anatomy

Question 1

what is a collection of nerve cell bodies in the CNS called?

Answer 1

nucleus

Question 2

what is a collection of nerve cell bodies in the PNS called?

Answer 2

ganglion

Question 3

where are spinal nerves found?

Answer 3

intervertebral foramina ONLY

Question 4

myotome

Answer 4

the skeletal muscle supplied with motor innervation from a single spinal nerve
- can be deep to the same or different dermatome

Question 5

what dermatome is the nipple and umbilicus at?

Answer 5

nipple = T4

umbilicus = T10

Question 6

which dermatomes cover the upper limb?

Answer 6

C5-T1

Question 7

which rami are involved in nerve plexuses?

Answer 7

anterior rami from a number of adjacent spinal nerves

-> anterior ONLY

Question 8

which spinal nerves are involved in the lumbar plexus?

Answer 8

L1-L4

Question 9

which spinal nerves are involved in the sacral plexus?

Answer 9

L5-S4

Question 10

which levels have lateral spial horns and why?

Answer 10

T1-L2 - sympathetic outflow

Question 11

via what do presynaptic parasympathetic axons leave the CNS?

Answer 11

cranial nerves - III, VII, IX + X

+ sacrall spinal nerves (hindgut, pelvis, perineum)

examples - ciliary ganglion, lacrimal gland, vagus nerve (neck-midgut)

Question 12

what causes symptoms of horners syndrome

Answer 12

compression of cervical parts of sympathetic trunk - impaired sympathetic innervation to head + neck

Question 13

layers of the sccalp

Answer 13

skin
connective tissue - contains rich anastomotic network
aponeurosis
loose connective tissue
pericranium

Question 14

which artery lies deep to the pterion in the skull?

Answer 14

middle meningeal artery

pterion = thinnest part of skull

Question 15

what are the 4 layers of the meninges?

Answer 15

dura mater - tough/fibrous
arachnoid mater - can outpouch into dura venous sinus

subarachnoid space - contains CSF
pia mater - adherent to brain + vesels entering/leaving brain

Question 16

what is the sensory nerve supply of the dura mater?

Answer 16

CN V

• dura mater enclose the dura venous sinuses
• no space between skull + dura

Question 17

roof of pituitary

Answer 17

diaphragm sellae

Question 18

the circle of Willis can be found in what space?

Answer 18

subarachnoid space

–> surrounded by CSF, if bleed will see in CSF

Question 19

what level do u do a lumbar puncture

Answer 19

L3/L4

Question 20

extradural haemorrhage location + causes

Answer 20

between bone + dura

ruptured middle meningeal artery -> trauma to pterion

Question 21

subdural haemorrhage location + causes

Answer 21

separates dura from arachnoid

torn cerebral arteries
-> falls in elderly

Question 22

subarachnoid haemorrhage location + causes

Answer 22

into CSF of subarachnoid space

ruptured Circle of Willis (“berry”) anneurysm
-> congenital aneurysm

Question 23

what does compression of the oculomotor nerve by an uncal herniation lead to?

Answer 23

an ipsilateral fixed dilated pupil
(a blown pupil)

Question 24

intrinsic muscles of the back

Answer 24

maintain back posture, move spine

2 groups -
- erector spinae - superficial
- transversospinalis - deep

Question 25

attachments of erector spinae

Answer 25

3 muscle groups - inferiorly -common tendon attaches to sacrum + iliac crest - superiorly - individual fibres attach to either a rib, tranverse or spinous process

Question 26

transversospinalis

Answer 26

found within grooves between tranverse + spinous processes individual muscle fibres attach between: - vertebra + skull - vertebra + rib - 1 vertebra + another - sacrum + a vertebra

Question 27

which muscles are responsible for flexion + extension of the spine respectively?

Answer 27

flexion = psoas major + rectus abdominis extension = erector spinae (if contracts unilaterally - lateral flexion)

Question 28

where in the spine are there no vertebral discs?

Answer 28

C1-C2 + fused sacrum/coccyx

Question 29

layers of intervertebral discs

Answer 29

outer fibrous ring = annulus fibrosus inner SOFT PULP = nucleus pulposus

Question 30

which vertebra has an odontoid process?

Answer 30

C2 - axis

Question 31

what level does spinal cord end

Answer 31

L1/L2 -> connus medullaris

Question 32

when giving epidural anaesthetic at L3/L4, what layers will the needle pass through? vs spinal anaesthetic

Answer 32

supraspinous ligament interspinous ligament ligamentum flavum epidural space (fat + veins) spinal anaesthetic, as above plus - - dura mater, arachnoid mater, reaches subarachnoid space containing CSF

Question 33

anatomy of caudal anaesthesia

Answer 33

local anaesthetic is injected into the sacral hiatus to anaesthetise the sacral spinal nerve roots of the cauda equina

Question 34

which spinal nerve dermatome innervates the badge patch area?

Answer 34

C5

Question 35

spinal root levels of femoral nerve

Answer 35

L2, L3, L4

Question 36

where is the "nerve point" on the neck and why is it important?

Answer 36

just above midpoint of posterior border of SCM -> sensory nerves of cervical plexus - special care required during biopsy

Question 37

what is the cutaneous supply to the anatomical snuff box?

Answer 37

cutaneous branches of radial nerve

Question 38

which spinal levels are important to know for referred pain from the myocardium?

Answer 38

T1+T2

Question 39

abduction and adduction of the shoulder joint tests which myotomes?

Answer 39

abduction = deltoid, C5 adduction = C7, pec major + lat dorsi

Question 40

flexion + extension of the elbow joint tests which myotomes?

Answer 40

flexion = C5, C6, biceps brachii extension = C7, C8, triceps brachii

Question 41

flexion + extension of the wrist joint tests which myotomes?

Answer 41

flexion = C6, C7, carpal flexors extension = C7, C8, carpal extensors

Question 42

flexion + extension of the finger joints tests which myotomes?

Answer 42

flexion = C8, digital flexors extension = C7, digital extensors

Question 43

abduction + adduction of the fingers test with myotome?

Answer 43

T1

Question 44

flexion + extension of the hip joint tests which myotomes?

Answer 44

flexion = L2, L3, psoas major extension = L5, S1, glute max + hamstrings

Question 45

flexion + extension of the knee joint tests which myotomes?

Answer 45

flexion = L5, S1, hamstrings extension = L3, L4, quadriceps

Question 46

dorsiflexion + plantarlfexion of the ankle joint tests which myotomes?

Answer 46

dorsiflexion = L4, L5, tibialis anterior plantar flexion = S1, S2, gastrocnemius/soleus

Question 47

inversion + eversion of the ankle joint tests which myotomes?

Answer 47

inversion = L4, tibialis ant + posterior eversion = L5, S1, fibularis longus + brevis

Question 48

does ascending or descending tracts control the reflex muscle contractions?

Answer 48

descending

Question 49

UMN vs LMN lesion affect on tone

Answer 49

UMN lesion = spasticity LMN = flaccidity

Question 50

bicep reflex tests which myotome?

Answer 50

C5 (6)

Question 51

tricep reflex tests which myotome?

Answer 51

C7

Question 52

knee reflex tests which myotome?

Answer 52

L4

Question 53

ankle reflex tests which myotome?

Answer 53

S1

Question 54

supinator/brachioradialis reflex tests which myotome?

Answer 54

C6