General Flashcards
(150 cards)
1
Q
With regard to spinal cord and cerebrum - what is dorsal and what is ventral
A
Dorsal = posterior/superior Ventral = anterior/inferior
2
Q
3 layers of meninges
A
Dura (outermost)
Arachnoid
Pia (inner most)
3
Q
What is Pia
A
Innermost layer of the meninges
On the surface of the brain and cant be separated from the brain
Microscopic layer, present between blood vessel and neurons also
4
Q
What is dura attached to
A
Outermost layer of meninges
Firmly adherent to inside of the skull
5
Q
Where do meningeal vessels arise
A
External carotid artery
6
Q
Where are meningeal vessels found
A
Extradural space, between bones of the skull and dura
7
Q
Example of blood vessels in cerebrum
A
Meningeal vessels
Bridging veins (between dura and arachnoid aka subdural space)
Circle of Willis
8
Q
Where is circle of Willis
A
subarachnoid space (between arachnoid and pia)
9
Q
What is white matter
A
Myelinated axons
10
Q
What is grey matter
A
Cell bodies
no myelin sheaths
11
Q
True or False:
There are no blood vessels deep to the pia
A
True
The pia forms part of the blood brain barrier
12
Q
What cells myelinate axons in the brain or CNS
A
Oligodendrocytes
13
Q
What cells myelinate axons in the PNS
A
Schwann cells
14
Q
What are afferents
A
axons taking information towards the CNS e.g. sensory fibres
15
Q
What are efferents
A
axons taking information to another site from the CNS e.g. motor fibres
16
Q
Functions of frontal lobe
A
Voluntary movement on opposite side of body
Brocas area - speech and writing (found in dominant hemisphere i.e. left if right-handed)
Intellectual functioning
Thought processes
Reasoning
Memory
17
Q
Functions of parietal lobe
A
Receives and interprets sensations, including pain, touch, pressure, size and shape and body-part awareness
Proprioception
18
Q
Functions of temporal lobe
A
Understanding spoken word (WERNICKES)
Understanding sounds
Memory
Emotion
19
Q
Functions of occipital lobe
A
Understanding visual images and meaning of written words
20
Q
Where is CSF produced
A
Ependymal cells in choroid plexuses of lateral ventricles (mainly)
21
Q
Where does CSF travel (describe ventricles of brain)
A
From lateral ventricles
Travels to 3rd ventricle via the interventricular foramen
From 3rd ventricle
Travels to 4th ventricle via the Cerebral Aqueduct
22
Q
How does the 4th ventricle communicate with/pass CSF into the subarachnoid space
A
Median Foramen of Magendie
Two lateral Foramens of Luschka
23
Q
Where is CSF absorbed after passing through subarachnoid space
A
Arachnoid granulations (VILLI) e.g. in superior sagittal sinus
24
Q
What is hydrocephalus
A
Abnormal accumulation of CSF in ventricular system
Often due to a blocked cerebral aqueduct
25
Which spinal roots make up the sympathetic trunk
T1-L2
26
Give examples of what sympathetic nervous system stimulates
* Increases heart rate
* Increases force of contractions in the heart
* Vasoconstriction
* BronchoDILATION
* Reduces gastric motility
* Sphincter contraction
* DECREASED gastric secretions
* Male ejaculation
27
Give examples of what parasympathetic nervous system stimulates
* Decreases heart rate
* Decrease force of contraction
* Vasodilation
* BronchoCONSTRICTION
* Increases gastric motility
* Sphincter relaxation
* INCREASED gastric secretions
* Male erection
28
What are the parasympathetic cranial nerves and where do they run via
Oculomotor nerve CN3 - to pupil
Facial nerve CN7 - to salivary glands
Glossopharyngeal nerve CN9 - for swallowing reflex
Vagus nerve CN10 - to thorax & abdomen
29
What are upper motor neurones and where do they generally originate
The descending pathways and neurones that originate in the motor cortex
Control the activity of the lower motor neurones
30
What are lower motor neurones and where are their cell bodies located
Alpha motor neurones that directly innervate skeletal muscle that have cell
bodies lying in the grey matter of the spinal cord and brainstem
31
What is spasticity
Increased muscle tone
When muscles do not develop increased tone UNTIL they are stretched a bit and after a brief increase in tone, the contraction subsides for a short time (Clasp-knife phenomenon)
32
Give an example of a disease in which you could see spasticity
Parkinsons
33
What is rigidity
Increased muscle contraction
Continous
Resistance to passive stretch is constant
34
How many vertebrae are there in one spine
```
7 cervical
12 thoracic
5 lumbar
5 sacral
4 coccyx
33 in total
```
35
How many pair of spinal nerves are there
```
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccyx
```
36
Where do cervical spinal nerve segments exit the spine
(around) 1 vertebra HIGHER than their corresponding
vertebra
EXCEPT C8 which exits below C7
37
Where do thoracic spinal nerve segments exit the spine
Around 1 (-2) vertebra BELOW their corresponding vertebra
38
Where do lumbar spinal nerve segments exit the spine
3-4 vertebra BELOW their corresponding vertebra
39
Where do sacral spinal nerve segments exit the spine
around 5 vertebra below
40
Define dermatome
Area of skin supplied by a single spinal nerve - sensory
41
Sensory innervation of the little finger
Ulnar nerve
| C8
42
Sensory innervation of the index finger
Median nerve
| C7
43
Sensory innervation of the thumb
C6
44
Sensory innervation of the clavicle
C4
45
Sensory innervation of the nipples
T4
46
Sensory innervation of the medial side of arm
T1
47
Sensory innervation of the umbilicus
T10
48
Sensory innervation of the knee
L4
49
Sensory innervation of the perianal area
S4
50
Sensory innervation of the anus
S5
51
Define myotome
Volume of muscle supplied by a single spinal nerve
52
Spinal roots of phrenic nerve
C3,4,5
53
Spinal roots of sensation of small muscles of hand
T1
54
Spinal roots of innervation of the penis
S2,3,4 (keeps the penis off the floor)
55
In what direction are all X-rays/MRIs/CT scans take
From perspective of foot to head
56
Examples of Motor tracts
```
Lateral corticospinal tract
Rubrospinal tract
Olivospinal tract
Vestibulospinal tract
Tectospinal tract
Anterior corticospinal tract
```
57
Examples of Sensory tracts
```
Fasciculus gracilis (more medial than cuneatus)
Fasciculus cuneatus
Posterolateral tract
Intersegmental tract
Posterior spinocerebellar tract
Lateral spinocerebellar tract
Anterior spinocerebellar tract
Spino-olivary tract
Spinorectal tract
Anterior spinothalamic tract
```
58
Examples of Ascending tracts
Dorsal/Medial lemniscal columns
Spinothalamic tract
Spinocerebellar tract
59
Which tracts are involved in Dorsal/Medial Lemniscal ascending columns
Fasciculus cuneatus
| Fasciculus gracilis
60
What sensations are detetcted/carried by Dorsal/Medial Lemniscal ascending columns
Proprioception
Vibration
Fine touch
61
Where does fasciculus cuneatus carry information to?
Lateral (one in spinal tract)
| Carries information from UPPER body to the cuneate tubercle in the medulla oblongata
62
Where does fasciculus gracilis carry information to?
Medial
| Carries information from LOWER body to the gracile tubercle in the medulla oblongata
63
Dorsal/Medial Lemniscal ascending columns - describe pathway after medulla oblongata
Decussates here (in medulla) to become the medial lemniscus then ascends to the thalamus then to SOMATOSENSORY cortex
64
What sensation is carried by the lateral spinothalamic tract
Pain and Temperature
65
What sensation is carried by the medial/anterior spinothalamic tract
Crude touch
66
Describe spinothalamic tract ascending pathway
Decussates soon upon entry into spinal cord (by 1/2 segments)
Ascends to the thalamus (unlike other sensory modalities that travel to the cortex)
PAIN reaches consciousness in the THALAMUS
67
What information is carried via the posterior spinocerebellar tract and to where
carries information on Proprioception
| to the IPSILATERAL INFERIOR Cerebellar Peduncle
68
What information is carried via the anterior spinocerebellar tract and to where
carries information on Proprioception
| to the CONTRALATERAL SUPERIOR cerebellar peduncle
69
Where do descending tracts originate
Cerebral cortex and brainstem (upper motor neurones)
70
2 types of descending pathways
Pyramidal
| Extrapyramidal
71
Features of pyramidal descending pathways
| where they originate, decussate etc
2 neurone pathway
Originates in cerebral cortex of cranial nerve nucleus
DECUSSATE in the Medulla and descend CONTRAlaterally
(also means neurones innervating our axial muscles (muscles of head and trunk) mostly do not decussate)
Synapses with the cell bodies of the ventral horn of the spinal grey matter
72
Example of pyramidal descending pathway
Corticospinal tract
73
Features of extra-pyramidal descending pathways
| origin, function
- Originate in the brainstem and carry motor fibres to the spinal cord
- Responsible for involuntary autonomic control of all musculature
74
Examples of extrapyramidal descending pathways
Rubrospinal tract
Tectospinal tract
Vestibulospinal tract
75
Function of corticospinal tract (what do medial and lateral ones innervate)
Transmits control of voluntary muscles (motor)
Lateral (75%) - limb muscles
Medial (25%) - axial muscles (head and trunk muscles needed to keep upright etc)
76
Pathway of corticospinal tract
Transmits control of voluntary
muscles (motor)
Originates from the contralateral motor cortex
• Lateral corticospinal tract
(75%): pyramidal (MEDULLARY)
DECUSSATION - limb muscles
• Medial (25%): DECUSSATES as it leaves via the anterior white commissure (a bundle of nerve fibres that cross the mid-line of the spinal cord) - axial muscles
• UMN go from cortex to ventral horn; Neurones (cell bodies) located in the ventral horns project to limb and
axial muscles - these are the lower motor neurones (LMN)
77
Where can an UMN lesion occur
Upper motor neurones (UMN) originate in the motor cortex - a UMN lesion can occur anywhere from the cortex all the way down to the ventral horn
78
Functions of vestibulospinal tract
Muscle tone, balance and posture (innervates antigravity muscles)
79
Where does vestibulospinal tract originate
Vestibular nucleus (CN8)
80
Which of these decussates and where:
Rubrospinal tract
Tectospinal tract
Vestibulospinal tract
Tectospinal and Rubrospinal tracts decussate at MIDBRAIN thus is CONTRAlateral
Vestibulospinal tract is NON-decussating thus IPSIlateral
81
What is brown-sequard syndrome
Hemi-section of spinal cord
82
Features of brown-sequard syndrome
- Ipsilateral loss of; proprioception, motor & fine touch
- Contralateral loss of; pain, temperature & crude touch
83
Explain features of brown-sequard syndrome
- Ipsilateral weakness (i.e. less motor etc.) below the lesion - due to damage to the ipsilateral descending motor corticospinal tract (decussated at the medulla already)
- Ipsilateral loss of dorsal column proprioception below lesion - sine the ascending tracts are damaged before they could decussate in the medulla
- Contralateral loss of spinothalamic pain & temperature below the lesion since spinothalamic fibres decussate just after entering cord within the spinal cord
84
Level of UMN and LMN lesions
UMN - above T10 vertebral or T12 spinal segment
| LMN - below T10 vertebral or T12 spinal segment
85
UMN and LMN lesions: Effect on bladder
UMN - spastic bladder + urge incontinence
| LMN - flaccid bladder + overflow incontinence
86
UMN and LMN lesions: Tone differences
UMN - Hypertonic (increased)
| LMN - Hypotonic (decreased)
87
UMN and LMN lesions: type of paralysis
U (or alpha) MN - Spastic paresis
| LMN - Flaccid paralysis
88
UMN and LMN lesions: Atrophy
UMN - No (only disuse) atrophy
| LMN - severe atrophy
89
Names 12 cranial nerves in order and if sensory, motor or both and if parasympathetic
```
(Oh Oh Oh To Touch And Feel Very Green Velvet Ah Heaven)
1 Olfactory - Some
2 Optic - Say
3 Oculomotor Money (Para)
4 Trochlear - Matters
5 Trigeminal - But
6 Abducens - My
7 Facial - Brother (Para)
8 Vestibulocochlear - Says
9 Glossopharyngeal - Big (Para)
10 Vagus - Breasts (Para)
11 Accessory - Matter
12 Hypoglossal - More
```
90
Vestibulocochlear nerve - which is ipsilateral, which is contralateral
Vestibular - Ipsilateral
| Cochlear - Contralateral
91
Cranial nerve brainstem nuclei location: Which cranial nerves have nuclei in midbrain?
3 and 4
Oculomotor
Trochlear
92
Cranial nerve brainstem nuclei location: Which cranial nerves have nuclei in pons?
```
5, 6, 7, 8
Trigeminal
Abducens
Facial
Vestibulocochlear
```
93
Cranial nerve brainstem nuclei location: Which cranial nerves have nuclei in medulla oblongata?
```
9, 10, 11, 12
Glossopharyngeal
Vagus
Accessory
Hypoglossal
```
94
Branches of trigeminal nerve
```
Ophthalmic nerve (V1)
Maxillary nerve (V2)
Mandibular nerve (V3)
```
95
What is Brocas area and where is it
Language (speaking and writing) area of the DOMINANT (normally left if right handed) FRONTAL LOBE
96
What can result from damage to Brocas area
Expressive aphasias
Difficulty forming words or sentences
Can understand what youre saying but can not express the words into meaningful language
97
What is Wernickes area and where is it
Comprehension area in DOMINANT (normally left if right handed) TEMPORAL LOBE and is responsible for understanding speech
98
What can result from damage to Wernickes area
Comprehension/receptive aphasias
Difficulty understanding spoken or written language, even though their hearing and vision are not impaired
Have fluent speech, but may scramble words do that their sentences make no sense (often adding unnecessary words or making own words)
Often unaware they're not speaking in clear sentences
99
What is supplied by external carotid
Everything in head and neck except the brain
100
What vessel only supplies the brain
Internal carotid
101
What does Anterior Cerebral Artery supply
Supplies motor cortex and top of brain
102
If ischaemic stroke in ACA (anterior cerebral), what would be affected
Lower limbs
103
What does Middle Cerebral Artery Supply
Majority of outer surface of the brain
104
If ischaemic stroke in MCA (middle cerebral), what would be affected
Chin to hip
| limb sparing
105
Whats does Posterior Cerebral Artery supply
Peripheral vision
106
If ischaemic stroke in PCA (posterior cerebral), what would be affected
Peripheral vision loss but no macular vision
107
What is 1st main artery to come off vertebral artery
Posterior Inferior Cerebellar Artery (PICA)
| Therefore emboli present will likely enter the PICA
108
What is supplied by the Posterior Inferior Cerebellar Artery (PICA)
Medulla (CN 9, 10, 11, 12)
109
What can result from an emboli in the Posterior Inferior Cerebellar Artery (PICA)
```
Dysphagia
Slurred speech
Ataxia
Facial pain
Nystagmus
Loss of pain and sensation on opposite side of body
```
110
What is the most common type of intercranial aneurysm
Berry aneurysms
111
Where do Berry Aneurysms occur
Most commonly at Anterior cerebral artery (ACA) and Anterior Communicating artery junction
Also at bifurcation of MCA, junction between Posterior Communicating A, MCA and Internal Carotid
112
What type of haemorrhage can result from a berry aneurysm and what is the main symptom
Subarachnoid haemorrhage
| Thunderclap headache
113
(with the exception of left and right coronary arteries) What are 3 initial main branches of the aorta (at (carotid) arch) in order
Brachiocephalic artery
Left Common Carotid artery
Left Subclavian artery
114
What are 2 arteries form from the bifurcation of Brachiocephalic trunk
Right Subclavian artery
| Right Common Carotid artery
115
Where do common carotid arteries bifurcate and into what?
Internal (larger than external) and External Carotid arteries
C4
(This bifurcation is at high risk of atherosclerosis)
116
What does the end of the Internal Carotid bifurcate into
Middle Cerebral artery
| Anterior Cerebral artery
117
Segments of Internal Carotid Artery
Cervical
Petrous ICA
Cavernous sinus ICA
Supraclinoid (intradural) ICA
118
Which ICA segment penetrates the skull
Petrous ICA
| penetrates the temporal bone and runs anteromedially int the carotid canal
119
Describe anatomical location of cervical ICA
Anterior and medial to internal jugular vein
Posterior and lateral to External Carotid artery at origin
Ascends behind then medial to external carotid artery
120
Branches of Petrous ICA
```
Caroticotympanic artery (small branch to middle/inner ear)
Vidian artery (small connection to external carotid artery)
```
121
In violent sport, what part of the ICA can rupture
Cervical ICA is free
Petrous ICA is anchored/fixed in the skull
Cervical can rupture and can even dissect with extreme rotation
122
Anatomy of cavernous sinus ICA
Turns superiorly at foramen lacerum to enter the skull via the carotid canal, anterior to the jugular foramen
There it enters the cavernous sinus
Pierces dura at level of anterior clinoid process
123
What can happen if an aneurysm ruptures, past where the cavernous sinus ICA pierces the dura
Subarachnoid haemorrhage
| Resulting in increased intracranial pressure
124
Branches of supraclinoid (intradural) ICA
Opthalmic artery
Superior hypophyseal arteries/trunk
Posterior communicating artery
Anterior choroidal artery
125
What does opthalmic artery supply
Orbit of eye
| passes into optic canal
126
What does superior hypophyseal arteries/trunk supply
Supply pituitary gland, stalk, hypothalamus and optic chiasm
127
What does posterior communicating artery
Connects to anterior cerebral vascular supply of head and posterior brain stem supply of head
128
What does anterior choroidal artery supply
```
Choroid plexus
Optic tract - vision
Cerebral peduncle - sensory motor fibres
Internal capsule
Medial temporal lobe
```
129
What artery supplies ganglia and internal capsule
Lateral lenticulostriate arteries
| From Middle Cerebral Arteries
130
Specifically what sturctures in cerebrum are supplied by anterior cerebral artery
Caudate nucleus and Internal capsule supplied by medial lenticulostriate arteries of anterior communicating artery of ACA
Genu of corpus callosum
131
Examples of intercranial vertebral artery branches
Anterior spinal artery
Small medullary perforators
Posterior inferior cerebellar artery (supplies medulla and inferior cerebellum)
132
Vertebral arteries unite to form what artery
Basilar arteries
133
What arteries branch off basilar artery
Pontine arteries
134
What 2 vessels arise from terminal (anterior) bifurcation of basilar arteries
Posterior cerebral artery
135
What specific structures are supplied by the PCA
Thalamus
Geniculate bodies
Cerebral peduncles
Tectum
136
Draw visual fields diagram
Pg 24
137
Which colliculus and which geniculate body relates to Visual field
Superior colliculus
Lateral geniculate body
(IM Auditory = Inferior colliculus + Medial geniculate body
138
Where does optic tract terminate
Lateral geniculate bodies
139
Which loop connects lateral geniculate body to visual cortex and results from lateral retinas sensing nasal visual fields
Meyers loop
140
What lobe does Meyers loop pass through
Temporal lobe
141
Which loop connects lateral geniculate body to visual cortex and results from medial retinas sensing temporal visual fields
Baums loop
142
What lobe does Baums loop pass through
Parietal
143
Which of these if false:
a - Fibres form the nasal portion of the retina (carrying the TEMPORAL VISUAL FIELDS) cross at the optic chiasm
b - Optic chiasm is located just anterior-superior to pituitary infundibulum
c - Lateral geniculate body is connected to visual cortex by the optic tract
c- Lateral geniculate body is connected to visual cortex by the optic radiation
144
Defect in left optic nerve
No light perception in the left eye
145
Defect of optic chiasm
Bitemporal hemianopia
146
Defect of left optic tract
Loss of vision of the temporal field of the left eye & the loss of the nasal field of the right eye
Homonymous Hemianopia
147
Defect of left Meyers loop
Carrying information from the inferior retina and thus the SUPERIOR VISUAL FIELD resulting in loss of vision in the superior nasal field of the left eye and the superior temporal field of the right eye
Right Homonymous Superior Quadrantopia
148
Defect of left Baums loop
Carrying information from the superior retina and thus the INFERIOR VISUAL FIELD resulting in loss of vision in the inferior temporal field of the right eye and the inferior nasal field of the left eye
Right Homonymous Inferior Quadrantopia
149
Pg26
Check visual field defects correct
150
Differences between UMN and LMN lesions
```
UMN:
Strength lowers
Tone increases (spastic)
Superficial reflexes absent
Increased reflexes (deep tendon reflexes) - Hyper-reflexia
Slight loss in muscle mass
Positive Babinski sign
LMN:
Strength lowers
Tone decreases (flaccid)
Fasciculations, Fibrillations, Reaction of degeneration
Decreased reflexes (deep tendon reflexes) - Hypo-reflexia
Decreased/atrophy muscle mass
Negative Babinski sign
```
