Neurology Flashcards
What structure(s) does the embryonic structure telencephalon go to become?
Cerebral hemispheres
What structure(s) does the embryonic structure diencephalon go to become?
Thalamus
Hypothalamus
What structure(s) does the embryonic structure mesencephalon go to become?
Midbrain
What structure(s) does the embryonic structure metencephalon go to become?
Pons
Cerebellum
What structure(s) does the embryonic structure myelencephalon go to become?
Medulla oblongata
give the function and the different subtypes of glial cells?
Support cells and give structural integrity Astrocytes Oligodendrocytes Microglia Ependymal cells
What glial cell subtype helps to maintain the BBB?
Astrocyte
What glial cell subtype produces myelin sheath around axons?
Oligodendrocytes
What glial cell subtype helps to mount an immune response in the brain?
Microglia (macrophage of the brain)
What glial cell subtype lines the ventricles of the brain? What is their histological cell classification
Ependymal cells
Ciliated columnar epithelium
What part of a neurone is found in the grey mater of the brain?
The cell bodies NOT the axons
What part of a neurone is found in the white mater of the brain?
The axons of the neurone and support cells. NOT the cell bodies
The precentral gyrus has what function?
It is the primary motor cortex foundi n the frontal lobe
Where neurones go to then innervate muscles
What is the function of the postcentral gyrus?
It is the somatosensory centre. found in the parietal lobe. Where sensory neurones give their information
What is the corpus collosum?
It is the largest connection between the left and right hemispheres. (The hat of the sea horse)
Name the meningeal layers surrounding the CNS
Dura mater (superficial just under the periosteum) Arachnoid mater (contains blood vessels) Pia mater
The posterior rootlets of the spinal cord carry what nerve modality?
Sensory!! Which is why there is a little bulge at the posterior root as thats where the cell bodies are
The anterior rootlets of the spinal cord carry what nerve modality?
Motor!! Innervates the lateral aspect of the body and the front
What is the modality of spinal nerves, and the anterior and posterior rami from the spinal cord?
MIXED (sensory and motor) also has sympthetic innervation
Only the root and rootlets of the spinal nerves have a single modality (PS and AM)
What is the dermatomal level of the nipple and umbilicus?
T4 nipple T10 umbilicus (0 think belly button)
Why may a patient experiencing numbness in a dermatomal area have more than one nerve damaged?
As there is overlap of surrounding nerves to an area. Therefore there will always be a minimum of 2 nerves damages. So even if someone experiences numbness in T10 area there could also be damage to T9/T10/T11
Define myotome
A group of skeletal muscles innervated by a single spinal nerve
When looking at an transverse section of the spinal cord (where can see the white and grey mater) how can you tell which is the anterior and posterior root?
The anterior root comes of the smaller fatter part of the grey mater ‘H’
The posterior root comes off the longer thinner part of the ‘H’
What is the arterial supply to the spinal cord?
3 longitudinal arteries
Segmental arteries
Radicular arteries
What is the venous drainage of the spinal cord?
Anterior plexus
Posterior plexus
Where is the sensory strip located in the brain?
Parietal lobe in the post central gyrus
What are the tracts that are responsible for sensory information transmission to the brain?
Dorsal column/medial lemniscus system
Spinothallamic tract/ anterolateral tract
What type of sensory information does the dorsal column transmit?
Vibration, fine touch and conscious proprioception
What type of sensory information does the spinothalamic tract transmit to the brain
Carries pain, temperature and deep pressure
At what level does the dorsal column move to the contralateral sides from the side of transmission going to the brain?
It dessucates in the medulla specifically the nucleus gracilis and nucleus cunaneus
At what level does the spinothalamic tract move to the contralateral sides from the side of transmission going to the brain?
Almost immediately at the vertebral level it enters the spinal cord
What are the tracts responsible for transmission of motor information to the brain?
Corticospinal tract
Tectospinal tract
Reticulospinal tract
Vestibulospinal tract
What motor information is transmitted in the corticospinal tract?
Fine precise motor movements
What motor information is transmitted in the tectospinal tract?
Vision, hearing reactions e.g moving head towards a noise
What motor information is transmitted in the reticulospinal tract?
Voluntary movements in the pons specifically extensory movements and in medulla flexor movements
What motor information is transmitted in the vestibulospinal tract?
In the vestibular nuclei to activate antigravity extensor muscles (stop from falling)
Which vertebral level is usually the first palpatable spinous process?
C7
What is the innervation for the extrinsiv back muscles?
Mainly the anterior rami of cervical nerves
What is the innervation of the intrinsic back muscles?
Innervated segmentally as per dermatome pattern
Name the intrinsic muscles of the back
Erector spinae
Transversopinalis
What type of joint is that between C1 and C2?
Synovial
What is the vertebral level that the spinal cord becomes the cauda equina?
L1/2
Name the lobes of the cerebellum
3 lobes
Anterior, posterior (biggest) and flocculonodular
How is the cerebellum attached to the pons?
Three stumps of white matter (peduncles) superior, middle and inferior.
What is the deep cerebellar nuclei?
In the posterior lobe of the cerebellum there is the arbor vitae (grey and white matter tree look alike) and within in there is deep grey matter which communicates with the rest of the brain.
What are the three layers of the cerebellum?
Molecular layer
Purkinje layer
Granular cell layer
The pons relays information from the spinal cord to The cerebellum which is an ipsilateral brain e.g control same side of body as fibres are on. T/F
True
Name the components of the basal ganglia (nuclei)
Caudate nucleus Putamen Globus pallidus Subthalamic nucleus Substantia nigra
What is the overall function of the basal ganglia?
Facilitate purposeful movement and inhibit unwanted movements as received to the cerebral cortex.
If there is damage to the left basal ganglia what will the presentation be?
Contralateral effects causing dyskinesia like tremor/chorea/ jerks. NOT paralysis as it is more of a corrector organ than a doing organ
What spinal nerve gives sensation to the middle finger?
C7
What is the dermatomal innervation to the nipple
T4 (cervical spinal nerve)
Give the dermatomoal innervation ot the heel of the foot
S1
What is the dermatomal innervatio for the front of the knee?
L3
What is the dermatomal innervatio for the back of the knee?
S2
What is the modality of the dorsal rootlets from the spinal cord?
Sensory only (can tell on prosection cause there is a bulge where the cell bodies are and grey matter ‘H’ is the long thin one)
What spinal nerves contribute to the intercostal nerves of the upper anterolateral trunk wall
T2-T11
What is the spinal nerve supply for the subcostal nerve
T12
What are the spinal nerve roots that make up the lateral cutaneous nerve of the thigh? what area of the body does it sensory supply?
L2/3
The lateral thigh
What are the spinal nerve axons that make up the femoral nerve. Which areas does it sensory innervate?
L2, L3, L4
Front of the thigh and leg
Name the layers of the scalp
S- skin C-connective tissue A- aponeurosis L- loose connective tissue P- pericranium
What is the artery that lies deep to the pterion?
Middle meningeal artery
What is the sensory innervation of the dura mater
CN V
What is the midline structure made of dura mater that separates the two cerebral hempispheres?
Falx cerebrip-
Give the path of CSF from production to the subarachnoid space
Secreted by choroid plexus to then move through the right and left lateral ventricles
through the foramen of munroe to enter the 3rd ventricle
then into the cerebral aquaduct to the 4th ventricle and into the subarachnoid space.
It can then be reabsorbed via arachnoid granulations to the dural venous sinuses
Define an extradural haemorrhage and how it occurs
Between the bone and dura due to a ruptured middle meningeal artery (pterion)
Define a subdural haemorrhage and how it occurs
Separates the dura from the arachnoid due to torn cerebral veins (commonly in the elderly
Define a subarachnoid haemorrhage and how it occurs
Into the CSF of the subarachnoid space due to a ‘berry’ aneurysm a rupture to the circle of willis
Damage to which nerve will cause a fixed dilated pupil?
The occulomotor nerve
Temporal lobe herniation inferiorly to the tentorium cerebelli is likely to cause damage to which nerve?
The occulomotor nerve
Name the nerves that transmit sensory fibres
Olfactory CN I Optic nerves CN II Trigerminal CN V Facial nerves CN VII Vestibulocochlear CNVIII Glossopharyngeal nerves CN IX Vagus nerve CN X
What is the foramen that the optic nerve passes through?
Optic canal
What is the foramen that the oculomotor nerve passes through?
Superior orbital fissure
What is the foramen that the occulomotor nerve passes through?
Superior orbital fissure
What is the foramen that the trochlear nerve (CNIV) passes through?
Superior orbital fissure
What is the foramen that the abducent nerve (CN VI) passes through?
Superior orbital fissure
And travels within the cavernous isnus
Give the muscles of the eye innervated by CN III
LR6 So4 R3
Lateral rectus CN VI Superior oblique CN IV Medial rectus Inferior oblique Superior rectus Inferior rectus
What is the foramen that the vestibulocochlear nerve (CNVIII) passes through?
Internal acoustic meatus
What is the foramen that the spinal accessory nerve (CNXI) passes through?
Jugular foramen
What is the foramen that the hypoglossal nerve (CN XII) passes through?
Hypoglossal canal
What is the foramen that the branches of the trigeminal nerve passes through?
V1; SOF
v2; foramen rotundum (can tell its the CN v2 as its pointed to the mid section of the face)
V3; foramen ovale (can tell as it supplies mandible so the foramen is pointed down
Give the structures given sensory innervation by the opthalmic nerve
Upper eyelid
Cornea (corneal relflex to blink)
Conjunctiva
Skin of the root/bridge/tip of nose
Give the structures sensory innervated by the maxillary nerve of the trigeminal
Skin of the lower eyelid, over maxilla, ala of the nose, upper lip
Give the structures that have sensory innervation from the mandibular nerve
Skin over the mandible and temporomandibular joint
Give the muscles of mastication that are responsible for opening the jaw
Lateral pterygoid
Give the muscles of mastication that are responsible for closing the jaw
Masseter
Temporalis
Medial pterygoid
Give the foramen which the facial nerve enters and exits the cranial cavity
Internal acoustic meatus (in)
Stylomastoid foramen (out)
What nerve does the chorda tympani branch off from? What does it supply
CN VII
Taste buds of the anterior 2/3 tongue
Parasympathetic supply to submandibular and sublingual glands
Give the muscles of facial expression that the facial nerve supplies
Frontalis
Orbicularis oculi
Elevators of the lips
Orbicularis oris
What is the foramen that the glossopharyngeal exits the cranial cavity from?
The jugular foramen
What is the innervation of the parotid gland
The glossopharyngeal nerve
What is the foramen that the vagus nerve exits the cranial cavity from ?
The jugular foramen
You ask a patient to say ‘aaahhh’ as they open their mouth. Their uvula points to the right. What does this indicate?
The left vagus nerve is dysfunctioning as if they were both working the uvula would be in the midline
You ask the patient to stick out their tongue. It deviates to the right. What does this indicate?
That the right side of the hypoglossal nerve is dysfunctional
What lobe(s) of the brain does the anterior cerebral artery supply?
Midline frontal lobe, superior medial parietal lobes
What lobe(s) of the brain does the middle cerebral artery supply?
Lateral vertebral cortex, lateral medial frontal lobe and lateral surface of the temporal and parietal lobes.
What lobe(s) do the posterior cerebral artery supply?
Posterior aspect of the brain like occipital lobe
If there is an blockage of the anterior cerebral artery what are the symptoms a patient is likely to develop?
Weakness and sensory loss
As supply frontal (motor cortex), medial parietal lobes (sensory cortex),
What information does the dorsal column medial lemniscus system communicate? When does it switch sides?
Vibration, fine touch and conscious proprioception
Moves up same side of the body until medulla where switches
What information does the spinothalamic tract communicate ? When does it switch sides?
Pain, temperature, deep pressure
Immediately crosses at same spinal level entered
What information does the corticospinal tract communicate? Where does it cross sides?
Motor of fine and precise movements
Most of it crosses in the medulla but some doesnt cross until correct spinal level
