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MB3 Neurology > Central spine and brain anatomy > Flashcards

Central spine and brain anatomy Flashcards

1
Q

what type of neurons make up motor neurons

A

multipolar

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2
Q

true/false - multipolar neuron cell bodies are found in the PNS

A

false

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3
Q

what makes a unipolar neuron unique

A

double process - one with dendrites and another with axons

usually transmit sensory information

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4
Q

what is a nerve within the CNS called

A

a tract

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5
Q

true/false - tracts tend to be single/mixed modality

A

single

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6
Q

12 cranial nerves?

A 
olfactory 
optic 
oculomotor 
trochlear 
trigeminal
abducent 
facial
vestibulocochlear 
glossopharyngeal
vagus 
accessory 
hypoglossal
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7
Q

modalities of the 12 cranial nerves

A 
I - S
II - S
III - M
IV - M
V - B
VI - M
VII - B
VIII - S
IX - B
X - B
XI - M
XII - M
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8
Q

origins of the 12 cranial nerves

A 
I - forebrain
II - forebrain
III - midbrain
IV - midbrain
V - pons
VI - pons/medulla
VII - pons/medulla
VIII - pons/medulla
IX - medulla
X - medulla
XI - spinal cord
XII - medulla
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9
Q

describe the exit of sympathetic nerves from the spinal cord

A

thoracolumbar T1-L2
from lateral horns, entering via anterior roots/rootlets and pass into the spinal nerve and then to the anterior rami
then pass to sympathetic trunk

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10
Q

describe the sympathetic innervation course to the heart

A

synapse in T1 or cervical paravertebral ganglia

postsynaptic nerves pass to the heart by cardiopulmonary splanchnic nerves

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11
Q

describe the sympathetic innervation course to the lungs

A

enter upper thoracic paravertebral ganglia, synapse and pass to the cardiopulmonary splanchnic nerves

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12
Q

describe the sympathetic innervation course to the abdominal organs

A

synapse in a prevertebral ganglia after passing out of sympathetic trunk without a synapse

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13
Q

describe the sympathetic innervation course to the renal medulla

A

pass directly through the aorticorenal ganglion and synapses directly onto the adrenal medulla

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14
Q

sympathetic ganglion for the foregut

A

celiac ganglion

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15
Q

sympathetic ganglion for the midgut

A

superior mesenteric ganglion of SM plexus

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16
Q

sympathetic ganglion for the hindgut/pelvis and perineum

A

inferior mesenteric ganglion of the IM plexus

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17
Q

sympathetic ganglion for the kidney

A

aorticorenal ganglion

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18
Q

what cranial nerves are responsible for parasympathetic outflow

A

III, VII, IX, X

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19
Q

what sacral nerves are responsible for parasympathetic outflow

A

S2,3,4

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20
Q

how many pairs of spinal nerves are there

A

31

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21
Q

describe the connection from spinal cord to spinal nerve

A

right/left posterior rootlets become roots and right/left anterior rootlets become roots
converge to become spinal nerve
emerge from intervertebral foramen to split to anterior/posterior ramus

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22
Q

what do anterior rami supply

A

anterolateral body wall

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23
Q

what do posterior rami supply

A

small strip on posterior body wall

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24
Q

describe the path sensory information takes from spinal nerve to spinal cord

A

enters onto posterior root, to posterior rootlet and onto posterior horn of spinal cord

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25
Q

describe the path motor information takes from spinal cord to spinal nerve

A

travels from anterior horn to anterior rootlets, to anterior root and then to spinal nerve

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26
Q

dermatome level for the niipple

A

T4

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27
Q

dermatome level for umbilicus

A

T10

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28
Q

dermatome levels for posterior scalp, neck, shoulder

A

C2-4

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29
Q

dermatome levels for upper limb

A

C5-T1

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30
Q

dermatome levels for lower limb, gluteal region and perineum

A

L2-Co1

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31
Q

describe what would have to happen for full anaesthesia of an area of the chest wall and what would happen if this were not to occur. what is the exception

A

dermatome level of the affected level, plus one above and one below would need to occur
if only one level was knocked out there would only be diminished sensation due to overlapping nerve supply
exception being if two levels are next to each other on dermatome map that are not in order of spinal level

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32
Q

spinal levels of the cervical plexus and what it supplies

A

C2-4

posterior scalp, neck, diaphragm

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33
Q

spinal levels of the brachial plexus and what it supplies

A

C5-T1

upper limb

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34
Q

spinal levels of the lumbar plexus and what it supplies

A

L1-L4

lower limb

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35
Q

spinal levels of the sacral plexus and what it supplies

A

L5-S4

lower limb, gluteal region and perineum

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36
Q

true/false - all rami of spinal nerves contribute to nerve plexuses

A

false - only the anterior rami

37
Q

what are the bony prominences of the back

A 
T1 spinous process 
spine of scapula 
spinous processes
sacrum
coccyx 
iliac crests 
PSIS
38
Q

extrinsic muscles of the back

A 
trapezius 
latissimus dorsi 
rhomboids 
levator scapulae 
teres major
39
Q

name of the superficial muscle group of the back and their names

A

erector spinae
iliocostalis
longissimus
spinalis

40
Q

where does spinalis attach

A

spinous processes

41
Q

where does longissimus attach

A

ilium and sacrum to mastoid process and transverse processes

42
Q

where does iliocostalis attach

A

sacrum and iliac crest to ribs

43
Q

what is the deep intrinsic muscle of the back and where does it attach

A

between transverse and spinous processes

attaches between vertebrae and skull, vertebrae and ribs, vertebrae to vertebrae and sacrum to vertebrae

44
Q

what is the nervous innervation to the intrinsic muscles of the back

A

by posterior rami of spinal nerves as per dermatome pattern

45
Q

if erector spinae contract bilaterally then ___ occurs

A

spinal extension

46
Q

if erector spinae contract unilaterally then ___ occurs

A

lateral flexion

47
Q

function of erector spinae and transversospinalis

A

maintenance of posture
support to spine
movement

48
Q

where does the spinal cord end generally

A

L1/2

49
Q

what is the end of the spinal cord named

A

conus medullaris

50
Q

how many vertebrae are there

A

31

51
Q

function of the vertebral column

A

support to head and trunk
movement of head and trunk
protects spinal cord

52
Q

what are the 4 curvatures of the spine? are they primary or secondary?

A

cervical lordosis - secondary
thoracic kyphosis - primary
lumbar lordosis - secondary
sacral kyphosis - primary

53
Q

what forms the vertebral arch posterior to the vertebral post?

A

two pedicles, then two laminae

54
Q

true/false - there are two spinous and one transverse process in a vertebra

A

false - two transverse and one spinous process

55
Q

where are the facet joints located and what type of joint are they

A

between the superior and inferior articular processes

synovial

56
Q

what are the outer and inner segments of the intervertebral discs known as

A

annulus fibrosis

nucleus pulposus

57
Q

true/false - there isnt an intervertebral disc between C1/2

A

true

58
Q

function and location of the ligamentum flavum

A

posterior to spinal cord and connects adjacent laminae

59
Q

function and location of the posterior longitudinal ligament

A

prevents over flexion of the spine and anterior to spinal cord

60
Q

function and location of the anterior longitudinal ligament

A

broad, strong and anterior to vertebral bodies

prevent over extension of the spjne

61
Q

function and location of the supraspinous ligament

A

connects tips of the spinous processes

62
Q

function and location of the interspinous ligament

A

connects superior and inferior surfaces of adjacent spinous processes

63
Q

unique features of cervical vertebrae

A

bifid spinous process
triangular vertebral foramen
transverse foramen

64
Q

what movements occur at the atlantooccipital joints

A

mainly flexion and extension iof the neck but also lateral rotation and lateral flexion

65
Q

what is the sacral hiatus

A

opening at the bottom of the sacral canal ie open end if the vertebral canal

66
Q

to apply an epidural anaesthetic, where is the needle generally entered

A

L3/4 interspace

67
Q

true/false - in raised ICP you should perform a lumbar puncture to drain excess csf from the subarachnoid space

A

false - it can lead to brain herniation

68
Q

what layers of fascia does a needle pass through for giving a lumbar puncture

A 
skin and fascia 
supraspinous 
interspinous 
ligamentum flavum
epidural space 
dura mater
arachnoid mater 
subarachnoid space
69
Q

explain why local anaesthetic is injected in the sacral hiatus to anaesthetise the sacral nerve roots

A

the dura mater ends at S2 so by injecting here only lower nerve roots would be affected

70
Q

what is a laminectomy and what fascial layers would laminectomy require

A

surgical removal of the spinous process with its adjacent laminae
skin and superficial fascia
aponeurotic origin of trapezius, lat dorsi
intrinsic back muscles
lig flavum, supraspinous, interspinous, lamina and spinous process

71
Q

layers of the scalp

A 
skin
connective tissue 
aponeurosis 
loose connective tissue 
pericranium
72
Q

what blood vessels supply the scalp anastomosis

A

ECA posterior

lateral artery and ophthalmic artery anterior from ICA

73
Q

what is the pterion and what is its clinical significance

A

H shape suture formed by frontal, sphenous, parietal and temporal bone
susceptible to fracture and middle meningeal artery runs right under it

74
Q

true/false - in the cranial cavity there are two layers of dura

A

true - a periosteal layer and a meningeal layer

75
Q

what is tentorium cerebelli

A

dura mater tenting over cerebellum

central gap to allow brainstem through

76
Q

what is the falx cerebri and where does it attach

A

midline dural fold separating right and left cerebral hemispheres
christa gali anteiror
internal occipital protuberance posterior
internal aspect of sagittal suture

77
Q

describe the venous drainage of the cranial cavity by the dural venous sinuses

A

superior and inferior sagittal sinus join straight sinus at confluence of sinuses
drained by the transverse sinus, draining to the sigmoid sinus and to IJV

78
Q

what is the danger triangle and why is it of clinical significance

A

top of bridge of nose to lips
veins on extenal face drain to deeper sinuses of the face, like cavernous sinus
bacterial infection superficially therefore has the capability to spread backwards deep into the cranium

79
Q

what arteries supply the head with blood

A

vertebral and carotid

80
Q

describe the circle of willis

A

right and left vertebral artery form the basillar
small branches of basillar supply cerebellum
braches off to posterior cerebral arteries
anastomoses with middle cerebral artery by posterior communicating arteries
anastomoses with anterior cerebral artery, connected to each other by anterior communicating artery

81
Q

in terms of the layers of the brain, where would you find the circle of willis

A

subarachnoid space

82
Q

where would you find an epidural haemorrhage

A

between bone and dura

83
Q

where would you find a subdural haemorrhage

A

between dura and arachnoid

84
Q

what is cingulate herniation of the brain

A

passes under falx cerebri

85
Q

what is uncal herniation of the brain

A

uncus on temporal lobe herniates inferior to tentorium cerebelli

86
Q

what is central herniation of the brain

A

supratentorial parts herniate inferior to tentorium cerebelli

87
Q

what is transcalvarial herniation of the brain

A

through skull

88
Q

what is infratentorial herniation of the brain

A

cerebellar tonsils hernaite into foramen magnum

MB3 Neurology (19 decks)

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