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Medicine > C&M Upper limb- control > Flashcards

C&M Upper limb- control Flashcards

1
Q

What is the name of the fissure that divides the cerebrum into two hemispheres

A

Great longitudinal fissure

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2
Q

What does the central sulcus divide

A

The frontal lobe from the parietal lobe
Pre central gyrus (motor cortex)
Post central gyrus (sensory cortex)

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3
Q

What structure separates the frontal lobe from the temporal lobe

A

Lateral sulcus

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4
Q

What are the 3 initial swellings in the rostral neural tube

A

Prosencephalon- forebrain
Mesencephalon- midbrain
Rhombencephalon- hindbrain

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5
Q

What do the 5 swellings become

A 
Telencephalon- cerebral hemispheres
Diencephalon- thalamus and hypothalamus
Mesencephalon- midbrain
Metencephalon- pons and cerebellum
Myelencephalon- medulla oblongata
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6
Q

What 2 layers make up the dura mater

A

Periosteal
Meningeal
Separate at dural venous sinuses

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7
Q

How does the internal carotid artery enter the skill

A

Carotid Canal

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8
Q

What is craniosynostosis: symptoms and treatment

A

Premature sutural fusion of the skull
Abnormal head shape, Raise ICP, cognitive deficits
Requires extensive surgical re-modelling of the cranial vault

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9
Q

What structures make up the brainstem

A

Midbrain
Pons
Medulla Oblongata

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10
Q

Boundaries of the brainstem

A

Caudally: Medulla continuous with spinal cord
Rostrally: Midbrain continuous with diencephalon
Ventrally: Clivus of occipital bone
Dorsally: Cerebellum

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11
Q

What structure separates the pyramids of the ventral medulla

A

Anterior Median Fissure

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12
Q

What structure separates the pyramids from the olives on the ventral medulla and what emerges from here

A

Anterolateral sulcus

Hypoglossal nerve emerges here

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13
Q

What nerves emerge at the posterolateral sulcus dorsal to the olives

A

Glossopharyngeal (9) and vagus (10)

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14
Q

What structure forms the roof of the 4th ventricle

A

Superior Cerebellar Peduncle

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15
Q

What structure forms the floor of the 4th ventricle

A

Rhomboid fossa

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16
Q

Where does the trochlear nerve emerge

A

Inferior to the inferior colliculi on the dorsal midbrain

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17
Q

What structure runs through the midbrain

A

Cerebral aquaduct

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18
Q

What are the 3 structures that can be found rostral to the obex at any point in the brainstem cross section

A

Basal- most anteriorly
Tegmentum- anterior to ventricular system
Tectum (midbrain- colliculi) posterior to ventricular system

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19
Q

What does the tegmentum contain

A

Cranial nerve nuclei and tract, reticular formation and some

ascending/descending pathways

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20
Q

What does the basal brainstem contain

A

descending fibres from cerebral cortex (pyramids, cerebral peduncles)

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21
Q

What does the reticular formation in the tegmentum control

A

Reticular nuclei – give rise to a descending motor pathway (reticulospinal tract)
Vital autonomic centres – eg. respiratory, cardiovascular
Cells giving rise to Ascending Reticular Activating System – pass to the cortex and involved in consciousness (damage = coma)
Modulate pain
Sleep wake cycle
Arousal

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22
Q

Where is the Edinger Westphal Nucleus and what does it control

A

Midbrain medial to occulomotor nucleus

Sends parasympathetic visceral fibres to sphincter pupillae and ciliary muscles- change pupil size

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23
Q

What are the 4 autonomic ganglia of the head and neck

A

Cilary
Otic
Pterygopalatine
Submandibular

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24
Q

Function of facial nerve

A

Muscles of facial expression, taste anterior 2/3rds tongue, parasympathetic to all glands except parotid

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25
Q

Which nerves exit the skull via the jugular foramen

A

Glossopharyngeal, vagus, accessory

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26
Q

Which nerves exit the skull via the internal acoustic meatus

A

Facial and vestibulocochlear

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27
Q

Function of glossopharyngeal nerve

A

Swallowing, parasympathetic to parotid, taste posterior 1/3rd tongue, cutaneous sensation from ear, sensation from carotid body

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28
Q

Function of accessory nerve

A

Motor to sternocleidomastoid and trapezius

29
Q

What foramen does the middle meningeal artery travel through the skull

A

Foramen spinosum

30
Q

How does the accessory nerve enter and leave the skull

A

Enters via Foramen magnum

Exits via Jugular foramen

31
Q

What lies in-between the two thalami

A

Third ventricle

32
Q

What is the function of the sub thalamus

A

Lateral structure
Part of basal ganglia
Involved in motor control

33
Q

What is the function of the epithalamus

A

Includes the pineal gland

Secretes melatonin; circadian rhythm maintenance

34
Q

What does the lamina terminalis form

A

Corpus callosum and anterior white commissure

35
Q

Do commissural fibres cross hemispheres

A

Yes

Corpus Callosum and Anterior Commisure

36
Q

Do association fibres cross hemispheres

A

No- communication between gyri in one hemisphere

short and long fibres

37
Q

What is the internal capsule

A

A v-shaped bundle of white matter lateral to the thalamus

Contains projection fibres that carry info from thalamus to/from cortex

38
Q

What makes up the lentiform nucleus

A

Globus pallidus

Putamen

39
Q

What is the basal ganglia

A

Lentiform nucleus + caudate nucleus

Deep grey matter nuclei controlling movement

40
Q

How does CSF travel from the lateral ventricles to the third ventricle

A

Interventricular foramen

41
Q

How does CSF travel from the 3rd ventricle to the 4th ventricle

A

Cerebral aquaduct

42
Q

How does CSF leave the 4th ventricle to the subarachnoid spaces

A

Lateral and median apertures

43
Q

What produces CSF

A

Choroid plexus (lining of ventricles) uses plasma from blood to produce approx 500ml/day

44
Q

How does the CSF leave the subarachnoid space

A

Through arachnoid villi to dural venous sinuses and into venous circulation (mainly superior saggital sinus)

45
Q

Which ventricle produces the most CSF

A

Lateral ventricle choroid plexus

46
Q

Where is the primary auditory cortex

A

Superior temporal gyrus (Heschl’s)

47
Q

What is the function of the cingulate gyrus

A

Integrating sensation and motor function with memory (associated with hippocampus in the temporal lobe)

48
Q

Primary olfactory cortex

A

Uncus (anterior extremity of parahippocampal gyrus)

49
Q

Primary visual cortex

A

Striate nucleus either side of calcarine sulcus

50
Q

Primary gustatory cortex

A

Inferior post central gyrus

51
Q

What info does the Lateral VPL nucleus of the thalamus receive

A

sensory input from leg projects to midline post central gyrus

52
Q

What info does the medial VPL nucleus of the thalamus receive

A

sensory input from arm project to lateral post central gyrus

53
Q

What info does the VPM nucleus receive

A

sensory input from face projects to lateral post central gyrus

54
Q

What is agnosia

A

Damage to secondary sensory areas leads to disorders of understanding
Awareness of sensation persists, but significance of this sensation is lost.
Eg. Eyes closes, handle scissors, can’t recognise

55
Q

What is apraxia

A

Damage to secondary motor areas leads inability to carry out purposive movements, although there is no paralysis
Leads to inability to perform learned movements

56
Q

What is the function of the pre-frontal cortex

A

Regulates moods and feelings
Involved in higher order cognitive functions
Conceptualisation, planning, judgement
(Phineas Gage)

57
Q

What is the function of the parieto-temporal cortex

A

Integrates information of different modalities

Involved in memory

58
Q

What is Wernicke’s area

A

Posterior language area
Sensory or receptive
Understanding/association

59
Q

What is Broca’s area

A

Anterior language area
Motor or expressive
Production

60
Q

What is Erb’s palsy

A

Excessive stretching of the neck during delivery causing damage to C5, C6 nerve roots (common in newborns)
Paralysis of muscles of shoulder/arm supplied by C5, C6
“waiter’s tip” position

61
Q

What is Klumpke’s palsy

A

Damage to inferior trunk of brachial plexus (C8, T1 – ulnar nerve)
Less common than Erb’s palsy
Occurs in newborns where the baby’s upper limb is pulled excessively during delivery
Claw hand- Paralysis of the majority of the intrinsic hand muscles (and ulnar flexors of the wrist and digits)

62
Q

What is Claw hand

A

Hyperextension at the metacarpophalangeal joints and flexion at the interphalangeal joints
Due to paralysed lumbricals of digits 4 and 5

63
Q

What condition can Klumpke’s palsy be associated with

A

Horner’s syndrome: Ptosis, Miosis, Anhidrosis, Vasodilation

Sympathetic neurons supplying the head originate from T1 and may also be damaged by traction

64
Q

What is cubital tunnel syndrome

A

Ulnar nerve entrapment in tendinous arch between the humeral and ulnar heads of flexor carpi ulnaris (elbow)
Same symptoms as Klumpke’s palsy + elbow pain (no horner’s)
Treatment initially anti-inflammatories then surgery if unresolved

65
Q

What is radial nerve palsy

A

Injury to radial nerve in spiral groove of humerus results in wrist drop
Inability to extend the wrist and metacarpophalangeal joints due to paralysis of extensor muscles of the forearm.
Triceps is usually weakened rather than paralysed

66
Q

Why are triceps not completely paralysed in radial nerve palsy

A

Long head triceps branch of radial nerve is given off before the spiral groove so can get some weak elbow flexion.

67
Q

How can the median nerve be damaged at the elbow

A

Supra condylar fractures or pronator teres syndrome

68
Q

What is the hand of benediction

A

Inability to flex digits 1-3

Weakened flexion of digits 4-5

69
Q

Two tests for median nerve compression

A

Tinel’s Test: percuss nerve

Phalen’s Test: compress nerve by acutely bending wrist

Medicine (7 decks)

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