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Anatomy > Neuro 3 INCOMPLETE > Flashcards

Neuro 3 INCOMPLETE Flashcards

1
Q

What are the two parts of the midbrain? What position are they in?

A

Tectum- located dorsal to the cerebral aqueduct

Tegmentum - located ventral to the cerebral aqueduct

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2
Q

What is in the tectum?

A

Superior colliculi - visual
Inferior colliculi - auditory

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3
Q

What is the function of the superior colliculi?

A

Regulating eye movements
And reflexes involving visual stimuli
E.g. turning head quickly when something enters field of vision

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4
Q

What is the function of the inferior colliculi?

A

Involved in sound location
Pitch discrimination
Reflexes associated with auditory stimuli
E.g. turning the head quickly when hearing a loud noise

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5
Q

What is in the tegmentum?

A

Substantia nigra
Cerebral peduncles (most ventral surface)
Red nuclei
(also periaqueductal grey matter)

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6
Q

Function of the substantia nigra?

A

Important in motor control by producing dopamine

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7
Q

What are the cerebral peduncles?

A

On the most ventral surface of the tegmentum
Large white matter bundles that connect the midbrain to the thalami

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8
Q

What is the function of the red nuclei?

A

Involved in supporting motor control of the limbs

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9
Q

Which prominent nuclei are in the midbrain?

A

Oculomotor (CN III)
Trochlear (CN IV)
Edinger-Westphal nuclei (pupillary light reflex)

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10
Q

What is on the dorsal surface of the pons?

A

Middle cerebellar peduncles
- large white matter connections to the cerebellum

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11
Q

What is on the ventral surface?

A

Basilar artery

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12
Q

Where is the fourth ventricle?

A

Situated dorsal to the pons, between the two middle cerebellar peduncles

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13
Q

What nuclei does the pons contain?

A

Trigeminal (CN V)
Abducens (CN VI)
Facial (CN VII)
Vestibulocochlear (CN VIII)

Also pneumotaxic and apneustic centres - involved in regulation of breathing

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14
Q

What structures are associated with the pons?

A

Basilar artery
Pons
Middle cerebellar peduncle
Fourth ventricle
Nuclei - CN V, CN VI, CN VII, CN VIII
Pneumotaxic and apneustic centres

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15
Q

What does the medulla oblongata connect?

A

The pons to the spinal cord

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16
Q

What is the name of the groove on the ventral surface of the medulla oblongata?

A

Anterior median fissure
Separates the two medullary pyramids

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17
Q

What is on the ventral surface of the medulla?

A

The two medullary pyramids, separated by the anterior median fissure
Medullary olives are immediately lateral to these

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18
Q

What runs inside the medullary pyramids?

A

Motor tracts
Such as corticospinal tracts

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19
Q

Where are the medullary olives?

A

On the ventral surface of the medulla, immediately lateral to medullary pyramids

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20
Q

What sensory pathway of nerves runs in the dorsal part of the medulla?

A

The dorsal column medial lemniscus (DCML) pathway
Runs within two pairs of nerve bundles

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21
Q

What two nerve bundles does the DCML pathway run in?

A

Fasciculus gracilis
Fasciculus cuneatus

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22
Q

What nuclei does the medulla contain?

A

Glossopharyngeal (CN IX)
Vagus (CN X)
Accessory (CN XI)
Hypoglossal nerve (CN XII)

Vital centres for regulating respiration, heart rate and blood pressure, initiating vomiting

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23
Q

What is bulbar palsy?

A

Dysfunction of the cranial nerves that arise from the medulla (9 to 12)

Symptoms include difficulty speaking, swallowing, excessive saliva production, wasting and fasciculations of the tongue, absent gag reflex

Causes include diseases that affect PNS

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24
Q

Why are the cranial nerves named as such?

A

They originate directly from the brain and not the spinal cord like other nerves

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25
Q

Which is the only cranial nerve that leaves the CNS posteriorly?

A

The trochlear nerves (CN IV)

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26
Q

For CN I what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Olfactory nerve
  • Sensory nerve
  • Cerebrum - olfactory cortex - temporal
  • Cribriform plate
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27
Q

What is the function of the olfactory nerve?
What does dysfunction present as?

A

Smell
Detect odour molecules
Convey information superiorly to the olfactory bulbs
Altered/loss of smell - coffee, chocolate, vanilla, cinnamon

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28
Q

What path does the olfactory nerve take through the brain?

A

Roof of nasal cavity
Through cribriform plate to olfactory bulbs, either side of the crista galli
Olfactory tracts carry smell info posteriorly under frontal lobes towards olfactory cortices in temporal lobes

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29
Q

For CN II what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Optic nerve
  • Sensory only
  • Final destination is visual cortex - occipital lobe
  • Optic canal - sphenoid bone
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30
Q

What is the function of the optic nerve? How is it tested for dysfunction?

A

Provides sense of sight

Altered/ Loss of vision
Visual acuity tested by Snellen chart(letters)
Also visual fields, accoomodation to near and far objects, colour vision, pupillary light reflex test function(Edinger-Westphal nucleus)

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31
Q

What is the path of the optic nerve?

A

Carries info from retina to the optic chiasm, where fibres cross over
Ends up in visual cortex in the occipital lobe

32
Q

For CN III what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Oculomotor nerve
  • Motor and parasympathetic
  • Midbrain
  • Superior orbital fissure - sphenoid bone
33
Q

What is the function of the oculomotor nerve?
What does dysfunction look like and how is it tested for?

A

Motor supply to extra-ocular muscles (LPS, SR, IR, MR, IO), Accommodation, Parasympathetics to the ciliary and constrictor pupillae muscles

Eye rests in ‘down and out’ position, ptosis, mydriasis
Clinician asks patient to follow their finger, watches to see how well patient can follow (H), can also test the pupillary light reflex

34
Q

For CN IV what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Trochlear nerve
  • Motor only
  • Midbrain
  • Superior orbital fissure
35
Q

Why is the Edinger-Westphal nucleus important?

A

Involved in the pupillary light reflex - where optic and oculomotor nerve communicate

36
Q

What is the function of the trochlear nerve What does dysfunction look like and how is it tested for?

A

Eye movement - superior oblique muscle only

Eye is unable to look down when adducted
Ask patient to follow clinicians finger movements and observe to see if the eye is following (H)

37
Q

For CN V what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Trigeminal nerve
  • Both motor and sensory - some branches only sensory
  • Pons origin
  • V1 - superior orbital fissure
    V2 - foramen rotundum
    V3 - foramen ovale
38
Q

What are the 3 branches of the trigeminal nerve?

A

V1 - ophthalmic branch
V2 - maxillary branch
V3 - mandibular branch

39
Q

For CN V1 what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Ophthalmic branch
  • Sensory only
  • Pons
  • Superior orbital fissure
40
Q

What is the function of the ophthalmic branch of the trigeminal branch?
How is dysfunction of the nerve tested?

A

Sensation to the upper 1/3 of the face

Test by seeing if the patient can detect brush of cotton wool over forehead on both sides, seeing if they can tell the difference between crude and sharp touch, test corneal reflex - do they blink when the cornea is touched?

41
Q

What nerves are involved in the corneal reflex?

A

Afferent nerve - ophthalmic nerve (V1)
Synapse at the pons
Efferent nerve - facial nerve (VII) causes blinking

42
Q

For CN V2 what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Maxillary branch of the trigeminal
  • Sensory only
  • Pons origin
  • Foramen rotundum - sphenoid bone
43
Q

What is the function of the maxillary branch of the trigeminal nerve?
What does dysfunction of V2 look like? How is it tested for?

A

Sensation to the middle third of the face, including most of internal nasal cavity, upper teeth and palate

Altered/absent sensation in dysfunction
Sensation is tested by brush of cotton wool against cheek on both sides, test if patient can differentiate between crude and sharp touch

44
Q

For CN V3 what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Mandibular branch of trigeminal nerve
  • Both sensory and motor
  • Pons
  • Foramen ovale - sphenoid bone
45
Q

What is the function of the maxillary branch of the trigeminal nerve?
What does dysfunction of V3 look like?

A

Sensation to lower third of face
Motor to the muscles of mastication (temporalis, masseter, medial and lateral pterygoid), tensor tympani and some suprahyoid strap muscles

Dysfunction - altered/absent sensation, weakness in mastication

46
Q

For CN VI what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Abducens nerve
  • Motor only
  • Pons
  • Superior orbital fissure - sphenoid bone
47
Q

What is the function of the abducens nerve?
What does dysfunction look like? How is it tested?

A

Eye movement - lateral rectus only

Dysfunction - unable to abduct the eye
Tested by seeing if the patient’s eyes can follow the clinician’s finger correctly or not (H)

48
Q

For CN VII what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Facial nerve
  • Both motor and sensory (and parasympathetic)
  • Pons
  • Internal auditory meatus, then stylomastoid foramen (temporal bone)
49
Q

What is the function of the facial nerve?

What does dysfunction look like?

A

Motor to muscles of facial expression, stapedius muscle
Sensation to the ear canal, secretomotor function (parasympathetics) to sublingual and submandibular salivary glands and lacrimal gland
Taste to anterior 2/3 of the tongue

Dysfunction - weakness/paralysis of facial muscles, reduced salivation

50
Q

How is dysfunction of the facial nerve tested for?

A

Only function that is routinely tested is motor function.
Ask patient to perform series of facial movements e.g. raising eyebrows, closing eyes tightly, blowing cheeks out, showing all their teeth
Clinician checks for asymmetry

51
Q

How is dysfunction of V3 tested for?

A

Tested for sensation by brushing cotton along jaw on both sides, can they tell the difference between crude and sharp pain.

Motor function tested by palpating jaw muscles as they clench their teeth or asking patient to forcibly open jaw against resistance

52
Q

Describe the pathway of the facial nerve out of the brain

A

Origin - pons
- First - internal auditory meatus with CN VIII
- Shortly after - gives off branch to supply lacrimal gland
- In middle ear cavity - gives off branch to stapedius muscle - also gives ‘chorda tympani’ branch for taste in tongue (2/3) and parasympathetic to submandibular and sublingual glands
- Then - leaves temporal bone of the skull by stylomastoid foramen
- After exiting - gives branch for sensory info from the ear and motor supply to some of scalp
- Main body of CN VII then enters parotid gland and splits into 5 branches to supply facial muscels - DOESNT INNERVATE THIS GLAND

53
Q

What are the 5 branches of the facial nerve that supply facial muscles?

A

Temporal
Zygomatic
Buccal
Marginal mandibular
Cervical

54
Q

For CN VIII what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Vestibulocochlear
  • Sensory only
  • Pons
  • Internal auditory meatus
55
Q

What is the function of the vestibulocochlear nerve?

What does dysfunction look like? How is it tested?

A

Provides sense of balance and hearing

Dysfunction - vertigo or tinnitus or deafness
Simplest test - block one ear and whisper word/number into other ear and ask patient to repeat it
Other tests with specialist equipment available

56
Q

For CN IX what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Glossopharyngeal nerve
  • Both motor, sensory and parasympathetic
  • Medulla
  • Jugular foramen - temporal/occipital bone
57
Q

What is the function of the glossopharyngeal nerve?

A

Motor - stylopharyngeus muscle - assists swallowing
Sensation - pharynx, middle and auditory tube, and posterior 1/3 of the tongue (also taste), carotid baroreceptors and chemoreceptors
Secretomotor (parasymp) - parotid salivary gland

58
Q

What does dysfunction of the glossopharyngeal nerve look like? How is it tested for?

A

Loss of gag reflex, reduced salivation

Test by assessing gag reflex, tongue depressor pressed against oropharynx - normal finding is patient gagging

59
Q

For CN X what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Vagus nerve
  • Both motor, sensory, parasympathetic
  • Medulla
  • Jugular foramen - temporal/occipital bone
60
Q

What is the function of the vagus nerve?

A

Motor - muscles of soft palate, pharyngeal muscles, internal laryngeal muscles, palatine folds
Sensation - external ear and ear canal, taste from epiglottis
Parasympathetics - to thoracic and abdominal organs

61
Q

What does dysfunction of the vagus look like? How is it tested for?

A

Loss of gag reflex, absent rise of soft palate, weak or absent cough/swallow, loss of parasympathetics to thoracic/abdominal organs

Test gag reflex
Ask patient to open mouth and say AAA - check elevation of soft palate

62
Q

Which nerves partake in the gag reflex?

A

Afferent nerve - glossopharyngeal nerve
Communicate in the medulla
Efferent nerve - vagus

63
Q

For CN XI what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Accessory
  • Motor only
  • Spinal cord C1-C5 - passes into medulla
  • IN - foramen magnum - occipital bone
  • OUT - jugular foramen - temporal/occipital bone
64
Q

What is the function of the accessory nerve?

A

Motor to the trapezius and sternocleidomastoid muscles

Dysfunction - weakness to shrugging shoulders and turning head
Test by asking patient to do these alone, then against resistance

65
Q

What is the pathway of the accessory nerve?

A

Originates spinal cord level C1 - C5
Join to form spinal accessory nerve
Enter skull by foramen magnum
Leave via jugular foramen

66
Q

For CN XII what is the…
Name?
Nerve fibre type?
CNS origin?
Skull base foramen?

A
  • Hypoglossal nerve
  • Motor only
  • Medulla
  • Hypoglossal canal - occipital bone
67
Q

What is the function of the hypoglossal nerve?
What does dysfunction look like? How is it tested for?

A

Motor to intrinsic and extrinsic muscles of the tongue (except palatoglossus which is vagus)

Dysfunction - weakness or paralysis of the tongue - tongue deviates to affected side
Test by asking patient to protrude their tongue - deviation implies damage

68
Q

Where do the cranial nerves originate from?

A
69
Q

Which cranial nerve originate from the pons?

A
70
Q

Which cranial nerves originate from the medulla?

A
71
Q

Which cranial nerve exits the brainstem posteriorly?

A

4 - abducens

72
Q

Which cranial nerves originate in the midbrain?

A

3 and 4

73
Q

Which cranial nerves don’t originate in the brainstem?

A

1 and 2
They originate from

74
Q

Which cranial nerves run through the wall of the carotid sinus? Which is the only one that isn’t in the lateral wall? Which vessel also runs through this sinus?

A

3, 4, 5)1, 5)2, 6
Abducens is the only one not in the lateral wall
Internal carotid runs through

75
Q

Which cranial nerves are purely motor?

A

Anatomy (18 decks)

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