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Neurology > Anatomy > Flashcards

Anatomy Flashcards

1
Q

how many cranial and spinal nerves

A

12 pairs of cranial

31 pairs of spinal

  • 8 cervical
  • 12 thoracic
  • 5 lumbar
  • 5 sacral
  • 1 coccygeal
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2
Q

how does the brain form

A

from the neural tube
at 4 weeks forms primary vesicles (pros, mes and rhomb -encephalons)
at 6-8 week form secondary vesicles

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3
Q

what does the telecephalon form

A

cerebral hemispheres

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4
Q

what does the diencephalon form

A

thalamus, hypothalamus

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5
Q

what does the mesencephalon form

A

midbrain

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6
Q

what does the metencephalon form

A

pons, cerebellum

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7
Q

what does the myelencephalon form

A

medulla oblongata

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8
Q

what makes up the brainstem

A

mid brain
pons
medulla oblongata

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9
Q

what makes up the diencephalon

A

thalamus + hypothalamus

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10
Q

what are the majority of neurones

A

multipolar with many dendrites and one axon

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11
Q

what is the soma of a neurone

A

contains the nucleus and cellular apparatus

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12
Q

what way is electric activity going in an axon

A

away from the cell body

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13
Q

what do glial cell do

A

support cells for CNS

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14
Q

what are the 4 types of glial cells

A

astrocytes, oligodendrocytes, microglia, ependymal cells

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15
Q

what do astrocytes do

A

support, maintain BBB, environment homeostasis

star shaped

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16
Q

what is the role of the BBB

A

prevents things in blood directly accessing parenchyma of the brain

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17
Q

is there connective tissue in the CNS

A

no- why you need glial cells

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18
Q

what is the role of oligodendrocytes

A

produce myelin in the CNS (not in PNS) (wrap cell membranes around axons to increase the speed of conduction)

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19
Q

what is the node of ranvier

A

a gap between two myelinated axon areas- APs skip from one node to the next

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20
Q

what is the role of microglia

A

(hemopoietic (bone marrow) origin)

immune monitoring and antigen presentation (when activates take on appearance of macrophages)

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21
Q

what are ependymal cells

A

ciliated cuboidal/ culomnar epithelium that line the ventricles

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22
Q

what is a gyrus, sulcus and fissure

A

gyrus- ridge in cerebral cortex
sulcus- groove in cerebral cortex
fissure- deeper than gyrus

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23
Q

what fissures does the brain have

A

lateral (2) and longitudinal

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24
Q

what is grey matter

A

has lots of neurones, cell processes, synapses and support cells
(forms outside of brain)

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25
Q

what is white matter

A

(medullary centre)

axons and their support cells

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26
Q

how can you identify the dorsal and ventral horns of the grey matter in the spinal chord

A

grey matter on inside
dorsal horn extends back towards the posterior surface of the spinal chord
ventral horn is a distance from the anterior surface of the spinal chord

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27
Q

what does the calcarine suclus demarcate

A

primary visual cortex

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28
Q

what is the corpus callosum

A

largest connection between the left and right hemisphere

a band of white matter

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29
Q

what is the fornix

A

band of white matter that goes into the hypothalamus

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30
Q

where is the 4th ventricle

A

sits behind the pons

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31
Q

where is the frontal lobe

A

lobe anterior to the central sulcus and superior to the lateral sulcus.

anterior to a line drawn from the central sulcus down to the corpus callosum

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32
Q

where is the parietal lobe

A

posterior to the central sulcus, superior to the lateral sulcus (and a backward extension of it), and anterior to a line from the parieto-occipital sulcus to the preocciptial notch

posterior to the frontal lobe and anterior to the parieto-occipital sulcus.

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33
Q

where is the occipital lobe

A

posterior to a line from the parieto-occipital sulcus to the preocciptial notch

posterior to the parieto-occipital sulcus.

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34
Q

where is the temporal lobe

A

inferior to the lateral sulcus (and a line extending the lateral sulcus posteriorly) and posteriorly by a line from the parieto-occipital sulcus and the preoccipital notch

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35
Q

what is the role of the insular lobe

A

role in the experience of pain

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36
Q

what are the three meninges from superficial to deep

A

Dura mater

Arachnoid mater.

-Subarachnoid space contains cerebrospinal fluid (CSF)

Pia mater.

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37
Q

what makes up the outer layer of the dura mata

A

the periosteum of the skull

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38
Q

what creates the subarachnoid space

A

pia mata follow the indentations of the brain but the arachnoid mata does not

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39
Q

what joins the lateral ventricles

A

communicate via 3rd ventricle (via intraventricular foramen)

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40
Q

what is the enteric nervous system

A

found in digestive system

controls motility in the muscles of the digestive system

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41
Q

what is the blood supply to the brain

A

internal carotid system- Common carotid -> internal carotid -> anterior cerebral artery -> (anterior communicating artery), middle cerebral artery

vertebro-basilar system- Subclavian arteries -> vertebral arteries -> unite forming the basilar artery -> anterior inferior cerebellar, superior cerebellar, posterior cerebral arteries(->posterior communicating artery)

circle of willis= Anastomosis between the anterior and posterior circulation

Polygonal anastomosis between:
Internal carotid artery (branch of the common carotid)
Anterior cerebral artery (branch of the internal carotid)
Anterior communicating artery (branch of the anterior carotid, connects left and right anterior cerebral arteries)
Posterior cerebral artery (branch of the basilar artery)
Posterior communicating artery (branch of the posterior cerebral, connects the three cerebral arteries on the same side)

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42
Q

what is the venous drainage of the brian

A

dural venous sinuses drain into the internal jugular vein

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43
Q

what makes up the PNS

A

cranial nerves and spinal nerves

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44
Q

what is a ganglion

A

collection of nerve cell bodies in the PNS (same thing in CNS called a nucleus)

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45
Q

how does information reach neurones

A

dendrites

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46
Q

whats the difference betwen multipolar ans unipolar neurones

A 
multipolar:
     - 2 or more dendrites
     - all MOTOR neurones of 
       skeletal muscle & ANS (symp and parasymp)
     - cell body in CNS

unipolar:

  • double process
  • aka pseudounipolar / SENSORY
  • cell body in PNS
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47
Q

what are motor neurones

A

efferent

impulses towards body wall/ cavity/ organ

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48
Q

what are sensory neurones

A

afferent

impulses towards brain

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49
Q

what is a tract

A

collection of axons surrounded by connective tissue and blood vessels

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50
Q

what is single and mixed modalities

A

a tract can be single:
one of somatic motor, sensory, special sensory, symp, parasymp, visceral afferent

or mixed where different nerves together in one (most tend to be mixed)

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51
Q

what cranial nerves connect to CNS at forebrain

A

CN I and II

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52
Q

what cranial nerves connect to CNS at midbrain

A

III IV

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53
Q

what cranial nerves connect to CNS at pons

A

V

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54
Q

what cranial nerves connect to CNS at pontomedullary junction

A

VI, VII, VIII

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55
Q

what cranial nerves connect to CNS at the medulla

A

CN IX, X, XII

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56
Q

what cranial nerves connect to CNS at the spinal chord

A

XI

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57
Q

how do you remeber the modalities of the cranial nerves

A

some say mary money but my brother says big balls matter more

s= special sensory 
m= motor 
b= both
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58
Q

where in spine are the spinal nerve

A

intervertebral foramina

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59
Q

what do spinal nerves connect to

A

spinal chord segment at the same number (C1 at C1) via roots and rootlets

structures of the soma (body walll) via rami

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60
Q

what is the path of spinal nerves

A 
spinal chord 
rootlets (ant and post)
roots (ant and post)
spinal nerve 
post and ant rami
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61
Q

what does the posterior rami do

A

is small, supplies the posterior body wall

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62
Q

what does the anterior rami do

A

bigger, supplies the anteriolateral body wall

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63
Q

what is the path of sensory axons from spinal nerves to chord

A

spinal nerve
posterior root
posterior rootlets
posterior horn of the spinal chord

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64
Q

what is the path of motor axons from chord to spinal nerves

A

anterior horn of spinal cord
anterior rootlets
anterior root
spinal nerve

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65
Q

what is the dorsal root ganglion

A

Location of cell bodies of primary afferent neurones

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66
Q

are roots mixed or single modality

A

single (as come from post or ant horn)

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67
Q

what does each spinal supply

A

general sensory supply to all structures

somatic motor supply to skeletal muscles

sympathetic nerve supply to the skin and to the smooth muscle of arterioles

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68
Q

what is a dermatome

A

area of skin supply sensory innervation from a single spinal nerve (and deeper structures)

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69
Q

what is a myotome

A

the skeletal muscles supplied with motor innervation from a single spinal nerve
(may be same as dermatome but not always)

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70
Q

what needs to be damaged for an area of skin to be numb

A

several adjacent spinal nerves as dermatomes overlap

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71
Q

what dermatome is the nipple

A

T4

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72
Q

what dermatome is the umbilicus

A

T10

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73
Q

what dermatome is the posterior scalp, neck and shoulder

A

C2-C4

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74
Q

what dermatome is the upper limb

A

C5-T1

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75
Q

what dermatome is the lower limb, gluteal region and perineum

A

L2-Co1

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76
Q

what forms nerve plexuses

A

ONLY anterior rami

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77
Q

what is the cervical plexus

A

C1-4

supplies posterior scalp, neck and diaphragm

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78
Q

what is the brachial plexus

A

C5-T1

upper limb

79
Q

what is the lumbar plexus

A

L1-L4

lower limb

80
Q

what is the sacral plexus

A

L5-S4

lower limb, gluteal region, perineum

81
Q

describe sympathetic outflow

A

originates from brain
passes down spinal chord
T1-L2 have lateral horns (cell bodies)
thoracolumbar outflow
presynaptic fibres enter the sympathetic trunks and either:
-ascend then synapse (head, cervical cardiopulmonary splanchnic nerves, neck, upper limb/ when spinal nerves involved are superior to intereomediolateral nucleus)
-synapse at level of entry (thoracic cardiopulmonary splanchnic nerves/ when spinal nerves are at sane level as
IML- middle trunk)
-descend then synapse (when spinal nerves involved are inferior to
IML (part of lower limb))
-pass through snyaptic trunk without synapsing to enter abdominopelvic splanchnic nerve (abdominopelvic viscera only)

present in all spinal nerves

82
Q

how does sympathetic innervation get to the heart

A

presynaptic axons synapse in T1 or cercival PARAvertebral ganglia (sympathetic chain)

post synaptic axons pass into cardiopulmonary splanchnic nerves to the SA and AN nodes and the myocardium

83
Q

how does sympathetic innervation get to the lungs

A

presynaptic axons synapse in upper thoracic PARAvertebral ganglia

postsynaptic axons pass into cardiopulmonary splanchnic nerves to the bronchiolar smooth muscle and mucous glands

84
Q

how does sympathetic innervation get to the abdonminopelvic organs

A

presynaptic axons synapse in one of the prevertebral ganglia
- celiac ganglion of celiac plexus (foregut)
- aorticorenal ganglion (kidney)
- superior mesenteric ganglion of SM plexus (midgut)
- inferior mesenteric ganglion of IF plexus (hindgut &
pelvic/perineal organs)

85
Q

how does sympathetic innervation reach the adrenal medulla

A

presynaptic axons pass through the aorticorenal ganglion
to synapse directly onto the adrenaline/noradrenaline
secreting cells of the adrenal medulla

86
Q

how do presynaptic parasympathetic axons leave the CNS

A

via cranial nerves III, VII, IX, X (1973)

sacral spinal nerves

87
Q

what is the path of parasympathetics

A

leave via CN 1973 and sacral spinal nerves

ciliary ganglion-> eye
parasympathetic ganglia in head-> lacrimal and salivary gland
vagus nerve-> organs of neck, chest and abdomen untill midgut
sacral spinal nerves-> hindgut, pelvis and perineum

88
Q

what are the symptoms of horners and why do you get them

A

miosis (pin point pupils)
ptosis (LPS)
reduced sweating (anhydrosis)
increased warmth and redness (vasodilation)

impaired SYMPATHETIC innervation

89
Q

what are the causes of horners syndrome

A

compression of cervical parts of the sympathetic trunk

  • root of neck trauma
  • carotid dissection
  • IJV engorgement
  • deep cervical node metastases
  • pancoast tumour (lung apex)
90
Q

what is paraesthesia

A

pins and needles

91
Q

what is ataxia

A

loss of co-ordination/ balance/clumbsiness

92
Q

what is sympathetic motor innervation

A

autonomic control (smooth muscle in vessels and hair follicles)

93
Q

how do you test both the dermatome and myotome innervation

A

spinal cord reflexes

94
Q

what is C1s dermatome

A

C1 HAS NO DERMATOME- is only motor

95
Q

what is C2s dermatome

A

back of scalp and adams apple

96
Q

what is C3s dermatome

A

back of neck and jugular notch

97
Q

what is C4s dermatome

A

clavicle and shoulder tip

98
Q

what is C5s dermatome

A

regimental badge area

99
Q

what is C6s dermatome

A

lateral forearm to thumb

100
Q

what is C7s dermatome

A

middle finger

101
Q

what is C8s dermatome

A

little finger

102
Q

what is T1s dermatome

A

medial forearm

103
Q

what is t2s dermatome

A

medial arm and sternal angle

104
Q

what is T4s dermatome

A

nipple

105
Q

what is t10s dermatome

A

umbilicus

106
Q

what is T12s dermatome

A

pubic symphysis

107
Q

what is L1s dermatome

A

groin (hands in pockets)

108
Q

what is L2s dermatome

A

anterior thigh

109
Q

what is L3s dermatome

A

anterior knee (L3 knee)

110
Q

what is L4s dermatome

A

medial malleolus

111
Q

what is L5s dermatome

A

dorsum of the foot

112
Q

what is s1s dermatome

A

heel

113
Q

what is S2s dermatome

A

posterior knee

114
Q

what is S3s dermatome

A

buttock

115
Q

what is S4s dermatome

A

perineum

116
Q

what is S5s dermatome

A

perianal skin

117
Q

what might be affected if only the dermatome not myotome is affected

A

dorsal rootlets or root

118
Q

what skin do the posterior rami supply

A

down the back and posterior neck

119
Q

what rami form plexuses

A

anterior

120
Q

what anterior rami do not form complexes

A

T2-T12

121
Q

what are the named cutaneous innervation of the trunk

A

lower antereolateral trunk wall- iliohypogadtric and ilioinguinal nerves

upper anterolateral trunk wall is supplies by intercostal nerves

subcostal nerve

122
Q

what is the difference between a spinal nerve and a names nerve

A

spinal contains axons from one spinal cord level

named contains from one of more spinal cord level supplying a particular area

123
Q

what levels in the femoral nerve

A

L2,3,4

124
Q

what is the named innervation of the neck

A

cervial plexus- anterolateral neck skin:

-lesser occipital C2 (skin posterior to external ear)
-great auricular nerve C2,3 (skin over mandible and external ear)
-transverse cervical C2,3 (anterior neck)
supraclavicular nerves C3,4 (shouldertip)

LITTLE
GOATS
TREAD
SOFTLY

125
Q

what supplies the posterior neck and scalp skin

A

posterior rami of spinal nerves C2-8

126
Q

what is the nerve point of the neck

A

when sensory nerves of cervical plexus pass from superficial to deep fascia at midpoint of posterior border of SCM

127
Q

what level is the supraclavicular nerve

A

C3,4

128
Q

what level is the axially nerve

A

C5,6

129
Q

what level is the cutanrous branch of the musculocutaneous nerve

A

C5,6,7

130
Q

what supplies the anatomical snuffbox

A

cutaneous branches of the radial nerve

131
Q

what are T1 and T2 important

A

referred pain from myocardium

132
Q

what level is the median nerve

A

C5,6,7,8 T1

133
Q

what level is the ulnar nerve

A

C7,8, T1

134
Q

what level is the radial nerve

A

C5,6,7,8, T1

135
Q

what level is the subcostal nerve

A

T12

136
Q

what level is the femoral branch of genitofemoral nerve

A

L1,2

137
Q

what level is the ilioinguinal nerve

A

L1

138
Q

what level is the obturator nerve

A

L2,3,4

139
Q

what level is the femoral nerve

A

L2,3,4

140
Q

what level is the saphenous nerve

A

(from femoral) L3,4

141
Q

what level is the superficial fibular nerve

A

L4, L5, S1

142
Q

what level is the tibial nerve

A

L4,5,S1,2,3 (goes into calcaneal nerves and medial and lateral plantar nerves)

143
Q

what level is the posterior cutaneous nerve of thigh

A

S1,2,3

144
Q

what level is the iliohypogastric nerve

A

L1

145
Q

what is the internal capsule

A

white matter, carries sensory and motor info information from cortex

146
Q

what does the cervical plexus do (motor)

A

C1-C4
neck, postural and strap muscles
diaphragm C3,4,5

147
Q

what does the brachial plexus do (motor)

A

C5-T1
muscles of upper limb
extrinsic back muscles that move the upper limb or scapula

148
Q

what do T2-L3 motor axons supply

A 
Postural back muscles (via posterior rami)
Intercostal muscles (via anterior rami)
Anterolateral abdominal wall muscles 
     (via thoracoabdominal, subcostal, iliohypogastric & ilioinguinal nerves)
149
Q

what does the lumbosacral plexus do (motor)

A

motor axons supply muscles of the lower limb and sperineal skeletal muscles

150
Q

how do you test myotome C5

A

shoulder abduction- deltoid

151
Q

how do you test myotome C6

A

elbow flexion- biceps brachii

152
Q

how do you test myotome C7

A

elbow extension - triceps brachii

153
Q

how do you test myotome C8

A

finger flexion - flexor digitorum superficialis

154
Q

how do you test myotome T1

A

finger abduction - dorsal interossi

155
Q

how do you test myotome L3

A

knee extension - quadriceps femoris

156
Q

how do you test myotome L2

A

hip felxion

157
Q

how do you test myotome L4

A

ankle dorsiflexion - tibilais anterior

158
Q

how do you test myotome L5

A

great toe extension- extensor hallucis longus

159
Q

how do you test myotome S1

A

ankle plantar flexion - gastrocnemius

160
Q

how do you test myotome S2

A

knee flexion- biceps femoris

161
Q

what pathway does a AP go to create motor function

A

APs are generated by voluntary intention in the primary somatomotor cortex

AP conducted via UMN axons of the corticospinal tract

AP continues along axons to anterior horn of spinal cord

UMN synapse with LMN stimulating AP

AP continues along axons to spinal nerve

AP continues to either posterior ramus OR anterior ramus.

APs then reach the NMJ of the supplied muscle

162
Q

what happens in a monosynaptic relfex

A

Occurs each time skeletal muscle is stretched - normal muscle “tone”

Muscle spindles initiate APs in the anterior rami axons
Sensory APs conducted to dorsal horn
Axons pass into anterior horn to synapse on LMNs
APs conducted via the LMN axons reach the NMJ
Muscle contracts

Reflex muscle contractions controlled by descending pathways

163
Q

what happens in a UMN lesion

A

= spasticity- does not have reciprocal inhibition (thinks muscle shouldnt be stretching)

164
Q

what happens in LMN lesions

A

flaccidity

165
Q

what level is being tested in the biceps brachii reflex

A

C5,6

166
Q

what level is being tested in the brachioradialis reflex

A

C6

167
Q

what level is being tested in the triceps brachii reflex

A

C7

168
Q

what level is being tested in the knee jerk

A

L3

169
Q

what level is being tested in the ankle jerk

A

S1

170
Q

why do you neuropathy in the lateral cutaneous nerve of the thigh

A

part of lumbar plexus under inguinal ligament and near ASIS. If iliopsoas hypertrophies and compresses this nerve

171
Q

Muscles of facial expression motor innervation

A

CN VII

172
Q

Muscles of mastication motor innervation

A

CN V3

173
Q

Muscles of the tongue motor innervation

A

CN XII

174
Q

Muscles of the soft palate motor innervation

A

CN X/pharyngeal plexus

175
Q

Neck postural muscles motor innervation

A

Posterior rami of cervical spinal nerves

176
Q

strap muscles motor innervation

A

cervical plexus C1-3

177
Q

diaphragm motor innervation

A

phrenic nerve: C3,4,5 – from the cervical plexus

178
Q

sternocleidomastoid and trapezius motor innervation

A

CN XI

179
Q

muscles of the pharnyx motor innervation

A

mainly CN X

180
Q

intrinsic muscles of the larynx motor innervation

A

CN X

181
Q

intercostal muscles motor innervation

A

intercostal nerves

182
Q

anterolateral abdominal wall muscles motor innervation

A

thoracoabdominal nerves

183
Q

erector spinae and transversospinalis group motor innervation

A

post rami of spinal nerves

184
Q

to what muscles does the axillary nerve (C5,6) provide motor innervation

A

deltoid and teres minor

185
Q

to what muscles does the musculocutaneous (C5,6,7) nerve provide motor innervation

A

all ant compartment of arm
biceps brachii
brachialis
coracobrachialis

186
Q

to what muscles does the median nerve (C5,6,7,8 T1) provide motor innervation

A

Muscles of anterior compartment of forearm:
-The pronator muscles (Teres & Quadratus)
-Flexor carpi radialis
-Palmaris longus
-Flexor digitorum superficialis
-Lateral half of flexor digitorum profundus
-Flexor pollicis longus
Muscles of the hand:
-Thenar muscles
-Lumbricals 1&2

187
Q

to what muscles does the radial nerve (C5,6,7,8 T1) provide motor innervation

A

Muscle of posterior compartment of arm:
Triceps brachii

Muscles of posterior compartment of forearm:
Brachioradialis
Supinator
ALL the extensors of the carpus & digits
Abductor pollicis longus

188
Q

to what muscles does the ulnar nerve (C7,8 T1) provide motor innervation

A

Muscles of anterior compartment of forearm:
Flexor carpi ulnaris
Medial half of flexor pollicis longus
Adductor pollicis

Muscles of the hand:
Hypothenar muscles, Lumbricals 3&4
& ALL the interossei (dorsal & palmar)

189
Q

to what muscles does the femoral nerve (L2,3,4) provide motor innervation

A

Quadriceps femoris
Sartorius
Pectineus

190
Q

to what muscles does the sciatic nerve (tibial division) (L4-S3) provide motor innervation

A

Muscles of posterior compartment of thigh:
Semimembranosus
Semitendinosus
Long head of biceps femoris

Muscles of posterior compartment of leg:
Gastrocnemius
Soleus
Plantaris
Popliteus
Tibialis posterior
Flexors of the digits

Muscles of the sole of the foot:
All intrinsic muscles of the sole of the foot

191
Q

to what muscles does the obturator nerve (L2,3,4) provide motor innervation

A

All of the medial compartment of thigh

All adductors & gracilis

192
Q

to what muscles does the sciatic nerve (fibular division) (L4-S2) provide motor innervation

A

Short head of biceps femoris

193
Q

to what muscles does the superficial fibular nerve provide motor innervation

A

Muscles of the lateral compartment of leg:

Fibularis longus & brevis

194
Q

to what muscles does the deep fibular nerve provide motor innervation

A 
Muscles of the anterior compartment of leg:
Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus
Fibularis tertius

Muscles of the dorsum of the foot:
Extensor digitorum brevis (EDB)
Extensor hallucis brevis (EHB)

Neurology (35 decks)

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