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MBBS - Year 3 > Neuro & Opthal - Intro > Flashcards

Neuro & Opthal - Intro Flashcards

1
Q

How many paired Cranial Nerves are there

A

12

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2
Q

Functions of cranial nerves

A

Sensory (general or special)
Motor
Parasympathetic

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3
Q

CN I

A

Olfactory

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4
Q

CN II

A

Optic

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5
Q

CN III

A

Oculomotor

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6
Q

CN IV

A

Trochlear

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7
Q

CN V

A

Trigeminal

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8
Q

CN VI

A

Abducens

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9
Q

CN VII

A

Facial

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10
Q

CN VIII

A

Vestibulocochlear

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11
Q

CN IX

A

Glossopharyngeal

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12
Q

CN X

A

Vagus

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13
Q

CN XI

A

Accessory

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14
Q

CN XII

A

Hypoglossal

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15
Q

Which CNs have a motor function

A

III
IV
V
VI
VII
IX
X
XI
XII

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16
Q

Which CNs have a sensory function

A

CN I
CN II
CN V
CN VII
CN VIII
CN IX
CN X

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17
Q

How do CNs communicate

A

Via reflex arc for integrated function

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18
Q

Do CNs generally decussate

A

No except VI which crosses before exiting brainstem and CN II partially

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19
Q

Basic concepts of CN

A

Motor info from CNS is carried in EFFERENT nerve fibres
Sensory info form internal and external environment is carried to CNS in AFFERENT nerve fibres - ‘general and special senses’

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20
Q

General vs special senses

A

General sense - pain, pressure, touch, temp, proprioception
Special sense - all carried in CN - olfaction, vision, taste, hearing and vestibular function

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21
Q

Organisation of CN based on functional components of each nerve

A

General Somatic Afferent (GSA) fibres
General Visceral Afferent (GVA) fibres
General Visceral Efferent (GVE) fibres
General Somatic Efferent (GSE) fibres

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22
Q

What are GSA fibres related to

A

Receptors for pain, temp, touch, proprioceptive receptors, in the skin, muscles, tendons and joints

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23
Q

What are GVA fibres related to

A

Receptors in visceral structures

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24
Q

What are GVE fibres

A

Preganglionic autonomic fibres

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25
Q

What do GSE fibres do

A

Innervate skeletal muscle (axons of alpha and gamma motor neurons)

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26
Q

Sequences of neurons in conscious sensation

A

3rd order neurones
Peripheral receptor (1st order)–> CNS (2nd order) –> thalamus (3rd order) –> sensory cortex
Perception of sensation occurs in cerebral cortex

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27
Q

What’s the exception to three order neurons in conscious sensation

A

Olfactory projections
Only have 2 neurons between receptor and cerebral cortex and doesn’t primarily project via thalamus

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28
Q

Sequences of autonomic efferent fibres

A

Two order neurones
Cell bodies of first order neurone (preganglionic neurone) are located in brain/ brainstem
Cell bodies of second order neurone (post-ganglionic neurone) are located in periphery in autonomic ganglion

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29
Q

What does brainstem consist of

A

Mid-brain
Pons
Medulla oblongata

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30
Q

Which CNs exit at mid-brain

A

III
IV

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31
Q

Which CNs exit at pons

A

V

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32
Q

Which CNs exit at ponto-medulaary junctions

A

VI
VII
VIII

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33
Q

Which CNs exit at medulla oblongata

A

IX
X
XI (cranial part)
XII

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34
Q

Which CNs leave at C1-C5

A

XI (spinal part)

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35
Q

Where do CNs leave the brainstem relationally

A

Anterior: CN III, VI and XII
Lateral: CN V and vII-XI (cranial root)
Posterior: CN IV

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36
Q

CN and their nuclei

A

Each CN is associated w/ one or more nuclei in the brain and brainstem
CN I and II are from nuclei compartments of the forebrain
CN III - XII are from CN nuclei in the brainstem

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37
Q

How are CN nuclei arranged

A

In columns according to their embryological origin

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38
Q

What do CN nuclei found in the midbrain deal with

A

Discrimination of tone and recognition of sound
Vision and light reflex
Movement of eyes

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39
Q

What do CN nuclei found in the pons deal with

A

Maintenance of awake state
Connection between cerebrum and cerebellum
Muscle movements of the face
Hearing and spatial orientation
Sensation from head and neck area

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40
Q

What do CN nuclei found in the medulla oblongata deal with

A

Balance
Movement of tongue
Sensation from head and neck area

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41
Q

General rule of thumb about location of CN nuclei

A

Sensory nerve nuclei tend to be located in the lateral brainstem, while motor nuclei tend to be located more medially

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42
Q

Nuclei of mixed CN

A

Nerves w/ mixed sensory and motor fibres have more than one nucleus of origin - at least sensory (afferent) and one motor (efferent)
Sometimes more than one nerve will originate form a single nucleus e.g. taste

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43
Q

Where do sensory CN nuclei receive input from

A

Periphery

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44
Q

Are sensory receptors cell bodies of sensory CN nuclei found in the nucleus itself

A

No, they are located outside the CNS in the dorsal root ganglion or trigeminal ganglion

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45
Q

Types of sensory afferent CN nuclei

A

General: trigeminal nucleus
Auditory and motion: vestibular and cochlear nuclei
Tase: nucleus solitarius

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46
Q

How many sensory efferent columns are there for CN nuclei

A

Somatic efferent
Branchiomotor
Parasympathetic efferent

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47
Q

Which CN nuclei are found in the somatic efferent column

A

CN III
CN IV
CN VI
CN XII

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48
Q

Which CN nuclei are found in the branchiomotor column

A

CN V
CN VII
CN IX
CN X
CN XI
Trigeminal motor & facial nuclei and nucleus ambiguus

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49
Q

Which CN nuclei are found in the parasympathetic column

A

CN III
CN VII
IX
X
Edinger-Westphal, salivary and motor vagus nuclei

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50
Q

Pathway of olfactory nerve

A

Olfactory epithelium
Olfactory nerve
Olfactory bulb
Olfactory tract
Olfactory cortex - frontal lobe (forebrain)

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51
Q

How many cranial nerves leave the cranial cavity

A

One - CN II

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52
Q

Decussation of CN II

A

Semi-dec sustain in optic chiasm and project to thalamus

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53
Q

Motor function of CN III

A

Innervates all but two extra ocular muscles of the eye and muscles of upper eyelid (SO, LR)

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54
Q

What movements are caused by CN III

A

Gaze fixation and eye tracking
Raises eyelid

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55
Q

Parasympathetic function of CN III

A

Contracts smooth intrinsic muscle fo pupil and accommodates lens - pupil constriction

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56
Q

What does the superior branch of the motor nerve fibres of CN III innervate

A

Superior rectus
Levator palpebrare

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57
Q

What does the inferior branch of the motor nerve fibres of CN III innervate

A

Medial rectus
Inferior rectus
Inferior oblique

58
Q

Motor function of CN IV

A

Innervates superior oblique on contralateral side, turns eyeball down & out

59
Q

Route of CN IV

A

Emerges from posterior aspect of midbrain
Fibres cross as they leave brainstem
Runs w/ CN III through cavernous sinus
Leaves skull via superior orbital fissure

60
Q

Divisions of CN V

A

Ophthalmic nerve
Maxillary nerve
Mandibular nerve - motor fibres only travel in this direction

61
Q

Sensory component of CN V

A

Touch, pain, temp of face

62
Q

Motor component of CN V

A

Mastication - tensor tympani and tensor veli palatini

63
Q

Sensory areas of body supplied by CN V

A

Face
Scalp
Cornea
Nasal and oral cavities
Teeth and gums
Cranial dura mater

64
Q

Role of mesenphalic nucleus in CNV

A

Proprioception form muscles of mastication and temporomandibular joint

65
Q

Sub-nuclei of sensory nuclei of CN V

A

Chief
Mesenphalic
Spinal

66
Q

Motor function of CN VI

A

Innervate lateral rectus - responsible for EOM w/ CN III (abduct eye)

67
Q

Nerve roots of CN VII

A

Lateral nervus intermedius (sensory and parasympathetic)
Medial facial nucleus (motor)

68
Q

Branches of CN VII

A

Temporal (forntal)
Zygomatic
Buccal
Marginal mandibular
Cervical

69
Q

Where does CN VII terminate at

A

Parotid gland

70
Q

How can we divide the facial nerve

A

Intracranial
Extracranial

71
Q

Role of special sensory fibres in CN VII

A

Taste to ant 2/3rd of tongue
Cutaneous sensation from external ear

72
Q

Where do the parasympathetic preganglionic fibres of CN VII go to

A

Lacrimal, submandibular, lingual glands
Nasal and oral mucosa

73
Q

Where do the parasympathetic preganglionic fibres of CN VI originate from

A

Superior salivary nucleus

74
Q

Components of CN VIII

A

Vestibular nerve carries info regarding position and movement of head
Cochlear nerve carries auditory info

75
Q

Where does CN IX originate from

A

4 nuclei - pair of sneery and motor each located in medulla oblongata

76
Q

What do the afferent fibres of CN IX innervate

A

General sensation - oropharynx, posterior 1/3rd of tongue, middle ear, carotid body, Eustachian tube
Chemo and baroreceptors

77
Q

Where do fibres of general sensation in CN IX end

A

Trigeminal sensory nucleus

78
Q

Somatic motor function of CN IX

A

Efferent fibres innervate stylopharyngeus

79
Q

Visceral motor function of CN IX

A

Innervate parotid gland

80
Q

What branches come off the general somatic sensory of CN IX

A

Tympanic
Carotid sinus
Pharyngeal
Tonsillar
Lingual

81
Q

Special sensory function of CN IX

A

Taste fibres from posterior 1/3 of tongue

82
Q

Structure of CN X

A

Pair of nerves emerging from L and R side of medulla oblongata

83
Q

Sensory function of CN X

A

Innervates skin of external acoustic meatus, laryngopharynx, larynx, visceral sensation to heart and abdo viscera

84
Q

Special sensory function of CN X

A

Taste sensation to epiglottis and root of tongue

85
Q

Motor function of CN X

A

Innervates majority of muscles of the pharynx, soft palate and larynx

86
Q

Parasympathetic branches of CN X

A

Cardiac
Bronchial
Oesophageal

87
Q

Role of cardiac parasympathetic branch of CN X

A

Slow HR

88
Q

Role of bronchial parasympathetic branch of CN X

A

Constricts bronchi

89
Q

Role of oesophageal parasympathetic branch of CN X

A

Control involuntary muscle in digestive system, stimulating peristalsis and GI secretions

90
Q

Components of CN XI

A

Spinal and cranial root

91
Q

Where does the spinal component of CN IX originate from

A

C1-C5/6

92
Q

Role of spinal component of CN XI

A

Innervates trapezius and SCM - allows head movement

93
Q

Where does the cranial component of CN XI originate from

A

Medulla oblongata and fibres distribute w/ vagus nerve fibres

94
Q

Motor function of CN XII

A

Innervates intrinsic and extrinsic muscles of tongue

95
Q

Reflex movements of CN XII

A

Chewing, sucking and swallowing

96
Q

Basic functional unit of brain

A

Neurone

97
Q

Basic structural unit of brain

A

Neuroglia

98
Q

Which cell bodies form groups

A

Those w/ similar functions
CNS: nucleus
PNS: ganglion (exception is basal ganglia inside brain)

99
Q

What is the CNS made up of

A

Cerebral hemisphere - L & R, covered in gyri and sulci
Diencephalon deep to hemispheres (gateway to brainstem)
Cerebellum
Brainstem
Spinal cord (continuation of brainstem)

100
Q

Where is thalamic lateral found

A

Diencephalon

101
Q

What does the brainstem consist of

A

Mid-brain
Pons
Medulla oblongata

102
Q

Ventricles in the brain

A

Two lateral ventricles Bothe drain into 3rd
Third ventricle in centre of diencephalon
Aqueduct passes through diencephalon into brainstem
Fourth ventricles has apertures which acts as outlets so CSF flows in subarachnoid space

103
Q

Functions of CSF

A

Supports and cushions structure
Provide nutrition
Removes waste products

104
Q

What are the two cerebral hemispheres divided by

A

Great longitudinal fissure (gap)

105
Q

What are cerebral hemispheres joined y

A

Corpus callosum

106
Q

What is white matter divided into

A

Fibre groups - association fibres, commissural fibres, projection fibres

107
Q

Where do the sensory fibres of the internal capsule pass through

A

Anterior limb - prefrontal cortex
Posterior limb - somatomotor
Retro-lentiform - visual
Sub-lentiform - auditory

108
Q

Where do the motor fibres of the internal capsule pass through

A

Genu - head and neck
Post limb (anterior) - truck and limbs

109
Q

What are hemispheres broken down into

A

Lobes that relate to cortical functional areas, separated by sulci

110
Q

Sulci of the brain

A

Central (separates frontal and parietal)
Lateral (separates frontal, parietal and lateral)
Parieto-occipital (separates parietal and occipital)

111
Q

What is the frontal lobe associated w/

A

Movement and higher order functions
Motor speech (Broca’s area)
Smell link to limbic system

112
Q

What is prefrontal area involved in

A

Personality and behaviour

113
Q

Role of parietal lobe

A

Integrates sensory info from various parts of body - associated w/ movement, orientation, lang, reading & taste

114
Q

Role of temporal lobes

A

Primary auditory area - auditory perception
Secondary auditory area - interpreting sounds
Balance and coordination
Wernicke’s area - understanding info

115
Q

What is the limbic system also known as

A

Primitive brain - coordinates instinctive behaviours w/ higher critical functioning

116
Q

Role of basal ganglion

A

Important in stabilising & coordinating slow and fine movements

117
Q

What is basal ganglion made of

A

Caudate nucleus
Lentiform nucleus
Amygdaloid body
Substantia Nigra

118
Q

Basal ganglia pathways

A

Direct - initials movements
Indirect - suppresses movement

119
Q

Role of thalamus

A

Transmits sensory info to cerebral cortex & areas controlling movement

120
Q

What is the thalamus involved in

A

Conscious awareness
Sleep-wake area
Emotions and behaviour through limbic system

121
Q

How many sensory systems have a thalamic nucleus

A

All (except olfactory system) incl a thalamic nucleus that receives sensory signals —> associated primary cortical area

122
Q

What is the hypothalamus involved in

A

Instinctive desires and behaviours

123
Q

Functions of hypothalamus

A

Regulation of body temp
Emotion and behaviour
Hunger & thirst
Sexual activity & procreation
Autonomic and endocrine activities and biorhythms

124
Q

Largest part of hindbrain

A

Cerebellum

125
Q

Where does the cerebellum originate

A

From the dorsal aspect of the brainstem overlies 4th ventricle

126
Q

How is the cerebellum connected to the brainstem

A

By three cerebellar peduncles - superior, middle and inferior

127
Q

What is the reticular formation

A

Cluster of nuclei that regulate sleep/wake cycle

128
Q

Number of nerves originating from spinal cord

A

8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal

129
Q

Regions of white and grey matter in spinal cord

A

Dorsal (posterior) horns - sensory neurons
Ventral (anterior) horns - motor neurons
Lateral horns - autonomic (motor neurons), thoracic regions - T1-L2
Columns - ascending (sensory) and descending (motor) tracts

130
Q

Features of hyperopia

A

Long sighted, smaller eyes, image focuses at back of retina

131
Q

Features of myopia

A

Short sighted, bigger eyes, image focuses in front of retina

132
Q

Significance of loss of colour vision

A

First thing lost in optic neuropathy or compressive lesion

133
Q

Measuring colour vision

A

Ishihara colour plates
Red desaturation

134
Q

Muscles involved in oculumotility

A

Superior oblique
Inferior oblique
Superior rectus
Inferior rectus
Lateral rectus
Medial rectus

135
Q

Muscles and ocular movements

A

Superior rectus - up & out
Lateral rectus - outwards
Medial rectus - inwards
Inferior oblique - up and in
Inferior rectus - down & out
Superior oblique - down & in

136
Q

Relative Afferent Pupillary Defect

A

Both pupils should constrict when performing swinging light test
Issue when only one constricts

137
Q

Aniscoria (R is constricted, L is dilated)

A

In dim light, pt’s R is abnormal
In bright light, pt’s L is abnormal

138
Q

Testing for Adie’s tonic pupil

A

Abnormal pupil constricts w/ pilocarpine eye drops, normal does not

139
Q

Testing for Horner’s syn

A

4% cocaine ye drops - cocaine blocks reuptake of noradrenaline in synapse
Normal pupil dilates, Horner’s does NOT (either pre- or post-ganglionic)

140
Q

Confirming Horner’s syn

A

Test w/ 1% hydroxyamphetamine - post-ganglionic lesion causes both pupils to dilate, pre- does NOT
Can also use weak once of adrenaline - post dilates
Apraclinidine - alpha2 agonist has not effect on normal pupils but Horner’s dilates

141
Q

Features of Horner’s syn

A

Ptosis
Anhidrosis
Miosis
Enopthalmos
Loss of ciliospinal reflex

MBBS - Year 3 (9 decks)

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