Anatomy Flashcards
what does the CNS consist of?
brain + spinal cord
what does the PNS consist of?
12 pairs cranial nerves
31 pairs spinal nerves + branches
which cranial nerve is thought to be almost part of the CNS?
optic nerve CN II
in the early stages of brain development, what are the 3 visible swellings in the neural tube?
prosencephalon
mesencephalon
rhombencephalon
will the prosencephalon become forebrain, midbrain or hindbrain?
forebrain
will the mesencephalon become forebrain, midbrain or hindbrain?
midbrain
will the rhombencephalon become forebrain, midbrain or hindbrain?
hindbrain
what major embryonic divisions does the prosencephalon divide into?
telencephalon
diencephalon
what major embryonic divisions does the rhombencephalon divide into?
metencephalon
myelencephalon
what does the telencephalon correspond to in the mature brain?
cerebral hemispheres
what does the diencephalon correspond to in the mature brain?
thalamus and hypothalamus
what does the mesencephalon correspond to in the mature brain?
midbrain
what does the metencephalon correspond to in the mature brain?
pons and cerebellum
what does the myelencephalon correspond to in the mature brain?
medulla oblongata
apart from the visible swellings, what does the remainder of the neural tube become?
spinal cord
what makes up the brainstem?
midbrain
pons
medulla oblongata
what are the supporting cells in the CNS called?
glial cells
what are the 4 types of glial cells in the CNS?
astrocytes
oligodendrocytes
microglia
ependymal cells
what are the 3 main roles of an astrocyte in the CNS?
- physical support
- instigates tight capillaries for blood brain barrier
- environmental homeostasis
what is the function of oligodendrocytes in the CNS?
produce myelin in the CNS
what cranial nerve is the odd one out because it is myelinated by oligodendrocytes instead of schwann cells?
CN II optic nerve
what is the function of microglia in the CNS?
immune monitoring and antigen presentation (phagocytes)
where are microglia produced?
bone marrow
what MHC class do microglia epress?
MHC II
what is the function of ependymal cells in the CNS?
ciliated cuboidal/columnar epithelium that lines the ventricles
what are deep sulci in the brain called?
fissures
in the cerebellum, what is the name for the bumps that are equivalent to gyri in the cerebrum?
fovia (singular = fovium)
what is the name of the deep sulcus at the anterior sagittal midline of the brain?
longitudinal fissure (or interhemispheric fissure)
is grey matter generally located peripherally or centrally in the brain?
generally peripherally
does grey matter contain cell bodies or axons?
cell bodies
does white matter contain cell bodies or axons?
axons
what is the function of sulci and gyri?
allow us to incorporate a lot of grey matter in a small space
is grey matter located peripherally or centrally in the spinal cord?
centrally
what is the name of the sulcus at the coronal midline of the brain?
central sulcus
anterior to the central sulcus, what is the gyrus called?
precentral gyrus
posterior to the central sulcus, what is the gyrus called?
postcentral gyrus
what is the name of the sulcus between the frontal or parietal lobe and temporal lobe?
lateral fissure
what is the name of the dura sheet which occupies the longitudinal fissure?
falx cerebri
what is the corpus callosum?
white matter that carries information from one cerebral hemisphere to the other
what sulcus separates the occipital lobe from the parietal lobe?
parieto-occipital sulcus
the primary visual cortex surrounds what sulcus?
calcarine sulcus
what connects both parts of the thalamus at their medial aspect?
interthalamic adhesion
what sulcus divides the pareital lbe and the frontal lobe?
central sulcus
what is the deep lobe of the brain?
insular lobe (insula)
what are the 3 layers of meninges from superficial to deep?
dura mater
arachnoid mater
pia mater
what does the subarachnoid space contain?
CSF
what does the dura adhere to?
the inner periosteum of the skull bones
which meningeal layer(s) coats the brain in every sulcus and gyrus?
pia mater
dura and arachnoid are wrapped around but do not go into the sulci
where does the 3rd ventricle lie?
between both parts of the thalamus in the diencephalon
where does the 4th ventricle lie?
between the cerebellum and the pons
what connects the lateral ventricles to the 3rd ventricle?
interventricula foramen of Monro
what connects the 3rd ventrcile to the 4th ventricle?
cerebral aqueduct
in what 2 plexuses is the enteric nervous system found?
myenteric plexus
submucosal plexus
the dural venous sinuses drain into what vein?
internal jugular vein
where is the cell body of multipolar cells? (eg skeletal muscle cell)
central nervous system
where is the cell body of pseudounipolar cells? (eg sensory)
peripheral nervous system
where are upper motor neurones located?
CNS
where are lower motor neurones located?
PNS
in the CNS, what is a collection of nerve cell bodies called?
nucleus
in the PNS what is a collection of nerve cell bodies called?
ganglion
in the CNS what is a bundle of axons called?
tract
in the PNS what is a bundle of axns called?
nerve
compare tracts (CNS axon bundle) and nerves (PNS axon bundle) in terms of modality?
tracts are usually single modality (eg motor tract)
nerves a can be mixed (eg spinal nerves)
what is the modality of CN I? (olfactory)
special sensory
what is the modality of CN II? (optic)
special sensory
what is the modality of CN III? (oculomotor)
somatic motor and parasympathetic
what is the modality of CN IV? (trochlear)
somatic motor
what is the modality of CN V? (trigeminal)
somatic motor (V3) and somatic sensory
what is the modality of CN VI? (abducens)
somatic motor
what is the modality of CN VII? (facial)
somatic motor, special sensory and parasympathetic
what is the modality of CN VIII? (vestibulocochlear)
special sensory
what is the modality of CN IX? (glossopharyngeal)
somatic sensory, special sensory, somatic motor and parasympathetic
what is the modality of the CN X? (vagus)
somatic motor, somatic sensory and parasympathetic
what is the modailty of CN XI? (spinal accessory)
somatic motor
what is the modality of CN XII? (hypoglossal)
somatic motor
all cranial nerves are associated with the brainstam (midbrain, pons and medulla) except which?
CN I and CN II
describe the 31 pairs of spinal nerves?
C1-C8 T1-T12 L1-L5 S1-S5 Co1
in which forminae are the spinal nerves located?
intervertebral foramina
describe the pathway of sensory axons from the spinal nerve to the dorsal horn?
spinal nerve
posterior root
posterior rootlet
dorsal horn
describe the pathway of motor axons from the ventral horn to the spinal nerve?
ventral horn
anterior root
ventral rootlet
spinal nerve
where does the spinothalamic tract decussate?
in spinal cord, at/a few levels above point of entry
where does the corticospinal tract decussate?
in medullary pyramid
where does the dorsal column lateral meniscus decussate?
in the brainstem
where is the primary afferent neurone of the sensory pathway located?
PNS
where is the second order neurone of the sensory pathway located?
CNS
where does the second order neurone of the sensory pathway synapse?
at the thalamus
where does the third order neurone of the sensory pathway synapse?
cerebral cortex
what dermatome supplies the shoulder?
C4
what dermatome supplies the lateral arm?
C5
what dermatome supplies the lateral forearm to thumb?
C6
what dermatome supplies the middle finger?
C7
what dermatoms supplies the pinky finger?
C8
what dermatome supplies the medial forearm?
T1
what dermatome supplies the medial arm?
T2
what dermatome supplies the nipple?
T4
what dermatome supplies the umbilicus?
T10
what dermatome supplies the area of your jean pockets? (groin)
L1
what dermatome supplies the anterior thigh?
L2
what dermatome supplies the medial thigh and anterior knee?
L3
what dermatome supplies the lateral leg?
L5
what dermatome supplies the medial leg?
L4
what dermatome supplies the lateral foot?
S1
what dermaome supplies the dorsum of the foot?
L5
what dermatome supplies the heel?
S1
what dermatome supplies the posterior knee?
S2
what dermatome supplies the posterior thigh?
S2
what dermatome supplies the buttocks?
S3
what dermatome map is used in dundee?
foerster map
what dermatomes supplies the posterior scalp, neck and shoulder?
C2-C4
what dermatomes supplies the upper limb?
C5-T1
what dermatome supply the lower limb, gluteal region and perineum?
L2-Co1
are nerve plexuses made of anterior or posterior rami?
anterior rami
what makes up the cervical plexus?
C1-C4 anterior rami
what does the cervical plexus supply?
posterior scalp, neck and diaphragm
what makes up the brachial plexus?
C5-T1 anterior rami
what does the brachial plexus supply?
upper limb
what makes up the lumbar plexus?
L1-L4
what does the lumbar plexus supply?
lower limb
what makes up the sacral plexus?
L5-S4
what does the sacral plexus supply?
lower limb, gluteal region and perineum
are dermatomes supplied by anterior or posterior rami of that spinal nerve?
both anterior and posterior rami
are myotomes supplied by anterior or posterior rami of that spinal nerve?
both
which spinal nerves comntain sympathetic outflow?
T1-L2
what horn of the spinal cord do sympathetic neurones leave from?
lateral horn
which segments of the spine have lateral horns?
T1-L2
where do sympathetic presynaptic axons which supply the heart synapse?
in cervical or T1 paravertebral ganglia
how do sympathetic postsynaptic axons travel from paravertebral gangla to the heart?
in cardiopulmonary splanchnic nerves
where do sympathetic -presynaptic axons which supply the lungs synapse?
upper thoracic paravertebral ganglia
how do sympathetic postsynaptic axons travel from the paravertebral ganglia to the lungs?
in cardiopulmonary splanchnic nerves
where do sympathetic presynaptic axons which supply the abdominopelvic organs synapse?
pass through paravertebral ganglia without synapsing and instead synapse with preverebtral ganglia (midline of abdominal aorta ie coeliac ganglia, superior mesenteric ganglion etc)
where do sympathetic presynaptic axons which supply the adrenal medulla synapse?
directly on adrenaline secreting cells of adrenal medulla
in horners syndrome, why is there ptosis?
loss of sympathetic supply to levator palpebrae superioris
in horners syndrome, why is there miosis?
loss of sympathetic supply to dilator pupillae?
in horners syndrome why is there reduced sweating of ipsilateral facial skin?
loss of sympathetic supply to skin sweat glands
what ganglion is associated with the parasympathetic supply of CN III?
ciliary ganglion (eye)
what ganglion is associated with the parasympathetic supply of CN VII?
pterygopalatine ganglion (lacrimal gland) submandibular ganglion (submandibular and sublingual gland)
what ganglion is associated with the parasympathetic supply of CN IX?
otic ganglion (parotid gland)
what ganglion is associated with the parasympathetic supply of CN X?
no associated ganglion
what ganglion is associated with parasympathetic supply from the sacral spinal nerves?
no associated ganglion
what is the tapered cone-shaped end of the spinal cord called?
conus medullaris
what is the name of the tfibrous cord which anchors the conus medullaris to the coccyx?
filum terminale
what is the filum terminale mainly made of?
pia mater
what ligaments suspends the spinal cord within the subarachnoid space?
denticulate ligaments
what are the denticulate ligaments made of?
pia and arachnoid mater
what are the 3 main components of the arterial supply of the spinal cord?
- 3 major longitudinal arteries
- segmental arteries
- radicular arteries
is the epidural space present in the brain or the spinal cord?
only in spinal cord
what is the epidural space between?
periosteum and dura mater
what does the epidural space contain?
adipose tissue and anterior and posterior epidural venus plexuses
where is the primary somatosensory cortex located?
post-central gyrus
how many neurones are involved in the sensory pathway?
3
where is the primary motor cortex located?
pre-central gyrus
where does the lateral corticospinatal tract cross?
pyramids of the medulla
crossed fibres
where does the anterior corticospinal tract cross?
segmentally
uncrossed fibres
in decorticate posturing, what happens to the upper limbs?
hyperflexion
-spastic paralysis
what is the function of the tectospinal tract? (extrapyramidal tract)
reflex head and neck movement to visual stimuli
what is the function of the reticulospinal tract? (extrapyramidal)
fibres from the medulla facilitate flexor movement/inhibit extensor movement
fibres from the pons facilitate extensor movement/inhibit flexor movement
what is the function of the vestibulospinal tract? (Extrapyramidal tract)
excitatory input to antigravity muscles (mainly extensors)
what is unusual about the vestibulospinal tract compared to other pyramidal/extrapyramidal tracts?
doesn’t ever cross to the other side
what are the 3 main extrapyramidal tracts?
rectospinal
vestibulospinal
tectospinal
what is the one sensory modality which doesnt have to access the cortex via the thalamus?
smell
what are the 3 lobes of the cerebellum?
anterior lobe
posterior lobe
follocculonodulae lobe
what tough sheet lies over the cerebellum?
tentorium cerebelli
what attaches the cerebellum to the brainstem?
3 peduncles
- superior cerebellar peduncle
- middle cerebellar peduncle
- inferior cerebellar peduncle
what is the vermis?
a worm like structure in the middle of the cerbellum
what are the gyri of the cerebellum known as?
folia
what are the 3 layers of the cerebellar cortex?
molecular layer (outer) purkinje cell layer (middle) granular layer (inner)
lesions in the cerebellum affect what side of the body?
ipsilateral side
describe cerebellar ataxia?
incordination of arms and staggering, wide-based gait
what are the signs of bilateral cerebellar dysfunction?
dysarthria
cerebellar ataxia
what is dysarthria?
slowed slurred speech
what happens to the cerebellum in acute alcohol exposure?
bilateral cerebellar dysfunction
dyarthria and cerebellar ataxia
what does a cerebellar midline lesion (lesion in the vermis) result in?
disturbance of postural control
what does the basal ganglia consist of?
caudate nucleus putamen globus pallidus subthalamic nucleus substantia nigra
what does the striatum consist of?
caudate nucleus
putamen
what does the corpus striatum consist of?
caudate nucleus
putamen
globus pallidus
what does the lenticular nucleus consist of?
putamen
globus pallidus
where does the putamen sit in relation to the thalamus?
lateral to the thalamus
where does the globus pallidus sit in relation to the putamen?
medial to the putamen
what does the caudate nucleus look like?
rams horns
where is the caudate nucleus in relation to the lateral vnetricles?
lateral to the ventricles
what separates the thalamus from the lenticular nucleus (globus pallidus and putamen?)
white matter tract called the internal capsule
lesions in the basal ganglia affect what side of the body?
contralateral side
what are the main motor signs caused by lesions of the basal ganglia?
changes in muscle tone
dyskinesias (tremor, chorea, myoclonus)
what is dyskinesia?
involuntary abnormal movements
what is the pathology of parkinsons disease?
degeneration of dopaminergic neurons of the substantia nigra?
what is the pathology of huntingtons disease?
progresssive degeneration of basal ganglia and cerebral cortex
what are the 4 main extrinsic back muscles?
trapezius
latissimus dorsi
levator scapulae
rhomboid minor and major
what are the 2 main groups of intrinsic back muscles?
erector spinae (superficial) transversospinalis (deep)
where does the transversospinalis lie? (in relation to a vertebra)
between spinous process and transverse process
what are the 2 main muscles of the posterior abdominal wall?
psoas major (medial) quadratus lumborum (more lateral, and posterior)
what are the 3 muscles of the anterolateral abdominal wall?
external oblique
internal oblique
transversus abdominis
what are the 3 erector spinae muscles?
iliocostalis (laterally)
longissimus (middle)
spinalis (medially)
what are the attachments of iliocostalis?
sacrum/iliac crest to ribs
what are the attachments of longissimus?
sacrum/iliac crest to transverse processes of vertebrae
what are the attachments of spinalis?
sacrum/iliac crest to spinous processes of vertebrae
what muscles are involved in extension/lateral extensions/rotational movements of the spine?
intrinsic back muscles
erector spinae and transversospinalis
what muscles are involved in flexion of the spine?
psoas major mainly (and rectus abdominis)
what is the nerve supply of the intrinsic back muscles?
posterior rami branches of the cervical, thracic and lumbar spine
what type of joints are between the inferior articular processes of one vertebra and the superior articular processes of another?
synovial facet joints
when synovial facet joints are affected by arthritis, which nerves transmit the pain signals?
posterior rami
when an intervertebral disc herniates, which nerves transmit the pain signals?
posterior rami
what is the function of the ligamentum flavum?
connects adjacent laminae
what is the function of the posterior longitudinal ligament?
attaches to posterior aspects of vertebral bodies and intervertebral discs
-prevents over-flexion of the spine
what is the function of the anterior longitudinal ligament?
attaches to the anterior aspects of vertebral bodies and intervertebral discs
-prevents over-extension of the spine
what are the 2 reasons disc herniations are likely to happen posteriorly?
annulus fibrosus is weakest posteriorly
posterior longitudinal ligament is weak
what is the function of the supraspinous ligament?
connects tips of spinous processes
what is the function of the interspinous ligament?
connects spinous processes
which vertebrae is vertebrae prominens?
C7
what additional foramen do the cervical vertberae have?
transverse foramen
foramen transversarium
why is C7’s spinous process different to the other cervical spinous processes
not bifid like the other cervical spinous processes
what kind of joint is the atlanto-occipital joint?
synovial joints
what are the movements of the atlanto-occipital joint?
flexion and extension of the neck
rotation
what are the 3 atlanto-axial joints?
2 between articular facets of atlas and axis (R and L)
1 between odontoid process of axis and anterior arch of atlas
what ligament holds the odontoid process of the axis against the anterior process of the atlas?
transverse ligament of the atlas
what foraminae allow the anterior rami of the sacral spinal nerves to pass through the sacrum?
anterior sacral foraminae
what foraminae allow the posterior rami of the sacral spinal nerves to pass through the sacrum?
posterior sacral foraminae
what is the name of the palpable inferior end of the spinal canal?
sacral hiatus
how is caudal anesthesia done?
local anaesthetic injected into sacral hiatus
sacral spinal nerve roots of cauda equina are anaesthetised
what dermatome supplies the back of the scalp and adams apple?
C2
what dermatome supplies the back of neck and jugular notch?
C3
what dermatome supplies the clavicle and shoulder tip?
C4
what dermatome supplies the perineum?
S4
what dermatome supplies the perianal skin?
S5
what nerve supplies the supplies the skin posterior to the external ear? what spinal roots is this?
lesser occipital nerve C2
what nerve supplies the skin over the angle of the mandible and some external ear? what spinal roots is this?
great auricular nerve
C2/3
what nerve supplies the skin over the anterior neck? what spinal roots is this?
transverse cervical
C2/3
what nerve supplies the skin over the clavicle and the shoulder tip? what spinal roots is this?
supraclavicular nerves
C3/4
where is the nerve point of the neck?
midpoint of the posterior border of sternocleiodmastoid
(where sensory nerves of the cervical plexus pass)
what nerve roots make the musculocutanoeous nerve?
C5, C6 (C7)
what nerve roots make the axillary nerve?
C5, C6
what nerve roots make the radial nerve?
(C5), C6, C7, C8, (T1)
what nerve roots make the ulnar nerve?
(C7), C8, T1
what nerve roots make the median nerve?
(C5), C6, C7, C8, T1
what nerve roots make up the ilioinguinal nerve?
L1
what nerve roots make up the iliohypogastric nerve?
L1
the lower anterolateral trunk wall (ie below T12 dermatome) is supplied by what nerves?
iliohypogastric and ilioinguinal nerves
what nerve roots make up the genitofemoral nerve?
L1, L2
what nerve roots make up the lateral cutaneous nerve of thigh nerve?
L2,3
what nerve roots make up the posterior cutaneous nerve of thigh?
S1,2,3
what nerve roots make up the obturator nerve?
L2,3,4
what nerve roots make up the femoral nerve?
L2,3,4
what nerve roots make up the saphenous nerve?
L3,4 (From femoral)
what nerve roots make up the sural nerve?
S1,2 (from tibial and common fibular)
what nerve roots make up the superficial fibular nerve?
L4,5, S1
what nerve roots make up the deep fibular nerve?
L5
what nerve roots make up the tibial nerve?
L4,5,S1,2,3
what muscles do the cervical plexus (C1-C4) supply?
neck postural and strap muscle
diaphragm
what muscles do the brachial plexus (C5-T1) supply?
muscles of upper limb
extrinsic back muscles
what muscles do T2-L3 supply?
postural back muscles (posterior rami) intercostal muscles (anterior rami) anterolateral abdominal wall muscles
what muscles do the lumbosacral plexus (L1-S4) supply?
muscels of lower limb
perineal skeletal muscles
what nerve supplies the muscles of facial expression?
facial nerve
what nerve supplies the muscles of mastication?
trigeminal mandibular division
what nerve supplies the muscles of the soft palate?
vagus/ pharngeal plexus
what nerves supplies the neck postural muscles?
posterior rami of cervical spinal nerves
what nerve supplies the strap muscles?
C1-C3 cervical plexus
what nerve supplies the diaphragm?
C3,4,5 (phrenic nerve)
what nerve supplies the sternocleidomastoid?
spinal accessory nerve
what nerve supplies the trapezius?
spinal accessory nerve
what nerve supplies the intrinsic muscles of the larynx?
vagus nerve
what nerve supplies the muscles of the pharynx?
vagus nerve
what nerves supply the intercostal muscles?
intercostal nerves
what nerves supply the anterolateral abdominal wall muscles?
thoracoabdominal nerves
what nerves supply the erector spinae?
posterior rami of spinal nerves
what nerves supply the transversospinalis muscles?
posterior rami of spinal nerves
what nerve supplies the deltoid muscle?
axillary nerve C5,6
what nerve supplies teres minor?
axillary nerve C5,6
what nerve supplies the biceps brachii?
musculocutaneous nerve C5,6,7
what nerve supplies the brachialis?
musculocutaneous nerve C5,6,7`
what nerve supplies the coracobrachialis?
musculocutaneous nerve C5,6,7
what nerve supplies the pronator muscle of the forearm? (pronator teres and quadratus)
median nerve (C5) C6,7,8,T1
what nerve supplies the flexor carpi radialis?
median nerve (C5) C6,7,8,T1
what nerve supplies the palmaris longus?
median nerve (C5) C6,7,8,T1
what nerve supplies the flexor digitorum superficialis?
median nerve (C5) C6,7,8,T1
what nerve supplies the lateral half of flexor digitorum profundus?
median nerve (C5) C6,7,8,T1
what nerve supplies the flexor pollicis longus?
median nerve (C5) C6,7,8,T1
what nerve supplies the flexor carpi ulnaris?
ulnar nerve (C7), C8, T1
what nerve supplies the medial half of the flexor digitorum profundus?
ulnar nerve (C7), C8, T1
what nerve supplies the adductor pollicis?
ulnar nerve (C7), C8, T1
what nerve supplies the thenar muscles? (opponens pollicis, abductor pollicis brevis, flexor pollicis brevis)
median nerve (C5), C6,7,8,T1
what nerve supplies the hypothenar muscles?
ulnar nerve (C7), C8, T1
what nerve supplies the lateral lumbricals?
median nerve (C5), C6,7,8, T1
what nerve supplies the medial lumbricals?
ulnar nerve (C7), C8, T1
what nerve supplies the interossei muscles of the hand?
ulnar nerve (C7), C8, T1
what nerve supplies the triceps brachii?
radial nerve (C5), C6,7,8 (T1)
what nerve supplies the brachioradialis?
radial nerve (C5), C6,7,8 (T1)
what nerve supplies the supinator?
radial nerve (C5), C6,7,8 (T1)
what nerve supplies the extensors of the carpus and digits?
radial nerve (C5) C6,7,8, (T1)
what nerve supplies the abductor pollicis longus?
radial nerve (C5), C6,7,8 (T1)
what nerve supplies the quadriceps femoris?
femoral nerve L2,3,4
what nerve supplies the sartorius?
femoral nerve L2,3,4
what nerve supplies the pectineus?
femoral nerve L2,3,4
what nerve supplies the adductors of the thigh?
obturator nerve L2,3,4
what nerve supplies the hamstrings?
tibial part of sciatic nerve (L4,5, S1,2,3)
what nerve supplies the muscles of the posterior comparment of the leg?
tibial part of sciatic nerve (L4,5, S1,2,3)
what nerve supplies the intrinsic muscles of the sole of the foot?
tibial part of sciatic nerve
what nerve supplies the short head of biceps femoris?
common fibular part of sciatic nerve (L4,5, S1,2)
what nerve supplies the muscles of the lateral comparment of the leg?
superficial fibular of common fibular (L4,5, S1,2)
what nerve supplies the muscles of the anterior compartment of the leg?
deep fibular branch of common fibular (L4,5, S1,2)
what nerve supplies the muscles of the dorsum of the foot? (extensor digitorum brevs and extensor halucis brevis)
deep fibular branch of common fibular (L4,5, S1,2)
how do you test myotome C5?
abduction (deltoid)
abduction of the shoulder tests which myotome?
C5
adduction of the shoulder tests which myotome?
C7
flexion of the wrist tests which myotome?
C6/7
extension of the wrist tests which myotome?
C7/8
flexion of the elbow tests which myotome?
C5/6
extension of the elbow tests which myotome?
C7/8
pronation of the elbow tests which myotome?
C6
supination of the elbow tests which myotome?
C8
flexion of the fingers test which myotome?
C8
extension of the fingers test which myotome?
C7
adduction of the fingers test which myotome?
T1
abduction of the fingers test which myotome?
T1
flexion of the hip joint tests which myotome?
L2,3
extension of the hip joint tests which myotome?
L5, S1
flexion of the knee joint tests which myotome?
L5, S1
extension of the knee joint tests which myotome?
L3,4
dorsiflexion tests which myotome?
L4,5
plantar flexion tests which myotome?
S1,2
inversion of the ankle joint tests which myotome?
L4
eversion of the ankle joint tests which myotome?
L5,S1
what nerve root is tested by the ankle jerk?
S1
what nerve root is tested by the knee jerk?
L4
what nerve root is tested by the triceps reflex?
C7
what nerve root is tested by the biceps brachii?
C5 (6)
what nerve root is tested by brachioradialis?
C6
which is the only cranial nerve to leave the brain posteriorly?
CN IV
from what nucleus in the midbrain does the oculumotor nerve originate from?
superior colliculus
from what nucleus in the midbrain does the trochlear nerve originate from?
inferior colliculus
which for cranial nerves emerge very close to the midline of the brainstem?
III, IV, VI, XII
where does the spinal accessory nerve arise from?
cervical spinal cord
what muscles does the trigeminal nerve supply?
muscles of mastication
tensor tympani
tensor veli palatini
what four nuclei are associated with the trigeminal nerve? (describe function)
mesencephalic nucleus (chewing proprioception)
pontine trigeminal nucleus (discriminative touch)
spinal nucleus (pain, temp)
motor nucleus
what muscles does the facial nerve supply?
muscles of facial expression
stapedius
what muscles does the glossopharyngeal nerve supply?
stylopharyngeus
what 3 nuclei are associated with the facial nerve? (describe function)
- motor nuleus
- superior salivatory (parasympathetic)
- solitary nucleus (taste)
what 4 nuclei are associated with the glossopharyngeal nerve? (describe function)
- solitary nucleus (taste)
- commissural nucleus (visceral)
- inferior salivatory nucleus (parasympathetic)
- nucleus ambiguus (stylophayryngeus)
what 4 nuclei are associated with the vagus nerve? (describe function)
- solitary nucleus (taste)
- commissural nucleus (visceral)
- dorsal motor nucleus (parasympathetic)
- nucleus ambiguus (stylopharyngeus)
what cranial nerves come out from the diencephalon?
CN II
what cranial nerves come out from the midbrain?
CN III, IV
what cranial nerves come out from the pons?
CN V
what cranial nerves come out from the pontomedullary junction?
CN VI, VII, VIII
what cranial nerves come out from the medulla olongata?
CN IX, X, XII
what is the cranial foramen of the olfactory nerve?
cribriform plate of ethmoid bone
-anterior cranial fossa
what are the 5 ways of testing CN II?
- visual acuity
- colour testing
- visual fields
- pupillary light reflex
- fundoscopy
what is the cranial foramen of the CN II?
optic canal
what is the cranial foramen of the CN III?
superior orbital fissure
how do you test CN III?
- H test
- pupillary light reflex
what is the cranial foramen of the CN IV?
superior orbital fissure
how do you test CN IV?
-H test (abduction)
what is the intracranial pathway of CN III, CN IV and CN VI?
III and IV travels towards orbit in the lateral wall of the cavernous sinus
VI travles towards orbit wihtin the cavernous sinus
what is the cranial foramen of the CN VI?
superior orbital fissure
how do you test CN VI?
-H test (down and in)
what is the cranial foramen for CN VIII?
internal acoustic meatus in posterior cranial fossa
how do you test CN VIII?
rinne and webers test
what is the cranial foramen of CN XI?
jugular foramen
how do you test CN XI?
shrug shoulders
turn head to flex neck
what is the cranial foramen of CN XII?
hypoglossal canal in posterior cranial fossa
describe the extrancranial course of CN XII in relation to carotid sheath?
descends lateral to carotid sheath
how do you test CN XII?
stick tongue straight out
what is the cranial foramen of CN V?
V1- superior orbital fissure
V2- foramen rotundum
V3- foramen ovale
what nerve supplies the sensation of the paranasal sinuses?
all CN V1 except maxillary sinus which is CN V2
what are the 4 muscles of mastication? (and give function)
jaw closing: -masseter -temporalis -medial pterygoid jaw opening: -laterl pterygoid
how do you test CN V?
brush skin in each dermatome, compare both sides
palpate contraction strength of masseter and temporalis
ask patient to open jaw against resistance
what is the cranial foramen of CN VII?
internal acoustic meatus
at what foramen does CN VII leave the skull?
stylomastoid foramen
what canal connects the internal acoustic meatus to the stylomastoid foramen?
facial canal in the petrous temporal bone
what is the function of the tensor tympani?
dampens noise produced by chewing
what are the 4 muscles of facial expression?
frontalis
orbicularis oculi
elevators of lips
orbicularis oris
how do you test CN VII?
ask patient to raise eyebrows
close eyes tightly
smile
puff out cheeks
what is the cranial foramen of CN IX?
jugular foramen
what papillae have special taste function?
vallate papillae
what nerve supplies visceral afferents to the carotid sinus and body?
glossopharyngeal nerve
how do you test CN IX?
gag reflex
what is the cranial foramen of CN X?
jugular foramen
describe the extrancranial course of CN X in relation to carotid sheath?
descends within the carotid sheath
what does the left recurrent laryngeal nerve curve under?
the arch of the aorta
what does the right recurrent laryngeal nerve curve under?
right subclavian artery
where does the vagus parasympathetic supply end?
splenix flexure of the colon
how do you test CN X?
ask patient to say ‘ahh’
ask patient to swallow
listen to speech
what is the thinnest part of the skull?
the pterion
what artery lies underneath the pteroid?
the middle meningeal artery
what give rise to the pain of meningitis?
stretching of the dura mater
why does the tentorium cereblli have a central gap?
to allow the brainstem to pass through
what is the name of the tough sheet of dura mater which sits over the pituitary fossa?
diaphragm sellae
what vein is part of the danger triangle of the face?
facial vein
what sinus runs superiorly on each side of the falx cerebri?
superior sagittal sinus
where is the confluence of cranial sinueses?
at the internal occipital protruberance (deep to external occipital protruberance)
describe the course of the vertebral arteries?
arise from subclavian arteries and ascend through the transverse forminae of cervical vertebrae
enters foramen magnum and joins the basilar artery
in which space is the circle of willis?
subarachnoid space
what is the term for increased CSF volume?
hydrocephalus
what is the symptomatic treatment of hydorcephalus?
ventricular peritoneal shunt
where is the bleed in an extradural haemorrhage?
between dura and bone
what blood vessel is most likely torn in an extradural haemorrhage?
middle meningeal artery
what is the most likely cause of an extradural haemorrhage?
trauma to pterion
where is the bleed in a subdural haemorrhage?
between dura and arachnoid (created a gap)
what blood vessel is most likely torn in a subdural haemorrhage?
cerebral veins
what is the most likely cause of a subdural haemorrhage?
falls in the elderly
where is the bleed in a subarachnoid haemorrhage?
into CSF of subarachnoid space
what blood vessel is most likely torn in a subarachnoid haemorrhage?
ruptured circle of willis
what ligaments are passed through during epidural anaesthesia or lumbar puncture?
supraspinous ligament
interspinous ligament
ligamentum flavum
what can damage to the extradural venous plexus of the spinal cord result in?
epidural haematoma
what is the most lateral cranial nerve?
CN VIII
