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Year 2 Term 1 Control > Lecture 2: Skull plus others > Flashcards

Lecture 2: Skull plus others Flashcards

1
Q

How do the vertebral arteries course to the brain?

A

Come off the subclavian arteries
Travel through vertebral processes of spine
Pass through foramen magnum into cranial cavity

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2
Q

At what level do the internal carotids branch off the common carotids?

A

C3

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3
Q

What is the carotid sinus?

A

Bulge in the common carotid, the point at which the internal carotid branches off

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4
Q

How does the internal carotid course to the brain?

A

Branches off common carotid
Ascends in carotid sheath into carotid canal, posterior to the external carotid - travels forward and comes out of the carotid canal (not foramen lacerum)
Passes through the cavernous sinus (a venous plexus) and emerges inferior to the optic nerves on ventral surface of the brain

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5
Q

Where does the internal carotid emerge in the brain?

A

Inferior to the optic nerves on the ventral surface

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6
Q

Which venous plexus does the internal carotid and some important nerves pass through and what is the clinical significance of this?

A

Cavernous sinus

Infection can lead to swelling of cavernous sinus which can squash these nerves aswell as the internal carotid

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7
Q

Which artery does the posterior system in the brain come off?

A

Vertebral arteries

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8
Q

Which artery does the anterior system in the brain come off?

A

Internal carotid

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9
Q

The ventral surface of the brain is actually what surface in situ?

A

The inferior surface

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10
Q

Which sulcus does the middle cerebral artery run in?

A

The lateral sulcus

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11
Q

Which part of the cerebellum does the posterior inferior cerebellar artery supply?

A

The posterior inferior part

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12
Q

Which part of the cerebellum does the anterior inferior cerebellar artery supply?

A

The anterior inferior part

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13
Q

What is the course of the anterior cerebral once it has come off the middle cerebral?

A

Goes into the longitudinal fissure

Travels anteriorly then loops posteriorly to supply the medial and superior part of the frontal and parietal lobe

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14
Q

What does the anterior cerebral artery supply?

A

Medial and superior part of the frontal and parietal lobes

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15
Q

What does the middle cerebral artery supply?

A

Lateral aspect of the cerebral hemispheres

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16
Q

What does the posterior cerebral artery supply?

A

Runs posteriorly to supply the occipital lobe and the lower part of the temporal lobe

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17
Q

What artery does the posterior spinal arteries branch off and where do they run?

A

Come off the posterior inferior cerebellar arteries and run along the posterior surface of the spinal cord

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18
Q

Give 5 functions of the skull?

A

1) Protects the brain
2) Helps to shape the face
3) Supports other structures eg. eyes
4) Channels of the upper airway are bounded by the skull
5) Use the skull to chew food (mandible is part of the skull)

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19
Q

Although the skull protects the brain what is the potential danger of the brain being in an enclosed space?

A

No room to expand - finite space, can put pressure on brain

Inside shape of the bones of the skull can cause lacerations to the brain

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20
Q

What are the 2 main sections of the skull?

A

Cranium

Mandible

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21
Q

What 2 parts is the cranium section of the skull made up of?

A

Viscerocranium

Neurocranium

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22
Q

Which 9 bones of the skull can be seen from a lateral view of the skull?

A 
Frontal bone
Occipital bone
Temporal bone
Parietal bone
Maxillae (2 (R & L) bones fused in midline)
Mandible 
Zygomatic bone
Sphenoid bone
Nasal bone
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23
Q

What is the anatomical name for the ‘eye sockets’?

A

Orbits

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24
Q

In which bone is the foramen magnum situated?

A

Occipital bone

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25
Q

The opening to the carotid canal is found in what bone?

A

Temporal bone

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26
Q

Which bone of the skull contributes to the hard palate?

A

Maxilla

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27
Q

What are the cranial fossae?

A

3 regions at the cranial base
Like 3 steps
Have an anterior fossa, a middle fossa and a posterior fossa

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28
Q

What are the 3 foramen found in the sphenoid bone in the cranial base and where are they roughly situated relative to eachother?

A

1) Foramen rotundum (most anterior - circular shaped)
2) Foramen ovale (posterior medial - oval shaped)
3) Foramen spinosum (posterior lateral)

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29
Q

What parts of the nasal cavity does the ethmoid bone contribute to?

A

Forms the roof, lateral walls and medial wall of nasal cavity

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30
Q

What is the ciribiform plate?

A

Part of the ethmoid bone

Has lots of small holes in it through which the nasal nerves pass

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31
Q

What is the most common joint in the skull?

A

Suture

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32
Q

What is meant by osteogenic?

A

Produces more bone

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33
Q

How many layers make up a suture and what is the rough structure?

A

5 layers

Osteogenic layer covered by periosteum, seperated by a central connective tissue layer

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34
Q

How are sutures an important site of cranial growth?

A

Growth at the bone edges displaces bone away from the suture

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35
Q

What is meant by ossification of sutures in the brain?

A

Fusion

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36
Q

In which decade of life does ossification of cranial sutures occur?

A

3rd - 20s

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37
Q

On which surface does ossification of sutures first begin (deep or superficial) and which suture tends to be affected first?

A

Deep surface

Sagittal suture is usually the first affected

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38
Q

Can ossification of cranial sutures be used to determine age in a post mortem?

A

No it is too variable

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39
Q

What is craniosynostosis?

A

Premature sutural fusion

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40
Q

What does craniosynostosis lead to? 4

A

Often leads to brain being small
Can cause abnormalities in head shape
raised intracranial pressure
Cognitive defects

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41
Q

What is the treatment for craniosynostosis?

A

Extensive surgical remodelling of the cranial vault

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42
Q

Through what foramen in what bone does the middle meningeal artery pass into the cranial cavity?

A

Foramen spinosum in the spenoid bone

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43
Q

What is the pterion and why is it clinically significant?

A

Site on the temporal bone where 3 sutures meet to make a H shape
This is an area of weakness and the middle meningeal artery runs medial to the pterion, and damage to the middle meningeal artery is associated with extradural haemorrhage

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44
Q

What are the 2 main parts to the mandible?

A

1) Ramus of the mandible

2) Body of mandible

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45
Q

Which 2 processes are found on the ramus of the mandible?

A

Condylar process - more posterior

Coronoid process - more anterior

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46
Q

Which 2 bones make up the temporomandibular joint?

A

Condylar process of the ramus of the mandible

Temporal bone

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47
Q

What is the action of the temporomandibular joint?

A

An anterior and posterior sliding action

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48
Q

In which direction do mandibles dislocate?

A

Anteriorly

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49
Q

What are the 4 sinuses in the skull?

A

1) Frontal
2) Maxillary
3) Sphenoid
4) Ethmoid

50
Q

The pituitary gland lies superior to which sinus?

A

Sphenoid sinus

51
Q

By which route is a pituitary tumour normally removed?

A

Transphenoidal route

Through the nasal cavity

52
Q

What is a blow out fracture of the orbit?

A

Object hits the eye, puts pressure on it, this increases the intraorbital pressure which blows out the small delicate bones beneath the eye ball

53
Q

What are the 3 le fort fractures?

A

1) Just maxilla separated
2) Maxilla and nasal area separated
3) Whole of viscerocranium separated

54
Q

Give the 3 general functions of the brain stem?

A

1) Conduit - allows ascending and descending pathways to reach the thalamus and cerebellum from spinal cord
2) Integrative - contains the respiratory and cardiovascular centers and has a role in conciousness
3) Cranial nerves - originate from here, they are the heads equivalent to spinal nerves and have a role in sight, hearing and gustation

55
Q

What lies in the gap between the 2 thalami?

A

The 3rd ventricle

56
Q

What is the cerebral aqueduct?

A

Connects the 3rd and 4th ventricles

57
Q

What are the caudal, rostral, ventral and dorsal relations of the brainstem?

A

1) Caudally it is continuous with the spinal cord
2) Rostrally it is continuous with the diencephalon
3) Ventrally lies the clivus of the occipital bone
4) Dorsally lies the cerebellum

58
Q

How many cranial nerves are there and how many arise from the brainstem?

A

There are 12

10 arise from the brainstem

59
Q

Which 2 cranial nerves do not arise from the brainstem and where do they arise from?

A 
The olfactory (CN 1) and the optic (CN 2) 
Arise from the forebrain
60
Q

What main structures are visible on the ventral surface of the medulla?

A

The pyramids

The olives

61
Q

What main structures are visible on the ventral surface of the brain stem?

A

The pyramids and olives of the medulla
The rounded pons
The cerebral peduncles

62
Q

What is the name of the junction which seperates the medulla and the pons?

A

The pontomedullary junction

63
Q

What seperates the 2 pyramids?

A

The anterior median fissure

64
Q

What is the decussation of the pyramids, how does it appear in a specimen?

A

Crossing over of fibres from the pyramids to the ipsilateral side, appears as a blurring or interruption of the anterior median fissure

65
Q

What do pyramids contain?

A

Corticospinal tracts

Contain descending motor fibres

66
Q

What is the name of the sulcus separating the pyramids from the olives?

A

Anterolateral sulcus

67
Q

What is the name of the sulcus emerging dorsal to the olives?

A

Posterolateral sulcus

68
Q

Which cranial nerve emerges from the anterolateral sulcus?

A

Hypoglossal CN XII

69
Q

Which cranial nerves emerge from the posterolateral sulcus?

A

Vagus CN X

Glossopharyngeal CN IX

70
Q

What is the name of the space inbetween the 2 cerebral peduncles?

A

Interpedunculer fossa

71
Q

Which cranial nerve emerges from the interpeduncular fossa?

A

Occulomotor nerve CN III

72
Q

What is the name of the sulcus seperating the pons from the medulla?

A

Pontomedullary sulcus

73
Q

The basillar artery is formed level with what?

A

The pontomedullary sulcus

74
Q

What structures can be seen if the cerebellum is removed on the dorsal surface of the brain stem?

A

The superior and inferior colliculi of the midbrain
The floor of the fourth ventricle
The cerebellar peduncles (specifically the middle one)
The gracile fascicle and tubercle
The cuneate fascicle and tubercle

75
Q

What 2 parts does the 4th ventricle divide the medulla into?

A

Open (rostrally) - no central canal, opens out into 4th ventricle
Closed (caudally) - central canal

76
Q

What is the anatomical name for the floor of the 4th ventricle?

A

Rhomboid fossa

77
Q

What is contained in the fascicles and what is contained in the tubercles?

A

Fascicles - nerve axons

Tubercles - cell bodies

78
Q

What info is generally carried in the cuneate and gracile fascicles?

A

Part of the dorsal column pathway - sensory info from the body to brain

79
Q

Superior colliculus is involved in what?

A

Vision

80
Q

The inferior colliculi are involved in what?

A

Hearing

81
Q

What is meant by tract/fascicle/lemniscus/peduncle?

A

Simply means a bundle of white matter

82
Q

What is the name of a collection of cell bodies in the CNS? And the PNS?

A

CNS - nucleus

PNS - ganglion

83
Q

The cerebrum passes info to the cerebellum via which cerebellar peduncle?

A

The middle cerebellar peduncle

84
Q

Info from the spinal cord passes to the cerebellum via which cerebellar peduncle?

A

The inferior cerebellar peduncle

85
Q

Info is passed from the cerebellum to the cerebrum via which cerebellar peduncle?

A

The superior cerebellar peduncle

86
Q

Which cranial nerve is the only cranial nerve to emerge from the dorsal surface of the brainstem and what does it supply?

A

CN IV - Trochlear nerve

Controls one muscle that moves the eye

87
Q

What are the caudal and rostral relations of the pons?

A

Caudally - medulla (pontomedullary junction)

Rostrally - midbrain (pontomesencephalic junction)

88
Q

A midline groove can be seen on the pons from a ventral view of the brainstem, what is this groove for?

A

The basillar artery

89
Q

Where does the trigeminal nerve emerge from?

A

Mid pontine level

90
Q

Which nerve emerges from the pontomedullary junction?

A

Abducens CN VI

91
Q

Which 2 nerves emerge from the cerebellopontine angle?

A

Facial CN VII

Vestibulocochlear CN VIII

92
Q

What is the main feature of the pons when the brainstem is viewed from a dorsal view?

A

The Cerebellar peduncles

93
Q

What forms the roof of the 4th ventricle?

A

The superior cerebellar peduncle

94
Q

What is the basis pedunculi?

A

Another word for cerebral peduncle

95
Q

Which nerve emerges inferior to the inferior colliculi?

A

The trochlear nerve CN IV

96
Q

Which structure does the cerbral aquaduct run through?

A

The midbrain

97
Q

What is the tectum and where is it found?

A

Found posterior to the ventricular system
Made up of the superior and inferior colliculi
Found only at the level of the midbrain

98
Q

What forms the roof of the cerebral aquaduct?

A

The tectum

99
Q

Where does the tegmentum lie and where is it found?

A

Lies anterior to the ventricular system

Found at level of midbrain, pons and medulla

100
Q

What is contained within the tegmentum?

A

Cranial nerve nuclei and tract
Reticular formation
Some ascending and descending pathways

101
Q

Where can the red nucleus and the substantia nigra be found?

A

In the tegmentum

102
Q

What does the basal part of the brainstem contain?

A

Descending fibres from the cerebral cortex

pyramids, cerebral peduncles

103
Q

What is the main difference seen in cross section of the open and closed medulla?

A

Closed medulla has a central canal

Open Medulla has no central canal, it is open at the back where the 4th ventricle lies

104
Q

In cross section will olives be seen in the caudal or rostral medulla?

A

In the rostral medulla

105
Q

When the brainstem is viewed at the level of the pons what are the main structures that can be seen?

A

1) The 4th ventricle
2) Middle cerebellar peduncle
3) Basal pons
4) Groove for basilar artery

106
Q

What structures can be seen when the closed medullar is viewed in cross section?

A

Central canal
Cuneate and gracile fascicles dorsally
Pyramids ventrally

107
Q

Where does the reticular formation lie?

A

Within the tegmentum of the brain stem

108
Q

What is the reticular formation?

A

Not well understood

Complex, multisynaptic network of neurons

109
Q

What 3 things does the reticular formation include?

A

1) Reticular nuclei - gives rise to a descending motor pathway - reticulospinal tract
2) Vital autonomic centers - eg. respiratory and cardiovascular
3) Cells giving rise to the Ascending Reticular Activating System (ARAS) - pass to the cortex and involved in conciousness

110
Q

As well as conciousness and autonomic centers what 3 other things is the reticular formation involved in?

A

1) Modulates pain
2) Sleep wake cycle
3) Arousal

111
Q

What is the basal pons?

A

Its the anterior portion to the pons

112
Q

What structure within the 4th ventricle forms the CSF?

A

The choroid plexus

113
Q

What are the structures at which the cuneate and gracile fascicle terminate called?

A

The cuneate and gracile tubercle

114
Q

What is the shape of the cut inferior cerebellar peduncle?

A

A crescent shape

115
Q

What is the name of the apex of the cerebellum on its superior surface?

A

The vermis

116
Q

What are the 3 lobes of the cerebellum and from which surface can they be seen?

A

The anterior, middle and posterior lobes

Seen from the superior surface

117
Q

On what do the bulbs of the olfactory nerves sits?

A

The ciribiform plate

118
Q

Which 5 major subdivisions of the brain make up the brainstem?

A

The midbrain, pons and medulla

119
Q

What information is carried in the nerve fibres that make up the pyramids?

A

Motor info, involved in voluntary movements

120
Q

Where does the median sulcus/median longitudinal fissure lie?

A

In the midline in the floor of the 4th ventricle

121
Q

In which region of the brainstem is the central canal expanded to form the fourth ventricle?

A

Rostral medulla + pons

122
Q

What structure sits on the roof of the 4th ventricle?

A

The cerebellum

Year 2 Term 1 Control (14 decks)

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