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organ systems > First aid neuroanatomy and physio part 2 > Flashcards

First aid neuroanatomy and physio part 2 Flashcards

1
Q

Which nerves exit above the corresponding vertebra?

A

C1-C7

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2
Q

Which nerves exit below the corresponding vertebra?

A

Everyone below C7

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3
Q

Vertebral disk herniation

A
  • nucleus pulposus (soft central disk) herniates though the annulus fibrosis (outer ring)
  • usually occurs posterolaterally at L4-L5 or L5-S1
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4
Q

Where does the spinal chord end?

A

L1-L2

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5
Q

Where does the subarachnoid space extend to?

A

S2

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6
Q

Where do we do a lumbar puncture?

A

L3-L4 or L4-L5.

To keep the chord alive keep the needle between L3 L5

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7
Q

Spinal chord associated tracts orientation

A

Legs are lateral in lateral corticospinal and spinothalamic (anterior lateral) tracts

Dorsal columns are organized like you, hands at sides so arms on the outside and legs on the inside

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8
Q

Upper motor neuron signs

A
  • weakness
  • increased reflexes
  • increased tone
  • postive babinski
  • positive spastic paralysis
  • clasp knife spasticity
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9
Q

lower motor neuron signs

A 
weakenss
atrophy
fasiculations
decreased reflexes
decreased tone
increased falccid paralysis
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10
Q

Dorsal column tract

A

Ascending:
pressure, vibration, fine touch and proprioception

Sensory nerve ending –> cell body in doral root ganglion –> enter spinal cord asceds ipsilaterally in dorsal columns.

  • synapses at ipsilateral nucleus cuneatus or gracilis in the medulla
  • decussates in medulla and ascedns contralateraly in the medial reminisces
  • synapses at VPL
  • goes to sensory cortex
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11
Q

LAterial Spintholamic tract (anteriolateral)

A

pain and temp
sesory nerve fibers (Adelta and C) cell body in dorsal root ganglion –> enters spinal chord
-synapses on ipsilater reay matter
-decussates at the anterior white commisure
-ascends contralaterally
-synapses on VPL
-then heads to the sensory cortex

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12
Q

Lateral corticospinal tract

A

descending voluntary movement of contralateral limbs
so UMN cell body in the primary cortex –> descends ipsilateraly though the internal capsule, most fibers decussate at caudal medulla (pyramid decussation)–> descends contralateraly till cell body in anterior horn–LMN leaves spinal cord and synapses at the NMJ

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13
Q

Spinal cord lesion: Poliomyelitis and spinal muscular atrophy (wednig hiffmann disease)

A
  • LMN lesion
  • destruction of anterior horns!
  • flaccid paralysis
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14
Q

Spinal cord lesion: MS

A
  • due to demyelnation
  • mostly white matter of cervical region in the dorsal columns, but random and asymmetric lesions
  • scanning speech, intention tremor and nystagmus
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15
Q

Spinal cord lesion: AML

A

UMN and LMN

  • no sensory deficts
  • can be caused by a defect in superoxide dismutase 1
  • anterior horns and cortiocalateral spinal tracts

presents with
fasiculations with eventual atrphy and weakenss of hands

treat: riluzole which decreased glutamate release

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16
Q

Spinal cord lesion: ASA occlusion

A
  • spares dorsal columns and lissauer tract
  • everything else
  • note the upper ASA territory is watershed area as the artery of adamkiewicz supplies ASA below T8
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17
Q

Spinal cord lesion: Tabes dorsales

A
  • tertiary syphillis
  • degeneration of dorsal columns
  • imparined sensation and proprioception and progressive sensory ataxia–> inability to sense or feel the legs–> poor coordination

assoc with charcot joins, shooting pain, argyll robertson pupuls
-postive romberg

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18
Q

What is Argyll Robertson Pupils?

A
  • tertiary syphillis

- small bilateral pupils that further constrict to accommodation and convergence but NOT TO LIGHT

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19
Q

Syringomyelia

A
  • syrinx expands and damges anterior white commisure of pniothalamic tract–> bilateral loss of pain and temperature sensation usually C8-T1
  • assoc with Chiari I
  • can expand and effect other tracts like the anterior horns
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20
Q

Vitamin B12 or Vitamin E deficiency

A

-subacute combine degerenation-demyelination of dorsal column and lateral corticospinal tracts and spinocerebellar tracts; ataxic gait, parenthesis, impaired postion and vibration sense

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21
Q

Poliomyelitis

A
  • polio virus
  • RNA virus
  • Fecal oral
  • replicates in the oropharynx and small intestine before spreading via bloodsteam to the CNS
  • anterior horn destruction
  • CSF increased wbc and slight increase in protein
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22
Q

werdnig hoffman disease spinal muscular atrophy

A

congenital degredation of anterior horns

  • LMN
  • floppy baby
  • tongue fasiculations
  • Autosomal recessive
  • death by 7 months
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23
Q

Friedreich ataxia

A

Autosomal recessive trinucelotide repease disorder (GAA)

  • chromosome 9 in the gene that encodes frataxin
  • leads to impairment in mitochondrial functioning
  • degeneration of multiple spinal cord tracts
  • muscle weakness and loss of DTRs, vibratory sense, proprioception
  • staggering ait, frequent falling, nystagmus, dysarthia, pes cause, hammer toes, hypertrophic cardiomyopathy
  • kyphoscoliosis
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24
Q

Brown sequard syndrome

A

Hemisection!! of spinal chord

  • ipsilateral UMP signs below the level of the lesion due to corticopisnal tract damage
  • ipsilateral loss of tactile, virbration and proprioception 1-2 levels below the lesion due to damage of dorsal column
  • contralateral pain and temperature loss below the level of the lesion due to damage of the spinothalamic tract
  • ipsilateral loss of alllll sensation at the level of the lesion (pain and proprio have not crossed the commisue yet at the entrance level)
  • ipsilateral LMN signs due to destruction of anteroir horn at the level

note if the lesion is above T1 –> horners

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25
Q

Horner syndrome

A
  • ptosis
  • anhidrosis (absence of sweating and flushing of affected side of face)
  • miosis (pupil constriction)

lesion of spinal chord above T1 like:
pancoast tumor, brown seqaurd, late stage syringomyelia)

Why?
Oculosympathetic pathway:
hypothalamys to the intermediolateral column of the spinal chord, then to the superio cervical sympathetic ganglion then back upto the pupil, smooth muscle of eye lids and sweat glands of the forehead and face.

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26
Q

C2

A

posterior half of the skull (cap)

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27
Q

C3

A

high turtle neck shirt

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28
Q

C4

A

low collar shirt

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29
Q

T4

A

nipple

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30
Q

T7

A

xiphoid process

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31
Q

T10

A

umbilicus bellybut TEN

-early appedicitis pain referral

32
Q

L1

A

inguinal ligament

33
Q

L4

A

includes the kneecaps

34
Q

S2,3,4

A

erection and sensation of penile and anal zones

35
Q

Diaphram and gallgbladder pain are referred to the right shoulder via?

A

phrenic nerve

36
Q

S1,2 buckle my shoe

37
Q

L3,4 kick the door

38
Q

C56 pick up sticks

39
Q

C7,8 lay them striaght

A

triceps reflex (extension)

40
Q

Dorsal brain stem Pineal gland

A

-melatonin secretion, circadian rhythms

41
Q

Dorsal brain stem: Superior colliculi

A

-conjugate vertical gaze center

Parinaud syndrome: paralysis of conjugate vertical gaze due to lesion in superior colliculi (pinealoma)

42
Q

Dorsal brain stem: Inferior Colliculi

43
Q

stapedius muslce in ear

44
Q

CN III

A 
EOM:
Superior rectus: eye elevation 
Inferior rectus:depression
Medial Rectus :adduction
Inferior oblique: elevation and abduction

SIMI

Pupillary constriction (sphincter puppilair: EW nucleus, muscarinc receptors)
Accommodation
eye lid opening (levator palpebrae)

45
Q

CNIV

A

Superior Oblique:
eye depression
other movements: medial rotation and abduction

46
Q

Inferior oblique

A

CN III
eye elevation
other movements: lateral rotation and abduction

47
Q

Lateral rectus

A

CN VI Abducens

Abduction

48
Q

Brain stem nuclei

A

lateral nuclei are normally sensory

medial nuclei are normally motor

49
Q

What nuclei are in the midbrain?

A

CNIII, CN IV

50
Q

What nuclei are in the pons?

A

CN V, VI, VII, VIII

51
Q

What nuclei are in the medulla?

A

CN IX, X, XII

52
Q

What nuceli are in the spinal chord?

53
Q

corneal reflex

A

afferent: V1
efferent: VII (temporal branch)

54
Q

Lacrimation reflex

A

afferent: V1
efferent is VII
but loss of reflex does not prevent emotional tears

55
Q

Jaw jerk reflex

A

afferent: V3 sesory muscle spindle
efferent: V3 motor -masseter

56
Q

Pupillary reflex

A

afferent: CNII
Efferent: CN III

57
Q

gag reflex

A

afferent: IX
Efferent: X

58
Q

Nucleus solitatius

A

viseceral sensory infromation (taste, baroreceptors and gut distention)
- VII, IX, X

59
Q

Nucleus ambiguous

A

motor innervation:
pharynx, larynx, upper esophagus
IX, X, X1

60
Q

Dorsal motor nucleus

A

sends autonomic parasympathetic fibers to heart, lungs, and upper GI
CN X

61
Q

What passes thorugh the cribiform plate?

62
Q

What passes though the optic canal?

A

CNII, opthalmic arter and central retinal vein

63
Q

What passes though the superior orbital fissures?

A

CN III, IV,V-1, VI, opthalmic vein, sympathetic fibers

64
Q

What passes through the foraemen rotundum?

65
Q

What passes through the foreamen ovale?

66
Q

What passes through the spinosum?

A

middle meningeal artery

67
Q

What passes through the internal auditory meatus?

A

CN VII and VIII

68
Q

What passes thought the jugular foramen?

A

CN IX, X, XI, jugular vein

69
Q

What passes though the hypoglossal canal?

70
Q

What passes though the foramen magnum?

A

spinal roots of CN XI, brainstem and vertebral arteries

71
Q

Cavernous sinus

A

A collection of venous sinuses on either side of the pituitary.
blood from eye and superficial cortex drain to the cavernous sinus and into the internal jugular vein

whats in it?
CN III, IV, V-1, V-2 and VI and post ganglionic sympatheitc fibers, internal carotid artery

72
Q

Cavernous sinus syndrome

A
  • due to mass effect, fistula, thrombosis
  • opthalmoplegia and decreased corneal and maxillary sensation (V1, V2) but normal visual acuity (CN II not affected), CN VI commonly affected
73
Q

CN V lesion

A

jaw deviates towards lesion due to unopposed pterygoing muscle

74
Q

CN X lesion

A

uvula deviates way from lesion as the weak side collapses and uvula turns away

75
Q

CN XII

A

tongue deviates twards the lesion, lick your wounds due to weakend tongue muscles on the affected side

76
Q

Conductive hearing loss

A

rinne test
abnormal bone> air
weber test localizes to affected ear

77
Q

Sensorineural hearing loss

A

rinner
Normal air> bone

weber: localizes to uneffected ear

organ systems (25 decks)

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