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MRCS A > MRCS neuroanatomy > Flashcards

MRCS neuroanatomy Flashcards

1
Q

List the input nuclei of the basal ganglia

A
  1. Caudate nucleus
  2. Putamen
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2
Q

what is the telencephalon ?

A

Telencephalon is another term for cerebrum. This is the largest part of the brain and contains the cerebral cortex.

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3
Q

What structures make up the basal ganglia ?

A
  1. Caudate nucleus
  2. putamen
  3. sub thalamic nuclei
  4. Globus pallidus [internus and externus]
  5. Sustantia Nigra
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4
Q

what structures form the Lentiform nucleus ?

A

Globus pallidus and Putamen

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5
Q

what structure forms the lateral aspect of the lentiform nucleus ?

A

Putamen

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6
Q

what are the intrinsic nuclei of the basal ganglia ?

A
  1. Globus pallidus external
  2. Subthalamic nuclei
  3. Pars compacta of the substantia nigra
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7
Q

In the basal ganglia, what structures from the Neostriatum ?

A

Caudate nucleus and putamen

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8
Q

Which white matter tract is located immediately lateral to the putamen?

A

External capsule

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9
Q

Which developmental component of the central nervous system is the substantia nigra located within?

A

Midbrain

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10
Q

what structure separates the cerebral hemispheres ?

A

Falx cerebri
a fold of dura mater that descends vertically to fill this fissure separating the two hemispheres.

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11
Q

what is the function of the corpus collosum

A

white matter structure connecting the two hemispheres.

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12
Q

what lobe of the cerebrum is the primary auditory cortex located ?

A

Temporal lobe

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13
Q

what are the functions of the temporal lobe ?

A

Memory and language

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14
Q

what structure separates the cerebrum from the cerebelli ?

A

tentorium cerebelli,

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15
Q

the middle cerebral arteries are a continuation of what artery ?

A

The internal carotid artery

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16
Q

The posterior cerebral arteries are a branch of what artery ?

A

Basilar

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17
Q

From which structure is the cerebrum embryonically derived ?

A

Procencephalon

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18
Q

what structure separates the cerebellum from the pons ?

A

The 4th ventricle

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19
Q

venous drainage from the head is into what structure ?

A

Internal jugular vein

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20
Q

what is the function of the arachnoid granulations ?

A

allow CSF to re-enter the circulation via the dural venous sinuses.

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21
Q

Which cranial nerve provides sensory innervation to the dura mater?

A

Trigeminal nerve

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22
Q

how is the pituitary gland accessed in surgery ?

A

Via the sphenoid sinus

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23
Q

what is the anatomical relationship of the pituitary gland to the cavernous sinus

A

Cavernous sinus is lateral

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24
Q

what structure is both inferior and anterior to the pituitary gland

A

Sphenoid sinus

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25
Q

how does the hypothalamus send neurotransmitters to the pituitary gland ?

A

hypophyseal portal vessels.

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26
Q

what two hormones are released by the posterior pituitary gland ?

A

ADH (responsible for control of blood osmolarity), and oxytocin (involved in parturition and milk secretion).

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27
Q

what is the function of hypophyseal portal vessels ?

A

These vessels ensure that the hypothalamic hormones remain concentrated, rather than being diluted in the systemic circulation. And allow transport from the hypothalamus to the pituitary gland

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28
Q

what is the function of the ventricles ?

A

production, transport and removal of cerebrospinal fluid, which bathes the central nervous system.

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29
Q

what structure allows passage of CSF from the lateral ventricles to the 3rd ventricle ?

A

Foramen of Monroe

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30
Q

where is CSF produced ?

A

Cerebrospinal fluid is produced by the choroid plexus, located in the lining of the ventricles

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31
Q

what is the function of the choroid plexus ?

A

production of CSF

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32
Q

In the ventricular system of the brain, the foramen of Munro connects which structures?

A

connects the lateral ventricles to the 3rd ventricle

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33
Q

This most common cause of CST is infection, which typically spreads from an extracranial location such as the orbit, paranasal sinuses, or the ‘danger zone’ of the face. What veins act as tracts for infection to reach the cavernous sinus ?

A

due to the anastomosis between the facial vein and superior ophthalmic veins.

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34
Q

how does a CN VI palsy present ?

A

The affected eye turns medially and is unable to abduct properly

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35
Q

what veins drain into the straight sinus ?

A

inferior sagittal sinus with the great cerebral vein.

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36
Q

what veins do the cavernous sinus drain into ?

A

Superior and Inferior petrosal veins

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37
Q

How is the straight sinus formed ?

A

The great cerebral vein combines with the inferior sagittal sinus

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38
Q

At what level does the common carotid artery bifurcate ?

A

C4

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39
Q

Vertebral arteries arise from which artery ?

A

Subclavian

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40
Q

what are the two types of ascending tracts ?

A

conscious tracts and unconscious tracts

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41
Q

what modalities are transmitted by the DCML pathway ?

A

fine touch (tactile sensation), vibration and proprioception.

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42
Q

what modalities are transmitted by the anteriolateral pathway ?

A

Anterior spinothalamic tract – carries the sensory modalities of crude touch and pressure.

Lateral spinothalamic tract – carries the sensory modalities of pain and temperature.

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43
Q

define fasciculus

A

bundle - could be of nerves or muscles

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44
Q

First order neurons carry signals from where to where in the DCML pathway ?

A

From the peripheral nervous system to the medulla oblongata

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45
Q

In the DCML pathway, sensory signals from the UL and LL are transported in two different pathways - describe these

A

Signals from the upper limb (T6 and above) – travel in the fasciculus cuneatus

Signals from the lower limb (below T6) – travel in the fasciculus gracilis

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46
Q

where do second order neurons in the anterolateral pathway decussate when carrying ascending sensory signals

A

In the spinal cord

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47
Q

what tracts carry unconscious sensory signals to the sensory cortex ?

A

The Spinocerebellar Tracts

48
Q

what symptoms would occur following damage to the DCML pathway in the spinal cord ?

A

Ispilateral loss of proprioception and fine touch.

49
Q

what symptoms occur following Injury to the anterolateral system ?

A

impairment of pain and temperature sensation - this sensory loss will be contralateral

50
Q

describe Brown-Séquard syndrome

A

hemisection (one sided lesion) of the spinal cord. This is most often due to traumatic injury, and involves both the anterolateral system and the DCML pathway:

DCML pathway – ipsilateral loss of touch, vibration and proprioception.

Anterolateral system – contralateral loss of pain and temperature sensation.

It will also involve the descending motor tracts, causing an ipsilateral hemiparesis.

51
Q

what tracts in the descending tracts pathway are responsible for involuntary movement

A

Extrapyramidal tracts

52
Q

where do pyramidal tracts and extrapyramidal tracts originate ?

A

Pyramidal tracts – These tracts originate in the cerebral cortex,

Extrapyramidal tracts – These tracts originate in the brain stem

53
Q

The pyramidal tracts derive their name from the medullary pyramids of the medulla oblongata, which they pass through.

What are the two groups of pyramidal tracts ?

A

Corticospinal tracts – supplies the musculature of the body.

Corticobulbar tracts – supplies the musculature of the head and neck.

54
Q

where do the neurons of the corticobulbar tract terminate ?

A

The neurones terminate on the motor nuclei of the cranial nerves. Here, they synapse with lower motor neurones, which carry the motor signals to the muscles of the face and neck.

55
Q

most cranial nerve nuclei receive bilateral innervation from descending coritcobulbar tracts - which are the exceptions

A

CN VII and CN XII

These both receive only contralateral innervation.

56
Q

where do extrapyramidal tracts originate ?

A

Brainstem

57
Q

In a stroke that damages the UMNs for CN XII - what would be the clinical signs ?

A

a lesion to the upper motor neurones for CN XII will result in spastic paralysis of the contralateral genioglossus.

This will result in the deviation of the tongue to the contralateral side.

58
Q

The corticobulbar tracts provide innervation to the musculature of which region of the body?

A

Head and neck

59
Q

The medial reticulospinal tract arises from what part of the brainstem ?

A

Pons

60
Q

what is the function of The tectospinal tract ?

A

coordinates movements of the head in relation to visual stimuli.

61
Q

what are the nuclei in the thalamus that receive signals from the optic nerve ?

A

lateral geniculate nucleus (LGN)

62
Q

what is the primary (lemniscal pathway)

A

this is the main pathway through which auditory information reaches the primary auditory cortex (A1).

63
Q

what is a ganglion ?

A

collection of cell bodies outside the central nervous system

64
Q

The olfactory bulb lies in the olfactory groove. Which cranial fossa is the olfactory groove located in ?

A

Anterior cranial fossa

65
Q

The oculomotor nerve splits into superior and inferior branches. what muscles are innervated by the superior branch ?

A

Superior rectus – elevates the eyeball

Levator palpabrae superioris – raises the upper eyelid.

66
Q

What muscles are innervated by the inferior branch of the oculomotor nerve ?

A
  1. Inferior rectus
  2. Medial rectus
  3. Inferior oblique
67
Q

What two structures in the eye receive parasympathetic innervation from the oculomotor nerve ?

A
  1. Sphincter pupillae
  2. Ciliary muscles
68
Q

how do the post ganglionic fibres leaving the ciliary ganglion reach the eye ?

A

via the short cilliary nerves

69
Q

The oculomotor nerve provides motor and __________ innervation to the eye muscles.

A

parasympathetic

70
Q

The hypoglossal nerve innervates all intrinsic and extrinsic muscles of the tongue except which muscle ?

And what nerve innervates this muscle ?

A

palatoglossus

innervated by vagus nerve

71
Q

how does the hypogossal nerve (CN XII) leave the cranial fossa ?

A

Via the hypoglossal canal

72
Q

This is the course of what cranial nerve ? and what muscle does it pierce ?

Hint - crosses the internal and external carotid

A

Hypoglossal nerve

73
Q

List the intrinsic tongue muscles

A

Genioglossus
Styloglossus
Hyoglossus
Palatoglossus

74
Q

what is the anatomical relationship between the C1/C2 roots and the hypoglossal nerve

A

The C1/C2 roots that travel with the hypoglossal nerve also have a motor function. They branch off to innervate the geniohyoid (elevates the hyoid bone) and thyrohyoid (depresses the hyoid bone) muscles.

75
Q

what is the ansa cervicalis ?

A

a loop of nerves that is part of the cervical plexus. From the ansa cervicalis, nerves arise to innervate the omohyoid, sternohyoid and sternothyroid muscles - the infra hyoid muscles

76
Q

C1/C1 nerve roots catch a ride on what cranial nerve ?

A

CN XII - Hypoglossal

77
Q

Where in the brainstem is the hypoglossal nucleus located

A

Medulla

78
Q

what nerve supplies sensory innervation to the posterior part of the external auditory canal and external ear.

A

The auricular branch of the vagus nerve

79
Q

The vagus nerve provides motor innervation to what structures ?

A
  1. Pharynx
  2. Larynx
  3. Soft palate
80
Q

what is the anatomical course of the right vagus nerve ?

A

passes anterior to the subclavian artery and posterior to the sternoclavicular joint, entering the thorax.

81
Q

what is the anatomical course of the left vagus nerve ?

A

passes inferiorly between the left common carotid and left subclavian arteries, posterior to the sternoclavicular joint, entering the thorax.

82
Q

which nerve forms the oesophageal plexus ?

A

The vagal trunk which is a branch of the vagus nerve

83
Q

what is the anatomical course of the right and left recurrent laryngeal nerve ?

A

Right loops under the right subclavian

Left loops under the arch of the aorta

They both ascend to innervate the majority of the intrinsic muscles of the larynx.

84
Q

which cranial nerve innervates the stylopharyngeus ?

A

glossopharyngeal nerve

85
Q

what muscle receives motor innervation from CN IX

A

Stylopharyngeus

86
Q

what nerve supplies parasympathetic function to the parotid gland ?

A

glossopharyngeal nerve (CN IX)

87
Q

List the sensory branches of CN IX

A

PLT

Pharyngeal branch - It innervates the mucosa of the oropharynx.

Lingual branch – provides the posterior 1/3 of the tongue with general and taste sensation

Tonsillar branch – innervates the palatine tonsils.

88
Q

Which cranial nerves are involved in the GAG reflex ?

A

The glossopharyngeal nerve supplies sensory innervation to the oropharynx, and thus carries the afferent information for the gag reflex. When a foreign object touches the back of the mouth, this stimulates CNIX, beginning the reflex. The efferent nerve in this process is the vagus nerve, CNX.

An absent gag reflex signifies damage to the glossopharyngeal nerve.

89
Q

what nerve supplies general sensory innervation and special taste sensation to the posterior 1/3rd of the tongue ?

A

the glossopharyngeal nerve.

90
Q

All pharyngeal muscles are innervated by the vagus nerve (CN X ) except one muscle - which muscle is this ?

A

stylopharyngeus

91
Q

Which part of the ear does the glossopharyngeal nerve innervate ?

A

The tympanic branch of the glossopharyngeal nerve innervates the middle ear, internal surface of the tympanic membrane and the Eustachian tube.

92
Q

The glossopharyngeal nerve provides parasympathetic (secreto-motor) function to the parotid gland. Where do the fibres synapse before they reach the parotid ?

A

Otic ganglion

93
Q

how does the vestibulocochlear nerve exit the cranium ?

A

Via the internal acoustic meatus

94
Q

True or false

The vestibulocochlear nerve has motor function

A

False

It is purely sensory

95
Q

the vestibulocochlear nerve splits, forming the vestibular nerve and the cochlear nerve. - what are the functions of these two nerves ?

A

The vestibular nerve innervates the vestibular system of the inner ear, which is responsible for detecting balance

The cochlear nerve travels to cochlea of the inner ear, forming the spiral ganglia which serve the sense of hearing.

96
Q

which branch of CN VIII is responsible for balance

A

Vestibular nerve

97
Q

Where are the cochlear hair cells located ?

A

organ of Corti

98
Q

While still intracranial, what branches come off the facial nerve ?

A
  1. Greater petrosal nerve
  2. nerve to stapedius
  3. chorda tympanii
99
Q

what is the function of the greater petrosal nerve ? and what nerve does it branch off

A
  1. Branches off the facial nerve
  2. parasympathetic fibres to mucous glands and lacrimal gland.
100
Q

How does the facial nerve exit the cranium ?

A

via the stylomastoid foramen

101
Q

what is the first extracranial branch of the facial nerve

A

Posterior auricular nerve

102
Q

Before the facial nerve terminates as the 5 terminal motor branches, there are three motor branches - what are these ?

A
  1. Posterior auricular nerve
  2. nerve to digatrsric
  3. nerve to stylohyoid
103
Q

What are the 5 terminal branches of the facial nerve ?

A

Temporal branch
Zygomatic branch
Buccal branch
Marginal mandibular branch
Cervical branch

104
Q

what is the first motor branch of the facial nerve ?

A

nerve to stapedius.

105
Q

The parasympathetic fibres of the facial nerve are carried by what nerves ?

A
  1. Greater petrosal nerve
  2. Chorda tympanii
106
Q

which two nerves combine to form the submandibular ganglion ?

A

chorda tympani and the Lingual branch of CN V

107
Q

Where does the facial nerve divide into the five terminal motor branches?

A

Within the parotid gland

108
Q

True or false -

The posterior belly of the digastric is innervated by the facial nerve

A

True

*While the anterior belly is innervated by the myelohyoid nerve – a branch of the inferior alveolar nerve (itself a branch of the mandibular nerve).

109
Q

How does an abducens nerve palsy present ?

A

The eye held in fixed adduction at rest

110
Q

what are the terminal branches of V1 ?

A

V1 - ophthalmic nerve

Branches
1. Frontal
2. Lacrimal
3. Nasocialliary

111
Q

which nerves are involved in the corneal reflex ?

A

the ophthalmic nerve acts as the afferent limb

The facial nerve is the efferent limb,

112
Q

The chorda tympanii provides special sensation (taste) to the anterior 2/3 of the tongue. What nerve provides general sensation to the anterior 2/3 of the tongue ?

A

V3 - Mandibular nerve

113
Q

List the terminal branches of the mandibular nerve

A

BAIL

Buccal
auriculotemporal
inferior alveolar
lingual

114
Q

what nerve provides afferent fibres for the corneal reflex ?

A

V1
Ophthalmic

115
Q

The trigeminal nerve provides innervation to muscles from which pharyngeal arch?

A

First

116
Q

Which branch of the trigeminal nerve provides sensory innervation to the lower eyelid?

A

Maxillary

MRCS A (3 decks)

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