Neuroanatomy Flashcards
Where are multipolar neurones typically present?
Skeletal muscle
ANS
Where are the soma of multipolar neurones typically found?
In CNS (presynaptic neurone for ANS)
Where are the soma of unipolar/pseudounipolar neurones found?
PNS - Dorsal root ganglion
What is the name for a collection nerve cell bodies in the CNS?
Nucleus
What is the name for a collection nerve cell bodies in the PNS?
Ganglion
What is the name for a bundle of axons in the CNS?
Tract
What is the name for a bundle of axons in the PNS?
Nerve
Where are spinal nerves located?
Only within the intervertebral foraminae
How do spinal nerves connect to the soma?
Via rami
How do spinal nerves connect to the spinal cord segment of the same number>
Via roots and rootlets
Which are bigger, posterior rami or anterior rami?
Anterior
What is the course of a sensory axon?
Passes from the spinal nerve…
…into the posterior root…
…into the posterior rootlets…
…into the dorsal horn of the spinal cord
What is the course of a motor axon?
Passes from ventral horn of the spinal cord…
…into the anterior rootlets…
…into the anterior root…
…into the spinal nerve
Where does the spinothalamic tract decussate?
In spinal cord (Usually 1-2 spinal levels above point of entry)
What dermatomal map is used in Dundee?
Foerster map
What does each segment of the body wall receive in terms of nervous supply?
General sensory supply (to all structures) Motor supply (to skeletal muscles) Sympathetic supply to: - Skin - Smooth muscles of all arterioles
What spinal level is the male nipple?
T4
What spinal level is the umbilicus?
T10
What spinal levels supply the posterior scalp, neck and shoulder?
C2-C4
What spinal levels supply the upper limb?
C5-T1
What spinal levels supply the lower limb, gluteal region and perineum?
L2-Coccygeal segment
What spinal levels make up the cervical plexus?
C1-C4
What does the cervical plexus supply?
Posterior scalp
Neck wall
Diaphragm
What spinal levels make up the brachial plexus?
C5-T1
What does the brachial plexus supply?
Upper limb
What spinal levels make up the lumbar plexus?
L1-L4
What does the lumbar plexus supply?
Lower limb
What spinal levels make up the sacral plexus?
L5-S4
What does the sacral plexus supply?
Lower limb
Gluteal region
Perineum
What segments of the spinal cord have lateral horns?
T1-L2
Why do some spinal cord segments have lateral horns?
For soma of the next SNS neurone in the chain
Presynaptic axons providing sympathetic outflow to the heart synapse where?
T1 or Cervical paravertebral ganglia
Postsynaptic axons providing sympathetic outflow to the heart travel in what nerves?
Cardiopulmonary splanchnic nerves
Where do postsynaptic sympathetic axons travel to in the heart?
SA node
AV node
Myocardium
Presynaptic axons providing sympathetic outflow to the lungs synapse where?
Upper thoracic paravertebral ganglia
Postsynaptic axons providing sympathetic outflow to the lungs travel in what nerves?
Cardiopulmonary splanchnic nerves
Where do postsynaptic sympathetic axons travel to in the lungs?
Bronchiolar smooth muscle
Mucous glands
Presynaptic axons providing sympathetic outflow to the foregut synapse where?
Celiac ganglion of the celiac plexus
Presynaptic axons providing sympathetic outflow to the kidney synapse where?
Aorticorenal ganglion
Presynaptic axons providing sympathetic outflow to the midgut synapse where?
Superior mesenteric ganglion of the superior mesenteric plexus
Presynaptic axons providing sympathetic outflow to the hindgut and pelvic/perineal organs synapse where?
Inferior mesenteric ganglion of the inferior mesenteric plexus
Presynaptic axons providing sympathetic outflow to the adrenal medulle synapse where?
Directly onto adrenaline/NA secreting cells of the adrenal medulla (pas through aorticorenal ganglion without synapsing
Why is there ipsilateral ptosis in Horner’s syndrome?
Lack of SNS innervation to levator palpebrae superioris smooth muscle
Why is there ipsilateral miosis in Horner’s syndrome?
No SNS innervation to dilator pupillae
What causes Horner’s syndrome?
Cervical sympathetic chain compression
What lung tumour causes Horner’s syndrome?
Pancoast tumour (most are non-small cell)
How do parasympathetic fibres reach the eye?
Via the ciliary ganglion
Parasympathetic fibres which travel through parasympathetic ganglia in the head travel to what structures?
Lacrimal glands
Salivary glands
Parasympathetic fibres in the vagus nerve supply what structures?
Neck
Chest
Abdomen (as far as midgut)
Parasympathetic fibres in the sacral spinal nerves supply what structures?
Hindgut
Pelvis
Perineum
Where do the extrinsic back muscle attach?
Back
To the upper limb/pectoral girdle
What is the function of the extrinsic back muscles?
Move the upper limb
What are the main extrinsic back muscles? What is their nerve supply?
Trapezius (CN XI)
Latissimus dorsi (Thoracodorsal nerve/C5-C7)
Levator scapulae (Cervical nerve/C3-C4 and Dorsal scapular nerve/C5)
Rhomboids (Dorsal scapular nerve)
The erector spinae and transversospinalis muscles are what type of back muscles?
Intrinsic
What is the function of the erector spinae and transversospinalis muscles?
Maintain back posture
Move the vertebral column
What are the three muscle groups of the erector spinae? (From medial to lateral) What are there insertions?
Spinalis (spinous processes)
Longissimus (transverse processes)
Iliocostalis (ribs)
What is the inferior attachment of the erector spinae muscles?
Common tendon to the:
- Sacrum AND
- Iliac crest
Where is the transversospinalis located?
Within the deep grooves between the transverse and spinous processes
What do the transversospinalis muscles lie superficial to?
Laminae
Articular processes
What muscles are responsible for back extension?
Intrinsic back muscles
What muscles are responsible for back flexion?
Psoas major (main) Rectus abdominis
Via what do pain signals from the facet joints and intervertebral discs travel?
Posterior rami
What ligament connects adjacent laminae posterior to spinal cord?
Ligamentum flavum
Where does the posterior longitudinal ligament attach to?
Posterior aspect of all:
- Vertebral bodies
- Intervertebral discs
What does the posterior longitudinal ligament prevent?
Over-flexion of spine
Where does the anterior longitudinal ligament attach to?
Anterior aspects of all:
- Vertebral bodies
- Intervertebral discs
Why is an intervertebral disc more likely to prolapse posteriorly than anteriorly?
Posterior longitudinal ligament is weaker and provides less support to the discs than the anterior longitudinal ligament
What does the anterior longitudinal ligament prevent?
Over-extension of the spine
What connects the tips of spinous processes?
Supraspinous ligament
What does the interspinous ligament connect?
Superior and inferior surfaces of spinous processes
Each cervical vertebra has a transverse foramina; why?
Passage of vertebral arteries
What is the special name given to:
- C1
- C2
- C7
C1 = Atlas C2 = Axis C7 = Vertebrae prominens
What are the atlanto-ocipital joints between?
Occipital condyles AND
Superior articular facets of the atlas/C1
How many joints exist between the atlas and the axis?
3:
- 2 facet joints
- 1 between anterior arch of atlas and odontoid process
What is the sacral promontory? What does it articulate with?
Part of the border of the pelvic inlet (posteriorly)
Articulates with L5 (Sacrovertebral angle)
Instead of intervertebral foraminae, how does the sacrum permit the passage of anterior and posterior rami of the sacral spinal nerves?
Anterior sacral foraminae
Posterior sacral foraminae
What does the sacral canal contain?
Cauda equina
Meninges
What does the sacral canal end in?
Sacral hiatus
In the spinal canal, what is the dural sac surrounded by?
Epidural fat (in epidural space)
Where are extradural venous sinuses located?
In the epidural fat
Where does the spinal cord begin and end?
C1
L2
What is the name of the ending of the spinal cord?
Conus medullaris
Why might a laminectomy be carried out?
Relieve pressure on cord/roots due to:
- Tumour
- Herniated disc
- Bone hypertrophy
How does a spinal nerve connect to a sympathetic ganglion?
Via grey and white rami communicantes
What are somatic general sensory symptoms?
Pain (neuralgia) Paraesthesia Anaesthesia Hyperaesthesia Hot/Cold Ataxia (loss of balance/coordination)
What are somatic motor symptoms?
Muscle stiffness/tightness/spasm
Hypotonia (LMN) or Hypertonia (UMN)
Reduced power
Ataxia
Where is a common locations of CVAs that may result in sensory pathology?
Internal capsule
C2 dermatome
Back of scalp and Adam’s apple
C3 dermatome
Back of neck and jugular notch
C4 dermatome
Clavicle and shoulder tip
C5 dermatome
Regimental badge area
C6 dermatome
Thumb
C7 dermatome
Middle finger
C8 dermatome
Little finger
T1 dermatome
Medial forearm
T2 dermatome
Medial arm and sternal angle
T4 dermatome
Male nipple
T8 dermatome
Ziphoid process
T10 dermatome
Umbilicus
T12 dermatome
Pubic symphysis
L1 dermatome
Groin (‘hands in pockets’)
L2 dermatome
Anterior thigh
L3 dermatome
Anterior knee
L4 dermatome
Medial malleolus
L5 dermatome
Dorsum of foot
S1 dermatome
Heel
S2 dermatome
Posterior knee
S3 dermatome
Buttocks
S4 dermatome
Perineum
S5 dermatome
Perianal skin
What is the cutaneous innervation of the lesser occipital (C2) nerve?
Skin posterior to external ear
What is the cutaneous innervation of the greater auricular (C2, C3) nerve?
Skin over angle of mandible and some of external ear
What its the cutaneous innervation of the transverse cervical (C2, C3) nerve?
Skin on anterior neck
What is the cutaneous innervation of the supraclavicular (C3, C4) nerve?
Skin over clavicle and shoulder tip
Where is the ‘nerve point’ of the neck? Why is this clinically important?
Midpoint of the posterior border of the SCM
Take cure during biopsy - cervical plexus
The anterior rami of T2-T11 spinal nerves are called what?
Intercostal nerves
The spinal nerves of T7-T11 continue as what?
Thoracoabdominal nerves
The T12 anterior ramus forms what nerve?
Subcostal nerve
What does the bifurcation of the anterior rami of L1 spinal nerves form?
Iliohypogastric nerves
Ilioinguinal nerves
How can we assess the cervical plexus?
Neck postural and strap muscles
Diaphragm
How can we assess the brachial plexus?
Upper limb muscles
Extrinsic back muscles
What supplies the motor control to the strap muscles?
Cervical plexus (C1-C3)
What supplies the diaphragm?
Phrenic nerve (C3, C4 and C5)
What supplies the SCM and trapezius?
CN XI
What supplies the pharyngeal muscles and the intrinsic laryngeal muscles?
CN X
What nerve supplies the deltoid and the teres minor?
Axillary nerve (C5, C6)
What nerve supplies the anterior arm compartment (biceps, brachialis, coracobrachialis)?
Musculocutaneous nerve (C5-C7)
What does the radial nerve supply?
Triceps (posterior arm) Posterior forearm: - Brachioradialis - Supinator - All extensors of carpus and digits - Abductor pollicis longus
What nerve roots form the radial nerve
C5-T1 (entire brachial plexus)
What does the median nerve supply?
Anterior forearm: - Pronators - Flexor carpi radialis - Palmaris longus - Flexor digitorum superficialis - Lateral half of flexor digitorum profundus - Flexor pollicis longus Muscles of the hand: - Thenar - Lumbricals 1 and 2
What does the ulnar nerve supply?
Anterior forearm: - Flexor carpi ulnaris - Medial half of flexor digitorum profundus - Adductor pollicis Muscles of the hand: - Hypothenars - Lumbricals 3 and 4 - All the interossei (dorsal and palmar)
What does the femoral nerve supply?
Anterior thigh:
- Quadriceps
- Sartorius
Pectineus
What does the obturator nerve supply?
All of medial thigh:
- All adducttors (brevis, longus and magnus)
- Gracilis
What does the tibial nerve supply?
Posterior thigh (True hamstrings): - Semimembranous - Semitendinosus - Long head of biceps femoris Posterior leg: - Gastrocnemius - Soleus - Plantaris - Popliteus - Tibialis posterior - Flexors of digits (Digitorum and hallucis longus) All intrinsic sole muscles
What does the common fibular nerve supply?
Short head of biceps femoris
What does the superficial fibular nerve supply?
Lateral leg:
- Fibularis longus
- Fibularis brevis
What does the deep fibular nerve supply?
Anterior leg: - Tibialis anterior - Extensor digitorum and hallucis longus - Fibularis tertius Dorsum of the foot: - Extensor digitorum brevis - Extensor hallucis brevis
Where does the extracranial part of the olfactory nerve lie?
Olfactory mucosa
What is the cranial foramina for CN i?
Cribiform plate (anterior fossa)
Where do the olfactory nerves synapse?
Olfactory bulb
How do the olfactory nerves get to the cortex?
Via olfactory tracts
What is the cranial foramina for CN ii?
Optic canal (middle fossa)
What is the intracranial path of CN ii?
Travels around pituitary stalk to optic chiasm
Forms optic tract
Where does CN ii connect to the CNS?
Diencephalon
What are the functions of CN iii?
Motor - Eye movement
PNS - Pupil constriction
Where does CN iii connect to the CNS?
Midbrain (mesencephalon)
Where do CNs iii, iv and vi leave the skull?
Superior orbital fissure (middle fossa)