Neuroanatomy Flashcards
The vertebral column is made up of
a. 8 cervical, 12 thoracic, 5 lumbar, 5 sacral and 4 coccygeal vertebrae
b. 7 cervical, 12 thoracic, 5 lumbar, 5 sacral and 4 coccygeal vertebrae
c. 7 cervical, 10 thoracic, 5 lumbar, 5 sacral and 4 coccygeal vertebrae
d. 7 cervical, 12 thoracic, 5 lumbar, 4 sacral and 4 coccygeal vertebrae
b - 7 cervical, 12 thoracic, 5 lumbar, 5 sacral and 4 coccygeal vertebrae
The uppermost spinous process that is palpable is that of the:
a. 6th cervical vertebra
b. 5th cervical vertebra
c. 7th cervical vertebra
d. you cannot palpate any spinous process
c - 7th cervical vertebra
The highest point of the iliac crest is in line with the interval between which spines?
a. L2-L3
b. L3-L4
c. L4-L5
d. L5-L6
b - L3-L4
The first cervical vertebra is known as the
a. axis
b. atlas
c. athras
d. athrus
b - atlas
Which of these is NOT a characteristic feature of the general cervical vertebra
a. triangular vertebral foramen
b. bi-fid spinous process
c. transverse foramina
d. no vertebral body or spinous process
d - no vertebral body or spinous process (this is only a feature of atlas (c1))
The dens articulates with the anterior arch of atlas creating which joint to allow rotation of the head independently from the torso?
a. lateral atlanto-axial joint
b. medial atlanto-axial joint
c. medial axial joint
d. medial atlanto joint
b - medial atlanto-axial joint allows rotation of the head independently of the torso
Which of these ligaments are not present throughout the vertebral column
a. anterior and posterior longitudinal ligaments
b. ligamentum flavum
c. interspinous ligament
d. intervertebral ligament
d. intervertebral ligaments
- Anterior and posterior longitudinal ligaments - long ligaments that run the length of the vertebral column, covering the vertebral bodies and intervertebral discs
- Ligamentum flavum - connects the laminae of adjacent vertebrae
- Interspinous ligament - connects spinous process of adjacent vertebrae
Ligaments unique to the cervical spine (2)
a. anterior and posterior longitudinal ligaments
b. nuchal ligament
c. transverse ligament of the atlas
d. ligamentum flavum
b & c = nuchal ligament & transverse ligament of the atlas
What structures pass through the transverse foramina (3)
a. vertebral artery
b. vertebral vein
c. sympathetic nerves
d. spinal artery
a,b,c
C7 has how many sets of spinal nerves extending from it
a. 1
b. 2
c. 3
d. 4
b - 2
Intervertebral discs contain a hydrated gel known as
a. annulus fibrosus
b. nucleus pulposus
c. annulus fibrosis
d. nucleus fibrosis
b - nucleus pulposus
What is herniation of the intervertebral disc?
What structure can become compressed?
Herniation of the intervertebral discs occurs when the nucleus of the disc is no longer inside the annulus and instead bulges out into the spinal canal/intervertebral foramen.
It can compress the spinal nerve running through the intervertebral foramen
Sciatica is compression or irritation of the sciatic nerve which runs from
a. L5
b. L6
c. L4
d. L7
a - L5 through pelvis and down the back of each leg
What are the signs and symptoms of sciatic nerve compression?
- Pain radiating down the buttock, into the leg down to the calf.
- Weakness in dorsiflexion causes foot drop - abnormal gait.
At what level does the spinal cord typically end?
a. L2
b. L1
c. L3
d. T12
b - L1 (conus medullaris)
Name the 5 muscles of the posterior abdominal wall
- iliacus
- psoas major
- psoas minor
- quadratus lumborum
- diaphragm
How many pairs of spinal nerves are there?
a. 32
b. 33
c. 31
d. 30
c - 31
8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal
The dorsal root of the spinal cord carries sensory or motor fibres?
Sensory from periphery to CNS
The ventral (anterior) room of the spinal cord carries motor or sensory fibres?
Motor efferent fibres from the CNS to the body
Where is the decussation location of the spinothalamic tract?
a. medulla
b. spinal cord
c. pons
b - spinal cord
Where is the decussation location of the lateral coticospinal tract?
a. spinal cord
b. pons
c. medulla
c - medulla
A needle is inserted in the subarachnoid space between what vertebra to perform a lumbar puncture?
a. L2-L3
b. L3-L4
c. L4-L5
b - L3-L4 (between the highest point of the iliac crest on both sides)
What are the 2 primary functions of the cerebellum?
- Adjusting postural movements of the body (co-ordinates rapid autonomic adjustments to maintain balance and equilibrium)
- Fine tuning of movements at the conscious and subconscious level (refining movements and learnt patterns such as riding a bike and makes movements smooth)
The primary fissure in the cerebellum separates what from what?
The anterior from posterior lobes
What is the vermis? What does it do?
Lies along the mid line of the cerebellum and separates the cerebellar hemispheres. Controls the subconscious positioning of the body, particularly trunk muscles.
What does the tentorium cerebella separate?
Cerebellum from cerebrum
The ‘arbor vitae’ in the cerebellum connects what?
The cerebellar cortex and the cerebellar peduncles
What are the 3 lobes of the cerebellum?
anterior
posterior
flocculonodular
Blood supply to the cerebellum
superior, anterior-inferior and posterior-inferior cerebellar arteries.
What are the 3 cerebellar peduncles and where do they connect?
- Superior cerebellar peduncle
- links the cerebellum with the nuclei in the midbrain, diencephalon and cerebrum
- Middle cerebellar peduncle
- carries communication between the cerebellum and the pons
- Inferior cerebellar peduncle
- links the cerebellum with the medulla oblongata and spinal cord
If a patient presented with ataxia and not being able to stand or sit without assistance, what area of the brain would you think is affected?
Cerebellum
What is the dentate nucleus? What is it important for?
Largest deep cerebellar nuclei without output branches going towards the superior cerebellar peduncle. It is important for the planning, initiation and control of movement.
Which tract transmits information on pain and temperature sensation?
Lateral spinothalamic tract
Which tract transmits information on pressure and crude touch?
Ventral spinothalamic
Which tract transmits information regarding vibration, proprioception and 2 point discrimination?
Dorsal columns
What runs between the midbrain and connects the 3rd and 4th ventricles?
The cerebral aqueduct
Sensory information from the semicircular canals feed through the vestibular components of CN8 directly to where in the cerebellum?
Flocculus
In what tract do 85% of the fibres decussate at the pyramids?
Corticospinal tract
Regarding the dorsal columns, where does information from the arm and information from the leg go to?
Leg and lower body = gracile tubercle
Arm and upper body = Cunate
If there was damage to the cerebellar tracts, where would you expect the damage to be, ipsilateral or contralateral?
Ipsilateral as they cross twice.
What white matter structure is the largest bundle of fibres?
Corpus callosum
What structure are extensions of the fornix which go down to the mamillary bodies?
Columns of the fornix
What is the hypothalamus important for?
Body homeostasis and control of the autonomic nervous and neuroendocrine systems
Difference between association fibres, commissural fibres and projection fibres?
Association: link cortical regions within ONE cerebral hemisphere
Commissural fibres: link similar functional areas of the TWO cerebral hemisphere (corpus callosum)
Projection fibres: link the cortex with subcortical structures such as thalamus and spinal cord via the internal capsule and corona radiata.
The basal ganglia is made up of what structures?
Caudate nucleus
Lentiform nucleus (Globus pallidus and putamen)
Claustrum
What do these structures make up?
cingulate gyrus, hippocampus, parahippocampal gyrus, anterior perforated substance, septal nuclei, uncus and amygdala?
Limbic system
Olfactory cells in the nasal epithelium project to where?
Olfactory bulb
CN1 (olfactory nerve tract) divides into what? Where do these fibres project?
Medial and lateral olfactory striae
Lateral olfactory striae projects to the uncus (majority) where the primary olfactory cortex is situated
Medial olfactory striae project to the septal nuclei in hypothalamus.
If there is damage to the papez circuit, what would you expect to happen?
- language impairment
- memory impairment
- language and memory impairment
- visual impairment
language and memory impairment
Degeneration of dopaminergic neurones in the substantial nigra can lead to what condition?
Parkinsons
In what areas of the spine does herniation commonly occur?
Lumbar region (L5/S1) or cervical (C6/7)
At what level does the spinal cord end?
Between first and second lumbar vertebrae
What cranial nerve passes through the ethmoidal foramen and cribriform plate?
Olfactory nerve (CN1)
Which cranial nerves pass through the superior orbital fissure?
III, IV, V(1), VI Oculomotor Trochlear Trigeminal opthalmic branch Abducens
Where does V(2) - maxillary branch of the trigeminal nerve pass out of the cranium?
- foramen rotundum
- foramen ovale
- jugular foramen
foramen rotundum
Where does V(3) - mandibular branch of the trigeminal nerve pass out of the cranium?
- foramen rotundum
- foramen ovale
- jugular foramen
foramen ovale
Which cranial nerves pass out of the internal acoustic meatus?
- VI, VII, VIII
- VII, VIII
- IX, X, XI
VII, VIII
facial nerve
vestibulococchlear nerve
Cranial nerves IX, X, XI all pass out of which foramen?
Jugular foramen
Which nerve passes out of the hypoglossal canal?
Hypoglossal nerve
If a patient came to see you with symptoms of headache, nausea, visual disturbance and altered consciousness levels and examination shows papilloedema and an increased blind spot, what condition would you suspect?
- migraine
- raised intracranial pressure
- haemorrhage
Raised intracranial pressure
What function (movement) does the inferior oblique muscle of the eye have?
rotates eye up and out
What movement does the superior oblique muscle of the eye perform?
rotates eye down and out
What is the function of elevator palpebral superioris?
Opens the eye lid
Function of superior rectus muscle?
Lifts and adducts the eye
Which muscle causes abduction of the eye?
Lateral rectus
What are the parasympathetic outflows from the CNS? (cranial nerves and spinal cord). Which CN’s have fibres to the orbit?
CN III, VII, IX, X and sacral spinal segments S2,3,4.
CN III and VII have fibres to the orbit.
Which nerves innervate the muscles of the eye?
Lateral rectus = abducens
Superior oblique = trochlear
All the rest = oculomotor
What parasympathetic function does CN III have on the orbit?
Travels to inferior oblique muscle and innervates the ciliary muscle (accommodation) and the sphincter pupillae.
What parasympathetic innervation does CN VII provide in the orbit?
Innervates the lacrimal gland
Where is the sympathetic outflow from the CNS?
T1-T12 and L1-2.
Sympathetic fibres from T1 pass up the sympathetic trunk through what to the base of the skull to dilate the pupil and dilate blood vessels?
- ciliary ganglion
- stellate ganglion
- sympathetic ganglion
stellate ganglion
What are the names of the ear ossicles?
Stapes
Maleus
Incus
What function do the semicircular canals have?
accelerometers and awareness of head movement
If there was an infection present in the middle ear and the air space got filled with mucus, what symptom might a patient present with?
Deafness
What part of the midbrain is a part of the visual system and concerned with eye reflexes?
Superior colliculi
What part of the midbrain is a part of the auditory system and concerned with reflex of looking towards a loud noise?
Inferior colliculi
Which endocrine organs synthesises melatonin?
pineal gland
If a patient presented with pain behind the ear, paralysis of facial muscles and failure to close eye, what condition would you suspect?
Bells palsy - inflammation of the facial nerve (can be caused by herpes zoster and if so, a rash might be present in oropharynx)
If a patient presented with dysphagia, slurring of speech, excess saliva, wasting and fasciculation tongue and an absent gag reflex, what condition might you think about and what 2 conditions can be causing it?
Bulbar palsy
Can be caused by motor neuron disease or guillian barre syndrome.
What condition can occur when sodium levels are corrected too quickly?
Central pontine myelinolysis - causes destruction of myelin in the pons and leads to confusion, balance problems, hallucinations, reduced consciousness, slurred speech and tremor and weakness.
What is the exit point for every cranial nerve?
CN1 = olfactory - ethmoidal sinus CN2 = optic - optic canal CN3,4,5(1), 6 = oculomotor, trochlear, ophthalmic division of trigeminal, abducens - superior orbital fissure CN5 (1) - maxillary branch - foramen rotundum CN 5(1) - mandibular - foramen ovale CN7, CN8 = facial and vestibulococchlear = internal acoustic meatus CN9,10,11 = glossopharyngeal, vagus and accessory = jugular Foramen CN12 = hypoglossal = hypoglossal canal
Overview of how to test each cranial nerve (write up and check with notes)
check in notes
The fibres from the nasal portion of the visual field carry temporal visual fields, true or false?
True
Do the inferior portions of the retina carry inferior visual field or superior visual field?
Superior visual fields
A pituitary tumour can lead to what type of visual defect?
Bitemporal hemianopia
If a patient presented with total blindness in the left eye, where would you expect the lesion to be?
- right optic nerve
- left optic nerve
- optic chiasm
- left optic radiation
- lesion of left optic nerve
If a patient presented with bitemporal hemianopia, where do you think the lesion would be?
optic chaism
If a patient presented with a left homonymous hemianopsia (can’t see left visual field in both eyes), where would you expect the lesion to be?
- chaism
- lesion of the right optic tract
- lesion of the left optic tract
- right optic radiation
lesion of the right optic tract
