Neuro & Opthal - Intro Flashcards
1
Q
How many paired Cranial Nerves are there
A
12
2
Q
Functions of cranial nerves
A
Sensory (general or special)
Motor
Parasympathetic
3
Q
CN I
A
Olfactory
4
Q
CN II
A
Optic
5
Q
CN III
A
Oculomotor
6
Q
CN IV
A
Trochlear
7
Q
CN V
A
Trigeminal
8
Q
CN VI
A
Abducens
9
Q
CN VII
A
Facial
10
Q
CN VIII
A
Vestibulocochlear
11
Q
CN IX
A
Glossopharyngeal
12
Q
CN X
A
Vagus
13
Q
CN XI
A
Accessory
14
Q
CN XII
A
Hypoglossal
15
Q
Which CNs have a motor function
A
III
IV
V
VI
VII
IX
X
XI
XII
16
Q
Which CNs have a sensory function
A
CN I
CN II
CN V
CN VII
CN VIII
CN IX
CN X
17
Q
How do CNs communicate
A
Via reflex arc for integrated function
18
Q
Do CNs generally decussate
A
No except VI which crosses before exiting brainstem and CN II partially
19
Q
Basic concepts of CN
A
Motor info from CNS is carried in EFFERENT nerve fibres
Sensory info form internal and external environment is carried to CNS in AFFERENT nerve fibres - ‘general and special senses’
20
Q
General vs special senses
A
General sense - pain, pressure, touch, temp, proprioception
Special sense - all carried in CN - olfaction, vision, taste, hearing and vestibular function
21
Q
Organisation of CN based on functional components of each nerve
A
General Somatic Afferent (GSA) fibres
General Visceral Afferent (GVA) fibres
General Visceral Efferent (GVE) fibres
General Somatic Efferent (GSE) fibres
22
Q
What are GSA fibres related to
A
Receptors for pain, temp, touch, proprioceptive receptors, in the skin, muscles, tendons and joints
23
Q
What are GVA fibres related to
A
Receptors in visceral structures
24
Q
What are GVE fibres
A
Preganglionic autonomic fibres
25
What do GSE fibres do
Innervate skeletal muscle (axons of alpha and gamma motor neurons)
26
Sequences of neurons in conscious sensation
3rd order neurones
Peripheral receptor (1st order)--> CNS (2nd order) --> thalamus (3rd order) --> sensory cortex
Perception of sensation occurs in cerebral cortex
27
What's the exception to three order neurons in conscious sensation
Olfactory projections
Only have 2 neurons between receptor and cerebral cortex and doesn't primarily project via thalamus
28
Sequences of autonomic efferent fibres
Two order neurones
Cell bodies of first order neurone (preganglionic neurone) are located in brain/ brainstem
Cell bodies of second order neurone (post-ganglionic neurone) are located in periphery in autonomic ganglion
29
What does brainstem consist of
Mid-brain
Pons
Medulla oblongata
30
Which CNs exit at mid-brain
III
IV
31
Which CNs exit at pons
V
32
Which CNs exit at ponto-medulaary junctions
VI
VII
VIII
33
Which CNs exit at medulla oblongata
IX
X
XI (cranial part)
XII
34
Which CNs leave at C1-C5
XI (spinal part)
35
Where do CNs leave the brainstem relationally
Anterior: CN III, VI and XII
Lateral: CN V and vII-XI (cranial root)
Posterior: CN IV
36
CN and their nuclei
Each CN is associated w/ one or more nuclei in the brain and brainstem
CN I and II are from nuclei compartments of the forebrain
CN III - XII are from CN nuclei in the brainstem
37
How are CN nuclei arranged
In columns according to their embryological origin
38
What do CN nuclei found in the midbrain deal with
Discrimination of tone and recognition of sound
Vision and light reflex
Movement of eyes
39
What do CN nuclei found in the pons deal with
Maintenance of awake state
Connection between cerebrum and cerebellum
Muscle movements of the face
Hearing and spatial orientation
Sensation from head and neck area
40
What do CN nuclei found in the medulla oblongata deal with
Balance
Movement of tongue
Sensation from head and neck area
41
General rule of thumb about location of CN nuclei
Sensory nerve nuclei tend to be located in the lateral brainstem, while motor nuclei tend to be located more medially
42
Nuclei of mixed CN
Nerves w/ mixed sensory and motor fibres have more than one nucleus of origin - at least sensory (afferent) and one motor (efferent)
Sometimes more than one nerve will originate form a single nucleus e.g. taste
43
Where do sensory CN nuclei receive input from
Periphery
44
Are sensory receptors cell bodies of sensory CN nuclei found in the nucleus itself
No, they are located outside the CNS in the dorsal root ganglion or trigeminal ganglion
45
Types of sensory afferent CN nuclei
General: trigeminal nucleus
Auditory and motion: vestibular and cochlear nuclei
Tase: nucleus solitarius
46
How many sensory efferent columns are there for CN nuclei
Somatic efferent
Branchiomotor
Parasympathetic efferent
47
Which CN nuclei are found in the somatic efferent column
CN III
CN IV
CN VI
CN XII
48
Which CN nuclei are found in the branchiomotor column
CN V
CN VII
CN IX
CN X
CN XI
Trigeminal motor & facial nuclei and nucleus ambiguus
49
Which CN nuclei are found in the parasympathetic column
CN III
CN VII
IX
X
Edinger-Westphal, salivary and motor vagus nuclei
50
Pathway of olfactory nerve
Olfactory epithelium
Olfactory nerve
Olfactory bulb
Olfactory tract
Olfactory cortex - frontal lobe (forebrain)
51
How many cranial nerves leave the cranial cavity
One - CN II
52
Decussation of CN II
Semi-dec sustain in optic chiasm and project to thalamus
53
Motor function of CN III
Innervates all but two extra ocular muscles of the eye and muscles of upper eyelid (SO, LR)
54
What movements are caused by CN III
Gaze fixation and eye tracking
Raises eyelid
55
Parasympathetic function of CN III
Contracts smooth intrinsic muscle fo pupil and accommodates lens - pupil constriction
56
What does the superior branch of the motor nerve fibres of CN III innervate
Superior rectus
Levator palpebrare
57
What does the inferior branch of the motor nerve fibres of CN III innervate
Medial rectus
Inferior rectus
Inferior oblique
58
Motor function of CN IV
Innervates superior oblique on contralateral side, turns eyeball down & out
59
Route of CN IV
Emerges from posterior aspect of midbrain
Fibres cross as they leave brainstem
Runs w/ CN III through cavernous sinus
Leaves skull via superior orbital fissure
60
Divisions of CN V
Ophthalmic nerve
Maxillary nerve
Mandibular nerve - motor fibres only travel in this direction
61
Sensory component of CN V
Touch, pain, temp of face
62
Motor component of CN V
Mastication - tensor tympani and tensor veli palatini
63
Sensory areas of body supplied by CN V
Face
Scalp
Cornea
Nasal and oral cavities
Teeth and gums
Cranial dura mater
64
Role of mesenphalic nucleus in CNV
Proprioception form muscles of mastication and temporomandibular joint
65
Sub-nuclei of sensory nuclei of CN V
Chief
Mesenphalic
Spinal
66
Motor function of CN VI
Innervate lateral rectus - responsible for EOM w/ CN III (abduct eye)
67
Nerve roots of CN VII
Lateral nervus intermedius (sensory and parasympathetic)
Medial facial nucleus (motor)
68
Branches of CN VII
Temporal (forntal)
Zygomatic
Buccal
Marginal mandibular
Cervical
69
Where does CN VII terminate at
Parotid gland
70
How can we divide the facial nerve
Intracranial
Extracranial
71
Role of special sensory fibres in CN VII
Taste to ant 2/3rd of tongue
Cutaneous sensation from external ear
72
Where do the parasympathetic preganglionic fibres of CN VII go to
Lacrimal, submandibular, lingual glands
Nasal and oral mucosa
73
Where do the parasympathetic preganglionic fibres of CN VI originate from
Superior salivary nucleus
74
Components of CN VIII
Vestibular nerve carries info regarding position and movement of head
Cochlear nerve carries auditory info
75
Where does CN IX originate from
4 nuclei - pair of sneery and motor each located in medulla oblongata
76
What do the afferent fibres of CN IX innervate
General sensation - oropharynx, posterior 1/3rd of tongue, middle ear, carotid body, Eustachian tube
Chemo and baroreceptors
77
Where do fibres of general sensation in CN IX end
Trigeminal sensory nucleus
78
Somatic motor function of CN IX
Efferent fibres innervate stylopharyngeus
79
Visceral motor function of CN IX
Innervate parotid gland
80
What branches come off the general somatic sensory of CN IX
Tympanic
Carotid sinus
Pharyngeal
Tonsillar
Lingual
81
Special sensory function of CN IX
Taste fibres from posterior 1/3 of tongue
82
Structure of CN X
Pair of nerves emerging from L and R side of medulla oblongata
83
Sensory function of CN X
Innervates skin of external acoustic meatus, laryngopharynx, larynx, visceral sensation to heart and abdo viscera
84
Special sensory function of CN X
Taste sensation to epiglottis and root of tongue
85
Motor function of CN X
Innervates majority of muscles of the pharynx, soft palate and larynx
86
Parasympathetic branches of CN X
Cardiac
Bronchial
Oesophageal
87
Role of cardiac parasympathetic branch of CN X
Slow HR
88
Role of bronchial parasympathetic branch of CN X
Constricts bronchi
89
Role of oesophageal parasympathetic branch of CN X
Control involuntary muscle in digestive system, stimulating peristalsis and GI secretions
90
Components of CN XI
Spinal and cranial root
91
Where does the spinal component of CN IX originate from
C1-C5/6
92
Role of spinal component of CN XI
Innervates trapezius and SCM - allows head movement
93
Where does the cranial component of CN XI originate from
Medulla oblongata and fibres distribute w/ vagus nerve fibres
94
Motor function of CN XII
Innervates intrinsic and extrinsic muscles of tongue
95
Reflex movements of CN XII
Chewing, sucking and swallowing
96
Basic functional unit of brain
Neurone
97
Basic structural unit of brain
Neuroglia
98
Which cell bodies form groups
Those w/ similar functions
CNS: nucleus
PNS: ganglion (exception is basal ganglia inside brain)
99
What is the CNS made up of
Cerebral hemisphere - L & R, covered in gyri and sulci
Diencephalon deep to hemispheres (gateway to brainstem)
Cerebellum
Brainstem
Spinal cord (continuation of brainstem)
100
Where is thalamic lateral found
Diencephalon
101
What does the brainstem consist of
Mid-brain
Pons
Medulla oblongata
102
Ventricles in the brain
Two lateral ventricles Bothe drain into 3rd
Third ventricle in centre of diencephalon
Aqueduct passes through diencephalon into brainstem
Fourth ventricles has apertures which acts as outlets so CSF flows in subarachnoid space
103
Functions of CSF
Supports and cushions structure
Provide nutrition
Removes waste products
104
What are the two cerebral hemispheres divided by
Great longitudinal fissure (gap)
105
What are cerebral hemispheres joined y
Corpus callosum
106
What is white matter divided into
Fibre groups - association fibres, commissural fibres, projection fibres
107
Where do the sensory fibres of the internal capsule pass through
Anterior limb - prefrontal cortex
Posterior limb - somatomotor
Retro-lentiform - visual
Sub-lentiform - auditory
108
Where do the motor fibres of the internal capsule pass through
Genu - head and neck
Post limb (anterior) - truck and limbs
109
What are hemispheres broken down into
Lobes that relate to cortical functional areas, separated by sulci
110
Sulci of the brain
Central (separates frontal and parietal)
Lateral (separates frontal, parietal and lateral)
Parieto-occipital (separates parietal and occipital)
111
What is the frontal lobe associated w/
Movement and higher order functions
Motor speech (Broca's area)
Smell link to limbic system
112
What is prefrontal area involved in
Personality and behaviour
113
Role of parietal lobe
Integrates sensory info from various parts of body - associated w/ movement, orientation, lang, reading & taste
114
Role of temporal lobes
Primary auditory area - auditory perception
Secondary auditory area - interpreting sounds
Balance and coordination
Wernicke's area - understanding info
115
What is the limbic system also known as
Primitive brain - coordinates instinctive behaviours w/ higher critical functioning
116
Role of basal ganglion
Important in stabilising & coordinating slow and fine movements
117
What is basal ganglion made of
Caudate nucleus
Lentiform nucleus
Amygdaloid body
Substantia Nigra
118
Basal ganglia pathways
Direct - initials movements
Indirect - suppresses movement
119
Role of thalamus
Transmits sensory info to cerebral cortex & areas controlling movement
120
What is the thalamus involved in
Conscious awareness
Sleep-wake area
Emotions and behaviour through limbic system
121
How many sensory systems have a thalamic nucleus
All (except olfactory system) incl a thalamic nucleus that receives sensory signals ---> associated primary cortical area
122
What is the hypothalamus involved in
Instinctive desires and behaviours
123
Functions of hypothalamus
Regulation of body temp
Emotion and behaviour
Hunger & thirst
Sexual activity & procreation
Autonomic and endocrine activities and biorhythms
124
Largest part of hindbrain
Cerebellum
125
Where does the cerebellum originate
From the dorsal aspect of the brainstem overlies 4th ventricle
126
How is the cerebellum connected to the brainstem
By three cerebellar peduncles - superior, middle and inferior
127
What is the reticular formation
Cluster of nuclei that regulate sleep/wake cycle
128
Number of nerves originating from spinal cord
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
129
Regions of white and grey matter in spinal cord
Dorsal (posterior) horns - sensory neurons
Ventral (anterior) horns - motor neurons
Lateral horns - autonomic (motor neurons), thoracic regions - T1-L2
Columns - ascending (sensory) and descending (motor) tracts
130
Features of hyperopia
Long sighted, smaller eyes, image focuses at back of retina
131
Features of myopia
Short sighted, bigger eyes, image focuses in front of retina
132
Significance of loss of colour vision
First thing lost in optic neuropathy or compressive lesion
133
Measuring colour vision
Ishihara colour plates
Red desaturation
134
Muscles involved in oculumotility
Superior oblique
Inferior oblique
Superior rectus
Inferior rectus
Lateral rectus
Medial rectus
135
Muscles and ocular movements
Superior rectus - up & out
Lateral rectus - outwards
Medial rectus - inwards
Inferior oblique - up and in
Inferior rectus - down & out
Superior oblique - down & in
136
Relative Afferent Pupillary Defect
Both pupils should constrict when performing swinging light test
Issue when only one constricts
137
Aniscoria (R is constricted, L is dilated)
In dim light, pt's R is abnormal
In bright light, pt's L is abnormal
138
Testing for Adie's tonic pupil
Abnormal pupil constricts w/ pilocarpine eye drops, normal does not
139
Testing for Horner's syn
4% cocaine ye drops - cocaine blocks reuptake of noradrenaline in synapse
Normal pupil dilates, Horner's does NOT (either pre- or post-ganglionic)
140
Confirming Horner's syn
Test w/ 1% hydroxyamphetamine - post-ganglionic lesion causes both pupils to dilate, pre- does NOT
Can also use weak once of adrenaline - post dilates
Apraclinidine - alpha2 agonist has not effect on normal pupils but Horner's dilates
141
Features of Horner's syn
Ptosis
Anhidrosis
Miosis
Enopthalmos
Loss of ciliospinal reflex
