Clinical Neuroanatomy Revision for Year 2

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Questions and Answers

Which structure is primarily responsible for coordination and balance?

  • Basal Ganglia
  • Brainstem
  • Cerebellum (correct)
  • Cerebrum

The primary motor tracts in the spinal cord are called corticospinal tracts.

True (A)

What is the function of sensory tracts in the spinal cord?

To carry sensory information from the body to the brain.

The _______ is responsible for the transmission of signals to muscles at the neuromuscular junction.

<p>nerve</p> Signup and view all the answers

Match the following nerve roots with their corresponding muscle actions:

<p>C5 = Elbow flexion C6 = Radial wrist extension C7 = Wrist flexion C8 = Ulnar deviation</p> Signup and view all the answers

In which sensory tract would you find the sensing of light touch and vibration?

<p>Sensory tracts 1 (C)</p> Signup and view all the answers

The basal ganglia primarily control aspects of speech.

<p>False (B)</p> Signup and view all the answers

What is the term used for the area of skin that is supplied by a single spinal nerve root?

<p>Dermatome</p> Signup and view all the answers

Which muscle is primarily tested for hip flexion at the L1 and L2 nerve roots?

<p>Psoas (C)</p> Signup and view all the answers

The L4 nerve root is responsible for ankle dorsiflexion.

<p>True (A)</p> Signup and view all the answers

List the primary muscle associated with hip extension at the L5 nerve root.

<p>Gluteus maximus</p> Signup and view all the answers

The _____ nerve root is associated with the back, upper buttock, anterior thigh, and knee.

<p>L3</p> Signup and view all the answers

Match the following nerve roots with their corresponding dermatomes:

<p>L1 = Back, over trochanter and groin L2 = Back, front of thigh to knee L3 = Back, upper buttock, anterior thigh and knee L4 = Medial buttock, lateral thigh, medial leg</p> Signup and view all the answers

What is the dermatome for the T1 nerve root?

<p>Base of little finger (D)</p> Signup and view all the answers

The function of the somatic nervous system is limited to involuntary reflexes.

<p>False (B)</p> Signup and view all the answers

The muscle test associated with the L5 nerve root is _____ dorsiflexion.

<p>ankle</p> Signup and view all the answers

Flashcards

L1 Nerve Root

Nerve root L1 supplies sensory information to the back, over the trochanter, and the groin. It also innervates the psoas muscle.

L2 Nerve Root

Nerve root L2 supplies sensory information to the back, front of the thigh to the knee, and innervates the psoas muscle. It also contributes to hip flexion.

L3 Nerve Root

Nerve root L3 supplies sensory information to the back, upper buttock, anterior thigh, medial lower leg, and knee. It innervates the psoas, quadriceps, and hip adductor muscles.

L4 Nerve Root

Nerve root L4 supplies sensory information to the medial buttock, lateral thigh, medial leg, dorsum of the foot, and big toe. It innervates the tibialis anterior, extensor hallucis longus, and gluteus medius muscles.

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L5 Nerve Root

Nerve root L5 supplies sensory information to the buttock, posterior and lateral thigh, lateral aspect of the leg, dorsum of the foot, and medial half of the sole, first, second, and third toes. It innervates the extensor hallucis longus, peroneals, and hamstring muscles.

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Somatic Nervous System

Function: Provides sensory information about touch, pain, and temperature to the skin. It also controls movement of the skeletal muscles.

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Dermatome

The region of skin supplied by the sensory fibers of a specific spinal nerve.

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Myotome

The group of muscles that are innervated by a specific spinal nerve.

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Planes of orientation

The three planes of orientation in anatomy are sagittal, axial, and coronal.

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What is the visual pathway?

The visual pathway is the complex network of structures that allows us to see. It starts with photoreceptors in the retina, travels through the optic nerve, optic chiasm, optic tracts, and finally reaches the visual cortex in the brain.

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Lesion of the optic pathway

A lesion in the optic pathway can cause various visual impairments depending on the location of the damage. This could include blindness in one eye, loss of peripheral vision, or even complete blindness.

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What are the key brain areas involved in speech?

The speech production process involves complex interactions between various brain regions, including Broca's area (language production), Wernicke's area (language comprehension), and the motor cortex (speech articulation).

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What is the spinal cord?

The spinal cord is a long, cylindrical bundle of nerves that extends from the brainstem down to the lower back. It acts as a central communication pathway between the brain and the rest of the body, transmitting sensory and motor information.

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How is the spinal cord organized?

The spinal cord is organized into segments, with each segment responsible for specific functions related to sensory input and motor output in a corresponding body region.

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What does the dorsal column-medial lemniscus pathway carry?

The dorsal column-medial lemniscus pathway carries information about light touch, vibration, and proprioception (sense of body position) from the periphery to the brain.

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What information does the spinothalamic tract carry?

The spinothalamic tract carries information about pain and temperature sensations from the periphery to the brain.

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Study Notes

Aims of Clinical Neuroanatomy Revision

  • Review of year 2 HHN block
  • Provide clinically relevant brain anatomy
  • Summarize neuroanatomy of special functions (vision and speech)
  • Highlight clinically important spinal neuroanatomy features
  • Show patterns of sensory loss
  • Briefly cover plexus anatomy

Components of the Nervous System

  • Brain: Cerebrum, Cerebellum, Basal Ganglia, Brainstem
  • Periphery: Plexus, Nerves (arms and legs), Neuromuscular Junction (NMJ), Muscle
  • Spine and Tracts: Spinal cord structures and pathways

Brain Structures (Diagrammed)

  • Ventricles: Interventricular foramen, Third ventricle, Cerebral aqueduct, Fourth ventricle
  • Cisterns: Interpeduncular cistern, Pontine cistern, Cisterna magna
  • Sinuses: Superior sagittal sinus, Straight sinus, Confluence of sinuses, Subarachnoid space
  • Spinal Cord Structures: Central canal, Conus medullaris, Filum terminale, Spinal cistern

Brain Lobes (Diagrammed)

  • Frontal Lobe, Parietal Lobe, Temporal Lobe, Occipital Lobe, Cerebellum, Medulla, Hypothalamus, Thalamus, Limbic Lobe, Diencephalon, Optic nerve (CN II), Optic chiasm, Olfactory bulb (CN I)

Brain Regions and Function

  • Primary Motor Area: Located in the frontal lobe
  • Association Areas: Involved in advanced cognitive functions
  • Visual Areas: Located in the occipital lobe
  • Language centers: -Broca's Area: Speech production -Wernicke's Area: Language comprehension
  • Sensory and Auditory Areas: Located in the parietal and temporal lobes, respectively
  • Long Term Memory: Located in the brain’s limbic structures

Cranial Nerve Functions

  • Vision: Summarized
  • Speech: Detailed in separate slide

Visual System

  • Contralateral visual fields project onto the temporal/lateral portion of each retina
  • Ipsilateral visual fields project onto the nasal/medial portion of the retina
  • Optic nerve carries information from the ipsilateral eye
  • Optic tract contains the fibers from the contralateral visual field
  • Optic radiations project from the lateral geniculate body to the primary visual cortex

Lesions of the Optic Pathway

  • Monocular vision loss: Loss of complete visual field in one eye
  • Bitemporal hemianopia: Loss of temporal visual field in both eyes due to chiasm lesion
  • Contralateral homonymous hemianopia: Loss of contralateral visual field in both eyes due to optic tract lesion
  • Quadrantanopia: Partial visual field defects

Speech Pathways

  • Broca’s area for speech production
  • Arcuate fasciculus for speech connection
  • Wernicke’s area for language comprehension
  • Corticobulbar tract for motor signals to the bulbar muscles

Brainstem Anatomy

  • Tectum with superior and inferior colliculi
  • Midbrain: Cerebral aqueduct
  • Pons: Pyramids, Basal Pons
  • Medulla: Pyramids, Tegmentum

Spinal Cord

  • Cervical enlargement, Thoracic, Lumbar, Sacral enlargement
  • Spinal Cord Regions: Cervical (C1-C8), Thoracic (T1-T12), Lumbar (L1-L5), Sacral (S1-S4)
  • Epidural space (fat, venous plexus) , Dura Mater , Pia Mater , Subarachnoid space (CSF ) , Spinal Meninges
  • Spinal Ganglion (sensory neuron cell bodies) , Posterior Roots (sensory)
  • Anterior Roots (motor)

Spinal Tracts

  • Sensory pathways: Ascending fibers, Fasciculus gracilis (lower limb), Fasciculus cuneatus (upper limb) , Spinocerebellar Tract, Lateral corticospinal tract, Spinothalamic tract
  • Motor pathways: Descending fibers, Anterior corticospinal tract (uncrossed), Lateral corticospinal tract (crossed)

Sensory Pathways (Light touch, vibration, proprioception) and (Pain and temperature)

  • Light touch, vibration, and proprioception pathways are mainly medial lemniscus
  • Pain and temperature pathways are mainly anterolateral system

Motor Tracts (Corticospinal)

  • Corticospinal tract (primary motor cortex)
  • Pyramid decussation (crossing of fibers to Lateral Corticospinal tract)
  • Anterior corticospinal tract (uncross)
  • Lateral and Anterior cortiospinal tract termination on lower motor neurons at the anterior horn.

Patterns of Sensory Loss (diagrammatic)

  • Generalized peripheral neuropathy
  • Sensory root lesion
  • Single dorsal column lesion
  • Transverse thoracic spinal cord lesion
  • Unilateral cord lesion (Brown-Sequard)
  • Central cord lesion
  • Mid-brain stem lesion
  • Hemisphere (thalamic) lesion

Peripheral Nerves (Brachial Plexus) and (Lumbar Plexus)-Diagrammed

  • Brachial Plexus with specific nerves and branching diagrams
  • Lumbar Plexus

Somatic Nervous System Function

  • Nerve root, dermatome, and myotome association

  • Tables displaying nerve roots, dermatomes, myotomes and associated muscle functions

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