Activities Flashcards
(171 cards)
1
Q
Identify the le ft and right cerebral hemispheres. What is the name of the fissure that separates them?
A
Longitudinal fissure
2
Q
Identify the central sulcus. Which two lobes does it separate?
A
Frontal and parietal
3
Q
Find the precentral gyrus (the gyrus that is anterior to the central sulcus) - what lobe does it lie in? It is important for motor function and has a specific name - what is it called?
A
Frontal lobe
Primary motor cortex
4
Q
Find the postcentral gyrus (the gyrus that is posterior to the central sulcus) - what lobe does it lie in? It is important for sensory processing and also has a specific name - what is it called?
A
Parietal lobe
Primary somatosensory cortex
5
Q
Identify the lateral sulcus. Which lobes does it separate?
A
Temporal lobe from frontal and parietal
6
Q
Why is the cerebral cortex referred to as grey matter? What is the cerebral cortex composed of?
A
It appears grey
Cell bodies and dendrites
7
Q
What are the 3 meningeal layers called and what order are they in from superficial to deep?
A
Dura mater
Arachnoid mater
Pia mater
8
Q
How many layers does the dura have?
A
2
Outer endosteal
Inner meningeal
9
Q
What is the falx cerebri and what is its function?
A
A folding of the meningeal layer of the dura
Separates the 2 cerebral hemispheres
10
Q
What does the arachnoid mater look like? What fluid lies deep to the arachnoid?
A
Spider webs
Cerebral spinal fluid
11
Q
Function of arachnoid granulations
A
Reabsorption of CSF
12
Q
What important structure does the pia contribute to?
A
physically separate the neural tissue from the blood vessels in the subarachnoid space
13
Q
Which dural fold separates the le ft and right cerebral hemispheres?
A
Falx cerebri
14
Q
What parts of the brain are separated by the tentorium cerebelli?
A
Occipital lobe and cerebellum
15
Q
Where does blood collect in the following types of intracranial bleeds?
○ Extradural haemorrhage.
A
Between skull and dura
16
Q
Where does blood collect in the following types of intracranial bleeds?
○ Subdural haemorrhage.
A
Between dura and arachnoid
17
Q
Where does blood collect in the following types of intracranial bleeds?
○ Subarachnoid haemorrhage.
A
Between arachnoid and pia
18
Q
Where does blood collect in the following types of intracranial bleeds?
○ Intracerebral haemorrhage.
A
Within brain below pia
19
Q
Which type of haemorrhage most commonly forms a convex shape on axial CT images?
A
Extradural
20
Q
Which type of haemorrhage most commonly forms a concave shape on axial CT images?
A
Subdue all
21
Q
What symptoms or signs might a patient present with if they have an intracranial haemorrhage?
A
Impairment of functions of the brain due to an increase in intracranial pressure
Consciousness for a ‘lucid’ period before becoming comatose
Death
22
Q
The major arteries of the cerebral arterial circle anastomose via communicating arteries. Whatʼs the advantage of this anastomotic arrangement?
A
Allows blood supply to be maintained to areas of the brain even when one of the vessels is occluded
23
Q
Where do the following arteries arise from?
○ internal carotid arteries.
A
Common carotid artery
24
Q
Where do the following arteries arise from?
○ vertebral arteries.
A
Subclavian arteries
25
Where do the carotid arteries emerge inside the skull?
Via the Foramen lacerum into the middle cranial fossa
26
Which areas of the brain are supplied by the:
● Anterior cerebral arteries.
Medial aspects of frontal and parietal lobes
Strip on cortex on superior aspect of brain- motor and somatosensory cortex of lower limbs
Anterior structures of diencephalon
27
Which areas of the brain are supplied by the:
● Middle cerebral arteries.
Majority of lateral aspects and deep parts of hemispheres- motor and somatosensory cortex of upper limbs, face and trunk
Internal capsule
Some diencephalon structures
28
Which areas of the brain are supplied by the:
● Posterior cerebral arteries.
Occipital lobe
Inferior temporal lobe
29
Which layer of the meninges contributes to the formation of dural venous sinuses?
Dura
30
Into which veins do the dural venous sinuses drain into to reach the heart?
Sigmoid sinuses —> internal jugular vein
Emissary veins (drain venous blood into bones of skull)
31
What symptoms and signs might a patient present with if they have an occlusion in their dural venous sinuses?
Headache
Compression of intracranial structures
32
Where is most CSF produced?
Choroid plexus in lateral ventricles
33
Between which meningeal layers does the CSF flow?
Dura and arachnoid
34
How does CSF reach the spinal canal?
Central canal
35
Where is CSF reabsorbed?
Arachnoid granulations
36
What is the function of CSF?
Physical protection
Mechanism for transfer of certain substances into and out of brain tissue
37
How can we acquire a sample of CSF from a patient?
○ What layers of tissue do we need to pass a needle through to reach it?
○ What diseases can clinicians test for using CSF?
Spinal tap
- level of L4/L5
- skin, subcutaneous fat, supraspinous ligament, interspinous ligament, Ligamentum flavum, dura, arachnoid
- infection, cancer, encephalitis, high blood glucose
38
What is hydrocephalus? Can you think of a cause of hydrocephalus, and what would happen if it is not treated?
Accumulation of CSF, characterised by enlarged lateral ventricles
-blockage to flow of CSF through ventricular system eg due to cancer
-causes headaches, vomiting, drowsiness, reduced conscious levels of seizures
39
Which bones make up the anterior cranial fossa?
Orbital part of Frontal bone
Lesser wings of Sphenoid bone
Cribriform plate and crista galli of the Ethmoid bone
40
Identify the cribriform plate.
○ Which bone is this structure part of?
Ethmoid bine
41
● Identify the cribriform plate.
○ What is the name of the linear projection in the middle of it?
Crista galli
42
● Identify the cribriform plate.
○ Which cranial nerve fibres pass through the holes in the cribriform plate?
Olfactory nerve fibres
43
On some skulls, you may be able to identify one of the pairs of facial sinuses at the front of the anterior cranial fossa. Which sinuses are these?
Frontal
Maxillary
Sphenoid
Ethmoid
44
Which bones make up the middle cranial fossa?
Petrous and squamous part of the Temporal bone
Greater wing and body of the Sphenoid bone
45
Identify the temporal bone.
○ What are the two parts of the temporal bone? What do their names mean?
Petrous part- ‘rock-like’ hard and bulbous inferior and middle part
Squamous part- ‘scale-like’ flare, lateral part
46
Identify the sphenoid bone.
○ What is the name of the depression in its centre where the pituitary gland is located?
Sella turcica (pituitary fossa)
47
Name which structure passes through them:
○ Optic canal
Optic nerve
48
Name which structure passes through them:
○ Superior orbital fissure
Oculomotor nerve
Trochlear nerve
Ophthalmic branch of trigeminal nerve
Abducens nerve
49
Name which structure passes through them:
○ Foramen rotundum
■ Which parts of the face does this nerve provide sensation to?
Maxillary branch of trigeminal nerve
Middle 1/3 of face including internal nasal cavity, upper teeth, palate
50
Name which structure passes through them:
○ Foramen ovale
■ What kind of sensation does this nerve provide to the anterior 2/3 of the tongue?
Mandibular branch of trigeminal nerve
General sensation
51
Name which structure passes through them:
○ Foramen lacerum
Internal carotid artery
52
Name which structure passes through them:
○ Foramen spinosum - if you look carefully, on some skulls you can see a slight groove in the bone that passes laterally and superiorly from this foramen.
■ Which blood vessel causes this groove?
■ Which kind of intracranial haemorrhage is this structure o en
implicated in?
Middle meningeal artery
Extradural haemorrhage
53
Which bones make up the pterion?
Frontal bone
Sphenoid bone
Temporal bone
Parietal bone
54
Which artery is located immediately behind the pterion?
Middle meningeal artery
55
Which bones make up the posterior cranial fossa?
Occipital bone
Part of the petrous part of the temporal bone
56
Identify the petrous part of the temporal bone.
○ What is located inside this part of the temporal bone?
The inner ear
57
Which foramen allows cranial nerves to enter the inner ear?
■ Which nerves travel through it?
Internal auditory meatus
-vestibulocochlear nerve and facial nerves
58
Identify the jugular foramen.
○ Which large blood vessel passes through it?
■ Which venous structure becomes this vein as it passes through?
Internal jugular vein
-sigmoid sinus
59
Identify the jugular foramen.
○ Which nerves pass through it?
Glossopharyngeal
Vagus
Accessory
60
Identify the large foramen in the centre of the posterior cranial fossa.
○ What is its name?
○ What passes through it?
Foramen magnum
- spinal cord
61
Which bones make up the orbits?
Larger:
Frontal bone
Maxillary bone
Sphenoid
Zygomatic
Smaller:
Ethmoid
Lacrimal
62
The orbital floor is o ften noted to be the weakest wall of the orbit. Which cavity is located immediately below it?
Sphenoid-ethmoid sinus —> nasal cavity
63
What are the names of the foramina at the back of the orbit?
○ What do they transmit?
Superior orbital fissure = oculomotor, trochlear, ophthalmic and abducens nerve
Optic canal = optic nerve
Inferior orbital fissure
64
The lacrimal gland is located in the superior and lateral part of the orbit.
○ Which nerve controls release of tears from the lacrimal gland?
■ Is this a somatic, sympathetic or parasympathetic function?
Facial nerve- parasympathetic
65
Where do tears drain after lubricating the surface of the eye?
Nasolacrimal duct into nasal cavity
66
How many extraocular muscles are there?
7
67
Which one is supplied by the trochlear nerve (CN IV)?
Superior oblique
68
Which one is supplied by the abducens nerve (CN VI)?
Lateral rectus
69
Which nerve supplies the 5 other extraocular muscles?
Oculomotor CN III
70
Which muscle is responsible for lifting the eyelid
Levator palpebrae superioris
71
Describe how the superior oblique muscle reaches the eye. What is the name of the pulley that it passes through? How does this affect its action on the eye?
The superior oblique originates at the back of the eye and passes through the trochlea (located in the superior and medial corner of the orbit)
It inserts into the top of the eye so its action will pull the top of the eye medially causing it to rotate - Intorsion
72
Can you explain why the superior and inferior oblique muscles are required to intort and extort the eye? When do you use this function?
Counter the secondary effects of extorsion and Intorsion caused by the superior and inferior recti muscles
-maintains steady vision when looking up or down
73
When they look up, which of their extraocular muscles are responsible for this movement?
Superior rectus
74
When they look to their le ft, which of their extraocular muscles are responsible for this movement?
In left eye = lateral rectus
In right eye = medial rectus
75
Which movement of their eye is useful for testing the superior oblique muscle?
Can they depress an adducted eye
76
Can you define what conjugate eye movements are?
Different muscles may be required in order for the eyes to look in the same direction
77
Which muscles control the thickness of the lens?
Ciliary muscles
78
Which muscle causes constriction of the pupil (miosis)?
Constrictor Pupillae - circular muscle
79
Which nerve carries the fibres that control accommodation and pupillary light reflex constriction?
○ Is this a somatic, sympathetic or parasympathetic function?
Oculomotor nerve- parasympathetic
80
Which nerves are involved in the pupillary reflex arc?
○ Which cranial nerve is the afferent limb?
○ Which cranial nerve is the efferent limb?
Afferent= optic
Efferent= oculomotor
81
Which muscle causes the dilation of the pupil (mydriasis)?
Dilator pupillae- sympathetic
82
Which nucleus in the midbrain is responsible for causing constriction of the other pupil?
Edinger-Westphal nucleus
83
Pinna
○ What is its function?
○ What is it made of?
To funnel sound waves into the ear canal
-cartilage
84
Tympanic membrane (ear drum)
○ What is its function?
○ What happens if it ruptures?
To transmit sound waves into vibrations that can be transmitted towards the cochlea
- loss/imparied hearing
85
Ossicles
○ What are their names? What order are they in from lateral to medial?
Malleus
Incus
Stapes
86
Ossicles
○ What is their function?
To transmit the vibrations from the tympanic membrane to the cochlea
87
Ossicles
○ What is the name of the window that the most medial bone is in contact with?
Oval window
88
Ossicles
○ Which muscle pulls on the most medial bone to limit sound transmission?
What is the function of this? Which nerve supplies it?
Stapedius muscle- dampens vibrations of stapes
-facial nerve
89
Auditory (Eustachian) tube
○ What does it connect to, and why?
Connects the middle ear cavity and nasal cavity in order to allow air flow to maintain equal air pressure
90
Auditory (Eustachian) tube
○ What might a patient experience if it became blocked? You can open your auditory tube by simply trying to blow air out of your nose, whilst pinching your nostrils closed. What is happening when you do this?
Pain
Potential rupture of tympanic membrane
Air passes through auditory tube to increase air pressure in inside if tympanic membrane- pressure correction
91
Auditory (Eustachian) tube
○ Can you explain why you feel a pop in your ear when ascending or
descending in altitude?
Pressure outside tympanic membrane increases and causes membrane to bulge inwards or vice versa
92
Which nerve travels into the middle ear cavity and out again whilst giving off a branch to the tongue?
Facial nerve
93
Semicircular canals
○ What is their function?
Perceive movement
94
What are the other two parts of the vestibular system? What is their
function?
Utricle and saccule
- perceive linear acceleration and gravity
95
Cochlea
○ What are the names of the two ʻwindowsʼ into the cochlea?
○ What is their purpose?
Oval window- contact with stapes
Round window- bulges in and out to allow fluid within the cochlea to move
96
Which cranial nerve carries information from the vestibular system and cochlea?
○ Which foramen does it traverse to enter the inner ear cavity?
○ Where does it travel to?
Vestibulocochlear nerve CN VIII
Internal auditory meatus towards nuclei in pons
97
Which part of the skull houses the middle and inner ear cavities?
Petrous part of temporal bome
98
Centrally, the cerebral aqueduct.
○ Which parts of the ventricular system does this structure connect?
Third and fourth ventricles
99
○ What is the name of the part of the midbrain that is dorsal to the cerebral aqueduct? What is the name of the part that is ventral to it?
Dorsal = tectum
Ventral = tegmentum
100
Dorsally, the superior and inferior colliculi.
○ What is the function of the colliculi?
To coordinate movement of the head and eyes in response to visual and auditory stimuli
101
Which cranial nerve nuclei are located within the midbrain?
Oculomotor
Trochlear
102
Which cranial nerve emerges posteriorly from the midbrain?
Trochlear
103
Which part of the brain is found immediately superior to the midbrain?
Diencephalon
104
Which artery runs along the ventral surface of the pons?
Basilar artery
105
Dorsally, the middle cerebellar peduncle.
○ Which structure connects to the pons here?
Cerebellum
106
What is the name of the cavity that is trapped between the middle
cerebellar peduncles and the pons? Which fluid fills this cavity?
Fourth ventricle - CSF
107
Which cranial nerve nuclei are located within the pons?
Trigeminal
Abducens
Facial
Vestibulocochlear
108
Which large cranial nerve emerges laterally from the pons?
Trigeminal nerve
109
Ventrally, the anterior median fissure and the medullary pyramids and olives.
● Which important tracts travel inside the pyramids?
Corticospinal
Corticobulbar
110
Dorsally, the gracile fasciculus and cuneate fasciculus.
○ Information about what types of sensation do these tracts carry?
Proprioception
Vibration
Fine touch and 2 point discrimination
111
Which cranial nerve nuclei are located within the medulla?
Glossopharyngeal
Vagus
Accessory
Hypoglossal
112
What vital functions does the medulla contribute to? What might be the consequence of compression of the medulla?
Regulating respiration, heart rate and blood pressure
Initiating vomiting
113
Using one coloured pen, highlight the region of the temporal retina of the right eye.
○ Which part of the visual field - le ft or right, and nasal or temporal - does this part of the retina receive light from?
Left nasal field
114
Now using the same coloured pen, highlight the nasal retina of the le eye.
○ Which part of the visual field - le ft or right, and nasal or temporal - does this part of the retina receive light from?
Right temporal field
115
patient has a field defect called right monocular blindness.
○ Where is the lesion to cause this defect?
Right optic nerve
116
A patient has a field defect called bitemporal hemianopia.
○ Where is the lesion to cause this defect?
Optic chiasm
117
A patient has a field defect called le ft homonymous hemianopia.
○ Where is the lesion to cause this defect?
Right optic tract
118
Cerebellar peduncles - where do each of the 3 pairs of cerebellar peduncles connect to the brainstem?
Superior = midbrain
Middle = pons
Inferior = medulla
119
Cerebral aqueduct - which part of the brain is wrapped around the cerebral aqueduct?
Midbrain
120
Hypothalamus - what are the main functions of the hypothalamus?
Thermoregulation
Water level monitoring
Homeostasis
121
Pineal gland - what is its function?
Melatonin secretiom
122
Pituitary gland - what attaches the pituitary gland to the hypothalamus?
Infundibulum
123
What type of fibre does the corpus callosum contain?
Commissural fibres
124
What type of fibre does the cingulate gyrus contain?
Association
125
What is the function of the limbic system?
Emotional regulation
Memories
Learning
126
What are the 3 parts of the caudate nucleus?
Head, body and tail
127
The nucleus accumbens is located at the point where the caudate and putamen meet anteriorly. What is its role?
Reward system
Addiction
128
Amygdala - which lobe is this structure located within?
Temporal
129
What is the term for the putamen and globus pallidus when grouped together?
Lentiform nucleus
130
What is the term for the putamen, globus pallidus and caudate nucleus when grouped together?
Striatum
131
In which part of the brainstem would you find the substantia nigra? Which neurotransmitter is produced in the substantia nigra? Which disease is characterised by a lack of dopamine?
Midbrain
Dopamine
Parkinson’s
132
Internal capsule (anterior and posterior limb)
○ What structures lie medial to the internal capsule?
Caudate nucleus
Thalamus
133
Where are the fibres that are within the internal capsule travelling to or from?
The cortex to the brainstem
134
After travelling upwards through the internal capsule, in what structure do sensory fibres travel in to reach their destination?
Corona radiata
135
What type of fibres does the corona radiata contain
Projection
136
How many of each type of vertebrae are there?
C7
T12
L5
S5
Co4
137
What is meant by the terms lordosis, kyphosis and scoliosis?
Lordosis = inward curve
Kyphosis = outward curve
Scoliosis = lateral curve
138
Which movements are permitted in the cervical,
thoracic and lumbar spine?
Cervical = lateral flexion, flexion and extension
Thoracic = rotation
Lumbar = lateral flexion, flexion and extension
139
Identify the atlas (C1) and axis (C2)
○ How do they articulate with each other?
The odontoid process of the axis takes the place of the body of the atlas such that the atlas can spin around the axis
140
What type of joint is the atlanto-axial joint and what movements does it allow?
Pivot joint
Rotation
141
The atlas and axis are highly modified compared to a typical cervical
vertebra. What are their unique features?
Atlas = shaped like a ring (no vertebral body) and no spinous process
Axis = odontoid process that projects vertically upwards
142
The vertebral bodies are separated by intervertebral discs.
○ What is the histological type of joint that they form?
Secondary cartilaginous joint
143
Herniation (prolapse) of a disc is a common problem.
○ What does ʻherniationʼ mean and what might be the consequence of a herniated intervertebral disc?
○ What other term is commonly used to describe a herniated disc?
Bursting of the intervertebral disc, allowing the nucleus pulposus to leak out of the anulus fibrosus
- muscle weakness or altered sensation due to compression of spinal nerves
-slipped disc
144
Which parts of the vertebrae are connected by the anterior and posterior longitudinal ligaments?
Vertebral bodies
145
Where is the erector spinae muscle located?
○ What is its function?
Column either side of the spinous processes
-help to maintain balance and posture
146
How many spinal nerves are there?
31
147
At what level does the spinal cord terminate?
○ What happens to the dura, arachnoid and pia a fter this level?
○ What is the name of the bundle of nerves within the spinal canal a fter this level?
L1/L2
- taper until the pia forms the filum terminale
- cauda equina
148
At what vertebral level is a lumbar puncture performed and why?
L4/5 - to avoid puncturing the spinal cord
149
Where is the cell body of the peripheral sensory neuron located?
Dorsal root ganglion
150
Where are the motor neurons located in the spinal cord?
Ventral horn
151
Where in the spinal cord are the cell bodies of the preganglionic sympathetic neurons located?
Posterior grey horn
152
How do the sympathetic fibres leave the cord?
○ Where do they synapse next?
Ventral roots
- sympathetic chain
153
What kind of sensory information do the dorsal columns convey?
Proprioception
Vibration
Fine touch and 2 point discrimination
154
Draw the DCML first order neuron entering the spinal cord via the spinal nerve.
○ Does it enter via the dorsal or ventral root?
○ Where is its cell body located?
Dorsal root
Dorsal root ganglion
155
Where does the first order neuron DCML synapse in the brainstem?
Medulla
156
Where does the DCML second order neuron decussate?
Medulla
157
Draw the DCML second order neuron ascending. Where does it synapse?
Thalamjs
158
Draw the DCML third order neuron ascending to the cortex.
○ Which two structures does it pass through to reach the cortex?
Internal capsule
Corona radiata
159
What kind of sensory information does the spinothalamic tract convey?
Anterior = crude touch and pressure
Posterior = pain and temperature
160
Draw the spinothalamic first order neuron entering the spinal cord via the spinal nerve.
○ Does it enter via the dorsal or ventral root?
○ Where is its cell body located?
Dorsal root
Dorsal root ganglion
161
Where does this Spinothalamic first order neuron decussate?
1-2 levels above its entry into the spinal cord
162
Where does the Spinothalamic second order neuron synapse?
Thalamus
163
Draw the Spinothalamic third order neuron ascending to the cortex.
○ Which two structures does it pass through to reach the cortex?
Internal capsule
Corona radiata
164
What kind of fibres do the lateral corticospinal tracts convey?
Motor
165
Draw the corticospinal first order neuron leaving the cortex in the brain.
○ Which part of the cortex is it coming from? Which lobe is this in?
○ Which structures does it pass through to reach the brainstem?
Primary motor cortex - frontal lobe
Internal capsule
166
Draw this corticospinal first order neuron entering the brainstem and descending.
○ Where does this neuron decussate?
Medullary pyramids
167
Draw the first order neuron descending down the spinal cord in the lateral corticospinal tract.
○ Where does it synapse?
Ventral horn
168
Draw the second order neuron leaving the spinal cord.
○ Which structures does it pass through to leave the cord?
Ventral root
169
If a patient were to suffer an injury where the LEFT half of their spinal cord was damaged (hemisection) at the level of T4:
○ What sensory deficit would they experience? Which side of their body? At which level? What about above or below this level?
○ What motor deficit would they experience? Which side of their body? At which level?
Sensory =
-ipsilateral loss of proprioception, fine touch, 2 point discrimination, vibration below level of lesion
- contralateral loss of crude touch, pressure, pain and temperature 1/2 levels below lesion
Motor =
- ipsilateral loss of movement below lesion
170
In a different situation, if the blood supply to the spinal cord was interrupted what symptoms might the patient experience in the following examples, and which spinal level?
○ The posterior parts of the spinal cord were affected?
Loss of DCML- proprioception, vibration , fine touch, 2 point discrimination below lesion
171
In a different situation, if the blood supply to the spinal cord was interrupted what symptoms might the patient experience in the following examples, and which spinal level?
○ The anterior parts of the spinal cord were affected?
Loss of Spinothalamic and corticospinal
-movement below lesion
- crude touch, pressure, pain and temperature 1/2 levels below
