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My Neurology > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What is a collection of nerve cell bodies called?

A

CNS- nucleus

PNS- ganglion

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2
Q

What is the myelin sheath made by/of?

A

PNS- Schwann cells

CNS- oligodendrocytes

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3
Q

What are the features of multipolar neurons?

A
  • MOTOR
  • 2+ dendrites
  • motor neurons of skeletal muscle and autonomic NS
  • cell bodies in CNS but axons in PNS
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4
Q

What are the features of unipolar neurons?

A
  • SENSORY
  • double process
  • cell body in PNS
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5
Q

What are tracts in the CNS?

A

collections of axons surrounded by connective tissue and blood vessels (nerves in PNS)

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6
Q

What part of the brain does each cranial nerve come off?

A
  • CNI+II = forebrain
  • CNIII+IV = midbrain
  • CN V = pons
  • CN VI+VII+VIII = junction
  • CN IX+X+XII = medulla
  • CN XI = spinal cord
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7
Q

What are the components of the autonomic nervous system?

A
  • sensory = visceral afferents

- motor = sympathetic and parasympathetic

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8
Q

What are the main facts about sympathetic nervous system?

A
  • thoracolumbar outflow

- cell bodies are in the T1-L2 lateral horns

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9
Q

What is the path of the sympathetic nerves?

A

anterior root –> anterior rami of spinal nerve –> white rami –> sympathetic trunk –> can ascend, descend, synapse at same level or can pass through to abdominopelvic splanchnic nerves

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10
Q

What is the sympathetic supply to the heart?

A

synapse at cervical paravertebral ganglia and then move in cardiopulmonary splanchnic nerves

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11
Q

What is the sympathetic supply to the lungs?

A

synapses in upper thoracic paravertebral ganglia and then to cardiopulmonary splanchnic nerves

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12
Q

What is the sympathetic supply to the abdomen and pelvis?

A

goes to prevertebral ganglia where they synapse then move in periarterial plexuses on arteries to organs

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13
Q

What is the main exception to the synapsing of the sympathetic nervous fibres?

A

the adrenal gland has nerves that synapse directly onto the suprarenal medullary cells

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14
Q

What is the outflow for parasympathetic?

A

craniosacral outflow (CN III, IX and X and sacral nerves)

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15
Q

What do the parasympathetic fibres travel via?

A
  • ciliary ganglion (eye)
  • parasympathetic ganglia of the head (lacrimal gland and salivary gland)
  • vagus nerve
  • sacral spinal nerves
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16
Q

What are the skin dimples in the back?

A

posterior superior iliac spines

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17
Q

Where is the only place that the spinal nerves are found?

A

the intervertebral foramina

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18
Q

What joins the articular processes of adjacent vertebrae?

A

facet joints

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19
Q

What are the three midline ligaments of the spine?

A
  • ligamentum flavum: posteriorly connects adjacent laminae
  • anterior longitudinal: strong and prevents over-extension
  • posterior longitudinal: weaker and prevents over-flexion
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20
Q

What are the two spinous ligaments of the spine?

A
  • supraspinatous: connects the tips of the spinous processes
  • interspinatous: connects in-between the spinous processes
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21
Q

What are the spinal nerve divisions?

A 
8c
12t
5l
5s
1c
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22
Q

Where do the spinal nerves run?

A

C1-C7 emerge above their vertebrae but the rest emerge below

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23
Q

What do the spinal nerves come from and go to?

A
  • from spinal cord segment of the same number via anterior and posterior roots which combine
  • to structures via rami
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24
Q

Which of the anterior and posterior rami are bigger?

A

anterior is bigger as it supplies everything but the back which is supplied by the posterior rami

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25
Q

What runs through each of the spinal roots?

A
  • motor runs through anterior to join spinal nerve

- sensory runs into posterior roots after spinal nerve

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26
Q

What is included within the spinal nerve?

A

both motor and sensory innervation

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27
Q

What does the spinal nerve supply within its segment?

A
  • general sensory
  • somatic motor to skeletal muscles
  • sympathetics to the skin and smooth muscle of arterioles
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28
Q

What is a dermatome?

A

area of skin that is supplied by sensory innervation from a single spinal nerve (overlaps)

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29
Q

What is a myotome?

A

skeletal muscles supplied with motor innervation from a single spinal nerve

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30
Q

What is the nipple and umbilicus area supplied by?

A 
Nipple = T4
Umbilicus = T10
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31
Q

What are the upper and lower limb nerve divisions?

A

Upper limb = C5-T1

Lower limb = L2-Co1

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32
Q

What are nerve plexuses?

A

intertwining of anterior rami and the fibres can be shared

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33
Q

What are the main nerve plexuses?

A
  • cervical C1-4
  • brachial C5-T1
  • lumbar L1-4/sacral L5-S4
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34
Q

What is Horner’s syndrome?

A
  • miosis, ptosis, reduced sweating and increased warmth/redness
  • impaired sympathetic innervation to head and neck
  • compression of the sympathetic ganglia
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35
Q

What is the type of fibres in each of the CNV divisions?

A
  • CNV1 and CNV2 are sensory

- CNV3 is sensory and motor

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36
Q

Where is the sensory division in the face of CNV?

A
  • CNV1 runs between eyelids and down ridge of nose

- CNV2 divides at lips

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37
Q

What are the muscles that CNV3 supplies?

A
  • muscles of mastication
  • tensor veli palatini
  • tensor tympani
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38
Q

What is the path of the facial nerve out of the cranium?

A

out of internal acoustic meatus until geniculate ganglion and then into facial canal and out of stylomastoid foramen

39
Q

What are the 5 branches of facial expression of the facial nerve?

A

Temporal Zygomatic Buccal Mandibular Cervical

to zanzibar by motor car

40
Q

What are the main roles of glossopharyngeal?

A
  • general sensation (eg tonsils, oropharynx, nasopharynx, middle ear etc)
  • special sensory for taste
  • visceral afferent to carotid sinus/ carotid body chemoreceptors
  • somatic motor
  • parasympathetic to parotid
41
Q

What layer are the arteries to the scalp in?

A

sCalp

connective tissue layer

42
Q

What is the pterion and what does it cover?

A
  • convergence of the frontal, parietal, temporal and sphenoid bones
  • H shaped suture
  • thinnest part of the skull
  • covers the middle meningeal artery
43
Q

What are the three parts of the erector spinae muscles?

A
  • sacrum iliocostalis
  • longissimus
  • spinalis
44
Q

What muscles move the spine and assist in posture?

A

Transversospinalis

Erector spinae

45
Q

Where do the vertebral arteries pass through in the cervical vertebrae?

A

C1-6 in the transverse foramen but not C7

46
Q

What are the two main movements at the neck?

A
  • 2 atlanto-occipital joint = flexion/extension

- atlanto-axial joint = lateral/medial rotation

47
Q

Why does the spinal cord not always get damaged if there is a vertebral dislocation?

A

the vertebral canal is bigger than the spinal cord

48
Q

Where do the arteries run through the sacrum?

A

anterior and posterior sacral foramen

49
Q

Where are epidural injections given?

A

L3/4 interspace where cauda equina is so less chance of damage

50
Q

When should a lumbar puncture never be performed?

A

when there is raised ICP as it can cause brain herniation due to the pressure

51
Q

What layers does the needle for a spinal anaesthetic go?

A

supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura mater, arachnoid mater to the subarachnoid space

52
Q

How is caudal anaesthetic given?

A

through the sacral hiatus into the epidural space

53
Q

What is a laminectomy?

A

removal of the laminae which form the arch that makes the spinous process

54
Q

Where is the best place to test a dermatome?

A

in the middle of it as far away from the edge as possible to avoid overlap

55
Q

What are the dermatomes for the badge patch area, groin, medial malleolus and heel?

A 
C5= badge patch area 
L1= groin
L4= medial malleolus
S1= heel
56
Q

Is peripheral nerve cutaneous innervation different to dermatomes?

A

peripheral nerves have more than one spinal nerve root and have names eg femoral nerve L2-4

57
Q

What is the nerve point of the neck?

A

above the midpoint of the posterior border of SCM where sensory nerves meet in cervical plexus

58
Q

What is the subcostal nerve?

A

T12

59
Q

What is the lower anterolateral trunk wall supplied by?

A

iliohypogastric and ilioinguinal nerves which are both L1

60
Q

How does referred pain in a heart attack work?

A

T1 and T2 anterior rami sensory axons connect to the heart and to the upper limb

61
Q

How do you clinically test myotomes?

A

there is one movement that is most strongly associated with each myotome

62
Q

What myotomes do shoulder abduction and adduction test?

A

Shoulder abduction= C5

Adduction= C7

63
Q

What myotomes do finger flexion, extension, abduction and adduction test?

A

Finger flexion= C8
Extension= C7
Abduction and adduction= T1

64
Q

What myotomes do elbow flexion and extension test?

A

Elbow flexion= C5 and C6

Extension= C7 (and C8)

65
Q

What myotomes do wrist flexion and extension test?

A

Wrist flexion= C7 (C6)

Extension= C6 (C7)

66
Q

What myotomes do hip flexion and extension test?

A

Hip flexion= L2 and L3

Extension= L5 and S1

67
Q

What myotomes do knee flexion and extension test?

A

Knee flexion= L5 and S1

Extension= L3 and L4

68
Q

What myotomes do ankle dorsiflexion, plantar flexion, inversion and eversion test?

A

Ankle dorsiflexion= L4 and L5
Plantar flexion= S1 and S2
Inversion= L4
Eversion= L5 and S1

69
Q

What is a monosynaptic reflex arc?

A

in a spinal cord reflex, the impulses pass through posterior rami, synapse in the spinal cord and then the motor impulses at the anterior rami go straight to cause a reaction

70
Q

What do upper and lower motor neuron lesions cause?

A

UMN lesions = spasticity (descending controls from the brain are not working to continual over contraction)
LMN lesions = flaccidity

71
Q

What are the main reflexes to test?

A
  • knee (L4) (34 kick the door)
  • ankle (S1) (12 tie my shoe)
  • supinator (C6)
  • biceps (C5) (56 pick up sticks)
  • triceps (C7) (78 lay them straight)
72
Q

Where do the first 6 CN leave the cranial cavity?

A
  • CNI- cribriform plate of ethmoid bone
  • CNII- optic canal
  • CNIII, IV, V1 and VI- superior orbital fissure
  • CN V2- foramen rotundum
  • CN V3- foramen ovale
73
Q

Where do the last 5 CN leave the cranial cavity?

A
  • CNVII and VIII- internal acoustic meatus
  • CNIX, X and XI- jugular foramen
  • CNXII- hypoglossal canal
74
Q

What is involved in the clinical testing of the trigeminal?

A
  • close eyes and use cotton wool to test sensory areas of the face (S)
  • palpate the temporalis and masseter with teeth clenched
  • patient open jaw against resistance (M)
75
Q

What is involved in the clinical testing of the facial nerve?

A
  • frown, close eyes tight, smile and puff out cheeks to check muscles of facial expression
  • ask about taste
76
Q

What is involved in the clinical testing of the vagus nerve?

A
  • say ‘ah’ to test palate (also tests CNV3 due to tensor veli palantini) and make sure uvula goes straight up
  • swallow
  • listen to speech
  • cough
77
Q

What does CNXI supply?

A

sternocleidomastoid and trapezius

78
Q

What is odd about the spinal accessory nerve?

A

it ascends through the foramen magnum and exits through jugular foramen

79
Q

What is involved in the clinical testing of the spinal accessory nerve?

A

shrug shoulders (trap) and turn head up to opposite side (stern)

80
Q

What is involved in the clinical testing of the hypoglossal nerve?

A

stick tongue out (points towards the side of the injury if there is one)

81
Q

What does the hypoglossal nerve supply?

A

all tongue muscles but not the palatoglossus

82
Q

What nerve is the dura mater innervated by?

A

CNV

83
Q

What are the two layers of the dura mater?

A

periosteal and meningeal

84
Q

What is the diaphragm sellae?

A

sheet that lies over the pituitary fossa

85
Q

What is the sheet that lies over the cerebellum?

A

tentorium cerebelli

86
Q

What is the falx cerebri?

A
  • midline structure
  • separates the cerebral hemispheres
  • attaches to crista galli of the ethmoid bone
87
Q

What drains the venous blood from the cranial cavity?

A
  • cerebral veins drain the brain then into
  • dural venous sinuses
  • drain into internal jugular vein
    eg superior and inferior sagittal sinuses and sigmoid sinus
88
Q

What is the arterial supply to the brain?

A

from the vertebral arteries through C6 to 1 (from RSA) and internal carotid artery

89
Q

What makes up the circle of Willis?

A
  • two vertebral arteries become one basilar artery
  • into posterior cerebral arteries
  • joins with posterior communicating to the internal carotid (gives off two terminal - middle cerebral and anterior cerebral arteries)
  • anterior communicating arteries join the cerebral arteries at the front laterally
90
Q

Where does the circle of Willis sit?

A

in the CSF in the subarachnoid space

91
Q

What is hydrocephalus?

A

excessive production or obstruction to the flow of CSF

92
Q

What is the treatment for hydrocephalus?

A

a shunt can carry excess fluid into peritoneal cavity where it is reabsorbed

93
Q

What are the three types of brain bleed?

A
  • Epidural: eg trauma to pterion
  • Subdural: eg cerebral veins from falls in the elderly
  • Subarachnoid: eg aneurysms so ruptured Circle of Willis
94
Q

What can raised ICP cause?

A

herniations which can be both supratentorial and infratentorial

My Neurology (6 decks)

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