Week 1 Wet

Question 1

What section of the skull is the brainstem found in?

Answer 1

The posterior cranial fossa

Question 2

What embryological vesicles form the brainstem?

Answer 2

Mesencephalon –> Midbrain

Rhombencephalon –> Pons and medulla (& cerebellum)

Question 3

What ventricles lie in relation to the brainstem?

Answer 3

cerebral aqueduct in the midbrain

IV ventricle posterior to the pons/medulla

Question 4

Where do the different cranial nerves emerge on the brainstem?

Answer 4

1/2 from cerebrum
3 from midbrain
4 from posterior aspect of midbrain
5 from pons
6, 7 & 8 from pontomedullary junction
9, 10 & 11 from sides of the medulla
12 from medullary pyramids

Question 5

Which cranial nerves have the longest intracranial course

Answer 5

IV because it emerges posteriorly

VII

Question 6

What are the main anatomical features of the medulla?

Answer 6

• Olives
• Pyramids
• Decussation of the Pyramids
• Open and closed parts on posterior surface

Question 7

What is the open part of the medulla?

Answer 7

The posterior superior section where it opens into the 4th ventricle

Question 8

How is the brainstem connected to the cerebellum?

Answer 8

By 3 cerebeller peduncles, one each from each section of the brainstem.
They contain Centripetal fibres

Question 9

What are the main anatomical features of the midbrain?

Answer 9

Cerebral peduncles connecting to the thalamus

Superior and inferior colliculi on the post surface

Question 10

What makes up the diencephalon and where is it found?

Answer 10

Between the cerebrum and the midbrain, it contains the thalamus and hypothalamus

Question 11

What do we call the visible surface projections of the hypothalamus?

Answer 11

Mamillary bodies

Question 12

What are the main parts of the cerebellum?

Answer 12

Ant/Post lobes
Flocculonodular lobe (V small)
Cerebeller tonsils (At the base by the brainstem)
Vermis (connecting hemispheres)

Question 13

What happens to the cerebellum during sudden increases in ICP?

Answer 13

The Cerebellar tonsils herniate through the foramen magnum, this is known as coning.
It can compress and damage vital centres in the brainstem resulting in death

Question 14

What fissure divides cerebral hemispheres?

Answer 14

Longitudinal or Cerebral Fissure

Question 15

What connects the two cerebral hemispheres?

Answer 15

The corpus collosum

A white matter tract made of Commisural fibres

Question 16

What are the 3 types of white matter fibres?

Answer 16

Commisural - Connect two hemispheres (e.g. Corpus callosum)
Association - Connect within one hemisphere
Projection - Connect cerebrum to elsewhere (e.g. int capsule)

Question 17

What do the cerebral hemispheres sit on?

Answer 17

Floor of ant and middle cranial fossae

On the tentorium cerebelli posteriorly

Question 18

List the 4 main sulci of the cerebral hemispheres?

Answer 18

• Lateral or Sylvian Fissure (Seperates temporal from frontal/parietal)
• Central Sulcus (seperates Fronto-parietal)
• Parieto-occipital sulcus
• Calcarine Sulcus (mainly on medial surface of occipital lobe)

Question 19

Where are the 4 primary cortex found? (visual, auditory, sensory and motor)

Answer 19

Motor - Pre-central gyrus (frontal lobe)
Sensory - Post-central Gyrus (Parietal Lobe)
Visual - Occipital Lobe
Auditory - Sup Temporal Gyrus

Question 20

At what level does the spinal cord terminate?

Answer 20

L1/2 in adults

L2/3 in kids

Question 21

At what level does the dura mater and arachnoid mater terminate?

Answer 21

S2

The pia continues as the filum terminale, attaching to the coccyx

Question 22

At what level would you perform an LP?

Answer 22

L3/4 in adults or L4/5 in kids

To ensure you enter the cauda equina where theres less risk of nerve damage

Question 23

How is a patient postitioned for LP?

Answer 23

Foetal position on their left side

This bends the lumbar spine to open up the vertebrae

Question 24

Is cauda equina damage an UMN lesion or LMN?

Answer 24

LMN lesion