G's Get Degrees Random Cards Imported Flashcards
Crus Cerebri
Loss of motor function of eye- CN III, IV
Superior Colliculi
Motor, sensory and orientation to danger
Inferior colliculi
Hearing loss CN 8 damaged - lateral lemniscus
Posterior cerebral artery(branch of basilar artery)
Ipsilateral side - CN 3
Pons -
cardiovascular, breathing control, acoustic, vestibular orientation
Facial colliculus(Caudomedial pontine floor)
Facial muscle, eye muscle problems (CN 6 & 7)
Vestibular Schwannoma- tumor in cerebellopontine angle
CN 7 & 8 function
Basilar artery
Locked in syndrome
Pneumotaxic center
Maintenance of normal breathing pattern
Medulla
expiration, inspiration, vasomotor , swallowing,vomiting
Pyramids
Motor function - weakness
Rostral ventrolateral Medulla (RVLM) - Pressor Area(Glutaminergic)
Loss of control of BP
Caudal Ventrolateral Medulla (CVLM)-Depressor Area(GABAergic)
Decrease in ADH release and inc in BP _ Dehydration
Ventromedial Medulla (raphe nuclei)
Dec regulation of temperature,pain, respiration. Lose sympathetic output and constriction of cutaneous blood vessels.
Nucleus Tractus Solitarius
Hypertension _ cardiac damage, pulmonary edema _ death
Nucleus Ambiguus
Loss of parasympathetic/visceral response to decrease BP
Dorsal Respiratory group(DRG)
Periodic activation during inspiration, feedback from lung
Ventral respiratory group(VRG)
Respiratory rhythm generation decreases
Pre-Botzinger complex in medulla
Respiratory rhythm generator
Phrenic Nucleus
Diaphragmatic contraction
Internal capsule (corticospinal tract) - projection tract
Opposite side motor function is weak
Cerebellum-
compares motor output with the sensory feedback. Coordinated and steady movement
Cerebellum - Flocculus(CN 8)
Uncoordinated, unsteady movement
Lateral cerebellum
Fine precise control of movements of fingers
Medial cerebellum (vermis)
Up and down movements - control of trunks and limbs
Tonsil herniation
Brain herniates through the foramen magnum
Vermis herniation
Prone to damage medulla
Hypothalamus -
integrates endocrine, behavioral info
Posterior Hypothalamus (normal function = Increases body temperature) it_s hot in the back
Decreased body temperature
Anterior Hypothalamus(normal function = decreases body temperature)
Increased body temperature
Ventromedial hypothalamus (normal function = inhibits feeding)
obesity
Lateral hypothalamus(normal function = increases feeding)
Decreased feeding (inhibitory neuronal link between arcuate nucleus and lateral hypothalamus _ suppresses food consumption _ weight loss)
Pterygoid canal
1.ÿÿÿÿ vasodilation (b/c sympathetics is lost (deep petrosal nerve)); ÿÿ no secretion from nasal, palatine, and lacrimal gland; loss of general sense and taste sensation of palate (damaged Greater petrosal- anterior 2/3 tongue gone)
Brain swelling
Uncus compresses CN III - dilated pupils, sleepiness
Lenticulo striate artery(branch of MCA)
Paralysis of upper body
Corticobulbar tract
Loss of motor function of CN
Suprasacral spinal transection(Above T12)
Automatic bladder- bladder is filled until a threshold is reached _ reflexing emptying
Midsacral afferents (cauda equina)
Atonic bladder _ loss of afferents - bladder is filled and leads to urinary retention due to loss of reflexive arc(micturition center) _ urine dribbling
Lateral brain- MCA dominant
Language deficit(understanding decreases-Wernicke_s and- Broca_s), weak mouth and face
Medial brain- ACA dominant in anteromedial
ACA- left Leg, foot weakness, loss of voluntary control of bowel and bladder (incontinence)
PCA is posteromedial
PCA - CN3 - Central vision is preserved but cannot see periphery, amnesia
Anterior spinal artery (ventral 2/3rd of spinal cord) - somatosensation
Cannot tell pain and temperature(ASA)
(Lateral column)
Paralysis(lateral column)
Posterior spinal artery
Dorsal column of the ipsilateral side
Herpes
Temporal lobe
Prolactinoma -pituitary gland tumor
Compresses optic chiasm - Decrease in endocrine cells,Optic nerve dysfunction
Fornix (connects hippocampus to mamillary body)
Amnesia, Korsakoff
Dorsal-column medial lemniscal system
Detect position, vibration
Spinothalamic tract
Pain and temperature
Corticospinal(cortical layer V)
Voluntary movement -strength decreases
Circumventricular organs - Subfornical organs, organum vasculosum lamina terminalis
Decreased secretion of ADH, decreased control of regulation of electrolytes
Amygdala
Decreased emotion and fear response
Solitary Nucleus
Decreased response to pain,temperature and special afferents(taste) from CN 7,9,10
Anterior Paracentral
Weakness in contralateral lower extremity
Mastoiditis
Petrous part of temporal bone
Inferior frontal gyrus(pars operacularis and triangularis)
Lose Broca_s speech area
Lateral funiculus
Weakness in arm and leg
Middle meningioma
Parieto-occipital sulcus
Achetylcholine
1) Basal forebrain: Basal nucleus of Meynert → cortex, limbic system -involved with Alzheimer’s 2) Dorsolateral pontine tegmental → brainstem, thalamus, hypothalamus, basal ganglia, cerebellum : motor control of movement
Glutamate
Ubiquitous (everywhere). a) AMPA/Quisqualate kainate : ionotropic cationic : Na+ influx, K+ efflux b) NMDA : glutamate binds, glycine has to occupy the strychnine-insensitive binding sites - Non-NMDA receptor mediated depolarization - Mg2+ removed → Na+,Ca2+ influx and K+ efflux Aspartate uses same receptor
GABA
- Small GABAergic neurons are ubiquitous modulators- Longer GABAergic pathways arise from varied nuclei- Striatum → substantia nigra- Substantia nigra → superior colliculus and thalamus- Medial vestibular nuclei → spinal cord- Cerebellar cortex → deep cerebellar nuclei- GABAa - ionotropic - Cl- passing receptor> benzodiazepines works with GABA(a) to allow Cl > barbiturates can work independently- GABAb - metabotropic: inc K+ efflux and Ca2+ dec influx → axoaxonic → reduce NT release
Glycine
- Neurons are small local regulators- Found near spinal and bulbar motor nuclei- Structurally and functionally similar to GABAa receptors - Cl- conducting (ionotropic)- Blocked by strychnine
Dopamine
- Substantia nigra pars compacta → via nigrostriatal pathway → caudate and putamen (motor function) -Parkinson’s affects midbrain 2. Ventral tegmental area situated medial to substantia nigra- Prefrontal cortex (mesocortical pathway) - increase schizophrenia - Nucleus accumbens and limbic structures(mesolimbic pathway) - happy center3. Hypothalamic arcuate nucleus → hypothalamic median eminence for dumping of DA into hypophyseal portal system → inhibits prolactinMetabotropic : D1 like (D1 & D5): excitatory coupled to cAMP1. D2 like (D2, D3, D4) - inhibitory coupling to cAMP
Norepinephrine
- Locus coeruleus → diencephalon, limbic system, cerebral lobes and cerebellum( indicated in depression)2. Other clusters of pontomedullary noradrenergic nuclei project → NTS and spinal targetsMetabotropic : a1 and B1 excitatory1. a2 & b2 inhibitory
Serotonin (Nuclei- only one found in brainstem)
Array of midline brainstem(raphe)- Mesencephalic and pontine nuclei → thalamus , limbic areas, cortex (Depression - Medullary serotonergic cells → within the medulla and to spinal cordMetabotropic5-Ht1, 5-Ht5 : inhibitory5-Ht2: excitatory5-HT3: excitatory ionotropic (cation -permeable)- 5-HT4, 5-HT6, 5-HT7 : excitatory
Buccal Nerve vs. Buccal Branch of Facial Nerve
Buccal Nerve comes off V3; Buccal Branch comes off Facial N. ; Buccal Nerve is Sensory; Buccal Branch of Facial is Motor.
Three Muscles on Styloid Process:
Stylopharyngeus – innervated by Glossopharyngeal N.;Stylohyoid – innervated by Facial N. (remember stylohyoid is associated with Posterior Belly of Digastric M., which is also innervated by Facial N.);Styloglossus – innervated by Hypoglossal N.
Superior Laryngeal Nerve: Internal vs. ExternalBranches
Internal Branch = sensory;External Branch = Motor (innervates Cricothyroid)
Cricothyroid vs. The Rest of LarynxInnervations:
Cricothyroid = innervated by External Branch of Superior Laryngeal Nerve.;All other Laryngeal Muscles = innervated by Recurrent Laryngeal Nerve.
Posterior vs. Anterior Belly of Digastric
Posterior Belly = innervated by facial;Anterior Belly = innervated by V3 (Nerve to Mylohyoid, to be exact – remember Anterior Belly is associated with Mylohyoid)
Left vs. Right Recurrent Laryngeal Nerve
Left = branches off Vagus, then loops around arch of aorta;Right = branches off Vagus, then loops around Right Subclavian Artery
Internal vs. External Jugular Veins:
Internal = runs deep to Sternocleidomastoid;External = runs superficial to Sternocleidomastoid
Internal Jugular V and Internal Carotid A. vs. External Jugular V and External Carotid A
Internal = goes straight up into brain;External = goes outside of brain.
Stapedius vs. Tensor Tympani:;
Facial N. → Stapedius → pulls on Stapes → dampens sounds (from voices);V3 → Tensor Tympani → pulls on malleus (which then pulls on tympanic membrane) → dampens sounds (from chewing).
Components of Carotid Sheath:;;
Internal Jugular Vein;Common Carotid Artery;Vagus Nerve runs between them.
Genioglossus vs. Geniohyoid vs. MylohyoidInnervations:;;
Genioglossus = innervated by Hypoglossal N. (XII);Geniohyoid = innervated by C1;Mylohyoid = innervated by V3 (Nerve to Mylohyoid)
Cranial Nerves that have Parasympathetic Innervation
CN 3, 7, 9, 10
What does the Superior Oblique muscle do?;
Its action is to make your eye look down and out;To test to see if the Superior Oblique works, look in and down (note: NOT down and in). Because the “out” action can also be done by lateral rectus, you can’t reliably test for Superior Oblique’s “out” function, and therefore you only test for the Superior Oblique’s “down” function. Because inferior rectus also does the “down” action, you tell the patient to look “in” first before looking “down” because inferior rectus doesn’t work well when the eye is adducted.
Innervation of the Tongue:;
Anterior 2/3 - general sensation lingual nerve from v3, taste from chorda tympani from facial and motor hypoglossal;post 1/3 - gen sense and taste glossopharnygeal and motor is hypoglossal
Larynx Muscles:;;;
Only Abductor — Posterior Cricoarytenoid.;Whispering Muscle (doesn’t adduct all the way) — Transverse Arytenoid M.;Lowers pitch — Thyroarytenoid M.;Raises pitch — Cricothyroid M.
Glossus Muscles Innverations
All “-glossus” muscles are innervated by hypoglossus except palatoglossus, which is innervated by vagus. All the pharynx muscles are vagus except stylopharyngeus, which is innervated by glossopharyngeus.
Branches of Facial Nerve;;;;;
Please = Posterior Auricular;Tell = Temporal Branch;Ziggy = Zygomatic Branch;Bob = Buccal Branch;Marley = Mandibular Branch;Called = Cervical Branch
Cutaneous Branches of V1 (Ophthalmic Nerve):;;;;
L = Lacrimal N.;I = Infratrochlear N.;E = Ethmoidal N.;S = Supratrochlear N.;S = Supraorbital N.
Cutaneous Branches of V2 (Maxillary Nerve):;;
Z = Zygomaticotemporal N.;I = Infraorbital N.;Z = Zygomaticofacial N.
Cutaneous Branches of V3 (Mandibular Nerve;;
B = Buccal N.;A = Auriculotemporal N.;M = Mental N.
Branches of External Carotid Artery, from inferior to superior
o Some = Superior Thyroid A. o Angry = Ascending Pharyngeal A. o Lady = Lingual A. o Found = Facial A. o Out = Occipital A. o P = Posterior Auricular A. o M = Maxillary A. o S = Superficial Temporal A.
Drainage to Superior Meatus;
P= Posterior Ethmoidal Air Sacs;S = Sphenoidal Sinus
Drainage to Middle Meatus;;;
F = Frontal Sinus;A = Anterior Ethmoidal Air Sacs;M = Middle Ethmoidal Air Sacs;M = Maxillary Sinus
Drinage to Inferior Meatus
N = Nasolacrimal Duct
Kiesselbach’s Area (Little’s Area) Anastomoses;;;
F = Facial Artery (Superior Labial Branch);O = Ophthalmic Artery (Anterior Ethmoidal Branch);M = Maxillary Artery (Greater Palatine Branch);M = Maxillary Artery (Sphenopalatine Branch)
Symptoms of Horner’s Syndrome;;;
S = Sympathetic Chain impingement;P = Ptosis (drooping eyelid);A = Anhydrosis (dehydration);M = Miosis (pin-point eye)
