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Phase 1 Anatomy > Anatomy - Neurology > Flashcards

Anatomy - Neurology Flashcards

1
Q

Medial plane

A

implies towards the sagittal plane/midline

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2
Q

Lateral plane

A

implies away from the sagittal plane/midline

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3
Q

Superior

A
  • towards the uppermost part of the cerebral hemisphere
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4
Q

Inferior

A
  • towards the base of the brain
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5
Q

Rostral

A
  • refers to the direction towards the front (literally the beak)
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6
Q

Caudal

A
  • refers to the direction towards the tail
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7
Q

Anterior/posterior (in brainstem and spinal cord)

A
  • towards anterior/posterior surfaces of the body respectively
  • synonymous with VENTRAL (anterior) and DORSAL (posterior)
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8
Q

Terminology in cerebral hemisphere

A
  • dorsal = superior
  • ventral = inferior
  • rostral = anterior
  • caudal = posterior
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9
Q

Terminology in referring to sections of the brain

A
  • coronal = vertical plane (perpendicular to the sagittal plane)
  • frontal = parallel (perpendicular to the sagittal plane)
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10
Q

Transverse plane

A
  • denote a plane at right angles to the long axis of a structure
  • divides the body at the waist (top and bottom halves of the body)
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11
Q

What are the three main parts of the brain?

A
  1. hindbrain
  2. midbrain
  3. forebrain
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12
Q

What is the Hindbrain also known as?

A

rhombencephalon

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13
Q

Divisions of the hindbrain

A
  1. medulla oblongata
  2. pons
  3. cerebellum
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14
Q

What is the medulla oblongata derived from?

A

myelencephalon

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15
Q

What is the pons derived from?

A

metencephalon

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16
Q

What is the cerebellum derived from?

A

metencephalon

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17
Q

What is the forebrain also known as?

A

prosencephalon (forms the majority of the brain)

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18
Q

What are the divisions of the Forebrain?

A
  1. diencephalon
  2. telencephalon
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19
Q

What is the diencephalon derived from?

A
  • anterior part of the developing neural tube
  • comprises the thalamus and hypothalamus
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20
Q

What is the telecephalon derived from?

A
  • cerebral vesicle of each side
  • consisting of an outer layer of grey matter, cerebral cortex, the basal ganglia (deep nuclei) which grows into the vesicle
  • cerebral hemisphere (description word)
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21
Q

What are the meninges?

A
  • three separate tubular sheaths of membrane
  • surround and enclose entire CNS
  • regional differences in detail of distribution and attachment exist but their basic composition is the same throughout
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22
Q

What are the three tubular sheaths of the meninges?

A
  1. dura mater
  2. arachnoid mater
  3. pia mater
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23
Q

Dura mater

A
  • fibrous sheet
  • white collagen fibres and a few elastic fibres arranged in dense laminae (often parallel fibres)
  • wide angle between direction of fibres in adjacent laminae (latticed appearance)
  • cranial dura mater has two layers: outer endosteal layer and inner meningeal layer (second is dura mater proper)
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24
Q

What is the dura mater proper?

A

the second inner meningeal layer of the dura mater

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25
Q

Arachnoid mater

A
  • named for spider-web appearance
  • poorly vascularised membrane of loose connective tissue (has collagen, elastin and reticulin fibres)
  • loosley covers brain without following the gyral and sulcal undulations
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26
Q

Pia mater

A
  • intimately adherent to entire surface of CNS (including gyrul and sulcal folds)
  • innermost layer of pial cells lies on the surface of the CNS (formed by underlying end-feet of astrocytes with their covering basement membrane
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27
Q

How is the pia mater separated from the arachnoid mater?

A
  • by the Subarachnoid space
  • contains cerebrospinal fluid (CSF)
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28
Q

White matter

A
  • formed by collections of nerve fibres (axons)
  • wrapped in fatty myelin sheaths
  • few/no neuronal somata (cell bodies)
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29
Q

Grey matter

A
  • formed by aggregations of neuronal cell bodies and their local processes
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30
Q

Neuropil

A
  • network of interconnected neuronal processes
  • occupies space between neuronal bodies
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31
Q

Difference in appearance of fatty myelin sheaths in fresh/not fresh brain

A
  • fresh: white
  • not fresh: greyish
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32
Q

Cortex

A
  • outer surface of the brain
  • formed by flatter sheets neurones
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33
Q

What shape is the grey matter in the spinal cord?

A

a butterfly shape

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34
Q

Frontal lobes- what key areas are found here?

A
  • primary motor cortex
  • prefrontal cortex
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35
Q

Temporal lobes- key features

A
  • primary auditory cortex
  • auditory association cortex (Wernicke’s area)
  • hippocampus
  • amygdala
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36
Q

Parietal lobes- what key areas are found here?

A
  • primary somatosensory cortex
  • association cortex
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37
Q

Occipital lobes- what key areas are found here?

A
  • primary visual
  • visual association cortex
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38
Q

Cerebellum- function

A
  • motor control of equilibrium, posture and muscle tone
  • movement co-ordination
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39
Q

Brainstem- key features

A
  • ascending and descending tracts
  • cranial nerve nuclei
  • reticular formation
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40
Q

What are the Gyri?

A

the rolls of cerebral cortex

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41
Q

What are the Sulci?

A

the grooves between the gyri

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42
Q

What is the central sulcus?

A
  • a large fissure separating the frontal from the parietal lobes
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43
Q

What is the lateral sulcus?

A
  • a large fissure that separates the temporal lobe from the parietal and frontal lobes
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44
Q

What are occipital poles?

A
  • the posterior most part of the occipital lobes
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45
Q

What is the insula?

A
  • forms the floor of the lateral sulcus
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46
Q

What is the opercula (lips)

A
  • the parts of the temporal, frontal and parietal lobes that overlie the insula
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47
Q

What is the Deep, interhemispheric median longitudinal fissure?

A
  • long fissure going down the midpoint of the brain
  • separates the right and left
  • sagittal
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48
Q

Corpus callosum

A
  • a large bundle of white matter connecting the two hemispheres
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49
Q

Olfactory tracts

A
  • run on the inferior surface of the frontal lobes
    (turn the brain upside down to see)
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50
Q

Optic nerves, optic chiasma, optic tracts

A
  • OPTIC NERVES are seen passing backwards and medially
  • converge in midline to form OPTIC CHIASMA
  • then pass backwards and laterally as the OPTIC TRACTS
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51
Q

Mamillary bodies

A
  • two rounded eminences behind optic chiasma
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52
Q

Hypothalamus- location

A
  • behind the optic chiasma up to and including the mamillary bodies
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53
Q

True or false? The only part of the diencephalon visible on the outside of the brain is the hypothalamus

A

true

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54
Q

Crus cerebri/crura cerebri of cerebral penducles

A
  • two large masses of white matter emerging behind mamillary bodies on each side
  • from cerebral hemisphere
  • pass backwards
  • converge in the midline at upper border of pons
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55
Q

Interpeduncular fossa

A
  • space between the crura roofed over by arachnoid
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56
Q

Pons

A
  • situated immediately behind the point where the crura meet in midline
  • forms bridge of neural tissue between the midbrain and medulla oblongata
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57
Q

Cerebellum (little brain) - general structure + location

A
  • two lobes
  • either side of medulla
  • central vermis joining the two hemispheres
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58
Q

Medulla oblongata- location

A
  • runs from caudal border of pons to where the spinal cord was cut off when brain removed
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59
Q

How many parietal lobes are there?

A

two, left and right

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60
Q

Which parietal lobe is dominant and what is it important for?

A
  • normally left
  • important for perception, interpretation of sensory information and formation of idea of complex, meaningful motor response
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61
Q

What is the supramarginal and angular gyrus of the dominant parietal lobe concerned with?

A
  • language
  • mathematical operations
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62
Q

What is the non-dominant parietal lobe and what is it important for?

A
  • usually the right lobes
  • important for visuospatial functions
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63
Q

What is the frontal lobe generally concerned with?

A
  • motor function
  • problem solving
  • spontaneity
  • memory
  • language
  • judgement
  • personality
  • impulse control
  • social and sexual behaviour
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64
Q

What is the anterior portion of the frontal lobe (prefrontal cortex) important for?

A
  • higher cognitive functions
  • determination of personality
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65
Q

What does the posterior portion of the frontal lobe contain?

A

the motor and premotor areas

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66
Q

Where is broca’s area found and what is it important for?

A
  • left inferior frontal gyrus
  • important for language production and comprehension
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67
Q

What does the temporal lobe contain?

A
  • primary auditory cortex
  • hippocampus
  • amygdala
  • Wernicke’s area
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68
Q

Where is the auditory cortex found?

A

around the lateral (sylvian) fissure in the temporal lobe

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69
Q

Where is the Wernicke’s area, what is it concerned with?

A
  • located in the superior temporal gyrus of left hemisphere
  • understanding spoken word
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70
Q

Where is the occipital lobe and what is it concerned with?

A
  • posterior aspect of brain
  • contains primary visual and visual association cortex
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71
Q

What is the limbic system?

A
  • limbic lobes surrounds medial margin of hemisphere
  • includes hippocampus, fornix, amygdala
  • involved in emotion, memory behaviour and olfaction
  • operates by influencing the endocrine system and autonomic nervous system
  • it is highly interconnected with the brains pleasure centre
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72
Q

What is the role of the hippocampus?

A
  • involved in long term memory formation
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73
Q

What is the role of the amygdala?

A
  • important in motivationally significant stimuli e.g. related to reward and fear
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74
Q

Nuclus accumbens

A
  • role in sexual arousal and the high experienced with recreational drugs
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75
Q

Describe the inner meningeal layer of the dura mater

A
  • envelopes the central nervous system
  • continues as tube of dura seen around the spinal cord
  • provides tubular sheaths for the cranial nerves
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76
Q

Why does the inner layer of the dura mater separate from the skull?

A
  • to form dural folds which support the subdivisions of the brain
  • partially divide the brain into three areas: right and left hemispheres and posterior cranial fossa (where cerebellum lies)
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77
Q

The dural venous sinuses

A
  • system of communicating blood filled spaces where the DURAL FOLDS ARE ATTACHED TO THE SKULL
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78
Q

Falx cerebri

A
  • arched crescent of dura lying in longitudinal fissure between the cerebral hemispheres
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79
Q

Superior sagittal sinus

A
  • where the falx cerebri attaches to the cranium
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80
Q

Inferior sagittal sinus

A
  • at free border of falx cerebri
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81
Q

Tentorium cerebelli

A
  • dura forming a thick fibrous roof over the posterior cranial fossa and cerebellum
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82
Q

Straight sinus

A
  • within tentorium cerebelli (at its attachment) to falx cerebri
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83
Q

Tentorial inscisure

A
  • a horseshoe-shaped space between the free concave border of tentorium and the dorsal sellae of the sphenoid
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84
Q

Transverse sinuses

A
  • along line of attachment of
  • tentorium cerebelli - occipital bone
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85
Q

Cavernous sinus position

A
  • lateral to the body of the sphenoid
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86
Q

Trigeminal cave

A
  • next to apex of petrous part of temporal bone
  • envelops the roots of the trigeminal nerve
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87
Q

Diaphragma sellae

A
  • small, circular, horizontal fold of dura mater which forms the roof of the pituitary fossa
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88
Q

Falx cerebelli

A
  • small, vertical, sickle-shaped reflection of dura
  • separates the two lobes of cerebellum
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89
Q

Subarachnoid cisterns

A
  • spaces between the arachnoid and pia mater
  • found where the arachnoid spans the gyri of the brain
  • full of CSF
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90
Q

Foramen of magendie

A
  • midline communication between the IVth ventricle and the subarachnoid space
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91
Q

Foramen of Luschka

A
  • lateral communication between the IVth ventricle and the subarachnoid space
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92
Q

What are the 6 cisterns of the subarachnoid cisterns?

A
  1. cerebellomedullary cistern
  2. pontine cistern
  3. interpeduncular cistern
  4. cistern of the lateral fissure
  5. superior cistern
  6. cisterna ambiens
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93
Q

Cerebellomedullary cistern

A
  • lies in angle formed by dorsal surface of medulla and inferior surface of cerebellum
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94
Q

Pontine cistern

A
  • on the ventral surface of the pons
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95
Q

Interpeduncular cistern

A
  • contains the circle of willis
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96
Q

Cistern of lateral fissure- what does it contain

A
  • contains the middle cerebral artery and bridges the lateral sulcus on each side
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97
Q

Superior cistern

A
  • contains the great cerebral vein (of Galen)
  • and the pineal gland
  • found between the posterior end (selenium) of the corpus callosum and the superior surface of the cerebellum
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98
Q

Cisterna Ambiens

A
  • group of subarachnoid cisterns which completely encircle the midbrain
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99
Q

What is the choroid plexus?

A

a network of blood vessels and cells in the ventricles (fluid-filled spaces) of the brain

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100
Q

True or false? The pia mater is indishtinguishable from the underlying nervous tissue with the naked eye

A

true - it also forms the blood brain barrier (acts as a barrier between the blood vessels and the neurological tissue)

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101
Q

Describe the blood brain barrier

A
  • on surface of brain the arteries lie in subarachnoid space
  • as vessels pass into the substance of the brain they take with them prolongations of pia mater and some of subarachnoid space
  • this forms a layer around the vessel
  • as it penetrates deeps into the brain tissue, tunica media thins and prolongation of subarachnoid space narrows
  • at level of capillary, basement membrans of endothelial cells and of pia fuse
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102
Q

What are the features unique to the brain and spinal cord in the blood brain barrier that limit the ability of molecules to pass between the blood and CNS?

A

(protects tissue from toxic substances)
1. edges of adjacent endothelial cells that line blood vessel are bonded closely together by ‘tight junctions’ to prevent molecules passing between them
2. basement membrane of CNS blood vessels lack ‘fenestrations’ (small holes) that are present elsewhere in the body
3. pericytes are cells that are embedded in basement membrane and wrap around endothelial cells (regulate capillary blood flow, immunity and vascular permeability)
4. astrocytes extend processes called end feet that envelop C|NS capillaries and restrict the flow of molecules into the CNS parenchyma

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103
Q

What is the cribiform plate of the ethmoid?

A

the portion of the ethmoid bone that forms the roof of the nasal cavity

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104
Q

What does the anterior cranial fossa contain?

A
  • frontal lobe of the brain
  • orbital part of frontal bone
  • ethmoid bone (cribriform plates and crista Galli)
  • lesser wing of the sphenoid bone
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105
Q

What does the middle cranial fossa contain?

A
  • temporal, parietal and occipital lobes of the brain
  • much deeper than the anterior cranial fossa
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106
Q

What does the posterior cranial fossa contain?

A
  • cerebellum, pons and medulla oblongata
  • deepest of three fossae
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107
Q

Where do the arteries and veins on the surface of the brain lie within?

A
  • the subarachnoid space, partially hidden by the arachnoid mater
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108
Q

How are the superficial cerebral veins easily distinguished?

A
  • darker in colour
  • fixed coagulated blood visible through thin fragile walls
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109
Q

How do the superficial cerebral arteries look compared to the veins?

A
  • arteries look paler
  • thicker, muscular walls and are not so easily torn
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110
Q

What are the three anatomical elements that contribute to the blood brain barrier?

A
  1. endothelial cells of capillaries
  2. basement membrane, which lies between the endothelial cells and astrocytic end feet and is formed from the true basement membrane and the pia
  3. the astrocyteic end feet themselves
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111
Q

What are the two pairs of vessels that supply arteriole blood to the brain?

A
  • internal carotid arteries (80% - of P CB + anterior + medial + diencephalon)
  • vertebral arteries (20% - of posterior cerebrum)
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112
Q

Where in the arterial blood supply to the brain is the weakest point?

A
  • at branches
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113
Q

At what level does the common carotid bifurcate into the internal and external carotid?

A
  • level of upper border of thyroid cartilage
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114
Q

Where does the internal carotid artery enter the brain from?

A
  • base of the skull
  • temporal bone
  • lies in the carotid canal
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115
Q

Describe the course of the internal carotid artery in the brain

A
  • temporal bone > carotid canal
  • > pierces the dura forming the roof of cavernous sinus to enter the cranial cavity > anterior perforated substance at medial end of lateral sulcus > divides into terminal branches (anterior and middle cerebral arteries)
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116
Q

Terminal branches off the internal caroitd artery

A
  • anterior cerebral artery
  • middle cerebral artery
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117
Q

What does the anterior cerebral artery supply?

A
  • the corpus callosum and medial aspects of the hemispheres
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118
Q

What does the middle cerebral artery supply?

A
  • largest of the terminal branches of the internal carotid artery
  • supplies majority of lateral surface of the hemisphere and deep structures of the anterior part of the cerebral hemisphere via its ANTERIOR PERFORATING BRANCHES
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119
Q

Purpose of the anterior communicating artery

A
  • connects together the two anterior cerebral arteries
  • provides anterior perforating branches
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120
Q

Purpose of the posterior communicating artery

A
  • connects the internal carotid and vertebra-basilar systems
  • via the posterior cerebral artery
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121
Q

Branches of the internal carotid artery NOT TERMINAL

Do we need to know this?

A
  • central artery
  • precentral artery
  • anterior cerebral artery
  • prefrontal artery
  • middle cerebral artery
  • anterior temporal artery
  • middle temporal artery
  • basilar artery
  • vertebral artery
  • posterior inferior cerebellar artery
  • anterior inferior cerebellar artery
  • superior cerebellar artery
  • angular artery
  • parietal artery
  • postcentral artery
  • temporo-occipital artery
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122
Q

What are the deep structures of the hemisphere, including the internal capsule supplied by?

A
  • central branches from the circle of willis
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123
Q

True or false? there is no functional anastomosis between the capillary beds and the circle of willis

A

true (clinically important as infarction of one area does not automatically mean that supply will be taken up by other vessels

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124
Q

Where does the vertebral artery arise from?

A

the subclavian artery

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125
Q

True or false? the two sides of vertebral arteries have different diameters?

A

true

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126
Q

Where do the vertebral arteries enter the skull from?

A

through the foramen magnum

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127
Q

Basilar artery

A
  • at the lower border of the pons, the two vertebral arteries unite in the midline
  • lying in the anterior median fissure on the pons
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128
Q

What is referred to as the posterior circulation?

A
  • vertebral and basilar arteries
  • branches from them
  • posterior cerebral artery
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129
Q

What is referred to as the anterior circulation?

A
  • right and left internal carotid arteries and their branches
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130
Q

True or false? the anterior and posterior circulations are linked via the circle of willis

A

true

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131
Q

Branches of the vertebro-basilar system

A
  • anterior spinal artery
  • posterior spinal arteries
  • posterior inferior cerebellar arteries
  • pontine arteries
  • labrinthine artery
  • anterior inferior cerebellar artery
  • superior cerebellar artery
  • posterior cerebellar artery
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132
Q

True or false? cerebral veins first drain into the dural venous sinuses before draining back towards the heart

A

true - they are channels formed between the two layers of dura mater

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133
Q

What are the two groups of cerebral veins?

A

Internal cerebral veins:
- run within the substance of the brain tissue and end when they reach the surface of the brain where they become external cerebral veins

External cerebral veins:
- run on the surface of the brain
- cross the subarachnoid space to drain the dural venous sinuses
- there are four named groups which drain into different dural sinuses

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134
Q

Great Cerebral vein (of Galen)

A
  • drains the deep structures of the brain
  • drains into the straight sinus
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135
Q

What do the sinuses connect?

A
  • they connect the major cerebral veins to the internal jugular veins
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136
Q

Name the 8 sinuses

A
  1. inferior sagittal sinus
  2. superior sagittal sinus
  3. straight sinus
  4. transverse sinus
  5. sigmoid sinus
  6. cavernous sinus
  7. superior petrosal sinus
  8. inferior petrosal sinus
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137
Q

Where can you find the inferior sagittal sinus?

A

at the inferior margin of the falx cerebri

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138
Q

Where can you find the superior sagittal sinus?

A

at the superior border of the falx cerebri

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139
Q

Where can you find the straight sinus?

A

in the midline of the tentorium cerebelli

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140
Q

Where can you find the transverse sinus?

A

in the posterior fixed margin of the tentorium cerebelli

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141
Q

Where can you find the sigmoid sinus?

A

a deep groove in the mastoid part of the temporal bone

142
Q

Where can you find the cavernous sinus?

A

beside the body of the sphenoid bone (contains five cranial nerves and the internal carotid artery)

143
Q

Where can you find the superior petrosal sinus?

A

in the attached lateral margin of the tentorium cerebelli

144
Q

Where can you find the inferior petrosal sinus?

A

in the groove between the petrous temporal bone and the basal part of the occipital bone

145
Q

Why does the cavernous sinus have an important clinical relevance?

A
  • houses five cranial nerves and the internal carotid artery
  • also very close to the pituitary gland
146
Q

Intracranial venous sinuses and the veins outside the skull communicate via…

A

a variable number of EMISSARY VEINS

147
Q

Why are emissary veins important?

A
  • they represent a possible route for infection or inflammation to spread into the cranial cavity from outside the skull
  • difficult to find but ‘grooves’ can be found on inside of skull that demonstrate where these veins run
148
Q

What does the brain develop from?

A
  • the hollow neural tube
  • it remains hollow
  • central spaces form the ventricles
149
Q

Why are the ventricles in the brain important?

A
  • involved in formation and circulation of CEREBROSPINAL FLUID (CSF)
  • the largest aggregation of choroid plexus is in the lateral ventricles
150
Q

Where is the majority of CSF formed?

A
  • in the choroid plexus in the ventricle of the brain
151
Q

How does the CSF travel after it has been made in the choroid plexus?

A
  • passes through the interventricular foramen into the IIIrd ventricle
  • then travels backwards through the cerebral aqueduct into the IVth ventricle
  • IVth ventricle communicates with the subarachnoid space via the median foramen of magendie and lateral foramen of Luschka
  • through these openings CSF passes out to occupy the subarachnoid space around the brain and the spinal cord
152
Q

The Choroid Process

A
  • invagination of vessels into the ventricles produces a vascular fold of pia mater
  • covered by an epithelium derived from ependymal lining of the ventricle
153
Q

What prevents passage of fluid from the extracellular space of the choroid plexus into the ventricle except via choroid cells themselves?
What does this enable?

A
  • tight junctions
  • enables close control over the volume and composition of the CSF
154
Q

Arachnoid granulations

A
  • projections of the arachnoid membrane (villi) into the dural sinuses
  • allow CSF to pass from the subarachnoid space into the venous space
155
Q

Ependyma

A
  • constitutes the CSF brain barrier
156
Q

Function of the arachnoid villi (tufts of arachnoid mater)

A
  • resorption of the CSF into the venous drainage of the brain
157
Q

What happens to arachnoid villi as you age?

A
  • these villi tend to calcify
  • will form arachnoid granulations
158
Q

What does the presence of arachnoid granulation cause occurrence of?

A
  • cause bone to be resorbed along the internal surface of the cranial vault near the midline
  • causing a pit-like structure
159
Q

Magendie foramen is the…

A

medial aperture

160
Q

Luschka foramen is the…

A

Lateral aperture

161
Q

Sella turcica

A
  • saddle shaped depression in the body of the sphenoid bone
  • holds the pituitary gland
162
Q

Foramen rotunda

A
  • greater wing of sphenoid bone
  • posterior to medial end of the superior orbital fissure
163
Q

Foramen lacerum

A
  • internal carotid artery emerges from here
164
Q

Foramen ovale

A
  • the mandibular nerve passes through here
165
Q

Foramen spinosum

A
  • middle meningeal artery
  • middle meningeal vein
  • meningeal branch of the mandibular nerve
166
Q

Internal acoustic (auditory) meatus

A
  • temporal bone
  • between inner ear and posterior cranial fossa
167
Q

what is cranial nerve 6

A

Abducens nerve

168
Q

What is the supra-orbital nerve?

A

a branch of the frontal nerve

169
Q

What is cranial nerve 5?

A

Trigeminal nerve
V1 - maxillary
V2 - ophthalmic
V3 - mandibular

170
Q

Levator palpebrae superioris

A
  • muscle in the eyelid
  • originates: posterior of orbit at the common tendinous ring
  • inserts: into the upper eyelid
171
Q

What is the common tendinous ring?

A
  • ring of fibrous tissue surrounding the optic nerve at its entrance at the apex of the orbit
172
Q

Lacrimal gland

A
  • inside lateral margin of orbit
  • adjacent to lateral margin of levator palpebrae superioris
173
Q

Superior rectus

A
  • originates: common tendinous ring
  • inserts: behind conjunctival sac
174
Q

What is cranial nerve 4?

A
  • trochlear nerve
  • at medial edge of superior orbital fissure passing forward from cavernous sinus
  • terminates on superior oblique muscle
175
Q

Lateral rectus muscle

A
  • running along the length of lateral walls of the orbit on a deeper plane to the lacrimal gland
176
Q

What is cranial nerve 3?

A
  • oculomotor nerve
  • deep to levator palpebral superioris
177
Q

Superior oblique

A
  • originates at the posterior of the orbit
  • runs forawrd to pass through the trochlear
  • inserts onto the posterior part of the eyeball
178
Q

Trochlea

A
  • structure that the superior oblique muscle passes through
179
Q

Medial rectus muscle

A
  • running along the length of the medial aspect of the orbit on a deeper plane than the superior oblique muscle
180
Q

What is cranial nerve 2?

A

the optic nerve

181
Q

Ophthalmic artery

A
  • first branch from internal carotid
182
Q

Nasociliary nerve

A
  • sensory nerve to the eye
  • attached to the ciliary ganglion
183
Q

What is cranial nerve 3?

A
  • Oculomotor nerve
  • supplies both medial and inferior rectus muscles
184
Q

What is cranial nerve 6?

A
  • Abducens nerve
  • supplies lateral rectus muscle
185
Q

Where is the inferior oblique muscle?

A
  • deepest plane
  • passing from the medial aspect of the orbit postereolaterally to insert onto the sclera behind the equator of the eyeball
186
Q

Where is the lacrimal puncti?

A
  • small medial holes in the upper and lower eyelids
187
Q

What is the medial palpebral ligament?

A
  • a ligament of the face
  • attaches to frontal process of maxilla, lacrimal groove and tarsus of each eyelid
188
Q

What is the tarsus of the eyelid?

A
  • dense connective tissue
  • contain eyelash follicles
189
Q

What is the nasolacrimal duct?

A
  • drains the inferior part of the lacrimal sac to the nasal cavity
190
Q

Which cranial nerves are responsible for parasympathetic outflow from the CNS?

A
  • CN III
  • CN VII
  • CN IX
  • CN X
    (+ sacral spinal segments 2, 3 and 4)
191
Q

True or false? Cranial nerves III and VII have branches to the orbit

192
Q

Where do the parasympathetic fibres in the oculomotor nerve (CN III) originate from?

A
  • Edinger-westphal nucleus in the mid-brain
  • travels into the branch to the inferior oblique muscle
  • leave the nerve to inferior oblique and enter a small ganglion (ciliary ganglion)
  • gives fibres that innervate the ciliary muscle (accommodation) and the sphincter papillae
193
Q

Where do the parasympathetic fibres in the facial nerve (CN VII) leave the nerve?

A
  • in the middle ear to synapse in a ganglion in the pterygopalatine fossa and supply the lacrimal gland
194
Q

Sympathetic outflow from the CNS is from the spinal segments…

A

T1 - L2
(these fibres pass into the sympathetic trunks which run from the base of the skull to the bottom of the sacrum)

195
Q

Where do the sympathetic fibres to the orbit arise from and where do they go from there?

A
  • segment T1
  • pass up the sympathetic trunk through the stellate ganglion to the base of the skull
  • leave the superior cervical ganglion of the sympathetic trunk to supply the dilator papillae muscle and blood vessels
196
Q

What do extraocular muscles do?

A
  • move the front of an eye in a specific direction or directions
197
Q

Movement of the medial rectus

A
  • move eye inwards towards the nose (adduction)
198
Q

What is the medial rectus innervated by?

A
  • oculomotor nerve (CN III)
199
Q

Movement of the lateral rectus

A
  • moves eye outwards away from the nose (abduction)
200
Q

What is the lateral rectus innervated by?

A
  • abducens nerve (CN VI)
201
Q

Movement of superior rectus

201
Q

What is the superior rectus innervated by?

A
  • oculomotor nerve (CN III)
202
Q

Movement of inferior rectus

A
  • primarily moves the eye downward (depression)
  • secondarily rotates the top of the eye away from the nose (extorsion)
  • tertiarily moves the eye inward (adduction)
203
Q

What is the inferior rectus innervated by?

A
  • oculomotor nerve (CN III)
204
Q

Movement of the superior oblique

A
  • primarily rotates the top of the eye toward the nose (intorsion)
  • secondarily moves the eye downward (depression)
  • tertiarily moves the eye outward (abduction)
205
Q

What is the superior oblique innervated by?

A
  • trochlear nerve (CN IV)
206
Q

Movements of the inferior oblique

A
  • primarily rotates the top of the eye away from the nose
  • secondarily moves the eye upward (elevation)
  • tertiarily moves the eye outward (abduction)
207
Q

What is the inferior oblique innervated by?

A
  • oculomotor nerve (CN III)
208
Q

Mnemonic to explain action of the superior and inferior muscles in the eye

A
  • RAD SIN
  • Rectus ADucts (therefore oblique abducts)
  • Superior INtorts (inferior extorts)
209
Q

Mnemonic to explain innervation of the extraocular muscles

A
  • LR6 SO43
  • Lateral Rectus is innervated by the abducens nerve (CN VI)
  • Superior Oblique is innervated by the trochlear nerve (CN IV)
  • all other extraocular muscles are innervated by oculomotor nerve (CN III)
210
Q

Petrous temporal bone

A

in floor of middle cranial fossa

211
Q

Greater petrosal nerve

A

parasympathetic branch of the facial nerve CN VII emerges from the petrous temporal bone and passes anteromedially

212
Q

Tegmen tympani

A

lies lateral and posterior to the greater petrosal nerve

213
Q

Tympanic membrane

A

malleus is attached to it and articulates with the incus

214
Q

Chorda tympani nerve

A

branch of the facial nerve CN VII crossing the tympanic membrane

215
Q

Internal acoustic meatus

A

transmits the facial CN VII and vestibulocochlear CN VIII nerves

216
Q

What is the midbrain divided into?

A
  • dorsal tectum
  • ventral tegmentum
217
Q

What is the medulla oblongata limited by?

A
  • the caudal border of the pons and the bulbopontine sulcus
218
Q

What is the bulbopontine sulcus?

A
  • transverse groove at the caudal border of the pons
219
Q

What is the basilar sulcus?

A
  • a shallow sulcus in which thr basilar artery runs
  • through the midline of the pons
220
Q

What are middle cerebellar peduncles?

A
  • lateral extensions of neural tissue from the pons to the cerebellum
221
Q

Ventrolateral suclus on medulla

A
  • on lateral border of the pyramid on each side continuous with the same groove in the spinal cord
222
Q

Olive

A
  • lateral to ventrolateral sulcus
  • caused by presence of underlying structure inferior olivary nucleus
223
Q

Inferior olivary nucleus

A
  • concerned with control of movement
224
Q

Inferior cerebellar peduncle

A
  • forms posterolateral margin of the medulla
  • a thick bundle of white matter passing into the cerebellar
225
Q

Superior colliculi

A
  • part of visual system
  • concerned with visual reflexes
226
Q

Inferior colliculi

A
  • part of auditory system
  • concerned with reflex of looking towards a loud noise
227
Q

Superior cerebellar peduncle

A
  • fibre bundle passing from the cerebellum to the midbrain
228
Q

Pineal gland

A
  • endocrine gland that synthesises melatonin which modulates sleep patterns in both circadian and seasonal cycles
229
Q

What are the two important nerve pathways hat lie just deep to the surface in the midbrain?

A
  • inferior brachium
  • superior brachium
230
Q

Inferior brachium

A
  • conveys auditory information from the medial geniculate body (nucleus) to the inferior colliculi
231
Q

Superior brachium

A
  • conveys visual information from the lateral geniculate body (nucleus) to the superior colliculi
232
Q

What does the tegmentum of the pons contain?

A
  • nuclei of CN VI
  • nuceli of CN VII
  • nuclei of CN V
233
Q

What is the gracile tubercle?

A
  • round swelling on either side of the midline in the medulla
  • overlying the gracile fasciculus
234
Q

Gracile fasciculus

A
  • carries fine touch, vibration, two-point discrimination and proprioception from the lower limb
235
Q

What does the tegmentum of the medulla contain?

A
  • nuceli of CN: IX, X, XI and XII
236
Q

Dorsal column medial lemniscal system DCMLS

A
  • nuclei underlying the gracile and cuneate tubercles
  • major relay site for the dorsal column sensory pathway
237
Q

True or false? The cerebellum is the largest part of the hindbrain?

238
Q

Describe the cerebellum

A
  • two ovoid hemispheres
  • joined by midline by the narrow median VERMIS
  • consists of outer layer of grey matter, cortex and inner core of white matter
239
Q

What is the folia of the cerebellar cortex?

A

the curves and ridges on the outside

240
Q

Red nucleus

A
  • circular mass of grey matter
  • ventro-lateral to the cerebral aqueduct
241
Q

Substantia nigra

A
  • black band of nerve cells overlying the crus cerebri (cerebral peduncles)
  • ventro-lateral to the red-nucleus on each side
242
Q

Primary fissure of the cerebellum

A
  • deeper
  • marks the division betweent the anterior and posterior lobes of each cerebellar hemisphere
243
Q

Tonsil (cerebellum)

A
  • a prominent rounded swelling of the cerebellar cortex anteriorly on either side of the vermis
244
Q

Flocculus (cerebellum)

A
  • approximately ovoid in shape with a crinkled edge
  • posterior to the lateral foramen of 4th ventricle on each side partly covered by choroid plexus
  • caudal to entry point of CN VIII and crossed anteriorly by emerging CN X and XII
245
Q

Nodule (cerebellum)

A
  • continuous with the flocculus via a peduncle of white matter
246
Q

Flocculo-nodular lobe (cerebellum)

A
  • the flocculus and nodule together
  • primarily concerned with vestibular information
247
Q

Corticopontocerebellar pathway/tract

A
  • information from the primary motor cortex of the motor plan
  • same information goes to the spine
248
Q

Vestibulocerebellar tract

A
  • vestibular impulses from labryrinths, directly and via the vestibular nucleus
249
Q

Vestibulocerebellar tract

A
  • vestibular impulses from labryrinths, directly and via the vestibular nucleusk
250
Q

Spinocerebellar tracts

A
  • sensory input for balance and position sense
251
Q

Dentate nucleus

A
  • largest and most lateral of the deep cerebellar nuclei
  • zig-zag edged oval mass with its major fibre bundles passing into the superior cerebellar peduncle
252
Q

Rhomboid fossa

A
  • diamond shaped floor of 4th ventricle
  • limited laterally by cerebellar peduncles
  • posteriorly by the gracile and cuneat tubercles
253
Q

Median sulcus

A
  • divides the rhomboid fossa into triangular left and right halves
254
Q

Facial colliculus

A
  • rounded swelling caused by fibres of facial nerve
  • in substance of the pons curving around the nucleus of the abducens nerve at level of superior fovea
255
Q

Medullary striae

A
  • aberrant ponto-cerebellar fibres passing from the pons to the cerebellum
  • they divide the floor of the ventricle into a rostral pontine half and a caudal medullary half
256
Q

Locus coeruleus

A
  • bluish-grey pigmented noradrenergic cells
  • under the ependyma at the rostral half of the sulcus limitans
  • small brainstem nucleus
257
Q

Hypoglossal trigone

A
  • medial triangular area overlying the hypoglossal nerve nucleus
258
Q

Vagal trigone

A
  • intermediate triangular area overlying the vagus nerve nucleus
259
Q

Vestibular trigone

A
  • lateral triangular area overlying the vestibulocochlear nerve nucleus
260
Q

Obex

A
  • inferior apex of the rhomboid fossa
261
Q

Area postrema

A
  • a small tongue-shaped area immediately rostra-lateral to the obex
  • site commonly associated with nausea control
  • chemoreceptive trigger zone for emetic response and lies outside the blood-brain barrier
262
Q

Area postrema

A
  • a small tongue-shaped area immediately rostra-lateral to the obex
  • site commonly associated with nausea control
  • chemoreceptive trigger zone for emetic response and lies outside the blood-brain barrier
263
Q

Splenium

A
  • posterior end of the corpus callosum
264
Q

Septum pellucidum

A
  • thing triangular double membrane
  • separating the frontal horns of the right and left lateral ventricles of the brain
265
Q

Paracentral lobule

A
  • U-shaped gyrus surrounding the medial extenion of central gyrus
  • contains representations of lower limb within the primary motor and somatic sensory areas of the cortex which on the lateral surface occupy the pre-central and post-central gyri respectively
266
Q

Cingulate sulcus

A
  • separates cingulate gyrus
  • runs above corpus callosum from rest of hemisphere
267
Q

Calcarine sulcus

A
  • roughly at right angles to parieto-occipital sulcus
  • runs posteriorly to reach the occipital lobe
  • primary visual cortex lies in the walls of the calcarine sulcus
268
Q

Pre-occipital notch

A
  • lies posteriorly on the inferolateral border of the hemisphere, vertically below and slightly in front of the point where the Pareto-occipital sulcus reaches the supero-lateral margin
269
Q

Striae of genari

A
  • white band in primary visual cortex running parallel with the pial surface in the mid-depth of the grey matter
  • this prominent feature gives the name striate cortex to the primary visual area
270
Q

Genu

A

anteiror curved end of the brain

271
Q

Splenium

A

rounded posterior end

272
Q

Fornix

A
  • bundle of white matter beneath the body of the corpus callosum
  • connects the hippocampus with the diencephalon and precommisural septum
273
Q

Commisure of the fornix

A
  • fibres from one hippocampus cross to the opposite fornix and so back to the opposite hippocampus
274
Q

Columns of the fornix

A
  • anterior and posterior extensions of the fornix
  • anteriorly they extend vertically downwards to the mamillary bodies
275
Q

Anterior commissure

A
  • thick bundle of white matter crossing the midline horizontally between the lamina terminals and the fornix
  • crosses to interconnect the temporal lobes and olfactory structures of each side
276
Q

Septum pellucidum

A
  • two thin vertical sheets made primarily of glia with a few white fibres
  • sparse grey matter and a covering of ependyma at the anterior inferior border of the corpus callosum from the fornices
277
Q

Lamina terminalis

A
  • thin sheet of ependyma and pia which extend downwards
  • from the rostrum of the callosum and fornix to the anterior wall of the IIIrd ventricle
278
Q

Interthalamic adhesion

A
  • flattened grey disc joining the thalami of each side
  • behind the interventricular foramen
  • may be absent
279
Q

Hypothalamic sulcus

A
  • shallow groove on lateral wall of IIIrd ventricle
  • extending from the cerebral aqueduct to the interventricular foramen
  • divides diencephalon into dorsal and ventral part
280
Q

Medial geniculate nucleus/body

A
  • relays auditory information from midbrain to auditory cortex
  • passes some fibres via the inferior brachium to the inferior colliculi
281
Q

Lateral geniculate nucleus/body

A
  • relays visual information from the optic nerve to both the visual cortex via the optic radiation (for vision) and the superior colliculi via the superior brachium (for pupillary reflexes)
282
Q

Hypothalamus

A
  • a ventral part of the diencephalon that extends from the lamina terminals in front to a vertical plane immediately behind the mamillary bodies
  • the hypothalamus is an important centre contributing to body homeostasis and to autonomic nervous and neuroendocrine systems control
283
Q

Subthalamus

A
  • a ventral part of the dienchephalon below thalamus and lateral to the hypothalamus merging posteriorly with the tegmentum
  • functionally this region is closely associated with the basal ganglia
284
Q

Preoptic area

A
  • adjacent to the lamina terminalis and in front of the optic chiasma
  • should be included as part of the hypothalamus on functional grounds
285
Q

Association fibres

A
  • link cortical regions within one cerebral hemisphere
286
Q

Commissural fibres

A
  • link similar functional areas of the two hemisphere
  • e.g. corpus callosum
  • upper and lower limb representations in somatic sensory cortex neither send nor receive commissural fibres due to it containing representations of either one half or the body of one hemi-visual field
287
Q

Projection fibres

A
  • these link the cortex the subcortical structures such as the thalamus and spinal cord via the internal capsule and the corona radiata
288
Q

True or false? the callosal connections are restricted to those parts containing the representation of the vertical midline of the retina while the periphery has no such connections

289
Q

True or false? The olfactory system is intimately related to the limbic system

290
Q

What connects the structures in the limbic system?

A

the papez system

291
Q

Parahippocampal gyrus

A
  • continuity with cingulate gyrus around splenium of corpus callosum
  • part of the temporal lobe
292
Q

UNCUS

A
  • hook shaped region of cortex at anterior end of temporal lobe
  • plays a role in olfaction, emotions and memory
293
Q

Olfactory tract

A
  • runs on the orbitofrontal surface of the brain
294
Q

Olfactory striae

A
  • medial and lateral (most of the fibres)
  • the olfactory tract divides into these along the anterior border of the anterior perforated substance
  • lateral striae run to the uncus
295
Q

Cingulum bundle

A
  • one of the many association fibre bundles
296
Q

What are association fibres?

A
  • axons interconnecting different areas of the cerebral cortex of one hemisphere
297
Q

What is the largest bundle of association fibres?

A
  • superior longitudinal fasciculus
298
Q

Corona radiata

A
  • white matter sheet
  • contains ascending and descending tracts
299
Q

choroid fissure

A
  • c shaped site of attachment for the choroid plexus in the lateral ventricles
300
Q

Caudate nucleus

A
  • head, body and tail
  • forms a large bulge into the infero-lateral aspect of the anterior horn of the ventricle
301
Q

stria terminalis

A
  • slender bundle of white fibres
  • accompany the curve of the caudate around into the temporal horn of the ventricle
  • connect the amygdala with the septum and hypothalamus
302
Q

Amygdaloid body

A
  • continuation of tail of caudate and stria terminalis at tip of inferior horn
303
Q

Amygdala (amygdaloid body)

A
  • shaped like an almond
  • overlies on medial side of tip of inferior horn deep to uncus
  • continuous medially with cortex of temporal lobe and posteriorly with tail of caudate nucleus
304
Q

Fimbria

A
  • efferent fibres from the hippocampus heading to the fornix forming a flattened, longitudinal bundle of white matter of medial argin of ventricular surface of hippocampus
305
Q

extreme capsule

A
  • white matter
306
Q

Claustrum

A
  • forms part of basal ganglia being subcortical nucleus derived from telencephalon
  • recieves from and projects to cerebral cortex in a topographically organised manner
  • known to have cells within it which respond to visual, auditory and sensory stimuli
307
Q

external capsule

A
  • white matter separating putamen from claustrum
308
Q

lentiform nucleus

A
  • comprised of putamen and medial globus pallidus
309
Q

lateral medullary lamina

A
  • white matter between putamen and medial globus pallidus
310
Q

lateral globus pallidus

A

grey matter

311
Q

medial medullary lamina

A
  • white matter between lateral and medial globus pallidus
312
Q

medial globus pallidus

A

grey matter

313
Q

internal capsule

A
  • convergence and concentration of white matter projection fibres which carries all motor and sensory fibres from and to the cortex
314
Q

Corona radiata

A
  • white matter fibres radiating from internal capsule
  • deep to lentiform
315
Q

Forceps major

A
  • posterior curve of corpus callosum fibres into parietal and occipital lobes
  • form ~2/3rds of a circle with the opposite side
316
Q

Forceps minor

A
  • anterior curve of corpus callosum fibres into the frontal lobe forming 2/3rds of a cricle with the opposite side
317
Q

Lacunar stroke

A
  • occlusion of a deep perforating artery
  • risk factors: hypertension, smoking and diabetes mellitus
  • lesions occur in deep nuclei pons or internal capsule
318
Q

What can happen due to a stroke in the internal capsule?

A
  • hemiparesis typically affecting half the face, one arm or leg
  • ataxic hemiparesis most commonly affecting the leg (combination of cerebellar and motor symptoms)
  • mixed sensorimotor stroke if thalamus is also affected, causing hemiparesis with ipsilateral sensory impairment
319
Q

Describe how many vertebrae there are in the spinal cord?

A
  • cervical: 7
  • thoracic: 12
  • lumbar: 5
  • sacrum: 5 fused vertebrae
  • coccyx: 4 fused (rudimentary) vertebrae
320
Q

Sacroilliac joints

A
  • link between pelvis and lower spine
  • they support the weight of the upper body whilst standing
321
Q

What is the highest point of the iliac crest in line with?‌

322
Q

True or false? the sinusoidal shape of the vertebral column is developed after birth

A

true
- secondary curvatures with convexity develop in the cervical region when she child holds their head up
- also in the lumbar region when the legs start weight bearing

323
Q

Describe the shape of the spine in a foetus

A
  • vertebral body is a c shape with concavity facing anteriorly
324
Q

Movements of the vertebral column

A
  • forward flexion (40 degrees)
  • extension (15 degrees)
  • lateral flexion (30 degrees)
  • rotation (40 degrees)
325
Q

Where is the maximum rotation possible in the spinal cord?

A

thoracic region

326
Q

Where in the spinal cord is the least flexion and extension?

A
  • thoracic (due to presence of rib cage)
327
Q

Intervertebral discs

A
  • strong fibrocartilaginous structures
  • can withstand compression forces
  • flexible enough to allow movements between vertebrae
  • made of: nucleus pulposus surrounded by annulus fibrosis
328
Q

Nucleus pulposus

A
  • a well hydrated gel having proteoglycan, collagen and cartilage cells
329
Q

Annulus fibrosis

A
  • made up of 10-12 concentric layers of collagen (oblique arrangment alters in successive layers)
  • peripherally it is attached to vertebral bodies and to posterior longitudinal ligament
330
Q

Herniation of intervertebral disc

A
  • narrows intervertebral foramen
  • cause compression of nerve root
  • more common in lumbar region
  • nucleus pulposus bulges out into spinal canal/intervertebral foramina
  • straight posterior herniation is prevented by firm attachment of disc to posterior longitudinal ligament
  • herniation into intervertebral foramina is more common
331
Q

Arthiritis of facet joints/bony irregularities in pedicle or vertebral body

A
  • can narrow intervertebral foramen and cause nerve root compression
332
Q

Radiculopathy

A
  • nerve root pathology
  • most commonly compression due to prolapsed intervertebral disc
  • most common: L5/S1 or C6/7
333
Q

Sciatica

A
  • compression or irritation of sciatic nerve L5
  • signs and symptoms: pain radiating down buttoc into leg down to calf, weakness in dorsiflexion causes foot drop, abnormal gait
334
Q

Epidural space (spinal cord)

A
  • space between vertebrae and dura mater
  • contains small arteries which supplies spinal cord and vertebral venous plexuses
  • veins in these plexuses (batson’s veins) contain no valves and communicate freely with intercostal veins and pelvic veins including veins draining the prostrate
335
Q

Cauda equina syndrome

A
  • compression of nerve roots below spinal cord termination (L1-S5)
  • most commonly caused by disc prolapse at L4/5 or L5/S1
  • signs: low back pain, perineal paraesthesia, decreased anal tone, bladder dysfunction, faecal incontinence, sciatica, variable lower extremity motor and sensory loss, sexual dysfunction
336
Q

How many spinal nerves do we have?

A
  • total: 31
  • cervical: 8
  • thoracic: 12
  • lumbar: 5
  • sacral: 5
  • coccygeal: 1
337
Q

Dorsal root

A

sensory and posterior

338
Q

Ventral root

A

motor and anterior

339
Q

Spinal nerve is formed by?…

A
  • anterior and posterior roots joining together at intervertebral foramen
340
Q

What occurs when the spinal nerve emerges from the intervertebral foramen?

A
  • it divides immediately into anterior and posterior rami
  • each containing both motor and sensory fibres
341
Q

True or false? the length of the nerve roots increases progressively from above downwards

342
Q

What forms the cauda equina?

A
  • lumbar and sacral nerve roots below the termination of the cord
343
Q

From where do the spinal nerves leave the vertebral canal?

A
  • through intervertebral foramen
344
Q

Anteriorly, the intervertebral foramen is bounded by?…

A

bodies of adjoining vertebrae and intervening intervertebral disc

345
Q

Posteriorly, the intervertebral formane is bounded by?…

A

synovial joints between two superior and two inferior articular processes

346
Q

Conus medullaris

A
  • tapering end of cord
347
Q

Filum terminale

A
  • fibrous strand extending from conus medullaris to coccyx
348
Q

Where in the spinal cord do the subarachnoid space and CSF extend into?

A

upper half of the sacrum

349
Q

mnemonic for spinocerebellar tracts

A

COVID
- contralateral is ventral
- ipsilateral is dorsal

Phase 1 Anatomy (8 decks)

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