Anatomy Flashcards
1
Q
What is the CNS composed of?
A
- the brain and spinal cord
2
Q
The ANS is a division of what nervous system
A
- PNS
3
Q
Define a neuron
A
- basic unit of the nervous system
4
Q
What is the function of a neurone
A
- receive and conduct nervous impulses
5
Q
A collection of neurones is termed?
A
ganglion
6
Q
Function of dendrites
A
- short
- gather information from neighbouring neurones
- recieve information towards the cell body
7
Q
What produces myelin in the CNS
A
- Oligodendrocytes
8
Q
What produces myelin in the PNS?
A
- Schwann cells
9
Q
Multipolar neurons are ___efferent/afferent___
A
- efferent
- motor
10
Q
Unipolar neurons are ___effferent/afferent___
A
- afferent
- sensory
11
Q
Where is the cell body located in a unipolar neuron?
A
- PNS
12
Q
Where is the cell body of a multipolar neuron located
A
- CNS
13
Q
Define a nerve in the PNS
A
- A collection of axons surrounded by connective tissue
14
Q
How many pairs of spinal nerves are there?
A
- 31
15
Q
How are spinal nerves in the cervical region named?
A
- by the vertebra below
16
Q
How are the spinal nerves in all regions other than the cervical region named?
A
- by the vertebra above
17
Q
The ___posterior/anterior___ rami is largest
A
- anterior
18
Q
Sensory axons pass through the __posterior/anterior__ root
A
- posterior root
19
Q
Motor axons pass through the ___posterior/anterior___ root
A
- anterior root
20
Q
Roots only carry a specific modality and spinal nerves are mixed?
TRUE OR FALSE
A
- TRUE
21
Q
Define dermatome
A
- area of skin supplied with sensory innervation from a single spinal nerve
22
Q
Define myotome
A
- the skeletal muscle supplied with motor innervation from a single spinal nerve
23
Q
What is used to visualise dermatome landmarks?
A
- dermatome map
24
Q
What dermatome level is the nipple?
A
- T4
25
What dermatome level is the umbilicus?
- T10
26
Only the anterior rami are involved in nerve plexuses?
TRUE OR FALSE
- TRUE
27
What is the sympathetic outflow region?
- T1-L2
28
Sympathetic innervation leaves via the __anterior/posterior___root?
- anterior rami
| - motor innervation
29
What is the parasympathetic outflow?
- CN III, VII, IX, X
| - S2, S3, S4
30
What is different about the sacral spinal nerves,
- synapse at target organ
| - e.g. hindgut, pelvis and perineum
31
Name the 4 curvatures of the spine
- cervical lordosis
- thoracic kyphosis
- lumbar lordosis
- sacral kyphosis
32
Where are the intervertebral foramen found
- between adjacent vertebra
| - location of spinal nerves
33
Facet joints are an example of ___ joints
- synovial
34
The intervertebral disc has an outer fibrous ring called ____ and an inner soft pulp called ___
- annulus fibrosus
| - nucellus pulposus
35
The ligamentum flavum lies ___ anterior/posterior___ to the spinal cord
- posterior
36
The posterior longitudinal ligament lies __anterior/posterior___ to the spinal cord
- anterior
37
What is unique about C1?
- No vertebral body or spinous process
38
What does C2 contain?
- odontoid process with is superiorly projected
39
What head movement is the atlanto-occipital joint responsible for?
- yes movement
40
What head movement is the atlanto-axial joint responsible for?
- no movement
41
How many articulations does the atlanto-axial joint has?
- 3 articulations
42
Skin dimples superior to the sacrum indicate?
- position of the posterior superior iliac spine (PSIS)
43
What are the muscles of the back?
- trapezius
- teres major
- latissimus dorsi
- erector spinae
44
What does extrinsic muscles of the back mean?
- superifical
| - have an attachment outwit the back
45
What are the 4 extrinsic muscles of the back?
- levator scapular
- rhomboids
- trapezius
- Latissimus dorsi
46
What does intrinsic muscles of the back mean?
- lies entirely within the back
47
What is the erector spinae muscles composed of?
- iliocostalis
- longissimus
- spinalis
48
What erector spinae muscles lies most laterally?
- lliocostalis
49
Which receptor spinae muscle lies in close association with the ribs?
- liocostalis
50
Which is the longest erector spinae muscle?
- longissmius
51
Which erector spinae muscle is most medial and in close association with the occipital bone and spinous processes?
- spinalis
52
Other than the erector spine muscle name another intrinsic muscle of the back?
- transversospinalis
53
What is the nerve supply for the intrinsic muscles of the back?
- posterior rami branches
54
Name the 3 layers of the muscles of the anterolateral back from superficial to deep
- external oblique
- internal oblique
- transverse abdominis
55
Bilateral contraction of the erector spinae causes?
- flexion of the spine
56
Unilateral contraction of the erector spinae causes
- lateral flexion of the spine
57
Where does the spinal cord begin?
- foramen magnum and is continuous with medulla oblongata
58
Where does the spinal cord end?
- level L1/2
59
What is the cauda equina composed of?
- spinal nerve roots from L2 to coccygeal segment
60
What is the spinal cord covered by?
- bone
- epidural fat
- 3 layers of meninges
61
Where is the venous plexus of the spinal cord located?
- in the epidural fat
62
Where is the usual location of a epidural anaesthetic performed?
- L3/4
63
When must you not perform a lumbar puncture?
- in cases of raised ICP
64
Where is a spinal block injected?
- CSF in subarachnoid space
65
Where is an epidural block injected?
- into the epidural fat
66
Where is a caudal anaesthetic injected?
- into sacral hiatus
67
Describe a laminectomy
- type of surgery to remove part of the vertebral lamina
| - gives access to spinal cord and roots
68
Symptoms of somatic general sensory pathology?
- pain
- pins and needles
- numbness
69
Symptoms of somatic motor pathology?
- stiffness
- cramp
- reduced tone
70
What dermatome is the badge patch area?
- C5
71
Why is peripheral nerve cutaneous innervation different to dermatome maps?
- overlap of dermatome areas
72
Name some peripheral nerves?
- femoral
- radial
- sural
73
What is the cutaneous innervation of the femoral nerve?
- L2, L3, L4
74
Where is the nerve point of the neck located?
- just above the midpoint of the posterior border of SCM
75
What nerve lies in the anatomical snuffbox
- radial nerve
76
Describe the route APs take when the anterior L2 femoral nerve area is stimulated
- Femoral area stimulated
- APs conducted along L2 anterior ramus
- Weave through lumbar plexus to L2 spinal nerve
- Enter L2 posterior root then L2 posterior rootlets (sensory)
- APs arrive at posterior horn of L2 spinal cord
- APs conducted via an ascending tract to primary somatosensory cortex
77
Area of muscle supplied by the femoral nerve crosses how many true myotomes?
- 3 true myotomes
78
Clinical testing the shoulder abduction is what myotome?
- C5
79
Shoulder adduction is what myotome?
- C7
80
Which muscle is responsible for shoulder abduction
- deltoid
81
Flexion of the fingers involves what myotome?
C8
82
What 2 myotomes are mainly involved in hip flexion
L2, L3
83
Explain myotome route of L3
- APs generated in primary somatomotor cortex and descend corticospinal tract
- APs reach L3 spinal cord anterior horn (motor)
- Enter anterior rami or posterior rami (back muscles only)
- APs arrive at neuromuscular junction to supply muscle
84
What myotomes are involved in hip joint extension
- L5, S1
85
What myotomes are involved in flexion of the knee joint
- L5, S1
86
Define a reflex?
- involuntary response to stimulus
87
What does monosynaptic reflex mean?
- only one synapse
| - between posterior sensory and anterior motor
88
Explain the patellar reflex
o Patellar ligament tapped
o Stretches quadriceps
o Muscle stretch receptors initiate APs in anterior rami within femoral nerve
o Sensory APs conduct to dorsal horn of L4
o Axons pass into anterior horn to synapse on LMNs (lower motor neuron) that supply quadriceps
o APs conducted via LMN axon in femoral nerve to reach quadriceps NMJ
o Muscle contracts to extend knee joint
89
Explain the effect of an upper motor neuron lesion
- spasticity
90
Explain the effect of a lower motor neuron lesion
- flaccidity
91
Which spinal nerve are you testing for the knee
- L4
92
Which spinal nerve are you testing for the ankle
S1
93
Which spinal nerve are you testing for the bicepes
C5
94
Define paralysis
- a muscle without a functioning motor nerve
| - reduced tone
95
Define spasticity
- muscle has an intact and functioning motor nerve
- descending controls from brain not working
- increased tone
96
Define polyneuropathy
- more than one dermatome or named peripheral nerve involved
97
When describing a cranial nerve what must you discuss?
- the CNS part
- intracranial
- foramen
- extracranial part
98
trochlear nerve has a __short/long__ intracranial path?
- long
99
hypoglossal nerve has a __short/long__ intracranial path?
- short
100
Which foramen does CN I exit?
- cribriform plate of ethmoid
101
What cranial nerves enter/exit via the superior orbital fissure?
- CN III
- CN IV
- CN V1
- CN VI
102
CN V2 leaves via what foramen?
- rotundum
103
CN V3 leaves via what foramen?
- ovale
104
What cranial nerves leave via the jugular foramen?
- CN IX, X , XI
105
What are the 3 divisions of the trigeminal nerve?
- Ophthalmic
- Maxillary
- mandibular
106
Which is the only cranial nerve to attach to the pons?
- trigeminal
107
explain the intracranial course of the trigeminal nerve?
- inferior edge of tentorium cerebelli
108
The motor division of the trigeminal nerve exits via which foramen?
- CN V3
| - Foramen ovale
109
main sensory function of the trigeminal nerve?
- sensory to the skin of face
110
CN V3 has motor control to which muscles?
- mastication ( masseter, temporalis, medial ptyergoid, lateral pterygoid)
- tensor veli palanti
- tensor tympani
111
Describe the CNS part of the facial nerve?
- pontomedullary junction
112
Where does the facial nerve exit and enter the cranial cavity by?
- internal acoustic meatus
113
Which branch of the facial nerve has parasympathetic function?
- greater petrosal
114
Which foramen does the main branch of the facial nerve exit via?
- stylomastoid foramen
115
Name the 5 main terminal branches of the facial nerve?
- temporal
- zygomatic
- buccal
- mandibular
- cervical
116
What mnemonic can be learnt to remember the 5 terminal branches of the facial nerve?
- to (temporal)
- zanzibar (zygomatic)
- by (buccal)
- motor (mandibular)
- car (cervical)
117
How do you clinically test the sensory division of the trigeminal nerve?
- close eyes
- brush skin in each dermatome with fine tip of cotton wool
- ask patient to say when they feel
- compare both sides
118
When testing the sensory division of CN V1 where should you brush?
- upper eye lid
- forehead
- tip of nose
119
When testing the sensory division of CN V2 where should you brush?
- mid-cheek
- lower eyelid
- upper lip
- nostril
120
When testing the sensory division of CN V3 where should you brush?
- lower cheek
- lower lip
- chin
121
How can you test the motor division of CN V?
- Ask to contract jaw
| - open jaw against resistance
122
Clinically testing the facial nerve?
- frown
- close eyes
- smile
- puff cheeks
123
Clinical testing of the vagus nerve?
- ask patient to say ah, uvula should go straight up (will deviate away from side of pathology)
- swallow water
124
CNS connection. of the glossopharyngeal?
- medulla
125
Foramen of the glossopharyngeal?
- jugular foramen
126
Special sensory division of the glossopharyngeal?
- taste posterior 1/3rd tongue
127
Explain the path of the recurrent laryngeal?
- right side under subclavian
| - left side under arch of aorta
128
Which foramen does the vagus nerve exit?
- jugular foramen
129
CNS connection of CN XI
- Spinal accessory
| - on spinal cord
130
Explain the intracranial course of CN XI
- Spinal cord
- upwards through foramen magnum
- exits via jugular foramen
131
Clinical testing of spinal accessory
- sternocleidomastoid (turn head look up)
| - trapezius (shrug shoulder)
132
CNS connection of the hypoglossal nerve
- pyramids of medulla
133
The hypoglossal canal is located on which bone?
- occipital
134
CLinical testing of hypoglossal nerve?
- tongue straight out
| - tongue will point to side of pathology
135
What are the 5 layers of the scalp?
- skin
- connective tissue
- aponeurosis
- loose connective tissue
- pericranium
136
Where do most of the arteries of the scalp live?
- in the connective tissue
137
What is the 2 main arteries supplying the scalp?
- external carotid
| - ophthalmic artery
138
What are skull sutures?
- fibrous joints
| - help prevent skull fractures from spreading
139
What is the pterion composed of?
- frontal
- parietal
- temporal
- sphenoid bone
140
What artery lies deep to the pterion?
- middle meningeal artery
141
What is the thinnest region of the skull?
- pterion
142
What are the names of the 2 layers of the dura in the cranial cavity?
- external periosteal
| - internal meningeal layer
143
What is tentorium cerebelli?
- dura mater over the cerebellum
| - attaches to the ridges of the petrous temporal bone
144
What is the majority of the dura mater innervated by?
- CN V
145
What is the falx cerebri?
- fold of dura
- midline structure
- separates right and left hemispheres
146
What are the dural venous sinuses?
- endothelial lined gaps between periosteal and meningeal dura
- cerebral veins empty here
147
Where does the dural venous sinuses drain ultimately?
- internal jugular vein
148
What is the danger triangle of the face?
- facial vein and sinuses
| - spread of infection into cranial cavity
149
2 main arteries to the brain
- internal carotid artery
| - vertebral artery
150
What does the circle of willis lie close to?
- midbrain
- pituitary stalk
- optic chiasma
151
Which meninges does the circle of willis lie in?
- subarachnoid space
| - bathed in CSF
152
Posterior cerebral artery is a branch of what artery?
- vertebral artery
153
Anterior and middle cerebral arteries are branches of what artery?-
- internal carotid artery
154
What is hydrocephalus?
- increased csf
| - communicating or obstructive
155
causes of hydrocephalus?
- excessive production
- obstruction to flow
- inadequate resorption
156
Treatment of hydrocephalus?
- ventricular peritoneal shunt
| - into peritoneal cavity
157
3 types of cranial haemorrhages?
- extradural (epidural)
- subdural
- subarachnoid
158
Causes of extradural hamerrhage?
- between bone and dura
| - trauma to pterion
159
Causes of subdural hameorrhage
- falls in elderly
160
Causes of subarachnoid haemorrhage?
- rupture of circle of willis
161
2 main groups of herniation of the brain?
- supratentorial
| - infratentorial
162
A blown pupil may be a sign of what type of brain herniation?
- uncal herniation
| supratentorial
