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From Flashcardlet > Control & Movement > Flashcards

Control & Movement Flashcards

1
Q

Where does the rubrospinal pathway start from?

A

Red nucleus in the midbrain

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2
Q

Where does the Vestibulospinal pathway start from?

A

Vestibular nucleus in the pons and rostral medulla?

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3
Q

What is the function of the Vestibulospinal pathway?

A

controls posture

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4
Q

Function of the Reticulospinal pathway?

A

Voluntary movement/breathing/consciousness

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5
Q

Function of rubrospinal pathway?

A

controls muscle tone

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6
Q

Do the descending motor fibres run in the anterior or posterior limb of the internal capsule?

A

Posterior - soma topically mapped with the face most anterior, then arm, trunk and leg most posterior

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7
Q

What happens at the pyramidal decussation?

A

85% of the corticospinal fibres cross over the midline and descend in the lateral corticospinal tract

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8
Q

In the CST, where do the UMNs synapse with the LMNs?

A

In the contralateral ventral grey horn

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9
Q

Corticobulbar fibres originate laterally or medially within the pre central gyrus?

A

Laterally

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10
Q

Corticobulbar innervation is largely bilateral or unilateral?

A

Bilateral with the exception of the facial nuclei

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11
Q

Left supranuclear lesion of the facial nucleus would result in paralysis of where on the face?

A

Right lower quadrant - result in weakness at the angle of mouth

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12
Q

Paralysis to the whole of one side of the face is a result of what?

A

Facial nerve damage giving rise to weakness to the ipsilateral side as the damaged facial nerve

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13
Q

What is SYNERGY?

A

The cerebellum co-ordinates time, force and duration of muscle action

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14
Q

Are the tonsils of the cerebellum on the ventral or dorsal view of the cerebellum?

A

Ventral - looking up at the medulla

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15
Q

Is the vermis on the dorsal or ventral view of the cerebellum?

A

Dorsal view - looking down at the midbrain

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16
Q

Where can you see the flocculonodular lobe of the cerebellum?

A

From the pons through the IV ventricle

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17
Q

Which part of the brainstem does the superior cerebellar peduncle take info from?

A

midbrain

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18
Q

Cerebellum has 3 functional subdivisions, what are they?

A

Vestibulocerebellum, Spinocerebellum & cerebrocerebellum

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19
Q

Is the spinocerebellum the same as the archicerebellum?

A

No - spinocerebellum = paleocerebellum. archicerebellum = vestibulocerebellum

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20
Q

Neocerebellum = ?

A

Cerebrocerebellum

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21
Q

Which division of the cerebellum is involved in co-ordinating muscles involved in posture and locomotion?

A

Spinocerebellum

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22
Q

Which division of the cerebellum is involved in co-ordinating fine, skilled movements of the hands?

A

Cerebrocerebellum

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23
Q

Inability to stand or sit without falling over is called?

A

Truncal ataxia - vestibulocerebellum

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24
Q

Gait ataxia is due to a lesion in which functional sub division of the cerebellum?

A

Spinocerebellum

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25
Q

Does spinal cord injuries affect males or females more?

A

Males 4:1

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26
Q

Spinal cord injury between C1 - T1 would result in tetra or paraplegia?

A

tetraplegia

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27
Q

What part of the spinal cord does the Brown squared syndrome effect?

A

One half in a sagittal section

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28
Q

Average life expectancy of an 82 year old after a spinal cord injury?

A

2.5 years

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29
Q

Lhermittes phenomenon presents in what condition?

A

Transverse myelitis - inflammation inside the spinal cord. 50% go on to develop MS

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30
Q

Diagnosis of MS: two conditions which present themselves but at different times?

A

Optic neuritis & transverse myelitis

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31
Q

1 disease modifying treatment for MS?

A

Interferon beta 1-b

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32
Q

How does Fingolimod work in treating MS?

A

prevents T cell invasion into CNS

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33
Q

What is driving a significant risk factor in relation to back pain?

A

prolapsed intervertebral disc

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34
Q

4 functions of the spine?

A

support, movement, protection of spinal nerve and shock absorption

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35
Q

What curve of the spine does the thoracic section show?

A

Kyphosis

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36
Q

Does the cervical region show a lordosis or kyphosis?

A

Lordosis

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37
Q

What two pathophysiological things happen with someone who has lower back pain?

A

loss of movement and muscle weakness and wasting

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38
Q

3 types of lower back pain - classification ?

A

Simple backache, nerve root involvement and possible serious spinal pathology

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39
Q

Nerve roots of sciatic nerve?

A

L4-S3

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40
Q

In Paget’s disease, what liver function test is raised?

A

Alkaline phosphatase

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41
Q

Who does ankylosing spondylitis affect?

A

Young men

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42
Q

Small diameter axon has a slow or rapid conducting velocity?

A

Slow

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43
Q

Are nociceptors associated with fast or slow axons?

A

Slow

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44
Q

Referred pain is due to what principle of nociceptive inputs?

A

Convergence of nociceptive inputs from viscera and skin. They both enter spinal cord through common routes and the cross talk between the two can give the perception of an actual visceral pain as being from a cutaneous source.

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45
Q

Where is ureter referred pain sensed?

A

Lower abdomen and back

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46
Q

Where is prostate referred pain sensed?

A

Lower trunk and legs

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47
Q

Where is oesophageal referred pain sensed?

A

Chest wall

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48
Q

Where is heart referred pain sensed?

A

Chest and arms

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49
Q

Where is bladder referred pain sensed?

A

Perineum

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50
Q

What is dissociated sensory loss?

A

When there is a unilateral spinal cord lesion, affecting both spinothalamic and dorsal column ascending sensory pathways.

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51
Q

Name given to pain which a patient experiences pain and touch sensations with no sensory inputs?

A

Phantom pain

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52
Q

Perception of pain is subject to what?

A

Central modulation - (soldiers suffering severe battle wounds can fight on. Labour pains vanish on childbirth)

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53
Q

Three opiate receptors in the brain?

A

Mu, kappa & sigma

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54
Q

Skin abrasions = acute or chronic pain?

A

acute

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55
Q

Cancer = acute or chronic pain?

A

chronic

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56
Q

neuralgias = acute or chronic pain?

A

Chronic

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57
Q

What is allodynia?

A

Pain due to stimulus which does not normally cause pain

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58
Q

What is hyperalgesia?

A

Increased pain sensation

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59
Q

What is the cornea continuous with?

A

Sclera

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60
Q

Where does refraction first occur in the eye?

A

cornea

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61
Q

Which way does light bend on refraction?

A

light bends towards a line that is perpendicular to the border between the media

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62
Q

What causes ‘winging’ of the scapula?

A

Damage to the long thoracic nerve.

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63
Q

Damage to which nerve causes ‘regimental badge’ anaesthesia?

A

AXILLARY nerve

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64
Q

Describe Tinel’s sign and Phalen’s manoeuvre for the diagnosis of carpal tunnel syndrome.

A

Tinel’s: Tapping over median nerve produces paraesthesia/pain along median nerve distribution. Phalen’s: Wrists flexed, dorsum of hands pressed together; produces paraesthesia/pain along median nerve distribution.

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65
Q

Explain the ‘ulnar claw’ sign.

A

Damage to ulnar nerve results in paralysis of the medial two lumbrical muscles. This means that extension at the MCP joints, and flexion at the PIP joints, is unopposed.

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66
Q

Explain the ‘hand of benediction’ sign.

A

Damage to the median nerve (at the elbow) results in paralysis of the long flexors in the forearm, except the medial half of flexor digitorum profundus.

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67
Q

What is the clinical manifestation of calcific scapulohumeral bursitis?

A

Painful arc syndrome.

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68
Q

The function of which rotator cuff muscle is assessed using the ‘lift-off’ test?

A

Subscapularis.

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69
Q

In which direction does glenohumeral dislocation most commonly occur?

A

Anteroinferiorly.

subcoracoid dislocation

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70
Q

‘Nursemaid’s elbow’ occurs as a result of weakness of which ligament?

A

Annular ligament.

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71
Q

Which nerve is affected in cubital tunnel syndrome?

A

Ulnar nerve.

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72
Q

What is ‘tennis elbow’?

A

Lateral epicondylitis. Caused by repeated excessive extension at the elbow.

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73
Q

What is ‘golfer’s elbow’?

A

Medial epicondylitis. Caused by repeated excessive flexion at the elbow.

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74
Q

Which nerve is commonly injured in fractures of the neck of the humerus?

A

Axillary nerve.

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75
Q

Which nerve is commonly injured in fractures of the shaft of the humerus?

A

Radial nerve.

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76
Q

Which vessels are commonly injured in supracondylar fractures of the humerus?

A

Median nerve and brachial artery.

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77
Q

What is ‘subclavian steal syndrome’?

A

Stenosis or occlusion of the subclavian artery proximal to the vertebral artery, resulting in reversed blood flow in the ipsilateral vertebral artery.

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78
Q

What is Allen’s test?

A

Test of the collateral circulation in the hand. Pressure applied to ulnar and radial arteries, until hand becomes pale. Ulnar artery released; hand should quickly return to its normal colour.

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79
Q

Why can avascular necrosis occur in fractures of the scaphoid?

A

Blood enters the scaphoid distally.

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80
Q

Describe Colle’s fracture.

A

Fracture of the distal radius and ulna. Usually results from FOOSH.

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81
Q

Damage to which nerve causes ‘foot drop’?

A

Common fibular/peroneal nerve.

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82
Q

Which anatomical transverse plane would you use as a landmark when carrying out a lumbar puncture?

A

Supracristal plane; between the highest points of the iliac crests.

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83
Q

Which tendon would you hit in order to elicit the knee-jerk reflex?

A

Patellar tendon.

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84
Q

What does the Trendelenburg test assess?

A

Hip abduction i.e. gluteus medius and minimus.

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85
Q

In which direction does the hip most commonly dislocate?

A

Posteriorly.

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86
Q

How would a posteriorly dislocated hip manifest clinically?

A

Limb shortened and internally rotated.

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87
Q

How would an anteriorly dislocated hip manifest clinically?

A

Limb externally rotated, abducted, and flexed.

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88
Q

Is the Q-angle increased or decreased in genu varum?

A

Decreased.

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89
Q

Is the Q-angle increased or decreased in genu valgum?

A

Increased.

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90
Q

Which bursa is affected in ‘housemaid’s knee’?

A

Prepatellar bursa.

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91
Q

The patellar tap test assesses the presence of effusion in which bursa?

A

Suprapatellar bursa

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92
Q

The anterior drawer sign indicates damage to which ligament?

A

Anterior cruciate ligament.

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93
Q

The posterior drawer sign indicates damage to which ligament?

A

Posterior cruciate ligament.

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94
Q

What is the ‘unhappy triad’ of injuries that result from a combined knee injury?

A

Ruptured medial collateral ligament, torn medial meniscus, rupture of the anterior cruciate ligament.

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95
Q

What is the most common cause of a sprained ankle?

A

Excessive inversion.

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96
Q

What is a Pott fracture and what causes it?

A

Excessive eversion ruptures the medial ligament, avulsing the medial malleolus, and lateral rotation of the talus fractures the distal fibula.

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97
Q

What are the two types of pes planus?

A

Flexible or rigid.

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98
Q

Primary function of the basal ganglia?

A

Provide a feedback mechanism to the cerebral cortex for initiation and control of motor response

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99
Q

Term used for abnormal, involuntary movements?

A

Dyskinesia - seen in basal ganglia lesions

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100
Q

What is the striatum made up of?

A

Caudate nucleus + putamen

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101
Q

The globus pallidus + putamen =

A

lentiform nucleus

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102
Q

Basal ganglia is made up of the…?

A

Corpus striatum + amgydala + claustrum

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103
Q

Where do you find the claustrum?

A

Dark black line lateral to the lentiform nucleus

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104
Q

Subdivisions of the globus pallidus?

A

Interna & externa

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105
Q

Which part of the functional basal ganglia contains melanin containing cells?

A

Par compacta of the substantial nigra = dark black ish colour

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106
Q

Which part of the substantial nigra is also functionally part of the globus pallidus interna?

A

Substantia nigra Pars reticulata

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107
Q

List the structures that make up the functional basal ganglia?

A 
Caudate nucleus
Putamen
Globus pallidus - interna & externa
Subthalamus
Substantia nigra - pars compacta & pars reticulata
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108
Q

What is the direct pathway? (basal ganglia)

A

Facilitate behaviour and movements that are required and appropriate

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109
Q

What is the indirect pathway? (basal ganglia)

A

Inhibit unwanted behaviour and movements

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110
Q

Main function of substantial nigra, pars compacta?

A

Initiate movement

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111
Q

Damage to substantia nigra results in what?

A

Inability to initiate movement

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112
Q

Effect of the dopinergic fibres on the direct pathway? - excite or inhibit?

A

Excite the direct pathway

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113
Q

Effect of the dopinergic fibres on the indirect pathway?

A

Inhibition of the indirect pathway resulting in increased excitation of the cortex

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114
Q

Damage to basal ganglia results in the disordered movement on which side of the body?

A

Contralateral side

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115
Q

Three key features of basal ganglia damage?

A

Hypokinesia
Tremor
Rigidity

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116
Q

In hyperkinetic disorders, which pathway does the degeneration occur?

A

Indirect pathway

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117
Q

In hyperkinetic disorders, degeneration of which fibres occur?

A

Degeneration of the sub thalamic nucleus (lose excitatory to globus pallidus)
Degeneration of inhibitory fibres from striatum to globus pallidus externa

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118
Q

Example of hyperkinetic disorder?

A

Huntington’s disease

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119
Q

What is isometric muscle contraction?

A

Muscle contracts without changing in length

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120
Q

What is muscle contracting with a change in length called?

A

Dynamic muscle contraction

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121
Q

What are the two types of dynamic muscle contraction?

A

Concentric contraction- Muscle shortens while contracting

Eccentric contraction- Muscle lengthens while contracting

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122
Q

Limb buds are visible at the end of which week pregnancy?

A

End of week 4

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123
Q

Name the 3 subdivisions of the mesoderm?

A
  • Paraxial
  • Intermediate
  • Lateral plate
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124
Q

What do somites and somitomeres form?

A

Skeletal muscle

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125
Q

Does the hypomere form the dorsal or the ventral muscles of the body?

A

Lateral and ventral muscles of thorax and abdomen

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126
Q

Posterior condensations of the limb buds give rise to what in the ULs & what in the LLs?

A

Upper limbs = extensors and supinators

Lower limbs = extensors and abductors of the lower limb

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127
Q

Flexors and adductors of the LL & flexors and pronators of the UL come from the anterior or the posterior condensations of the limb bud?

A

Anterior condensation

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128
Q

Upper limbs rotate laterally or medially so flexors are anterior?

A

Rotate laterally

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129
Q

Lower limbs rotate lateral or medially so the flexors are posterior?

A

Rotate medially

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130
Q

What does AER stand for?

A

Apical ectodermal ridge - allows for proximodistal growth. Expression of Fgfs

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131
Q

Craniocaudal control of limb development is done by what protein?

A

Sonic hedgehog diffuses away from zone of polarising activity (found caudally) cranially

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132
Q

Dorsoventral control of limb development is done by what protein?

A

Wnt7 = dorsal ectoderm.

Engrailed 1 = ventral ectoderm inhibits Wnt7

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133
Q

Complete absence of limbs is called?

A

Amelia

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134
Q

Meromelia is what?

A

Partial absence of limbs

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135
Q

Premature development of limbs is called?

A

Phocomelia

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136
Q

Fused digits is called?

A

Syndactyly

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137
Q

Polydactyly is what?

A

Extra digits

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138
Q

What name is given to lobster claw?

A

Ectrodactyly

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139
Q

Innervation of trapezius?

A

Motor accessory nerve (CNXI)

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140
Q

Innervation of serratus anterior?

A

Long thoracic nerve - damage to this = winged scapula

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141
Q

Stability of the glenohumeral joint is improved by what 4 things?

A

1) glenoid labrum
2) ligaments
3) biceps tendon
4) rotator cuff muscles

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142
Q

What is the coraco-acromial arch made up of?

A

Coracoid process, acromion and coracocromial lig = prevents superior displacement of humerus

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143
Q

GHJ is weakest inferiorly or superiorly?

A

inferiorly

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144
Q

Another name for calcific scapulohumeral bursitis?

A

Painful arc syndrome

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145
Q

Four rotator cuff muscles?

A

Supraspinatus,
Infraspinatus,
teres minor,
subscapularis

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146
Q

To which tubercle do the rotator cuff muscles attach?

A

Supra, infra and teres minor = greater tubercle = lateral rotators

Subscap = lesser tubercle = medial rotators

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147
Q

What nerve is most commonly injured in the anterior inferior dislocation of the shoulder?

A

Axillary

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148
Q

What muscle initiates abduction of the shoulder?

A

Supraspinatus, then taken over by deltoid after 15 degress

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149
Q

Contents of the quadrangular space?

A

Axillary nerve and posterior circumflex humeral artery

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150
Q

Nerve roots of brachial plexus?

A

C5 to T1

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151
Q

Surgical neck fracture of the humerus damages which nerve?

A

Axillary nerve damage - elderly patients

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152
Q

Humeral shaft fractures will damage which nerve?

A

Radial nerve

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153
Q

Distal humerus fracture may damage which nerve?

A

Median nerve

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154
Q

Elbow capsule is thin and loose anteriorly and posteriorly, why?

A

Allow for flexion and extension

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155
Q

Biceps, brachialis and coracobrachialis are innervated by what nerve of the brachial plexus?

A

Musculocutaneous

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156
Q

Innervation of triceps brachii?

A

Radial nerve (c5-T1) - posterior cord of the brachial plexus

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157
Q

What is the third and seventh carpal bone? (lateral to medial)

A

Triquetrium & capitate

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158
Q

Which of the two bones in the forearm do not articulate with the carpal bones?

A

Ulnar

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159
Q

Innervation of thenar eminence?

A

Recurrent median nerve. Flexor pollicis brevis, opponens pollicis and abductors pollicis brevis

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160
Q

What structures pass through the carpal tunnel?

A

FDS tendon, FDP tendon, Flexor pollicis longus tendon & MEDIAN NERVE

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161
Q

What enters the hand via Guyon’s canal?

A

Ulnar nerve and artery

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162
Q

What is the most common type of Guyon’s canal syndrome?

A

Type 2 - compression of ulnar nerve at the level of lower wrist. Sensory branch to the dorsal aspect of hand and innervation of muscles of the base of palm are spared

163
Q

Right subclavian artery is a branch of what?

A

Brachiocephalic trunk/artery off the arch of the aorta

164
Q

Three branches of the subclavian artery?

A

Internal thoracic, thyrocervical & vertebral artery

165
Q

Stenosis or occlusion of the subclavian artery proximal to the vertebral artery origin results in what syndrome?

A

Subclavian steal syndrome = reverse blood flow in the ipsilateral vertebral artery. blood is stolen from the circular vertebrobasilar system

166
Q

When does the subclavian artery become the axillary artery?

A

Passes between first rib and clavicle ( inf border of first rib)

167
Q

Branch of what artery is the posterior circumflex humeral artery?

A

Axillary artery.

168
Q

When does the axillary artery become the brachial artery?

A

Inferior border of teres major

169
Q

Three main branches of the brachial artery?

A

1) produnda brachi
2) superior ulnar collateral
3) inferior ulnar collateral

170
Q

In the arm the median nerve runs medial or lateral to the brachial artery?

A

Runs lateral

171
Q

In the cubital fossa the median nerve runs medial or lateral to the brachial artery?

A

Runs medial to the brachial artery

172
Q

Ligation of the brachial artery proximal or distal to the profunda brachii artery will result in loss of limb in 50% of cases?

A

Proximal

173
Q

Which artery contributes predominantly to the deep palmar arch?

A

Radial

174
Q

Which artery contributes to the superficial palmar arch?

A

Ulnar

175
Q

What vein drains the lateral side of the dorsal venous arch in the arm?

A

Cephalic vein

176
Q

What vein drains the medial side of the dorsal venous arch in the arm?

A

Basilic vein

177
Q

What vein does the cephalic vein drain into?

A

Axillary vein after running in the deltopectoral triangle

178
Q

What vein drains from the cephalic into the basilic?

A

Median cubital vein

179
Q

Where does the basilic vein drain?

A

Joins with venue commitantes to form the axillary vein

180
Q

Tri-radiate cartilage located where? Joins what?

A

Acetabulum - ilium, ischium and pubis bones of the innominate bone

181
Q

Which one of the three ligaments of the hip joint covers the hip joint posteriorly?

A

Ischiofemoral

182
Q

Function of the iliofemoral ligament?

A

Limits adduction and lateral rotation. Resists hyperextension

183
Q

Function of ischiofemoral ligament?

A

Limit medial rotation

184
Q

Function of the pubofemoral ligament?

A

limits abduction

185
Q

Blood supply to the head of the femur?

A

Ligamentum teres = branch of obturator

186
Q

Is sartorius a flexor, extensor, abductor, adductor of the hip join?

A

Flexor

187
Q

Abductors of the hip joint?

A

Gluteus medius & minimus + tensor fascia lata (also internal rotators)

188
Q

Adductors of the hip joint?

A

Adductor longus & brevis & brevis, gracilis & pectineus

189
Q

When are posterior dislocations of the hip most likely to occur?

A

RTA - hip is flexed, adducted and medially rotated

190
Q

Which nerve can be damaged in posterior hip dislocations?

A

Sciatic nerve

191
Q

O/E = External rotation, abduction and flexion of the hip would suggest what dislocation?

A

Anterior dislocation - force applied during extreme abduction with external rotation of hip. Anterior hip capsule avulsed and femoral head is levered out anteriorly

192
Q

What type of dislocation is caused by the head of the femur being driven though the floor of the acetabulum?

A

Internal dislocation

193
Q

What nerve may be damaged due to internal dislocation of the hip?

A

Obturator

194
Q

Normal range of flexion at hip?

A

120 degrees

195
Q

Normal range of extension at hip?

A

30 degrees

196
Q

Normal range of adduction at hip?

A

25 degrees

197
Q

Normal range of abduction at hip?

A

45 degrees (same as internal and external rotation)

198
Q

During the trendelburg test, if someone raises their leg and their pelvis rises on the side the leg has been lifted, is this normal or abnormal?

A

Normal

199
Q

During the trendelburg test, if someone stands on their affected hip, does their pelvis on the opposite drop or rise on lifting that leg?

A

Drops

200
Q

Which bone is not associated with the knee joint?

A

Fibula

201
Q

What is genu varum?

A

Bow leg = Q angle < 17 degrees

202
Q

Q angle > 17 degrees =?

A

Genu valgum (knock knee)

203
Q

Lateral dislocation of the patella is prevented due to the action of which muscle?

A

Vastus medialis

204
Q

Which collateral ligament of the knee is attached to the menisci?

A

Medial collateral ligaments is attached to the medial meniscus - lateral blow to the knee causes tearing of the medial collateral

205
Q

3 things that are damaged in the unhappy triad?

A

ACL, MCL & medial lemniscus

206
Q

What muscles are the inverters of the foot?

A

Tibialis anterior and tibialis posterior

207
Q

What muscles are the evertors of the foot?

A

Fibularis longus & fibularis brevis

208
Q

3 arches of the foot?

A

Medial & lateral longitudinal + transverse arch

209
Q

Small saphenous vein drains into?

A

Popliteal vein

210
Q

Great saphenous vein drains the medial or lateral side of the leg?

A

Medial side

211
Q

Increase in ICP, increases or decreases cerebral perfusion pressure?

A

Decreases. CPP = MAP - ICP

CPP normally around 70-90mmHg

212
Q

Nerve roots of Femoral nerve?

A

L2-L4

213
Q

Nerve roots of obturator nerve?

A

L2-L4

214
Q

Nerve roots of sciatic nerve?

A

L4-S3

215
Q

5 nerves of the brachial plexus?

A

Posterior cord = Axillary & radial nerve
Lateral cord = musculocutaneous
Medial cord = ulnar
Lat + Med = median

216
Q

Nerve roots of pudendal nerve?

A

S2-S4

217
Q

Name the three primary brain vesicles?

A

1) Prosencephalon
2) Mesencephalon
3) Rhombencephalon

218
Q

Cerebral hemispheres originate form which secondary brain vesicle?

A

Telencephalon which is from the prosencephalon

219
Q

The thalamus & hypothalamus originate from which secondary brain vesicle?

A

Diencephalon - from prosencephalon

220
Q

Midbrain originates from which primary brain vesicle?

A

Mesencephalon

221
Q

Pons & cerebellum originate from which secondary brain vesicle?

A

Metencephalon from rhombencephalon

222
Q

Medulla originates from which secondary brain vesicle?

A

Myelencephalon from rhombencephalon

223
Q

On the surface of the cerebral hemispheres, are the gyri the fold or the groove?

A

The fold. sulci = groove

224
Q

What is the name given to the reflection of dura mater between the two cerebral hemispheres?

A

Falx cerebri

225
Q

Name given to the reflection of dura mater between the cerebrum & cerebellum?

A

Tentorium cerebelli

226
Q

What CN passes through the cribriform plate?

A

Olfactory CN I

227
Q

What Cranial nerves pass through the Superior orbital tissue?

A

Occulomotor (III),
Trochlear (IV)
Opthalmic div of trigeminal (V1),
Abducens (VI)

228
Q

CNv3 passes through which foramina?

A

Foramen ovale

229
Q

CNv2 passes through which foramina?

A

Foramen rotundum

230
Q

What passes through foramen spinosum?

A

Middle meningeal artery and vein

231
Q

Which CNs pass through the internal acoustic meatus?

A

CN VII & CNVIII

232
Q

What passes through the jugular foramen?

A

CNIX, CNX, CNXI & IJV

233
Q

Name the four paranasal air sinuses?

A

Frontal, ethmoid, sphenoid, maxillary

234
Q

Where is the weakest part of the skull?

A

Pterion = fusion of parietal, frontal, greater wing of sphenoid and squamous part of temporal bone

235
Q

Are sensory cranial nerve nuclei located laterally or medially within the brainstem?

A

Laterally. Motor cranial nerve nuclei are located medially

236
Q

Which cranial nerves carry motor, sensory & parasympathetic fibres?

A

Facial, Glossopharyngeal, Vagus

237
Q

Which cranial nerves carry parasympathetic fibres?

A

Occulomotor
Facial
Glossopharyngeal
Vagus

238
Q

Cavity of the telencephalon gives rise to what ventricle?

A

lateral ventricles

239
Q

What links the lateral ventricles to the 3rd ventricle?

A

Inter-ventricular foramen

240
Q

3 classes of nerve fibre in white matter?

A

1) Association fibres - link within each hemisphere
2) Commisural fibres - link between hemispheres (corpus callosum and ant commisure)
3) Projection fibres - carry info to or from hemispheres (internal capsule)

241
Q

What produces CSF?

A

Choroid plexus - PIA mater

242
Q

Where is the primary olfactory cortex?

A

UNCUS

243
Q

Where is the primary auditory area?

A

Heschl’s gyrus

244
Q

Term given to damage to secondary sensory areas? - leads to disorders of understanding

A

Agnosia - awareness of sensation persists but significance of the sensation is lost

245
Q

What is apraxia?

A

damage to secondary motor areas leads to inability to carry out purposive movements, although no paralysis

246
Q

Does spinal nerve T2 leave from above or below its corresponding vertebrae?

A

Below. C1-C7 leave above

247
Q

Does the thoracic cord have a lateral grey horn?

A

Yes - sympathetic output

248
Q

What is a diverging circuit?

A

One neurone given rise to many outputs

249
Q

What is a converging circuit?

A

Many inputs to one output

250
Q

Which cranial nerve carries sensation from the the posterior third of tongue, pharynx and middle ear?

A

Glossopharyngeal

251
Q

Which cranial nerve carries sensory information from face, nose, scalp and dura?

A

Trigeminal

252
Q

Which cranial nerve carries sensation from auditory canal, larynx, pharynx and oesophagus?

A

Vagus

253
Q

Which cranial nerve carries sensation from the anterior two thirds of the tongue?

A

Facial

254
Q

All information from V, VII, IX, X sensory information is carried in the same cantral pathway?

A

Trigeminal sensory pathway

255
Q

3 nuclei of the trigeminal nucleus? + what sensation they carry

A

1) Mesencepahlic nucleus - propriception
2) Chief/pontine nucleus - discriminative tough
3) Spinal nucleus - rostrally = touch and pressure. caudally = pain and temp

256
Q

What does the motor division of the trigeminal nerve supply?

A

Muscles of mastication

257
Q

In what order do the ossicles vibrate from the tympanic membrane to the oval window?

A

Malleus, incus, stapes

258
Q

What does the cochlea duct contain?

A

Endolymph. Cochlea itself contains perilymph

259
Q

What does the scala vestibule and scala tympani contain?

A

Perilymph

260
Q

What does the vestibular membrane separate?

A

Scala vestibule from the cochlear duct

261
Q

What does the spiral organ of corti sit on>?

A

Basilar membrane (separates cochlear duct from scala tympani)

262
Q

Where do low pitched frequency sounds go to on heschl’s gyrus?

A

Apex of cochlear duct responds to low pitch. Goes to lateral part of Heschl’s gyrus

263
Q

Inferior brachium is involved in what pathway?

A

Auditory pathway - carries info from inferior colliculus to medial geniculate nucleus in thalamus

264
Q

Name four locations (nuclei) that the auditory pathway travels through after leaving the spiral organ?

A

Spiral organ to cochlear nuclei to both SUPERIOR olivary nuclei then to both INFERIOR colliculi (midbrain) via lateral lemniscus then to both MEDIAL geniculate nuclei (thalamus) via the inferior brachium then to heschl’s gyrus,

265
Q

What term of deafness is described as a defect in sound transmission up to spiral ganglion?

A

Conductive deafness - inability to conduct the sound in the airways due to wax, infection leads to dec in amplification. ossicle damage

266
Q

Defect in the function of spiral ganglion or cochlear nerve results in what type of deafness?

A

Sensorineural deafness - sound is still amplified but the hair cells aren’t picking it up

267
Q

What hearing test uses bother air and bone conduction?

A

Rinne’s test

268
Q

Results of rinne’s test; if you hear the sound louder when tuning fork pressed against the mastoid process? (bone conduction > air conduction)

A

Conductive hearing loss - because the sound isn’t being amplified by the ossicles when the tuning fork is by the ear.

269
Q

In Rinne’s test, is air conduction suppose to be louder than bone conduction?

A

Yes, ossicles greatly amplify sound. Bone conduction bone shakes and vibrations move the cochlea completely avoiding the ossicles.

270
Q

Weber’s test: if a subject has conductive hearing loss in one ear, which ear will the sound be heard the loudest? Health or damage ear?

A

Damaged ear because hearing in the normal ear is inhibited by ambient sound (auditory masking)

271
Q

What would be the result of weber’s test if someone had unilateral sensorineural loss?

A

Sound heard louder in the normal ear as sound needs to be amplified to hear it

272
Q

What is the retina an outgrowth of?

A

diencephalon = CNS

273
Q

What is the duochrome test?

A

Used to test refraction. Similar to snellen’s test but uses two sheets, one green and one red. green light reflected more than red. If refraction is normal (emmetropic) the green image is as much in from of the retina as the red one is behind so both images will appear slightly and equally blurred.

If eye is short sighted (myopic) the red letters will be seen most clearly.
If eye is long sighted (hypermetropic) the green letters will be most clear.

274
Q

What is the ishihara test?

A

Testing for colour vision

275
Q

If someone has hyperopia then what type of lens would you use to correct it?

A

Hyperopia = long sightedness therefore need to bring the image forward onto the retina = use of CONVEX lens (inc refractive power)

276
Q

If someone has myopia then what type of lens would you use to correct it?

A

Myopia = short sightedness therefore need to move the image back onto the retina = use of CONCAVE lens (dec refractive power)

277
Q

Photoreceptors synapse with x and x then synapses with y which join together to form CN?

A

Bipolar cells which then synapse with ganglion cells which join together to form CNII (optic nerve)

278
Q

Where in the thalamus does the optic tract go to?

A

Lateral geniculate nucleus

279
Q

Not all the optic tract fibres of to the LGN, where do the rest go? + the rest of pathway

A

Pre tectal area of midbrain synapse with interneurones which go to the edinger-westphal nucleus (CNIII nucleus involved in pupillary light reflex) on both ipsilateral and contralateral sides.

Occulomotor nerve (PS division) runs from EWN to ciliary ganglion on both sides.

Ciliary ganglion gives off post ganglionic fibres that goes to sphincter.

Constriction of both pupils if normal

280
Q

What is the efferent component of the pupillary light reflex?

A

Occulomotor

281
Q

When light is shined in the right eye, if there is ipsilateral occulomotor nerve damage what would you observe?

A

Right eye - loss of direct pupillary light reflex (pupil would stay dilated)
Left eye - Consensual component would respond (pupil would constrict)

282
Q

What three things happen in the accommodation reflex?

A

1) Accommodation (thickening of lens via contraction of ciliary muscle)
2) Pupillary constriction (sphincter pupillae)
3) Ocular convergence (medial rectus contracts)

283
Q

Describe the accommodation reflex pathway?

A

1) afferent fibres of optic nerve and tract synapse in LGN
2) Optic radiation takes info to primary visual cortex
3) PVC to association area
4) efferent association fibres run to the CNIII nuclei
5) Efferent CNIII parasymp div run to ciliary ganglion & CNIII motor div to Medial rectus
6) Medial rectus causes ocular convergence & the parasymp is constricting the pupil and contracting the ciliary muscle to thicken the lens)

284
Q

Segmental distribution of LMNs in the spinal cord compared to peripheral musculature;

  • motor neurones that control flexors lie dorsal/ventral to extensors?
  • motor neurones that control axial muscles lie medial/lateral to those controlling distal muscles?
A
  • flexors lie dorsal to extensors

- axial muscles lie medial to distal muscles

285
Q

What are the three main sources of input to an alpha motor neurone?

A
  • sensory inputs from peripheral proprioceptors
  • local inputs from spinal interneurones
  • descending inputs from brain UMNs
286
Q

What detects changes in muscle length?

A

Muscle spindle - intrafusal muscle fibre

287
Q

Innervation of intrafusal muscle fibres?

A

Gamma motor neurones regulate the length of the muscle spindle. Intrafusal fibres have a sensory function and do not generate tension

288
Q

Innervation of extrafusal muscle fibres?

A

Alpha motor neurones.

289
Q

During isotonic contraction which afferent fibre is firing?

A

Ia

290
Q

During isometric contraction which afferent fibre is firing?

A

Ib

291
Q

Aalpha afferent fibres carry what type of sensory info?

A

Proprioception of skeletal muscle = blood fast

292
Q

What type of afferent fibre carries pain and temperature?

A

Adelta & C = slower

293
Q

What would the patient show if they had a lesion of their cerebellar hemisphere?

A

Tremor of intent, past pointing, adiadochokinesia, dysarthria, nystagmus

294
Q

Which part of the cerebellum ‘knows what muscles are doing’?

A

Spinocerebellar

295
Q

What part of the cerebellum knows about intended movements?

A

Cerebrocerebellum - input from cortex including the motor cortex via the inferior olivary nucleus or via the nuclei in pons

296
Q

What three sensory modalities contribute to maintaining balance and posture?

A

1) vestibular system
2) somatosensory - muscle & proprioception
3) visual system

297
Q

What are the two otolithic organs?

A

Utricle & saccule

298
Q

How is the vestibular apparatus divided?

A

Vestibule & Semicircular canals

299
Q

What does the ampullary nerve carry information from, to?

A

The semicircular canal to the vestibular branch of the vestibularcochlea nerve

300
Q

Linear acceleration and translational motion is detected by what part of vestibular apparatus?

A

Utricle & Saccule

301
Q

Rotational motion and angular acceleration is detected by what part of the vestibular system?

A

Semicircular canals

302
Q

What are the sensory detectors of the utricle & saccule?

A

Maculae

303
Q

If sterocilia move away from the kinocilium is there going to be an increase in firing of sensory nerve or decrease? Depolarisation of hyper polarisation?

A

Decrease in firing = hyperpolarisation

304
Q

Depolarisation of hair cells in the utricle and saccule occur when the sterocilia move toward or away from the kinocilium?

A

Toward

305
Q

What’s a key biochemical difference between hair cells and neuronal cells w.r.t depolarisation?

A

Hair cells = potassium flows into them to cause depol as there is a higher conc of potassium outside the cell.

Neurones = potassium flows out

306
Q

What is the neurotransmitter released from hair cells in the vestibule?

A

Glutamate

307
Q

Is the macula horizontal or vertical in the utricle?

A

Horizontal. Vertical in the saccule

308
Q

With what fluid are the semicircular canals filled with?

A

Endolymph

309
Q

Is the cupula associated with the semicircular canals or vestibule?

A

Semicircular canals

310
Q

Rotation of head to the right results in cupula bending in which direction?

A

Opposite (left) direction.

311
Q

Semicircular canals are arranged in pairs so the left anterior pairs with the…?

A

Right posterior

312
Q

To which nucleus do the afferents from the cupola of semicircular camas project to?

A

Medial vestibular nucleus = sends efferents to extra-ocular muscles and neck motor neurones (vestibulo-ocular reflex)

313
Q

To which nucleus do the afferents from the otoliths project to?

A

Lateral vestibular nucleus - sends efferents to cerebellum and limb motor neurones to maintain body posture

314
Q

What is Meniere’s syndrome?

A

Increased volume of endolymph rupturing membranous labyrinth. Symptoms include pressure, earache, tinnitus & dizziness

315
Q

What causes benign paroxysmal positional vertigo?

A

Calcium carbonate crystals dislodged from otoliths that flora into canals

316
Q

Damage of the vestibulocochlear nerve due to drugs or chemicals is called what?

A

Ototoxicity

317
Q

Term given to a slow tracking movement of eyes followed by a fast component?

A

Nystagmus

318
Q

What is the slow component in Rightwards nystagmus?

A

Slow track to the left followed by a fast click to the right

319
Q

Does cold water depolarise or hyperpolarise hair cells during caloric testing?

A

Hyperpolarise

320
Q

Which muscles laterally rotate the humerus in order for abduction to go beyond 90 degrees ?

A

Teres minor

321
Q

What could cause damage to the suprascapular nerve ? Effect ?

A

Scapular fracture
Posterior shoulder dislocation

  • patient can only produce first 10-15 degrees of movement by leaning to one side (abdicates passively the deltoid takes over)
322
Q

The axillary nerve is a terminal branch of what ?

A

The posterior cord of the brachial plexus

323
Q

What is quadrangular space syndrome ?

A

Transient blockage of post. Circumflex artery and axillary nerve by compression on quadrangular space

  • e.g. Lying with arm abducted, extended and externally rotated - paraesthesia
324
Q

In which directions is the elbow capsule thin and lose ?

A

Ant and post

Allows for flexion and extension

325
Q

Which test is used to evaluate tears in the menisci ?

A

McMurray’s - circumduction test

  • looking for locking of the knee, pain or clicking
326
Q

How to test for a rotator cuff tear ?

A

Abduct arm fully then lower arm with control.

If torn, at about 90 degrees, arm will drop.

327
Q

Which is the most common rotator cuff to be torn ?

A

Supraspinatous

328
Q

How does dislocation of the GHJ usually present?

A

Arm held with elbow flexed
Arm slightly Abducted
humeral head prominent
shoulder appears flattened

329
Q

what is the normal range of extension at the GHJ ?

A

45-60 degrees

330
Q

Name the three flexor muscles of the elbow :

A
  1. Brachialis
  2. Biceps brachii
  3. Brachioradialis (accessory flexor)
331
Q

What is the common innervation of the flexors of the elbow ?

A

Musculocutaneous nerve (C5-C7) - branch of the lateral cord of the brachial plexus

brachialis also receives small part from radial nerve

332
Q

What are the two extensors if the elbow ?

A

Aconeous

Triceps brachii

333
Q

What is the common innervation if the extensor compartment of the arm ?

A

Radial nerve (C5-T1) - posterior cord of brachial plexus

334
Q

At which joint does pronation and supination of the forearm occur ?

A

Proximal radio-ulnar joint

335
Q

Which two muscles are involved in pronation of the forearm ? And which compartments are they a part of ?

A

Pronation Terres - superficial flexor comp. (ant.)

Pronator quadratus - deep flexor comp. (ant.)

336
Q

Which two muscles are involved in supination ?

A

Biceps brachii

Supinator (deep extensor compartment)

337
Q

What is the treatment for epicondylitis ?

A

Rest

Injection of corticosteroid (severe pain only)

338
Q

Do the tendons of flexor digitorum superficialis or flexor digitorum profoundus attach to the distal phalanges ?

A

Profundus

339
Q

Which bone does the flexor retinaculum attach to medially ?

A

Pisiform (and hook of hamate)

340
Q

What passes through the flexor retinaculum ?

A

Median nerve
Flexor digitorum superficialis (4 tendons)
Flexor digitorum profoundus (4 tendons)
Flexor pollicis longus (1 tendon)

341
Q

Which nerve supplies the thenar eminence ?

A

(Recurrent) Median nerve

342
Q

Which muscles make up the thenar eminence ?

A

Abductor pollicis Bevis
Flexor pollicis brevis
Opponens pollicis

343
Q

What is Dupuytren’s contracture ?

A

Flexion contraction of the hand, fingers bend towards hand and cannot be fully extended

  • a result of shortening of the palmar aponeurosis
  • shortening usually more severe on ulnar side
344
Q

Presentation of tenderness in anatomical snuffbox is suggestive of what fracture ?

A

Fracture of the scaphoid

345
Q

What are the borders of the anatomical snuffbox .

A

Above - tendon of extensor pollicis longus

Below- tendons of extensor pollicis brevis & abductor pollicis brevis

346
Q

Which pulse can be palpated in the anatomical snuffbox ?

A

Radial pulse

347
Q

Which artery forms a complete anastomoses around the surgical neck of the humerus ?

A

The posterior circumflex humeral artery

348
Q

Which muscles are supplied by the posterior circumflex humeral artery ?

A

Deltoid
Triceps muscle

(Runs with axillary nerve)

349
Q

As the brachial artery runs into the cubital fossa, what branches does it terminate into ?

A

Ulna and radial artery

350
Q

What are the three main branches of the brachial artery ?

A

Profunda brachii (runs in the spiral groove)
Superior ulnar collateral
Inferior ulnar collateral

351
Q

Which compartment of the arm does Profunda brachii supply ?

A

Posterior compartment (along with post. Circumflex humeral artery )

352
Q

Which artery forms an anastomoses with the radial artery ?

A

Deep brachial artery

353
Q

Which artery supplies the anterior compartment of the forearm ?

A

Anterior interosseous branch of the ulnar artery

354
Q

Which artery supplies the posterior compartment of the forearm .

A

Posterior interosseous artery branch of ulnar artery

355
Q

Which arteries supply the majority of the deep and superficial palmar arches ?

A 
Deep = radial
Superficial = ulnar
356
Q

Which artery supplies the deep muscles of the hand ?

A

Deep branch of ulnar artery

357
Q

Which muscles does the cephalon vein run between before draining into the axillary vein e deltopectoral triangle ?

A

Deltoid

Pectoralis major

358
Q

What are association fibres ?

A

Fibres within hemispheres

359
Q

What are commissural fibres ?

A

Link BETWEEN hemispheres

360
Q

What are projection fibres ?

A

Interact between cerebral cortex and sub-cortical structures e.g. Brainstem

361
Q

What does the myelencephalon form ?

A

Medulla oblongata

362
Q

What are the cerebral hemispheres formed from ?

A

Telencephalon (from prosencephalon)

363
Q

What is the ventricular system derived from?

A

Lumen of neural tube

364
Q

Damage to which artery would cause loss if sensation to the face ?

A

Middle cerebral artery

365
Q

Which nucleus does discriminative touch from the face synapse in ?

A

Principle nucleus (pons)

366
Q

Which modality from the face synapses in the rostrum spinal nucleus ?

A

Simple touch and pressure

367
Q

Monocular blindness is caused by a lesion where ?

A

In the ipsilateral optic nerve

368
Q

What is heteronymous hemianopia ?

A

Loss of the opposite halves of visual fields in each eyes

  • caused by lesion in the optic chiasma
369
Q

A lesion in cranial nerve II will result in a loss of the consensual or direct pupillary light response ?

A

Loss of direct pupillary light response in ipsilateral eye (to lesion)

370
Q

A loss of consensual light reflex suggests a lesion where ?

A

CN III contralateral (to eye shining light in)

371
Q

Which part of heschl’s gyrus does low pitch sound project to?

A

Antero-lateral heschl’s gyrus

372
Q

A patient who is ataxic but gives a negative romberg’s sign suggests what ?

A

Cerebellar ataxia

Opposed to sensory if positive I.e. Proprioception not functioning

373
Q

Which subdivision of the cerebellum maintains constancy of visual field ?

A

Archicerebellum (vestibulo)

374
Q

In the presentation of nystagmus due to cerebellar lesion, when is it at greatest amplitude ?

A

When gaze is directed to same side of lesion

375
Q

What are the three components forming the vestibular branch of CN VIII ?

A

Utricular nerve
Saccular nerve
Ampullary nerve

376
Q

Where is motion and linear acceleration detected ?

A

Mainly utricle and saccule

377
Q

What type of motion is detected mainly by semi circular canals ?

A

Angular acceleration

378
Q

Where is the primary auditory cortex located ?

A

Superior temporal gyrus (heshls gyrus)

379
Q

Where is the primary gustatory cortex ?

A

Inferior post central gyrus

380
Q

Which muscles are lateral rotators of the hip?

A

Piriformis
S and I gemelli
Obturator internus
Quadratus femoris

381
Q

What are the hamstrings muscles ?

A

Semimembranosus
Semitendenosus
Biceps femoris (long head)

(Common origin = ischial tuberosity)

382
Q

What is pes anserinus and which muscles insert there ?

A

Conjoined tendon on anteromedial, proximal, tibia

  • sartorius
  • gracilis
  • semitendinosus
383
Q

What nerve are the hamstrings innervated by ?

A

Tibial division of sciatic nerve

384
Q

Which nerve innervates the anterior compartment of thigh ?

A

Femoral nerve

385
Q

What is the blood supply to the quadriceps muscles and main action ?

A

Profunda femoris
Extend knee

(Sartorius also weak flexor of hip)

386
Q

What is the common blood and nerve supply to the medial compartment of the thigh ?

A

Obturator artery and nerve

Pectineus also receives contribution from femoral nerve and hamstring part of adductor Magnus = tibial nerve

387
Q

Which compartment of the leg does does dorsiflexion of foot ?

A

Anterior compartment

388
Q

What is the blood supply to the lateral compartment of the leg ?

A

Fibular artery, branch of the posterior tibial artery

389
Q

What is the blood and nerve supply to the lateral compartment of the leg?

A

Superficial fibular nerve

Fibular artery

390
Q

What is the nerve supply to posterior compartment of the leg ?

A

Tibial nerve

391
Q

What is the nerve and artery supply to the anterior compartment of the leg?

A

Deep fibular nerve

Anterior tibial artery

392
Q

Blood supply to superficial posterior compartment of leg?

A

Sural arteries branching from popliteal artery

393
Q

The tendons of which muscles support the medial longitudinal arch ?

A

Tibialis anterior and posterior

394
Q

Which muscle controls the lowering. Of forefoot to ground in heel strike?

A

Tibialis anterior

395
Q

What movements and muscles are involved in loading response of stance phase ?

A

Foot comes into full contact with ground, requires KNEE EXTENSION - quadriceps femoris

396
Q

What happens during midstance ?

A

Opposite limb swings past stance limb

Requires stabilitation of hips (abduction) - contraction of glut med and min & tensor fascia lata

397
Q

Which Stage of stance phase does this decribe:

Point at which heels starts to lift off ground (plantar flexors)

A

Terminal stance

398
Q

Which is the final stage of stance phase ?

A

Preswing (toe off)

Hallux plantar flexion essential

399
Q

What is characteristic of an apropulsive gait (due to missing hallux)

A

Shorter stride length

Decreased gait velocity

400
Q

Muscles and movements in initial and mid swing ?

A
  • hip flexion (carry limb forward) - iliopsoas, rectus femoris
  • toe and foot dorsiflexed- tib ant
  • knee flexion- hamstrings
401
Q

Muscles and movements in terminal swing phase ?

A
  • Knee flexion changes to extension- quads
  • Dorsiflexion - tib ant
  • contraction of hamstrings (deceleration ready for heel strike)
402
Q

What is erb’s palsy?

A

Common in newborns due to excessive stretching of neck during delivery- damage to C5,C6

  • damages to shoulder muscles- waiters tip
403
Q

What is klumpke’s palsy?

A

Damage to inferior trunk of brachial plexus - C8-T1- ulnar nerve

  • arm pulled during delivery
  • paralysis of intrinsic hand muscles & ulnar flexors

From Flashcardlet (22 decks)

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