Nervous system Flashcards
1
Q
List the 3 parts of the brainstem from most superior to inferior
A
Midbrain
Pons
Medulla
2
Q
Which part of the brainstem is just posterior to the optic chiasm?
A
Midbrain
3
Q
Which part of the brainstem has the superior, middle and inferior cerebellar peduncles?
A
Pons
4
Q
Which part of the brainstem has the pyramids, decussation of the pyramids and olives?
A
Medulla
5
Q
Which two vesicles of the embryological neural tube give rise to the brainstem?
A
Mesencephalon - midbrain
Rhombencephalon - metencephalon (pons and cerebellum) + myelocephalon (medulla)
6
Q
What parts of the ventricular system of the brain lie within the midbrain?
A
Cerebral aqueduct
4th ventricle
7
Q
Which cranial nerves emerge from the pontomedullary junction?
A
Abducens (VI) + Facial (VII) + Vestibulocochlear (VIII)
8
Q
Which cranial nerve that emerges from the pontomedullary junction has the longest intracranial course, and what is its clinical significance?
A
Abducens nerve - travels to superior orbital fissure, while all the others travels to the internal acoustic meatus
Makes it vulnerable to injury from increased intracranial pressure (convergent strabismus), though can cause false localising sign
9
Q
What produces the pyramids, and what is their function?
A
Descending motor tracts - pyramidal tracts
10
Q
What produces the decussation of the pyramids?
A
Where the motor fibres cross over to the contra-lateral side of the body
11
Q
What produces the olives?
A
Neural cell bodies
12
Q
What are the open and closed parts of the medulla?
A
Open - superior
Closed - inferior
13
Q
What structure does the open part of the medulla open onto?
A
4th ventricle
14
Q
What is the obex?
A
Point in human brain where 4th ventricle narrows to become central canal of the spinal cord, occurring in the caudal medulla where decussation occurs
15
Q
What is the middle cerebellar peduncle made of, and what is its function?
A
Pontine nucleus of opposite hemisphere - connects cerebellum to pons
16
Q
Which part of the brainstem has cerebral peduncles, and what are they made of?
A
Midbrain - contains ascending sensory fibres and descending motor fibres from the cortex, while connecting midbrain and cerebrum
17
Q
Which part of the brain lies immediately superior to the midbrain?
A
Diencephalon (thalamus and hypothalamus)
18
Q
Which part of the brain lies immediately inferior to the midbrain?
A
Rhombencephalon - metencephalon (pons and cerebellum) + myelocephalon (medulla)
19
Q
On which part of the brainstem is the superior and inferior colliculi?
A
Midbrain
20
Q
What projection is seen on the bottom surface of the hypothalamus?
A
Infundibulum/pituitary stalk
21
Q
What is the name given to the midline structure connecting the two cerebellar hemispheres?
A
Vermis
22
Q
List the lobes of the cerebellum
A
Anterior lobe
Posterior lobe
Flocculonodular lobe
23
Q
Which part of the brain has tonsils?
A
Cerebellum
24
Q
What part of the cerebellum lies above the foramen magnum and what is the clinical significance of this?
A
Cerebellar tonsils - when there is a sudden drop in intracranial pressure, the tonsils may herniate through the foramen magnum, which is referred to as “cerebellar coning”
25
What name is given to the large fissure separating the two cerebral hemispheres?
Median longitudinal fissure
26
What connects the two cerebral hemispheres?
Corpus callosum - made up of commissural fibres
27
What does the posterior aspect of the cerebrum lie on?
Tentorium cerebelli - covers cerebellum
28
In which lobe is the primary motor cortex?
Frontal lobe
29
In which lobe is the primary sensory cortex?
Parietal lobe
30
In which lobe is the primary visual cortex?
Occipital lobe
31
In which lobe is the primary auditory cortex?
Temporal lobe
32
At what vertebral level does the spinal cord terminate in adults and kids?
Adults - L1/L2
| Kids - L2/L3
33
At what vertebral level does the dura mater terminate?
S2
34
At what vertebral level does the arachnoid mater terminate?
S2
35
What is the conus medullaris?
Tapered lower end of the spinal cord
36
What happens to the pia mater after the spinal cord ends?
Reaches conus medullaris and extends as a thin filament called the filum terminale and attaches to the periosteum of the coccyx to become the coccygeal ligament
37
At what vertebral level would you perform a lumbar puncture in adults and kids?
Adults - L3/L4
| Kids - L4/L5
38
How many pairs of spinal nerves are there?
31 (8C, 12T, 5L, 5S, 1Co)
39
Is damage to the cauda equina considered an upper or lower motor neurone lesion?
Lower motor neurone lesion
40
From which arteries do the left and right vertebral arteries arise?
Subclavian artery
41
How is the basilar artery formed and with which part of the brain is it most closely related to?
Union of vertebral arteries, found near the pons/pontomedullary junction
42
In which groove does the anterior cerebral artery travel?
Median longitudinal fissure
43
In which groove does the middle cerebral artery travel?
Lateral sylvian fissure
44
In which groove does the posterior cerebral artery travel?
Calcarine sulcus
45
Describe the blood supply to the primary motor cortex
Mainly MCA, small region by ACA
46
Describe the blood supply to the primary sensory cortex
Mainly MCA, small region by ACA
47
Describe the blood supply to the primary visual cortex
PCA (calcimine branch of PCA)
48
Describe the blood supply to the primary auditory area of the brain
MCA
49
Describe the blood supply to the areas of olfaction in the brain
MCA
50
What system supplies blood to the posterior aspect of the circle of willis?
Vertebro-basilar system - supplies the cerebellum, thalamus and the brainstem
51
What commonly occurs following an aneurysm of the posterior cerebral artery?
Oculomotor palsy - CN III is found just under posterior cerebral artery and just over superior cerebellar artery. Down and out appearance of affected eye(s)
52
List the nerve supply components to the arteries of the brain
Carotid sinus - group of pressure receptors at junction of CCA and ICA; sensory nerves are from the glossopharyngeal nerve and the vagus nerve
Carotid body - group of chemoreceptors on posterior wall of terminal part of CCA; sensory innervation from the glossopharyngeal nerve.
Sympathetic motor nerves - from superior cervical ganglion from plexus around ICA
53
Describe the venous drainage of the brain
Drained by a series of veins which drain into dural venous sinuses, which are present between the periosteum and the dura mater. These sinuses drain into the IJV, which exits via the jugular foramen of the skull
54
What veins drain into the cavernous sinus?
```
Ophthalmic veins
Superficial cerebral veins
Middle cerebral veins
Inferior cerebral veins
Sphenoparietal veins
```
55
How can an infection causing cavernous sinus thrombosis lead to bulging eyes?
Infections can spread intracranially through valveless veins via the connection go the facial vein to the superior ophthalmic vein. The cavernous sinus is found just behind the eye and therefore when inflammed can push the eyes outwards and cause paralysis to the nerves supplying them
56
Describe the blood supply to the spinal cord
Three longitudinal spinal arteries (1 anterior and 2 posterior) as well as multiple segmental spinal arteries supply the spinal cord
57
Describe the venous drainage of the spinal cord
Longitudinal anterior and posterior spinal veins join the internal vertebral (epidural) venous plexus lying in the epidural space
58
Where in terms of the meninges of the brain is CSF found?
Subarachnoid space
59
Which structures does the falx cerebri separate?
Hemispheres of the cerebrum
60
To which bony structures does the falx cerebri attach to?
Crista galli and internal occipital processes
61
Which dural venous sinus runs within the upper border of the falx cerebri?
Inferior sagittal sinus
62
Which dural venous sinus runs along the upper border of the falx cerebri?
Superior sagittal sinus
63
Which structures does the tentorium cerebelli separate?
Cerebellum and occipital lobes
64
To which bony points does the anterior edge of the tentorium cerebelli attach to?
Clinoid processes of the sphenoid bone
65
Which dural venous sinus runs along the attachment of the falx cerebri to the tentorium cerebelli?
Straight sinus
66
What dural fold separates the two cerebellar hemispheres?
Falx cerebelli/cerebellar falx
67
What fold of the dura surrounds the infundibulum?
Diaphragma sellae
68
Which arteries supply the dura mater?
Branches of ICA, ECA and vertebral arteries
69
In what part of the brain is the anterior horn of the lateral ventricle found?
Frontal lobe
70
In what part of the brain is the body of the lateral ventricle found?
Parietal lobe
71
In what part of the brain is the posterior horn of the lateral ventricle found?
Occipital lobe
72
In what part of the brain is the inferior horn of the lateral ventricle found?
Temporal lobe
73
Where in the brain is the interventricular foramen (also known as at the Foramen of Monro)?
Diencephalon
74
Where in the brain is the 3rd ventricle?
Diencephalon
75
Where in the brain is the cerebral aqueduct?
Midbrain
76
Where in the brain is the 4th ventricle?
Pons and medulla
77
What creates CSF and where is it found?
Choroid plexus - found on the lining of the ventricles
78
How does CSF pass from the ventricular system back into the general circulation?
3 foramen in the 4th ventricle (1 medial and 2 lateral) allows drainage of CSF into the subarachnoid space, where it empties into the superior sagittal sinus via arachnoid villi/granulations, which itself drains into the IJV
79
What are the 4 parts of the corpus callosum from most anterior to most posterior?
Rostrum
Genu
Body
Splenium
80
What is the septum pallucidum, and what is found superiorly and inferiorly?
Thin sheet which lies in the midsagittal plane and separates the two anterior horns of the lateral ventricles.
Continued superiorly by the corpus callosum and inferiorly by the fornix.
81
What is the fornix?
Bundle of fibres which connects the hippocampus to the mammillary bodies of the hypothalamus
82
What is the bulbous projection found on the floor of the lateral ventricles?
Caudate nucleus - member of basal ganglia
83
Where does most of the sensory information of the body relay to?
Ventro-postero-lateral (VPL) nucleus of the thalamus
84
Where is the pineal gland in relation to the thalamus?
Pineal gland is found immediately posterior to the thalamus
85
Where are the colliculi of the midbrain in relation to the pineal gland?
Colliculi are found inferior and lateral to the pineal gland
86
List some functions of the hypothalamus
```
Controls body temp
Hunger
Thirst
Fatigue
Hormone release
Motivated behaviours e.g. fear
```
87
List the structures that make up the basal ganglia
Caudate nucleus
Lentiform nucleus - putamen and globus pallidus
Substantia nigra
88
What type of fibres connect the cerebral hemispheres with other parts of the brain?
Projection fibres
89
What type of fibres connect the cerebral hemispheres with other regions within the same hemisphere?
Association fibres
90
List the parts of the internal capsule
Anterior horn
Genu
Posterior horn
91
Which cerebral artery supplies the internal capsule?
Branches of middle cerebral artery
92
Where is the red nucleus in relation to the substantial nivea in the midbrain?
Red nucleus is found posterior to the substantia nigra
93
List the features of a spinal cord segment in each region of the spinal cord
Cervical - large oval segment, long slender posterior and anterior horns
Thoracic - small, oval segment, slender posterior and anterior horns, lateral horns present
Lumbar - large round segment, bulbous horns
Sacral - small round segment, very bulbous horns, lateral horns present
94
Which aspect of the spinal cord receives sensory information?
Posterior dorsal horns
95
Which aspect of the spinal cord do motor nerves emerge?
Anterior ventral horns
96
Through which foramen does the olfactory nerve pass through?
Cribriform plate of the ethmoid bone
97
Through which foramen does the optic nerve pass through?
Optic canal
98
Through which foramen does the oculomotor nerve pass through?
Superior orbital fissure
99
Through which foramen does the trochlear nerve pass through?
Superior orbital fissure
100
Through which foramen does the trigeminal nerve pass through?
Ophthalmic division - superior orbital fissure
Maxillary division - foramen rotundum
Mandibular division - foramen ovale
101
Through which foramen does the abducens nerve pass through?
Superior orbital fissure
102
Through which foramen does the facial nerve pass through?
Internal acoustic foramen
103
Through which foramen does the vestibulocochlear nerve pass through?
Internal acoustic foramen
104
Through which foramen does the glossopharyngeal nerve pass through?
Jugular foramen
105
Through which foramen does the vagus nerve pass through?
Jugular foramen
106
Through which foramen does the accessory nerve pass through?
Jugular foramen
107
Through which foramen does the hypoglossal nerve pass through?
Hypoglossal canal
108
Which cranial nerves travel through the superior orbital fissure?
Oculomotor nerve
Trochlear nerve
Abducens nerve
Opthalmic division of the trigeminal nerve
109
Which cranial nerves travel through the jugular foramen?
Glossopharyngeal nerve
Vagus nerve
Accessory nerve
110
What type of fibres are present in the olfactory nerve?
Special sensory - smell
111
What type of fibres are present in the optic nerve?
Special sensory - sight
112
What type of fibres are present in the oculomotor nerve?
Motor and parasympathetic
113
What type of fibres are present in the trochlear nerve?
Motor to the superior oblique
114
What type of fibres are present in the abducens nerve?
Motor to the lateral rectus
115
What type of fibres are present in the trigeminal nerve?
Ophthalmic - general sensory
Maxillary branch - general sensory
Mandibular branch - general sensory and motor
116
What types of fibres are found in the facial nerve?
General sensory
Special sensory
Motor
Parasympathetic
117
What types of fibres are found in the vestibulocochlear nerve?
Special sensory
118
What types of fibres are found in the glossopharyngeal nerve?
General sensory
Special sensory
Motor
Parasympathetic
119
What types of fibres are found in the vagus nerve?
General sensory
Special sensory
Motor
Parasympathetic
120
What plexus does the vagus nerve form part of and what does it innervate?
Pharyngeal plexus along with CN IX, innervates the palate and pharynx
121
Name two branches of the pharyngeal plexus that innervate the muscles of the larynx
Superior laryngeal nerve
| Recurrent laryngeal nerve
122
What types of fibres are found in the accessory nerve?
Motor
123
What types of fibres are found in the hypoglossal nerve?
Motor
124
Which cranial nerves have a parasympathetic component?
Oculomotor (III), facial (VII), glossopharyngeal (IX) and vagus (X) nerves
125
Which cranial nerves are directly attached to the brain?
Olfactory (I) and optic (II)
126
Which cranial nerves are directly attached to the midbrain?
Oculomotor (III) and trochlear (IV)
127
Which cranial nerve is the only to arise from the posterior aspect of the brain?
Trochlear (IV)
128
Which cranial nerve is attached directly to the pons?
Trigeminal (V)
129
Which cranial nerves are attached to the pontomedullary junction?
Abducens (VI)
Facial (VII)
Vestibulocochlear (VIII)
130
Which cranial nerves are attached to the medulla?
Glossopharyngeal (IX)
Vagus (X)
Accessory (XI)
Hypoglossal (XII)
131
Which cranial nerves are tested by the pupillary light reflex?
II (afferent) + (III) efferent
132
Which cranial nerves would be tested by sticking their tongues out?
Hypoglossal (XII)
133
What is another name for the primary auditory cortex?
Brocas area
134
What broadman region is the primary motor cortex?
4
135
What is the primary function of the thalamus?
Relay and prioritise sensory information to the brain
136
What V shaped strip of white matter is often implicated in strokes?
Internal capsule
137
Name a part of the dorsal column pathway found in the pons
Medial lemniscus
138
What are the dark staining bodies in neuronal cell bodies responsible for protein synthesis?
Nissl bodies
139
What gyrus is the primary somatosensory area?
Post-central gyrus
140
What type of neurons are the majority of peripheral sensory neurons?
Pseudo-unipolar
141
Which of the meningeal layers is vascularised?
Pia mater
