Neuroanatomy Flashcards

1
Q

what does the brainstem consist of?

A

Midbrain, Pons and Medulla Oblongata

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2
Q

what does the diencephalon consist of?

A

Thalamus, Hypothalamus

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3
Q
A
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4
Q

Name the 4 types of glial cell and their functions

A

Astrocytes- Support, Communicate with endothelial cells to maintain blood brain barrier

Oligodendrocytes- Produce Myelin (found in CNS, Schwann cells found in PNS)

Microglial Cells- Macrophages

Ependymal Cells- Lines cavities, Ciliated

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5
Q

what is the term for a deep groove, shallow groove and lump on the brain and cerebellum?

A

fissure,

Sulcus

Gyrus- Brain

Folium- Cerebellum

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6
Q
A
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7
Q
A
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8
Q
A

calcarine sulcus- vision

cingulate sulcus- suffering

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9
Q
A
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10
Q

what are the landmarks demarcating the frontal lobe?

A

the central and lateral sulci

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11
Q

what’s the name of the 5th lobe and what is its function?

A

Insular lobe or insula

Co-ordinates and pain

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12
Q

what is the enteric nervous system called?

A

myenteric plexus

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13
Q
A
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14
Q

where are the cavernous sinuses located?

A

Lateral to the sella turcica

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15
Q

what are the two different types of neuron and what is the difference between them?

A

Multipolar (ANS and Motor)- cell body found in CNS- multiple proccesses

Unipolar (sensory)- cell body found in PNS (dorsal route ganglion)

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16
Q

where are spinal nerves located?

A

only within the intervertebral foramina

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17
Q
A
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18
Q

describe the dermatomes

A
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19
Q

name the 4 plexi, where they inervate and what spinal nerves contribute to them

A
  • Cervical plexus
  • C1-C4 anterior rami
  • Posterior scalp, neck wall …..and diaphragm
  • Brachial plexus
  • C5-T1 anterior rami
  • Upper limb
  • Lumbar plexus
  • L1-L4 anterior rami
  • Lower limb
  • Sacral plexus
  • L5-S4 anterior rami
  • Lower limb, gluteal region and perineum
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20
Q

which spinal nerves make up the sympathetic chain?

A

T1-L2

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21
Q

how would you recognise a segment of the spinal cord running from T1 to L2

A

Lateral horns

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22
Q

describe the sympathetic outflow via the paravertebral ganglion

A
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23
Q

describe how sympathetic outflow reaches organs

A

for heart and lungs spinal presynaptic axons synapse at paravertebral ganglions. Postsynaptic axons continue in cordiopulmonary spanchnic nerves

For abdominal organs. presynaptic axons synapse in prevertebral ganglia.

For adrenal medulla the presynaptic axons synapse directly to it

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24
Q

what are the facial signs and causes of horner’s syndrome?

A

-Facial signs include:

  • ipsilateral ptosis: drooping of the upper eyelid

due to lack of sympathetic innervation of the

smooth muscle within levator palpebrae

superioris

  • ipsilateral miosis (pinpoint pupil) due to lack of

sympathetic innervation of the dilator pupillae

  • reduced sweating of the ipsilateral facial skin

due to lack of sympathetic innervation of skin

sweat glands

  • Causes of compression of the cervical parts of the sympathetic trunk:
  • root of neck trauma (transection or haematoma)
  • arch of aorta dissection
  • internal jugular vein engorgement
  • goitre
  • deep cervical node metastases
  • direct spread from lung apex malignancy

(pancoast tumour)

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25
Q

describe parasympathetic outflow

A

-Parasympathetic ganglia in head – to lacrimal gland (facial nerve) and salivary glands (parotid glossopharyngeal and facial for other 2)
-
-Vagus nerve supplies organs of the neck, chest and abdomen as far as the mid-gut
-
-Sacral spinal nerves ‘carry’ parasympathetic axons to the hindgut, pelvis and perineum
-

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26
Q

The spinal cord terminates in a tapered cone-shape called the …… which in turn, continues as a thin connective tissue cord called the …… which is anchored to the dorsum of the coccyx.

A

conus medullaris

filum terminale

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27
Q

The spinal cord is suspended in the canal by a ribbon of tissue on the lateral aspects of the cord called the ……. This ligament is formed of pial and arachnoid tissue and attaches to the dura at points along the length of the cord.

A

denticulate ligament

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28
Q

name the four comlumns in the spinal cord

A

lateral, posterior and anterior

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29
Q

name the sulcus and fissure found on the spinal cord

A

dorsal median sulcus and septum

ventral median fissure

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30
Q

describe the arterial supply of the spine

A

A. Three major longitudinal arteries: one anterior and two posterior that originate from the vertebral arteries. These run the length of the cord.

B. Segmental arteries derived from vertebral, intercostal and lumbar arteries.

C. Radicular arteries that travel along the dorsal and ventral roots.

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31
Q

Unlike the dura in the cranial cavity, which is attached to the periosteum, in the spinal canal there is a space between the dura and the bone, termed the ….., which contains adipose tissue and the anterior and posterior epidural venus plexuses. This space is utilized in epidural anaesethesia.

A

epidural space

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32
Q

where is the primary somatosensory cortex located?

A

just posterior to the central sulcus in the parietal lobe

post central gyrus

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33
Q

What is the name of the system that supplies fine touch and concious proprioception (particularly from the upper limb)

A

Dorsal Column/ Medial Lemniscus Sytem

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34
Q

how many nerves are there in the dorsal column/medial lemniscus system? Where do they synapse? Where do they cross?

A
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35
Q

what are the two components of the dorsal column (dorsal funiculus)?

A

Fasciculus Gracilis (fine touch and concious proprioception from leg)

Fasciculus Cuneatus (from upper limb)

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36
Q

what is the name of the tract that carries pain, temperature and deep pressure?

where does it cross

A

spinothalamic tract

crosses segmentally

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37
Q

where is the primary motor cortex?

A

precentral gyrus

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38
Q

Which tract allows fine, precise movement, particularly of distal limb muscles (e.g. digits).

A

Corticospinal tract

Tract forms visible ridges referred to as the ‘pyramids’ on the anterior surface of the medulla, so also called the pyramidal tract. About 85% of fibres cross in the caudal medulla at the decussation of the pyramids.

Crossed fibres form the Lateral CST.

Uncrossed fibres form the Ventral CST, which cross segmentally.

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39
Q

what is docorticate posturing and what causes it?

A

hyperflexion of the upper limbs caused by a CVA in internal capsule resulting in a lack of descending control

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40
Q

There are a number of motor systems outside of the pyramidal tract and these are often referred to collectively as the……

A

“extrapyramidal system”

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41
Q

The reticulospinal tract has variety of functions including infuencing volantary movements.

where is the reticular formation found?

Where are fibres influencing extension and flexion located?

A

Core of brainstem

In general: Fibres originating in pons facilitate extensor movements and inhibit flexor movements, while those originating in the medulla do the opposite.

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42
Q

which tract is involved in the process of stopping a fall

A

vestibulo spinal tract

input into “antigravity muscles”

fibres originate vestibular nuclei of pons and medulla, which in turn recieve inout from vestibular apparatus and cerebellum

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43
Q

The ….. is thought to play an important role in patients exhibiting decerebrate rigidity and paraplegia in extension. Lesions of the brainstem at or below the midbrain can result in a lack of descending cortical control of this tract (plus others). This leads to domination of extensor muscle tone and hyperextended spastic paralysis.

A

vestibulospinal tract

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44
Q

give a definition for the back

A

a part of the soma (body wall)

anatomically it is:

the posterior aspect of the trunk

(trunk = chest + abdomen + pelvis + back)

lies inferior to the neck

lies superior to the gluteal region

is attached to the upper limbs

is attached to the lower limbs

composed mainly of skeletal muscle &

bone

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45
Q

name the two main groups of intrinsic back muscles

A

Erector spinae (superficial)

Transversospinalis (deep)

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46
Q

which are the only vertebrae not to have discs?

A

-between all vertebrae except C1-C2 and the fused sacrum/coccyx

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47
Q

Fescribe all the ligaments attatched to the spinal cord

A

Ligamentum flavum
-short
-connect adjacent laminae posterior to spinal cord
-
-posterior longitudinal ligament
-narrow, weak
-attaches to posterior aspects of all vertebral bodies and intervertebral discs
-less support for disc
-prevents over-flexion of spine-anterior longitudinal ligament
-broad, strong
-attaches to anterior aspects of all vertebral bodies and intervertebral discs
-stronger support for disc
-prevents over-extension of spine
-

  • supraspinous ligament
  • short
  • connects tips of spinous processes
  • strong, fibrous-
  • interspinous ligament
  • short
  • connect superior and inferior surfaces of adjacent spinous processes
  • weak, membranous
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48
Q

what feature is unique to cervical vertibrae?

A
  • All have a foramen in each transverse process
  • transverse foramen
  • passage of vertebral arteries
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49
Q

which joints main movementes are nodding and shaking the head?

A

nodding- atlanto-occipital join

shaking- atlanto-axial joint

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50
Q
A
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51
Q

in caudal anaesthesia local anaesthetic is injected into the …… to anaesthetise the sacral spinal nerve roots of the cauda equina

A

sacral hiatus

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52
Q

at what level does the spinal cord end?

A

L2

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53
Q

Outline the points at which you examine the spinal nerves dermatomes

A

C2 – back of scalp & Adam’s apple

C3 – back of neck & jugular notch

C4 – clavicle & shoulder tip

C5 – “badge patch”

C6 - thumb

C7 – middle finger

C8 – little finger

T1 – medial forearm

T2 – medial arm & sternal angle

T3

T4 – male nipple

T5

T6

T7

T8 – xiphoid process

T9

T10 - umbilicus

T11

T12 – pubic symphysis

L1 – groin (“hands in pockets”)

L2 – anterior thigh

L3 – anterior knee

L4 – medial malleolus

L5 – dorsum of foot

S1 - heel

S2 – posterior knee

S3 - buttock

S4 - perineum

S5 – perianal skin

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54
Q
A
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55
Q
A
56
Q
A
57
Q

outline the lobes of the cerebellum

A
58
Q

The cerebellar cortex is divided into 3 layers. Name them

A

The cerebellar cortex is divided into 3 layers:

Molecular layer (outer)

Purkinje cell layer (middle)

Granular layer (inner)

59
Q

From all three lobes of the cerebellum: the only output is via the axons of ….. cells which mainly synapse on neurons of the deep ……. and subsequently contribute to coordinating the functions all of the motor tracts of the brainstem and spinal cord (corticospinal, vestibulospinal, rubrospinal tracts).

Most efferent axons of the deep cerebellar nuclei cross the midline and synapse in the thalamus. The thalamus in turn sends fibres to the motor cortex.

A

Purkinje

cerebellar nuclei

60
Q

Cerebellar hemispheres influence the …… side of the body

Bilateral cerebellar dysfunction: Results in ……

A

ipsilateral

slowed, slurred speech (dysarthria), bilateral incoordination of the arms and a staggering, wide based gait (cerebellar ataxia).

61
Q

Functions of the Basal Ganglia

A

facilitates ourposeful movement

inhibits unwanted movements

Somewhat like the accelarator and breaks of a car

role in posture and muscle tone

62
Q

name the basal ganglia

A
63
Q

where is the substantia nigra found?

A

photo shows axial section of midbrain

64
Q

out of the direct and indirect pathways which enhance/inhibits signals?

A

Direct pathway enhances

indirect inhibits

65
Q

lesions in the basal ganglia cause….

A

changes in muscle tone

dyskinesias (abnormal, involuntary movements) including:

tremor (sinusoidal movements),

chorea (rapid, asymmetrical movements usually affecting distal limb musculature)

myoclonus (muscle jerks).

(lesions affect the contralateral side of the body)

66
Q

what is the cause and signs of Parkinson’s Disease

A

Parkinson’s Disease

Pathology: degeneration of dopaminergic neurons of the substantia nigra

Signs: akinesia, rigidity and resting tremor

67
Q

what is the cause, signs and genetics of Huntington’s Disease?

A

Genetics: autosomal dominant disorder

Pathology: progressive degeneration of the basal ganglia and cerebral cortex

Signs: chorea and progressive dementia

68
Q

highlight the key sensory points

A
69
Q

what are the named nerves of cutaneous innervation of the neck?

A
70
Q

what is the named nerve cutaneous innervation of the trunk?

A
71
Q

describe the named nerve cutaneous innervation of the back

A
72
Q

describe the named nerve cutaneous innervation of the skin

A
73
Q

describe the named nerve cutaneous innervation of the lower limb

A
74
Q

muscles of facial expression …….

muscles of mastication…….

muscles of the tongue ……………

muscles of the soft palate ……………

A

muscles of facial expression (CN VII)

muscles of mastication (CN V)

muscles of the tongue (CN XII)

muscles of the soft palate (CN X/pharyngeal plexus)

75
Q

neck postural muscles …………

strap muscles ………..

diaphragm ………….

sternocleidomastoid & trapezius …………

muscles of the pharynx …………….

intrinsic muscles of the larynx………….

A

neck postural muscles (posterior rami of cervical spinal nerves)

strap muscles (cervical plexus)

diaphragm (phrenic nerve: C3,4,5 – from the cervical plexus)

sternocleidomastoid & trapezius (CN XI)

muscles of the pharynx (mainly CN X)

intrinsic muscles of the larynx (CN X)

76
Q

intercostal muscles ………….

anterolateral abdominal wall muscles …………….

A

intercostal muscles (intercostal nerves)

anterolateral abdominal wall muscles (thoracoabdominal nerves)

77
Q

axillary nerve: nerve roots…………

innervates ……&…….

A

axillary nerve: C5,6

deltoid & teres minor

78
Q

musculocutaneous nerve: roots……………

innervates …………………..

A

musculocutaneous nerve: C5,6,7

ALL of the anterior compartment of arm

biceps brachii

coracobrachialis

brachialis

79
Q

median nerve: roots………….

innervates……………..

A

median nerve: C6,7,8,T1

muscles of the anterior compartment of forearm:

the pronator muscles (teres & quadratus)

flexor carpi radialis

palmaris longus

flexor digitorum superficialis

lateral half of flexor digitorum profundus

flexor pollicis longus

muscles of the hand:

thenar muscles

lumbricals 1&2

80
Q

radial nerve: roots………..

innervates………….

A

radial nerve: C6,7,8

muscle of the posterior compartment of arm: triceps brachii

muscles of the posterior compartment of forearm: brachioradialis

supinator

ALL the extensors of the carpus & digits

abductor pollicis longus

81
Q

ulnar nerve: roots……………

innervates……………

A

ulnar nerve: C(7),8,T1

muscles of the anterior compartment of forearm: flexor carpi ulnaris

medial half of flexor pollicis longus

adductor pollicis

muscles of the hand:

hypothenar muscles, lumbricals 3&4

& ALL the interossei (dorsal & palmar)

82
Q

femoral nerve: roots………..

innervates………….

A

femoral nerve: L2,3,4

quadriceps femoris, sartorius & pectineus

83
Q

sciatic nerve (roots…….) -

tibial part: roots…..

innervates……

A

sciatic nerve (L4-S3) -

tibial part: L4-S3

muscles of the posterior compartment of leg:

true hamstrings -

semimembranosus

semitendinosus

long head of biceps femoris

muscles of the posterior compartment of leg:

gastrocnemius

soleus

plantaris

popliteus

tibialis posterior

muscles of the sole of the foot:

flexors of the digits (digitorum & hallucis longus)

ALL intrinsic muscles of the sole of the foot

84
Q

obturator nerve: roots……

innervates…….

A

obturator nerve: L2,3,4

ALL of the medial compartment of thigh

ALL adductors (brevis/longus/magnus) & gracilis

85
Q

sciatic nerve – (roots….)

common fibular part: roots……

innervates…….

A

sciatic nerve – (L4-S3)

common fibular part: L4-S2

short head of biceps femoris

86
Q

common fibular nerve -

superficial fibular branch: roots

innervates…….

A

common fibular nerve -

superficial fibular branch: L4-S2

muscles of the lateral compartment of leg:

fibularis longus & brevis

87
Q

common fibular nerve -

deep fibular branch: roots…..

innervates……

A

common fibular nerve -

deep fibular branch: L4-S2

muscles of the anterior compartment of leg:

fibularis longus & brevis

muscles of the dorsum of the foot:

extensor digitorum brevis (EDB)

extensor hallucis brevis (EHB)

88
Q

all cranial nerves exit anteriorly with the excepetion of…..

A

IV Trochlear

89
Q

which is the only sensory modality that does not synapse in the thalamus prior to reaching the cortex.

A

olfactory nerve

90
Q

where is the primary olfactory area?

A
91
Q

name the motor nerves

A

III, IV, VI, XI, XII

92
Q

where are the motor and sensory areas within the brainstem?

A
93
Q

where are the inf/sup colliculus?

the middle cerebellar peduncle?

and the floor of the 4th ventricle?

A
94
Q

what are the functions of the trigeminal nerve?

A
  1. Somatosensation of face: discriminative touch, vibration sense, pain, temperature
  2. Proprioception associated with chewing (TMJ, muscles of mastication, teeth
  3. Motor control: muscles of mastication, tensor tympani, mylohyoid, ant. belly of digastric, tensor veli palatini
95
Q

what would happen if there was a lesion haff way down the spinal nucleus on the left hand side?

A

loss of pain and temp sensation on left face with perioral sparing

96
Q

what is the purpose of the Pontine Trigeminal nucleus (Principal nucleus)?

A

discriminative touch, vibration

97
Q

what is the function of the Mesencephalic nucleus?

A

(proprioception info from chewing muscles)

98
Q
A
99
Q

what is the function of the facial nerve?

A
  1. Motor (muscles of facial expression, stapedius).
  2. Parasymp. innervation to pterygopalatine and submandibular ganglia.
  3. Taste (anterior 2/3 of tongue via c. tympani).
100
Q

What is the function of the glossopharyngeal nerve?

A
  1. Tactile sense, pain and temperature sense from the posterior tongue pharyngotympanic tube and upper pharynx.
  2. Taste (posterior 1/3 of the tongue).
  3. Parasympathetic fibres to the otic ganglion (parotid gland).
  4. Motor (one muscle: stylopharyngeus)
101
Q

what is the function of the vagus nerve?

A
  1. Tactile sense, pain and temperature sense from the pharynx, larynx, trachea, oesophagus and thoracic and abdominal viscera.
  2. Taste (epiglottis)
  3. Parasympathetic innervation to ganglia serving thoracic and abdominal viscera.
  4. Motor (striated muscle of the pharynx and larynx) (cranial accessory contributes to this function).
102
Q

describe the solitary nucleus

which nerves originate from it?

what are the two segments?

A
103
Q

what is the most destinctive feature of the medulla?

A

the olivary nucleus

104
Q

what is the corticobulbar tract?

A

The corticobulbar tract is the part of the pyramidal tract that is motor to cranial nerves.

105
Q
A
106
Q

describe the path that fibres take after leaving the cochlea

A

input is bilateral

Superior olivary nucleus and nucleus of lateral lemniscus are important in sound localization and as relays for stapedial and tensor tympany reflexes.

107
Q

Name: Q,N,L,F,H,G

A

Q = CN VIII

N = 4th Ventricle

L= Middle cerebellar peduncle

F = Inferior colliculus

H = Medial geniculate nucleus

G = Inferior brachium

108
Q

where is Broca’s Area?

Wernicke’s Area?

and the primary auditory cortex?

A
109
Q

what does damage to Broca’s/ Wernicke’s area cause?

A

Broca’s, motor or expressive aphasia.

Wernicke’s, sensory or receptive aphasia.

110
Q

describe the visual pathway

A
111
Q

where is the primary visual cortex?

A
112
Q

where do the visual fields lie in the visual cortex?

A
113
Q

Fibres of the geniculocalcarine tract initially form part of the internal capsule. Those carrying visual information from the upper half of the visual field first loop anteriorly around the temporal part of the lateral ventricle in …… ending below the calcarine sulcus.

A

Meyer’s loop

114
Q

Tracking movements tend to be smooth, while movements of command tend to be “jumpy” (saccadic). Why is this?

A

The frontal eye fields control “movements of command”, that is movements that are independent of moving visual stimuli.

In general the visual cortex provides for movements in response to visual stimuli, for example tracking moving objects.

115
Q

through which foramen do the branches of the trigeminal nerve pass?

A

CN V1- superior orbital fissure

CN V2- foramen rotundum

CN V3- foramen ovale

116
Q

outline the different regions of trigeminal nerve innervation

A
117
Q

describe the trigeminal nerve’s motor innervation

A
118
Q

where does the facial nerve exit the skull

A

stylomastoid foramen

after intering internal acoustic meatus and passing through facial canal

119
Q

what is the function and composition of the lingual nerve?

A

supplies somatic sensory and taste to anterior 2/3rds of tongue and parasympatherti innervation to submadidibular and sunligual salivary glands

Branch of V3 but includes fibres from facial nerve (chorda tympani) which provide taste and parasympatheic innervation

120
Q

name 4 important muscles of facial expression

A

-orbicularis oculi
-
-elevators of lips
-
-orbicularis oris

121
Q

list the functions of the glossopharyngeal nerve

A
122
Q

describe the route of the thoracic vagus nerves

A
  • both pass posterior to lung root and onto oesophagus
  • both pass through diaphragm with oesophagus
123
Q

what are the origins and insertions of the spinal accessory nerve

A
124
Q

by what foramen does XII exit the skull

A

hypoglossal canal

125
Q

what are the 5 layers of the scalp?

A
  • S = Skin
  • C = Connective tissue
  • A = Aponeurosis
  • L = Loose connective tissue
  • P= Pericranium
126
Q

what bones form the pterion?

what lies under the pterion?

A

sphenoid, frontal, parietal, temporal

middle meningeal artery

127
Q
A
128
Q
A
129
Q

where does the vertebral artery originate?

A

subclavian artery

130
Q

describe the arteries that form the circle of willis

A
131
Q

where is CSF produced, reabsorbed

A

choroid plexus of the ventricles

  • reabsorbed into the dural venous sinuses
  • via arachnoid granulations
132
Q

CSF circulates from the right & left lateral ventricles to the 3rd ventricle via the right and left …….

A

foraminae of Monro

133
Q

describe the different types of bleeding within the cranial cavity

A
134
Q

what are the two main types of herniation caused by raised ICP?

A

Supratentorial and Infratentorial

135
Q

If vision is lost in the same visual field in both eyes it is termed ‘……..’. The opposite is ‘………’.

A

homonymous

heteronymous

136
Q
A
137
Q
A