Control Flashcards
Which layer of dura continues with the spinal cord?
Meningeal
What does the tentorium cerebelli separate?
Occipital lobe and Cerebellum
Injury to which artery is responsible for an extradural/epidural haematoma?
Middle meningeal artery
Which branch of the trigeminal nerve innervates the following parts of the brain?
1) Flax cerebri
2) Tentorium cerebelli
3) Middle cranial fossa
Flax cerebri - V1
Tentorium cerebelli - V1
Middle cranial fossa - V2/V3
When does a subdural haemorrhage occur?
Tearing of veins from venous dural sinuses
What is the cause of a subarachnoid haemorrhage?
How does it present?
Thrombus in Circle of Willis
Thunderclap headache, vomiting, confusion
Name 3 ways hydrocephalus occurs.
1) Overproduction of CSF
2) Obstruction to flow of CSF
3) Failure to reabsorb CSF through arachnoid granulations
GCS score of 3 suggests a patient is in what state?
Coma/dead
What is the GCS score for a patient being fully awake?
15
At what angle does the cephalic flexure bend?
100*
Which type of neural matter has unmyelinated axons?
Grey
Which lobe is responsible for behaviour, mood and language?
Frontal
Which lobe is responsible for memory and hearing?
Temporal
Which lobe is responsible for calculations and visuospatial function?
Parietal
Which lobe is responsible for vision?
Occipital
What separates the cerebral cortex into L and R hemispheres?
Corpus callosum
Which type of fibres link WITHIN hemispheres?
Association
Which type of fibres link BETWEEN hemispheres?
Commisural
Which type of fibres are carried to/from hemispheres for example in the posterior limb of the internal capsule?
Projection
Which arteries exit the skull from the foramen magnum?
Vertebral arteries
Which arteries supply the deep structures in the cerebrum eg: internal capsule?
Striate arteries (arising from middle cerebral)
Emboli can travel up the internal carotid into the middle cerebral artery and can therefore occur in which arteries?
In which sulcus would these strokes get stuck?
Striate arteries
Lateral sulcus
Which arteries are not branches or continuations of the ICA?
Posterior cerebral
What structure separates the cerebellum from the pons?
4th ventricle
The colliculi are on the posterior surface of which part of the brainstem?
Midbrain
Which gyrus separates occipital lobe into upper and lower?
Calcarine sulcus
What are the basal ganglia involved in?
Movement control
Which lobes of the brain does the lateral ventricle project into?
Frontal (anterior horn)
Occipital (posterior horn)
Temporal (inferior horn)
What connects the lateral ventricles to the 3rd ventricle?
Foramen of Monro (between R/L thalamus)
What connects and transports CSF between the 3rd ventricle to the 4th ventricle?
Cerebral aqueduct
How is CSF drained in the brain?
Lateral ventricles –> foramen of Monro
–> 3rd ventricle –> cerebral aqueduct
–> 4th ventricle –> central spinal canal
or –> subarachnoid cisterns
Levator palpibrae superioris does what to the eyelid?
Elevates it
What is the classic triad of Horner’s syndrome?
Miosis (constricted pupil)
Partial ptosis
Anhidrosis (loss of sweating)
What is the cause of Horner’s syndrome?
Interruption of sympathetic pathways often due to a pancoast tumour
Which eye muscle is inactivated resulting in ptosis?
Superior tarsal muscle (branch of levator palpibrae superioris)
What do the following eye muscles do: Superior rectus Inferior rectus Lateral rectus Medial rectus Superior oblique Inferior oblique
Superior rectus - elevation
Inferior rectus - depression
Lateral rectus - abduction
Medial rectus - adduction
Superior oblique - intorsion (inward rotation)
Inferior oblique - extorsion (outward rotation)
What muscle is responsible for accommodation?
Ciliary
What muscle is responsible for constriction of the pupil?
Sphincter pupillae
What muscle is responsible for dilation of the pupil?
Dilator pupillae
Damage to occulomotor nerve would result in what eye presentations?
Lateral rectus/Superior oblique intact –> eyes point down and out
Levator palpibrae superioris damaged –> ptosis
Sphincter pupillae damaged –> dilation of pupil
How could you differentiate between CN3 damage and Horner’s Syndrome?
Horners: pupil constricted (miosis), anhidrosis
CN3 damage: pupil dilated, eyes inward and down
What does the temperomandibular joint enable?
Elevation/depression of jaw
Which muscle of mastication is the most powerful?
Masseter
Which muscle of mastication is the major protractor of the mandible? What shape is it?
Lateral pterygoid
Triangle
Which muscle of mastication is the only one to depress the mandible?
Lateral pterygoid
What is the innervation for the muscles of mastication?
V3 trigeminal
Unilateral damage to trigeminal nerve causes the jaw to deviate towards or away from the lesion?
Towards the paralysed side
Which mater are the denticulate ligaments found in?
What role do they have?
Pia mater
Prevent rotation of spinal cord
Which vertebral boundary do the following terminate at:
Spinal cord?
Dural sac?
Lumbar cistern - L1/L2
Dural sac - S2
At what level of the spinal cord is a lumbar puncture performed?
L3/L4
or L4/L5
Damage to the anterior segmental medullary arteries results in which deficits?
Pain and temperature
Damage to the posterior segmental medullary arteries results in which deficits?
Propriception and discriminative touch
White matter increases as you go up or down the spinal cord?
Up (cervical has the most)
The ventral grey horn is enlarged in which segments of the spinal cord? Why?
Cervical and lumbosacral
Accumulation of motor neurons for innervation of the limbs
Which nuclei and lamina are the following: Pain and temp Spinothalamic tract cells Motor - SCM/trapezius Sympathetic neurons General sensory processing
Pain and temp - substantial gelatinous II
Spinothalamic tract cells - marginal zone I
Motor - SCM/trapezius - accessory IX
Sympathetic neurons - lateral column VII
General sensory processing - posterior horn III-VI
Which structure units the ventral and dorsal roots?
Interventricular foramen
Which type of skin thickness does NOT have hair follicles on?
Thick - palms, soles
Is the dermis of thick skin thick too or thin?
Thin - opposite
What type of epithelium is skin?
Keratinised stratified squamous epithelium
Put in order of superficial to deep layers of skin: Stratum granulosum Stratum germinativum/basale Stratum corneum Stratum lucidium Stratum spinosum
1) Stratum corneum
2) Stratum lucidium
3) Stratum granulosum
4) Stratum spinosum
5) Stratum germinativum/basale
Which layer of skin contains keratinocytes?
Stratum germinativum/basale
For the following skin receptors mention their function in detection and if their adaptation is rapid/slow:
1) Merkel cell
2) Pacinian corpuscle
3) Meissener’s corpuscle
4) Ruffini endings
Merkel cell neutrite complex - pressure/texture - slow
Pacinian corupscle - vibration - rapid
Meissener’s corpuscle - flutter/motion - rapid
Ruffini endings - stretching - slow
Which skin receptor is involved with reading braille?
Merkel cell neutrite complex
In the cerebellum what is the order of the function subdivision from medial to lateral?
Vestibulocerebellum
Spinocerebellum
Cerebrocerebllum
Which of the cerebellum subdivisions comprises of the flocculonodular lobe?
Vestibulocerebellum
Which of the cerebellum subdivisions comprises of most of the vermis?
Spinocerebellum
Which of the cerebellum subdivisions coordinates balance and posture?
Vestibulocerebellum
Which of the cerebellum subdivisions coordinates fine movements?
Cerebrocerebellum
Which of the cerebellum subdivisions coordinates posture and locomotion?
Spinocerebellum
Damage to which part of the medulla results in inability to blink?
Inferior olivary nucleus
Is cerebellum influence contralateral or ipsilateral?
Ipsilateral
Which cerebellum connection involves the superior cerebellar peduncle?
Motor cortex passing to midbrain
Which cerebellum connection comes into the inferior cerebellar peduncle from the same side?
Spinocerebellum
Which cerebellum connection knows what your muscles are doing?
Spinocerebellum
Which cerebellum connection knows what you want to do (intended movements)?
Cerebrocerebellum
Is the input from the cerebellum connection moving across the midline or entering the ICP from the same side?
Crossing the midline
Tuncal ataxia is the inability to stand or sit without falling over - a lesion in which subdivision of the cerebellum is responsible?
Vestibulocerebellum
A lesion in the cerebrocerebellum results in what type of incoordination?
Incoordination of voluntary movement
Tremor of intent
Past pointing/dysmetria
A lesion in which subdivision of the cerebellum results in gait ataxia?
What type of people are at a higher risk of this
Spinocerebellum
Chronic alcoholics
For the basal ganglia DIRECT pathway are the following pathway points excitatory or inhibitory:
1) Cortex –> Striatum (caudate + putamen)?
2) Thalamus –> Cortex
3) Striatum –> Globus pallidum
4) Globus pallidum –> Thalamus
Caudate –> Striatum = excitatory
Thalamus –> Cortex = excitatory
Striatum –> Globus pallidum = inhibitory
Globus pallidum –> Thalamus = inhibitory
What is the effect of the direct basal ganglia pathway on the cortex?
Excitatory
For the basal ganglia INDIRECT pathway are the following pathway points excitatory or inhibitory:
1) Cortex –> Striatum
2) Striatum –> Globus Pallidum (externa)
3) Globus Pallidum –> Subthalamic Nucleus
4) Subthalamic Nucelus –> Globus Pallidum (interna)
5) Globus Pallidum (interna) –> Thalamus
6) Thalamus –> Cortex
Cortex --> Striatum = excitatory Striatum --> Globus Pallidum (externa) = inhibitory Globus Pallidum --> Subthalamic Nucleus = inhibitory Subthalamic Nucelus --> Globus Pallidum (interna) = excitatory Globus Pallidum (interna) --> Thalamus = inhibitory Thalamus --> Cortex = excitatory
In the direct pathway what increase of which fibres is the GP Interna receiving?
Increase of inhibitory fibres
In the indirect pathway what increase of which fibres is the GP Interna receiving?
Increase of excitatory fibres
What is the main function of the substantia nigra pars compacta?
Initiate movement
What is the effect of the substantia nigra on the direc/indirect pathways?
Direct - excites
Indirect - inhibits (excitatory effect as a result)
What is the result of a diminished substantia nigra?
No movement initiation
Most common disease of basal ganglia?
Disruption of nigrostrial input –> PD
