Week 1 - wet room

Question 1

embryologically, which two vesicles of the neural tube give rise to the brainstem?

Answer 1

mesencephalon & rhombencephalon

Question 2

what are the cavities (of the ventricular system) which lie within the brainstem?

Answer 2

cerebral aqueduct

4th ventricle

Question 3

what is the name of the groove which separates the pons and medulla?

Answer 3

pontomedullary junction

Question 4

which nerves emerge from the pontomedullary junction?

Answer 4

CN VI and VII (abducens and facial nerve)

Question 5

what surface features are found on the medulla?

Answer 5

pyramids
olives (laterally to the pyramids)
inferior cerebellar pedundle

Question 6

what is the decussation of the pyramids and what part of the brainstem is this present?

Answer 6

medulla

decussation is the crossing over of fibres from the pyramidal tract from one side to the other.

Question 7

what type of fibres does the pyramids contain?

Answer 7

motor fibres

Question 8

what is the function of the olives and where are they found?

Answer 8

The medulla - lateral to the pyramids

They are associated with perception of sound

Question 9

what does the open part of the medulla open into?

Answer 9

the 4th ventricle

Question 10

what is the middle cerebellar peduncle made up of?

Answer 10

centripetal fibres / incoming fibres

Question 11

what structure does the cerebral peduncle arise from?

Answer 11

midbrain

- the cerebral peduncle is the whole of the midbrain except from the tectum

Question 12

what fibres does the cerebral peduncle contain?

Answer 12

sensory and motor

Question 13

where do fibres which run in the cerebral peduncle go to and come from?

Answer 13

the cerebrum and pons

Question 14

what connects the 2 cerebral hemispheres?

Answer 14

corpus callosum

Question 15

what is the function of the cerebellar peduncles?

Answer 15

they connect the cerebellum to the brainstem

Question 16

what is the function of the cerebral peduncle?

Answer 16

it helps transport nerve impulses from higher parts of the brain to the brain stem to help refine our movements

Question 17

what are the different parts of the cerebellum?

Answer 17

anterior and posterior lobes
cerebellar tonsil
flucculonodular node
grey and white matter?

Question 18

if there is changes in intra cranial pressure what part of the brain herniates through the foramen magnum first?

Answer 18

cerebellar tonsil

Question 19

what change in pressure would cause herniation of the cerebellar tonsil into the foramen magnum?

Answer 19

a sudden drop in intracranial pressure

Question 20

what is the term for herniation of the cerebellar tonsil into the foramen magnum?

Answer 20

cerebellar coning

Question 21

what is the name of the fissure which separates the two cerebral hemispheres?

Answer 21

longitudinal fissure

Question 22

the cerebral hemispheres sit on the base of the anterior and middle cranial fossa’s but what does it sit on in the posterior fossa?

Answer 22

tentorium cerebelli

fold of dura matter

Question 23

what covers the cerebellum?

Answer 23

tentorium cerebelli

fold of dura matter

Question 24

what type of nerve fibres are found within the corpus callous?

Answer 24

commissural fibres (connecting bundle)

Question 25

what is the main function of each part of the cerebrum? - frontal lobe ? - parietal lobe ? - occipital lobe ? - temporal lobe ?

Answer 25

primary motor cortex primary sensory cortex primary visual cortex primary auditory cortex

Question 26

at what level does the spinal cord terminate in an adult and child?

Answer 26

``` adult = L1 child = L2/3 ```

Question 27

at what vertebral level does the arachnoid and dura matter terminate?

Answer 27

S2

Question 28

what lies within the spinal canal?

Answer 28

spinal cord meninges CSF central gelatinous substance of spinal cord

Question 29

what happens to the pia matter inferior to the spinal cord termination?

Answer 29

becomes and extends as a thin filament called the film terminale

Question 30

at what level would you perform a lumbar puncture and why?

Answer 30

L3/4 | your spinal cord terminates at L1 and beyond this until S2 lies the CSF wrapped in arachnoid and dura matter

Question 31

what is the difference between upper and lower motor neurones?

Answer 31

upper motor neurones travel within the spinal cord | lower motor neurones are the neurones which U.M.N synapse with when it exits the spinal cord

Question 32

what is the name of the continuation of the spinal nerves after the cord terminates?

Answer 32

cauda equina

Question 33

is damage to the cauda equina classified as an upper or lower motor neurone lesion?

Answer 33

lower motor neurone lesion

Question 34

what are the symptoms of an upper motor neurone lesion?

Answer 34

spasticity increase in muscle tone complex sensory syndromes

Question 35

what are the symptoms of a lower motor neurone lesion?

Answer 35

decrease in muscle tone (flaccid paralysis) | global sensory changes

Question 36

What embryological vesicle give rise to the midbrain of the brainstem?

Answer 36

Mesencephalon

Question 37

What embryological vesicle gave rise to the hindbrain (pons & medulla) ?

Answer 37

Rhombencephalon

Question 38

What is the disadvantage of the abducens nerve having the longest course when it leaves the pontomedullary junction?

Answer 38

It leaves it vulnerable to damage due to raised intracranial pressure or other mechanical damage such as intracranial fractures of cerebral artery aneurysms. This can result in CN VI palsy

Question 39

Damage to the abducens nerve due to increased intracranial pressure can give a misleading clinical presentation, how?

Answer 39

The clinical presentation of damage to the nerve causes doubles vision and the patient wont be able to abduct the eye. This is misleading because it makes you think that there is something wrong with the eye and not about intracranial pressure

Question 40

What part of the brain stem are superior and inferior colliculi located?

Answer 40

Midbrain

Question 41

where do you find the calcarine sulcus and what does it divide?

Answer 41

In the medial side of the occipital lobe | It divides the visual cortex into 2

Question 42

What are the different parts of the ending of the spinal cord?

Answer 42

The spinal cord ends at L1 It tapers out in a cone shape called the conus medullaris After conus medullaris there is still nerves which continue down the spine called the cauda equina When the spinal cord ends at conus medullaris, the pia matter becomes filament our forming the film terminale The arachnoid and pia matter end at S2

Question 43

What ligaments are removed so you can view the spinal cord?

Answer 43

Ligamentum spinosum

Question 44

What is the procedure called which removes part of the vertebra so you can view the spinal cord?

Answer 44

Laminectomy

Question 45

What nerves emerge from between the midbrain and pons?

Answer 45

The occulomotor and trochlear nerves