Chapter 2.1 · Neuroanatomy

Brain Regions & Functions — INBDE Review

Cortical lobes, basal ganglia, limbic system, brainstem, cerebellum, and vascular territories — with the lesion patterns that show up most often on the INBDE. 11 board-style MCQs.

11 practice MCQsQuick-reference tableMnemonics + clinical pearlsFull distractor explanations
High-yield review

Concept summary & clinical relevance.

Quick-reference structure first, then nerve-by-nerve detail. Mnemonics in amber, clinical pearls in blue.

Brain regions are best learned by what they do — and what shows up clinically when they're damaged. Lesion-based reasoning is what the INBDE tests: aphasia patterns, hemineglect, hemianopia, Parkinson's, and the vascular territories of MCA/ACA/PCA strokes.

Cortical lobes — function & classic lesions
LobeKey functionsClassic lesion
FrontalVoluntary movement (precentral gyrus); executive (prefrontal); motor speech (Broca's, dominant)Broca's aphasia: effortful, “broken” speech with intact comprehension
ParietalSomatosensation (postcentral gyrus); calculation/praxis (dominant); spatial attention (non-dominant)Hemineglect (non-dominant lesion); 2-point discrimination loss
TemporalAuditory cortex; language comprehension (Wernicke's, dominant); memory (hippocampus); emotion (amygdala)Wernicke's aphasia: fluent nonsense, poor comprehension; hippocampal lesion → no new memories
OccipitalPrimary visual cortexContralateral homonymous hemianopia (often with macular sparing)
Brainstem cranial nerve nuclei
Brainstem levelCN nucleiClinical correlation
MidbrainCN III, IVPupillary reflexes; eye movements
PonsCN V (motor for mastication), VI, VII, VIIITrigeminal motor + facial expression + balance
MedullaCN IX, X, XI, XII; respiratory & cardiac centersLoss of respiratory drive = medullary lesion
Vascular territories — strokes you must recognize
ArteryTerritoryClassic deficit
MCA (dominant)Lateral cortex: face & arm motor/sensory + languageAphasia + face/arm hemiparesis
MCA (non-dominant)Same region, opposite hemisphereHemineglect + face/arm hemiparesis
ACAMedial cortex (leg motor/sensory area)Contralateral leg weakness; abulia
PCAOccipital lobe; thalamusContralateral homonymous hemianopia
Clinical pearl — Aphasia in 30 seconds
If speech is fluent but the words don't make sense → Wernicke's (temporal). If speech is halting and effortful but the patient understands you → Broca's (frontal). If repetition specifically is impaired → conduction aphasia (arcuate fasciculus). “Wernicke's wonders, Broca's broken.”
Clinical pearl — Why dental students need neuroanatomy
Patients with prior strokes, Parkinson's, or dementia are common in the dental chair. Recognizing facial droop, dysarthria, or hemineglect during a routine visit can flag a new event. And drug interactions (e.g., levodopa with epinephrine, anticonvulsants) directly affect anesthetic choices.
Mnemonic — Brainstem CN nuclei
“3–4 mid, 5–8 pons, 9–12 medulla.” Cranial nerves III & IV in midbrain; V, VI, VII, VIII in pons; IX, X, XI, XII in medulla.
Mnemonic — Hypothalamus
“THE PASt” — Temperature, Hormones, Eating, Parasympathetic/Sympathetic, Arousal, Sleep. The hypothalamus regulates all of these.

Cerebral lobes

  • Frontal: precentral gyrus = primary motor cortex (voluntary movement, contralateral). Prefrontal cortex = executive function (planning, judgment, impulse control). Broca's area (dominant) = motor speech.
  • Parietal: postcentral gyrus = primary somatosensory cortex (touch, pain, temperature, proprioception). Non-dominant parietal = spatial attention; lesion → hemineglect.
  • Temporal: primary auditory cortex; Wernicke's area (dominant) = language comprehension; hippocampus = memory consolidation; amygdala = fear/emotion.
  • Occipital: primary visual cortex; lesion → contralateral homonymous hemianopia.

Deep gray systems

  • Basal ganglia (caudate, putamen, globus pallidus, subthalamic nucleus, substantia nigra): smooth voluntary movement.
  • Parkinson's = substantia nigra dopaminergic loss → bradykinesia, rigidity, resting tremor.
  • Huntington's = caudate atrophy → chorea.
  • Hemiballismus = subthalamic nucleus lesion → flinging movements.

Diencephalon

  • Thalamus: relay station for all sensory information except smell.
  • Hypothalamus: homeostasis (temperature, hunger, thirst, sleep, autonomics) and endocrine control via the pituitary.

Cerebellum

  • Compares motor plan to actual movement → coordination and balance.
  • Vermis lesion: wide-based, “drunk” gait.
  • Hemisphere lesion: ipsilateral intention tremor and dysmetria.
  • Flocculonodular lobe: balance and eye movements.

CSF & ventricles

  • Produced by the choroid plexus in the ventricles.
  • Flow: lateral ventricles → foramen of Monro → 3rd → aqueduct of Sylvius → 4th → foramina of Luschka/Magendie → subarachnoid space → arachnoid granulations → venous sinuses.
  • Obstructive hydrocephalus: blocked flow (e.g., aqueduct stenosis).
  • Communicating hydrocephalus: impaired absorption at arachnoid villi.
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Self-assessment · Core Recall

11 board-style MCQs.

Active recall is the highest-yield study method for the INBDE. Pick an answer, check it, and read why every distractor is wrong — that's where the learning compounds.

In the book — different question type

The MCQs above are Core Recall — testing what you've memorized. The book adds a full Clinical Integration set: board-style patient scenarios where you apply this anatomy to real clinical reasoning. That's the section the INBDE actually weights heaviest.

  1. Question 1
    Easy
    The precentral gyrus corresponds to which functional area of the brain?
  2. Question 2
    Easy
    Lesion to Broca's area produces which deficit?
  3. Question 3
    Easy
    Which lesion causes fluent but meaningless speech with poor comprehension?
  4. Question 4
    Easy
    Which structure consolidates short-term memory into long-term memory?
  5. Question 5
    Moderate
    Parkinson's disease results from degeneration of which basal ganglia component?
  6. Question 6
    Easy
    Which sensory modality bypasses the thalamus?
  7. Question 7
    Moderate
    Which brainstem structure contains nuclei for cranial nerves III and IV?
  8. Question 8
    Easy
    Failure of respiratory drive localizes to which structure?
  9. Question 9
    Easy
    Which structure produces cerebrospinal fluid?
  10. Question 10
    Moderate
    A stroke in the left middle cerebral artery (MCA) of a right-handed patient is most likely to cause:
  11. Question 11
    Moderate
    Which artery supplies most of the motor and sensory cortex for the legs?
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