Ab main apne knowledge se saare important questions ke short, exam-ready answers dunga:
🧠 NEURO ANATOMY — IMP QUESTIONS & ANSWERS
1. INTERNAL CAPSULE
Parts:
- Anterior limb — frontopontine + thalamocortical fibres
- Genu — corticobulbar fibres (face)
- Posterior limb — corticospinal fibres (arm > leg), thalamic radiations
- Retrolenticular — optic radiations
- Sublenticular — auditory radiations
Blood Supply:
- Lenticulostriate arteries (MCA branch) — main supply
- Anterior choroidal artery — posterior limb
Lesion:
- Contralateral hemiplegia (face + arm + leg)
- Genu lesion → facial weakness + dysarthria
2. CORPUS CALLOSUM
Parts: Rostrum → Genu → Body → Splenium
Functions:
- Connects two cerebral hemispheres
- Transfers sensory, motor, cognitive information
Lesion (Callosal Disconnection):
- Left hand apraxia
- Alexia without agraphia (splenium lesion)
3. THALAMUS
Important Nuclei:
| Nucleus | Function |
|---|
| VPL | Body sensation |
| VPM | Face sensation |
| LGN | Vision |
| MGN | Hearing |
| VA/VL | Motor (cerebellar relay) |
| Pulvinar | Visual association |
Lesion: Contralateral hemisensory loss, thalamic pain syndrome
4. HYPOTHALAMUS
Nuclei & Functions:
| Nucleus | Function |
|---|
| Supraoptic | ADH secretion |
| Paraventricular | Oxytocin |
| Anterior | Heat loss (cooling) |
| Posterior | Heat conservation |
| Lateral | Hunger centre |
| Ventromedial | Satiety centre |
| Suprachiasmatic | Circadian rhythm |
Clinical: Diabetes insipidus (ADH loss), Frohlich syndrome
5. BASAL GANGLIA
Components:
- Caudate nucleus
- Putamen → together = Striatum
- Globus pallidus
- Subthalamic nucleus
- Substantia nigra
Function: Control of voluntary movement, posture, tone
Lesions:
- Parkinson's disease — substantia nigra (dopamine loss)
- Huntington's — caudate nucleus (GABA loss)
- Hemiballismus — subthalamic nucleus lesion
6. CEREBELLUM
Lobes:
- Anterior lobe — spinocerebellum (tone, posture)
- Posterior lobe — cerebrocerebellum (skilled movements)
- Flocculonodular lobe — vestibulocerebellum (balance)
Deep Nuclei (medial to lateral):
- Fastigial → Globose → Emboliform → Dentate
- Mnemonic: "Feel Good Every Day"
Peduncles:
- Superior — output (to thalamus)
- Middle — input (from cortex via pons)
- Inferior — input/output (to/from medulla)
Lesion (IPSILATERAL):
- Ataxia, Dysmetria, Intention tremor
- Dysdiadochokinesia, Nystagmus
- Hypotonia
7. CIRCLE OF WILLIS
Arteries:
- Anterior: 2x ACA + 1x ACoA
- Posterior: 2x PCA + 2x PCoA + 2x ICA
Clinical:
- Aneurysm most common at ACoA
- 3rd nerve palsy → PCoA aneurysm
8. BLOOD-BRAIN BARRIER (BBB)
Structure:
- Tight junctions between endothelial cells
- Astrocyte foot processes
- Basement membrane
What crosses BBB:
- Lipid soluble substances (O2, CO2, alcohol)
- Water, glucose (carrier mediated)
What doesn't cross:
- Proteins, bacteria, most drugs
Where BBB is absent (CVOs):
- Area postrema (vomiting centre)
- Neurohypophysis, Pineal gland
9. PYRAMIDAL TRACT (Corticospinal Tract)
Origin: Motor cortex (Betz cells, area 4)
Course:
- Corona radiata
- Internal capsule (posterior limb)
- Cerebral peduncle (middle 3/5)
- Pons (scattered bundles)
- Pyramid of medulla
- Decussation at lower medulla (85%)
- Lateral corticospinal tract → spinal cord
Lesion (UMN):
- Spasticity, hyperreflexia
- Babinski sign positive
- No muscle wasting
10. SPINOTHALAMIC TRACT
| Anterior | Lateral |
|---|
| Carries | Crude touch, pressure | Pain, temperature |
| Crosses | Same level | Same level (1-2 segments up) |
| Lesion | Crude touch loss | Pain/temp loss contralateral |
11. DORSAL COLUMN (Posterior Funiculus)
Carries: Fine touch, vibration, proprioception, 2-point discrimination
Pathway:
- Fibres enter → ascend SAME side → nucleus gracilis/cuneatus (medulla) → decussate → medial lemniscus → thalamus (VPL)
Lesion: Ipsilateral loss of fine touch + proprioception
Conditions: Tabes dorsalis, Subacute combined degeneration (B12 deficiency)
12. BROWN-SEQUARD SYNDROME (Cord Hemisection)
| Finding | Side |
|---|
| UMN signs (spasticity) | Ipsilateral (below lesion) |
| Fine touch/proprioception loss | Ipsilateral |
| Pain/temperature loss | Contralateral (1-2 levels below) |
13. CSF — IMPORTANT FACTS
| Parameter | Normal Value |
|---|
| Pressure | 60–150 mmH₂O |
| Volume | 150 mL total |
| Formed by | Choroid plexus (lateral ventricles) |
| Absorption | Arachnoid granulations |
| Protein | 15–45 mg/dL |
| Glucose | 2/3 of blood glucose |
| Cells | 0–5 lymphocytes |
Circulation: Lateral ventricles → Foramen of Monro → 3rd ventricle → Aqueduct of Sylvius → 4th ventricle → Foramina of Luschka & Magendie → Subarachnoid space
14. LUMBAR PUNCTURE
Level: L3-L4 or L4-L5 interspace
Structures pierced (skin to subarachnoid):
- Skin
- Superficial fascia
- Supraspinous ligament
- Interspinous ligament
- Ligamentum flavum
- Epidural space
- Dura mater
- Arachnoid mater
- Subarachnoid space ✓
15. FACIAL NERVE (VII)
Nucleus: Pons
Course: IAM → Facial canal → Stylomastoid foramen → Face
Branches: "To Zanzibar By Motor Car"
- Temporal, Zygomatic, Buccal, Marginal mandibular, Cervical
UMN vs LMN Palsy:
| UMN | LMN |
|---|
| Forehead | Spared | Involved |
| Cause | Stroke | Bell's palsy |
| Side | Contralateral | Ipsilateral |
16. CRANIAL NERVES — QUICK TABLE
| CN | Name | Type | Function |
|---|
| I | Olfactory | Sensory | Smell |
| II | Optic | Sensory | Vision |
| III | Oculomotor | Motor | Eye movement, pupil |
| IV | Trochlear | Motor | Superior oblique |
| V | Trigeminal | Both | Face sensation, chewing |
| VI | Abducens | Motor | Lateral rectus |
| VII | Facial | Both | Face expression, taste |
| VIII | Vestibulocochlear | Sensory | Hearing, balance |
| IX | Glossopharyngeal | Both | Taste, swallowing |
| X | Vagus | Both | Autonomic, voice |
| XI | Accessory | Motor | SCM, trapezius |
| XII | Hypoglossal | Motor | Tongue movement |
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