Flashcards
Anatomy practicals pt.2
Cards in this deck (52)
- 1How many spinal/cranial nerves are there?Spinal- 31 pairs
Cranial- 12 pairs - 2Function of cranial meninges?-Protect the brain
-Form supportive framework for arteries, veins and venous sinuses
-Enclose a fluid filled cavity (sub-arachnoid space) with CSF- vital for normal function of the brain - 3Layers that make up the meninges? Superficial to deepDura mater
Arachnoid mater
(sub-arachnoid space)
Pia mater - 4Mnemonic for Cranial Nerves?Oh, Oh, Oh, To Touch And Feel Velvet. AH!
- 5Order of cranial nerves?1- Olfactory
2- Optic
3- Oculomotor
4- Trochlea
5- Trigeminal
6- Abducens
7- Facial
8- Vestibulocochlear
9- Glossopharyngeal
10- Vagus
11- Accessory
12- Hypoglossal - 6Mnemonic for function of Cranial Nerves?Some Say Marry Money But My Brother Says Big Brains Matter More
S-sensory
M-motor
B-both - 7Which nerve converys sensation from the mandibular teeth? Where would it be anaesthetised by a dentist?Mandibular branch of CN V (3rd branch)
In the foramen ovale (skull) - 8What results from lesion due to a compression injury at the stylomastoid foramen?Facial nerve compressed
No facial expression, taste sensation to anterior 2/3 of tongue, glands of head/neck affected - 9Where does the vagus nerve run in the neck?Inferior to internal jugular vein and common carotid artery
- 10How is accessory nerve function tested?-Rotate head
-Shrug shoulders with/without resistance - 11If CN XI is damaged, what are signs/symptoms?-Diplopia (double vision)
-Blurred vision
-Eye cannot abduct past midline (patient may compensate by looking sideways) - 12What would be the signs/symptoms for nerve damage in those leaving the jugular foramen?CN IX- adsent gag reflex
CN X- dysphagia, absent gag reflex, dysphonia (diffuculty speaking), aphonia (loss of voice), stridor (inspiratory wheeze)
CN XI- unable to rotate heard, weakness in shrugging, asymmetrical neckline - 13At what level does the spinal cord end? Name for the end of the spinal cord?L1/2
Cauda equina - 14Does the spinal nerve leave above or below the vertebra?Above for cervical nerves (hence why there are 8 cervical nerves but only 7 vertebra)
Below for thoracic, lumbar and sacral - 15Dermatome for: -Clavicles -Thumb -Middle finger -Ring/little finger -Lateral upper limb -Medial upper limb -Nipples -Umbilicus -Medial side of big toe -Lateral side of foot/little toeC5
C6
C7
C8
C5, 6, 7
C8, T1
T4
T10
L4
S1 - 16What does the... supply? Brachial plexus Lumbosacral plexusUpper limb
Lower limb - 17How does a cervical segment of the spinal cord differ from a lumber segment?It is wider than the lumbar segment
- 18Where is the epidural space?Between the dura mater and vertebral wall
- 19What is the filum terminale?Continuation of the pia mater to the conus medullaris. It descends all the way to the coccyx anchoring the spinal cord
- 20What spinal nerves is the brachial plexus made up of?C5, 6, 7, 8 and T1
- 21What are the spinal levels of the... reflex? -Ankle -Knee -Biceps brachii -TricepsS1, 2
L3, 4
C5, 6
C7, 8 - 22How would you assess cutaneous sensation?Close eyes and press skin (eg. with cotton bud). Ask if patient can feel
- 23How would you assess strength/weakness of a muscle?Test by putting resistance on a muscle and ask them to move it
- 24Where is the internal acoustic meatus? Nerves that pass through?Found on temporal bone
CN VII + CN VIII - 25What happens in an Acoustic Schwannoma?-An acoustic neuroma (benign, slow growing tumour)
-Arises from Schwann cells from vestibulocochlear nerve
-Tumour grows and compresses trigeminal nerve/affect facial nerve
-Can eventually compress brainstem and cerebellum - 26Signs/symptoms of an Acoustic Schwannoma?-Hearing loss in 1 ear
-Tinnitus
-Peripheral vertigo
-Facial numbness on one side
-Ataxia
-Persistent headaches
-Temporary blurred/double vision - 27Treatment for Acoustic Schwannoma?-Surgery
-Radiation
-Observation - 28What is epidural anaesthesia used for?-Pain management during labour
-Sensory nerves are affected more than motor
-Effects wear off within 2 hours of last exposure - 29Where is epidural anaesthesia given and why?-Injected into epidural space through bones and ligament
-Given at L3/L4 since there is little risk of damaging the spinal cord (stops at L1)
-Iliac crests used as a landmark (top of pelvis) - 30Risks associated with epidural anaesthesia? What functions are lost?Risks:
-Puncturing dura where CSF is at a high pressure (causes severe headaches)
-Puncturing and damaging epidural veins
-Anaesthesia incorrectly passed into bloodstream causing severe problems
Loss of:
-function of SNS (risk of hypotension)
-sensation
-bladder control - 31Which nerves have close anatomical relation to the humerus? What is the consequence of damage to these nerves?Axillary- unable to abduct arm
Radial- weakened triceps and unopposed flexion of wrist
Musculocutaneous- weakened flexion at shoulder/loss of sensation on lateral forearm
Median
Ulnar- unable to abduct/adduct fingers - 32Functions of radial nerve?-Extension of elbow, hand and wrist
-Innervates biceps brachii and posterior compartment of forearm - 33Signs/symptoms of mid-shaft fracture of humerous?-Pain
-Swelling
-Bruising
-Difficulty in moving arm - 34What is a prolapsed disc?-Annulus fibrosus is injured
-Nucleus pulposus reptures out
-Material enters spinal canal, squashing spinal cord and spinal nerves - 35What nerves are likely to be affected by a prolapsed disc between L2/L3? What signs/symptoms would occur?Lateral cutaneous nerve- numbness in thigh
Femoral nerve- numbness in skin/weakness in knee
Obturator nerve- weakness in thigh, knee and hip joints - 36Possible causes of herniated discs?-Spondylosis (spinal conditions caused by degeneration)
-Trauma caused by injury
-Smoking (associated with loss of flexibility)
-Long term poor posture
-Lack of exercise
-Lifting heavy objects - 37Define: -radiculopathy -myelopathy -myeloradiculopathyCompression of spinal root
Compression of spinal cord
Compression of spinal cord/roots - 38Signs/symptoms of prolapsed disc? Medication used for treatment?-Lower back pain
-Numbness
-Tingling
-Lower back muscle weakness
Combination of anti-inflammatory and paracetamol-based medications + physiotherapy - 39What type of tissues do autonomic nerves supply? What significance does this have?Myogenic
They do not initiate contraction but influence rate and contractility - 40What stimuli does afferent autonomic fibres respond to?-Distension
-Hypoxia
-Hypercapnia
-Changes in pH - 41Differences in somatic and autonomic pain?Autonomic- poorly localised/described: dull, grumbling, ache
Somatic- hot, cold, sharp - 42Describe the symNS?-Arise from lateral horn of T1-L2
-Ganglia form paravertebral ganglia
-Post-ganglionic fibres that arise join spinal nerves/blood vessels (since they aren't myelinated) - 43Where is the...? -coeliac ganglia -inferior mesenteris ganglia -superior mesenteris ganglia -stellate ganglionAbove adrenal
Below kidneys
On adrenal/kidney boundary
On either side of root of neck (superior to subclavian artery) - 44Describe the paraNS-Cranio-sacral outflow (CN III/VII/IX/X and S2-S4)
-Have long pre-ganglionic fibres and short post-ganglionic fibres which synapse in tissues
-Supplies salivary/gastric glands and walls of alimentary tract - 45What is Raynud's syndrome?-Spasm of arteries causing reduced blood flow to fingers (and rarely to toes)
-Area turns white-blue then red and burns when blood flow returns
-Caused by emotional stress/pain
-Numbness and pain - 46What is Horner's syndrome?-Arises when sympathetic trunk is damaged/ can be congenital
-Signs are on same side as lesion
-Signs/symptoms: miosis (constricted pupil), partial ptosis, anhidrosis, enophthalmos - 47Some ventral rami of spinal nerves unite to form plexuses. What is an advantage of that?-Most skeletal muscles are supplied by fibres from more than 1 spinal segment
-To paralyse would mean damage of several nerve segments eg. to paraylse biceps brachii you would need to damage C5-C7 - 48What does destruction of the nerves leaving 1 spinal segment mean?Weakness of all the muscles supplied by that segment
- 49Difference between presentation of LMN and UMN lesions?LMN- transmission between brain/muscle is affected. Weakness, paralysis or changes in reflexes allows accurate identification of the site of lesion
UMN- damage is to spinal cord or brain. It affects many muscles in groups - 50Describe history taking in a neurological assessment (prior to physical assessment)-Presenting problem
-Its course/duration
-Functional deficits
-Onset
-Previous illnesses
-Drug use
-Family/social history - 51Describe motor examination-Taken when patient is relaxed and warm (shivering can be mistaken for fasciculations)
-Inspection of muscles (look for atrophy, fasciculation, increased muscle bulk)
-Assess muscle tone
-Assess power/weakness of limb muscles
-Assess deep tendon reflexes - 52Describe sensory examination-If patient mentions sensory reduction in a particular region, assess it first and return to it later on
-Light touch, 2-point discrimination, propioception, vibration sense, pain, temperature and an assessment of weight/size/shape/texture of unseen object is used
-See is nerves are cut (if superficial) or crush (if have close relations to bone or in joints)
-Assess both sides to allow for comparison
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- Topography of the Brain and Cranial Nerves Topography of the Spinal Cord and Spinal Nerves PBL session Autonomic Nervous System
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- Dolu Falowo
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