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Flashcards in neuro cortex - neuro-oncology Deck (41)
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1
Q

where is the embryological origin of the cerebrum?

A

telencephalon

2
Q

where is the primary motor area located?

A

precentral gyrus in the frontal lobe

3
Q

what is located in the inferior frontal gyrus?

A

broca’s area - important for language production

4
Q

what happens if broca’s area is damaged?

A

expressive dysphasia (the patient can comprehend words but produces faulty sentences and phonemic errors) eg parket vs carpet

5
Q

where is the postecentral gyrus located? and what does it contain?

A

parietal lobe

contains the primary soamtosensory area

6
Q

damage to which area causes nominal aphasia?

A

inferior parietal lobule

7
Q

what is nominal aphasia?

A

problems recalling words, name and numbers

8
Q

what is in the superior temporal gyrus?

A

the auditory area of the cortex and Wernicke’s speech area in the dominant hemisphere (left)

9
Q

what does damage to Wernick’es area cause?

A

receptive dysphasia - impaired comprehension but speech is fluent

10
Q

what does the limbic system do?

A

emotional functions and memory system

11
Q

which important structures are located in the limbic?

A

cingulate gyrus and hippocampus

12
Q

where embryologically does the cerebellum come from?

A

metencephalon

13
Q

which structure separates the cerebrum from the cerebellum?

A

tentori cerebelli

14
Q

which 3 components is the cerebellum divided into?

A

vestibulocerebellum
spinocerebellum
cerebrocerebellum

15
Q

what does the vestibulocerebellum do?

A

recieves input fro the vestibular organs for the maintanence of balance and coordinating vestibule ocular reflexes

16
Q

what does the spinocerebelum do?

A

maintains muscle tone and participates in posture and gait

17
Q

what does the cerebrocerebellum do?

A

coordination of voluntary motor activity and correct any error in the movements to ensure they are smoothly executed

18
Q

which mneumonic is used to rememer the symptoms produced by cerebellar dysfunction?

A

DANISH
d - dysdiadochokineasia = impairment of rapid alternating movements (ask patient to perform quick, alternating pronation and supination of the hand)
a - ataxia (broa-based gait)
n - nystagmus (carry out the H test for extraoccular muscle function)
i - intention tremor (ask patient to do the finger-nose test)
s - scanning dysarthria - patient speaks slowly with poor articulation of speech
h - hypotonia - reduced tone

19
Q

which structures come from the diencephalon?

A

thalamus, hypothalamus, subthalamus, epothalamus

20
Q

which 3 systems does the hypothalamus influence?

A
  • autonomic nervous system
  • endocrine system
  • limbic system
21
Q

which symptoms arise from lesions to the subthalamic nuclei?

A

contralateral hemiballism - flinging movements of the upper and lower limbs on 1 side of the body

22
Q

which are the main diseases affected by lesions to the basal ganglia and surrounding structures?

A

parkinson’s and huntington’s

23
Q

a tumour / lesion/ stroke in the frontal lobe will present with which symptoms?

A
  • contralateral weakness due to deficit in the primary motor cortex
  • personality changes including disinhibition and cognitive slowing
  • urinary incontinence
  • gaze abnormalities
  • expressive dysphasia / aphasia for left sided lesions if Broca’s area is involved
  • seizures
24
Q

a tumour / lesion / stroke in the temporal lobe will present with which symptoms?

A
  • memory deficits
  • receptive aphasia / dysphasia for left sided lesions if Wernikie’s area is involved
  • contralateral superior quadrantopia
  • seizures
25
Q

a tumour / lesion / stroke in the parietal lobe will present with which symptoms?

A
  • contralateral weakness and sensory loss due to deficit in the primary somatosensory cortex
  • contralateral inferior quadrantopia
  • dyscalculi (difficulty understanding maths), dysgraphia (unable to write), finger agnosia (unable to distinguish fingers) and left-right disorientation (confusion between right and left limbs) if dominant lobe is affected - GERSTMANN SYNDROME
  • neglect (deficit in awareness of one side of the body), dressing apraxia and constructional apraxia - if nondominant lobe affected
26
Q

a tumour / lesion / stroke in the occipital lobe will present with which symptoms?

A
  • contalateral homonymous hemianopia

- visual hallucinations

27
Q

a tumour / lesion / stroke in the cerebellum will present with which symptoms ?

A
  • ipsilateral ataxia
  • nausea and vomiting
  • dizziness and vertigo
  • slurred speech
  • intention tremor
28
Q

what is the WHO grading?

A

I - no morphological features
II - atypia alone
III - atypia and mitosis
IV - atypia and mitosis with vascular proliferation or necrosis

29
Q

what are the most common primary brain tumours?

A
  • high grade glioma (grade III eg anaplastic astrocytoma) or IV eg glioblastoma multiforme)
30
Q

who gets glioblastoma multiforme?

A

60-70 year olds

31
Q

what do glioblastomas look like on MRI?

A

butterfly appearance

32
Q

what are the most common low grade gliomas?

A

pilocytic astrocytomas (grade 1) and diffuse astrocytoma or oligodendrogliomas (WHO grade II)

33
Q

who gets pilocytic astrocytomas?

A

children and young adults

34
Q

what is the appearance of pilocytic astrocytomas?

A

bipolar cells with long hair-like projections

35
Q

what is the most common site for pilocytic astrocytomas?

A

cerebellum and midline stuctures eg thalamus or optic chaism

36
Q

in which condition are optic pathway gliomas seen in ?

A

NF1

37
Q

what are diffuse astrocytes (grade II)?

A
  • have the potential to transform to high grade gliomas
  • slow growing
  • seizures
38
Q

what is an oligodendroglioma?

A
  • best prognosis
  • frontal lobe of cerebral hemisphere
  • can invade the subarachnoid space leading to a white toothpaste appearance
  • seizures + headaches
39
Q

what is a meningioma?

A
  • originate from the arachnoidal cap cells within the arachnoid membrane
  • common in elderly
  • high risk in patients with NF2
  • headahce
40
Q

what is an acoustic neuroma?

A
  • benign tumour derived from schwann cells
  • arise in cerebellopontine angle
  • if bilateral and young - NF2
41
Q

what is a haemangioblastoma?

A
  • benign, cystic, highly vascular tumours
  • develop in posterior fossa, leading to cerebellar dysfunction symptoms and raised ICP
  • associated with hippel landau syndrome