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Neuro 1 Flashcards

1
Q

Stroke involving right anterior cerebral artery would have the most significant effect on which part of the body?

A

Left leg
Brain supplies body in contralateral manner
ACA supplies legs - because medial portion of hemispheres hence why it’s left leg

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2
Q

Obstruction of arachnoid granulations prevents CSF being reabsorbed into dural venous sinuses. This associated with?

A

Meningitis

Can cause inflammation, which is what prevents fluid being reabsorbed into dural venous sinuses

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3
Q

35 Y/O man visits his physician because experiencing sporadic, involuntary movements and was becoming increasingly uncoordinated. Got Huntington’s disease - AD disease caused by loss GABAergic neurones in basal ganglia - which structure is affected?

A

Caudate nucleus/ putamen

affected because MRI can see caudate nucleus is degenerated

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4
Q

Young woman pushed cotton bud into ear too far

Can see perforated tympanic membrane - which nerve is most likely to be damaged

A

Nerve to stapedius because nerve which connected to facial nerve and stapedius is one of the bones involved in connecting eardrum to hearing parts of ear

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5
Q

What is CN1 and what does it do?

A

Olfactory nerve

Mainly involved in transmitting info relating to smell

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6
Q

Where is the olfactory tract and olfactory bulb located?

A

Proximally have olfactory bulb

Distally (Closer to cerebral hemispheres) have olfactory tract

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7
Q

What structure does the olfactory bulb go through?

A

Fasicles of olfactory nerve pass through the cribiform plate from muscosa of upper nasal cavity, join to olfactory bulb + go down through the tracts

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8
Q

How many pairs of cranial nerves are there?

A

Left and right cranial nerves

eg. Left and right olfactory bulbs

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9
Q

Where is the gyrus rectus in relation to the olfactory tracts?

A

Olfactory tract is on top of gyrus rectus

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10
Q

What is lateral to the gyrus rectus and the olfactory tract?

A

Olfactory sulcus

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11
Q

What is the olfactory trigone?

A

Where the olfactory tract divides into the medial and lateral olfactory stria

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12
Q

What is posterior to the olfactory trigone?

A

Anterior perforated area which give blood supply to deep grey matter nuceli mostly from branches of MCA + close to limbic lobe

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13
Q

What is CNII and what does it do?

A

Optic nerve + transmits visual sensory information

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14
Q

What are the 3 parts of the optic nerve?

A
  1. optic nerve
  2. optic chiasm
  3. optic tract
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15
Q

Where does the optic nerve go?

A

Straight to the eye

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16
Q

What is the optic chiasm?

A

Joint structure where L+R optic nerve meet

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17
Q

Where is the optic tract and where does it go?

A

Behind the chiasm and divide into optic radiations

go posteriorly into occipital lobe to primary visual cortex area

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18
Q

Where is the primary visual cortex area?

A

Calcarine sulcus in occipital lobe

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19
Q

How does the optic nerve enter skull to the brainstem?

A

Via the optic canal in the sphenoid bone

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20
Q

What travels with the optic nerve through the optic canal?

A

Ophthalmic artery - branch of internal carotid artery

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21
Q

What structure is related close to the optic tract and what way?

A

Cerebral peduncles

optic tract curves around cerebral peduncles (pillar like structures in midbrain)

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22
Q

What does the optic chiasm sit on top of?

A

Pituitary gland

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23
Q

What is the clinical significance of the optic chiasm sitting on top of the pituitary gland?

A

Inflammation or outgrowth of pituitary gland can cause compression optic nerves
= bilateral hemianopoeia

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24
Q

What are the 2 optic radiations?

A

Meyer’s loop = lower optic radiation

Balm’s loop = upper optic radiation

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25
Where do the optic radiations terminate?
visual cortex (calcarine sulcus)
26
What is the brainstem made up of?
Midbrain superiorly Pons - middle Medulla - inferiorly
27
What are the two junctions in the brainstem?
Ponto-mesencephalic junction (Superiorly) Ponto-medullary junction (inferiorly)
28
From which junction does many CN emerge?
Pontomedullary junction
29
What is the crus cerebri?
On the cerebral peduncles transmits corticospinal tract (motor tracts)
30
What are the mammillary bodies?
2 small pea structures on side of the cerebral peduncles - underneath the optic chiasm
31
What do the cerebral peduncles hold?
Cerebral hemispheres
32
Where is the interpeduncular fossa and what CN originates in this structure?
In between the cerebral peducnles and CN3 originates from it
33
What is the basilar pons?
Where basilar artery runs on top of
34
What are the middle cerebellar peduncles?
Bumps on the lateral side of the pons From the tracts through which the cerebellum receives and give out information Attaches cerebllum to the brainstem
35
How many cerebellar peduncles are there?
3: superior - seen in posterior aspect - attaches cerebellum to brainstem middle inferior - small bump just below middle cerebellar peduncle (medial to middle)
36
What is the ventral medial fissure?
Line in between the 2 aspects of the medulla
37
What is lateral to ventral medial fissure?
Pyramids of medulla - where corticospinal tract criss cross .˙. known as pyramidal tract
38
What are the olives?
Lateral to the pyramid - small bead like structures on the side
39
Which clinically important tract descends into the pyramids of the medulla?
Corticospinal tract (pyramidal)
40
Why might damage to inferior cerebella peduncle cause gait ataxia?
Major route for sensory information (unconscious proprioception) about lower limbs to reach cerebellum; without it walking becomes disordered and uncoordinated.
41
What is the midbrain made up of?
Tectum (roof) + tegmentum (more anteriorly)
42
What structure is between the tectum + tegmentum?
Cerebellar aqueduct in midline
43
What is more prominent from the lateral aspect - the medial cerebellar peduncle or the cerebral peduncle?
Medial cerebellar peduncle
44
What is visible on the posterior view of the brainstem?
The 4th ventricle (if the cerebellum is removed)
45
How is the 4th ventricle connected to the third ventricle?
By the cerebellar aqueduct - runs vertically in the brainstem
46
What is the function of the superior and inferior colliculus?
Transmit sensory information | Can see midbrain on posterior aspect
47
What is the cruciform sulcus?
Cross like structure in between superior and inferior colliculus
48
Where is the frenulum?
Inferior to the inferior colliculus
49
What are visible superiorly on the posterior aspect of the brainstem?
The ends of the thalamus - pulvinar nuclei
50
What is the rhomboid fossa and what is it bounded by?
Rhomboid shaped depression upper 2/3 = pons lower 1/3 = medulla
51
What is the medulla like?
Largely closed Superiorly opens up to become the open medulla continues down to join the spinal cord
52
What is the obex?
Site for the emetic centre or the chemoreceptor trigger zone (CTZ). No Blood brain barrier so helps sample blood If any emetic material - can test and cause emesis
53
What is the alar plate of the neural tube and its function?
Sensory + towards the back
54
What is the basal plate of the neural tube and its function?
Anterior - motor plate
55
Where is the sulcus limitans in the neural tube?
between alar and basal plate
56
How does this change in a fully developed human?
The brainstem opens up opens up at the medulla just after the obex Alar plates end up laterally located Basal plates in medial aspect
57
On axial slice?
Cranial nerve nuclei can see is bound posteriorly by cerebellum And have roof of 4th ventricle
58
What are the 2 cranial nerve nuclei?
Motor | Sensory
59
What are the 3 motor columns?
Medial to lateral Somatic Visceral Branchiomotor
60
What does the somatic motor nuclei supply?
Supplies the extra-ocular muscles of tongue | Make up CN III, IV, VI, XII
61
What does the visceral motor nuclei supply?
Lateral to somatic motor supplies smooth muscle, cardiac muscle, glands - PS
62
Which nerves is the visceral motor nuclei associated with?
CN III - sphincter pupillae muscle and ciliary body (pupil constriction, accommodation) Edinger westphal nuclei CN VII - lacrimal gland and all salivary glands, apart from the parotid Superior salivatory nuclei CN IX - parotid salivary gland Inferior salivatory nuclei CN X - parasympathetic supply to the majority of the thorax and abdomen dorsal motor nucleus of vagus
63
What does the branchiomotor supply?
Special visceral afferent (goes to organs) Muscles of mastication Muscles of facial expression Larynx and pharynx involved in speech and swallowing
64
What nerves are associated with the branchiomotor?
``` Three vertically aligned nuclei CN V - Muscles of mastication CN VII - Muscles of facial expression CN IX, X and XI - Larynx and pharynx involved in speech and swallowing (nucleus ambiguus) ```
65
Which CN are ps?
3 +7 is not 9 but 10 | CN 3,7,9,10 = PS + have PS actions related to them
66
Where is the nucleus for CN V + VII located?
Pons
67
Where is the nucleus for the nucelus ambiguus located?
Full length of the medulla
68
At what stage does the embryo emplant?
Blastocyst
69
Pharyngeal arch derivatives primarily receive motor innervation from which region?
Branchiomotor column because supplies parts of larynx + pharynx
70
A lesion in the lateral recess of the floor of the 4th ventricle is most likely to have what cranial nerve related effects?
Dizziness Lateral recess is at widest part of 4th ventricle - corners of rhomboid fossa Can see in the area mainly vestibulocohclear nerve nuclei are involved If damaged, get issues with balance aspect
71
What are the 3 sensory nuceli?
Trigeminal Vestibularchochlear Visceral afferent
72
Describe the trigeminal nuclei
Sensory for head and neck Main nuclei – Mid pons General tactile sensation of the face. Inferior portion into medulla Pain and temperature Upwards into midbrain Proprioception
73
Describe the vestibulocochlear nuclei
Located in lateral recess of the 4th ventricle ``` 2 x cochlear nuclei Dorsal and ventral 4 x Vestibular nuclei Superior (pons), Inferior Medial, lateral (medulla) ```
74
Describe the visceral afferent
V-shaped Information arriving Taste buds Viscera of abdomen and thorax Nucleus of solitary tract or nucleus tractus solitarius - because located individually in white matter tract around the medulla, connected at the bottom
75
Describe the parts of the visceral afferent
3 parts ``` Top part Taste buds (CN VII, IX and X) ``` Middle part Thorax (CN IX and X) Lower part GI tract Abdominal viscera
76
Describe the location of the nuclei in the brain
Hypoglossal most medial Vagus - visceromotor Vestibular posterior Trigeminal sensory more anterolateral
77
Find these structures on the skull
``` Optic canal Superior orbital fissure Rotundum Ovale Spinosum Lacerum Carotid Canal Internal Acoustic meatus Jugular foramen Hypoglossal Foramen Magnum ```
78
What comes out of the superior orbital fissure and what bone is it in?
Sphenoid bone CNIII, IV, VI V1 branches Ophthalmic vein
79
What goes through the foramen rotundum?
In sphenoid bone | CN V2 - maxillary branch
80
Foramen ovale?
Sphenoid bone CNV3 Accessory meningeal artery Lesser petrosal nerve
81
Foramen spinosum?
Middle meningeal artery enters cranial fossa this way
82
What do the foramen rotundum and spinosum form?
Together form an exclamation mark
83
What is the foramen lacerum?
Filled with soft tissue - superior aspect occupies by internal carotid artery
84
Contents internal acoustic meatus?
Petrous temporal bone CNVII | CNVIII
85
Jugular foramen
CNIX, CNX, CNXI, Sigmoid sinus
86
What is the contents of the hypoglossal canal?
CNXII
87
Contents of foramen magnum
Medulla oblongata Meninges Vertebral arteries and plexus Spinal roots of the accessory nerve
88
What are the skull base foramina?
Stylomastoid foramen CN VII Carotid canal ICA
89
A tumour in the jugular foramen that is compressing the internal jugular vein might also be compressing which of the following groups of cranial nerves?
a. X, XI, XII | b. IX, X, XI
90
A patient has been in a bar fight and received an upper cut to the nose and hard palate. Which of the following symptoms may be a complication of the fractures sustained?
a. Visual defects b. Loss of taste c. Loss of smell
91
What goes through the petrous part of the temporal bone?
Things to do with the ear: Semicircular canals, cochlear ducts, vestibulocochlear nerve Facial artery is not a part
92
The blood vessel that goes through the foramen spinosum is a branch of which artery?
Internal carotid artery Middle cerebral artery Facial artery Maxillary artery
93
Where do the lower 10 cranial nerves come from?
``` Brainstem Midbrain - 2 Pons - 1 Pontomedullary junction - 3 Medulla - 4 ```
94
Which nerves are related to eye movement?
CN III – Oculomotor nerve CN IV – Trochlear CN VI - Abducens
95
Where does CN III arise?
Interpeduncular fossa between cerebral peduncles of midbrain
96
Where does the abducens nerve arise?
Pontomedullary junction
97
Where does the trochlea nerve originate?
Pontomesencephalic junction
98
What does the CNIII supply?
``` 4 eye muscles medial rectus inferior oblique superior rectus inferior rectus ``` Innervates palpebrae
99
What does the levator palpebrae superioris do?
Elevates upper eyelid
100
Where does CN IV originate + what does it supply?
Arises from dorsal aspect the midbrain, below inferior colliculus Superior oblique
101
What does the superior oblique muscle do?
Neutral position – Abducts and depresses the eyes Depresses an adducted eye. Called – Tramp’s muscle Deflects the pupil – DOWN and OUT
102
Where does CN VI originate + what does it supply?
originates from midline Pontomedullary junction Supplies 1 eye muscle Lateral rectus
103
What does the lateral rectus muscle supply?
Abducts the eye
104
What goes through the superior orbital fissure?
From the sphenoid bone CNIII, IV, VI V1 branches Ophthalmic vein
105
What is the CN V originate and what does it have?
At the point of middle cerebellar peduncle Sensory nerve for head and neck Larger sensory root – lateral Smaller motor root - medial
106
What are the 3 branches of CNV?
Three branches V1 – Ophthalmic V2 – Maxillary nerve V3 - Mandibular
107
Where does each of the CN-V exit?
V1 – SOF V2 – Foramen rotundum V3 – Foramen Ovale
108
What does CN-V supply?
``` Motor Branchiomotor fibres Muscles of mastication Mylohyoid Diagastric (anterior belly) Tensor tympani Tensor veli palatini ```
109
What is and where does it originate CNVII?
Facial nerve Lateral aspect of pontomedullary junction Region of the cerebellopontine angle
110
What is the function of the facial nerve?
``` Motor Innervates: muscles of facial expression, digastric, Stylohyoid, stapedius muscle ```
111
Describe the journey of CNVII
Enters as internal acoustic meatus, once in temporal bone, goes into facial canal, exits via stylomastoid foramen
112
What does the internal acoustic meatus?
passage where nerves can pass from inside skull to inner ear and face
113
What branches does the facial nerve give off?
Gives off chorda tympani carries taste messages from the front of tongue to brain Nerve to the stapedius
114
What is the nervus intermedius?
Between VII + VIII Aka - CN 7.5 transmits sensory and parasympathetic part of facial nerve Supplies lacrimal + salivary glands - except parotid (CNIX)
115
What does the chorda tympani supply?
Innervates taste buds anterio 2/3 (taste) Carries taste messages to brain Branch of nervous intermedius
116
Describe the CNVIII
Can see lateral to facial nerve (CN VII is anterior to it) on lateral aspect of pontomedullary junction Enter the brainstem at the Cerebellopontine angle and terminate in the vestibular and cochlear nuclei
117
What are the functions of the vestibulocochlear nerve?
Cochlear = attaches to cochlea which contains spinal ganglion involved in hearing Vestibular - supply vestibule and semicircular canal + involved in balance hence all these structures located in temporal bone
118
Where does CN VIII come out of the skull?
Traverses through internal acoustic meatus
119
What is the main structure of the medulla?
Olives
120
What are the sulci relating to the olives?
Pre-olivary sulcus/ venterolateral | Behind olive - dorsolateral sulcus
121
What are the 3 nerves housed by the dorsolateral (post-olivary) sulcus?
Glossopharyngeal Vagus Accessory
122
What nerve does the anterolateral sulcus house?
Hypoglossal nerve
123
What is the function CN IX?
From post-olivary sulcus Sensory - post 1/3rd taste buds Tactile sensation to posterior tongue and pharynx Carries afferent limb of gag reflex Fibres are more posterior to CNXII - on brain specimen Sensation to ear drum Carries visceral afferents from carotid sinus + body Supplies parotid gland Innervates stylopharyngeus muscle
124
What carries sensory information from the anterior 2/3 of the tongue?
The lingual branch of V3 (trigeminal nerve)
125
What gives motor innervation to tongue?
Hypogossal nerve, except palatoglossus - pharyngeal branch vagus X
126
Where does the vagus nerve originate?
Rootlets from post olivary sulcus
127
What does the vagus nerve supply?
Muscles of larynx and pharynx involved in speech and swallowing Parasympathetic fibres to thoracic and abdominal viscera until the splenic flexure Sensory fibres from the epiglottis Pain and temperature from the dura, larynx and external ear
128
What are the 2 parts of CN XI?
Cranial accessory nerve (XIc) - receives rootlets from C1-C5 join together to form the nerve Spinal accessory nerve from dorsolateral sulcus
129
What does the spinal accessory nerve supply?
innervates trapezius + SCM
130
What does the spinal accessory nerve do?
Joins vagal trunk + has similar targets to vagus because both origin from nucleus ambiguss
131
Contents of jugular foramen?
CN 9, 10, 11
132
Where does CN 12 arise?
Arises anterolateral sulcus
133
What is the function of CN 12?
Motor nerve to tongue All tongue muscles except palatoglossus Genioglossus Hyoglossus Styloglossus Intrinsic muscle
134
What does the hypoglossal canal contain?
CN 12
135
Where will the optic tract carry information?
To lateral geniculate nucleus + optic radiations + calcarine sulcus
136
Look at midbrain slice
``` Locate: Substantia nigra Red nucleus (at level of superior colliculi) Superior colliculi Crus cerebri ```
137
Look at pontine slice
``` Pons Tectum Tegmentum Narrow ventricular cavity 2 deeply pigmented nucleis - locus coerulus ```
138
What is the function of the Locus coerulus?
Deeply pigemented nuclei in pons | Make noroepinephrin
139
Which is not a branch of the facial nerve?
Temporal nerve Zygomatic Maxillary
140
Which skull base foramina does CN V2 pass through?
Foramen rotundum
141
Which muscle does CN X innervate?
Palatoglosuss muscle of tongue
142
Which nerve innervates occipitofrontalis muscle? (frontal belly)
Temporal branch

Clinical Anatomy (10 decks)

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