Anatomy Practical 1 Flashcards

1
Q

Which are the cranial bones?

A

Frontal, parietal, occipital, temporal, sphenoid, ethmoid

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2
Q

Which are the facial bones?

A

Mandible, maxilla, zygomatic, nasal, lacrimal, palatine, vomer

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3
Q

What are the features of the temporal bone?

A
  • petrous part
  • zygomatic process -> zygomatic arch
  • mastoid process
  • styloid process
  • external acoustic meatus
  • internal acoustic meatus
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4
Q

What is the petrous part?

A

Thicker part of temporal bone

houses middle and inner ear

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5
Q

What passes through the internal acoustic meatus?

A
  • vestibulocochlear nerve

- facial nerve

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6
Q

What is the zygomatic process?

A

Bar like part of temporal bone

Forms the zygomatic arch (cheek bone)

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7
Q

What is the mastoid process?

A

Anchoring site for some neck muscles

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8
Q

What is the styloid process?

A

Needle like

Attachment for tongue and pharynx

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9
Q

What are the features of the sphenoid bone?

A

Butterfly shaped
Articulates with all the other cranial bones
- central body, greater wings, lesser wings, 4 pterygoid plates
- foramen (5)

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10
Q

What are the 5 foramen in the sphenoid bone?

A
SOF
Optic canals
Foramen Rotundum
Foramen Ovale
Foramen Spinosum
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11
Q

What is the pterion?

A

Temple
Position of anterior branches of middle meningeal artery
Union of frontal, parietal, temporal, sphenoid bones
Skull at its thinnest point
Periosteum - groove which runs middle meningeal artery

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12
Q

What does the middle meningeal artery supply?

A

Dura and bone

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13
Q

When is middle meningeal artery impacted?

A

Intracranial haemorrhage

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14
Q

What are the features of the ethmoid bone?

A

Sieve through which air can pass

Cribiform plate on superior surface where olfactory bulbs of olfactory nerve sits

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15
Q

What are fontanelles?

A

Where bones of skull do not contact

Wide areas of fibrous tissue

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16
Q

Which bones contain air sinuses?

A

Frontal, sphenoid, ethmoid, 2 maxillary bones

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17
Q

What are paranasal air sinuses and what do they do?

A

Mucosa-lined air filled sinuses

Lighten the skull and enhance resonance of the voice

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18
Q

How many vertebrae are there in the spine and what are they separated by?

A

33

Intervertebral discs which act as shock absorbers

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19
Q

What are the common features of the vertebrae?

A

Body
Vertebral arch forming vertebral foramen where spinal cord passes through
Transverse and spinous process (attachment for muscles of back)

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20
Q

What is C1?

A

Atlas

vertebra which articulates with occipital condyles of the skull

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21
Q

What is C2?

A

Axis

Vertebra with a dens process, acts like a pivot, allows atlas to pivot around horizontal axis (shaking head to say no)

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22
Q

What is the sacrum?

A
Triangular
Forms back of pelvis
Formed by 5 fused vertebrae
Laterally articulates with 2 hip bones forming sacroiliac joints
Vertebral canal continues inside
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23
Q

What is the coccyx?

A

Triangular bone consisting of 4 fused vertebrae

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24
Q

What are the developmental parts of the brain?

A
Telencephalon (cerebral hemispheres)
Diencephalon (thalamus, hypothalamus)
Mesencephalon (midbrain)
Metencephalon (pons, cerebellum)
Myelencephalon (medulla oblangata)
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25
Q

What developments parts make up the forebrain, midbrain and hindbrain?

A

Forebrain - telencephalon, diencephalon
Midbrain - mesencephalon
Hindbrain - metencephalon, myelencephalon

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26
Q

What are the features of the midbrain on the ventral surface of the brainstem?

A

Short

Cerebral peduncles

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27
Q

What are the cerebral peduncles?

A

Massive bundles of nerve fibres descending from cerebral motor cortex to the brainstem and spinal cord carrying corticospinal tract

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28
Q

What are the features of the pons on the ventral surface of the brainstem?

A

Bridge like
Sharply demarcated
Ridged appearance
4 pairs of cranial nerves - CN V to VIII

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29
Q

Which cranial nerves are associated with the pons?

A
CNV-VIII
Trigeminal
Abducens
Facial
Vestibulocochlear
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30
Q

What are the features of the medulla on the ventral surface of the brainstem?

A

Medullary pyramids
Decussation for the corticospinal tracts
Inferior olive laterally
CN IX-XII

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31
Q

What cranial nerves are associated with the medulla?

A
CN IX-XII
Glossopharyngeal
Vagus
Accessory
Hypoglossal
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32
Q

What are the features of the midbrain on the dorsal surface of the midbrain?

A

2 paired swellings - inferior and superior colliculi
Buried beneath overlying cerebral hemispheres
CN III-IV

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33
Q

What is the obex?

A

1/3 of the way up the medulla
central canal
opening of the 4th ventricle

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34
Q

What is the function on the 4th ventricle?

A

Contains CSF that drains into the central canal of the spinal cord inferiorly and into the cerebral aqueduct superiorly

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35
Q

Where does the blood supply to the brainstem arise from?

A

Vertebral arteries

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36
Q

What do the internal carotid and vertebral arteries supply?

A

Internal carotid - anterior/superior of cerebrum

Vertebral arteries - posterior/inferior of cerebrum

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37
Q

What does the internal carotid divide into? What do these vessels supply?

A

Anterior cerebral in midline of cerebrum - lower limbs

Middle cerebral in lateral cerebrum - upper parts of body

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38
Q

What is the significance of the pontine-midbrain junction?

A

Basilar artery splits into the posterior cerebral artery

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39
Q

What branches does the basilar artery give off?

A

AICA - anterior inferior cerebellar artery

SCA - superior cerebellar artery

40
Q

What is PICA derived from?

A

Posterior inferior cerebellar artery is derived from the vertebral arteries

41
Q

Which arteries supply the cerebellum?

A

Posterior inferior cerebellar
Anterior inferior cerebellar
Superior cerebellar

42
Q

What is the pathway of the olfactory nerve?

A

Receptor neurons in mucosa in roof of nasal cavity -> through cribiform plate of ethmoid bone -> reach olfactory bulbs in anterior cranial fossa where nerves synapse on

43
Q

How can the olfactory nerve be damaged?

A

Olfactory fibre loss with aging
Injury to nasal mucosa/olfactory bulbs
Olfactory neurons torn away as pass through cribiform plate

44
Q

What are the optic nerves surrounded by?

A

Extensions of cranial meninges and subarachnoid space

45
Q

What are pathways of the optic nerves?

A

Pass in the orbit through optic canal and enter middle cranial fossa forming optic chiasm to then form optic tract

46
Q

What happens at the optic chiasm?

A

Fibres from nasal/medial half of each retina decussate and join uncrossed fibres from lateral/nasal half of retina forming optic tract

47
Q

What is the pathway of the oculomotor nerve?

A

Exit the midbrain -> through cavernous sinus -> divides into superior and inferior branches -> both pass through SOF -> innervate extraocular muscles and send presynaptic PS fibres to ciliary ganglion to innervate ciliary muscle and sphincter pupillae

48
Q

Which muscles does the oculomotor nerve innervate?

A

All extra-ocular muscles except lateral rectus and superior oblique:
medial rectus, inferior oblique, inferior rectus, superior rectus, levator palpebrae superioris

49
Q

How can lesions of the oculomotor nerve occur?

A

Pressure from herniating uncus
Fracture involving cavernous sinus
Aneurysms

50
Q

Where is the uncus?

A

At the anterior and most medial portion of the temporal lobe

51
Q

What is the pathway of the trochlear nerve?

A

Arises from posterior surface of midbrain -> passes anteriorly around brainstem -> pierces dura mater at tentorium cerebella -> passes lateral wall of cavernous sinus -> through SOF to superior oblique

52
Q

What cranial nerves are on the dorsal surface of the brainstem?

A

Only trochlear

53
Q

When may the trochlear nerve be damaged?

A

Torn when severe head injuries as has long intracranial course

54
Q

What is a sign of trochlear nerve damage and why?

A

Double vision - diplopia when looking down

Superior oblique assists inferior rectus I depressing pupil and is only muscle to do so when eye is adducted

55
Q

What is the pathway of the abducens nerve?

A

Emerges from the brainstem between the pons and medulla -> pierce dura -> enter SOF -> to lateral rectus

56
Q

What can the abducens nerve be affected by and why?

A

By increased intracranial pressure - because of long intradural course and sharp bend along petrosal part of temporal bone

  • pressure from atherosclerotic plaque in internal carotid
  • cerebral aneurysm of circle of Willis
  • septic thrombosis of sinus due to infection in nasal cavities or paranasal air sinuses
57
Q

What does complete abducens nerve damage cause?

A

Medial deviation due to unopposed action of medial rectus

Diplopia

58
Q

What is the pathway of the trigeminal nerve?

A
  • Arises from lateral pons -> ganglion housed in dural recess lateral to cavernous sinus -> peripherally forms V1 ophthalmic V2 maxillary V3 mandibular
  • motor root is smaller -> passes inferior to ganglion -> fibres join V3 supplying muscles of mastication
59
Q

What is the pathway of the V1 ophthalmic nerve?

A

Passes anteriorly through lateral wall of cavernous sinus and through SOF
Divides into frontal nerve, nasociliary and lacrimal nerve

60
Q

What is the pathway of the maxillary nerve?

A

Exits middle cranial fossa through foramen rotundum

61
Q

What are the 3 divisions of the trigeminal sensory to?

A

V1 - cornea, upper conjunctiva, upper nasal mucosa, frontal and ethmoid sinus, anterior dura, superior eyelid, forehead/scalp
V2 - dura, middle cranial fossa, inferior conjunctiva, upper dentition and skin and mucous membranes associated with upper jaw
V3 - oral mucosa, anterior 2/3 of tongue, lower teeth and jaw, temporal regions of face and external ear

62
Q

What is the pathway of the V3?

A

Leaves middle cranial fossa through foramen ovale

63
Q

What are the 2 branches of the mandibular nerve?

A

Lingual nerve

Inferior alveolar nerve

64
Q

What muscles does the mandibular nerve supply?

A
Lateral medial pterygoid
Masseter
Temporalis
Mylohyoid
Anterior belly of digastric
Tensor tympani
65
Q

What is the pathway of the facial nerve?

A

Arises from the pontine medullary junction lateral to abducens -> larger motor roots and smaller intermediate nerve carrying taste and PS fibres -> exits posterior cranial fossa through internal auditory meatus -> courses through temporal bone close to tympanic cavity -> gives rise to other nerves -> exits temporal bone through stylomastoid foramen -> enters parotid gland giving rise to terminal motor branches

66
Q

What does the facial nerve give rise to in the temporal bone?

A
  • greater petrosal nerve (PS to lacrimal gland)
  • nerve to stapedius (dampens vibrations of stapes)
  • chorda tympani (special sensory to anterior 2/3 of tongue, PS to submandibular ganglion)
67
Q

Which cranial nerve is most frequently paralysed?

A

Facial nerve

68
Q

What happens when there is damage to the facial nerve?

A

Depends on location of damage
Can cause paralysis of facial muscles with or without loss of taste or altered secretion from lacrimal or salivary glands

69
Q

How can the facial nerve be damaged?

A

Motor branches are superficial so damaged through cuts, birth injury, fractured temporal bone, surgery to parotid or submandibular surgery

70
Q

What is Bell’s palsy?

A

Unilateral facial paralysis of sudden onset
Lesion of facial nerve
Lesion near origin of facial nerve - paralysis of muscles on ipsilateral side
Central lesion (UML) - paralysis of muscles on contralateral inferior face

71
Q

What is the pathway of the vestibulocochlear nerve?

A

Originates from pontine medullary junction -> exits posterior cranial fossa through internal acoustic meatus -> divides into cochlear and vestibular components

72
Q

What is the function of the vestibulocochlear nerve?

A
  • cochlear is sensory to spiral organ for hearing

- vestibular is sensory to semi-circular ducts for sense of equilibration

73
Q

Which nuclei in the medulla send or receive fibres from the glossopharyngeal nerve?

A
  • nucleus ambiguous (motor)
  • inferior salivatory nucelus (motor)
  • sensory of trigeminal nerve (sensory)
  • solitary tract (sensory)
74
Q

Which nuceli supplied via CN IX are shared with the vagus?

A

Nucelus ambiguous
Sensory of trigeminal
Solitary tract

75
Q

What is the pathways of the glossopharyngeal nerve?

A

Exits the posterior cranial fossa through jugular foramen -> follows stylopharyngeus passing between superior and middle pharyngeal constrictors

76
Q

What is the function of the glossopharyngeal nerve?

A

PS - parotid gland via otic ganglion
Somatic sensory and special sensory - posterior 1/3 of tongue and oropharynx
Carotid sinus nerve branch - carotid sinus (baroreceptor) and carotid body (chemoreceptor)

77
Q

When would the glossopharyngeal be injured?

A

rare
Accompanied by X, XI injuries and signs as all pass through jugular foramen
Tumour creates multiple nerve palsies (JUGULAR FORAMEN SYNDROME)

78
Q

What is the pathway of the vagus?

A

Arises from rootlets of lateral medulla -> exits the posterior cranial fossa through jugular foramen -> descends in carotid sheath through neck to root of neck -> lies between IJV and common carotid

79
Q

What is the function of the vagus?

A

Somatic sensory to laryngopharynx and larynx
Visceral sensory from thoracic and abdominal organs
Somatic motor to palate, pharynx, larynx
Visceral motor (PS) to thoracic and abdominal organs

80
Q

What does the vagus give rise to in the neck?

A

Pharyngeal branch (pharyngeal plexus) and superior laryngeal nerve

81
Q

What do the pharyngeal branches supply?

A

Branches of the vagus
Supply muscles of pharynx and palate
Injuries to branches = dysphagia

82
Q

What is the pathway of the spinal accessory nerve?

A

Arises from column of anterior horn motor neurons C1-C5/6 of spinal cord -> ascend into cranial cavity via foramen magnum -> exit through jugular foramen -> descends in carotid sheath -> pierces to innervate SCM -> emerges from posterior border of SCM and crosses to trapezius

83
Q

Why is accessory nerve susceptible to injury?

A

During surgical procedures as travels superficially through posterior triangle to trapezius

84
Q

What is the pathway of the hypoglossal nerve?

A

Exits cranium via hypoglossal canal -> spirals behind vagus to emerge between ICA and IJV -> lies on carotid sheath deep to muscles which attach to styloid process

85
Q

What does injury to hypoglossal nerve result in?

A

Paralyses ipsilateral half of the tongue

Tongue may shrink and wrinkle over time

86
Q

Why are the posterior communicating arteries so important?

A

Establish the circle of willis by linking anterior and posterior circulation

87
Q

What carries out cerebral drainage?

A

Superficial and deep veins into dural sinuses which drain into the IJV

88
Q

What is the confluence of the sinuses?

A

Junction of the straight, superior, sagittal and transverse sinuses

89
Q

What are fissures?

A

Deep grooves

90
Q

What are gyri?

A

Elevated folds/Ridges

91
Q

What are sulci?

A

Shallow grooves between folds

92
Q

What is each lobe divided into?

A

3 gyri and 2 sulci

93
Q

What is the function of the cerebral cortex?

A

Enables us to be aware of ourselves and our sensations, communicate, remember, understand, initiate voluntary movements

94
Q

What is the cortex composed of?

A

Gray matter (cell bodies) only

95
Q

What is each hemisphere concerned with?

A

Sensory and motor functions of contralateral side of the body

96
Q

What is lateralisation?

A

Hemispheres are symmetrical in structure but not entirely equal in function

97
Q

What is the homunculus?

A

Mapping - amount of cortex devoted dependent on motor control of specific body region or region sensitivity