High Yield Neuroanatomy 2nd Edition

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    41 *4 & IPPINCOTT WILLIAMSoWILKINSA Wolterr Kluwcr CompanyPhiladelphia Baltimore New York LondonBuenos Aires Hong Kong Sydney Tokyo

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    Acquitirions Editor: Eli~abcth . NicginrkiEditorid Directoroj Detuhplnm~t: ulie hdnrtinerDcrvL~pnmtEditor: Karln h4. Schroedcr .Srr~ior\tamgirrg Editor:Alny G. Dinkel

    a Co&t-ight0I&W by Lippincott \Villiims & Wilkips.

    All rights reserved. +is &k is prcltectd by copyright. No part of it mayk rduc ed. storedin a rerrieval $-stem, or tn ns rn it rd , in any form or by any means -elec tronic, mech;lnical,p h o r ~ o p y ,ecording. or othenrise--without the prior written permission of the publisher, ex -cept forbriefquotations einturdied in critical articles, reviews, and testing and e\.nluation ma-teriaL by th e publisher r o sch=ls that have adopted its accompanying tex tbook.Print& in h e United States of America. For information, \\-rite Lippincon Will iams &W i l k h , 227 East Washington Square. Philadelphia, PA 191@6.~ i t e r i a l sppearing in this b c d repared by individuals as part of their official duties as U.S. =Go\-ernnenc employees are not covered by the ah- e-m ent ion ed copyright.

    Fix, JaiiesD.Hish-yield n~~tronnatomyJames D. Fix.-2nd ed. - . ..--..---p. ; m. - High-yield series) - :.:-Includes index.ISBN @-653-30721-51. Neuroanatom).-Ourlines, syllabi. etc. 2. N euroanatomy-Examinations. questions.

    ecc I. Title. 11. Series.iDNLh!: I. Nervous System-anatomy Sr histology-Esamination Questions. 2.Xervous Sptem-anatomy & histolo~--Outlines.3. Nen-ous SystemDiseasec-Esamination Questions. 4. Nervous System Diseasej--Outlines. \WL 18.2

    Fj66h ZkW]Qxftjl .F%8 2039 .61 1 .Sf07f;~2l 99-051352Care has been caken to confirm the accuracy of th e information presented and to desc ribe

    generally accepted practices. However, th e authors, edirors, and publisher 2re nor responsible .fcr erron or omissions or for any consequences from application of the information in this bookand make no u.arranc)., express or implied. u it h respect to the c ontena of th e publicat ion.The authors, editors, and publisher have ese ned ever{ efforr ro ensure that drug se lec tion *and do s g e set forth in this text.are in accordance with current recommendations and p rac tic eat the time of pubiicacion. However, in view of ongoing research, changes in governmen: reg-ulations, and the constant flow of information relating to drug therapy and drug reactions , t hereader is urged to check the ~ackagenserr for each drug for any change in indications anddosage and for added warnings and precautions. Th is is particularly important when ch i rec-ommended agen: is a new or infrequently ernploycd drug.

    Some drugs and 5e di wl devices presented in this publication have F d nd Drug Adminixration (FDA) clearance for limited use in restrictcli research settings. It is the resens i- .biliry of the heal th care provider to ascertain the FDA status of each drug or device p lahned 'for use in their clinical practice.

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    . . . .4 .1 Th e second edition of Hi.&-Yield Ne~t roni~aro~~lvs still neuronnatainv at its irreduc;ibleminimum. cI ' raining most, if not a ll, of th e nationa l board themes. T he sole purpose of t he book is to getthrough the nert-ous system topics covered on the Uniced States Medical Licensing Exatnina(USMLE) Step 1. Substi~nt ial dditions ha\-e been inade to accointnodate s tudent requests and

    gestions.

    N E W TO THIS EDITION . .Mini-atlas of nuclear ~nag neti cnlasing scansCarorid and vertebra l digital subtraction angiographyNuclear magnetic angiopra~h!- .1 Additional figures of cranial nen-e function conlponents .Chap ter o n aphasia. aprasia. and dysprosodyIndex

    J TO THE STUDENTTo make the most. of chis book, study the illustrations, computed tomography scans, and magnresonance images carehlly, and read the legends. Many board-type questions come from this souIn fact, the answers to a t least 20 common USMLE questions are found wichin this preface. Finremember these tips as you scan the chapters:Chapter I: T h e mini-at las provides you \vith the essential examination strucrures labeled on cpuced tomography scans and magnetic resonance images.Chogter 2: Cerebrospinal fluid pach\vays are \\'ell demonstrated in Figure 2-1. Cerebrospinal fluiI produced by the choroid plesus and absorbed by the arachnoid villi that jut into the venous sinuChapter 3: T h e essent ial arteries and the functional areas that they irrigate are shown. Study carotid and verrebral angiograms and the epidural and subdural hematomas in computed tomograscans and magnetic resonance images. .I Chapter 4: The neural crest and its derivatives, the dual origin of the pituitary gland, and the dif1 ence between spina bifida and the Arnold-Chiari ~nalformation re presented. Study the figures tillustrate the Arnold-Chiari and Dandy-Walker malformations.Chnprer 5 : What is t he dif ference betiyeen Lewy and Hirano bodies'? Nerve cells contain Niss! s

    I stance in the ir perikaq-a and dendrites, but not in their axons. Remember tha t Nisslsubstance (roendoplasmic reticulum) plays a role in protein synthesis. Study Figure 5-2 on the localization pre\*alenceof common bra in and spinal cord tumors. Remember that, in adults, glioblascoma muI fortne is che most c om mo n brain tumor, follo\\~ed y astrocycoma and meningioma. In children,trocyroma is the most common brain tumor, followed by rnedulloblastoma and ependymoma. In J spilial cord, ependymoma is the most common tuhor.I Chnptcr 6: Tile adult spinal cord tcrrninatcs (conus ter~ninalis)c the lo\ver border of th e first lumI \vertebra. Thc newborn's spinal cord extends to thc third lumbar vcrtcbra. In adul ts, th e cauda equcsrentls froni \-crtcbral le\*clsL-2 to Co.

    Cliaf)tC)' : The tracts of th e spinal cord arc rcduccd to four: corticospinnl (pyramidal ), dorsal co!::-:npnii~ l l c l tctnpcraturc, and Horncr's. Know the111cold.

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    . -I"CG.-.-...-...............................:............:...................,..............*- - - ...- L L L ~ - C ~ ~ L I I I I ilrc v n B A - e r g i c . In Alzhei l ll r rk d isease , ther e i s n lonccr) . lcbol inrrg ic nc t~ronr n tllr 1.nsal nucleus of Mcynerr. In Parkinson's disease, there is n lodopnminc rg ic ne t lmns in th e s i~ l, )mnrinnigr;,.

    ~ h n p r k r3: This c11;r~re idescr ihzshe corricnl locslirilrion of fitnctionnl a re is of rl;e hrnin. Holv. t h e do nl in nn t h e o ~ i s ~ ~ l ~ r r eiffer frolll th e nonti.ominnnr hemisp here? Figure 23-4 slrows t he effevario us lllajor llelnisplreric lesions: \Vllat s!-nlproms result froin n lesiorr of th e infer ior parlobe ! \Vha t is G e n r m a n n i sy trd rome?

    n Chnprcr 24: This c l l i~p te r escri1 .e~ n p m s i ~ ' * . .i i - - -: . aphasia f r6m W emicke ' s nphasia .'Whrr is cvn uuc rlolr aphasiil! 1his is h ~ n r d - r ~ l ~ ~ ~ ~aterial .I wish you good luck.--

    . . JatncsD. Fix

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