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Week 1 Flashcards

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1
Q

What bones make up the Neurocranium?

A

Frontal
Parietal x2
Occipital
Sphenoid
Temporal x2
Ethmoid

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2
Q

What bones make up the Viscerocranium?

A

Nasal x2
Palatine x2
Vomer
Maxilla x2
Mandible
Zygomatic x2
Lacrimal x2
Ethmoid

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3
Q

Name structures 1-5

A

1 - Pterion
2 - Zygomatic Arch
3 - Mastoid Process
4 - External Acoustic Meatus
5 - Mandibular Angle

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4
Q

Name the 3 suture lines

A

Coronal
Sagittal
Lambdoid

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5
Q

Name the 3 Structures

A

Groove for sup. sagittal sinus
Granular Foveolae (Arachnoid Granulations)
Grooves for middle meningeal arteries

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6
Q

What are Fontanelles and what is their purpose?

A

ant. and post. fontanelles are soft areas between the skulls bones after birth that allow the head to be easier pushed out during birth and for the skull to grow

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7
Q

What is the Pterion?

A

The H shaped suture point where the temporal, frontal, parietal and greater wings of sphenoid join

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8
Q

What would be a possible issue caused by trauma to the Pterion?

A

Haematoma

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9
Q

What nerves pass through the Sup. Orbital fissure?

A

Sup. + Inf. Oculomotor CN III (branches)
Trochlear CN IV
Abducens CN VI
Lacrimal n.
Frontal n.
Nasociliary n.
Sup. + Inf. ophthalmic vein

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10
Q

what structures pass through Inf. Orbital fissure?

A

Zygomatic branch of maxillary n.
Infra orbital n.
Inf. ophthalmic vein

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11
Q

What do the superior aspects of the temporalis muscle and its fascia attach to on the skull?

A

Temporalis - Inf. temporal line
Fascia - Sup. temporal line

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12
Q

Within what structure does the Facial CN VII branch?

A

Parotid Gland

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13
Q

What is the purpose of the Cribriform foramina?

A

Allow the Olfactory CN I bulbs to receive nerve fibres from Nasal cavity

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14
Q

What is the main symptom of a fractured cribriform plate?

A

CSF Rhinorrhoea

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15
Q

What is the function of the Sup. and Inf. articular cavities in the Temporomandibular joint (TMJ)?

A

Sup. allows sliding for initial opening
Inf. allows rotation for biting motion

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16
Q

Lateral ligament in the Temporomandibular joint (TMJ) prevents what?

A

Post. dislocation

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17
Q

What are the two major systems of descending pathways from cortex to motor centres?

A

Lateral Pathways & Ventromedial (Medial) Pathways

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18
Q

What’s the function of the lateral pathways?

A

Control voluntary movement
Control distal muscles
Mainly controlled by cerebral cortex

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19
Q

What is Apraxia?

A

Inability to perform complex sequence of movements (ie. brushing teeth, drawing sketch)

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20
Q

What is a potential cause of Apraxia?

A

Damage to premotor area of brain

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21
Q

What percentage of Corticospinal tract (CST) nerves are in the Lateral & Anterior CST respectively?

A

85% & 15%
Lateral tract nerves will decussate in the medulla where as the anterior will stay ipsilateral until they innervate bilaterally at level of their ventral root

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22
Q

What is the most common causes of lesions of corticospinal neurons?

A

Infarcts related to cerebrovascular incidents (particularly middle cerebral a.)
Trauma
Tumours
Demyelinating diseases

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23
Q

What is the difference between +ve and -ve signs of corticospinal neuron lesions?

A

+ve is the appearance of an abnormal response
-ve is the loss of function (weakness or paralysis)

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24
Q

Corticospinal lesions may give rise to what?

A

Upper motor neurone syndrome

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25
What are the symptoms of Upper motor neurone syndrome?
Pyramidal muscle weakness (hemiparesis) No muscle atrophy No fasciculations Increased muscle tone Increased stretch reflexes Abnormal reflexes
26
What are the symptoms of Lower motor neurone lesions?
Muscle weakness (lesion dependant) Muscle atrophy Fasciculations Reduced muscle tone Reduced stretch reflexes
27
What is the main function of the Ventromedial pathways?
Posture
28
What are the principal compensatory reflexes for Vestibular, Collicula, Reticular, and Tectal?
Body Head / Body Body Head / Trunk
29
What are the functions of the Corpora Quadrigemina?
Controls position of head and eyes in response to visual, auditory and somatic stimuli Also transmits auditory signals to auditory centre in brain
30
What are the pros and cons of a CT scan?
Fast & widely available however, produces ionising radiation
31
CT scans are taken in what plane?
Supraorbitomeatal plane
32
What 3 ways can an MRI be weighted?
T1, T2, or PD (proton density)
33
What is the benefit of a T1 weighted MRI?
Good for anatomy and contrast
34
How do substances appear on a T1 weighted MRI?
Water (CSF) is dark Grey matter is dark grey White matter is off-white Fat is white
35
What is the benefit of a T2 weighted MRI?
Good for identifying pathology - inflammation, oedema
36
How do substances appear on a T2 weighted MRI?
Water is white White matter is darker than grey mater
37
What benefit is there to Diffusion Weighted Imaging (DWI)?
Very good for detection of ischemia, infarct, and stroke
38
What may be done complimentary to a Diffusion Weighted Image?
Apparent Diffusion Coefficient (ADC)
39
Examples of MRI contraindication
Implanted metal devices Foreign bodies (shrapnel) Claustrophobia
40
What benefit is there to SPECT & PET?
Useful for identifying cancer, infection, coronary artery disease, brain disorders
41
What does the ABC'S system for interpreting Brain scans stand for?
Adequacy, Alignment, Artefact Bones, Blood & Brain CSF-filled spaces Subcutaneous & surfaces, symmetry
42
What structure carries sensory info from the lower trunk and lower limbs in the spinal cord (below C6)?
Fasciculus Gracilis
43
What structure carries sensory info from the upper trunk and upper limbs in the spinal cord (above C6)?
Fasciculus Cuneatus
44
Where in the spinal cord are Fasciculi Gracilis and Cuneatus found?
Dorsal Column (medial & lateral respectively)
45
At what spinal & vertebral levels are the cervical and lumbar enlargements of the spinal cord?
Cervical Spinal: C4 - T1 Vertebral: C4 - C7 Lumbar Spinal: L2 - S3 Vertebral: T11 - T12
46
What is the function of the Clarke n. and at what levels is it present?
Relay for proprioceptive info traveling to the cerebellum, C8 - L3
47
What pathway does proprioceptive info going to the cerebellum take?
Below L3 travels in fasciculus gracilis, travels through Clarke nucleus to C8, moves through fasciculus cuneatus until they synapse in Cuneate nuc.
48
Modality of Meisner corpuscles?
Fine touch / light touch
49
Modality of hair follicle endings?
Touch
50
Modality of Merkel discs?
Pressure, low freq vibration
51
Modality of Pacinian corpuscles?
Vibrations
52
Modality of Ruffini endings?
Skin stretch, pressure
53
Modality of Nociceptors?
Pain
54
Modality of muscle spindles?
Muscles length / stretch
55
What is the benefit of lateral inhibition in sensory neurons?
Allows better discrimination of where a stimulus is located by inhibiting surrounding neurons
56
What information is carried in the dorsal and ventral spinocerebellar tracts?
Unconscious Proprioceptive info from muscle spindles and golgi organs
57
What information is transported in spinothalamic tracts?
Pain & temperature
58
Name the 3 principal ascending tract systems in the spinal cord
Spinothalamic, Spinocerebellar, Dorsal column-medial lemniscus
59
Where does the spinothalamic tract nerves cross over the mid line?
At the vertebral level it enters +/- 1 or 2 dermatomes
60
Where do the Medial lemniscus nerves cross over the midline?
After gracile/cuneate nuclei in brainstem
61
Where do the Spinocerebellar nerves cross over the midline?
They DON'T
62
What information is transported in the Dorsal column-medial lemniscus?
JPS, Conscious proprioception, Light touch, Vibration, Pressure
63
What is Astereognosis?
Inability to discriminate shape and size by touch and inability to recognise objects by touch
64
What is Amorphosynthesis?
No somatosensory info from one side of the body usually caused by a lesion in the left parietal lobe
65
What is a common symptom of a lesion in fasciculus Gracilus?
Gait problems
66
A lesion in fasciculus Cuneatus may cause motor problems in the arms but this can be minimised thanks to...
Vision allowing corrections of arm movement to be made
67
What is the difference in Aδ and C fibres?
Aδ detect Heat, cold, and sharp pain C detect dull aching pain and itch
68
What 4 pathways make up the Anterolateral pathway?
Paleo-spinothalamic tract (thalamus) Neo-spinothalamic tract (thalamus) Spinomesencephalic tract (midbrain) Spinoreticular tract (midbrain)
69
What would be the consequence of a lesion in the lateral spinothalamic tract?
Decreased perception of pain and temp on the contralateral side of the body 1 or 2 dermatomes below the lesion
70
Identify all structures
^^^
71
Why can LMN damage still lead to fasciculations when UMN damaged can't?
In UMN lesions the LMN’s are still intact and still send out inhibitory signals to the muscles preventing fasciculations. In LMN lesions the muscles don’t receive inhibitory signals, therefore they only get excitatory signals leading to fasciculations
72
Function of Spinomesencephalic tract?
For descending pain modulation
73
Function of Spinoreticular tract
For arousal and other pain driven responses
74
Where does the Neo-spinothalamic tract synapse, and where does it project?
Synapses at the Ventral posterolateral lobe of the thalamus (VPL) Projects to somatosensory cortex
75
Where does the Paleo-spinothalamic tract synapse, and where does it project?
Synapses at the Dorsal medial intralaminar section of the thalamus (DM) Projects to limbic centres and memory
76
What is thought to be the most probable cause of depression?
Reduction in serotonin receptors in hippocampus Serotonin levels themselves have little impact
77
What are MAOI (mono amine oxadase inhibitors)?
Inhibit MAO enzymes MAO breaks down norepinephrine/serotonin and dopamine Therefore inhibition causes all 3 levels to increase
78
Give an example of a MAOI and list some side effects
Phenelzine Weakness, headache, weight gain, fatigue ect.
79
What can MAOI not be used in combination with?
SSRI/Tricyclic nor morphine/tramadol as will increase serotonin to dangerous levels (potentially death)
80
What foods shouldn't be consumed when taking MAOI's?
Foods high in tyramine ie. Cheese Venison Alcohol
81
How do Tricyclic Antidepressants work?
Act by inhibiting re-uptake of norepinephrine and serotonin by blocking the transporters responsible for re-uptake of these neurotransmitters Increases conc of neurotransmitters in the synapses, triggering further neurotransmission
82
What can Tricyclic antidepressants be used for?
Depression Anxiety Chronic pain
83
What are some of the side effects of Tricyclic antidepressants?
Risk of arrythmias Reduced intestinal mobility Urinary retention
84
Name some common Tricyclic antidepressants
Amitriptyline Lofepramine
85
How do SSRI's (selective serotonin re-uptake inhibitors) work?
Increase levels of neurotransmitter serotonin by limiting its re-absorption and pure SSRI have only weak affinity for norepinephrine and dopamine transmitters
86
What is the name for serotonin receptors?
5-HT receptors
87
What are some of the side effects of SSRI's?
Sexual dysfunction + reduced libido QT interval prolongation Increased risk of GI bleeds Increase risk of suicide (18-25 y/o can't be prescribed SSRI's) Epilepsy
88
What other condition may present with similar symptoms to depression?
Hypothyroidism
89
What are 3rd line drug treatments for depression?
SNRI's (serotonin norepinephrine re-uptake inhibitors)
90
Why are Tricyclic antidepressants effective in chronic pain management?
Have direct effect on the mechanisms of the pain pathway (blocking of pathway)
91
Give an example of a commonly used antidepressant for pain management
Amitriptyline
92
What should you check for in a patients drug history before prescribing antidepressants?
Any other drugs that may elongate the QT interval
93
Define Anhedonia
Loss of interest or pleasure in hobbies and activities that were once enjoyed
94
According to NICE guidelines, what are the key symptoms of depression?
Persistent sadness or low mood and/or Anhedonia
95
What are some risk factors for depression?
Genetics and family factors Early life experiences Stressful life events Social support Gender
96
What is the BEST treatment for depression?
Placebo
97
What structures pass through the Optic canals?
Optic n. and Ophthalmic a.
98
What structures pass through the Sup. Orbital Fissure?
CN V1, III, IV, VI Sympathetic fibres Ophthalmic veins (sup. + inf.)
99
What structures pass through the Inf. Orbital Fissure?
Infra Orbital n. v. and a. Inf. Ophthalmic v. Zygomatic n.
100
What structures pass through Foramen Rotundum?
CN V2 (Maxillary)
101
What structures pass through Foramen Ovale?
CN V3 (Mandibular) and Accessory meningeal a.
102
What structures pass through Foramen Spinosum?
Middle Meningeal a. and v. Meningeal branch of CN V3
103
What structures pass through Foramen Lacerum?
Deep Petrosal n. Meningeal a. branches and small veins
104
What structures pass through the Groove or Hiatus of Greater Petrosal n.?
Greater Petrosal n. Petrosal branch of mid Meningeal a.
105
What structures pass through Foramen Magnum?
Medulla and Meninges Vertebral a. CN XI Dural veins ant. + post. Spinal a.
106
What structures pass through the Jugular Foramen?
CN IX, X, and XI Sup. bulb of Int. Jugular v.
107
What structures pass through the Hypoglossal Canal?
Hypoglossal n. CN XII
108
What structures pass through the Condylar Canal?
Emissary v. that passes from sigmoid sinus to vertebral veins in neck
109
What structures pass through the Mastoid Foramen?
Mastoid emissary v. from sigmoid sinus Meningeal branch of Occipital a.
110
Name the structures
^^^
111
What are the 2 Extrinsic and 1 Intrinsic ligaments of the Temporomandibular Joint (TMJ)?
Extrinsic: Sphenomandibular lig Stylomandibular lig Intrinsic: Lateral lig
112
Name the structures
^^^
113
Name the structures
^^^
114
Name the structures
^^^
115
Name the structure
^^^
116
What 2 structures make up the intervertebral joints?
Intervertebral symphysis and Facet Joint
117
What happens in a whiplash injury?
Tearing of Interspinous ligaments and tearing in Facet joint capsules

Neuro (14 decks)

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