Neuroanatomy 1 Flashcards
1
Q
- How many bones make up the cranium?
- What are their names?
- Which ones are paired?
A
- 8 bones:
- frontal
- parietal (paired)
- temporal (paired)
- occipital
- sphenoid
- ethmoid
2
Q
- What are the two major areas of the cranium?
- What do they make up?
A
- cranial vault (calvarium): superior/lateral/posterior wall of the skull
- cranial floor: bottom of the skull
3
Q
What are the 3 fossae that make up the cranial floor?
A
- anterior cranial fossae
- middle cranial fossae
- posterior cranial fossae
4
Q
- What sutures (fibrous joints) make up the cranium?
- Where are they found between?
- Which joint is the only non-sutured joint of the skull?
A
- coronal suture (frontal bone/parietal bone)
- squamous suture (parietal bone/temporal bone)
- sagittal suture (parietal bone/parietal bone)
- lambdoid suture (parietal bone/occipital bone/temporal bone)
- only non-sutured: TMJ
5
Q
- What are the 4 parts/regions of the temporal bone?
- What structures are found on the temporal bone?
A
- squamous, tympanic, mastoid, petrous
structures: - zygomatic process
- external acoustic meatus
- styloid process
- internal acoustic meatus
6
Q
What structures are found on the occipital bone?
A
- foramen magnum (entry/exit of spinal cord)
- occipital condyles (atlas-C1)
7
Q
What is the only bony articulation of the head with the rest of the body?
A
occipital condyles
8
Q
- Which cranial bone is bat-shaped and is the keystone of the cranium as it articulates with all other cranial bones?
- What are the important structures found on this bone?
A
- sphenoid
- sella turcica (hypophyseal fossa - surrounds pituitary gland)
9
Q
What does the sella turcica surround?
A
the pituitary gland
10
Q
- What does the ethmoid form?
- What important structures are found on this bone?
A
- roof of nasal cavity, upper nasal septum, part of the medial orbit walls
structures: - crista galli
- cribriform plates
11
Q
What is a vertical projection that provides a point of attachment for the dura, helping to secure the brain within the skull?
A
crista galli
12
Q
What is found lateral to the crista galli and allows olfactory fibers to pass to the brain from the nasal mucosa?
A
cribriform plates
13
Q
What structure in the cranium serves as an attachment site for multiple muscles?
A
styloid process
14
Q
- What is housed in the anterior cranial fossa?
- What is housed in the middle cranial fossa?
- What is housed in the posterior cranial fossa?
A
- frontal lobe
- temporal lobe
- cerebellum
15
Q
- What foramina/apertures are found within the anterior cranial fossa?
- What is found in these foramina?
A
- foramen cecum: nasal emissary vein (1% of population; in danger of injury during surgery)
- cribriform foramina in cribriform plate: axons of olfactory cells in olfactory epithelium that form olfactory nerves (CN I)
16
Q
- What foramina/apertures are found within the middle cranial fossa?
- What is found in these foramina?
A
- optic canals: optic n (CN II) and ophthalmic aa
- superior orbital fissure: ophthalmic vv, CN III, IV, VI, and ophthalmic n (CN V1), sympathetic fibers
- foramen rotundum: maxillary n (CN V2)
- foramen ovale: mandibular n (CN V3)
- foramen spinosum: middle meningeal a and v, meningeal branch of CN V3
- foramen lacerum: connective tissue
- carotid canal: internal carotid a, internal carotid plexus
- internal acoustic meatus: facial n (CN VII) and vestibulocochlear n ( CN VIII)
17
Q
What runs over the foramen lacerum?
A
carotid canal
18
Q
- What foramina/apertures are found within the posterior cranial fossa?
- What if found in these foramina?
A
- foramen magnum: medulla/meninges (spinal cord), vertebral aa, CN XI, anterior/posterior spinal aa, dural vv
- jugular foramen: CN IX, X, XI; internal jugular vein
- hypoglossal canal: hypoglossal n (CN XII)
19
Q
- What are fontanelles called in lay terms?
- Why are they important clinically?
- How long before the anterior fontanelle closes?
A
- soft spots
- providers can tell if a baby is dehydrated of it is sunken in, or if they have increased cranial pressure if it is bulging out; also, can provide a spot for IV access in infants
- 12 months (should be completely closed by 2 years)
20
Q
- How many bones make up the facial bones?
- How many are paired?
- What are the bones?
A
- 14 bones
- 12 paired
bones: - mandible
- maxilla
- lacrimal
- palatine
- zygomatic
- nasal
- vomer
- inferior nasal conchae
21
Q
- Which two facial bones are not paired?
- What is the smallest facial bone?
A
- vomer and mandible
- lacrimal
22
Q
What bones form the nasal cavity (7)?
A
- nasal
- maxilla
- palatine
- vomer
- ethmoid
- sphenoid
- inferior nasal concha (independent bone)
23
Q
What bones form the orbit (7)?
A
- frontal
- sphenoid
- ethmoid
- lacrimal
- maxilla
- palatine
- zygomatic
24
Q
What bones make up the cheek bone?
A
- zygomatic bone
- temporal bone (zygomatic process)
25
The zygomatic bone (commonly called "_____"), articulates with the (...), forming the zygomatic arch
- "cheekbone"
- zygomatic process of the temporal bone
26
Which wall of the orbit is the weakest?
the medial wall
27
Because of the thinness of the (1) and (2) walls of the orbit, a blow to the eye may fracture the orbital walls while the margin remains intact
1. medial
2. inferior
28
Indirect traumatic injury that displaces the orbital walls is called a (...)
“blowout” fracture
29
Fractures of the (...) wall may involve the ethmoidal and sphenoidal sinuses, whereas fractures in the (...) wall may involve the maxillary sinus and may entrap the inferior rectus muscle, limiting upward gaze
- medial wall
- inferior wall
30
Although the (...) wall is stronger than the medial and inferior walls, it is thin enough to be translucent and may be readily penetrated. Thus, a sharp object may pass through it into the (...) of the brain.
- superior
- frontal lobe
31
A tumor in the middle cranial fossa may enter the orbital cavity through the (...)
superior orbital fissure
32
What are the borders of the scalp covering calvaria? (anterior, posterior, lateral)
- anterior: supraorbital margin
- posterior: external occipital protuberance, superior nuchal line
- lateral: zygomatic arch
33
- The scalp is composed of how many layers?
- What are these layers?
**5 layers:**
- skin
- connective tissue
- aponeurosis
- loose connective/areolar tissue
- pericranium
34
Which layers of the scalp are connected and move as a unit (when wrinkling the forehead)?
the first three layers (skin, connective tissue, aponeurosis)
35
What is contained in the skin layer of the scalp?
- sweat glands
- sebaceous glands
- hair follicles
36
What are the features/what is contained in the connective tissue layer of the scalp?
- richly vascularized
- supplied with cutaneous nn
- blood vessel walls have fibrous attachments that prevent closure when lacerated
37
What are the features/what is contained in the aponeurosis (epicranial aponeurosis) layer of the scalp?
- strong tendinous sheet that covers the calvaria
- serves as intermediate tendon of frontal and occipital belly of the occipitofrontalis muscle
38
What are the features/what is contained in the loose connective tissue layer of the scalp?
- sponge-like layer
- has potential spaces that may distend with fluid due to injury or infection
- allows for **free movement** of the first 3 layers
39
What are the features/what is contained in the pericranium layer of the scalp?
- dense connective tissue
- forms external periosteum of calvaria
- firmly attached but can be stripped from calvaria of living people, except at cranial sutures
40
The (...) layer is the danger area of the scalp because pus or blood spreads easily in it. Infection in this layer can also pass into the cranial cavity through (...), which pass through the calvaria and reach intracranial structures such as the meninges.
- loose connective tissue
- emissary veins
41
Infection can spread from the scalp into the cranial cavity via the (...)
emissary veins
42
What connects the dural venous sinuses with veins outside the cranium?
emissary veins
43
How can you close gaping wounds on the scalp?
- stiches
- hair apposition
- staples
44
What are two scalp hematomas that occur as a result of vaginal birth trauma and where are they located between?
- **cephalohematoma:** between periosteum and bone
- **caput succedaneum:** between skin and aponeurosis (temporary, interferes with venous flow)
45
Which scalp hematoma resulting from vaginal birth trauma is temporary and interferes with venous flow?
caput succedaneum
46
- Which hematoma results from a blow to the head causing bleeding in the subgaleal space?
- What symptoms can this cause?
- Where is this hematoma found between?
- subgaleal hematoma
- black eyes due to blood slowly pooling in eyelids b/c frontalis has no bony attachment
- between apponeurosis and periosteum
47
- What are the coverings of the brain that lie immediately internal to the cranium?
- What is the function of these?
- meninges
- protect and enclose the brain in a fluid-filled cavity, the subarachnoid space
48
What forms the supporting framework for arteries, veins, and venous sinuses?
- meninges
49
What are the 3 membranous connective tissue layers of the cranial meninges and what are their features?
1. dura mater: tough, thick, external fibrous layer
2. arachnoid mater: thin intermediate layer
3. pia mater: delicate internal layer (attached directly to brain)
50
- Which layer is the dura mater?
- Which layer is the arachnoid mater?
- Which layer is the pia mater?
- 1
- 3
- 2
51
- What are the different layers of the dura mater?
- What are these layers attached to? What are their features?
- outer periosteal layer: attached to inner aspect of the cranium
- inner meningeal layer: in close contact with the underlying arachnoid mater; continuous with the spinal dura mater at the level of the foramen magnum
52
The meningeal dura mater separate to form thick connective tissue folds or layers that separate the various brain regions and lobes, what are they?
1. falx cerebri
2. falx cerebelli
3. tentorium cerebelli
4. diaphragma sellae
53
- Describe the falx cerebri and what it separates
- Describe the falx cerebelli and what it separates
- Describe the tentorium cerebelli and what it separates
- Describe the diaphragma sellae
- **falx cerebri:** double layer of meningeal dura mater between the left and right cerebral hemispheres
- **falx cerebelli:** meningeal dura mater between the cerebellar hemispheres
- **tentorium cerebelli:** meningeal dura mater that covers cerebellum and supports the occipital lobes; separates occipital lobes of cerebral hemispheres from cerebellum
- **diaphragma sellae:** horizontal shelf of meningeal dura mater that forms roof of sella turcica covering pituitary gland
54
The infundibulum passes through the diaphragma sellae to connect what?
the hypothalamus with the pituitary gland
55
The (...) covers the pituitary gland in this fossa and has an aperture for passage of the infundibulum and hypophysial veins
diaphragma sellae
56
- What is the dura mater very sensitive to?
- Any irritation of the dura often causes what?
- stretch
- sensation of a headache, meningitis, hematoma
57
- What nerves supply the dura mater?
- trigeminal n (V1, V2, V3)
- cervical nn (C1, C2, C3)
58
What supplies the anterior cranial fossa and the falx cerebri?
- anterior meningeal nn from the ethmoidal nn from ophthalmic branch of trigeminal n
59
What supplies the posterior falx cerebri and tentorium cerebri?
meningeal branches (tentorial nn) from ophthalmic branch of trigeminal n
60
What supplies the anterior and middle cranial fossa?
- meningeal branches of the maxillary branch of the trigeminal n
- meningeal branches of the mandibular branch of the trigeminal n
61
What supplies the posterior cranial fossa?
meningeal branches of the cervical nerves
62
What is the blood supply to/from the cranial cavity?
1. meningeal vessels
2. dural venous sinus system and "cerebral" veins
3. internal carotid and vertebral arteries
63
What permits blood supply to the bones of the skill and periosteal dura mater?
meningeal vessels
64
What promotes venous return from the CNS?
dural venous sinus system and "cerebral" veins
65
What provides blood flow into the cranial cavity to supply the brain and brainstem?
internal carotid and vertebral arteries
66
Extradural or epidural hemorrhage is arterial in origin. Blood from torn branches of a (...) collects between the external periosteal layer of the dura and the calvaria, usually after a hard blow to the head. This results in the formation of an extradural or epidural hematoma
middle meningeal artery
67
What causes the lenticular shape on a CT with an extradural/epidural hematoma?
sutures stop it from spreading around the rest of the brain
68
(...) hemorrhage is typically venous in origin and commonly results from tearing of a superior cerebral vein bridging in as it enters the superior sagittal sinus
Dural border/subdural hematoma
69
(...) hemorrhage usually follows a blow to the head that jerks the brain inside the cranium and injures it. The precipitating trauma may be trivial or forgotten, but a hematoma may develop over many weeks from venous bleeding
Dural border/subdural hematoma
70
This crescent shape on a CT scan is associated with what type of hematoma?
subdural
71
(...) hemorrhage is an extravasation (escape) of blood, usually arterial, into the subarachnoid space. Most result from rupture of a saccular aneurysm
subarachnoid hemorrhage
72
This star pattern on this CT and blood in surrounding spaces is associated with what type of hematoma?
subarachnoid
73
- What is the dural venous sinus?
- What does the dural venous sinus include?
- What do they drain blood from the brain into?
- What do these sinuses lack? How does this alter the movement of blood?
- large venous channels between its periosteal and meningeal dural layers
- superior/inferior sagittal sinuses, straight sinus, confluence of sinuses, transverse, sigmoid, and cavernous sinuses, and several smaller dural sinuses
- drain blood from brain into the internal jugular veins
- they lack valves, so direction of blood flow through sinuses is pressure dependent
74
- What three sinuses meet to form the confluence of sinuses?
- What is the path of blood from the confluence of sinuses to the internal jugular veins?
- superior sagittal sinus, straight sinus, and occipital sinus
- confluence of sinuses → transverse sinus → sigmoid sinus → internal jugular sinus
75
The sinuses are channels, they do not (1) or (2) and they also drain (3)
- vasoconstrict
- vasodilate
- CSF
76
- What is located bilaterally on each side of the sella turcica on the body of the sphenoid bone?
- What does this have an anatomical relationship with?
- cavernous venous sinus
- internal carotid artery and CN III, CN IV, CN V1, CN V2, CN VI
77
- Impact to the cavernous venous sinus area can cause what?
- What else can cause compression in this area?
- optic symptoms
- pituitary tumor
78
- What does the ventricular system do?
- What does the ventricular system consist of?
- produces, transports, and excretes CSF, which coats the CNS
- 2 lateral ventricles, 3rd ventricle, and 4th ventricle
79
**This is describing the direction of flow of the ventricular system**
- The (...) open into the 3rd ventricle through the (...).
- The (...), a slit-like cavity between the right and the left halves of the diencephalon, is continuous with the (...), a narrow channel in the midbrain connecting the 3rd and 4th ventricles.
- The (...), lying in the posterior parts of the pons and medulla, extends inferoposteriorly. Inferiorly, it tapers to a narrow channel that continues into the spinal cord as the (...).
- CSF drains from the 4th ventricle through a single (...) and paired (...) into the subarachnoid space.
- CSF returns to the (...)
- lateral ventricles
- interventricular foramina (of Monro)
- 3rd ventricle
- cerebral aqueduct
- 4th ventricle
- central canal
- median aperture (of Magendie)
- lateral apertures (of Luschka)
- dural venous sinuses
80
What does the subarachnoid space contain?
- CSF
81
What is the function of the CSF and subarachnoid space?
1. supports and cushions the spinal cord and brain
2. fulfills some functions normally provided by lymphatic system by draining CSF macromolecules into meningeal dural lymphatics
82
- CSF occupies a volume of about (...) in the subarachnoid space
- CSF is produced by the (...) in the brain's ventricles
- CSF is produced continuously at a rate of about (...) mL/day
- What is CSF reabsorbed largely by?
- 150 mL
- choroid plexuses
- 500 mL/day
- the cranial arachnoid granulations and by arachnoid granulations feeding into venules along the length of the spinal cord
83
A blockage of CSF would cause what?
hydrocephalus
84
- What are tufts of arachnoid that protrude through the meningeal layer of dura mater into the dural venous sinuses? (collections of arachnoid villi)
- What do these drain and into what?
- arachnoid granulations
- drains CSF to the venous system
85
What is ultrafiltrate formed in the choroid plexus (small capillary knots hanging from the roof of the ventricles) of each ventricle?
CSF
86
- A yellowish tinge to the CSF fluid is called (...)
- What is this caused by?
- xanthochromia
- caused by RBC degeneration in the CSF as would be seen in subarachnoid hemorrhage
87
What are the 4 major regions of the brain?
1. cerebral hemispheres
2. diencephalon (thalamus/hypothalamus)
3. brainstem (midbrain/pons/medulla)
4. cerebellum
88
What can be found in the cerebral hemispheres? Describe them
- lobes (frontal, parietal, temporal, occipital, insula)
- gyri (elevated ridges of tissue)
- sulci (shallow grooves separating gyri and fissures are deeper grooves)
- corpus callosum (major commissure connecting the cerebral hemispheres
89
- What are the different fissures found in the brain?
- What are the different sulci and where are they found?
- longitudinal fissure, transverse cerebral fissure
- central sulcus (frontal/parietal), lateral sulcus (temporal/parietal), parieto-occipital sulcus (parietal/occipital)
90
- What is contained in the white matter of the brain?
- What does this do?
- insulated (myelinated) nerve fibers (axons)
- transmits/conducts information
91
What is contained in the gray matter of the brain?
- What does this do?
- contains neuron bodies
- processes and responds to stimuli
92
- When does myelination of the brain finish in females?
- When does it finish in males?
- 18-20 years old
- 20-24 years old
93
Myelination on a neuron allows it to do what?
operate more efficiently
94
What is the frontal lobe associated with?
higher brain functions:
- decision-making
- problem-solving
- planning
- organizing
- motivation
- discipline
- emotional regulations
**also long term memory, motor, ocular, movement, verbal expression**
95
What are the structures of the forebrain and what are contained in each?
*prosencephalon:*
- cerebral hemispheres, basal ganglia, limbic system
*diencephalon:*
- thalamus, hypothalamus
96
What are the structures of the midbrain?
mesencephalon
97
What are the structures of the hindbrain and what are contained in them?
*rhombencephalon:*
- cerebellum, pons, medulla
98
- What does the longitudinal fissure separate?
- What extends in this fissure?
- The frontal lobes occupy the (...) fossa
- The temporal lobes occupy the lateral parts of the (...) fossa
- The occipital lobes extend posteriorly over the (...)
- 2 cerebral hemispheres
- falx cerebri
- anterior cranial fossa
- middle cranial fossa
- tentorium cerebelli
99
What lobe mediates precise voluntary motor control, learned motor skills, planned movement, eye movement, expressive speech, personality, working memory, complex problem solving, emotions, judgement, socialization, olfaction, and drive (executive functions and motor)?
the frontal lobe
100
What lobe affects sensory input, spatial discrimination, sensory representation and integration, taste and receptive speech (special senses)?
parietal lobe
101
What lobe affects visual input and processing?
occipital lobe
102
What lobe mediates auditory input and auditory memory integration, spoken language (dominant side), and body language (non-dominant side)?
temporal lobe
103
What is the fifth deep lobe of the brain that lies medial to the temporal lobe (sometimes included as part of temporal lobe)?
insula
104
What lobe (deep lobe) influences vestibular function, some language, perception of visceral sensations (ex: upset stomach), emotions, and limbic functions?
insula
105
Functional neuroimaging studied have linked the (...) to desires, cravings, and addiction
insula
106
What is also sometimes considered a fifth medial lobe (cingulate cortex) that influences emotions and some autonomic functions?
limbic
107
- What is known as the primary motor cortex?
- What is known as the primary somatic sensory cortex of the brain?
- precentral gyrus
- postcentral gyrus
108
Voluntary movements can be found in the (...) of the frontal lobe
precentral gyrus (primary motor cortex)
109
What is located in the postcentral gyrus and receives information from the skin and skeletal muscles?
primary sensory cortex
110
What is a map along the cerebral cortex of where each part of the body is processed? Where is this located?
- sensory homunculus
- primary sensory cortex
111
- What is the function of Broca's area?
- Damage to this area can do what?
- Describe what happens when this area is damaged
- motor to coordinate muscles of speech
- damage can disrupt speech
- when damaged, person can understand language but words may not be properly formed, speech may be slow and patients may get frustrated because they know that something is wrong
112
- What is the function of Wernicke's area?
- Damage to this area can do what?
- Describe what happens when this area is damaged?
- allows understanding of spoken and written language, is the part that enables a person to interpret language
- damage can cause person to become unaware of his own speech and the speech of others
- when damaged, the person can speak clearly, but the words put together make no sense. This way of speaking has been called "word salad" because it appears that the words are all mixed up; might use complete nonsense words; often not aware of their problem
113
- Expressive aphasia can be seen in damage to what area (unable to find words or sentences)?
- Receptive aphasia can be seen in damage to what area (unable to understand words)?
- Broca's area
- Wernicke's area
114
- What designates the areas of the basal forebrain and midbrain known to be involved in the control of movement and motor learning?
- This is described as islands of gray matter called (...) deep within the (...) matter of the cerebral hemispheres
- flank lateral and third ventricles involved in regulating (...)
- This is composed of (...) and (...) - collectively referred to as (...); the internal capsule passes between them
- basal ganglia
- nuclei; within the white matter
- regulating motor activities
- composed of caudate nucleus and lentiform nucleus; referred to as corpus striatum
115
What are the functions of the basal ganglia?
1. part of extra-pyramidal motor system
2. facilitate behavior and movement - required and appropriate
3. inhibit unwanted and inappropriate movement
4. deficits tend to fall into one of two categories:
- presence of extraneous unwanted movements OR
- absence or difficulty with intended movements
116
- What does the balance between the cerebellum and the basal ganglia allow for?
- What can a disturbance in either system show up as?
- smooth, coordinated movement
- movement disorders
117
What serves as a major integrating and relay station for sensory impulses passing upward to the cortical sensory areas for localization and interpretation?
thalamus
118
What makes up the thalamus and what does it enclose?
2 large lobes of gray matter and laterally encloses third ventricle
119
- Where is the hypothalamus located?
- What does it do?
- base of cerebral brain
- homeostasis
120
What is the gateway to the cortex and simplistically is the relay station? (you constantly have stimuli coming in, but this decides what you will become made aware of and what you will not)
thalamus
121
What generally serves to provide sensorimotor integration through conscious perception of sensation (either external or internal) to guide the motor system and facilitate communication for higher cortical functions?
thalamus
122
- The homeostatic functions of the hypothalamus include what?
- What are the survival functions it includes?
- control of body temp, circulation of blood
- regulation of food/water intake, the sleep-wake cycle, sexual behavioral patterns, defense mechanisms against attack
123
What consists of 2 lateral hemispheres, each with 3 lobes, is similar to the cerebrum with outer cortical area of gray matter and inner area of white matter (arbor vitae)?
cerebellum
124
- What is the cerebellum concerned with?
- What does the cerebellum remain constantly aware of?
- Fibers of the cerebellum converge from where?
- unconscious coordination of skeletal muscle activity and control of balance and equilibrium
- remains constantly aware of position and state of tension of various body parts
- fibers converge from ear, visual pathways, proprioceptors or tendons, and skeletal mm
125
- Moving from point A to point B is controlled by what?
- What makes these movements smooth?
- precentral gyrus
- cerebellum
126
Why are the purkinje fibers important?
- they contain tons of dendrites that communicates between 100,000-200,000 other cells to allow movements to be smooth and balanced
127
- Describe the midbrain.
- What CN are associated with the midbrain?
- The midbrain serves important functions in what?
- superior part of the brainstem, lies at the junction of the middle and posterior cranial fossa
- CN III and IV
- motor movement, particularly movements of the eye, and in auditory and visual processing
128
- Describe the pons.
- What CN arise off of the pontomedullary junction of the pons?
- means "bridge," connected to cerebellum by cerebral peduncles
- CN VI, VII, VIII
129
- Describe the medulla oblongata?
- What does the medulla oblongata house?
- What CN arise off the medulla?
- composed primarily of fiber tracts, decussation of pyramids (crossover pt for the major motor tracts descending from the cerebrum to the cord, "pyramidal tracts")
- houses many vital autonomic centers involved in the control of HR, respiratory rhythm, blood pressure, vomiting, and swallowing
- CN IX, X, XI, XII
130
Which nerve is the only nerve that comes off the midbrain posteriorly?
CN IV
