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NEUROLOGY > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What is a collection of nerve cell bodies called when found in the CNS and when found in the PNS?

A 
CNS = nucleus 
PNS = ganglion
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2
Q

Dendrites conduct information in which direction?

Axons conduct information in which direction?

A

Dendrites conduct information TOWARDS the cell body

Axons conduct information AWAY from the cell body

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3
Q

Which cell type produces myelin for the myelin sheath in the CNS and PNS?

A 
CNS = Oligodendrocytes 
PNS = Schwann cells
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4
Q

Where are the cell bodies of multipolar and unipolar neurones located?

A

Multipolar - cell body in the CNS

Unipolar - cell body in the PNS

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5
Q

Which cranial nerve is the only one to arise from the pons?

A

CN V (Trigeminal)

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6
Q

How many pairs of spinal nerves are there?

A

31 pairs (8C, 12T, 5L, 5S, 1C)

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7
Q

Describe the route of motor axons from the spinal cord to the spinal nerve

A

All motor axons pass from the ANTERIOR horn of the spinal cord into the anterior rootlets then into the anterior root and into the spinal nerve

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8
Q

Describe the modalities of roots, spinal nerve and rami

A

Roots have single modalities (anterior roots are MOTOR, posterior roots are SENSORY)

Spinal nerves and rami have mixed modalities

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9
Q

Describe the route of sensory axons from the spinal nerve into the spinal cord

A

all sensory axons pass from the spinal nerve to the POSTERIOR roots then into the posterior rootlets and then posterior horn of the spinal cord

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10
Q

Spinal nerves only contain sympathetic fibres, no parasympathetics T/F

A

TRUE

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11
Q

What is a dermatome?

A

An area of skin supplied with sensory innervation from a single spinal nerve

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12
Q

What is a myotome?

A

The skeletal muscles supplied with motor innervation from a single spinal nerve

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13
Q

Considering dermatomes, what is the landmark of the male nipple and umbilicus?

A

Male nipple - T4

Umbilicus - T10

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14
Q

The anterior rami of which spinal nerves form the cervical plexus?

A

C1-C4

Posterior scalp, neck and diaphragm

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15
Q

The anterior rami of which spinal nerves form the brachial plexus?

A

C5-T1

Upper limb

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16
Q

The anterior rami of which spinal nerves form the lumbar plexus?

A

L1-L4

Lower limb

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17
Q

The anterior rami of which spinal nerves form the sacral plexus?

A

S1-S4

Lower limb, gluteal region and perineum

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18
Q

How many bilateral plexuses of nerves are there in the body?

A

4; cervical, brachial, lumbar, sacral

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19
Q

Describe sympathetic outflow form the spinal cord

A

Exits via T1-L2 (thoracolumbar outflow)

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20
Q

Which part of the spinal cord (anterior or posterior roots) do sympathetic axons pass through?

A

Anterior - MOTOR

They then pass into all spinal nerves and into both anterior and posterior rami

(remember it is just the roots which are single modalities)

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21
Q

Describe the location of paravertebral and pre vertebral ganglia

A

Paravertebral ganglia are associated with the sympathetic chain

Prevertebral ganglia are associated with the abdominal aorta

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22
Q

Parasympathetic outflow leaves the CNS via which cranial nerves?

A

CN III, VII, IX and X

*Also leave via sacral spinal nerves

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23
Q

What are some of the causes of Horner’s syndrome (impaired sympathetic innervation to the head and neck)

A

Root of the neck trauma, carotid dissection, pancoast tumour

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24
Q

What do the skin dimples in the back indicate the positions of?

A

The posterior superior iliac spines (PSIS)

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25
Q

Lower back pain may be due to strain of which muscle?

A

Erector spinae

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26
Q

What are the extrinsic back muscles?

NB these attach the back to the pectoral girdle and move the upper limb (they are not actually for back functions (e.g maintenance of posture))

A

Levator spinae
Rhomboids
Trapezius
Latissmus dorsi

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27
Q

Which extrinsic back muscle attached superiorly to the occipital bone?

A

Trapezius

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28
Q

What are the intrinsic back muscles?

NB these are entirely within the back and maintain back posture and move the spine

A 
Erector spinae (superficial) 
Transversospinalis (deep)
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29
Q

Describe the attachments of the 3 vertical muscle groups which make up the erector spinae

A

Inferiorly a common tendon attaches to the sacrum and iliac crest

Superiorly the muscle fibres attach via a tendon to; ribs (between rib angles and tubercles), transverse process of vertebra and spinous process of vertebra

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30
Q

Describe the location of transverspospinalis

A

Located within the grooves between transverse and spinous processes

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31
Q

What are the muscles of the anterolateral abdominal wall from superficial to deep?

A

External oblique
Internal oblique
Transversus abdominus

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32
Q

Which muscle is involved in extension of the spine?

A

Erector spinae (if it contracts unilaterally then lateral flexion occurs)

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33
Q

Which muscles are involved in flexion of the spine?

A

Psoas major and rectus abdomoinus

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34
Q

What happens to the size of vertebrae from superior to inferior?

A

Vertebrae become larger as they bear more weight and become smaller again as weight is transferred to the hip bones

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35
Q

What are the curvatures of the spine?

A

Cervical lordosis, thoracic kyphosis, lumbar lordosis, sacral kyphosis

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36
Q

What are the primary and secondary curvatures of the spine?

A

Primary - thoracic and sacral kyphosis

Secondary - cervical and lumbar lordosis

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37
Q

Which joints in the back are affected by arthritis?

A

Facet joints

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38
Q

Where are the spinal nerves found in the vertebral column?

A

Intervertebral foramen

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39
Q

Which parts of the spine don’t have intervertebral discs?

A

None between C1 and C2 and none at the fused sacrum/ coccyx

40
Q

Intervertebral discs contribute to how much length of the spine?

A

20-25%

41
Q

Describe the composition of an intervertebral disc

A

Outer fibrous ring (annulus fibrosus)
NB this is FIBROCARTILAGE

Inner soft pulp (nucleus pulposus)

42
Q

Describe the location of the ligamentum flavum ligaments

A

Connect to adjacent laminae of vertebrae

43
Q

What are the functions of the anterior and posterior longitudinal ligaments of the spine?

A

Anterior LL - prevents over-extension of the spine

Posterior LL - prevents over-flexion of the spine

NB these attach to the anterior/ posterior aspects of vertebral bodies and to intervertebral discs

44
Q

Describe the location of the supraspinous ligaments

A

Connects the tips of spinous processes

NB strong and fibrous

45
Q

Describe the location of interspinous ligaments

A

Connect superior and inferior surfaces of adjacent spinous processes

NB weak and membranous

46
Q

Which vertebrae doesn’t have a body or spinous process?

Which vertebrae has an odontoid process?

Which is the first palpable spinous process?

A

C1 (atlas)

C2 (axis)

C7 (vertebrae prominens)

47
Q

What are the main movements of the atlanto-occipital joint?

A

Flexion and extension of the neck

48
Q

What is the main movement of the atlanto-axial joint?

A

Rotation

49
Q

What types of joints are the atlanto-occipital and the atlanto-axial joints?

A

Synovial

50
Q

What is contained within the sacral canal of the sacrum?

A

Cauda equina and meninges

51
Q

In caudal anaesthesia, where is the local anaesthetic injected into?

A

The sacral hiatus

this anaesthetises the sacral spinal nerve roots of the caudal equina

52
Q

Where does the spinal cord begin and end?

A

Begins at the foramen magnum (continuous with the medulla oblongata where the brainstem ends)

Ends at L1/L2 (caudal equina begins)

53
Q

How many cervical spinal nerves are there?

A

8

54
Q

What is the function of epidural fat?

A

Shock absorber (protects the spinal cord)

55
Q

What is a laminectomy?

A

Removal of 1+ spinous processes and the adjacent lamina to allow the spinal cord to be visualised

56
Q

When is laminectomy used?

A

To relieve pressure on the spinal cord

57
Q

What are some somatic general sensory symptoms a patient may complain of?

( if there is a pathology of somatic sensory nerves)

A

Pain (neuralgia)

Pins and needles

Numbness (anaesthesia)

Sensitivity (hyperaesthesia)

Hot or cold

Loss of co-ordination/ balance/ clumsiness (ataxia)

58
Q

What are some somatic motor symptoms a patient may complain of?

( if there is a pathology of motor nerves)

A

Muscle stiffness, tightness or spasm (cramp)

Muscle loosness (reduced tone/ hypotonia)

Muscular weakness (reduced power)

Loss of co-ordination/ balance/ clumsiness (ataxia)

59
Q

Sensory pathology can be due to a CVA. Where is a common location for this to occur?

A

Internal capsule in the brain

60
Q

Which dermatome has no sensory component?

A

C1

61
Q

What is the difference between a spinal nerve and a named nerve?

A

A spinal nerve contains axons from one spinal cord level only e.g C5

A named nerve contains axons originating from 1 or more spinal cord levels e.g musculocutaneous nerve C5,6,7

62
Q

Which is worse; injury to a spinal nerve or injury to a named nerve?

A

Injury to a spinal nerve

This may impact many structures supplied by its branches whereas a named nerve will just affect the couple of structures it supplies

63
Q

T1 and T2 are important sites for what?

A

Referred pain from the myocardium

64
Q

The anatomical snuff box is supplied by the cutaneous branches of which nerve?

A

Radial nerve

65
Q

What do cervical plexus (C1-C4) motor axons supply?

A

Neck postural and strap muscles

Diaphragm

66
Q

What do the brachial plexus (C5-T1) motor axons supply?

A

Muscles of the upper limb

Extrinsic back muscles

67
Q

What do T2-L3 motor axons supply?

A

Postural back muscles

Intercostal muscles

Anterolateral abdominal wall muscles

68
Q

What do the lumbosacral plexus L1-L4 motor axons supply?

A

Muscles of the lower limb

Perineal skeletal muscles

69
Q

Describe the patellar tendon reflex

A

Patellar tendon tapped
Quadriceps contract
Knee joint extends

70
Q

Describe a monosynaptic reflex arc

A

Normal muscle tone - monosynaptic reflex arc occurs each time skeletal muscle is stretched

71
Q

What do UMN and LMN lesions cause?

A

UMN - Spasticity

LMN - flaccidity

72
Q

Why might athletes present with anaesthesia (loss of sensation) in parts of a limb?

A

They have big muscles which can compress nerves on movement

73
Q

What is a space occupying lesion and give some examples

A

Abnormal tissue taking up space in the brain

E.g tumours, bleeds

74
Q

What is the Monro-Kellie hypothesis?

A

The relationship between pressure and volume in the brain

SOL can cause increased ICP which can result in herniation of brain contents though foramina in the skull

75
Q

What are the 5 layers of the scalp?

A

SCALP;
Skin

Connective tissue (rich blood supply here- contains the named arteries of the scalp)

Aponeurosis (tendinous layer)

Loose connective tissue (thinnest layer)

Pericranium (periosteal layer - membranous layer on the surface of bone)

76
Q

DO YOU NEED TO REVISE THE BONES OF THE SKULL

A

YES

77
Q

What type of joints are the sutures of the skull?

A

Fibrous joints

78
Q

What is the thinnest part of the skull?

What structure can be damaged if this part of the skull is damaged?

A

Pterion (H suture)

Middle meningeal artery can haemorrhage

79
Q

From superficial to deep what are the 3 layers of the meninges?

A

Dura, arachnoid mater, pia mater

80
Q

What is the sensory nerve supply to the dura matter?

A

CN V

81
Q

What are the 3 folds of dura to be aware of?

A

Diaphragm sellae
(forms a roof over the pituitary fossa)

Tentorium cerebelli
(forms a tent over the cerebellum)

Falx cerebri
(sits between the R&L cerebral hemispheres)

82
Q

Describe the location of the falx cerebri

A

Sits between the R&L cerebral hemispheres

Extends between the crista galli of the ethmoid bone anteriorly and the internal occipital protuberance of the occipital bone posteriorly

83
Q

Where do the superior and inferior sagittal sinuses meet?

A

The confluence of the sinuses

84
Q

Where does the sigmoid sinus drain into?

A

Internal jugular vein

85
Q

Why are the facial veins a bad site for infection to start (danger triangle of the face)?

A

They have no valves

They are thick so don’t heal well if they get a laceration

86
Q

Wha is the function of the arachnoid granulations?

A

Reabsorption of CSF into the dural venous sinuses

87
Q

What level of the spine is used for lumbar punctures?

A

L3-L5 (within the caudal equina - the nerves are much more mobile so less likely to pierce a nerve)

88
Q

The cerebral aqueduct connects which two structures?

A

The third and fourth ventricles of the brain

89
Q

The central canal passes all the way down the spinal cord, it is continuous with the 4th ventricle of the brain and contains CSF. T/F

A

True

90
Q

What is the difference between the following;

Extradural haemorrhage

Subdural haemorrhage

Subarachnoid haemorrhage

A

Extradural haemorrhage - bleed between bone and dura

Subdural haemorrhage -
Bleed between the dura and arachnoid

Subarachnoid haemorrhage - bleed into the CSF of the subarachnoid space

91
Q

Trauma to the pterion, rupturing the middle meningeal artery would cause what kind of bleed?

A

Extradural haemorrhage

92
Q

Falls in the elderly and those with drinking problems may tear cerebral veins, causing what kind of bleed?

A

Subdural haemorrhage

93
Q

Ruptured circle of willis (‘berry aneurysm) causes what kind of bleed?

A

Subarachnoid haemorrhage

The circle of willis sits in the subarachnoid space

94
Q

How does a ventricular peritoneal shunt for hydrocephalus work?

A

Hydrocephalus means water on the brain. A ventricular peritoneal shunt connects the ventricles with the peritoneal cavity where CSF can be absorbed.

95
Q

Describe the passage of the needle during lumbar puncture?

A

Supraspinous, intraspinous and ligamentum flavum ligaments

Epidural fat

Dura mater, arachnoid mater

SUBARACHNOID SPACE

96
Q

What is meant by the ‘nerve point’ of the neck?

A

Where the sensory nerves of the cervical plexus converge

This is at the midpoint of the posterior border of the SCM

NEUROLOGY (18 decks)

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