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MRCEM Primary Exam > Anatómía CNS > Flashcards

Anatómía CNS Flashcards

1
Q

Hvernig er uppbyggingin á internal spinal cord?

A

The internal spinal cord consists of white matter in the periphery, grey matter centrally, and a tiny central canal filled with cerebrospinal fluid (CSF) at the centre. A single layer of cells, called the ependymal layer, lies immediately around the central canal.

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2
Q

Hvernig er uppbyggingin á gráa efninu í mænunni?

A

The grey matter surrounding the ependymal layer is shaped like a butterfly. The two “wings” of the butterfly are connected across the midline by the dorsal grey commissure and below by the white commissure.

The shape and size of the grey matter vary according to spinal cord level. At the lower levels, the ratio between grey and white matter is greater than at higher levels because the lower levels contain fewer ascending and descending nerve fibres.

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3
Q

Hvaða frumur inniheldur gráa efnið í mænunni og í hvaða fjóra parta skiptist það?

A

The grey matter mainly contains the cell bodies of neurons and glia and is divided into four parts:

  • The dorsal horn
  • The intermediate column
  • The lateral horn
  • The ventral horn

The dorsal horn is found at all spinal cord levels and is comprised of sensory nuclei that receive and process incoming somatosensory information. From there, ascending projections emerge to transmit the sensory information to the midbrain and diencephalon. The intermediate column and the lateral horn comprise autonomic neurons innervating visceral and pelvic organs. The ventral horn comprises motor neurons that innervate skeletal muscle.

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4
Q

Hvers konar frumur eða vefur er í hvíta efninu í mænunni?

A

The white matter mainly consists of the spinal tracts.

These are large bundles of nerves that conduct information from the brain to the spinal cord and vice versa. The white matter tracts include:

  • The corticospinal tracts
  • The spinothalamic tracts
  • The posterior tracts (dorsal column-medial lemniscal pathway)
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5
Q

Blóðflæði til Intraocular portion of optic nerve?

A

Central retinal artery

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6
Q

Blóðflæði til Intraorbital portion of optic nerve? (2)

A

Branches of central retinal artery

Branches of internal carotid artery

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7
Q

Blóðflæði til Intracanalicular portion of optic nerve?

A

Ophthalmic artery

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8
Q

Blóðflæði til Intracranial portion of optic nerve?

A

Superior hypophyseal artery

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9
Q

Blóðflæði til optic chiasm? (3)

A

Superior hypophyseal artery
Anterior cerebral artery
Anterior communicating artery

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10
Q

Blóðflæði til optic tract:

A

Anterior choroidal artery

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11
Q

Blóðflæði til Lateral geniculate nucleus?

A

Anterior and lateral choroidal arteries

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12
Q

Blóðflæði til optic radiation?

A

Middle and posterior cerebral arteries

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13
Q

Blóðflæði til visual cortex?

A

Posterior cerebral artery

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14
Q

Hvernig liggur mænan?

A

The spinal cord is the main pathway for information connecting the brain and the peripheral nervous system. It originates in the brainstem, passes through the foramen magnum, continues through to the conus medullaris vertebral level), before terminating in a fibrous extension known as the filum terminale. At birth the conus medullaris lies at L1, but by the age of 21 it les at L1/2 in the majority of people.

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15
Q

Hvar eru “the two enlargements” á mænunni? Hvaða klíníska relevance hafa þeir?

A

There are two enlargements during the course of the spinal cord:

  • The cervical enlargement (between C3 and T1), which represents the origin of the brachial plexus, and;
  • The lumbosacral enlargement (between T9 and L1), which represents the origin of the lumbosacral plexus
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16
Q

Hvar eru “the two depressions” á yfirborði mænunnar?

A

The spinal cord is marked by two depressions on its surface:

  • The anterior median fissure, which is a deep groove extending the length of the anterior surface of the spinal cord, and;
  • The posterior median sulcus, a shallower depression extending the length of the posterior surface of the spinal cord
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17
Q

Hvor mænurótin er motor og hvort er sensory - ant. eða post?

A

Each of the spinal nerves begins as an anterior (motor) nerve root and a posterior (sensory) nerve root. These roots emerge from the cord and amalgamate at the intervertebral foramina, forming a single spinal nerve.

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18
Q

Hvernig liggja spinal taugarnar og hvert bera anterior og posterior rami upplýsingar?

A

The spinal nerves then leave the vertebral canal via their individual intervertebral foramina and divide into anterior and posterior rami.

  • The anterior rami carry sensory and motor information to and from the anterolateral parts of the trunk and limbs.
  • The posterior rami carry sensory and motor information to and from the skin and deep muscles of the back.
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19
Q

Í hvaða röð eru heilataugarnar númeraðar?

A

The cranial nerves are accordingly numbered by the location within the brainstem (superior to inferior then medial to lateral) and the order of their exit from the cranium (anterior to posterior).

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20
Q

Hvaða heilataug á uppruna sinn í midbrain?

A

Trochlear nerve (CN IV)

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21
Q

Hvaða tvær heilataugar eiga uppruna sinn í heilanum sjálfum?

A

Fyrstu tvær:

the olfactory nerve and the optic nerve

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22
Q

Hvaða heilataug á uppruna sinn í midbrain-pontine junction?

A

Oculomotor nerve (CN III)

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23
Q

Hvaða heilataug á uppruna sinn í pons?

A

Trigeminal nerve (CN V)

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24
Q

Hvaða 3 heilataugar eiga uppruna sinn í pontine-medulla junction?

A 
Abducens nerve (CN VI)
Facial nerve (VII)
Vestibulocochlear nerve (CN VIII)
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25
Q

Hvaða 3 heilataugar eiga uppruna sinn í Medulla oblongata, posterior við olive?

A 
Glossopharyngeal nerve (CN IX)
Vagus nerve (CN X)
Accessory nerve (CN XI)
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26
Q

Hvaða heilataug á uppruna sinn í Medulla oblongata

(anterior to the olive)?

A

Hypoglossal nerve (CN XII)

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27
Q

Myotome fyrir deltoid:

A

C5

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28
Q

Myotome fyrir wrist extensors

A

C6

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29
Q

Myotome fyrir elbow etensors:

A

C7

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30
Q

Myotome fyrir Finger flexors to middle finger (flexor digitorum profundus):

A

C8

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31
Q

Myotome fyrir Small finger abductors (abductor digiti minimi)

A

T1

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32
Q

Myotome fyrir Hip flexors (iliopsoas)

A

L2

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33
Q

Myotome fyrir knee extensors:

A

L3, L4

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34
Q

Myotome fyrir knee flexion:

A

L4, L5 & S1

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35
Q

Myotome fyrir Ankle and big toe dorsiflexors:

A

L5

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36
Q

Myotome fyrir Ankle plantar flexors

A

S1

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37
Q

Í hvað skiptast “the descending tracts” í mænunni?

A

The descending tracts can be divided into the pyramidal tracts and the extrapyramidal tracts.

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38
Q

Hvaða hlutverk hafa “the descending tracts” í mænunni og í hvaða tvo hluta skiptast þær?

A

The descending tracts are pathways through which motor signals travel from the brain to the lower motor neurons to innervate muscles and cause movement. There are no synapses in the descending pathways. All of the neurons in the descending tracts are upper motor neurons, with their cell bodies being located in the cerebral cortex or brain stem and their axons remaining in the central nervous system.

The descending tracts can be divided into the pyramidal tracts and the extrapyramidal tracts.

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39
Q

Pyramidal tracts í mænu eru annar hlutinn af descending tracts. Í hvaða tvo hluta skiptast pyramidal tracts og hvað gera þeir?

A

The pyramidal tracts are efferent nerve fibres that start in the cerebral cortex and carry motor fibres to the spinal cord (corticospinal tracts) and brain stem (corticobulbar tracts).

They are involved in the voluntary control of muscles of the body and face. Both the pyramidal tracts pass through the pyramids of the medulla, hence their name.

40
Q

Corticobulbar tracts eru annar hluti pyramidal tracts í mænunni (hinn er corticospinal tracts). Hvaða hlutverk hafa corticobulbar tracts og hvar í taugakerfinu eiga þeir upptök sín?

A

The corticobulbar tracts start in the lateral part of the primary motor cortex. They also receive inputs from the primary motor cortex, premotor cortex, somatosensory area and supplementary motor area. Their path passes through the internal capsule to the brainstem.

41
Q

Hvar enda corticobulbar brautirnar?

A

They end on the motor nuclei of the cranial nerves, where they synapse with lower motor neurons that carry motor signals to the muscles in the face and neck. Most of the fibres of the corticobulbar tracts supply the cranial nerves bilaterally. There are, however, two exceptions:

  • The facial nerve – the muscles of the lower face are supplied by contralateral nerves only
  • The hypoglossal nerve – only receives innervation from contralateral upper motor neurons
42
Q

Spinal cord tracts:

A
43
Q

Hvaða 3 spinal brautir er hægt að testa auðveldlega?

A

Of the many tracts within the spinal cord, only three can be easily assessed clinically:

  • The corticospinal tract
  • The spinothalamic tract
  • The dorsal columns
44
Q

Hvar er corticospinal tract staðsettur í mænunni og hvernig er hann testaður?

A

The corticospinal tract is located in the posterolateral segment of the spinal cord and controls ipsilateral motor power. It can be tested by assessing voluntary muscle contractions or involuntary responses to painful stimuli.

45
Q

Hvar er spinothalamic tract staðsettur í mænunni og hvernig er hann testaður?

A

The spinothalamic tract is located in the anterolateral aspect of the spinal cord and is responsible for transmitting contralateral pain and temperature sensation. It can be tested clinically with the assessment of pinprick and light touch.

46
Q

Hvar eru dorsal columns staðsettir í mænunni og hvað gera þeir (hvernig eru þeir testaðir)?

A

The dorsal columns are located in the posteromedial aspect of the spinal cord and are responsible for transmitting ipsilateral position sense (proprioception), vibration sense, and some light-touch sensation.

47
Q

Hvernig er sensory, motor og neurological level of injury ákvarðað eftir mænuskaða?

A

The sensory level is the most caudal (lowest) dermatome with normal sensory function.

The motor level is the most caudal level at which muscles have grade 3 strength (full range of movement against gravity) or above, while the segment above is grade 5 (full range of movement against full resistance).

The neurological level of injury is the most caudal level at which both sensory and motor levels are intact.

48
Q

Motor funksjon og skyn fyrir C5 spinal level:

A

Shoulder abduction

Area over deltoid

49
Q

Motor og skyn fyrir C6 spinal level:

A

Wrist extension

Thumb

50
Q

Motor og skyn fyrir C7 spinal level:

A

Elbow extension

skyn: Middle finger

51
Q

Motor og skyn fyrir C8 spinal level:

A

Finger flexion

Little finger

52
Q

Motor og skyn fyrir T1 spinal level:

A

Finger abduction

Medial upper arm

53
Q

Motor og skyn fyrir T4 spinal level:

A

Ekkert motor

Nipple skyn

54
Q

Motor og skyn fyrir T8 spinal level:

A

Ekkert motor

Xiphisternum skyn

55
Q

Motor og skyn fyrir T10 level:

A

Ekkert motor

Umbilicus skyn

56
Q

Motor og skyn fyrir T12 spinal level:

A

Ekkert motor

Symphysis pubis skyn

57
Q

Motor og skyn fyrir L2 spinal level:

A

Hip flexion motor

Upper thigh skyn

58
Q

Motor og skyn fyrir L4 spinal level:

A

Knee extension

Medial aspect of calf

59
Q

Motor og skyn fyrir L5 spinal level:

A

Big toe extension

1st dorsal web space

60
Q

Motor og skyn fyrir S1 spinal level:

A

Ankle plantar-flexion

Lateral border of foot

61
Q

Motor og skyn fyrir S3 spinal level:

A 
Anal reflex (S3/4)
Ischial tuberosity area
62
Q

Motor og skyn fyrir S4/5 spinal level:

A 
Anal reflex (S3/4)
Perianal region
63
Q

Inni í parotis kirtlinum skiptist facialis taugin í 5 greinar:

A 
Temporal branch
Zygomatic branch
Buccal branch
Marginal mandibular branch
Cervical branch
64
Q

Hvaða 5 vöðvar eru ítaugaðir af temporal branch facialis taugar?

A 
Frontalis
Orbicularis oculi
Corrugator supercilli
Auriculares anterior
Auriculares superior
65
Q

Hvaða 2 vöðvar eru ítaugaðir af zygomatic branch facialis taugar?

A

Orbicularis oculi

Zygomaticus

66
Q

Hvaða 9 vöðvar eru ítaugaðir af buccal branch facialis taugar?

A
  • Orbicularis oris
  • Procerus
  • Buccinator
  • Zygomaticus
  • Risorius
  • Levator labii superioris
  • Levator labii superioris alaeque nasi
  • Nasalis
  • Depressor septi nasi
67
Q

HVaða 3 vöðvar eru ítaugaðir af Marginal mandibular branch facialis taugar?

A

Mentalis
Depressor labii inferioris
Depressor anguli oris

68
Q

Hvaða vöðvi er ítaugaður af cervical branch facialis taugar?

A

Platysma.

69
Q

Sjónsvið einstaklings eftir stroke. Hvar er lesionin?

A

This patient has right-sided inferior homonymous quadrantanopia demonstrated by their visual field testing. Homonymous quadrantanopias are caused by lesions of the optic radiation.

Lesionin er í parietal lobe (upper optic radiation).

70
Q

Hvernig liggja optic tracts?

A

Each optic tract passes from the posterolateral angle of the optic chiasm, running lateral to the cerebral peduncle and medial to the uncus of the temporal lobe before reaching the lateral geniculate nucleus (LGN) in the thalamus.

71
Q

Hvernig fara sjónboðin eftir að þau koma frá optic tract og lateral geniculate nucleus?

A

The LGN acts as a relay centre and sends axons through the optic radiation to the primary visual cortex in the occipital lobe. The upper optic radiation carries fibres from the superior retinal quadrants (which corresponds to the lower half of the visual field) and travels through the parietal lobe. The lower optic radiation carries fibres from the inferior retinal quadrants (which corresponds to the upper half of the visual field) and travels through the temporal lobe.

72
Q

Hvernig lítur optic nerve lesion út í sjónsviðinu?

A
73
Q

Hvernig lítur optic chiasm lesion út í sjónsviðinu?

A
74
Q

Hvernig lítur optic tract lesion út í sjónsviðinu?

A
75
Q

Hvernig lítur temporal lower optic radiation lesion út í sjónsviðinu?

A
76
Q

6 einkenni við stroke í anterior cerebral artery:

A
  • Contralateral motor weakness (leg/shoulder > arm/hand/face)
  • Minimal contralateral sensory loss
  • Dysarthria, aphasia
  • Left limb apraxia
  • Urinary incontinence
  • Behavioural and personality changes
77
Q

4 einkenni við stroke í middle cerebral artery:

A
  • Contralateral hemiparesis (face/arm > leg)
  • Contralateral hemisensory loss
  • Expressive or receptive dysphasia (dominant hemisphere)
  • Contralateral neglect (non-dominant hemisphere)
78
Q

3 einkenni við stroke í posterior cerebral artery:

A
  • Contralateral homonymous hemianopia
  • Quadrantic visual field defects
  • Contralateral thalamic syndrome (PCA supplies thalamus)
79
Q

Hvar liggur cerebellum - í hvaða fossu, hvað heitir sá hluti af dura mater sem liggur þar yfir?

A

The cerebellum is located at the back of the brain, below the occipital and temporal lobes of the cerebral cortex, within the posterior cranial fossa. It is separated from these lobes by the tentorium cerebelli, an infolding of the dura mater. It is lies at the same level as the pons and is separated from it by the fourth ventricle.

80
Q

Blóðflæði til medullu (4):

A
  • The anterior spinal artery supplies the paramedian region of the caudal medulla
  • The posterior spinal artery supplies the rostral areas of the medulla and the posterior aspect of the inferior cerebral peduncles
  • The vertebral artery supplies areas of both the caudal and rostral medulla via its bulbar branches
  • The posterior inferior cerebellar artery supplies the lateral medullary areas
81
Q

Hvaða æð nærir paramedian hluta caudal medullu?

A

The anterior spinal artery supplies the paramedian region of the caudal medulla

82
Q

Hvaða æð nærir posterior hluta inferior cerebral peduncles og rostral hluta medullu?

A

The posterior spinal artery supplies the rostral areas of the medulla and the posterior aspect of the inferior cerebral peduncles

83
Q

Hvaða æð nærir bæði caudal og rostral medullu?

A

The vertebral artery supplies areas of both the caudal and rostral medulla via its bulbar branches

84
Q

Hvaða æð nærir lateral medullary svæði?

A

The posterior inferior cerebellar artery supplies the lateral medullary areas

85
Q

Hvaða vöðvi lamast þegar 6. heilataug (abducens) er úti? Hvaða funksjon hefur hann?

A

Lateral rectus vöðvinn. Hann abducerar augað.

86
Q

Hvað sjáum við klínískt ef hægri abducens taug lamast?

A

Hægra augað getur þá ekki horft yfir miðlínu til hægri.

87
Q

Hvaða vöðva ítaugar trochlear taugin? (fjórða heilataug)

A

The trochlear nerve (CN IV) is the fourth of the cranial nerves. It is a purely motor nerve that innervates a single muscle, the superior oblique.

88
Q

Hvar kemur chorda tympani út úr höfuðkúpunni?

A

The chorda tympani exits the cranium through the petrotympanic fissure to enter the infratemporal fossa.

89
Q

Hvar er Broca´s area staðsett?

A

Broca’s area is located in the frontal lobe of the dominant cerebral hemisphere in the posterior part of the inferior frontal gyrus.

90
Q

Hvar er Wernicke´s area staðsett?

A

Wernicke’s area is located in the temporal lobe of the dominant cerebral hemisphere in the posterior part of the superior temporal gyrus.

91
Q

Hvar er primary auditory area staðsett?

A

The primary auditory area is located bilaterally within the temporal lobes in the inferior wall of the lateral sulcus.

92
Q

Hvar er secondary auditory area staðsett?

A

The secondary auditory area is located posterior to the primary auditory area in the lateral sulcus and superior temporal gyrus.

93
Q

Hvar er primary visual area staðsett?

A

The primary visual area is located bilaterally within the occipital lobes in the walls of the posterior part of the calcarine sulcus.

94
Q

Hvar er secondary visual area staðsett?

A

The secondary visual area surrounds the primary visual area on the medial and lateral surfaces of the hemisphere.

95
Q

Hvað er medial pontine sx, hver eru einkennin og stroke í hvaða æð orsakar það?

A

Obstruction of the paramedian branches of the basilar artery results in the medial pontine syndrome, which is characterised by:

  • Contralateral hemiplegia (damage to pyramidal tracts)
  • Contralateral loss of joint position sense, vibratory sene and discriminatory touch (damage to medial lemniscus)
  • Double vision caused by lateral rectus muscle paralysis (damage to CN VI)

MRCEM Primary Exam (21 decks)

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