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LWBK006-FM[i-xvi].qxd 28/06/2007 02:57 PM Page i TECHBOOKS(PPGQUARK) BOARD REVIEW SERIES NEUROANATOMY 4TH EDITION LWBK006-FM[i-xvi].qxd 28/06/2007 02:57 PM Page ii TECHBOOKS(PPGQUARK) LWBK006-FM[i-xvi].qxd 28/06/2007 02:57 PM Page iii TECHBOOKS(PPGQUARK) BOARD REVIEW SERIES NEUROANATOMY 4TH EDITION James D. Fix, Ph.D. Professor Emeritus of Anatomy Marshall University School of Medicine Huntington, West Virginia Questions Contributor: Deon M. Harvey, Ph.D. LWBK006-FM[i-xvi].qxd 04/21/2008 07:57 PM Page iv Aptara Inc. Acquisitions Editor: Crystal Taylor Managing Editor: Kelly Horvath Marketing Manager: Emilie J. Moyer Production Editor: Beth Martz Design Coordinator: Holly Reid McLaughlin Compositor: Aptara Copyright © 2008 Lippincott Williams & Wilkins 351 West Camden Street Baltimore, Maryland 21201-2436 USA 530 Walnut Street Philadelphia, Pennsylvania 19106 USA All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form or by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner. The publisher is not responsible (as a matter of product liability, negligence, or otherwise) for any injury resulting from any material contained herein. This publication contains information relat- ing to general principles of medical care which should not be construed as specific instructions for individual patients. Manufacturers’ product information and package inserts should be reviewed for current information, including contraindications, dosages, and precautions. Printed in China Library of Congress Cataloging-in-Publication Data Fix, James D. Neuroanatomy / James D. Fix.—4th ed. p. ; cm. — (Board review series) Includes bibliographical references and index. ISBN-13: 978-0-7817-7245-7 ISBN-10: 0-7817-7245-1 1. Neuroanatomy—Examinations, questions, etc. I. Title. II. Series. [DNLM: 1. Neuroanatomy—Examination Questions. WL 18.2 F566n 2002] QM451 .F59 2002 611Ј.8Ј076—dc21 2001037710 The publishers have made every effort to trace the copyright holders for borrowed material. If they have inad- vertently overlooked any, they will be pleased to make the necessary arrangements at the first opportunity. We’d like to hear from you! If you have comments or suggestions regarding this Lippincott Williams & Wilkins title, please contact us at the appropriate customer service number listed below, or send correspondence to [email protected]. If possible, please remember to include your mailing address, phone number, and a reference to the book title and author in your message. To purchase additional copies of this book call our customer service department at (800) 638-3030 or fax orders to (301) 824-7390. International customers should call (301) 714-2324. 2 3 4 5 6 7 8 9 10 LWBK006-FM[i-xvi].qxd 28/06/2007 02:57 PM Page v TECHBOOKS(PPGQUARK) To Ilse, for her constant support and understanding. LWBK006-FM[i-xvi].qxd 28/06/2007 02:57 PM Page vi TECHBOOKS(PPGQUARK) Preface BRS Neuroanatomy, fourth edition, is a concise review of human neuroanatomy intended prima- rily for medical and dental students preparing for the United States Medical Licensing Examination (USMLE) Step 1 and other examinations. It presents the essentials of human neu- roanatomy in a concise, tightly outlined, well-illustrated format. There are over 600 board-type questions with complete answers and explanations, some included at the end of each chapter and some in a comprehensive examination at the end of the book. New to This Edition • Magnetic resonance angiograms • Color used throughout to enhance neuroanatomic pathways • Color used to block in tables and highlight clinical correlations • Cerebellar atrophies • Localization of sensory disorders To the Student To make the most of this book, carefully study the illustrations, computed tomography scans, magnetic resonance images, and angiograms, as well as the figure legends; much of the board question information lies within the images and legends. The answers to at least 30 common USMLE questions are outlined below; refer to these tips as you review the chapters: Chapter 1: The mini-atlas provides you with the essential examination structures labeled on computed tomography scans, magnetic resonance images, and gross stained sections. Chapter 2: Meninges and cerebrospinal fluid (CSF). Three membranes envelop the brain and spinal cord. What is their function? CSF is produced by the choroid plexus and absorbed by the arachnoid villi that jut into the dural venous sinuses. Name a noninvasive tumor that arises from the arachnoid granulations. Distinguish between normal-pressure hydrocephalus and pseudotumor cerebri (benign intracranial hypertension). Chapter 3: Blood supply of the central nervous system (CNS). The essential arteries and the functional areas that they irrigate are shown: The anterior spinal artery (ASA) perfuses the ante- rior two-thirds of the spinal cord including the corticospinal and spinothalamic tracts. In the medial medulla the ASA supplies the corticospinal tract and medial lemniscus. In the lateral medulla the posterior inferior cerebellar artery (PICA) irrigates the nucleus ambiguus, the inferior cerebellar peduncle, spinal trigeminal nucleus and tract, and the spinothalamic tract. In the pos- terolateral pons the PICA irrigates the nucleus of facial nerve, nucleus and tract of the trigeminal nerve. In the rostral midbrain the posterior cerebral artery (PCA) irrigates the intra-axial fibers of cranial nerve III and the corticospinal tracts. Know the arterial circle of Willis! What is the most common cause of nontraumatic intraparenchymal hemorrhage? Study the distribution of the anterior, medial, and posterior cerebral arteries! vi LWBK006-FM[i-xvi].qxd 28/06/2007 02:57 PM Page vii TECHBOOKS(PPGQUARK) PREFACE vii Chapter 4: Development of the nervous system. The neural tube (neuroectoderm) gives rise to the CNS. Failure of the neuropores to close results in neural tube defects such as anen- cephaly. Name the derivatives of the neural crest. Know the following congenital malfunc- tions: spina bifida, meningohydroencephalocele, Arnold-Chiari, and Dandy-Walker mal- functions. Chapter 5: Neurohistology. Where are pseudounipolar and bipolar neurons found? What is Wallerian degeneration? What is Nissl substance? Hortega cells arise from monocytes, which enter the CNS via abnormal blood vessels. Schwann cells are myelin-forming periph- eral neuroglial cells. The glioblastoma multiforme is the most rapid-growing and fatal glioma. Chapter 6: The adult spinal cord terminates (conus terminalis) at the lower border of the first lumbar vertebra. The newborn’s spinal cord extends to the third lumbar vertebra. The adult cauda equina extends from vertebral levels L2 to Co. Chapter 7: Tracts of the spinal cord are reduced to four: corticospinal tract, spinothalamic tract, dorsal column-medial lemniscus, and hypothalamospinal tract. Transection of this descending autonomic tract results in Horner syndrome. Chapter 8: Lesions of the spinal cord. Review the eight classic national board lesions of the spinal cord: poliomyelitis, multiple sclerosis, dorsal column disease (syphilis, locomotor atax- ia, tabes dorsalis), amyotrophic lateral sclerosis (ALS), hemisection of spinal cord (Brown- Séquard syndrome), subacute combined degeneration (vitamin B12 neuropathy), syringomyelia, and anterior (ventral) spinal artery syndrome. Chapter 9: Brainstem. Study the transverse sections of the brainstem and localize the cranial nerve nuclei. Study the ventral surface of the brainstem and identify the exiting and entering cra- nial nerves. On the dorsal surface of the brainstem, identify the only exiting cranial nerve, the trochlear nerve. Chapter 10: Trigeminal system. The trigeminal nerve (CN V) is the largest cranial nerve. Which is the smallest? Name the afferent and efferent limbs of the corneal and jaw jerk reflexes. Study the sensory pathway of the ventral trigeminothalamic tract. Where is the cave of Meckel? What is tic douloureux? Trigeminal neuralgia? Which trigeminal nerve branches pass through the cav- ernous sinus? Chapter 11: Auditory system. Study the auditory pathway and its way stations: hair cells of the organ of Corti S cochlear nuclei S superior olivary nucleus S lateral lemniscus S nucleus of inferior colliculus S brachium of inferior colliculus S medial geniculate body S auditory radia- tions S auditory cortex, transverse gyrus of Heschl, Brodmann areas 41 and 42. Chapter 12: Vestibular system. Study the vestibular pathways; recall the anatomy and function of the sensory hair cells found in the utricle and saccule. Lesions of the vestibular system result in nystagmus. What is vestibular, postrotational, optokinetic and caloric nystagmus? What is Ménière disease? What is benign positional vertigo? Chapter 13: Cranial nerves and their major functions: CN I smells. CN II sees. CN III moves the eyeball and elevates the upper eye lid. CN IV depresses, intorts, and abducts the eyeball. CN V provides sensory innervation of the face and innervates the muscles of chewing. CN VI abducts the eyeball. CN VII moves the face, tastes, salivates, and cries. CN VIII hears and mediates bal- ance. CN IX tastes, swallows, and mediates input from the carotid sinus that via baroreceptors regulate arterial blood pressure. It also mediates input from the carotid body that monitors the carbon dioxide and oxygen concentration of the blood. CN X phonates, swallows, and innervates LWBK006-FM[i-xvi].qxd 28/06/2007
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