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Y3 MOD Neurology > Clinical Neuroanatomy > Flashcards

Clinical Neuroanatomy Flashcards

1
Q

What are the 3 main divisions of the CNS?

A
  • Forebrain
  • Brainstem
  • Cerebellum
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2
Q

The forebrain is made up of?

A

The cerebral cortex and the diencephalon

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3
Q

The brainstem is made up of?

A

The midbrain, the pons and the medulla oblongata

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4
Q

Where is the thalamus found in the brain?

A

In the diencephalon in the forebrain

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5
Q

What are the 4 functional segments of the spine?

A
  • C1 - C5
  • C6 - T2
  • T3 - L3
  • L4 - S3
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6
Q

What are the two main divisions of the spine?

A

Peripheral white mater and central grey mater

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7
Q

What is contained within the peripheral white matter of the spine?

A

Nerve tracts - motor (efferent) which go down and sensory (afferent) which go up

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8
Q

What is contained within the central grey mater of the spine?

A

Interneurons and motor neurones that innervate muscles

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9
Q

What are the 3 main divisions of the peripheral nervous system?

A
  • Nerves
  • Neuromuscular junction
  • Muscle
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10
Q

What are the 3 nerve types?

A

Motor, sensory or both

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11
Q

Where is a motor neurone cell body located?

A

In the ventral horn of the spinal cord

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12
Q

Where are sensory cell bodies located?

A

In the dorsal root ganglion of the spinal cord

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13
Q

Myelination occurs through which cells in the:

  1. PNS
  2. CNS
A
  1. Schwann cells

2. Oligodendrocytes

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14
Q

How many spinal and cranial nerves are there?

A

36 pairs of spinal nerves

12 pairs of cranial nerves

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15
Q

What are the 3 main components of a neuromuscular junstion?

A
  • Axon terminal
  • Synaptic cleft
  • Endplate of skeletal muscle
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16
Q

What are some of the main features of the autonomic NS?

A
  • Involuntary
  • Controls visceral functions
  • Made of the sympathetic and parasympathetic systems
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17
Q

Describe the sympathetic NS

A
  • Thoracolumbar region

- Fight or flight (rapid responses)

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18
Q

Describe the parasympathetic NS

A
  • Craniosacral region

- Rest and digest

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19
Q

Describe how the autonomic NS works in bladder filling and emptying

A

Filling:
- Detrusor muscle relaxes and sphincter tone increases
- As bladder gets bigger, messages go to pons until a critical size is reached and bladder is ready to empty
Bladder emptying:
- Detrusor muscle contracts, under control of parasympathetic system in sacral SC
- Sphincters relax, due to reduced activity in motor neurons in sacral SC (external sphincter) and sympathetic neurons (internal sphincter)

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20
Q

Describe UMN bladder incontinence

A
  • Lesions cranial to sacral SC

* Distended bladder difficult to express (loss of inhibitory pathways to sympathetic and somatic efferents)

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21
Q

Describe LMN bladder incontinence

A
  • Lesions in sacral SC and/or sacral spinal nerves

* Distended bladder, that overflows and dribbles (only internal sphincter working

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22
Q

Describe the 3 orders of neurons that connect and provide the sympathetic supply to the eye

A
  • 1st order neuron: starts in brainstem and courses caudally in cervical SC
  • 2nd order neuron: leaves SC at T1-T3 through brachial plexus, courses rostrally through neck in vagosympathetic trunk; synapse at cranial cervical ganglion ventromedial to the tympanic bulla
  • 3rd order neuron: courses rostrally towards the eye
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23
Q

Which parts of the eye are innervated by the sympathetic supply?

A
  • Smooth dilator of the pupil
  • Orbitalis muscle (smooth muscle in periorbita and eyelids, including 3rd eyelid)
  • Smooth ciliaris muscle
  • Smooth muscle of blood vessels and sweat glands of head
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24
Q

Describe the grey matter in the brain

A
  • Contains cell bodies (neurones)
  • In surface of brain and in centre (H) of spinal cord
  • Processes information, “computer”
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25
Q

Describe the white matter in the brain

A
  • Mostly contains myelinated axon tracts
  • Deep parts of brain and superficial parts of spinal cord
  • Connects, “network cables”
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26
Q

Describe the 3 layers of meninges in the brain?

A
  • Dura mater: thick outer layer
  • Arachnoid: thin layer containing the subarachnoid space
  • Pia mater: thin inner layer
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27
Q

What is found in the subarachnoid space?

A

CSF
Blood vessels
Nerve roots

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28
Q

Where is CSF found? How and where does it flow?

A
  • Covers all surface of brain and spinal cord
  • CSF flows by pulsations of blood in choroid plexus
  • Courses caudally: CSF collection caudally to lesions
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29
Q

Which 7 parts of the brain/spinal cord make up the CSF pathways?

A
  1. Lateral ventricles
  2. Interventricular foramen
  3. 3rd ventricle
  4. Mesencephalic aqueduct
  5. 4th ventricle
  6. Lateral apertures
  7. Subarachnoid space
30
Q

Which of the cranial nerves arise in the brainstem (midbrain, pons and medulla)?

A

CN III

CN XII

31
Q

Describe the features of CNI

A

Olfactory nerve

  • involved in the conscious perception of smell
  • Cell bodies in olfactory epithelium rather than on a ganglion
  • Axons pass through cribriform plate and synapse in olfactory bulb (then to piriform lobe)
32
Q

Describe the features of CNII

A

Optic nerve

  • Not a true nerve but an “extension of brain” (myelinated by oligodendrocytes, surrounded by meninges)
  • 1st neuron in bipolar cells of retina receiving information from rods and cones - vision
  • Axons course caudally and enter skull through optic canal, then join at optic chiasm
33
Q

Describe the features of CNIII

A

Oculomotor nerve

  • Ipsilateral dorsal, ventral and medial recti. and ventral oblique extraocular m.
  • Levator palpebrae superioris - elevation of upper eyelid
  • Parasympathetic component controls pupillary constriction
  • Nucleus in midbrain, axons exit skull through orbital fissure
34
Q

Describe the features of CNIV

A

Trochlear nerve

  • Contralateral dorsal oblique m.
  • Nucleus in caudal midbrain, axons exit skull through orbital fissure
35
Q

Describe the innervation of CNV

A

Trigeminal nerve

  • Sensory innervation of face
  • Motor innervation of masticatory muscles
36
Q

Name the 3 branches of the trigeminal nerve

A
  • Ophthalmic (S)
  • Maxillary (S)
  • Mandibular (S & M)
37
Q

Describe the features of CNVI

A

Abducens

  • Ipsilateral lateral rectus and retractor bulbi m.
  • Nucleus in rostral medulla
  • Axons exit skull through orbital fissure
38
Q

Describe the features of CNVII

A

Facial

  • Motor innervation to muscles of facial expression
  • Sensory innervation to rostral 2/3 of tongue and palate
  • Parasympathetic innervation to lacrimal, mandibular & sublingual glands
39
Q

Describe the features of CNVIII

A

Vestibulocochlear

  • Hearing and vestibular function
  • Receptors in inner ear, pass internal acoustic meatus to get to medulla
  • Vestibular nuclei in medulla (CNs eye movement, spinal tracts and cerebellum)
  • Cochlear nucleus in medulla
40
Q

Describe the features of CNIX

A

Glossopharyngeal

  • Motor innervation of pharynx and palate
  • Sensory innervation of caudal 1/3 of tongue and pharynx
  • Parasympathetic innervation of parotid and zygomatic glands
41
Q

Describe the features of CNX

A

Vagus

  • Motor innervation larynx, pharynx and oesophagus
  • Sensory innervation of larynx, pharynx and thoracic and abdominal viscera
  • Parasympathetic innervation to all thoracic and abdominal viscera (except pelvic region)
42
Q

Describe the features of CNXI

A

Accessory

- Trapezius and part of sternocephalicus and brachiocephalicus m.

43
Q

Describe the features of CNXII

A

Hypoglossal

- Motor innervation to tongue

44
Q

Describe the main features of the LMN system

A
  • Efferent neurones of PNS
  • Connect the CNS with the muscle to be innervated
  • Neuronal cell bodies in ventral GM of spinal cord
  • Axon leaves spinal cord through ventral root and then travels as PN into muscle
45
Q

Where do LMNs come out of the spinal cord for:

  1. Forelimbs
  2. Hindlimbs
A
  1. C6-T2

2. L4-S3

46
Q

Describe the pathway of a reflex

A
  • Stimulus: dendritic zone (receptor) in sensory nerve in skin or muscle
  • Sensory PN, dorsal root, enters SC; synapse with other neuron in GM (usually dorsal column)
  • Directly (monosynaptic - patellar) or through interneuron (polysynaptic - withdrawal)
  • Exit SC, ventral root, motor PN, n-m junction – muscle contraction!
47
Q

What is a common mistake associated with relfexes?

A

That they are a pain response

- You don’t need to feel (consciously perceive pain) to withdraw limb

48
Q

Why do reflexes help the vet?

A

Allows direct assessment of LMNs which allows localisation of the lesion

49
Q

Give two examples of reflexes used to test cranial nerves

A

Palpebral

Pupillary light reflex

50
Q

The UMN system is confined to?

A

CNS; axons organised in tracts in white matter that synapse with LMNs in SC grey matter

51
Q

What are the main functions of the UMN system?

A
  • Initiation of voluntary movement
  • Maintenance of muscle tone for support against gravity
  • Pyramidal and extrapyramidal functions
52
Q

What are pyramidal functions?

A
  • Skilled movement; poorly developed in animals

- Start in cerebral cortex and passing through pyramids in brainstem

53
Q

What are extrapyramidal functions?

A
  • Most start in brainstem, do not pass through pyramids
  • Provide tonic mechanisms for support of body against gravity and recruit spinal reflexes for initiation of voluntary movement
54
Q

What is general proprioception?

A

Part of sensory system that detects position and movement of muscles and joints

55
Q

Compare the pathways of conscious and unconscious proprioception

A

Conscious proprioception: Spinal tracts – cross to contralateral side in medulla – thalamus – proprioceptive information to contralateral sensory cerebral cortex (parietal lobe)
Unconscious proprioception: Spinocerebellar tracts – proprioceptive information mostly to ipsilateral cerebellum

56
Q

The vestibular system is a sensory system that maintains which 3 components?

A
  • Maintains balance
  • Maintains normal orientation relative to the gravitational field
  • Maintains position of eyes, neck, trunk and limbs relative to the position and movement of the head
57
Q

Name the two main divisions of the vestibular system

A

Peripheral and central

58
Q

Describe the peripheral vestibular system

A
  • Made up of the inner ear and vestibulocochlear nerve

- Relies on movement of fluid between ducts and bending of hair cells

59
Q

Describe the vestibular nuclei in the central vestibular system

A

4 in either side of brainstem receive information from CnVIII

60
Q

Where do the vestibular nuclei project to?

A
  • Spinal cord
  • Cerebellum
  • Medial longitudinal fasciculus
  • Forebrain
61
Q

Conscious perception of balance occurs in which part of the brain?

A

Forebrain

62
Q

What are the main functions of the cerebellum?

A
  • Control of motor activity: receives information from spinocerebellar tracts and coordinates and smoothes out movement induced by the UMN system
  • Maintenance of balance (through connections with vestibular nuclei)
63
Q

Which parts of the brain would be linked to ataxia?

A
  • Need general proprioception (UMNs)
  • Need the cerebellum to coordinate the movement
  • Need to vestibular system to maintain balance
64
Q

What are the functions of rods and cones in the retina?

A

Rods – low level light (night vision)

Cones – high level light (day vision) and colour vision

65
Q

Central blindness is localised as a lesion of the…?

A

Forebrain

66
Q

Describe the conscious pathway involved in the conscious perception of vision

A
  • Eye, CN2, crosses at optic chiasm
  • Lateral geniculate n. (thalamus)
  • Optic radiation
  • Contralateral cerebral cortex
67
Q

Describe the reflex pathway involved in pupil constriction in the eye

A
  • Eye, CN2, crosses at optic chiasm
  • Pretectal n. (brainstem)
  • Parasympathetic oculomotor n.
  • Bilateral response but direct response greater than consensual
68
Q

What are the functions of the forebrain (cerebral cortex and diencephalon)?

A
  • Behaviour, decision making
  • Conscious perception for all sensory systems
  • Some motor functions (pyramidal system)
69
Q

Where is the hypothalamus located?

A

In the forebrain

70
Q

What is the ascending reticular activating system (ARAS)

A
  • Receives information from all sensory systems

- Information courses through brainstem to thalamus and then projects to cerebral cortex

71
Q

What are the 3 functions of the ascending reticular activating system (ARAS)?

A
  • Arouse cortex
  • Awake brain to a conscious level
  • Prepare brain to receive sensory information

Y3 MOD Neurology (5 decks)

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