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Neurology > Anatomy 2 > Flashcards

Anatomy 2 Flashcards

1
Q

what are the dimples in you back landmarks of

A

posterior superior iliac spines

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2
Q

what is the first palpable spinous process

A

t1

70% have C7 palpable

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3
Q

what are the extrinsic back muscles

A

attach the back to the pectoral girdle

  • levator scapulae
  • rhomboids
  • trapezius
  • latissimus dorsi
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4
Q

what mainly innervates the external back muscles

A

anterior rami of the cervical nerves

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5
Q

what innervates the trapezius

A

accessory nerve

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6
Q

what are the intrinsic back muscles

A 
(maintain posture and move spine)
erector spinae (superficial)
transversospinalis (deep)
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7
Q

where are transversospinalis found

A

between the transverse and spinous processes

attach between vertebrae and: rib, skull, another vertebra or the sacrum

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8
Q

what is the main role of transversospinalis

A

stability and rotation of the vertebrae

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9
Q

what is the nerve supply of the intrinsic back muscles

A

segmental - posterior rami branches (cervical, thoracic and lumbar)

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10
Q

what happens when the erector spinae contracts unilaterally

A

lateral flexion

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11
Q

what are the curvatures of the vertebral column

A

cervical lordosis
thoracic kyphosis
lumbar lordosis
sacral kyphosis

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12
Q

where in vertebra is the spinal cord

A

vertebral foramen

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13
Q

what is a facet joint

A

articular processes of adjacent vertebrae

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14
Q

what vertebrae is there no intervertebral discs between

A

C1-2

fused sacrum/ coccyx

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15
Q

what makes up the intervertaebral discs

A

outer fibrous ring- annulus fibrosus

inner doft pulp- nucleus pulposus

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16
Q

what is the ligamentum flavum

A

connects adjacent laminae posterior to the spinal cord

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17
Q

what is the posterior longitudinal ligament

A

narrow, weak, prevents overflexion

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18
Q

what does the anterior longitudinal ligament do

A

strong, broad, prevents over extension of the spine

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19
Q

which way are vertebral disc more likely to herniate

A

posteriorly as posterior longitudinal ligament weaker than anterior

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20
Q

what does the supraspinous ligament do

A

connects TIPS of spinous processes

strong

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21
Q

what does the interspinous ligament do

A

connects superior and inferior surfaces of adjacent spinous processes
weak

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22
Q

what goes through the transverse foramen

A

vertebral arteries (off subclavian)

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23
Q

which vertebrae have bifid spinal processes

A

cervical

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24
Q

describe the anatomy of C1 (atlas)

A

does not have a body or spinous process (post and ant arch instead)

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25
Q

which vertebrae has an ondontoid process

A

C2- axis

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26
Q

what movement at the atlanto-occipital joint

A

flexion and extension of neck

a little lateral flexion and rotation

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27
Q

what joint type is atlanto axial

A

synovial

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28
Q

what movement at the atlanto-axial joint

A

rotation mainly

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29
Q

where does the spinal cord start and finish

A 
foramen magnum (continuous with medulla oblongata)
ends vertebral level (L1/2) at conus medullaris
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30
Q

what is the cauda equina

A

spinal nerve roots from L2 to Co1 that descend to the numbered vertebrae

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31
Q

where is the epidural space

A

outside the dura in the spinal chord

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32
Q

where is anaesthesia injected in caudal anaesthesia

A

sacral hiatus

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33
Q

where is epidural anaesthesia inserted

A

subarachnoid space surrounding cauda equina where vertebrae arent fused (l3/4 interface)

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34
Q

where does the subarachnoid space end

A

L2

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35
Q

when do you not perform a lumbar puncture

A

when there is raised ICP

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36
Q

what does the needle go through in an epidural

A

supraspinous ligament
interspinous ligament
ligamentum flavum
epidural space (fat and veins)

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37
Q

what does the needle go through in a lumbar puncture

A 
supraspinous ligament 
interspinous ligament
ligamentum flavum
epidural space (fat and veins)
dura mater 
arachnoid mater 
(reaches subarachnoid space)
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38
Q

what is a laminectomy

A

removal or one or more spinous processes and the adjacent lamina

used to access spinal cord/ spinal roots or to relieve spinal cord or nerve roots (tumour, herniated disc, bone hypertrophy)

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39
Q

as spinal nerves pass through the intervertebral foramina why is the posterior root enlarged

A

by the dorsal (posterior) root ganglion

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40
Q

what is the conus medullaris

A

where the spinal cord terminates

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41
Q

why is the posterior root enlarged as it leaves the intervetebral foramina

A

enlarged by dorsal root ganglion

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42
Q

what suspends the spinal cord in the canal

A

denticulate ligament

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43
Q

what is in the white matter of the spinal cord

A

axons, glial cells, blood vessels

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44
Q

what is in the grey matter of the spinal cord

A

soma, cell processes, synapses, glia and blood vessels

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45
Q

what is the lateral horn

A

at levels T1-L2 there is a smaller horn which contains the preganglionic sympathetic neurones

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46
Q

what is the blood supply of the spinal cord

A 
3 longitudinal arteries (1 ant 2 post) that original from vertebral arteries 
segmental arteries 
radial arteries (travel along roots)

venous has longitudinal and segmental vessels also in epidural space

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47
Q

the right side of the cortex represents which side of the body

A

left

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48
Q

where is the primary somatosensory cortex

A

post central gyrus (poSt = Sensory)

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49
Q

describe the dorsal column/ medial lemniscus

A

ascending tract for fine touch and proprioception

enter dorsal column
sypanse in medulla @ nucleus gracillus- where it crosses to midline
goes to thalamus
the PostCG

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50
Q

describe the spinothalamic tract

A

ascending tract for pain, temp and deep pressure

synapse immediately in posterior horn and ascended on CONTRAlateral side
synapses in thalamus
PostCG

fibres cross Segmentally= Switch Sides Straight away as they enter cord= Spinothalamic

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51
Q

what is the primary motor cortex

A

pre central gyrus

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52
Q

describe the corticospinal tract

A

descending tract for fine precise movement (esp digits)

cortex PreCG
85% of fibres cross at the decussation of the pyramids in the medulla (forming the lateral CST)
other 15% form ventral CST which cross segmentally (at level they leave cord)

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53
Q

what are pyramidal tracts

A

corticospinal tract forms these on the anterior surface of the medulla- 85% of fibres cross here in medulla

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54
Q

what is the internal capsule

A

white matter strip where lots of sensory information (e.g. CST) travels through)

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55
Q

what happens if there is a CVS in the internal capsule

A

lack of descending control of the corticospinal tract which results in a spastic paralysis with hyperflexion of the upper limbs = decorticate posturing.

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56
Q

describe the tecto spinal tract

A

begins in tectum (post. mid brain)
dorsal tegmental decussation
mediates head and neck reflec to visual stimuli

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57
Q

decsribe the reticulospinal tract

A

Network of nuclei in the brainstem that control breathing, cardiac

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58
Q

describe the vestibulospinal tract

A

Fibres originate in the vestibular nuclei of pons and medulla

project down cord ipsilaterally

excite anti gravity extensor muscles

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59
Q

in general what motor influence do fibres from the pons and medulla do

A

Fibres originating in pons facilitate extensor movements and inhibit flexor movements, while those originating in the medulla do the opposite

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60
Q

when do you get decerebrate regidity and paraplegia in extension

A

Lesions of the brainstem at the level of the midbrain can result in a lack of descending cortical control of the vestibulosponal tract. This leads to domination of extensor muscle tone and hyperextended spastic paralysis.

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61
Q

how would a lateral hemisection of the cors (brown sequard) affect:
motor
reflexes
sensation

A

motor- ipsilateral paralysis (CST crosses (85%) at medulla)

reflexes- ipsilateral

sensation:

  • ipsilateral loss vibration and proprioception (MLS crosses at medulla)
  • contralateral loss pof pain and temp (STT crosses segmentally)
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62
Q

how are the cranial nerves numbered

A

form anterior to posterior and medial to lateral on where they connect with CNS

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63
Q

what is in the optic canal

A

optic nerve and ophthalmic artery

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64
Q

what is the path of CN I

A 
olfactory mucosa 
cribiform plate of ethmoid 
anterior cranial fossa 
olfactor bulb (synapse)
olfactory tract 
cortical areas
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65
Q

what is the path of CN II

A 
retina 
optic nerve 
optic canal (middle cranial fossa)
around pituitary stalk 
optic chiasm 
forms optic tract 
diencephalon
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66
Q

how do you test CN I

A

smell a familiar smell while covering the contralateral nostril

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67
Q

how do you test CN II

A 
acuity (snellens)
colour (ishihara)
fields 
relfexes (pupillary light)
fundoscopy
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68
Q

what is the path of CN III

A 
midbrain (mesencephalon)
lateral wall of cavernous sinus 
superior orbital fissure
orbit
(parasympathetics (pupil constriction) synapse in cilliary ganglion)
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69
Q

how do you test CN III parasympathetics

A

pupillary constriction

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70
Q

what is the path if CN IV

A 
midbrain (mesencephalon) (exits via dorsal surface)
lateral wall of the cavernous sinus 
superior orbital fissure
orbit 
(superior oblique)
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71
Q

what is the path of CN VI

A 
pontomedullary junction 
within cavernous sinus 
superior orbital fissure 
orbit 
(lateral rectus muscle)
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72
Q

what is in the cavernous sinus

A

internal carotid artery

CN III, IV, V (V1 and V2) and VI

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73
Q

how do you test the SO

A

look down and IN

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74
Q

how do you test IO

A

look up and in

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75
Q

how do you test superior and inferior rectus

A

SR up and out

IR down and out

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76
Q

what is the path of CN VIII

A

axons from cochlear and vestibular apparatus
internal accoustic meatus (post cranial fossa)
travels posteromedially to the pontomedullary junction

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77
Q

how do you test CN VIII

A

rinne and weber tests

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78
Q

what is the function of CN XI

A

motor to sternocleidomastoid and trapezius

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79
Q

what is the path of CN XI

A 
cervical spinal cord 
ascends through foramen magnum 
jugular foramen in post cranial  fossa 
SCM (deep surface)
posterior triangle 
trapezius and SCM
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80
Q

how do you test CN XI

A

shrug shoulders

flex neck and tern to opposite side

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81
Q

what is the path of CN XII

A

rootlets lateral to the pyramids of the medulla oblongata
hypoglossal canal (posterior cranial fossa)
descends lateral to carotid sheath
at hyoid turns anteriorly towards tongue

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82
Q

what does CN XII innervate

A

all the nerves ending in glossus except palatoglossus (vagus)

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83
Q

how do you test CN XII

A

Ask patient to stick tongue straight out
If both CNXII’s are functioning normally the tongue tip remains in the midline on protrusion
If there is unilateral CN XII pathology the tongue tip will point towards the side of the injured nerve

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84
Q

what are the modalities of CN V

A

V1 sensory
V2 sensory
V3 sensory and motor

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85
Q

what is the path of CN V

A 
pos 
inferior to tentorium cerebelli 
cranial foramina:
-V1 SOF
-V2 foramen rotundum 
-V3 foramen ovale
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86
Q

what does CN V1 supply

A
  • The upper eyelid
  • The cornea (corneal reflex)
  • All the conjunctiva
  • Skin of the root/bridge/tip of the nose

deep sensory:
Bones & soft tissues of the orbit (except the orbital floor & lower eyelid)
Upper anterior nasal cavity
Paranasal sinuses (except the maxillary sinus)
Anterior & posterior cranial fossae

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87
Q

what does CN V2 supply

A
  • The skin of the lower eyelid
  • The skin over the maxilla
  • The skin of the ala of the nose
  • The skin/mucosa of the upper lip
deep sensory:
Lower posterior nasal cavity
Maxilla & maxillary sinus
Floor of the nasal cavity/palate
Maxillary teeth & associated soft tissues (gingivae & mucosae)
88
Q

what does CN V3 supply

A
  • Skin over the mandible and temporomandibular joint
    (apart from the angle of the mandible – supplied by C2,3 spinal nerves)
deep sensory:
Middle cranial fossa
Mandible
Anterior 2/3rds of the tongue
Floor of the mouth
Buccal mucosa
Mandibular teeth & associated soft tissues
89
Q

what is the great auricular nerve and what does it do

A

(C2,3) – a sensory branch of the cervical plexus

Supplies: - The skin over the angle of the mandible & some of the external ear

90
Q

what motor action does CN V3 have

A

jaw closing- masseter, temporalis, medial pterygoid

jaw opening- lateral pterygoid

tensor veli palatini
tensor tympani

91
Q

how do you test CN V

A

sensory
Ask the patient to close their eyes
Gently brush the skin in each dermatome with a fine tip of cotton wool
Ask the patient to tell you when they feel their skin being touched
Compare the 2 sides

motor
Palpate the strength of contraction of the masseter & temporalis by asking patient to clench their teeth
Ask the patient to open their jaw against resistance

92
Q

what is the path of CN VII

A

pontomedullary junction
internal acoustic meatus (into petrous part of temporal bone)
stylomastoid foramen
parotid gland/ muscles of facial expression

93
Q

what does the chorda tympani do

A

Taste buds of the anterior 2/3rds of the tongue
Parasympathetic supply to the submandibular & sublingual glands (salivation).

(branch of CN VII)

94
Q

what supplies the stapedius

A

CN VII

95
Q

what does stapedius do

A

Reduces stapes movement to protect the internal ear from excessive noise

96
Q

what does CN VII do

A

sensory, motor, parasymp

motor- muscles of facial expression, stapedius

sensory- taste ant 2/3rds of tongue (c. tympani)

para- sublingual, submandibular, lacrimal and mucous glands

97
Q

how do you test CN VII

A

raise eyebrows- frontalis
close eyes tightly- orbicularis oculi
smile- elevators of lips
puff out cheeks and hold air- orbicularis oris

98
Q

what is the path of CN IX

A

medulla oblongata
jugular foramen
descends towards pharynx and mouth

To the :
stylopharyngeus muscle
parotid gland
pharyngeal mucosa
carotid body and sinus
posterior 1/3rd of tongue
99
Q

what does CN IX do

A

General sensory to:

The posterior 1/3rd of the tongue
The mucosa of most of the nasopharynx and oropharynx
The mucosa of some of the laryngopharynx (some overlap with CN X territory)
The palatine tonsil
The eustachian tube
The middle ear cavity

Special sensory to:
The vallate papillae (with taste buds) of the posterior 1/3rd of the tongue

Visceral afferent to the carotid sinus baroreceptors & the carotid body chemoreceptors

Somatic motor
(Stylopharyngeus)

Parasympathetic (secretomotor) to the parotid gland (salivary)

100
Q

how can you test CN IX

A

gag reflex

101
Q

what is the path of the vagus nerve

A

lateral aspect of medulla oblongata
jugular foramen
supplies between palate and midgut
-runs within carotid sheath
-posterior to and between the common carotid artery and IJV
-gives of recurrent laryngeal branch
-right CN X lies on trachea
-left CN X lies on aortic arch
-both pass posterior to lung root and onto oesophagus
-pass through diaphragm with oesophagus at T10

both pass onto surface of stomach
branches pass to celiac and superior mesenteric ganglia follows GI arteries

102
Q

what is the path of the two recurrent laryngeal nerves

A

Left recurrent laryngeal nerve curves under arch of the aorta
Right recurrent laryngeal curves under the right subclavian artery

103
Q

how do you test CN X

A

Ask patient to say ‘ahhhhh’ – also tests CNV3
(MUSCLES OF PALATE)
Motor function
Uvula should lift straight up in midline
Unilateral pathology will pull uvula away from the non-functioning side

swallow water

listen to speech

104
Q

what are the five layers of the scalp

A 
SCALP 
s= skin 
C= connective tissue (contains arteries)
A= aponeurosis 
L= loose connective tissue 
P= pericranium (periosteum of the skull)
105
Q

what do skull sutures do in skull fractures

A

help prevent fractures spreading

106
Q

what bones make up the pterion

A

frontal, parietal, temporal, sphenoid

107
Q

what artery courses over the deep aspect of the pterion

A

the middle meningeal artery

108
Q

what is meningitis

A

inflammation (usually bacterial or viral infection) of the meninges

109
Q

what supplies the sensory innervation to the dura mater

A

CN V

110
Q

what meninges enlcoses the dural venous sinuses

A

dura mater

111
Q

what is the diaphragm sellae

A

sheet of dura mater that forms a roof over the pituitary fossa

112
Q

what is the tentorium cerebelli

A

sheet of dura mater that tents over the cerebellum
attaches to the ridges of the petrous temporal bones
has a central gap to allow the brainstem to pass through

113
Q

what is the falx cerebri

A

dura mater midline structure that attaches to deep aspect of skull:

  • from crista galli of the ethmoid bone anteriorly
  • internal aspect of the sagittal suture
  • to internal occipital protuberance posteriorly

it separates the left and right cerebral hemispheres

blends with tentorium cerebelli

114
Q

what do cerebral veins do

A

drain venous blood from the brain into the dural venous sinuses

115
Q

where is the confluence of dural venous sinuses

A

midline at internal occipital protuberance

116
Q

what lines dural venous sinuses

A

endothelium

117
Q

what is the danger triangle

A

are if face where there is connection between superficial facial veins and deep facial veins - infection here can spread backwards to cranium

118
Q

what foramen does the vertebral artery go through

A

transverse foraminae in vertebrae then foramen mangum

119
Q

how does the internal carotid enter the cranial cavity

A

cranial canal

120
Q

what does the external carotid supply

A

neck face and scalp

121
Q

what does the right anterior cerebral artery supply

A

medial aspect of the right cerebral hemisphere

122
Q

what links the anterior cerebral arteries

A

anterior communicating artery

123
Q

what does the left middle cerebral artery supply

A

lateral aspect of the left cerebral hemisphere

124
Q

what does the right posterior cerebral artery supply

A

posterior aspect of the right cerebral hemisphere including the visual cortex

125
Q

what links the posterior cerebral arteries to the middle cerebral arteries

A

posterior communicating arteries

126
Q

where is the circle of willis

A

in subarachnoid space

inferior to midbrain- close to pituitary stalk and optic chiasm

127
Q

how much CSF is made each day and where

A

400-500mls
choroid plexus of the ventricles
reabsorbed via arachnoid granulations

128
Q

what level does the subarachnoid space end

A

S2

129
Q

where is the 3rd venticle

A

midline within the diencephalon

130
Q

where is the 4th ventricle

A

between the cerebellum and pons

131
Q

how does the CSF get from the lateral ventricles to the 3rd ventricle

A

foraminae of munro

132
Q

where is CSF in the spinal cord

A

in subarachnoid space around it ans in central canal

133
Q

what is hydrocephalus

A

when excessive production, obstruction to flow or inadequate reabsorption causes increased CSF volume

134
Q

what is a ventricular peritonieal shunt

A

when a shunt catheter is tunnelled beneath the skin of the neck and chest and then sited within the peritoneal cavity to help hydrocephalus

135
Q

where do cerebral arteries go between

A

brain to dural sinuses

136
Q

where are the middle meningeal arteries

A

between bone and dura

137
Q

what is an extradural haemorrhage

A

bleed between brain ans dura (middle meningeal artery- trauma to pterion)

138
Q

what is a subdural haemorrhage

A

a bleed separates the dura from the arachnoid (cerebral veins- falls in the elderly)

139
Q

what is a subarachnoid haemorrhage

A

bleed in to the csf of the subarachnoid space (ruptured circle of willis ‘berry aneurysm’- congenital)

140
Q

what is an uncal herniation

A 
the uncus (medial part) of the temporal 
   lobe herniates inferior to the tentorium cerebelli
141
Q

describe an infratentorial herniation

A

can be upward, downward or tonsillar:

-the cerebellar tonsils herniate into the foramen magnum

142
Q

what does compression of the oculomotor nerve by an uncal herniation cause

A

ipsilateral fixed dilated pupil (blown pupil)

143
Q

what is the basic function of the cerebellum and basal ganglia

A

adjust and coordinate movement

144
Q

what is the flocculonodular lobe

A

ear like lobe on the cerbellum

145
Q

how is the cerebellum attached to the brainstem

A

via 3 penduncles- middle, superior and inferior- made of white matter

146
Q

what is the vermis

A

centre of the cerebellum

147
Q

how does the cerebellum talk to the brainstem and thalamus

A

via deep cerebellar nuclei (deep grey matter)

148
Q

what are the three layers of the cerebellum

A

outer- molecular (lots of neurones)
middle- purkinje (output cells- talks to brainstem)
inner- granular (>50% of neurones)

149
Q

what are the afferet projections to the cerebellum (inputs)

A 
spinal cord (from somatic proprioceptors and pressure receptors)
cerebral cortex (relayed via the pons)
vetsibular apparatus (via vestibular nuclei)

all enter via cerebellar peduncles and project mainly to granular layer

150
Q

what are the efferent projections of the cerebellum (outputs)

A

(only output is via axons of purkinje cells which synapse at deep cerebellar nuclei and contribute to coordinating the functions of all the motor tracts of brain stem and spinal cord)

  • corticospinal
  • vestibulospinal
  • rubrospinal
151
Q

where do most efferent axons of the deep cerebellar nuclei cross the midline and synapse

A

in the thalamus- which in turns send fibres to the motor cortex

152
Q

what side if the body do the cerebral hemispheres influence

A

ipsilateral (lesions will have ipsilateral affects)

153
Q

what will a unilateral hemispheric lesion cause

A

intention tremor, unsteady gait

NO weakness or sensory loss

154
Q

what does bilateral cerebellar dysfunction cause

A

slowed, slurred speech (dysarthia)
bilateral incoordination of arms
staggering, wide based gait (cerebellar ataxia)

155
Q

how does alcohol affect the cerebellar

A

causes bilateral cerebellar hemisphere dysfunction

156
Q

what will a midline lesion in the cerebellum cause

A

disturbance of postural control

157
Q

what does the vermis control

A

automonic information

158
Q

what are the functions of the basal ganglia

A

facilitate purposeful movement
inhibit unwanted movement
role in posture and muscle tone

159
Q

what are the 5 basal ganglia

A
  1. caudate nucleus
  2. putamen
  3. globus pallidus
  4. subthalamic nucleus
  5. substantia nigra
1+2 = striatum 
1+2+3 = corpus striatum 
2+3 = lenticular nucleus
160
Q

what are basal ganglia

A

a number of small masses of grey matter located near the base of each cerebral hemisphere

161
Q

what is the direct pathway of the basal ganglia

A

Enhances outflow of thalamus, enhancing the desired movement

162
Q

what is the indirect pathway of the basal ganglia

A

inhibits outflow of thalamus

prevents movement you don’t want

163
Q

what side of body to basal ganglia lesoins affect

A

in contrast to cerebellar lesions affect the contralateral side of the body

164
Q

what DONT lesions of the basal ganglia cause

A

paralysis
sensory loss
loss of power
ataxia

165
Q

what DO basal ganglia lesions cause

A

changes in muscle tone
dyskinesias (abnormal involuntary movements):
-temor (sinusoidal movements)
-chorea (rapid, asymmetrical movements, usually distal limb)
-myoclonus (muscle jerks)

166
Q

where is the pathology in parkinsons

A

generation of dopaminergic neurones of the substatia nigra (direct pathway affected)

167
Q

what are the signs of parkinsons

A

akineasia, rigidity and resting tremor

168
Q

where is the pathology in huntingtons disease

A

autosomal dominant disorder causes progressive degeneration of the basal ganglia and cerebral cortex (indirect pathway affected- no inhibition of movement)

169
Q

what are the signs of huntingtons

A

chorea and progressive dementia

170
Q

list the modality, central connection and function of CN I

A

sensory
olfactory bulb (only CN to not synapse in thalamus before going to cortex)
innervates olfactory epithelium- olfaction

171
Q

list the modality, central connection and function of CN II

A

sensory
cc=lateral geniculate nucleus, prectal nucleus
f= vision (innervates retina), pupillary light reflex

172
Q

list the modality, central connection and function of CN III

A

motor and parasympathetics

motor
CC=oculomotor nucleus
f= eye movements (sup., inf,. medial rectus, inf. oblique), elevate eyelid (LPS)

para
cc=EWN
f= pupillary constriction and accommodation (innervates sphincter pupillae + cilliary muscle via ciliary ganglion)

173
Q

list the modality, central connection and function of CN IV

A

motor
cc-trochlear nucleus
f- moves up (SO- down and out)
(only CN to exit posteriorly)

174
Q

list the modality, central connection and function of CN V

A

sensory and motor

sensory
cc- trigeminal sensory nucleus
f- somatosensation (discriminative touch, vibration, pain, temp of face, scalp, cornea, nasal and oral cavities and cranial dural mater) via pontine trigeminal nucleus
proprioception of chewing via mesencephalic nucleus

motor
cc- trigeminal motor nucleus
f- opening and closing mouth (muscles of mastication)
tensor tympani

175
Q

list the modality, central connection and function of CN VI

A

motor
cc- abducens nucleus
f- move eye (LR)

176
Q

list the modality, central connection and function of CN list the modality, central connection and function of CN

A

sensory, motor, parasympathetics

sensory
cc- nucleus solitarius
f- taste of ant 2/3rds of tongue (via c. tympani)

motor
cc- facial nucleus
f- facial expression muscles, tenses stapedius

para
cc- superior salivatory nucleus
f- salivation and lacrimation (via submandibular and pterygopalatine ganglia)

177
Q

list the modality, central connection and function of CN list the modality, central connection and function of CN

A

sensory
cc- vestibular nuclei, cochlear nuclei
f- vestibular sensation and hearing

178
Q

list the modality, central connection and function of CN IX

A

sensory, motor and para

sensory (2)
1. f- general sensation for pharynx, posterior 1/3rd of tongue, eustachian tube, middle ear
cc- trigeminal sensory nucleus

  1. f- taste to post 1/3rd of tongue (chemo and baroreception)
    cc- nucleus solitarus

motor
cc- nucleus ambiguus
f- stylopharyngeus muslces (swallowing)

para
cc- inferior salivatory nucleus
f- salivation (parotid gland via otic ganglion)

179
Q

list the modality, central connection and function of CN X

A

sensory motor and para

sensory (2)
1. general sensation for pharynx, larynx, trachea, oesophagus, external ear
cc- trigeminal sensory nucleus

  1. visceral sensation, chemo and baro reception for thoracic and abdominal viscera, aortic bodies and aortic arch
    cc- nucleus solitarius

motor
cc- nucleus ambiguis
f- speech and swallowing (soft palate, pharynx, larynx, upper oesophagus)

para
f- innervation of cardiac muscle, smooth muscle and glands or cardiovascular system, resp and GI tracts (thoracic and abdo viscera)
cc- dorsal motor nucleus of vagus

180
Q

list the modality, central connection and function of CN XI

A

motor
cc- cervical spinal cord
f- SCM and trapezius- movement of head and shoulder

181
Q

list the modality, central connection and function of CN XII

A

motor
cc- hypoglossal nucleus
f- intrinsic and extrinsic muscles of the tongue (expect palato)

182
Q

what CN dont exit brainstem anteriorly

A

IV (posterioly) and VIII (laterally)

183
Q

what is the motor input to CNs

A

corticobulbar tract (part of pyramidal tract)

184
Q

what is the parasymp input into CNs 1973

A

hypothalamus

185
Q

what are the functions of the reticular formation

A

Integrate cranial nerve reflexes.
Participate in conduction and modulation of pain.
Influence voluntary movement.
Regulate autonomic activity.
Integrate some basic functions, like respiration and sleep.
Activate the cerebral cortex

186
Q

what CN in myelinated

A

CN II (optic)

187
Q

where are the nuclei of the motor CNs

A

midline of the brainstem

188
Q

what CNs share the solitary nucleus

A

VII, IX, X

taste and visceral sensory information

189
Q

what CNs share the superior and inferior salivatory nucleus

A

CN VII and IX

parasymp to ganglia of salivary glands and pterygopalatine ganglion

190
Q

what CNs share the nucleus ambiguus

A

CN IX and X

motor efferents to muscles of pharynx, larynx and upper oesophagus

191
Q

where is the solitary nucleus

A

extends in a V shape from upper to lower medulla

192
Q

where is the nucleus ambiguus

A

lower pons/ upper medulla

193
Q

what is the auditory pathway

A
  1. cochlear nerve (spiral ganglion- carries APs from organ of corti to cochlear nuclei in pons)
  2. internal accoustic meatus
  3. pontomedullary junction (bilateral now)
  4. ventral and dorsal cochlear nuclei
  5. olivary nucleus (1st synapse- not all synapse here tho for localisation)
  6. inferior colliculus (all synapse here)
  7. medial geniculate body in thalamus
  8. primary auditory cortex
194
Q

why are the suprior olivary and lateral lemniscus nuclei important in the auditory pathway

A

for locaisation and relays for stapedius and tensor tympani reflexes

195
Q

where is the auditory cortex

A

temporal superior gyrus

196
Q

what is the vestibular pathway

A 
vestibular nerve 
vestibular ganglion 
vestibular nuclei 
thalamus 
cerebral cortex (no primary cortex area)
medial longitudinal fasciculus to CN 3,4,6
6. cerebellum 
7. spinal cord via vestibulospinal tract
197
Q

what is the medial longitunidal fasciculus

A

white matter tract that allows vestibular nuclei to coordinate eye movements

carries both ascending and descending tracts

198
Q

what is tonotopic organisation in the auditory cortec

A

Fibres carrying information regarding low frequency sound end in the anterolateral part of the auditory cortex

Fibres carrying information regarding high frequency sound end in the posteromedial part of the auditory cortex.

199
Q

what is aphasia

A

inability to use language

200
Q

what happens if there is damage to brocas area

A

difficulty in producing language

201
Q

what happens if there is damage to wernickes area

A

difficulty comprehending language

202
Q

what is the optic pathway

A 
optic nerve 
chiasm 
optic tract
lateral geniculate nucleus (+superior colliculi)
optic radiation (meyers loop)
visual cortex
203
Q

what part of visual cortex does the lower visual field go to

A

gyrus superior to the calcarine sulcus

204
Q

what part of visual cortex does the upper visual field go to

A

gyrus inferior to the calcarine sulcus

205
Q

which visual field goes around meyers loop

A

upper

206
Q

what part of vision responds to visual stimuli (tracking)

A

visual cortex

207
Q

what part of vision does movements of command (saccadic)

A

frontal eye fields

208
Q

what is affected in internuclear ophthalmoplegia

A

medial longitudinal fasciculus

209
Q

what are the steps of the pupillary light reflex

A
  1. light shone in eye
  2. APs reach pretectal nuclei (both sides)
  3. edinger-westphal nucleus
  4. oculomotor nerves
  5. ciliary ganglion
  6. pupil constriction (pupillary sphincter)
210
Q

why is the accomoationd reflex different from the pupillary light refelx

A

as accomodation needs input to EWN and occulomotor nucleus from the visual cortex not just direct pathway

211
Q

what are the steps of the accomodation reflex

A 
optic nerve 
lateral geniculate nucleus 
visual cortex
pretectal area 
EWN
occulomotor nerve 
muscles of accomodation (medial rectus, cilliary muscle, sphincter pupillae)
212
Q

for most right handed people where in the brain is dominant for language

A

left hemisphere

213
Q

what are association fibres

A

connect cortical sites lying in the same hemisphere

214
Q

what are commisural fibres

A

connext one hemisphere to the other, usually connecting areas with similar function

215
Q

what are projection fibres

A

connect hemispheres to deeper structures including thalamus, corpus striatum, brain stem and spinal cord

Neurology (35 decks)

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