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C&M Upper limb- control Flashcards

1
Q

What is the name of the fissure that divides the cerebrum into two hemispheres

A

Great longitudinal fissure

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2
Q

What does the central sulcus divide

A

The frontal lobe from the parietal lobe
Pre central gyrus (motor cortex)
Post central gyrus (sensory cortex)

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3
Q

What structure separates the frontal lobe from the temporal lobe

A

Lateral sulcus

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4
Q

What are the 3 initial swellings in the rostral neural tube

A

Prosencephalon- forebrain
Mesencephalon- midbrain
Rhombencephalon- hindbrain

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5
Q

What do the 5 swellings become

A 
Telencephalon- cerebral hemispheres
Diencephalon- thalamus and hypothalamus
Mesencephalon- midbrain
Metencephalon- pons and cerebellum
Myelencephalon- medulla oblongata
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6
Q

What 2 layers make up the dura mater

A

Periosteal
Meningeal
Separate at dural venous sinuses

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7
Q

How does the internal carotid artery enter the skill

A

Carotid Canal

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8
Q

What is craniosynostosis: symptoms and treatment

A

Premature sutural fusion of the skull
Abnormal head shape, Raise ICP, cognitive deficits
Requires extensive surgical re-modelling of the cranial vault

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9
Q

What structures make up the brainstem

A

Midbrain
Pons
Medulla Oblongata

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10
Q

Boundaries of the brainstem

A

Caudally: Medulla continuous with spinal cord
Rostrally: Midbrain continuous with diencephalon
Ventrally: Clivus of occipital bone
Dorsally: Cerebellum

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11
Q

What structure separates the pyramids of the ventral medulla

A

Anterior Median Fissure

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12
Q

What structure separates the pyramids from the olives on the ventral medulla and what emerges from here

A

Anterolateral sulcus

Hypoglossal nerve emerges here

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13
Q

What nerves emerge at the posterolateral sulcus dorsal to the olives

A

Glossopharyngeal (9) and vagus (10)

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14
Q

What structure forms the roof of the 4th ventricle

A

Superior Cerebellar Peduncle

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15
Q

What structure forms the floor of the 4th ventricle

A

Rhomboid fossa

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16
Q

Where does the trochlear nerve emerge

A

Inferior to the inferior colliculi on the dorsal midbrain

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17
Q

What structure runs through the midbrain

A

Cerebral aquaduct

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18
Q

What are the 3 structures that can be found rostral to the obex at any point in the brainstem cross section

A

Basal- most anteriorly
Tegmentum- anterior to ventricular system
Tectum (midbrain- colliculi) posterior to ventricular system

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19
Q

What does the tegmentum contain

A

Cranial nerve nuclei and tract, reticular formation and some

ascending/descending pathways

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20
Q

What does the basal brainstem contain

A

descending fibres from cerebral cortex (pyramids, cerebral peduncles)

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21
Q

What does the reticular formation in the tegmentum control

A

Reticular nuclei – give rise to a descending motor pathway (reticulospinal tract)
Vital autonomic centres – eg. respiratory, cardiovascular
Cells giving rise to Ascending Reticular Activating System – pass to the cortex and involved in consciousness (damage = coma)
Modulate pain
Sleep wake cycle
Arousal

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22
Q

Where is the Edinger Westphal Nucleus and what does it control

A

Midbrain medial to occulomotor nucleus

Sends parasympathetic visceral fibres to sphincter pupillae and ciliary muscles- change pupil size

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23
Q

What are the 4 autonomic ganglia of the head and neck

A

Cilary
Otic
Pterygopalatine
Submandibular

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24
Q

Function of facial nerve

A

Muscles of facial expression, taste anterior 2/3rds tongue, parasympathetic to all glands except parotid

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25
Which nerves exit the skull via the jugular foramen
Glossopharyngeal, vagus, accessory
26
Which nerves exit the skull via the internal acoustic meatus
Facial and vestibulocochlear
27
Function of glossopharyngeal nerve
Swallowing, parasympathetic to parotid, taste posterior 1/3rd tongue, cutaneous sensation from ear, sensation from carotid body
28
Function of accessory nerve
Motor to sternocleidomastoid and trapezius
29
What foramen does the middle meningeal artery travel through the skull
Foramen spinosum
30
How does the accessory nerve enter and leave the skull
Enters via Foramen magnum | Exits via Jugular foramen
31
What lies in-between the two thalami
Third ventricle
32
What is the function of the sub thalamus
Lateral structure Part of basal ganglia Involved in motor control
33
What is the function of the epithalamus
Includes the pineal gland | Secretes melatonin; circadian rhythm maintenance
34
What does the lamina terminalis form
Corpus callosum and anterior white commissure
35
Do commissural fibres cross hemispheres
Yes | Corpus Callosum and Anterior Commisure
36
Do association fibres cross hemispheres
No- communication between gyri in one hemisphere | short and long fibres
37
What is the internal capsule
A v-shaped bundle of white matter lateral to the thalamus | Contains projection fibres that carry info from thalamus to/from cortex
38
What makes up the lentiform nucleus
Globus pallidus | Putamen
39
What is the basal ganglia
Lentiform nucleus + caudate nucleus | Deep grey matter nuclei controlling movement
40
How does CSF travel from the lateral ventricles to the third ventricle
Interventricular foramen
41
How does CSF travel from the 3rd ventricle to the 4th ventricle
Cerebral aquaduct
42
How does CSF leave the 4th ventricle to the subarachnoid spaces
Lateral and median apertures
43
What produces CSF
Choroid plexus (lining of ventricles) uses plasma from blood to produce approx 500ml/day
44
How does the CSF leave the subarachnoid space
Through arachnoid villi to dural venous sinuses and into venous circulation (mainly superior saggital sinus)
45
Which ventricle produces the most CSF
Lateral ventricle choroid plexus
46
Where is the primary auditory cortex
Superior temporal gyrus (Heschl's)
47
What is the function of the cingulate gyrus
Integrating sensation and motor function with memory (associated with hippocampus in the temporal lobe)
48
Primary olfactory cortex
Uncus (anterior extremity of parahippocampal gyrus)
49
Primary visual cortex
Striate nucleus either side of calcarine sulcus
50
Primary gustatory cortex
Inferior post central gyrus
51
What info does the Lateral VPL nucleus of the thalamus receive
sensory input from leg projects to midline post central gyrus
52
What info does the medial VPL nucleus of the thalamus receive
sensory input from arm project to lateral post central gyrus
53
What info does the VPM nucleus receive
sensory input from face projects to lateral post central gyrus
54
What is agnosia
Damage to secondary sensory areas leads to disorders of understanding Awareness of sensation persists, but significance of this sensation is lost. Eg. Eyes closes, handle scissors, can’t recognise
55
What is apraxia
Damage to secondary motor areas leads inability to carry out purposive movements, although there is no paralysis Leads to inability to perform learned movements
56
What is the function of the pre-frontal cortex
Regulates moods and feelings Involved in higher order cognitive functions Conceptualisation, planning, judgement (Phineas Gage)
57
What is the function of the parieto-temporal cortex
Integrates information of different modalities | Involved in memory
58
What is Wernicke's area
Posterior language area Sensory or receptive Understanding/association
59
What is Broca's area
Anterior language area Motor or expressive Production
60
What is Erb's palsy
Excessive stretching of the neck during delivery causing damage to C5, C6 nerve roots (common in newborns) Paralysis of muscles of shoulder/arm supplied by C5, C6 "waiter's tip" position
61
What is Klumpke's palsy
Damage to inferior trunk of brachial plexus (C8, T1 – ulnar nerve) Less common than Erb’s palsy Occurs in newborns where the baby’s upper limb is pulled excessively during delivery Claw hand- Paralysis of the majority of the intrinsic hand muscles (and ulnar flexors of the wrist and digits)
62
What is Claw hand
Hyperextension at the metacarpophalangeal joints and flexion at the interphalangeal joints Due to paralysed lumbricals of digits 4 and 5
63
What condition can Klumpke's palsy be associated with
Horner's syndrome: Ptosis, Miosis, Anhidrosis, Vasodilation | Sympathetic neurons supplying the head originate from T1 and may also be damaged by traction
64
What is cubital tunnel syndrome
Ulnar nerve entrapment in tendinous arch between the humeral and ulnar heads of flexor carpi ulnaris (elbow) Same symptoms as Klumpke’s palsy + elbow pain (no horner's) Treatment initially anti-inflammatories then surgery if unresolved
65
What is radial nerve palsy
Injury to radial nerve in spiral groove of humerus results in wrist drop Inability to extend the wrist and metacarpophalangeal joints due to paralysis of extensor muscles of the forearm. Triceps is usually weakened rather than paralysed
66
Why are triceps not completely paralysed in radial nerve palsy
Long head triceps branch of radial nerve is given off before the spiral groove so can get some weak elbow flexion.
67
How can the median nerve be damaged at the elbow
Supra condylar fractures or pronator teres syndrome
68
What is the hand of benediction
Inability to flex digits 1-3 | Weakened flexion of digits 4-5
69
Two tests for median nerve compression
Tinel's Test: percuss nerve | Phalen's Test: compress nerve by acutely bending wrist

Medicine (7 decks)

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