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Medicine Phase 2a Neuro > General > Flashcards

General Flashcards

1
Q

With regard to spinal cord and cerebrum - what is dorsal and what is ventral

A 
Dorsal = posterior/superior
Ventral = anterior/inferior
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2
Q

3 layers of meninges

A

Dura (outermost)
Arachnoid
Pia (inner most)

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3
Q

What is Pia

A

Innermost layer of the meninges
On the surface of the brain and cant be separated from the brain
Microscopic layer, present between blood vessel and neurons also

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4
Q

What is dura attached to

A

Outermost layer of meninges

Firmly adherent to inside of the skull

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5
Q

Where do meningeal vessels arise

A

External carotid artery

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6
Q

Where are meningeal vessels found

A

Extradural space, between bones of the skull and dura

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7
Q

Example of blood vessels in cerebrum

A

Meningeal vessels
Bridging veins (between dura and arachnoid aka subdural space)
Circle of Willis

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8
Q

Where is circle of Willis

A

subarachnoid space (between arachnoid and pia)

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9
Q

What is white matter

A

Myelinated axons

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10
Q

What is grey matter

A

Cell bodies

no myelin sheaths

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11
Q

True or False:

There are no blood vessels deep to the pia

A

True

The pia forms part of the blood brain barrier

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12
Q

What cells myelinate axons in the brain or CNS

A

Oligodendrocytes

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13
Q

What cells myelinate axons in the PNS

A

Schwann cells

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14
Q

What are afferents

A

axons taking information towards the CNS e.g. sensory fibres

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15
Q

What are efferents

A

axons taking information to another site from the CNS e.g. motor fibres

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16
Q

Functions of frontal lobe

A

Voluntary movement on opposite side of body
Brocas area - speech and writing (found in dominant hemisphere i.e. left if right-handed)
Intellectual functioning
Thought processes
Reasoning
Memory

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17
Q

Functions of parietal lobe

A

Receives and interprets sensations, including pain, touch, pressure, size and shape and body-part awareness
Proprioception

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18
Q

Functions of temporal lobe

A

Understanding spoken word (WERNICKES)
Understanding sounds
Memory
Emotion

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19
Q

Functions of occipital lobe

A

Understanding visual images and meaning of written words

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20
Q

Where is CSF produced

A

Ependymal cells in choroid plexuses of lateral ventricles (mainly)

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21
Q

Where does CSF travel (describe ventricles of brain)

A

From lateral ventricles
Travels to 3rd ventricle via the interventricular foramen
From 3rd ventricle
Travels to 4th ventricle via the Cerebral Aqueduct

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22
Q

How does the 4th ventricle communicate with/pass CSF into the subarachnoid space

A

Median Foramen of Magendie

Two lateral Foramens of Luschka

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23
Q

Where is CSF absorbed after passing through subarachnoid space

A

Arachnoid granulations (VILLI) e.g. in superior sagittal sinus

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24
Q

What is hydrocephalus

A

Abnormal accumulation of CSF in ventricular system

Often due to a blocked cerebral aqueduct

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25
Q

Which spinal roots make up the sympathetic trunk

A

T1-L2

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26
Q

Give examples of what sympathetic nervous system stimulates

A
  • Increases heart rate
  • Increases force of contractions in the heart
  • Vasoconstriction
  • BronchoDILATION
  • Reduces gastric motility
  • Sphincter contraction
  • DECREASED gastric secretions
  • Male ejaculation
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27
Q

Give examples of what parasympathetic nervous system stimulates

A
  • Decreases heart rate
  • Decrease force of contraction
  • Vasodilation
  • BronchoCONSTRICTION
  • Increases gastric motility
  • Sphincter relaxation
  • INCREASED gastric secretions
  • Male erection
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28
Q

What are the parasympathetic cranial nerves and where do they run via

A

Oculomotor nerve CN3 - to pupil
Facial nerve CN7 - to salivary glands
Glossopharyngeal nerve CN9 - for swallowing reflex
Vagus nerve CN10 - to thorax & abdomen

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29
Q

What are upper motor neurones and where do they generally originate

A

The descending pathways and neurones that originate in the motor cortex
Control the activity of the lower motor neurones

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30
Q

What are lower motor neurones and where are their cell bodies located

A

Alpha motor neurones that directly innervate skeletal muscle that have cell
bodies lying in the grey matter of the spinal cord and brainstem

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31
Q

What is spasticity

A

Increased muscle tone
When muscles do not develop increased tone UNTIL they are stretched a bit and after a brief increase in tone, the contraction subsides for a short time (Clasp-knife phenomenon)

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32
Q

Give an example of a disease in which you could see spasticity

A

Parkinsons

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33
Q

What is rigidity

A

Increased muscle contraction
Continous
Resistance to passive stretch is constant

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34
Q

How many vertebrae are there in one spine

A 
7 cervical
12 thoracic
5 lumbar
5 sacral
4 coccyx
33 in total
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35
Q

How many pair of spinal nerves are there

A 
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccyx
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36
Q

Where do cervical spinal nerve segments exit the spine

A

(around) 1 vertebra HIGHER than their corresponding
vertebra
EXCEPT C8 which exits below C7

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37
Q

Where do thoracic spinal nerve segments exit the spine

A

Around 1 (-2) vertebra BELOW their corresponding vertebra

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38
Q

Where do lumbar spinal nerve segments exit the spine

A

3-4 vertebra BELOW their corresponding vertebra

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39
Q

Where do sacral spinal nerve segments exit the spine

A

around 5 vertebra below

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40
Q

Define dermatome

A

Area of skin supplied by a single spinal nerve - sensory

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41
Q

Sensory innervation of the little finger

A

Ulnar nerve

C8

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42
Q

Sensory innervation of the index finger

A

Median nerve

C7

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43
Q

Sensory innervation of the thumb

A

C6

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44
Q

Sensory innervation of the clavicle

A

C4

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45
Q

Sensory innervation of the nipples

A

T4

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46
Q

Sensory innervation of the medial side of arm

A

T1

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47
Q

Sensory innervation of the umbilicus

A

T10

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48
Q

Sensory innervation of the knee

A

L4

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49
Q

Sensory innervation of the perianal area

A

S4

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50
Q

Sensory innervation of the anus

A

S5

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51
Q

Define myotome

A

Volume of muscle supplied by a single spinal nerve

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52
Q

Spinal roots of phrenic nerve

A

C3,4,5

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53
Q

Spinal roots of sensation of small muscles of hand

A

T1

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54
Q

Spinal roots of innervation of the penis

A

S2,3,4 (keeps the penis off the floor)

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55
Q

In what direction are all X-rays/MRIs/CT scans take

A

From perspective of foot to head

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56
Q

Examples of Motor tracts

A 
Lateral corticospinal tract
Rubrospinal tract
Olivospinal tract
Vestibulospinal tract
Tectospinal tract
Anterior corticospinal tract
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57
Q

Examples of Sensory tracts

A 
Fasciculus gracilis (more medial than cuneatus)
Fasciculus cuneatus
Posterolateral tract
Intersegmental tract
Posterior spinocerebellar tract
Lateral spinocerebellar tract
Anterior spinocerebellar tract
Spino-olivary tract
Spinorectal tract
Anterior spinothalamic tract
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58
Q

Examples of Ascending tracts

A

Dorsal/Medial lemniscal columns
Spinothalamic tract
Spinocerebellar tract

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59
Q

Which tracts are involved in Dorsal/Medial Lemniscal ascending columns

A

Fasciculus cuneatus

Fasciculus gracilis

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60
Q

What sensations are detetcted/carried by Dorsal/Medial Lemniscal ascending columns

A

Proprioception
Vibration
Fine touch

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61
Q

Where does fasciculus cuneatus carry information to?

A

Lateral (one in spinal tract)

Carries information from UPPER body to the cuneate tubercle in the medulla oblongata

62
Q

Where does fasciculus gracilis carry information to?

A

Medial

Carries information from LOWER body to the gracile tubercle in the medulla oblongata

63
Q

Dorsal/Medial Lemniscal ascending columns - describe pathway after medulla oblongata

A

Decussates here (in medulla) to become the medial lemniscus then ascends to the thalamus then to SOMATOSENSORY cortex

64
Q

What sensation is carried by the lateral spinothalamic tract

A

Pain and Temperature

65
Q

What sensation is carried by the medial/anterior spinothalamic tract

A

Crude touch

66
Q

Describe spinothalamic tract ascending pathway

A

Decussates soon upon entry into spinal cord (by 1/2 segments)
Ascends to the thalamus (unlike other sensory modalities that travel to the cortex)
PAIN reaches consciousness in the THALAMUS

67
Q

What information is carried via the posterior spinocerebellar tract and to where

A

carries information on Proprioception

to the IPSILATERAL INFERIOR Cerebellar Peduncle

68
Q

What information is carried via the anterior spinocerebellar tract and to where

A

carries information on Proprioception

to the CONTRALATERAL SUPERIOR cerebellar peduncle

69
Q

Where do descending tracts originate

A

Cerebral cortex and brainstem (upper motor neurones)

70
Q

2 types of descending pathways

A

Pyramidal

Extrapyramidal

71
Q

Features of pyramidal descending pathways

where they originate, decussate etc

A

2 neurone pathway
Originates in cerebral cortex of cranial nerve nucleus
DECUSSATE in the Medulla and descend CONTRAlaterally
(also means neurones innervating our axial muscles (muscles of head and trunk) mostly do not decussate)
Synapses with the cell bodies of the ventral horn of the spinal grey matter

72
Q

Example of pyramidal descending pathway

A

Corticospinal tract

73
Q

Features of extra-pyramidal descending pathways

origin, function

A
  • Originate in the brainstem and carry motor fibres to the spinal cord
  • Responsible for involuntary autonomic control of all musculature
74
Q

Examples of extrapyramidal descending pathways

A

Rubrospinal tract
Tectospinal tract
Vestibulospinal tract

75
Q

Function of corticospinal tract (what do medial and lateral ones innervate)

A

Transmits control of voluntary muscles (motor)
Lateral (75%) - limb muscles
Medial (25%) - axial muscles (head and trunk muscles needed to keep upright etc)

76
Q

Pathway of corticospinal tract

A

Transmits control of voluntary
muscles (motor)
Originates from the contralateral motor cortex
• Lateral corticospinal tract
(75%): pyramidal (MEDULLARY)
DECUSSATION - limb muscles
• Medial (25%): DECUSSATES as it leaves via the anterior white commissure (a bundle of nerve fibres that cross the mid-line of the spinal cord) - axial muscles
• UMN go from cortex to ventral horn; Neurones (cell bodies) located in the ventral horns project to limb and
axial muscles - these are the lower motor neurones (LMN)

77
Q

Where can an UMN lesion occur

A

Upper motor neurones (UMN) originate in the motor cortex - a UMN lesion can occur anywhere from the cortex all the way down to the ventral horn

78
Q

Functions of vestibulospinal tract

A

Muscle tone, balance and posture (innervates antigravity muscles)

79
Q

Where does vestibulospinal tract originate

A

Vestibular nucleus (CN8)

80
Q

Which of these decussates and where:
Rubrospinal tract
Tectospinal tract
Vestibulospinal tract

A

Tectospinal and Rubrospinal tracts decussate at MIDBRAIN thus is CONTRAlateral

Vestibulospinal tract is NON-decussating thus IPSIlateral

81
Q

What is brown-sequard syndrome

A

Hemi-section of spinal cord

82
Q

Features of brown-sequard syndrome

A
  • Ipsilateral loss of; proprioception, motor & fine touch
  • Contralateral loss of; pain, temperature & crude touch
83
Q

Explain features of brown-sequard syndrome

A
  • Ipsilateral weakness (i.e. less motor etc.) below the lesion - due to damage to the ipsilateral descending motor corticospinal tract (decussated at the medulla already)
  • Ipsilateral loss of dorsal column proprioception below lesion - sine the ascending tracts are damaged before they could decussate in the medulla
  • Contralateral loss of spinothalamic pain & temperature below the lesion since spinothalamic fibres decussate just after entering cord within the spinal cord
84
Q

Level of UMN and LMN lesions

A

UMN - above T10 vertebral or T12 spinal segment

LMN - below T10 vertebral or T12 spinal segment

85
Q

UMN and LMN lesions: Effect on bladder

A

UMN - spastic bladder + urge incontinence

LMN - flaccid bladder + overflow incontinence

86
Q

UMN and LMN lesions: Tone differences

A

UMN - Hypertonic (increased)

LMN - Hypotonic (decreased)

87
Q

UMN and LMN lesions: type of paralysis

A

U (or alpha) MN - Spastic paresis

LMN - Flaccid paralysis

88
Q

UMN and LMN lesions: Atrophy

A

UMN - No (only disuse) atrophy

LMN - severe atrophy

89
Q

Names 12 cranial nerves in order and if sensory, motor or both and if parasympathetic

A 
(Oh Oh Oh To Touch And Feel Very Green Velvet Ah Heaven)
1 Olfactory - Some
2 Optic - Say
3 Oculomotor Money (Para)
4 Trochlear - Matters
5 Trigeminal - But
6 Abducens - My 
7 Facial - Brother (Para)
8 Vestibulocochlear - Says
9 Glossopharyngeal - Big (Para)
10 Vagus - Breasts (Para)
11 Accessory - Matter 
12 Hypoglossal - More
90
Q

Vestibulocochlear nerve - which is ipsilateral, which is contralateral

A

Vestibular - Ipsilateral

Cochlear - Contralateral

91
Q

Cranial nerve brainstem nuclei location: Which cranial nerves have nuclei in midbrain?

A

3 and 4
Oculomotor
Trochlear

92
Q

Cranial nerve brainstem nuclei location: Which cranial nerves have nuclei in pons?

A 
5, 6, 7, 8
Trigeminal
Abducens
Facial
Vestibulocochlear
93
Q

Cranial nerve brainstem nuclei location: Which cranial nerves have nuclei in medulla oblongata?

A 
9, 10, 11, 12
Glossopharyngeal
Vagus
Accessory
Hypoglossal
94
Q

Branches of trigeminal nerve

A 
Ophthalmic nerve (V1)
Maxillary nerve (V2)
Mandibular nerve (V3)
95
Q

What is Brocas area and where is it

A

Language (speaking and writing) area of the DOMINANT (normally left if right handed) FRONTAL LOBE

96
Q

What can result from damage to Brocas area

A

Expressive aphasias
Difficulty forming words or sentences
Can understand what youre saying but can not express the words into meaningful language

97
Q

What is Wernickes area and where is it

A

Comprehension area in DOMINANT (normally left if right handed) TEMPORAL LOBE and is responsible for understanding speech

98
Q

What can result from damage to Wernickes area

A

Comprehension/receptive aphasias
Difficulty understanding spoken or written language, even though their hearing and vision are not impaired
Have fluent speech, but may scramble words do that their sentences make no sense (often adding unnecessary words or making own words)
Often unaware they’re not speaking in clear sentences

99
Q

What is supplied by external carotid

A

Everything in head and neck except the brain

100
Q

What vessel only supplies the brain

A

Internal carotid

101
Q

What does Anterior Cerebral Artery supply

A

Supplies motor cortex and top of brain

102
Q

If ischaemic stroke in ACA (anterior cerebral), what would be affected

A

Lower limbs

103
Q

What does Middle Cerebral Artery Supply

A

Majority of outer surface of the brain

104
Q

If ischaemic stroke in MCA (middle cerebral), what would be affected

A

Chin to hip

limb sparing

105
Q

Whats does Posterior Cerebral Artery supply

A

Peripheral vision

106
Q

If ischaemic stroke in PCA (posterior cerebral), what would be affected

A

Peripheral vision loss but no macular vision

107
Q

What is 1st main artery to come off vertebral artery

A

Posterior Inferior Cerebellar Artery (PICA)

Therefore emboli present will likely enter the PICA

108
Q

What is supplied by the Posterior Inferior Cerebellar Artery (PICA)

A

Medulla (CN 9, 10, 11, 12)

109
Q

What can result from an emboli in the Posterior Inferior Cerebellar Artery (PICA)

A 
Dysphagia
Slurred speech
Ataxia
Facial pain
Nystagmus
Loss of pain and sensation on opposite side of body
110
Q

What is the most common type of intercranial aneurysm

A

Berry aneurysms

111
Q

Where do Berry Aneurysms occur

A

Most commonly at Anterior cerebral artery (ACA) and Anterior Communicating artery junction

Also at bifurcation of MCA, junction between Posterior Communicating A, MCA and Internal Carotid

112
Q

What type of haemorrhage can result from a berry aneurysm and what is the main symptom

A

Subarachnoid haemorrhage

Thunderclap headache

113
Q

(with the exception of left and right coronary arteries) What are 3 initial main branches of the aorta (at (carotid) arch) in order

A

Brachiocephalic artery
Left Common Carotid artery
Left Subclavian artery

114
Q

What are 2 arteries form from the bifurcation of Brachiocephalic trunk

A

Right Subclavian artery

Right Common Carotid artery

115
Q

Where do common carotid arteries bifurcate and into what?

A

Internal (larger than external) and External Carotid arteries
C4
(This bifurcation is at high risk of atherosclerosis)

116
Q

What does the end of the Internal Carotid bifurcate into

A

Middle Cerebral artery

Anterior Cerebral artery

117
Q

Segments of Internal Carotid Artery

A

Cervical
Petrous ICA
Cavernous sinus ICA
Supraclinoid (intradural) ICA

118
Q

Which ICA segment penetrates the skull

A

Petrous ICA

penetrates the temporal bone and runs anteromedially int the carotid canal

119
Q

Describe anatomical location of cervical ICA

A

Anterior and medial to internal jugular vein
Posterior and lateral to External Carotid artery at origin
Ascends behind then medial to external carotid artery

120
Q

Branches of Petrous ICA

A 
Caroticotympanic artery (small branch to middle/inner ear)
Vidian artery (small connection to external carotid artery)
121
Q

In violent sport, what part of the ICA can rupture

A

Cervical ICA is free
Petrous ICA is anchored/fixed in the skull

Cervical can rupture and can even dissect with extreme rotation

122
Q

Anatomy of cavernous sinus ICA

A

Turns superiorly at foramen lacerum to enter the skull via the carotid canal, anterior to the jugular foramen
There it enters the cavernous sinus
Pierces dura at level of anterior clinoid process

123
Q

What can happen if an aneurysm ruptures, past where the cavernous sinus ICA pierces the dura

A

Subarachnoid haemorrhage

Resulting in increased intracranial pressure

124
Q

Branches of supraclinoid (intradural) ICA

A

Opthalmic artery
Superior hypophyseal arteries/trunk
Posterior communicating artery
Anterior choroidal artery

125
Q

What does opthalmic artery supply

A

Orbit of eye

passes into optic canal

126
Q

What does superior hypophyseal arteries/trunk supply

A

Supply pituitary gland, stalk, hypothalamus and optic chiasm

127
Q

What does posterior communicating artery

A

Connects to anterior cerebral vascular supply of head and posterior brain stem supply of head

128
Q

What does anterior choroidal artery supply

A 
Choroid plexus
Optic tract - vision
Cerebral peduncle - sensory motor fibres
Internal capsule
Medial temporal lobe
129
Q

What artery supplies ganglia and internal capsule

A

Lateral lenticulostriate arteries

From Middle Cerebral Arteries

130
Q

Specifically what sturctures in cerebrum are supplied by anterior cerebral artery

A

Caudate nucleus and Internal capsule supplied by medial lenticulostriate arteries of anterior communicating artery of ACA
Genu of corpus callosum

131
Q

Examples of intercranial vertebral artery branches

A

Anterior spinal artery
Small medullary perforators
Posterior inferior cerebellar artery (supplies medulla and inferior cerebellum)

132
Q

Vertebral arteries unite to form what artery

A

Basilar arteries

133
Q

What arteries branch off basilar artery

A

Pontine arteries

134
Q

What 2 vessels arise from terminal (anterior) bifurcation of basilar arteries

A

Posterior cerebral artery

135
Q

What specific structures are supplied by the PCA

A

Thalamus
Geniculate bodies
Cerebral peduncles
Tectum

136
Q

Draw visual fields diagram

A

Pg 24

137
Q

Which colliculus and which geniculate body relates to Visual field

A

Superior colliculus
Lateral geniculate body
(IM Auditory = Inferior colliculus + Medial geniculate body

138
Q

Where does optic tract terminate

A

Lateral geniculate bodies

139
Q

Which loop connects lateral geniculate body to visual cortex and results from lateral retinas sensing nasal visual fields

A

Meyers loop

140
Q

What lobe does Meyers loop pass through

A

Temporal lobe

141
Q

Which loop connects lateral geniculate body to visual cortex and results from medial retinas sensing temporal visual fields

A

Baums loop

142
Q

What lobe does Baums loop pass through

A

Parietal

143
Q

Which of these if false:
a - Fibres form the nasal portion of the retina (carrying the TEMPORAL VISUAL FIELDS) cross at the optic chiasm
b - Optic chiasm is located just anterior-superior to pituitary infundibulum
c - Lateral geniculate body is connected to visual cortex by the optic tract

A

c- Lateral geniculate body is connected to visual cortex by the optic radiation

144
Q

Defect in left optic nerve

A

No light perception in the left eye

145
Q

Defect of optic chiasm

A

Bitemporal hemianopia

146
Q

Defect of left optic tract

A

Loss of vision of the temporal field of the left eye & the loss of the nasal field of the right eye
Homonymous Hemianopia

147
Q

Defect of left Meyers loop

A

Carrying information from the inferior retina and thus the SUPERIOR VISUAL FIELD resulting in loss of vision in the superior nasal field of the left eye and the superior temporal field of the right eye
Right Homonymous Superior Quadrantopia

148
Q

Defect of left Baums loop

A

Carrying information from the superior retina and thus the INFERIOR VISUAL FIELD resulting in loss of vision in the inferior temporal field of the right eye and the inferior nasal field of the left eye
Right Homonymous Inferior Quadrantopia

149
Q

Pg26

A

Check visual field defects correct

150
Q

Differences between UMN and LMN lesions

A 
UMN:
Strength lowers
Tone increases (spastic)
Superficial reflexes absent
Increased reflexes (deep tendon reflexes) - Hyper-reflexia 
Slight loss in muscle mass
Positive Babinski sign
LMN:
Strength lowers
Tone decreases (flaccid)
Fasciculations, Fibrillations, Reaction of degeneration
Decreased reflexes (deep tendon reflexes) - Hypo-reflexia 
Decreased/atrophy muscle mass
Negative Babinski sign

Medicine Phase 2a Neuro (28 decks)

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