Anatomy wk 1 Flashcards

1
Q

Name the parts of the brainstem

A

Midbrain
Pons
Medulla

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2
Q

What cranial fossa does the brainstem lie in

A

Posterior

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3
Q

Which part of the diencephalon is immediately superior to the midbrain

A

Thalamus

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4
Q

Which 2 embryological vesicles give rise to the brainstem

A

Midbrain (mesencephalon) and hindbrain (rhombencephalon) vesicles

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5
Q

What part of the ventricular system lies within the brainstem

A

Cerebral aqueduct - in midbrain

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6
Q

What groove separates the pons from the medulla

A

Pontomedullary junction

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7
Q

Which 3 cranial nerves emerge from the pontomedullary junction

A

CN VI, VII, VIII

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8
Q

Which cranial nerve has the longest intracranial course + what other Nerve emerging from pontomedullary junction has a long course

A

CN IV

CN VI

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9
Q

Consequence of CN VI being damaged

A

CN VI palsy –> unable to abduct eye –> diplopia

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10
Q

3 surface features of the medulla

A

Pyramids
Olives
Decussation of the pyramids (Can’t actually see this)

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11
Q

What are the pyramids of the medulla made up of

A

Descending motor fibres (corticobulbar fibres and corticospinal fibres) collectively forming the pyramidal tracts

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12
Q

What 2 tracts collectively form the pyramidal tract

A

Corticobulbar and corticospinal

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13
Q

What occurs at the decussation of the pyramids

A

Motor fibres in CST cross over to contralateral side

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14
Q

What are the olives of the medulla made up of

A

Inferior olivary nuclei

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15
Q

Function of inferior olivary nuclei

A

Receives motor input from cerebral cortex and has efferent connections with cerebellum to regulate cerebellar motor learning

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16
Q

Posteriorly on the medulla, there’s an open and closed medulla - which of these is superior

A

Open medulla

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17
Q

What structure does the open part of the medulla open into

A

IV ventricle

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18
Q

2 surface features of the pons

A

CN V

Middle cerebellar peduncle

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19
Q

What kind of fibres is the middle cerebellar peduncle made of

A

Purely afferent (Sensory) fibres

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20
Q

Inferior cerebellar peduncle connects what with what

A

Medulla with cerebellum

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21
Q

Middle cerebellar peduncle connects what with what

A

Pons with cerebellum

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22
Q

Superior cerebellar peduncle connects what with what

A

Midbrain with cerebellum

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23
Q

Surface features of the midbrain

A

Cerebral peduncles

Superior and inferior colliculi

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24
Q

What fibres are the cerebral peduncles made of

A

Sensory + motor, but mostly motor

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25
Q

What do the cerebral peduncles connect

A

Midbrain with thalamus and thereby the cerebrum

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26
Q

Function of superior colliculi

A

Involved in visual reflex

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27
Q

Function of inferior colliculi

A

Involved in auditory reflex

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28
Q

4 components of the diencephalon

A

Thalamus, hypothalamus, subthalamus and epithalamus (pineal gland)

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29
Q

Diencephalon is immediately superior to what

A

Midbrain

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30
Q

Name the surface projections on the surface of the hypothalamus

A

Mamillary bodies

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31
Q

Another name for epithalamus

A

Pineal gland

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32
Q

Name the thing connecting the 2 cerebellar hemispheres in the midline

A

Vermis

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33
Q

Name the 3 lobes of each cerebellar hemisphere

A

Anterior lobe
Posterior lobe
Flocculondular lobe

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34
Q

Name the extra lobe like structure of each cerebellar hemisphere inferiorly

A

Cerebellar tonsil

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35
Q

Name the space anterior to the cerebellum and posterior to brainstem

A

IV ventricle

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36
Q

Cerebellum sits above what foramen

A

Foramen magnum

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37
Q

What components of the cerebellum sit above the foramen magnum

A

Cerebellar tonsils

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38
Q

Clinical significance of cerebellar tonsils

A

When intracranial pressure suddenly drops, the cerebellar tonsils can herniate down through foramen magnum, compressing lower brainstem and the first part of spinal cord = CEREBELLAR CONING

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39
Q

Posterior inferior cerebellar artery occlusion causes what syndrome

A

Lateral medullary syndrome

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40
Q

What fissure separates the 2 cerebral hemispheres

A

Median longitudinal fissure

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41
Q

What fold of dura lies in the median longitudinal fissure

A

Falx cerebri

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42
Q

What massive white matter tract structure connects the 2 cerebral hemispheres

A

Corpus callosum

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43
Q

Function of corpus callosum + what fibres it carries

A

Made up of commissural fibres that allow communication between the right and left side

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44
Q

The cerebral hemispheres sit on which 2 cranial fossae + what sits on the remaining cranial fossa

A

Anterior and middle

Cerebellum sit on the posterior cranial fossa

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45
Q

What fold of dura mater do the cerebral hemispheres sit above in the posterior cranial fossa

A

Tentorium cerebelli

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46
Q

Name the fissure that divides the frontal and parietal lobe superiorly and the temporal lobe inferiorly

A

Lateral fissure

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47
Q

Name the sulcus that divides the frontal and parietal lobe (primary motor cortex from primary somatosensory cortex)

A

Central sulcus

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48
Q

Name the sulcus on the MEDIAL surface of the cerebral hemispheres that divides the parietal and occipital lobe

A

Parieto-occipital sulcus

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49
Q

Name the sulcus on the MEDIAL surface of the cerebral hemisphere that extends anteriorly from the parieto-occipital sulcus to the occipital pole posteriorly

A

Calcarine sulcus

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50
Q

Name the 3 poles of the cerebral hemispheres

A

Frontal pole
Temporal pole
Occipital pole

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51
Q

Which lobe contains the primary motor cortex

A

Frontal

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52
Q

Which lobe contains the primary visual cortex

A

Occipital

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53
Q

Which lobe contains the primary somatosensory cortex

A

Parietal

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54
Q

Which lobe contains the primary auditory cortex

A

Temporal

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55
Q

What parts of the vertebrae are removed in a laminectomy

A

Lamina + spinous process

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56
Q

What muscle overlies the lamina of the vertebrae

A

Erector spinae

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57
Q

What 4 ligaments might be encountered in a laminectomy

A

Ligamentum flavum
Interspinous
Supraspinous
Posterior longitudinal

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58
Q

Function of ligaments flavum

A

Connects laminae of adjacent vertebrae

Broad pale yellow fibrous tissue appearance

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59
Q

Function of interspinous ligament

A

Connect adjoining spinous processes and extend from the root to apex of spinous processes

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60
Q

Function of supraspinous ligament

A

Connects the tips of spinous processes from C7 onwards

61
Q

Function of posterior longitudinal ligament

A

Connects the posterior surface of vertebral bodies and IV discs; mainly connected to IV discs, less so bodies

62
Q

What level does spinal cord end in adult

A

L1-L2

63
Q

What level does spinal cord end in newborn

A

L3

64
Q

What level does the dura mater end

A

S2

65
Q

What level does the arachnoid mater end

A

S2

66
Q

What happens to the Pia mater inferior to the spinal cord

A

Extends as the filum terminale

67
Q

What occupies space between conus medullaris and the termination of the dura and arachnoid mater

A

Cauda equina (nerve roots of L2- Cc1)

68
Q

Clinical significance of the caudal equina

A

Where to do lumbar puncture

69
Q

What vertebral level would you do lumbar puncture

A

Between L3 and L4

70
Q

How many pairs of spinal nerves + describe how many of each

A

31 pairs - 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal

71
Q

Lower motor neurone lesion is in where

A

In spinal nerves that have left the spinal cord (i.e. spinal nerve roots)
LMNs in the ventral horn of spinal cord

72
Q

Upper motor neuron lesion is in where

A

CNS - brain and spinal cord

73
Q

Is damage to the caudal equina an UMN or LMN lesion

A

LMN

74
Q

Name the arteries entering the cranial cavity to supply the brain

A

Right and left vertebral arteries

75
Q

What happens to the vertebral arteries after entering the foramen magnum

A

They fuse once they’ve entered the cranial cavity to form basilar artery

76
Q

Basilar artery terminates as what 2 arteries

A

Right and left posterior cerebral arteries

77
Q

Name the small branch that comes off the vertebral arteries before they fuse

A

Posterior inferior cerebellar arteries

78
Q

Name the 3 main branches of the basilar artery from posterior to anterior before terminating as the posterior cerebral arteries

A

Anterior inferior cerebellar a
Labyrinthine a
Superior cerebellar a

79
Q

What does the posterior communicating artery join

A

The posterior cerebral a to the middle cerebral/ICA (as MCA is branch of ICA)

80
Q

What does the anterior communicating artery join

A

The 2 anterior cerebral arteries

81
Q

How many posterior and anterior communicating arteries are there

A

2 posterior

1 anterior

82
Q

What cerebral arteries are branches of the ICA

A

Middle and anterior cerebral

83
Q

Name the arteries forming the circle of willis (4 are paired) that supply the brain

A
  1. L+ R INTERNAL CAROTID ARTERY
  2. L+ R ANTERIOR CEREBRAL ARTERY
  3. ANTERIOR COMMUNICATING ARTERY
  4. L+ R POSTERIOR CEREBRAL ARTERY
  5. L + R POSTERIOR COMMUNICATING ARTERY
84
Q

Protective function of circle of willis

A

If one of the arteries that make up the circle of Willis occluded, ischaemia can be prevented because the other arteries would compensate for it by preserving cerebral perfusion through COLLATERAL CIRCULATION

85
Q

Which arteries do the left and right vertebral arteries arise from

A

Left and right subclavian

86
Q

What level range do the left and right ICAs arise

A

C3 - C5

87
Q

Which part of brainstem is basilar artery related to

A

Lies on pons

88
Q

What fissure does the ACA lie in
What sulcus does the MCA lie in
What fissure does the PCA lie in

A

Median longitudinal fissure
Lateral sulcus
Transverse/horizontal fissure (between cerebellum and occipital lobe)

89
Q
Which cerebral artery supplies the:
Primary motor cortex
Primary somatosensory cortex
Primary visual cortex
Primary auditory cortex
Olfactory area
A
MCA
ACA & MCA
PCA
MCA
MCA?
90
Q

What parts of brain does the vertebra-basilar system supply

A

Brainstem
Cerebellum
Occipital lobes

91
Q

Which arteries runs superior to superior cerebellar arteries

A

PCAs

92
Q

Which cranial nerve emerges just above superior cerebellar artery

A

CN III

93
Q

Aneurysm of PCA often results in palsy of what closely anatomically related nerve

A

CN III

94
Q

Features of CN III palsy

A

SR, IR, MR, IO wouldn’t function normally

LR and SO can still abduct and depress so eye is typically in down and lateral position

95
Q

What 3 things help to control blood flow to brain

A

Carotid sinus
Carotid body
Sympathetic motor nerves

96
Q

What is the carotid sinus anatomically + function + what nerves are sensory to it

A

Dilatation on the terminal part of the CCA/proximal part of ICA
Is a pressure receptor which monitors blood flow to brain

Glossopharyngeal and vagus

97
Q

What is the carotid body anatomically + function + what nerves are sensory to it

A

Area on the posterior wall of the terminal part of CCA
Contains chemoreceptors which are sensitive to low oxygen (hypoxia), if hypoxia detected then heart rate, respectively rate and blood pressure stimulated to increase

Glossopharyngeal

98
Q

How are sympathetic motor nerves involved with the ICA

A

Sympathetic motor nerves from the superior cervical ganglion form a plexus around the ICA and enters the skull with the ICA through the carotid canal

99
Q

Venous drainage of the brain

A

By a series of smaller veins which drain into dural venous sinuses

100
Q

Dural venous sinuses are located between what 2 layers

A

Cranial dura and the periosteum (inner surface of skull)

101
Q

Name a cerebral vein belonging to the deep group of cerebral veins that can be seen on specimen

A

Great cerebral vein

102
Q

What major vein do dural venous sinuses drain into and through which foramen of the skull does this vein exit

A

IJV

Jugular

103
Q

Name the veins that connect the intracranial venous sinuses with extra cranial veins (3) + clinical significance of these

A

Superior ophthalmic vein
Emissary veins
Inferior petrosal sinuses

Potential routes of infection carried in the blood towards the brain

104
Q

Superior ophthalmic vein drains into what

A

Cavernous sinus

105
Q

What are emissary veins + clinical significance of these

A

Small veins that connect the dural venous sinuses with the dipole of the skull which contains blood sinuses (in the bone marrow of the dipole) that are continuous with veins in the superficial fascia of the outer part of skull and scalp

Spread infection into brain

106
Q

What sinus connects the 2 inferior petrosal sinuses

A

Basilar sinus

107
Q

Name some dural venous sinuses (8)

A
Superior saggital
Inferior saggital
Transverse
Sigmoid
Cavernous
Straight
Superior petrosal
Inferior petrosal
108
Q

What bony part of the skull does the confluence of sinuses occur

A

Internal occipital protuberance

109
Q

Location of cavernous sinus

A

On either side of the sella turcica

110
Q

What vein drains into cavernous sinus

A

Superior ophthalmic

111
Q

What neurovascular structures run in the cavernous sinus (6)

A

ICA

CN III, IV, VI, V1, V2

112
Q

What structures in skull base is cavernous venous sinus closely related to (3)

A

Pituitary gland
Sphenoid air sinus
CN II

113
Q

Serious disease associated with cavernous sinus + describe it

A

Cavernous sinus thrombosis

Sphenoid air sinus can spread infection into the cavernous venous sinus if a fistula forms between them

114
Q

Clinical features of cavernous sinus thrombosis

A

Bulging eyes

Loss of vision (due to impaired venous drainage from orbit + eye –> retinal congestion –> papilloedema or retinal haemorrhages)

115
Q

Arterial supply to spinal cord

A

Anterior spinal artery to anterior spinal cord

Posterior spinal artery to posterior spinal cord

116
Q

Branches of which arteries fuse to form the anterior spinal a

A

Vertebral a

117
Q

Posterior spinal a is branch of

A

Vertebral OR PICA - variable in people

118
Q

What venous plexus lies in the epidural space + what 2 veins join the plexus

A
Internal vertebral (epidural) venous plexus
Anterior and posterior spinal veins
119
Q

The internal vertebral venous plexus passes superiorly within the vertebral canal through the …. to communicate with dural sinuses and veins within the skull

A

Foramen magnum

120
Q

The internal vertebral venous plexus also communicates with what other plexus on the external surface of the vertebrae

A

External vertebral venous plexus

121
Q

3 layers of meninges

A

Dura mater
Arachnoid mater
Pia mater

122
Q

What circulates in the subarachnoid space

A

CSF

123
Q

What fold of dura is in the midline + what does it separate

A

Falx cerebri

The 2 hemispheres

124
Q

What bony structures does the falx cerebri attach anteriorly and posteriorly to

A

Anterior - crista galli

Posterior - internal occipital protuberance

125
Q

Name the 4 folds of dura in the brain

A

Falx cerebri
Tentorium cerebelli
Falx cerebelli
Diaphragma sellae

126
Q

What dural sinus runs in the upper border of the falx cerebri

A

Superior saggital

127
Q

What dural sinus runs in the lower border of the falx cerebri

A

Inferior saggiata

128
Q

What structures lie on either side of the tentorium cerebelli

A

Occipital lobes and cerebellum

129
Q

What bony points does the anterior edge of the tentorium cerebelli attach to

A

Clinoid processes of sphenoid bone

130
Q

What dural venous sinus runs along the attachment of the falx cerebri to the tentorium cerebelli

A

Straight sinus

131
Q

What dural fold separates the two cerebellar hemispheres

A

Falx cerebelli

132
Q

What dural fold surrounds the pituitary stalk

A

Diaphragm sellae

133
Q

Arterial supply of dura mater (3) + name a clinically significant artery that is branch of the maxillary artery that supplies the dura

A

Branches of ICA, ECA and vertebral a

Middle meningeal

134
Q

What is the middle meningeal artery a branch of

A

Maxillary artery which is a branch of ECA

135
Q

Formane that middle mengineal artery traverses

A

Foramen spinosum

136
Q

What are ventricles in the brain

A

CSF filled cavities

137
Q

What are ventricles of the brain embryologically derived from

A

Lumen of neural tube

138
Q

Name the ventricles + what connects the ventricles to each other

A

Lateral (2)
3rd
4th

Lateral connected to 3rd by inter ventricular foramen (foramen of munro)

3rd connected to 4th by cerebral aqueduct (of sylvius)

139
Q

What part of the brain do these parts of the lateral ventricles lie in:

  • anterior horn
  • body
  • inferior horn
  • posterior horn
A

Anterior horn - frontal lobe
Body - under corpus callosum
Inferior - temporal lobe
Posterior - occipital lobe

140
Q

What part of the brain is the 3rd ventricle in

A

In the diencephalon, between R + L thalamus

141
Q

What part of the brain is the cerebral aqueduct in

A

Midbrain

142
Q

Where is the 4th ventricle

A

Posterior to pons + medulla but anterior to cerebellum

143
Q

What specialised structures in the ventricles produce CSF

A

Choroid plexus

144
Q

How does CSF pass into subarachnoid space from 4th ventricle (hint: 2 foramina)

A

Passes through small holes called the the foramen of Magendie (more medial) and the foramen of Luschka (more lateral) in the roof of the 4th ventricle into the subarachnoid space

145
Q

How is CSF resorbed once in the subarachnoid space

A

Via arachnoid villi which protrude into the walls of the superior saggital sinus usually

146
Q

If CSF circulation restricted –> increase in ICP; in infants congenital defects in circulation of CSF can occur leading to enlargement of the head because ventricles dilated –> degeneration of surrounding brain tissue; what is this called

A

Hydrocephalus

147
Q

What surgical procedure can be carried out for hydrocephalus + why

A

Shunt to redirect fluid out of cerebral circulation into deep venous system

148
Q

What dural fold separates the occipital lobes from the cerebellum

A

Tentorium cerebelli

149
Q

What does cingulate gyrus separate

A

Separates the frontal and parietal lobes from the cingulate gyrus on the medial surface of the hemisphere