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eMRCS questions > Anatomy nervous system > Flashcards

Anatomy nervous system Flashcards

1
Q

Order of nerves from brachial plexus

A

Roots, trunks, divisions, cords, branches

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2
Q

Which plexus does subcostal originate from

A

Lumbar

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3
Q

Saphenous nerve is a branch of

A

Femoral

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4
Q

Course of saphneous nerve

A

Runs in adductor canal with femoral artery
Doesn’t run through adductor hiatus
Crosses femoral artery to lie medially and passes between sartorial and gracilis, passing through deep fascia to run inferiorly with great saphenous vein

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5
Q

Branches of facial nerve extracranial

A

Branches to posterior auricular, stylohyoid, and to post digastric

Then enters parotid
Temporal, zygomatic, buccal, marginal mandibular, cervical

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6
Q

Nerve supply of pinna and external acoustic meatus

A

Greater auricular C2
Lesser occipital
Auriculotemporal (V3)

EAM- AT ant, vagus, PA from facial

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7
Q

Nerve damaged for foot drop

A

Common peroneal

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8
Q

Klumpke vs erb palsy anatomically

A

Erb- upper trunk C5,C6

Klumpke- lower C8, T1

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9
Q

Nerve roots of medial, lateral and posterior cord

A

Lateral- C5-C7
Posterior - C5-T1
Medial - C8, T1

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10
Q

Which muscles foes medial plantar supply

A

First lumbrical
FDB
FHB
Abductor hallicus

LAFF

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11
Q

Sensory supply of forearm

A

Lateral cutaneous nerve of forearm - from muscocutaenous
Medial cutaneous- brachial plexus
Posterior -radial nerve

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12
Q

Course of superficial radial nerve

A

At the cubital fossa as the radial nerve divides into superficial and deep branches at the level of the lateral epicondyle

Travels in a plane between the brachioradialis and pronator teres muscles.

About 7cm proximal to the wrist, it pierces the deep fascia of the forearm to wind around the radius, pass over the anatomical snuffbox

Provides sensory function to the dorsal of hand

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13
Q

Sensory function of radial nerve

A

Lower lateral arm
Posterior arm
Posterior forearm
Dorsal of hand - by superficial branch

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14
Q

Branches of radial nerve

A

Superficial
Deep- which continues at posterior interosseous after passing through supinator

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15
Q

Nerve roots assigned to each movement in upper limb

A

C5- elbow flexion
C6- wrist extension
C7- elbow extension
C8- flexion of middle distal phlanx
T1- little finger abduction

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16
Q

Symptoms of facial nerve palsy proximal to internal acoustic meatus

A

Hyperacousis - stapedius
Decreased salvation - nerves to sublingual and submandibular
Loss of taste in ant 2/3- chorda tympani
Unilateral face paralysis

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17
Q

Nerve root of sciatic nerve

A

L4,5 S1-3

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18
Q

Scatic nerve pathway out of pelvis

A

Greater sciatic foreamen
Under piriformis
Over top of obturator externes and quadratus femoris
On top of adductor magnus

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19
Q

Dermatomes of leg

A

L1- hip and groin
L2- Anterior thigh
L3- knee
L4- medial lower leg (floor)
L5- lateral
S1-little toe
S2- post knee
S3,4,5 smaller circles in central buttock

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20
Q

Symptoms of different areas radial nerve damage occurs

A

Above elbow- reduced sensation in forearm
In spiral groove- tricep reflex maintained, but brachioradialis decreased

Axillary- tricep reflex lost, decreased sensation of triceps

Below- sensation in tact in forearm

Wrist- isolated sensory changes in dorsum of hand

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21
Q

Vagus nerve relations

A

Passes in between internal jugular and common carotid in sheath

Right R passes under subclavian

Left R passes under aortic arch from anterior to posterior lateral to ligament arteriosum

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22
Q

Where does the radial nerve pass through triceps

A

Between medial and long head of triceps

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23
Q

Ulnar nerve roots

A

C8, T1

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24
Q

Radial nerve roots

A

C5-T1

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25
Q

Median nerve roots

A

C5-T1

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26
Q

Ulnar nerve pathway

A

Travels down between axillary vein and artery to lies posterior to carocobrachialis

Medial to brachial artery

In forearm passes between 2 heads of FDP

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27
Q

Roots of cervical plexus

A

C1-4

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28
Q

Branches of cervical plexus

A

Nerves to genio and thyrohyoid- C1

Greater auricular -C2,3- sensation to external ear and parotid

Lesser occipital - C2- posterior scalp sensory

Transverse cervical - C2 and C3. It curves around the posterior aspect of the sternocleidomastoid, and supplies sensation to the anterior neck

Ansa cervicalis - loop of nerves, formed by nerve roots C1-C3. It gives off four muscular branches:
Superior belly of the omohyoid muscle
Inferior belly of omohyoid muscle
Sternohyoid
Sternothyroid

Phrenic - C3,4,5- diaphragm

Supraclavicular nerves- C3,4 - sensory to supraclavicular fossa

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29
Q

Where to do a cervical nerve block

A

Midway up the posterior border of the sternocleidomastoid

As this is where lots of cutaneous branches emerge

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30
Q

Median nerve course

A

Lies lateral
Cross over to medial at midpoint of humerus
Separated from ulnar nerve in forearm by pronator teres

Gives off anterior interosseous
Supplying PQ, FPL, FDP

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31
Q

Phrenic nerve course

A

Arrises from anterior C3,4,5
Passing between scalenus medius and anterior
Travel laterally to vagus then anterior

Right courses inferiorly lateral to SVC onto fibrous pericardium overlying right atrium
Travels anterior to root of lung then passes through with IVC at canal orifice at T8

Left- crosses anterior arch of aorta (vagus is posterior)
Courses inferiorly anterior to left pulmonary artery
Crosses left lung root anteriorly
Pierces central tendon of diaphragm

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32
Q

Where each cervical ganglion lie

A

Superior C2-3
Middle C6
Inferior C7- often infusing with thoracic- called stellate

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33
Q

What cranial nerves receive input from superior cervical ganglion

A

II, III IV, VI and IX.

For sympathetic input

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34
Q

Action of trochlear nerve

A

Down and in

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35
Q

Nerves passing through tendinous ring

A

Superior division of the oculomotor nerve (CNIII)
Nasociliary nerve (branch of ophthalmic nerve)
Inferior division of the oculomotor nerve (CNIII)
Abducens

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36
Q

Where does the ciliary ganglion lie and what goes through it

A

Apex of orbit, lateral to optic nerve

Sensory from nasociliary
Post Sympathetic from internal carotid
Pre para from Erdinger Westphal

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37
Q

What is the carotid plexus

A

Sympathetic fibres from cervical ganglion

38
Q

Where does vagus originate

A

Medulla

39
Q

How do vagus nerves enters abdomen in relation

A

At T10
Left anterior to oesophagus
Right posterior

40
Q

Branches of vagus

A

Pharyngeal
Superior laryngeal- splits into internal and external
Recurrent laryngeal
Cardiac

41
Q

Damage to stellate ganglion can lead to

A

Horners syndrome

42
Q

Cremastatic innervation

A

Gential of genitofemoral
L1-2

43
Q

Which nerve causes Meralgia parasthesia

A

Lateral cutaneous nerve of thigh

44
Q

What may distinguish between a peripheral nerve lesions vs nerve root

A

Whether it has a motor/sensory deficit

45
Q

Symptoms of ilioinguinal injury

A

Parasthesia over pubis and anterior scrotum

46
Q

Motons neuroma effects which nerve

A

Common plantar nerve

47
Q

Origination of CN

A

CN3-4 midbrain (3 at junction)
5-8 Pons originate (6-8 junction between pons and medulla)
9-12 Medulla (11 originate in spinal cord)

48
Q

Which cranial nerves have parasympathetic innervation

A

3- sphincter pupillae, cilliary
7- lacrimal, submandibular, sublingual
9- parotid
10- abdo viscera up until colic flexure

49
Q

Is wrist extension possible if damage to posterior interosseous muscle

A

Yes
Since main branch of radial supplies EDRL

50
Q

Which 2 muscles does radial nerve pass between when entering forearm

A

Brachial and brachioradialis

51
Q

Which structure separates discs from spinal cord

A

Posterior longitudinal ligament

52
Q

What controls circadian rhythm in hypothalamus

A

Suprachiasmic nucleus

53
Q

What controls temperature in hypothalamus

A

Pre optic, anterior and posterior nuclei

54
Q

Sphenoid sinus and pituitary relation

A

Pituitary superior

55
Q

blood supply of pituitary

A

Share venous

Different arterial

ANt- superior hypophyseal artery (a branch of the internal carotid artery). This vessel first forms a capillary network around the hypothalamus

Post- inferior hypophyseal

56
Q

Areas of pituitary

A

Pars anterior – the largest part, responsible for hormone secretion.
Pars intermedia – a thin epithelial layer that separates the pars anterior from the posterior lobe.
Pars tuberalis – an upwards extension of the pars anterior that surrounds the anterolateral aspect of the infundibulum.

57
Q

Pelvic splanchnic roots

A

S2-4

58
Q

Where does the vagus supply up to in the gut and what supplies beyond

A

Until the midgut - until splenic flexure

Beyond is pelvic splanchnic

59
Q

Symp and para innervation of pupil

A

Sym- superior cervical T1
Para- CN 3

60
Q

Which ventricle is bound laterally by thalamuc

A

Third

61
Q

What is between optic chimsm and pituitary

A

Diaphragma sella
Fold of dura covering - between optic chasm

62
Q

Relation of stellate ganglion

A

Anterior to the neck of the first rib

Stellate fuses with frost thoracic

63
Q

Stroke effecting medial pons symptoms

A

Contains 6,7th CN
Also 5th and 8th

Inability to abduct, facial palsy mainly

Also cause hemisensory loss
Horners

64
Q

What area does the middle meningeal artery originate

A

Infratemporal from maxillary

65
Q

Sympathetic ganglion to abdo

A

Greater- T5-9- coeliac- foregut

Lesser- T10-11- SM- midgut

Least-T12- renal

Lumbar splanchnic- IML1-2 hindgut

66
Q

Lateral geniculate nucleus of thalamus is involved in

A

Vision

67
Q

Where taste is perceived in brain

A

Solitary nucleus

68
Q

Where is the inferior sagittal sinus located

A

Enclosed in posterior half of free margin of flax cerebri

Has no valves

69
Q

Anterior vs middle cerebral artery symptoms

A

Anterior - Leg>arm

Middle - Arm, face >leg
Largest , most commonly affected

70
Q

Branches of basilar arteries

A

AICA
Pontine arteries
Superior cerebellar
PCA

71
Q

Wernicke and Broca location and function

A

Wernicke- comprehension, temporal lobe

Broca- language production, frontal lobe of dominant

72
Q

Midbrain, pons, medulla other names

A

Midbrain- mesencephalon

Pons- meten

Medulla- myelen

73
Q

What connects hypothalamus and pituitary

A

Infundibiulum

Posterior hypothalamus- neurosecretory cells which run down to poster pituitary - called median eminence

Anterior- hypophyseal portal vessels connects

74
Q

Nucleus in hypothalamus controlling satiety

A

Verntromedial

75
Q

Where is ADH synthesised

A

Supraotpic nuclei of hypothalamus

76
Q

Sympathectomy levels and what is avoided

A

T2-3

Avoid T1 for Horners

77
Q

Stroke to thalamus symtpoms

A

Contraleteral hemianaethesia
Hyperaesthesia
Mood swings

78
Q

Cause of macular sparing homonymous hemianopia

A

Occipital stroke

If occipital pole in tact through dual supply of MCA

79
Q

Pedicles vs laminae

A

Pedicles- body and transverse

Lamina- transverse and spinous

80
Q

Intrafusal vs Extrafusal muscle fibres

A

Intrafusal- detect change of length

Extrafusal- contraction- a motor

81
Q

What can narrow spinal cord posteirorly

A

Ligamentum flavus hypertrophy

82
Q

Cause of locked in syndrome

A

Basillar artery occlusion

83
Q

Which vertebra do the facet joints lie parallel to frontal plane

A

Cervical

84
Q

Spinal nerves of sacral plexus

A

L4-S4

85
Q

Problem in spondylosis and its location

A

Pars Artciularis

Part of a vertebra located between the inferior and superior articular processes of the facet join

86
Q

Most common spondylosis vertebrae

A

L5

87
Q

Roots of femoral

A

L2-4

88
Q

Guillan Barre features

A

Ascending paralysis
Autonomic neuropathy
Arrythmia
Acute dymelingation

89
Q

Location of venous plexus of spine

A

Epidural space

90
Q

Can extend knee but not flex- level of damage

A

L5

91
Q

Myotomes of leg

A

Hip flexion- L1/2
Knee extension-L3
Dorsiflexion-L5
Great toe- L5
Ankle plantar- S1

eMRCS questions (45 decks)

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