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Anatomy > Neuro Anatomy > Flashcards

Neuro Anatomy Flashcards

1
Q

Parts of forebrain

A

Cerebral hemispheres: telencephalon
-lateral ventricle

Diencephalon: thalmus and hypothalamus
-third ventricle

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2
Q

Parts of midbrain

A

Mesencephalon

-cerebral aqueduct

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3
Q

Parts of hindbrain

A

Pons
Medulla
Cerebellum

4th ventricle

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4
Q

Primary brain vesicles

A

Prosencephalon –> forebrain
=telencephalon and diencephalon

Mesencephalon –> midbrain
=mesencephalon

Rhombencephalon –> hindbrain
=metencephalon and mylencephalon

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5
Q

Prosencephalon

A

=Forebrain

–> Telencephalon –> cerebrum
+ lateral ventricles

–> Diencephalon –> thalamus and hypothalamus
+third ventricle

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6
Q

Mesencephalon

A

= Midbrain

–> mesencephalon + cerebral aqueduct

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7
Q

Rhombencephalon

A

=Forebrain

–> Metencephalon –> Pons + cerebellum

–> Mylencephalon –> Medulla oblongata

AND fourth ventricle

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8
Q

Lateral sulcus of brain

A

Separates:
parietal and frontal lobes

temporal lobe from

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9
Q

Central sulcus of brain

A

Separates:
pre-central gyrus = MOTOR - frontal lobe

post-central gyrus = SENSORY - parietal lobe

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10
Q

Parieto-ooccipital sulcus of brain

A

Separates:
occipital lobe

parietal lobe

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11
Q

Calcarine and postcalcarine sulci

A

Medial aspect of occipital lobe

= visual centre

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12
Q

Broca’s area

A

Posterior part of the inferior frontral gyrus

(of dominant hemisphere)

Controls the motor elements of speech

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13
Q

Auditory cortex

A

Temporal lobe

Lying on the superior temporal gyrus, which receives afferents from the medial geniculate body and is concerned with auditory stimuli

Temporal association cortex, which surrounds the auditory cortex and is responsible for the perception of auditory stimuli and their integration with other sensory modalities

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14
Q

Temporal uncus function

A

Major role in olfactory stimuli

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15
Q

Cranial nerves in the midbrain

A

Cranial nerves III and IV

Portion of sensory nucleus of cranial nerve V

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16
Q

Cranial nerves of the medulla

A

Contains cranial nerve nuclei IX, X, XI and XI

Contains nucleus ambiguus (motor to cranial nerves
IX and X

Contains nucleus of tractus solitarius (sensory for
cranial nerves VIII, IX and X)

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17
Q

Cranial nerves of the medulla

A

Contains cranial nerve nuclei IX, X, XI and XI

Contains nucleus ambiguus (motor to cranial nerves
IX and X)

Contains nucleus of tractus solitarius (sensory for
cranial nerves VIII, IX and X)

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18
Q

Cranial nerves origin

A

2 : brain itself

2: midbrain
4: pons
4: medulla

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19
Q

Blood supply to cerebellum

A

Three arteries
PICA - vetebral arteries
AICA - basilar arteries
SICA - basilar arteries

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20
Q

Cerebellar peduncles

A

Three pairs

Midbrain: superior peduncles
Pons: middle peduncles
Medulla: inferior peduncles

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21
Q

Cerebellar lesions

A

Give signs on same side of body

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22
Q

End of subarachnoid space

A

Dura mater fuses with filum terminale at S2

= end-point of subarachnoid space

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23
Q

31 pair of nerves originate from the cord:

A
  • eight cervical
  • twelve thoracic
  • five lumbar
  • five sacral
  • one coccygeal
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24
Q

Dorsal horns

A

Grey matter sensory cell bodies

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25
Q

Ventral horns

A

Grey matter motor cell bodies

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26
Q

Lateral horns

A

Found in the thoracic and upper lumbar cord

Cells of origin of preganglionic sympathetic system.

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27
Q

Arrangemen of motor fibres indescending tract

A

somatotopically arranged in the tract

Upper half medially

Lower part of the cord laterally

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28
Q

Descending tracts

A

Lateral corticospinal tracts = limbs

  • Commences motor cortex
  • Decussates in medulla
  • Descends in pyramidal tract on contralateral side
  • Enters anterior horn at each spinal segment to synapse with morot nuclei

Anterior corticospinal tracts =axial muscles (of the trunk)

  • Fibres do no decussate in medulla
  • Fibres eventually cross midline at segmental levels and terminate close to those in lateral corticospinal tract
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29
Q

Lateral corticospinal tract

A

= limbs

  • Commences motor cortex
  • Decussates in medulla
  • Descends in pyramidal tract on contralateral side
  • Enters anterior horn at each spinal segment to synapse with morot nuclei
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30
Q

Anterior corticospinal tract

A

=axial muscles (of the trunk)

  • Fibres do no decussate in medulla
  • Fibres eventually cross midline at segmental levels and terminate close to those in lateral corticospinal tract
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31
Q

Ascending tracts

A

Lateral and anterior spinothalamic tracts
=pain and temperature

Anterior and posteiror spinocerebellar tracts
=equilibrium

Posterior dorsal columns
=sensation: vibration, touch and proprioception
-medial fasciculus gracilis (of Goll) and the lateral fasciculus cuneatus (of Burdach)

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32
Q

Lateral and anterior spinothalamic tracts

A

Fibres enter posterior roots

Ascend a few spinal segments and relay in substanti gelatinosa

Cross to opposite side in ventral grey commissure close to central canal

Ascend in spinothalamic tracts to the thalamus, whence they are relayed to the sensory cortex

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33
Q

Arrangement of spinothalamic tracts

A

somatotopically arranged in the lateral spinothalamic tract

lower limb = superficial

upper limb = deep

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34
Q

Anterior and posteiror spinocerebellar tracts

A

Ascend on same side of cord

Anterior –> superior cerebellar peduncle

Posterior –> inferior cerebellar peduncle

Concerned with the maintenance of equilibrium
- This is why cerebellar lesions affect unilateral side

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35
Q

Dorsal columns

A

Composed of:

  • Medial: fasciculus gracilis (of Goll)
  • Lateral: fasciculus cuneatus (of Burdach)

Contain fibres subserving fine and discriminative
tactile sensation, proprioception and vibration

As cord is ascended, fibres are added to lateral part of posterior columns
— fasciculus gracilis deals mostly with the lower
limb and the fasciculus cuneatus with the upper limb

Fibres in dorsal columns are uncrossed

  • -> synapse in gracile and cuneate nuclei in medulla
  • -> second–order fibres cross in the sensory decussation whence they synapse in the thalamus
  • -> third–order fibres pass to the sensory cortex

Some fibres pass from medulla to cerebellum
along the inferior cerebellar peduncle.

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36
Q

Lateral: fasciculus cuneatus (of Burdach)

A

Lower limb sensation and propioception

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37
Q

Medial: fasciculus gracilis (of Goll)

A

Upper limb sensation and propioception

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38
Q

Blood supply to spinal cord

A

Vertebral arteries –>

  • anterior spinal artery
  • posterior spinal artery

Anterior spinal artery
-whole of cord in front of posterior grey columns

Posterior spinal artery
-posterior grey columns and dorsal columns

Spinal artery reinforced at segmental level by radicular arteries, i.e. branches of the ascending cervical, cervical part of the vertebral, posterior intercostal and lumbar arteries

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39
Q

Blood supply to dorsal columns

A

Posterior spinal artery, branch of vertebral arteries

Supplies posterior grey columns and dorsal columbs

(anterior spinal arterior supples rest of cord)

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40
Q

Anterior cord syndrome

A

Associated with flexion / rotation injuries –> anterior dislocation or compression fracture

–> Loss of power below lesion
–> Loss of pain and temperature below lesion
(the anterior spinal artery may be compressed)

Posterior columns remain intact so sensation and proprioception normal

Also can occur if anterior spinal artery interupted for any reason

41
Q

Central cord syndrome

A

Occurs in syringomyelia and centrally placed tumours

Initially involves decussating spinothalamic tracts
–> pain and temperature sensation is lost below lesion

Later, the lateral corticospinal tracts are involed
–> intially involing the more centrally placed cervical tract supplying the arm
–> flaccid weakness of the arms
–> distal leg and sensory fibres are spared, perianal sensation and some leg movement and sensation may
be preserved

Proprioception and fine touch are preserved in
the dorsal columns until late

42
Q

Posterior cord syndrome

A

Hyper-extension injuries with fractures of the posterior vertebral elements

Loss of proprioception with profound ataxia with unsteady and faltering gait

Good power and pain and temperature sensation below the lesion

43
Q

Brown Sequard syndrome

A

Hemisection of the cord - stab injury or damage to lateral mass of vertebrae

–> Paralysis on affected side below lesion (pyramidal
tract)
–> Loss of proprioception and fine discrimination
(dorsal columns) on affected side below lesion

AND
–> Loss of pain and temperature on opposite side
below lesion (normal on affected side because of decussation below level of hemisection)

Therefore the uninjured side has good power, but absent sensation to pinprick and temperature

44
Q

Cauda equina syndrome

A

Compression of lumbosacral nerve roots below conus medullaris

Caused by bony compression OR disc protrusion in lumbosacral region
–> Lower motor lesion

  • -> Faecal incontinence
  • -> Over-flow incontinence from urinary retention
  • -> Leg numbness and weakness
45
Q

Layers of dura mater

A

Two layers

  • Endosteal layer (outermost)
  • Meningeal layer (innermost)

Continuos together except when meningeal layer folds to make walls of venous sinuses

Inner meningeal layer is continuous with dura mater of spinal cord

46
Q

Folds in dura mater

A

Falx cerebri
= between the two cerebral hemispheres

Tentorium cerebelli
=posterior clinoid process of sphenoid bone –> runs posteromedially along the superior border of the petrous temporal bone where superior petrosal sinuses enclosed

Falx cereblli
=lies between the two lateral lobes of the cerebellum

47
Q

Tentorium cerebelli

A

Attaches anteriorly to clinoid process of sphenoid

Runs posteromedially along superior border of petrous temporal bone where superior petrosal sinus enclosed

Runs posterior and medially, curving round the
midbrain, forming tentorial notch.

Just behind the apex of the petrous temporal bone,
the inferior layer prolongs into the middle cranial fossa as the trigeminal cave

48
Q

Straight sinus

A

Inferior sagittal sinus lies in free inferior border of falx cerebri

Straight sinus = where the falx meets the tentorium cerebelli

49
Q

Subarachnoid cisterns

A

Cerebellomedullary cistern (cisterna magna): posterior to medulla below cerebellum

Pontine cistern: anterior to pons

Interpeduncular cistern: between cerebral peduncles and optic chiasma—contains circle of Willis and cranial nerves III and IV

50
Q

Openings of fourth ventricle

A

Three openings in roof of fourth venttricle

Foramen of Magendie in midline

Paired: foramina of Luschka laterally

51
Q

Branches of basilar artery

A

Anterior inferior cerebellar

Labyrinthine artery

Pontine arteries

Superior cerebellar arteries

Posterior cerebral artery (terminal branches of basilar artery)

52
Q

Branches of internal carotid artery

A

Posterior communicating artery

Anterior cerebral artery

Middle cerebral artery

Anterior choroidal artery

53
Q

Superior cerebral veins

A

Drain into superior sagittal sinus

  • runs from crista galli –> internal occipital protuberence
  • -> becomes right transverse sinus
54
Q

Inferior dural sinus

A

Lies along inferior border of falx cerebri.

  • Receives cerebral veins from medial surface of hemispheres
  • Joins great cerebral vein to form straight sinus

Straight sinus

  • Formed by union of inferior sagittal sinus and great cerebral vein
  • Lies in attachment of falx cerebri to tentorium cerebelli
  • Becomes continuous with left transverse sinus near internal occipital protuberance
55
Q

Confluence of sinuses

A

Formed by the two transverse sinuses near the internal occipital protuberance

Superior sagittal –> RIGHT

Inferior sagittal –> straight sinous –> LEFT

56
Q

Sigmoid sinus

A

Passes through jugular foramen

Becomes continuous with internal jugular vein

57
Q

Occipital sinus

A

Small sinus extending from foramen magnum
–> drains into confluence of sinuses

Lies along falx cerebelli and connects vertebral venous plexuses to transverse sinus

58
Q

Cavernous sinus

A

Situated on body of sphenoid

From suprior orbital fissure –> apex of petrous temporal bone

Medial: pituitary gland and sphenoid sinus
Lateral: temporal lobe

59
Q

Structures running THROUGH cavernous sinus

A

Internal carotid artery

Abducens nerve CN VI

60
Q

Structures running in lateral wall of cavernous sinus

OTOM

A

From superior –> inferior:

  • oculomotor nerve CN III
  • trochlear nerve CN IV
  • opthalmic division of trigeminal CN V1
  • maxillary division of trigeminal CN V2

OTOM

61
Q

Drainage of the cavernous sinus

A

Opthalmic veins drain into anterior part

Emissary veins passing through the foramina of the middle cranial fossa connect the cavernous sinus to the pterygoid plexus and facial veins

Two sinuses are connected by anterior and posterior cavernous sinuses lying in front of and behind the pituitary gland

Cavernous sinus drains posteriorly

  • superiorly: transverse sinus via superior petrosal sinus
  • inferiorly: sigmoid sinus via inferior petrosal sinus
62
Q

Cavernous sinus thrombosis

A

Oedema of conjuctivae and eyelids

Exopthalmos with transmitted pulsations from internal carotid artery

Opthalmoplegia due to CN palsies

Opthalmoscopy: papilloedema and retinal haemorrhages

63
Q

Uncinate fit

A

Tumours of temporal uncinate may present as an unincate fit

Uncinate = olfactory centre

Unincate fit = olfactory hallucinations with impairment of consciousness and involuntary chewing movements

64
Q

Lamina cribrosa

A

Axons of ganglion cells of the retina pierce sclera to form optic nerve

65
Q

Geniculate body

A

Geniculate body is in thalamus

=end of optic tract

66
Q

Superior colliculus or prerectal nucleus

A

Small proportion of optic tract end at superior colliculus or prerectal nucleus

–> pupillary, ocular and head and neck reflexes =afferent limb of light reflexes

67
Q

Complete division of CN III causes..

A

Ptosis, due to paralysis of levator palpebrae superioris

Divergent squint, caused by unopposed action of lateral rectus and superior oblique

Dilatation of the pupil, caused by unopposed action of dilator pupillae
-supplied by sympathetic fibres in the long ciliary branches in the nasociliary nerve

Loss of accommodation and light reflexes, due to paralysis of ciliary muscles and constrictor pupillae

Diplopia

68
Q

Path of CN III

A

Oculomotor nere emerges between cerebral peduncles

Passes forwards between SICA and PCA

Pierces dura to lie on lateral wall of cavernous sinus

Divides into superior and inferior branches before entering superior orbital fissure

  • superior: levator palpebrae superiosis and superior rectus
  • inferior: medial rectus, inferior rectus, inferior oblique

Parasympathetic leaves inferior branch heaidng for inferior oblique to synapse in ciliary ganglion

Post-ganglionic fibres via short ciliary nerve to constrictor pupillae and ciliary muscles

69
Q

Only CN to airse from dorsum of brianstem

A

Trochlear nerve

Arises from dorsal surface of pons

70
Q

Path of CN IV

A

Nucleus lies at level of inferior colliculus

Fibres pass dorsally around cerebral aqueduct and decussate in superior medullary vellum

Emerges from dorsum of pons (only cranial nerve
to arise from dorsum of brainstem)

Winds round cerebral peduncle

Passes forwards between superior cerebellar and
posterior cerebral arteries to pierce dura

Runs forward on lateral wall of cavernous sinus
between oculomotor and ophthalmic nerves

Enters orbit through superior orbital fissure lateral
to tendinous ring from which recti take origin

Passes medially over optic nerve to enter superior
oblique muscle

71
Q

Difficulty walking downstairs

A

Trochlear nerve palsy

Resulting in diplopia when patient looks downwards and laterally

72
Q

Nuclei of the trigeminal nerve

A

Motor: upper pons near floor of fourth ventricle

Sensor:

  • mesencephalic nucleus in midbrian
  • chief sensory nucleus, lies in the pons
73
Q

Nervus spinosus

A

Branch of mandibular division og trigeminal

Nervus spinosus to supply dura mater and nerve to medial pterygoid,
–> from which otic ganglion is suspended

74
Q

Sympathetic output from otic ganglion

A

–> middle meningeal artery causing vasoconstriction

75
Q

Only cranual ganglion with motor fibres

A

Otic ganglion

Nerve to medial pterygoid passes through it supplying tensor tympani and tensor palati

76
Q

Path of CN VI

A

Nucleus in floor of fourth ventricle in upper part of pons

Fibres of facial nerve wind round nucleus to form facial colliculus.

Emerges between medulla and pons.

Passes forwards through pontine cistern.

Pierces dura mater to enter cavernous sinus lying
on lateral aspect of internal carotid artery.

Enters orbit through tendinous ring at superior orbital
fissure.

77
Q

CN VII Nuclei

A

Motor nucleus in lower pons
–> fibres loop around abducens nerve nucleus (facial colliculus) and emerge at cerebellopontine angle with nervus intermedius

Nervuus intermedius contains sensory and parasympathetic fibres
-autonomic fibres originate in the superior salivary
nucleus in the pons
-sensory fibres synapse in tractus solitarius in the pons

78
Q

Nervus intermedius

A

Lies lateral to motor fibres of facial nerve

79
Q

Branches of facial nerve in petrous temporal bone

A
  • Greater petrosal nerve
  • Nerve to stapedius
  • Chorda tympani
80
Q

Supranuclear facial palsy

A

Contralateral side affected with sparing of frontalis and orbicularis oculi

81
Q

Infranuclear facial palsy

A

Unilateral side affected, complete side of face

82
Q

Nuclei of glossopharyngeal nerve

A

Nuclei in medulla

Nucleus ambiguus: fibres to stylopharyngeus; also
innervates the muscles of the pharynx, larynx and
soft palate via the vagus nerve

Inferior salivatory nucleus, supplying the parotid gland

Nucleus of tractus solitarius, which receives taste
fibres via the glossopharyngeal nerve

Dorsal motor nucleus of vagus (shared with vagus)
for general sensation from the posterior third of the tongue and oropharynx

83
Q

Branches of vagus nerve

A

At jugular forman forms superior ganglion, upon leaving foramen forms infeiror ganglion

Branches:
-meningeal: supplies dura of posterior cranial fossa

-auricular: supplies medual aspect of auricle and external auditory meatus and outer surface of tympanic membrane

  • pharyngeal: supplies muscle of soft palate and phaynx
  • superior laryngeal: divides into internal and external branches
  • ->external = cricothyroid
  • ->internal = sensation to laryngeal pharynx and laryngeal mucosa above level of cords

-recurrent laryngeal nerve

  • cardiac branches
  • pulmonary branches
  • branches to abdominal viscera
84
Q

Nucleus of accessory nerve

A

Nucleus ambiguus: emerges with fibres from vagus nerve

  • -joins spinal root for short distance
  • ->cranial section branches off to rejoin vagus to be distributed to muscles of soft palate, pharynx and larynx

Spinal segment: C1 -C5

  • -> enters skull through foramen magnum
  • joins cranial root
  • leaves through jugular foramen
  • immediately below jugular foramen –> spinal root passes backwards to supply sternocleidomastoid and trapezius
85
Q

Innervation of palatoglossus

A

Only extrinsic tongue muscle NOT to be innervated by hypoglossal nerve

Innervated by cranial root of accessory nerve CN XI, carried by vagus nerve

86
Q

Supranuclear hypoglossal palsy

A

Infranuclear division of hypoglossal nerve cause satrophy of extrinsic muscle on same sid
–> deviation to affected side on protrusion due to atrophy

Supranuclear damage causes weakness to CONTRALTERAL side but not atrophy,
hence still points to affected side?

87
Q

Dorsal rami of C1 L4 and L5

A

Have no cutaneous branches

88
Q

Ventral rami plexi

A

Cervical plexus: C1 - C4

Brachial plexus: C5 - T1

Lumbar plexus: L1 - L4
-contribution from T12

Sacral plexus: S1 - S5
-contribution from L4 L5

89
Q

Cervical plexus

A

C1 - C4

Motor:

  • prevertebral muscles
  • levator scapulae
  • scalene muscles
  • sternocleidomastoid and trapezius via accessory nerve XI
  • diaphragm (+C5)

Sensory:

  • skin of anterior and lateral neck
  • shoulder
  • lower jaw
  • external ear.
90
Q

Sympathetic outflow

A

Lateral horn of grey matter T1 - L2

–> white rami communicantes

91
Q

Lumbar sympathectomy

A

L3 and L4 GANGLION removal

sympathetic ouput from T12 -L2 roots

92
Q

Thoracic sympathectomy

A

T2 and T3 GANGLION removal

T1 not removed as this would cause Horner’s syndrome

Sympathetic outlfow form T2–T7 roots

93
Q

Location of hypogastric plexus

A

Lies in front of L5 vetrebrae as continuation of aortic plexus

Hypogastric and aortic plexuses may be damaged
in aortic aneurysm surgery and extensive pelvic surgery,
e.g. anterior resection of the rectum: ejaculation may be compromised.

94
Q

Four head and neck parasympathetic ganglion

A

Ciliary ganglion in orbit

  • site of pre-ganglionic fibres with oculomotor nerve
  • postganglionic fibres supply ciliary muscles and constrictor pupillae

Sphenopalatine ganglion in pterygopalatine fossa

  • site of pre-ganglionic synapse of facial nerve
  • post-ganglionic fibres supply lacrimal gland and glands in nasal cavity and palate

Submandibular ganglion attached to lingual nerve
-site where preganglionic fibres accompanying
facial nerve and chorda tympani synapse
- postganglionic fibres supply submandibular and
sublingual glands, and glands in tongue and
floor of mouth

Otic ganglion attached to trunk of mandibular nerve in infratemporal fossa

  • pre-ganglionic nerves from glossopharyngeal
  • post-ganglionic fibres innervate parotid
95
Q

Ciliary ganglion

A

Ciliary ganglion in orbit

  • site of pre-ganglionic fibres with oculomotor nerve
  • postganglionic fibres supply ciliary muscles and constrictor pupillae
96
Q

Sphenopalatine ganglion

A

Sphenopalatine ganglion in pterygopalatine fossa

  • site of pre-ganglionic synapse of facial nerve
  • post-ganglionic fibres supply lacrimal gland and glands in nasal cavity and palate
97
Q

Submandibular ganglion

A

Submandibular ganglion attached to lingual nerve

-site where preganglionic fibres accompanying
facial nerve and chorda tympani synapse

  • postganglionic fibres supply submandibular and
    sublingual glands, and glands in tongue and
    floor of mouth
98
Q

Otic ganglion

A

Otic ganglion attached to trunk of mandibular nerve in infratemporal fossa

  • pre-ganglionic nerves from glossopharyngeal
  • post-ganglionic fibres innervate parotid

Anatomy (22 decks)

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