area 40 (Vice President to Area 39)

What is Area 40

Supramarginal Gyrus

What does Area 40 assist with?

Sensory Processing
Phonological Processing
Speech Fluency

(aka organizes fluency and processes)

What would a lesion in Area 40 look like?

Tactile Agnosia (similar to Stereognosis, so it does support Area 3, 2, 1)

What are all the Brain Areas in the Parietal Lobe?

Area 3, 2, 1: Primary Somatosensory Area (President)
Area 5, 7: Somatosensory Association Area (Vice President)
Area 39: Angular Gyrus / Posterior Speech Area (President)
Area 40: Supramarginal Gyrus / Posterior Speech Area (Vice President)

What Brain Areas is the Primary Auditory Cortex?

Area 41, 42

What is Area 41,42

Primary Auditory Area

What is another name often referred to as Area 41, 42?

Heschl Gyrus

What is Area 41, 42 responsible for?

Hearing! Relay station of auditory information

What would a unilteral, bilateral or irritative lesion of Area 41, 42 look like?

Unilateral - mild hearing loss
Bilateral - complete hearing loss
Irritative - buzzing, roaring sensation, auditory hallucination

What Area is Wernicke’s Area / Auditory Association Area?

Area 22 (Vice President to Area 41, 42)

What is Brain Area 22 responsible for?

Wernicke’s Area
- processing of sound
- comprehension of speech

What would a lesion in Area 22 look like?

Wernicke’s Aphasia
Language Comprehension Deficit
- jumbled words
- non-sensical sentences
(can produce speech but words are random and have no association to conversation for both listening and talking)

What are all the Brain Areas located in Temporal Lobe?

Area 41, 42: Primary Auditory Cortex (President)
Area 22: Wernicke’s Area (Vice President)

What Brain Area is the Primary Visual Area?

Area 17

What is Area 17

Primary Visual Area

What is Area 17 responsible for?

Interpreting and processing visual information

What would a lesion in Area 17 look like?

Visual hallucinations
Contralateral homonymous hemianopsia (inability see opposite side of both visual fields)
Cortical blindness

What Brain Areas is responsible for Secondary Visual / Visual Association Area?

Area 18, 19

What is Area 18, 19

Secondary Visual Area

What is Area 18, 19 responsible for?

Further analysis of visual information
Complex processing of visual information
(Vice President to Area 17)

What would a lesion in Area 18, 19 look like?

Visual agnosia
Prosopagnosia (faces)
(Can see object/person, but can’t identify, Ex. See person but don’t know its wife)

What are all the Brain Areas in Occipital Lobe?

Area 17: Primary Visual Area (President)
Area 18, 19: Secondary Visual Association Area (Vice President)

What is considered the “principal relay station for sensory impulse”

Thalamus

The Thalamus can interpret some sensations, including (4)

Pain
Temperature
Touch
Pressure

For individuals with Thalamic Syndrome, they have increased sensitivity to (3):

Pinprick
Heat
Cold

What is considered the body’s master control center that maintains Homeostasis

Hypothalamus

What are some things in the body the Hypothalamus controls?

Body Temperature
Water Balance and Thirst
Circadian Rhythm
Regulates release of hormone from pituitary gland

What acts as the control center in the brain’s basal ganglia network, responsible for managing/stopping uncontrolled movements through motor pathways?

Subthalamus

What is responsible for connecting the limbic system to other brain systems, to regulate sleep, emotions to odors, and drive?

Epithalamus

How many Rexed Laminia are in the spinal cord’s gray matter?

10

What is Lamina 1?

Marginal Zone

Which Lamina responds to noxious or thermal stimuli and sends information to the brain via contralateral spinothalamic tract?

Lamina 1: Marginal Zone

What is Lamina 2?

Substantia Gelatinosa

What Lamina is responsible for pain and temperature via spinothalamic tract and is involved in sensation of noxious and non-noxious stimuli?

Lamina 2: Substantia Gelatinosa

What is Lamina 3?

Nucleus Propius

What Lamina is responsible for proprioception and light touch?

Lamina 3: Nucleus Propius

What is Lamina 4?

Nucleus Propius (same as 3)