Central nervous system Flashcards

1
Q

What is the gross anatomy of the brain (forgetting about lobes)?

A

Cerebrum (forebrain).

  • Cerebral cortex – outer layer of neural tissue of the cerebrum. [PHOTO].
  • Sulcus – groove of the cerebral cortex.
  • Gyrus – ridge of the cerebral cortex.
  • Corpus collosum – thick band of nerve fibres that join the two hemispheres of the brain.

Cerebellum (hind brain).

Pituitary gland.

Brainstem.

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2
Q

What is the function of the brainstem?

A

Oldest part so has most important functions. Involved in cardiovascular system control, respiratory control, pain sensitivity control, alertness, awareness, and consciousness.

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3
Q

Why are the folds important in the cerebrum?

A

Increases surface area so more surface to pack in neurones. Means we don’t have huge heads.

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4
Q

How is dorsal and ventral interpreted in the CNS?

A

In the brain, dorsal means superior. In the spinal cord, dorsal means posterior.

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5
Q

What are the names and locations of the cranial nerves?

A

Olfactory nerve (I) Optic nerve (II) Oculomotor nerve (III) Trochlear nerve (IV Trigeminal nerve (V) Abducens nerve (VI) Facial nerve (VII) Vestibulocochlear nerve (VIII) Glossopharyngeal nerve (IX) Vagus nerve (X) Accessory nerve (XI) Hypoglossal nerve (XII).

Ooh, Ooh, Ooh, to touch and feel very good velvet. Such heaven.

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6
Q

What is the structure of the cross-section of the spinal cord? (x2 points of focus)

A

Grey matter (cell bodies of the neurones) is surrounded by white matter (myelinated nerve fibres). Grey matter is where the processing happens. Two nerves emerge from each side – posterior (dorsal) root and anterior (ventral) root (each exist as horns in the spinal cord as seen in the diagram). Dorsal is the afferent root (sensory info enters and it either processes or sent to the brain). Ventral root is the efferent root (motor neurones that go out to the periphery).

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7
Q

What is the structure of the white matter in the spinal cord?

A

There are bundles called ascending tracts that carry sensory information UP to the brain, and descending tracts which bring motor information down from the brain.

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8
Q

What anatomical differences differentiate the dorsal and ventral horn?

A

Dorsal route has a dorsal root ganglion (loads of cell bodies). This is because in sensory neurones, the dendrites extend into the periphery, and the cell bodies sit somewhere in the middle.

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9
Q

What is the purpose of the vertebral column?

A

Spinal cord is protected and enclosed within the vertebral column.

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10
Q

What is the structure of the vertebral column in relation to how the CNS fits in? (x2 points)

A

Vertebral foramen is the large hole in the middle of each vertebra where the spinal cord sits. The vertebral column is arranged such that there are intervertebral foramen where nerves emerge from the CNS.

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11
Q

How many segments are there in the spinal cord?

A

31 segments in the spinal cord. Each correspond to the 31 pairs of spinal nerve.

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12
Q

What are the names of each of the spinal nerves and spinal segments?

A

8 cervical – named C1-C8. 12 thoracic – named T1-T12. 5 lumbar – named L1-L5. 5 sacral – named S1-S5. 1 coccygeal nerve – named Co.

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13
Q

How many vertebrae does the body have?

A

30 vertebras.

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14
Q

How are the spinal nerves arranged when there is one less vertebra than there are spinal nerve pairs?

A

This is because the C1 spinal nerves emerge from ABOVE the first vertebra, and the C8 spinal nerves emerge BELOW the C7 vertebra.

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15
Q

How are each spinal nerve pairs named (with exception to the cervical curvature)?

A

The nerves emerge lower than the corresponding vertebral segment.

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16
Q

What is length of the spinal cord relative to the vertebral column? What is the anatomy – therefore, of the remaining vertebral column?

A

Spinal cord is shorter than the vertebral column. (REMEMBER, the spinal cord is still made up of C, T, L, S and Co segments; it’s just the L, S and Co segments are found relative to the thoracic curvature of the vertebral column, and spinal roots and nerves emerge from here down the cistern)

Spinal cord finishes at the beginning of the lumbar curvature. Where the spinal cord ends, a bundle of spinal nerves and roots (the first part of the emerging nerves from the CNS) emerge from the lumbar enlargement of the spinal cord. This bundle is called the Cauda equina. There is an enlargement of the subarachnoid space in the lumbar region of the vertebral column called the lumbar cistern.

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17
Q

Where is a lumbar puncture done and why this location?

A

Lumbar puncture done between L3,L4 or L4,L5 because there’s no nervous tissue, so the risk of harming the spinal cord is avoided.

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18
Q

What is a dermatome?

A

An area of the skin supplied by A spinal nerve. It maps all the nerves, with exception to C1 and the coccygeal nerve.

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19
Q

What is a myotome?

A

A group of muscles that a single spinal nerve innervates.

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20
Q

What is the nature of the diameter of each segment of the spinal cord?

A

Cervical and lumbar regions of the SPINAL CORD are enlarged – called the cervical and lumbar enlargements. Because these regions innervate the arms and legs.

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21
Q

What are the functions of the spinal cord? (x4)

A

Connects brain to the PNS (peripheral) and ANS (autonomic). Carries sensory signals to the brain. Carries motor signals to the muscles. Coordinates reflexes.

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22
Q

What are the two methods that the brain can be classified?

A

Embryonic origin. Functionality.

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23
Q

How is the brain classified embryogenically? (x3) Alternative names for each.

A

FOREBRAIN: aka prosencephalon.

MIDBRAIN: aka mesencephalon.

HINDBRAIN: aka rhombencephalon.

Embryogenically, the forebrain, midbrain and hindbrain develop first, and each develop into their own constituent parts. The midbrain however, stays pretty much the same.

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24
Q

What does the hindbrain consist of? (x3)

A

Hindbrain includes the cerebellum, pons and the medulla.

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25
Q

What does the forebrain consist of? (x2) Alternative name for each.

A

Telencephalon (or cerebral hemisphere). Diencephalon (the thalamus and hypothalamus).

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26
Q

How is the brain classified functionally?

A

BRIAN STEM: Midbrain, pons, medulla oblongata. CEREBRUM: includes the cerebral hemisphere and diencephalon. CEREBELLUM.

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27
Q

What does the brain stem comprise of? (x3)

A

Midbrain, pons, medulla oblongata.

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28
Q

What are the functions of the brain stem? (x3)

A

Responsible for the control of many vital functions such as: breathing, heart rate, blood pressure, swallowing, balance etc. Responsible for defensive reflexes (cough, gag, sneeze…) Involved in sleep-wake cycles, alertness and consciousness.

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29
Q

What is the nature of the brainstem in relation to the cranial nerves?

A

Contains the nuclei (meaning a group of cell bodies of a neurone – all with similar function) of 10 of the 12 cranial nerves which control vital functions.

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30
Q

What does the diencephalon consist of?

A

Thalamus and hypothalamus. REMEMBER, this is in the cerebrum and the forebrain.

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31
Q

What is the structure of the thalamus?

A

Made up of two thalami connected together in the centre.

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32
Q

What does the thalamus and hypothalamus look like in your brain?

A

The two photos are from a lateral and coronal (ventral/dorsal) view respectively. Thalamus is above the hypothalamus.

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33
Q

What are the functions of the hypothalamus and thalamus?

A

Thalamus: Relay station and integration centre for somatic and special senses information and projection to cortex. Involved in emotional status, consciousness, appropriate motor response. Hypothalamus: integration hub. Regulates temperature, hunger, thirst, hormone (connected with pituitary) and autonomic function i.e. it is important in coordinating haemostasis.

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34
Q

What is the structure of the cerebral hemispheres? (x2)

A

Cortex and a subcortical structure called the basal ganglia (technically, it’s basal NUCLEI, because ganglia are relevant only to the periphery).

35
Q

What are the main basal ganglia? Where does each component lie when you look at the brain horizontally AND laterally?

A

Caudate nucleus (highlighted in purple – has a head and tail). Putamen (highlighted in pink – it is the ball-like structure below the head of caudate). The caudate and putamen together is called the corpus striatum.

Globus pallidus (highlighted in dark blue). The globus pallidus and putamen together forms the Lentiform nucleus.

Subthalamic nucleus and Substantia Nigra (which is part of the MIDBRAIN; not the forebrain).

36
Q

Where does the basal ganglia lie relative to other brain structures?

A

It surrounds the thalamus.

37
Q

What is the function of the basal ganglia?

A

Control of movement: facilitating voluntary movement, inhibiting unwanted or inappropriate movements, “fine tuning”. Therefore, works with the motor cortex in the cerebrum.

38
Q

How big is the cerebral cortex? Where is it found?

A

Outer layer of the cerebrum. Cerebral cortex is just a few millimetres thick.

39
Q

What are the wrinkles called in the cerebral cortex? (x2)

A

All wrinkled into gyri (gyrus). The grooves are called sulci (sulcus).

40
Q

What are the names of the deeper grooves that divide the lobes of the brain?

A

The deeper grooves that divide the cortex into lobes are called fissures.

41
Q

What fissures are there in the cerebral cortex? (x3)

A

Longitudinal – divides the two hemispheres of the brain. Central – divides the frontal and parietal lobe. Lateral fissure – separating temporal from frontal and parietal.

42
Q

What are the different lobes of the cerebral cortex, their location and basic function? (x4)

A

FRONTAL: house the primary motor cortex = voluntary movement. PARIETAL: somatosensory cortex = sensory information from the somatic area of your body is processed here. TEMPORAL: auditory perception, primary auditory cortex, and also part of your personality. OCCIPTIAL: visual cortex.

43
Q

What is the definition of cortical areas?

A

Regions of the cerebral CORTEX.

44
Q

What are the two types of cortical area?

A

Primary cortical areas. Association cortex.

45
Q

What are the histological characteristics of the cortex? (x3)

A

It’s laminar – meaning consisting of layers. It has a somatotopic arrangement - arranged like a body map. Area at the bottom controls movement of the head, top controls movement of the legs – like an upside down man. Most of the neurones are pyramidal – one axon and multiple dendrites with one apical dendrite.

46
Q

What are the main primary cortical areas of the brain? (x4)

A

PRIMARY MOTOR CORTEX: stimulate motor neurones for movement – contralateral. PRIMARY SOMATOSENSORY CORTEX: adjacent to the primary motor cortex and somatotopic. Receives general sensory information coming from the body e.g. temperature, pain, touch. PRIMARY AUDITORY CORTEX: first to receive information from the ears. PRIMARY VISUAL CORTEX: first to receive information from the retina.

47
Q

What are the main association cortical areas? Where are they found?

A

Wernicke’s area – understanding language. Broca’s area – for speech. Can be located on the photo, but main point is that they are found in the LEFT region of the brain!

48
Q

Where is the cerebellum found? How is it associated to the rest of the brain?

A

Back of the brain. Attached to the brainstem posteriorly by three pairs of peduncles.

49
Q

What is the anatomy of the cerebellum?

A

Two hemispheres. Joined by central vermis. The external surface is grey matter, called a grey cortex. It has deep parallel folds with gyri called folia. The deeper regions of the cerebellum contain white matter with nuclei, and SMALL amounts of grey matter.

50
Q

What are the functions of the cerebellum? (x3)

A

Connected to the vestibular system in the ears for balance. Connected to the spinal cord and muscles of locomotion for posture and muscle tone. Connected to motor cortex and thalamus for learned movements.

51
Q

Different parts of the brain are connected by two types of white matter fibres: what are these types?

A

Commissural fibres connect the two halves of the brain e.g. corpus collosum. Association fibres connect different structures on the same side. Projection fibres are vertical and connect lower parts of the brain to the spinal cord. What are the cranial fossae?

52
Q

What are the cranial fossae?

A

Internal depressions or cavities in the cranium.

53
Q

What is the cranial fossa split into? (x3)

A

Frontal, middle and posterior cranial fossa.

54
Q

What brain structures relate to the anterior/frontal cranial fossa? (x1)

A

Frontal lobe of the cerebral cortex.

55
Q

What brain structures relate to the middle cranial fossa? (x3)

A

Temporal lobe, pituitary gland, and hypothalamus.

56
Q

What brain structures relate to the posterior cranial fossa? (x2)

A

Brainstem and cerebellum lie in the BASE of the posterior.

57
Q

What are the bones of the anterior cranial fossa? (x2)

A

Frontal and ethmoid (at the base next to the nose) bones. Calvarium means the upper part of the neurocranium.

58
Q

What are the bones of the middle cranial fossa? (x3)

A

Sphenoid and temporal bones in the base. Parietal bone across the top. Calvarium means the upper part of the neurocranium.

59
Q

What is the bone anatomy of the posterior cranial fossa? (x2)

A

Occipital bone. And the foramen magnum. Calvarium means the upper part of the neurocranium.

60
Q

What is the function of the meninges?

A

Connective tissue layer that protects the brain.

61
Q

Where do the meninges lie?

A

In between the cranium (bone) and the brain.

62
Q

What are the components of the meninges? (x5 components). OUTER –> INNER:

A

Dura mater (outer and inner layer). Hard and fibrous. In some areas, there’s a space between the outer and inner layers where venous blood collects e.g. superior sagittal space at top of the head. Arachnoid mater. Connective tissue that holds blood vessels in place. Subarachnoid space – contains the cerebrospinal fluid. This is where the blood vessels lie (connected to the arachnoid mater). Pia mater: enclose cerebrospinal fluid. By containing this fluid, the pia mater works with the other meningeal layers to protect and cushion the brain. It is very thin and flexible and coats all the gyri and sulci of the cerebral cortex.

63
Q

Where is CSF found in the brain? (x2)

A

Meninges. Fills the ventricles in the brain.

64
Q

What are ventricles?

A

Ventricles are hollow spaces in the brain filled with CSF.

65
Q

List the ventricles of the CNS. (x3) What is the structure of the biggest one?

A

Lateral ventricles – biggest. Have anterior, inferior and posterior horns. Found in both hemispheres. The third ventricle – in yellow. Has characteristic shape with hole. Fourth ventricle is lower down (purple). Has characteristic diamond shape.

66
Q

What are the ‘links’ in the ventricular system? (x3)

A

The lateral ventricles are joined by two interventricular foramina (bright blue), which joins onto the third ventricle and allow passage of CSF between the two ventricles. Aqueduct – in red – carries out the same role as the interventricular foramina, but links CSF between the third and the fourth ventricle. Central canal – green – extends down.

67
Q

How is each component of the ventricle system anatomically related to other regions of the brain? (x6)

A

LATERAL: travels through parietal, temporal and frontal lobes in BOTH hemispheres. INTERVENTRICULAR FORAMINA: above the thalami – converge towards midline. THIRD: found between the two thalami at the MIDLINE. The hole contains the band which connects the two thalami. AQUEDUCT: found within the midbrain. FOURTH: has the brainstem at the front, and the cerebellum at the back. Located within the pons and upper part of the medulla. CENTRAL CANAL: extends down the MIDDLE of the entire length of the spinal cord with CSF.

68
Q

How does each ventricle look like histologically in the brain?

A

REALLY REVISE THIS. This is crucial. DON’T JUST LOOK AT THESE PHOTOS, LOOK AT OTHERS ONLINE TOO!

69
Q

How is CSF synthesised?

A

CSF is produced by the choroid plexus found in the ventricles in the brain?

70
Q

What is the total volume of CSF produced per day by the choroid plexuses?

A

THIS IS THE FLOW RATE OF CSF!!! 500ml/day.

71
Q

How much CSF is in the body in total?

A

150ml.

72
Q

What is the composition of CSF relative to plasma? (x8 things)

A

High sodium levels. Lower blood glucose than plasma. Much lower protein level than the plasma. Lower calcium and potassium. Higher chloride and magnesium. Slightly lower pH.

73
Q

What are the functions of CSF? (x4)

A

Provides a mechanical protection and cushioning for the CNS. Nutrition. Removes waste from CNS. Carries immune cells.

74
Q

What is the pathway of CSF flow?

A

It circulates from the lateral ventricles, down to the third and fourth ventricle. CSF then, through lateral and median apertures, enters the subarachnoid space of the meninges and circulates round the meninges of the brain. CSF is then filtered out via arachnoid villi into the Dural venous sinuses (in the dura mater space) where it enters the system circulation.

75
Q

What is an epidural haemorrhage also known as?

A

Extradural.

76
Q

Where does an epidural haemorrhage occur?

A

Head trauma resulting in a damaged meningeal ARTERY between skull and outer dura mater.

77
Q

What is a subdural haemorrhage?

A

Damaged VEIN between the inner dura mater and arachnoid membrane.

78
Q

What are the differences in clinical presentation between an epidural and a subdural haemorrhage? (x5)

A

Epidural results in RAPID filling of the space because it is an artery. Deterioration can be rapid. Dura has peeled away from the skull. Tends to remain confined to a smaller area of the hemisphere. Underlying brain damage less severe. Subdural is SLOWER filling because it results in damaged vein. Dura is still associated with the skull. Neurological decline is slower. Blood spreads more diffusely across the hemisphere – i.e. entire surface of the brain. Underlying brain damage more severe, so prognosis is worse than extradural.

79
Q

What is hydrocephalus?

A

Hydrocephalus is a condition in which an accumulation of CSF occurs within the brain, causing increased intracranial pressure. Symptoms include headaches, poor balance, blurred vision, and vomiting.

80
Q

How is hydrocephalus treated? (x2)

A

Hydrocephalus can usually be treated using a shunt, a thin tube that’s surgically implanted in the brain and drains away the excess fluid. OR, a hole is made in the floor of the brain to allow the trapped CSF to escape to the surface, where it can be absorbed. This is called endoscopic third ventriculostomy.

81
Q

What is the optic chiasm and where is it found?

A

The optic chiasm or optic chiasma is the part of the brain where the optic nerves partially cross. The optic chiasm is located at the bottom of the brain immediately inferior to the hypothalamus.

82
Q

What is the Infundibulum?

A

The hollow stalk which connects the hypothalamus and the posterior pituitary gland.

83
Q

What is the major difference in analysis of CSF between bacterial and viral meningitis?

A

CSF glucose concentration is less than half of that of plasma in bacterial meningitis while, in viral meningitis, CSF sugar concentration is more than half of that of plasma. Because bacteria are metabolising – viruses are not.