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Anatomy > Neuroanatomy > Flashcards

Neuroanatomy Flashcards

1
Q

What are the 5 lobes of the brain?

A 
Frontal
Parietal
Temporal
Occipital
Limbic
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2
Q

What is the role of the frontal lobe?

A

Executive function - planning and decision making
Behavioural traits
Praxis - purposeful learned movement
Primary motor cortex - voluntary movements
Brocas area - speech (word formation and saying them)

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3
Q

What is the role of the parietal lobe?

A

Sensory cortex - integrates sensory inputs
Object recognition
post central gyrus - conscious feelings of touch

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4
Q

What is the role of the occipital lobe?

A

Vision, contains the visual cortex

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5
Q

What is the role of the temporal lobe?

A

Primary auditory cortex (hearing)
emotions
learning and memory

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6
Q

Where is the limbic lobe/ system located?

A

Deep to the temporal lobe

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7
Q

What is the role of the limbic system?

A

Emotions
behaviour
smell
Associated with PTSD

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8
Q

What is the role of the cerebellum?

A

Coordination and balance

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9
Q

Longitudinal fissure

A

Separates the left and right hemispheres, stops at the corpus callosum

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10
Q

What is a sensory homunculus

A

A pictorial representation of the primary somatosensory cortex

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11
Q

Broca’s area

A

Speech formation

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12
Q

Wernicke’s area

A

Speech understanding, located in the temporal lobe near the parietal lobe

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13
Q

Where are the speech areas normally located?

A

Left hemisphere, but in some people they are in the right .

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14
Q

What is dysphasia?

A

A deficiency in the formation / generation or comprehension of speech caused by a brain disease or damage. Receptive or expressive. Site of problem = speech centres - brocas or wernickes areas

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15
Q

Broca’s dysphasia

A

Motor. expressive aphasia
inability to produce the words
limited effect on comprehension

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16
Q

Wernicke’s dysphasia

A

Receptive/ sensory aphasia
speech is unaffected
speech is meaningless as they are unable to comprehend what they are being asked.

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17
Q

Dysarthria

A

problems with the mechanical creation of words. Occurs in the motor neural pathway - upper/ lower or NMJ or pharyngeal muscles

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18
Q

Dysphonia

A

Problems in production of sound for speech. Occurs in motor pathway or vocal cords .

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19
Q

What is found within the brainstem?

A

Respiratory, cardiovascular and vomiting centres

Nuclei involved in motor control, sleep, respiration and bladder control

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20
Q

What are the 3 parts of the brainstem?

A

Midbrain
Pons
Medulla

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21
Q

What is the cardiovascular centre?

A

Responsible for regulation of heart rate, found in the medulla oblongata

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22
Q

Respiratory centre

A

made up of 3 major groups - 2 in medulla and one in pons. Its main function is to control the rate of involuntary respiration
For voluntary respiration the motor cortex controls it. Voluntary respiration can be overridden by involuntary

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23
Q

Pons

A

Contains nerve tracts - ascending and descending. Nerves of different pathways cross over at the medulla .

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24
Q

Medullary pyramids

A

2 pyramid shaped swellings on the medulla oblongata, on either side of the ventral midline.

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25
Q

What are the 2 paired arteries that supply the brain?

A

Vertebral and Internal carotid

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26
Q

What do the vertebral and internal carotid arteries form?

A

Circle of Willis

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27
Q

What is the blood supply to the midbrain?

A

Basilar superior cerebellar

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28
Q

What is the blood supply to the pons?

A

Pontine

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29
Q

What is the blood supply to the medulla?

A

Anterior spinal artery

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30
Q

Regional blood supply

A

Anterior cerebral supplies the very front of the frontal cortex. The middle cerebral artery supplies the majority of the cerebral cortex. The posterior cerebral artery supplies the posterior of the parietal, occipital and inferior of the temporal lobes.
Anterior cerebral supplies all the centre of the brain up to corpus callosum and posterior cerebral supplies the posterior section.

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31
Q

Which artery is stroke most common in?

A

Middle cerebral - affects speech

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32
Q

Arteries supplying the spinal cord

A

3 - 1 anterior and 2 posterior.

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33
Q

Where does the anterior spinal artery originate?

A

Branches off the vertebral arteries

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34
Q

Where do the posterior spinal arteries originate?

A

Vertebral or posteroinferior cerebellar artery

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35
Q

Venous drainage of spinal cord

A

Anterior and posterior spinal veins drain into the internal and external vertebral plexuses

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36
Q

What are the 2 types of stroke?

A

Haemorrhagic and ischaemic

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37
Q

Ischaemic stroke

A

Obstruction within the blood vessel supplying the brain due to atherosclerosis

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38
Q

Haemorrhagic stroke

A

weakened blood vessel ruptures and bleeds into the brain. Blood accumulates and compresses the brain tissue

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39
Q

How to treat haemorrhagic stroke

A

Reverse existing anticoagulant treatment

Give clotting factors and vitamin K

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40
Q

How to treat ischaemic stroke

A

Thrombolytics e.g. altepase injection

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41
Q

How to differentiate between the 2 types of stroke?

A

CT scan

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42
Q

management of stroke

A

aspirin for life

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43
Q

What is a TIA

A

Transient Ischaemic attack - mini stroke

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44
Q

What are the signs of a stroke

A

Facial weakness
Arm weakness
speech problems

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45
Q

What are the cranial nerves?

A 
olfactory
optic 
oculomotor
trochlear
trigeminal
abducens
facial
vestibulocochlear
glossopharyngeal
vagus
accessory 
hypoglossal
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46
Q

How many branches does the trigeminal nerve have and what are they

A

3
Opthalmic
Maxillary
mandibular

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47
Q

What nerves do through the cribriform plate?

A

Olfactory

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48
Q

What nerves go through the optic canal

A

optic

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49
Q

What nerves go through the superior orbital fissure

A

Occulomotor
Trochlear
V1 - opthalmic
Abducens

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50
Q

What goes through the foramen rotundum?

A

V2 - maxillary

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51
Q

What goes through the foramen ovale?

A

V3 - mandibular

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52
Q

What goes through the foramen lacerum?

A

arteries, no nerves

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53
Q

What goes through the foramen spinosum?

A

Middle meningeal artery

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54
Q

What goes through the internal acoustic/ auditory meatus?

A

Vestibulocochlear and facial nerves

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55
Q

What does through the jugular foramen

A

Glossopharyngeal
vagus
accessory
nerves

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56
Q

Venous drainage of the brain

A

Drained by sinues that are hollow cavities in the skull where deoxygenated blood drains into. They are like veins but do not have valves

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57
Q

Main sinuses of the brain

A 
Superior sagittal sinus
Inferior sagittal sinus
Straight sinus
Transverse sinus
Sigmoid sinus
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58
Q

What is found at the back of the head?

A

Confluence of the sinuses, where the sinuses all connect

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59
Q

Where do the sinuses drain into?

A

The internal jugular vein

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60
Q

What are the layers that cover the brain?

A

Dura mater
Arachnoid mater
Pia mater

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61
Q

what is the dural sinus

A

hollow spaces that collect pools of blood and drain into the internal jugular vein

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62
Q

Where are dural sinuses found?

A

Between the layers of the dura mater - periosteal and meningeal layers

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63
Q

How many sinuses are there?

A

11

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64
Q

Route through sinuses

A

Converge at confluence of sinuses > transverse sinus > sigmoid sinus > Internal jugular vein

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65
Q

Where are the straight, superior and inferior sagittal sinuses found?

A

Falx cerebri of dura mater

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66
Q

Straight sinus

A

A continuation of the great cerebral vein and inferior sagittal sinus

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67
Q

What does the cavernous sinus drain?

A

drains the ophthalmic veins and can be found either side of the sella turcica

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68
Q

What goes through the hypoglossal canal

A

Hypoglossal nerve

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69
Q

What is a cerebral venous sinus thrombosis

A

The presence of a thrombus within one of the dural venous sinuses. Venous return is occluded through the sinuses and causes an accumulation of deoxygenated blood and cerebrospinal fluid which can no longer drain .

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70
Q

How is cerebral venous sinus thrombosis treated?

A

Anticoagulation

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71
Q

What can accumulation of blood and cerebrospinal fluid cause?

A

Venous infarction

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72
Q

What are the symptoms of venous infarction?

A

Headache, nausea and vomiting

neurological defects

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73
Q

How is venous infarction diagnosed?

A

CT or MRI scan

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74
Q

What innervates the meningeal layers?

A

Middle meningeal artery and trigeminal nerve

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75
Q

If there was pain due to stretching of the meningeal layers as a result of a haemorrhage where would the pain be referred to?

A

Face and forehead

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76
Q

What innervates the dura mater below the tentorium

A

Cervical plexus, so pain is referred to the back of the head and neck

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77
Q

Arachnoid mater

A

No innervations
beneath the arachnoid is the subarachnoid space - where the CSF is contained. Arachnoid granulations reabsorb CSF from the dural sinuses

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78
Q

Dura mater

A

Has no innervations and is avascular

has 2 layers periosteal and meningeal

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79
Q

Pia mater

A

Underneath the subarachnoid space
tightly adhered to the surface of the brain - follows the gyri and fissures
Highly vascularised - vessels which supply the underlying neural tissue

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80
Q

Spinal meningeal layers

A

Dura mater - periosteal and meningeal layers join together
Arachnoid mater
Pia mater

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81
Q

What are the extensions of the dura mater that divide the brain?

A

Falx cerebri
Tentorium cerebelli
Falx cerebelli
Tentorial notch

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82
Q

Falx cerebri

A

In the longitudinal fissure between the cerebral hemispheres

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83
Q

Tentorium cerebelli

A

Separates the cerebellum from the occipital lobes

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84
Q

Falx cerebelli

A

Separates the 2 cerebellar hemispheres

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85
Q

Tentorial notch

A

An opening that is bounded by the anterior border of the tentorium cerebelli

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86
Q

Intracranial haemorrhage

A

Increases intracranial pressure

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87
Q

What are the types of Intracranial haemorrhage?

A

Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage
Intracerebral hemorrhage

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88
Q

Epidural hematoma

A

Blood accumulates between the skull and periosteal layer of the dura

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89
Q

Subdural hematoma

A

Subdural space blood collects between the dura and arachnoid mater - damage to cerebral veins

90
Q

Subarachnoid hemorrhage

A

Bleeding into the subarachnoid space

91
Q

Intracerebral hemorrhage

A

Bleeding inside your brain

92
Q

Hematoma

A

Contained blood - clotted. Can result from an injury to any type of blood vessel.

93
Q

Hemorrhage

A

Ongoing bleeding out of a structure

94
Q

Meningitis

A

Inflammation of the meninges. Most commonly caused by Neisseria meningitidis and Streptococcus pneumoniae

95
Q

Streptococcus pneumoniae

A

Gram positive spheres

causes meningitis in the very young and elderly

96
Q

Neisseria meningitidis

A

Gram negative spheres causing meningitis in the young adults and middle aged people .

97
Q

What causes the symptoms of meningitis?

A

The immune response to the infection causes cerebral oedema which raises intracranial pressure. Complications of this can cause death

98
Q

Effects of meningitis

A

Raised ICP causes part of the brain to be forced into the cranial cavity - cranial herniation. Systemic hypotension - dilation of blood vessels because of toxins. Raised intracranial pressure reduces cerebral perfusion.

99
Q

Treatment for meningitis

A

Antibiotics - Penicillins, aminoglycosides - Gentamicin, Cefotaxime

100
Q

Effect of meningitis on spinal cord

A

Infection spreads down the meningeal layers, which is why meningitis can be diagnosed by a lumbar puncture.

101
Q

what are the parts of the spinal vertebrae?

A 
Spinous process
Spinal canal
Transverse process
Articular process
Vertebral body
Lamina
Pedicle 
Intervertebral foramen
102
Q

How to distinguish between different types of vertebrae?

A

They get larger, lumbar is larger due to need for weight bearing lower down the spine .

103
Q

Where does the spinal nerve emerge?

A

Intervertebral foramen

104
Q

How many cervical vertebrae and nerves are there?

A

7 vertebrae and 8 nerves

105
Q

How many thoracic nerves and vertebrae are there?

106
Q

How many lumbar nerves and vertebrae are there?

107
Q

How many sacral nerves and vertebrae are there?

108
Q

Where is the lumbar puncture done?

109
Q

Where is an epidural done?

110
Q

What do you collect in a lumbar puncture?

111
Q

Spina bifida

A

Malformation of spine, meaning there is no bone covering the spinal cord

112
Q

Cauda Equina

113
Q

Why do you get a headache after a lumbar puncture?

A

If CSF escapes from the site there is reduced intracranial pressure which causes the brain to sag and pulls on the meningeal attachments - worse on sitting/ standing

114
Q

Cerebrospinal fluid

A

75ml in brain and 75ml in spine

115
Q

where is CSF produced?

A

Choroid plexus by ependymal cells in the lateral and 3rd ventricles.

116
Q

Route of CSF

A

Flows from lateral to 3rd ventricle via foramina of Monro and then through aqueduct of Sylvius into 4th ventricle
Flows over surface of brain and spinal cord

117
Q

What reabsorbs CSF

A

Arachnoid granulations

118
Q

What is the function of CSF?

A

cushions brain
regulated ICP
acts as a transfer medium for nutrients, elimination of metabolic products and circulates neurotransmitters

119
Q

Intracranial pressure normal

120
Q

Raised ICP

A

Will compromise the cerebral perfusion pressure and cause a lack of perfusion through the brain. Compensation can occur quickly - more CSF will move into the spinal space and lower it. This may not be enough

121
Q

How is ICP regulated long term?

A

Variation in reabsorption of CSF as production is constant

122
Q

What is in CSF?

A

Glucose
Protein
Ions

123
Q

Hydrocephalus

A

CSF blockage leading to a build up of CSF causing raised ICP.

124
Q

Types of hydrocephalus

A

Communicating - still circulating not being reabsorbed

Non-communicating - blockage

125
Q

Treatment for hydrocephalus

A

Temporarily relieved by shunt

126
Q

Common causes of hydrocephalus

A

Tumours
Hemorrhage
Aqueduct blockage

127
Q

Symptoms of Hydrocephalus

A

Enlarged head in babies

prominence of the veins of forehead

128
Q

What is grey matter?

A

Cell bodies

129
Q

What is white matter?

130
Q

White and grey matter in brain

A

White is in the centre and grey outside

131
Q

White and grey matter in spinal cord

A

White matter is on the outside and grey in the centre

132
Q

What are the types of cortical fibres?

A

Association
Commissural
Projection

133
Q

Projection fibres

A

Run between the cerebral cortex and subcortical structures - diencephalon, brainstem and basal ganglia

134
Q

Association fibres

A

Connect cortical sites in one hemisphere

135
Q

Commissural fibres

A

Run between the 2 cerebral hemispheres via corpus callosum

136
Q

What is myelin?

A

White, lipid rich wrapping layer that surrounds an axon

137
Q

Function of myelin

A

Provides electrical insulation and prevents current loss/ ion leakage and causes saltatory conduction

138
Q

What are the types of myelination?

A

Schwann cells

Oligodendrocytes

139
Q

Schwann cells

A

PNS
whole cell wraps around axon
applied to single neuron

140
Q

Oligodendrocyte

A

CNS

process from cell wrap around axon and are applied to multiple neurones

141
Q

Input and output to spinal cord

A

Sensory input comes into the dorsal horn and motor output from the ventral horn

142
Q

Where does the spinocerebellar tracts get their inputs from?

A

Muscle spindles

Golgi tendon organs

143
Q

What are the somatosensory pathways?

A

Dorsal columns

Spinothalamic tracts

144
Q

What do the dorsal columns provide input on?

A

Proprioception, pressure, vibration and fine touch

145
Q

What do the spinothalamic tracts provide input on?

A

Pain, temperature and crude touch

146
Q

Fine touch

A

Sense and localisation of touch

147
Q

Crude/ coarse touch

A

Sense of touch but cannot localise

148
Q

Somatosensory pathways

A

Involves 3 neurons and the thalamus is the relay station

149
Q

Thalamus

A

Large mass of grey matter that relays sensory signals and motor signals to the cerebral cortex. Can screen out irrelevant information. Specific nuclei for certain functions. Extensive CNS connections

150
Q

Somatic body senses

A 
Pain sharp vs dull
touch fine vs coarse
pressure
temperature 
proprioception
vibration
151
Q

Special senses

A 
Vision
Hearing
Taste
Smell 
Balance
152
Q

Lateral spinothalamic tract

A

1st order neurone enters via dorsal root and synapses in dorsal horn
crosses at spinal level
pain and temperature

153
Q

Anterior spinothalamic tract

A

crude touch
synapses at thalamus so ascends to the contralateral side of stimulus
crosses at spinal level

154
Q

Dorsal columns

A

1st order neurone enters via dorsal root and ascends ipsilaterally
synapses and crosses in medulla - 2nd order neurone to thalamus
3rd order neurone to cortex

155
Q

Motor pathways?

A

Lateral and anterior corticospinal tracts

only 2 neurons in each pathway - upper and lower motor neurones

156
Q

Lateral corticospinal tract

A

Crosses at medullary pyramids and synapses at ventral horn

157
Q

Upper and lower motor neurones

A

Upper = within CNS
Lower = from CNS to periphery
Cranial nerves = lower

158
Q

Anterior corticospinal tract

A

Descends ipsilaterally and decussates at spinal cord level . Synapses at ventral horn

159
Q

Upper motor neurone lesion

A 
Increased muscle tone
No change in muscle bulk
Increased reflexes
Clonus
Babinskis reflex - upgoing 
No fasciculations
160
Q

Lower motor neurone lesions

A 
Decreased muscle tone
Reduced muscle bulk - wasting
Decreased or absent reflexes
Babinskis reflex is normal 
Fasciculations
161
Q

Sensory lesions

A

Paraesthesia / numbness

162
Q

Motor lesion

A

weakness/ paralysis

163
Q

Brown sequard syndrome

A

spinal lesion that causes weakness or paralysis on one side of the body and a loss of sensation on the opposite side

164
Q

Hemiparaplegia

A

one sided weakness/ paralysis

165
Q

Hemianesthesia

A

loss of sensation on one side of the body

166
Q

Syringomyelia

A

Development of a fluid filled cyst within the central spinal cord. Loss of pain, temperature and coarse touch and bilateral weakness due to damage to crossing fibres of spinothalamic

167
Q

Spondylosis

A

refers to degenerative changes in the spine - bone spurs and degenerating intervertebral discs

168
Q

Lesions

A

Loss always occurs below the lesion

169
Q

Poliomyelitis

A

Lower motor neuron lesions due to destruction of ventral horns - flaccid paralysis

170
Q

Multiple Sclerosis

A

Mostly white matter of cervical region, random and asymmetric lesions due to demyelination. Scanning speech, intention tremor and nystagmus

171
Q

ALS

A

combined upper motor and lower motor neuron deficits

172
Q

Tertiary Syphilis

A

Degeneration of dorsal roots and dorsal columns, impaired proprioception and locomotor ataxia

173
Q

Vitamin B12 neuropathy

A

demyelination of dorsal columns, lateral corticospinal tracts and spinocerebellar tracts - ataxic gait, hyperreflexia, impaired position and vibration

174
Q

Are the cranial nerves motor or sensory?

A 
Sensory
Sensory
Motor
Motor 
Both
Motor
Brother
Sensory 
Both
Both
Motor 
Motor
175
Q

Where does the olfactory nerve come from?

176
Q

Role of olfactory nerve

177
Q

Where does the optic nerve come from?

178
Q

Where does the trochlear nerve come from?

179
Q

Where does the oculomotor nerve come from?

A

midbrain-pontine junction

180
Q

Where does the trigeminal nerve come from?

181
Q

Where does the abducens nerve come from?

A

pontine-medulla junction

182
Q

Where does the facial nerve come from?

A

pontine-medulla junction

183
Q

Where does the vestibulocochlear nerve come from?

A

pontine-medulla junction

184
Q

Where does the glossopharyngeal nerve come from?

185
Q

Where does the vagus nerve come from?

186
Q

Where does the accessory nerve come from?

187
Q

Where does the hypoglossal nerve come from?

188
Q

Role of optic nerve

A

sensory

transmits visual info to brain

189
Q

Role of oculomotor nerve

A

all muscles except superior oblique and lateral rectus

190
Q

role of inferior oblique muscle

A

moves eye up and in

191
Q

Role of superior oblique muscle

A

moves eye down and in

192
Q

Role of trochlear

A

Innervates superior oblique

193
Q

Trochlear nerve palsy

A 
normal = when head tilts to the left both eyes rotate in opposite direction
palsy = compensatory head tilt on opposite side
194
Q

What happens when superior oblique is paralysed?

A

slight drift of pupil upwards and difficulty looking down
vertical diplopia in affected eye
patient presents with a head tilt to compensate for vertical diplopia

195
Q

Role of opthalmic branch of trigeminal

A

sensation to forehead and scalp and upper part of face

196
Q

Role of maxillary branch

A

sensation to cheeks and nasal cavity and upper lip

197
Q

Role of mandibular

A

sensation of tongue and innervates and muscles of mastication

198
Q

Trigeminal Neuralgia

A

Chronic pain disorder affecting trigeminal nerve

caused by idiopathic - relating to compression of nerve or loss of myelin

199
Q

signs and symptoms of trigeminal neuralgia

A

intense facial pain - electric shock and burning sharp pain
pain lasts minutes and comes on in bouts
triggered by eating, wind, shaving, talking, brushing teeth

200
Q

Investigations for trigeminal neuralgia

A

usually none/ MRI

201
Q

Treatment of trigeminal neuralgia

A

carbameazepine

decompression or destruction of nerve

202
Q

Role of abducens nerve

A

innervates lateral rectus

purely motor

203
Q

Clinical features of abducens nerve palsy

A

Nasal shoot
diplopia
adduction of eye - unopposed activity of medial rectus
patient may compensate by rotating their head to look sideways

204
Q

Role of facial nerve

A

Sensory and motor functions
innervates muscles of facial expression and taste to anterior 2/3 of tongue
innervates to lacrimal gland and submandibular and sublingual salivary glands

205
Q

Branches of facial nerve

A 
temporal
zygomatic
buccal
marginal mandibular
cervical
206
Q

Bell’s palsy

A

palsy of facial nerve
similar presentation to stroke
entire half of face paralysed, in stroke forehead is spared
limb movement and strength is preserved in bell’s palsy

207
Q

Salivary glands and innervations

A

Submandibular- facial
sublingual - facial
parotid - glossopharyngeal

208
Q

Parotidectomy

A

can damage facial nerve as it runs through but does not innervate the parotid gland

209
Q

Role of vestibulocochlear

A

sensory

hearing and balance

210
Q

Vestibular schwannoma/ acoustic neuroma

A

benign primary intracranial tumour of myelin forming cells of the vestibulocochlear nerve
occurs in middle aged people
unknown cause

211
Q

Signs/ symptoms and diagnosis and treatment of vestibular schwannoma

A 
hearing loss
tinnitus
balance affected 
facial weakness
taste affected
MRI
radiotherapy and surgery
212
Q

Role of glossopharyngeal nerve

A

sensory
taste to posterior 1/3 of tongue
gag reflex
innervates parotid gland

213
Q

Role of vagus nerve

A

innervates:

  1. skin of external acoustic meatus
  2. larynx
  3. visceral sensation to heart and abdomen
  4. provides taste sensation to the epiglottis and root of tongue
  5. muscles of pharynx, soft palate and larynx
  6. parasympathetic innervation of smooth muscle of trachea, bronchi and gastro-intestinal tract
  7. regulates heart rhythm
214
Q

Injury to vagus to nerve

A

normally uvula is in midline
if one side of the vagus nerve is damaged the uvula elevates asymmetrically and deviates towards the strong side and away from the side of tumour/ injury

215
Q

Role of accessory nerve

A

innervates the sternocleidomastoid

216
Q

Role of hypoglossal nerve

A

innervates intrinsic and extrinsic muscles of tongue

tongue movements, speech and swallowing

217
Q

Palsy of hypoglossal

A

tongue deviates to one side - toward affected side

218
Q

Ramsay Hunt syndrome

A

shingles affecting facial nerve which causes facial paralysis and hearing loss

219
Q

treatment for ramsay hunt syndrome/ shingles/ HSV/ Herpes virus

A

valacyclovir

220
Q

What causes a thunderclap headache?

A

Subarachnoid hemorrhage

221
Q

What is hypercarbia?

A

Raised carbon dioxide levels

222
Q

autonomic innervation of blood vessels of cerebral cortex

Anatomy (16 decks)

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