Neuro - Anatomy & Physiology Part 3 Flashcards
A 6’5” man with long limbs has a CT scan three months after a stroke and “the worst headache of his life.” What caused the stroke?
This man likely has Marfan’s syndrome and developed a berry aneurysm that caused subarachnoid hemorrhage (“worst headache of his life”)
The third division of the trigeminal nerve exits the skull via the foramen _____.
Foramen ovale
The middle meningeal artery exits at the foramen _____.
Foramen spinosum
Which cranial nerves exit the skull through holes in the posterior cranial fossa?
Cranial nerves VII through XII
The internal auditory meatus contains which two cranial nerves?
Cranial nerves VII and VIII
Which foramen contains cranial nerves IX through XI and the jugular vein?
The jugular foramen
Which cranial nerve is found in the hypoglossal canal?
Cranial nerve XII
The spinal cord exits the skull via the _____ _____.
Foramen magnum
The spinal roots of cranial nerve XI and the vertebral arteries exit the skull via which opening?
Foramen magnum
Through which three holes do the three branches of the trigeminal nerve leave the skull? Use the mnemonic Standing Room Only.
V1 through Superior orbital fissure; V2through foramen Rotundum; V3through foramen Ovale
The cavernous sinus is a collection of venous sinuses surrounding which gland?
The pituitary gland
The cavernous sinus contains venous return from which structures? What is the drainage of the cavernous sinus?
Blood from the eye and superficial cortex; the internal jugular vein
Which cranial nerves traverse the cavernous sinus?
Cranial nerves III, IV, V1, V2, and VI
What are the manifestations of cavernous sinus syndrome?
Ophthalmoplegia and ophthalmic and mandibular sensory loss
Which artery passes through the cavernous sinus?
Internal carotid artery
A lesion of CN XII results in tongue deviation _____ (toward/away from) the side of the lesion.
Toward (remember: lick your wounds)
A patient;s jaw deviates to the right; this indicates a lesion in which cranial nerve, and on which side?
Right cranial nerve V motor lesion; the jaw deviates in the same direction as the side of the cranial nerve V lesion
A lesion in CN X results in uvula deviation _____ (away from/toward) the lesion.
Away from
A lesion in cranial nerve XI results in weakness turning the head to the _____ (contralateral/ipsilateral) side and a shoulder droop on the _____ (contralateral/ipsilateral) side.
Contralateral; ipsilateral
The upper face receives _____ (unilateral/bilateral) upper motor neuron innervation.
Bilateral
A lower motor neuron lesion after the facial nucleus results in _____ (ipsilateral/contralateral) paralysis of the upper and lower face.
Ipsilateral
An upper motor neuron lesion between the cortex and the facial nucleus results in what pattern of paralysis in the face?
Contralateral paralysis of the lower face only
Complete destruction of the facial nucleus or its branchial efferent fibers results in what disorder?
Bell;s palsy
Bell;s palsy is characterized by peripheral _____ (ipsilateral/contralateral) facial paralysis with an inability to close the _____ (eye/mouth) on the affected side.
Ipsilateral; eye
Name six conditions that can present with Bell;s palsy; use the mnemonic Alexander Graham Bell with an STD.
AIDS, Lyme disease, Herpes zoster, Sarcoidosis, Tumors, Diabetes (remember: ALexander graHam Bell with STD)
Name the three muscles that close the jaw.
Masseter, teMporalis, and Medial pterygoid (remember: the three M;s Munch)
Which muscle opens the jaw?
The lateral pterygoid (Lateral Lowers the jaw)
Which nerve innervates all the muscles of mastication?
The trigeminal nerve (V3)
With one exception, all muscles with the root -glossus are innervated by what nerve?
The hypoglossal nerve
All muscles with the root -glossus are innervated by the hypoglossal nerve, except for which one? Which nerve is it innervated by?
The palatoglossus; it is innervated by the vagus nerve
Within which bone is the inner ear located?
The temporal bone
Name the three parts of the bony labyrinth. What fluid is the bony labyrinth filled with, and what ion is it rich in?
The cochlea, the vestibule, and the semicircular canal; perilymph; sodium (peri means around so think of extracellular fluid)
Endolymph is rich in what ion?
Potassium (endo means internal so think of intracellular fluid)
Name the four elements of the membranous labyrinth.
Cochlear duct, utricle, saccule, and semicircular canals
The vestibular apparatus detects what sensory information?
Spatial orientation
The base of the cochlea, which is most sensitive to high frequency sounds, is _____ (stiff/flexible) and _____ (wide/narrow). Which part detects low frequencies?
Stiff and narrow; low frequency is detected by the wide and flexible apex of the cochlea
Endolymph is made by what structure?
The stria vascularis
Within the inner ear, in what two places are maculae found? Maculae are important for sensing what kind of acceleration?
The utricle and the saccule; linear
Trace the path of auditory conduction from the tympanic membrane to cranial nerve VIII.
Vibration travels from the tympanic membrane through the ossicles and oval window to the basilar membrane, where bending of hair cell cilia against the tectorial membrane causes hyper- or depolarization of cranial nerve VIII
Semicircular canals contain _____, which are important for detecting angular acceleration.
Ampullae (Ampullae detect Angular acceleration)
A negative Rinne test indicates that air conduction is _____ (better/worse) than bone conduction, and implies _____ (conductive/sensorineural) hearing loss.
Worse; conductive
Someone with sensorineural hearing loss would have a _____ (positive/negative) Rinne test, and a Weber test that lateralizes to the _____ (same/opposite) ear.
Positive; opposite
The progression of hearing loss in the elderly starts with ____ (high/low) -frequency sounds and progresses to ____ (high/low) -frequency sounds.
High; low
A man with decreased hearing in his left ear is found to have a negative Rinne test and a Weber test that localizes to his left ear. What type of hearing loss does he have?
Conductive hearing loss
A woman with decreased hearing in her left ear is found to have a positive Rinne test and a Weber test that localizes to her right ear. What type of hearing loss does she have?
Sensorineural hearing loss
Which end of the cochlear membrane is narrow and stiff, and which is wide and flexible?
Like a scuba flipper, the cochlea is narrow/stiff at the base and wide/flexible at the apex
Describe the relative locations and sizes of the macula and the fovea.
The macula is a spot approximately 5 mm in diameter at the center of the retina; the fovea is at the center of the macula
The fovea has a high density of ____ (rod/cone) cells.
Cone
Retinitis is associated with what pathological appearance on fundoscopic exam?
Retinal necrosis and edema, which can lead to atrophic scarring of the retina
Reiter syndrome (reactive arthritis) can lead to inflammation of which ocular structure?
Iritis