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142 Cards in this Set

  • Front
  • Back
astrocytes
-fxn
-stain
-embryologic layer
-physical support in CNS
-BBB

-GFAP stain
-ectoderm (all CNS/PNS cells arise from ectoderm--"neuroectoderm"--except "M"icroglia (AKA "M"acrophage arise from "M"esoderm)
ependymal cells
-desc
-embryologic layer
line ventricles

-ectoderm (all CNS/PNS cells arise from ectoderm--"neuroectoderm"--except "M"icroglia (AKA "M"acrophage arise from "M"esoderm)
microglia
-desc
-what embryologic layer
phagocytes

Mesoderm:
(all CNS/PNS cells arise from ectoderm--"neuroectoderm"--except "M"icroglia (AKA "M"acrophage arise from "M"esoderm)
oligodendroglia
-desc
-embryologic layer
central myelin production: each oligodendrocyte myelinates multiple CNS axons, up to 30 each

-destroyed in MS

-ectoderm (all CNS/PNS cells arise from ectoderm--"neuroectoderm"--except "M"icroglia (AKA "M"acrophage arise from "M"esoderm)
Schwann cells
-desc
-embryologic layer
peripheral myelin production

-each Schwann cells myelinates only 1 PNS axon
-promotes axonal regeneration
-ex of Schwannoma is acoustic neuroma (location commonly assoc w/internal acoustic meatures: CN 7,8)

-ectoderm (all CNS/PNS cells arise from ectoderm--"neuroectoderm"--except "M"icroglia (AKA "M"acrophage arise from "M"esoderm)
from what embryologic layer to CNS/PNS supportive cells arise?
all arise from ectoderm ("neuroectoderm"), except "M"icroglia (arise from "M"esoderm)

[mneum: "M"icroglia & "M"acrophages arise from "M"esoderm]

ectoderm:
-astrocytes
-ependymal cells
-oligodendroglia
-Schwann cells
peripheral nerve layers
==>desc
==>which layer must be rejoined in microsurgery for limb reattachment
Peripheral nerve layers:

1. endoneurium surrounds a single nerve fiber

2. perineurium surrounds fascicle of nerve fibers
["P"erineurium="P"ermeability barrier and thus must be rejoined in microsurgery for limb reattachment)

3. epineurium (dense CT) surrounds entire nerve (fascicle+bv)
meissner's corpuscle
-small encapsulated nerve endings
-LIGHT discriminatory touch of glabrous (hairless) skin, like DERMIS of palms, soles, digits [makes sense that something superficial like dermis would handle LIGHT touch)

[mneum: Meissner's ~ "MISER" whose DISCRIMINATORY touch helps him hang onto his money in his PALMS AND DIGITS (miserly fingers) ]
Merkel's corpuscle
-cup-shaped nerve endings
-LIGHT, crude touch
-DERMIS of fingerips, hair follicles, hard palate
Pacinian corpuscle
-LARGE encapsulated nerve endings found in DEEPER layers of skin at ligaments, joint capsules, serous membranes, mesenteries
-coarse touch [makes sense b/c in deeper layers of skin]
-vibration, tension
inner ear
1. Bony labyrinth (within temporal bone):

-contains PERILYMPH (Na+ rich, think outside the cell)
-contains:
*cochlea (hearing)
--base (narrow & stiff) picks up high-frequency sounds
--apex (wide and flexible) picks up low-freq sounds

(Elderly people lose high freq sounds first, then low)

*vestibule (spatial orientation)
*semicircular canals

2. Membranous labyrinth
-within bony labyrinth
-contains ENDOLYMPH (K+ rich, think inside the cell)
-contains:
*Maculae (within utricle and saccule)--detects LINEAR acceleration

* "A"mpullae (within semicircular canals)--detects "A"ngular acceleration
cochlea
*cochlea (hearing)
--base (narrow & stiff) picks up high-frequency sounds
--apex (wide and flexible) picks up low-freq sounds

(Elderly people lose high freq sounds first, then low)
what detects linear acceleration
maculae (within utricle & saccule)
what detects angular acceleration
Ampullae (within semicircular calans)

["A"mpullae="A"ngular acceleration)
BBB
-desc
-what can pass thru BBB
3 things make up BBB:
1. tight jxns b/w non-fenestrated capillary epithelial cells

2. BM

3. astrocyte foot processes


-nonpolar > polar can cross BBB
-glucose & aa cross via carrier-mediated transport mechanism
fxns of hypothalamus
mneum: The hypothalamus wears "TAN HATS":

T=Thirst and water balance (supraoptic nucleus)
A=Adenohypophysis (ant pit) control via RH's (Releasing Hormones, i.e. TRH)
N=Neurohypophysis hormone production(oxytocin & ADH)

H=Hunger (destroy lateral nucleus==>anorexia & starvication) & satiety (destroy ventromedial nucleus==>hyperphagia & obesity; mneum: destroy VENTROMEDIAL nucleus==>grow VENTRALLY & MEDIALLY)
A=Autonomic Regulation (ant hypothalamus regulates PSNS; post hypo regulates SNS) & circadian rhythms (suprachiasmic nucleus)
T=Temperature ("A/C": "A"nterior hypo "C"ools when too hot; post hypo heats when too cold)
S="S"ex & Emotions ("S"eptal nucleus; destruction==>rage)
what controls thirst and water balance
supraoptic nucleus, hypothalamus
what controls sex & emotion
"S"ex= "S"eptal nucleus of hypothalamus;

destruction==>rage
destruction of what leads to rage
Septal nucleus of hypothalamus ("S"eptal="S"ex and emotion)
what coordinates cooling
"A/C"

-ant hypothalamus coordinates cooling when too hot
what regulates PSNS
ant hypothalamus
what regulates SNS
post hypothalamus
destruction of what leads to anorexia and starvation
lateral nucleus of hypothalamus
destruction fo what leads to hyperphagia and obesity
ventromedial nucleus of hypothalamus

(mneum: if destroy ventromedial nucleus==>grow ventrally and medially)
what coordinates circadian rhythms
suprachiasmic nucleus of hypothalamus
what coordinates warming when it's too cold
post hypothalamus

(mneum: "A/C": ant hypothalamus cools when it's too hot; post hypothalamus warms when it's too cold)
neurohypophysis receives projections from where
from hypothalamus: supraoptic nucleus (ADH; thus this nucleus controls thirst) & paraventricular nucleus (oxytocin)
thalamus
-major relay for ascending sensory info that will eventually reach cortex

-lateral geniculate nucleus: visual
-medial geniculate nucleus: auditory

[mneum: "L"ateral=light (visual);
"M"edial=music (auditory)]

*VPL (Ventral Posterior nucleus, Lateral part)=BODY SENSATION:
-dorsal column (touch, proprioception, vibration, pressure)
-spinothalamic (pain, temp)

*VPM (Ventral Posterior nucleus, Medial part)=FACIAL SENSATION:
-CN 5

*VA/VL (Ventral Anterior/Lateral nuclei)=MOTOR
Limbic system fxns
"5 F's":

-Feel
-Feed
-Fight
-Flight ("Fight/flight" response)
-Fuck
broadmann area 4
-desc
-what lobe
-motor cortex
-frontal lobe
broadmann area 6
-desc
-what lobe
pre-motor cortex
frontal lobe

*part of extrapyramidal circuit
broadmann area 8
-desc
-what lobe
-frontal eye fields
-frontal lobe
broadmann area 44,45
-desc
-what lobe
-Motor speech (Broca's) area
-frontal lobe
broadmann area 41, 42
-desc
-what lobe
primary auditory cortex
-temporal lobe (makes sense b/c temporal lobe is near the ear)
broadmann area 22
-desc
-what lobe
-associative auditory cortex (Wernicke's area)
-temporal lobe (makes sense b/c temporal lobe is near the ear)
broadmann area 17
-desc
-what lobe
principal visual cortex
-occipital lobe
frontal lobe functions
"Executive fxn": planning, organizing, inhibition, lnaguage, motor regulation

frontal lobe lesion==>lack of social judgment
homonculus
for sensory and motor:

upside-down man named HAL ("H"ead, "A"rm, "L"eg):

leg (inferior stuff) most medial, then arm, then head (superior)
ACA supplies what
-medial surface of brain, thus
==>leg area (makes sense; leg is most medial on sensory-motor homonculus)
MCA supplies what
-lateral surface of brain, thus
==>trunk-arm-head area of sensory-motor homonculus
==>Broca and Wernicke's speech area
MC site of Berry aneurysm?
ant comm artery
==>can cause visual field defects (frontal eye fields)
posterior communicating artery
-pathology
common site of aneurysm;
==>CN 3 palsy
"arteries of stroke"
(pic in HY Neuro p. 31)

lateral striate arteries (come off MCA)

="arteries of stroke"
-supply IC, caudate, putamen, GP
stroke of anterior circle causes what defects?
(think of Brodmann's areas)

[anterior circle=branches of IC, i.e. ACA, MCA)

-general sensory/motor prob
-language prob (aphasia)
-motor prob
stroke of posterior circle causes what defects?
think of Brodmann's areas)

[posterior circle=branches of vertebral arteries, i.e. PCA, basilar artery, cerebellar arteries)

-CN defects (vertigo, visual defects)
-coma
-cerebellar deficits (ataxia)
-CN defects (vertigo, visual defects)
-coma
-cerebellar deficits (ataxia)

suggest lesion where?
posterior circle=vertebral artery distribution--PCA, basilar artery, cerebellar arteries
-general sensory/motor prob
-language prob (aphasia)
-motor prob

suggest stroke where?
[anterior circle=branches of IC distribution, i.e. ACA, MCA)
CSF flow
choroid plexus of lateral ventricles produces CSF
==>Interventricular foramen/foramen of Monro
==>3rd ventricle
==>Cerebral Aquaduct
==>4th ventricle
==>subarachnoid space via 2 foramen of "L"ushka ("L"ateral) & 1 foramen of "M"agendie ("M"edial)
spinal nerves
31 total:

8 cerv
12 thoracic
5 lumbar
5 sacral
1 coccygeal
where does vertebral disk herniation usually happen?
b/w L5 and S1
to what level do these extend down to?
-spinal cord
-subarachnoid space

At what level do you perform lumbar puncture?

What structures pierced in lumbar puncture?
(pic-Neuro made simple: p. 5)

-spinal cord: vertebral level L2 , but spinal nerves L2-S5 exit the spinal cord caudally to continue caudally as the cauda equina to exit by their corresponding vertebrae

-subarachnoid space: S2

Thus, perform lumbar puncture in L3-L4 or L4-L5 interspace @ level of cauda equina(below s.c. but subarachnoid space still there)

mneum: "To keep the cord ALIVE, keep the spinal needle b/w L3 and L5")

Structures pierced in lumbar puncture:
1. Skin/Superficial fascia
2. Ligaments (supraspinous, interspinous, ligamentum flavum0
3. Epidural space
4. Dura mater
5. Subdural space
6. Subarachnoid space (CSF)
7. NOT PIERCED: pia
dorsal column
-fxn
-1st-order neuron
-Synapse 1
-2nd-order neuron
-Synapse 2
-3rd-order neuron
Fxn: touch/vibration/pressure, proprioception

1st order neuron: DRG
==>enters s.c.
==>ascends ipsilaterally in dorsal column

-Synapse 1: nucleus gracilis/cuneatus (medulla)

-2nd order neuron: DECUSSATES in medial lemniscus (medulla); ascends contralaterally in medial lemniscus

2nd synapse: VPL (thalamus)

3rd order neuron: sensory cortex
spinothalamic tract
-fxn
-1st-order neuron
-Synapse 1
-2nd-order neuron
-Synapse 2
-3rd-order neuron
Fxn: pain & temperature

1st order neuron: sensory nerve ending [A-delta (fast) & C (slow) fibers]
==>enters s.c.

1st synpase: ipsilateral gray matter, dorsal horn (s.c.)

2nd order neuron: DECUSSATES in AWC; ascends contralaterally until thalamus

2nd synapse: VPL (thalamus)

3rd order neuron: sensory cortex
Lateral corticospinal tract
-fxn
-1st-order neuron
-Synapse 1
-2nd-order neuron
-Synapse 2
fxn=descending voluntary mvmt of contralateral limbs

1st-order neuron= UMN:
descends ipsilaterally from motor cortex==>thalamus (IC; VA/VL nuclei)==>down to pyramidal decussation (medullary-s.c. jxn)
==>DECUSSATES in pyramidal decussation, then descends contralaterally

1st synapse: ant horn cells of spinal cord (remember ant s.c.=motor; dorsal s.c.=sensory)

2nd order neuron= LMN
==>leaves s.c.

2nd synapse: NMJ (SkM)
what causes waiter's tip
=Erb's palsy

-damage to upper trunk (C5 & 6) of brachial plexus d/t violent stretch b/w head and shoulder, i.e. during baby delivery
what causes Klumpke's Palsy
=Claw hand

-damage to Lower Trunk, d/t sudden upward pull of arm, i.e.:

-swinging from tree branch
-during baby delivery- pulling on baby's abducted arm (upward) arm to pull them out of vagina
what causes claw hand
-damage to ulnar nerve
-damage to lower trunk (Klumpke's palsy)
what causes wrist drop
-damage to radial nerve
-damage to posterior cord (gives rise to radial and ax nerves)
what causes winged scapula
damage to long thoracic nerve (derived from C 5,6,7)
what protects brachial plexus in a clavicle fracture?
subclavius muscle
radial nerve

-passes thru what muscle
-site of injury
-innervates what?

Injury
==>what motor deficit
==>what sensory deficit
Passes thru supinator

site of injury=shaft of humerus

-radial nerve supplies all muscles in extensor/posterior compartments of arm and forearm

Motor Deficit- Loss of:
-Extensor carpi radialis longus==>wrist drop

Only if damage oprximal to origin of radial N's branches to triceps:
-brachioradialis==>loss of brachioradialis reflex
-triceps==>loss of triceps reflex
-cannot extend at elbow

Sensory deficit- Loss of:
-posterior brachial cutaneous
-posterior antebrachial cutaneous
Median nerve
-passes thru what muscle
-site of injury
-innervates what?

Injury
==>what motor deficit
==>what sensory deficit
-passes thru pronator teres

site of injury=supracondyle of humerus

Lateral root of Median Nerve innervates:
-all muscles of forearm flexor/anterior compartment except Flexor Carpi Ulnaris & 1/2 of FDP (Flexor Digitorum Profundis), which are innervated by ulnar
-first two lumbricals
-thenar eminance

Motor Deficit: Loss of:
-(NO loss of any arm muscles)
-forearm pronation
-wrist flexion
-finger flexion
-thenar atrophy

Sensory Deficit: Loss of
-lateral palm and thumb and radial 2.5 fingers
Ulnar Nerve
-passes thru what muscle
-site of injury
-innervates what

Injury
==>what motor deficit
==>what sensory deficit
-passes thru flexor carpi ulnaris

-site of injury=medial epicondyle (makes sense; picture it in your head)

Innervates all muscles of hands and forearm except those innervated by median N:

-flexor carpi ulnaris
-ulnar half of FDP (median nerve innervates all other muscles of forearm flexor/anterior compartment)
-palm hypothenar eminence

Motor deficit:
-claw hand (d/t unopposed action of FDP)
-impaired wrist flexion & adduction/ulnar deviation

Sensory deficit:
-medial palm (hypothenar eminance)
-ulnar 1.5 fingers
axillary nerve
-site of injury
-motor deficit
-site of injury=surgical neck of humerous or anterior shoulder dislocation

-loss of deltoid action
musculocutaneous nerve
-passes thru what muscle
-innervates what

Injury
==>what motor deficit
==>what sensory deficit
-passes thru coracobrachialis

Innervates:
-all muscles in anterior/flexor compartment of arm
-skin of lateral forearm [lateral antebrachial cutaneous nerve]

-lose fxn of muscles in anterior/flexor compartment[Netter p 412]:
corachobrachialis,
biceps,
brachialis muscles

These:
*control biceps reflex
*flex at elbow
what causses:

-loss of forearm pronation
median nerve injury
what causes:

impaired wrist flexion and adducdtion
ulnar nerve injury
what causes loss of triceps reflex
radial nerve injury==>

-wrist drop
-loss of triceps (triceps reflex)
-loss of brachioradialis (brachioradialis reflex)
what causes loss of brachioradialis reflex
radial nerve injury==>

-wrist drop
-loss of triceps (triceps reflex)
-loss of brachioradialis (brachioradialis reflex)
what causes loss of biceps reflex
Musculocutaneous nerve injjury==>

-loss of biceps reflex (coracobrachialis, biceps, & brachialis)
Erb-Duchenne palsy
-d/t tearing of upper trunk of brachial plexus (C5 & C6) d/t sudden forced separation of head and shoulder, i.e.:
*fall on shoulder
*complicated baby delivery

1. arm hangs at side (loss of abductors)
2. arm medially rotated (loss of lateral rotators)
3. forearm pronated (loss of biceps, which supinates the forearm)
thoracic outlet syndrome
=Klumpke's palsy

-embryologic defect compresses subclavian A and inf trunk of brachial plexus (C8, T1)

*Injured ulnar nerve (innervates all hand muscles except thenar muscles & 2 radial lumbricals, which are innervated by median N):

==>Atrophy of thenar (median N) & hypothenar (ulnar N) eminences
==>Atrophy of interosseous muscles
==>Sensory deficits on medial side of forearm and hand


*Injured median nerve
==>atrophy of thenar eminence

Also, disappearance of radial pulse when turn head toward opposite side
common peroneal/fibular nerve
-spinal levels
-fxn
-injury ==> ?
L4, L5, S1, S2

mneum: "PED= Peroneal Everts & Dorsiflexes; if injured, foot is dropPRED"

*Loss of dorsiflexion (foot drop)

Common Peroneal nerve==>
1. Deep peroneal nerve innervates leg anterior compartment==>dorsiflex
2. Superficial peroneal nerve innervates leg lateral compartment==>evert
tibial nerve
-spinal levels
-fxn
-injury ==> ?
L4-S3

*loss of plantar flexion
*innervates posterior compartment (of leg)

mneum: "TIP=Tibial nerve Inverts & Plantarflexes;
if injured, can't stand on TIPtoes"
radial nerve
innervates posterior/extensor compartment of both the arm and forearm:

AKA innervates the "BEST":

-Brachioradialis
-Extensors of wrist and fingers (injury==>wrist drop)
-Supinator
-Triceps
thenar muscles
thenar and hypothenar eminences both have "OAF" muscles:

O=Opponens (pollicis/digiti minimi)
A=Abductor (pollicis brevis/digiti minimi)
F=Flexor (pollicis brevis/digiti minimi)
hypothenar muscles
thenar and hypothenar eminences both have "OAF" muscles:

O=Opponens (pollicis/digiti minimi)
A=Abductor (pollicis brevis/digiti minimi)
F=Flexor (pollicis brevis/digiti minimi)
location of pudendal nerve block?
ischial spine
location of appendix
2/3 of the way b/w umbilicus and ant sup iliac spine (McBurney's point)
where do lumbar puncture
iliac crest
pain in right shoulder?
referred gallbladder pain via phrenic nerve
C2 dermatome
posterior half of "skull cap"
C3 dermatome
high turtleneck shirt
C4 dermatome
low-collar shirt
T4 dermatome
nipple

mneum: "T4 at the TEAT PORE"
T7 dermatome
xyphoid process
T10 dermatome
umbilicus (imp for early appendicitis pain referral)

mneum: "T10 is at belly butTEN"
L1 dermatome
inguinal ligament

Mneum: "L1 = IL (Inguinal Ligament)"
L4 dermatome
includes the kneecaps

Mneum: "down on L4 (all fours")
S2-4 dermatome
erection and sensation of penile and anal zones
Biceps reflex tests what nerve root
C5;

makes sense b/c biceps is innervated by MSK, which comes from C5,6

mneum: Reflexes counting up in order:

S1,2 (S1=Achilles)
L3,4 (L4=Patella)
C5,6 (C5=Biceps)
C7,8 (C7=Triceps)
triceps reflex tests what nerve root
C7

makes sense b/c triceps is innervated by radial N, which derives from C7

mneum: Reflexes counting up in order:

S1,2 (S1=Achilles)
L3,4 (L4=Patella)
C5,6 (C5=Biceps)
C7,8 (C7=Triceps)
Achilles reflex tests what nerve root
S1

mneum: Reflexes counting up in order:

S1,2 (S1=Achilles)
L3,4 (L4=Patella)
C5,6 (C5=Biceps)
C7,8 (C7=Triceps)
patellar reflex tests what nerve root
L4

mneum: Reflexes counting up in order:

S1,2 (S1=Achilles)
L3,4 (L4=Patella)
C5,6 (C5=Biceps)
C7,8 (C7=Triceps)
moro reflex
primitive reflex;

extension of limbs when startled
rooting reflex
primitive reflex;

nipple seeking
palmar reflex
primitive reflex;

grasps object in palm
what CN's lie medially at brain stem?
3, 6, 12

(mneum: 3 (x2) = 6 (x2) = 12)
CN 7 actions
-facial mvmt
-closes eyelid
-lacrimation (2-neuron path)
-salivation (2-neuron path; via submaxillary and sublingual glands)
-taste on ant 2/3 tongue
CN 9 actions
-taste from post 1/3 tongue
-sensation from eustachian tube (middle ear) & upper pharynx
-swallowing
-salivation (via parotid gland: otic ganglion)
-monitor caroitid body/sinus chemo- and baroreceptors
what CN mediates salivation
-CN 7 (via sublingual and submandibular glands)
-CN 9 (via parotid gland: otic ganglion)
what CN mediates swallowing
CN 9 and 10
what CN mediates carotid body/sinus chemo- and baroreceptors
CN 9
what CN mediates Ao Arch chemo- and baroreceptors
CN 10
what CN mediates talking
CN 10
CN 10 actions
-thoracic and abdominal viscera
-swallowing
-palate elevation
-Ao arch chemo and baroreceptors
-taste from epiglottis
-sensory info from lower pharynx, larynx, trachea, and esophagus
where are CN nuclei located?
midbrain: CN 3,4
pons: CN 5-8
medulla: CN 9-12

Note:
Lateral nuclei =sensory
"M"edial nuclei="M"otor
vagal nuclei
1. nucleus "S"olitarius: CN 7,9, 10
*visceral "S"ensory info:
-taste
-baroreceptors
-gut distention

2. nucleus a"M"biguus: CN 9, 10, 11
*"M"otor innervation of:
-larynx
-pharynx
-upper esophagus
==>swallowing, palate elevation

3. dorsal motor nucleus of X (DMX)
-sends autonomic (PSNS) fibers to heart, lungs, upper gI
nucleus solitarius
CN 7,9, 10
*visceral "S"ensory info:
-taste
-baroreceptors
-gut distention
nucleus ambiguus
CN 9, 10, 11
*"M"otor innervation of:
-larynx
-pharynx
-upper esophagus
==>swallowing, palate elevation
what CN goes thru cribriform plate
CN 1
where does CN1 go thru
cribiform plate
middle cranial fossa
-what structures does it contain
-what CN's does it contain
CN 2-6: through sphenoid

*optic canal (CN 2, opthalmic A, central retinal V)

*superior orbital fissure (eye stuff: CN 3,4,V1,6, opthalmic V)

*foramen rotundum (CN V2)

*foramen ovale (CN V3)

*foramen spinosum (middle meningeal A)
posterior cranial fossa
-what structures does it contain
-what CN's does it contain
CN 7-12: thru temporal or occiptal bone

*internal auditory meatus (CN 7,8)
*jugular foramen (CN 9,10,11,jugular vein)
*hypoglossal canal (CN 12)
*foramen magnum (spinal roots of CN 11, brain stem, vertebral arteries)
optic canal
-which cranial fossa is it in
-what goes thru
-middle cranial fossa

CN 2
opthalmic artery
central retinal vein
superior orbital fissure
-in which cranial fossa is it
-what goes thru it
-middle cranial fossa

eye stuff: 3,4,V1,6,opthalmic V
internal acoustic meatus
-in which cranial fossa is it
-what goes thru it
-posterior cranial fossa

CN 7,8
jugular foramen
-in which cranial fossa is it
-what goes thru it
-posterior cranial fossa

CN 9,10,11
jugular V
foramen rotundum
-in which cranial fossa is it
-what goes thru it
-middle cranial fossa

CN V2
foramen ovale
-in which cranial fossa is it
-what goes thru it
-middle cranial fossa

CN V3
foramen magnum
-in which cranial fossa is it
-what goes thru it
-post cranial fossa

*spinal roots of CN 11
*brain stem
*vertebral A
cavernous sinus
-collection of venous sinus4s on either side of the pituitary
-blood from eye and superficial cortex==>cavernous sinus==>int jugular vein

(makes sense that drains eye b/c cavernous sinus contains muscles extraocular eye muscles)

contains:
-CN 3,4,V1,V2,6 (only CN6 is "free-floating")
-postganglionic sympathetic fibers
cavernous sinus syndrome
-d/t mass effect

-opthalmoplegia (CN 3, 4, 6)
-opthalmic (V1) and maxillary sensory (V2) loss
damage to what nerve can cause extreme hoarseness

-what can cause the damage
Recurrent laryngeal (branch of vagus)

-can be damaged during thyroid surgery b/c the nerve passes b/w trachea and esophagus, very close to thyroid
lumbar puncture
-at what level
-sequence of layers punctured
-L3-L4 or L4-L5 ("To keep the spinal cord alive, poke b/w L3 and L5")

Layers Punctured:
-skin
-superficial fascia
-deep fascia
-supraspinous ligament
-interspinous ligament
-interlaminar space
-epidural space
-dura
-arachnoid
-subarachnoid space
(pia not punctured)
what mediates gag reflex
-CN9 mediates afferent path
-CN10 mediates effect path
mastication muscles
3 "M"'s "M"unch (close jaw):
1. Masseter
2. teMporalis
3. Medial pterygoid

"L" Lowers (opens jaw):
Lateral pterygoid
muscles with "glossus" in their name are innervated by what CN?
hypoGLOSSal nerve, except for "palatoglosses," which is innervated by vagus ("palat"=vagus)
muscles with "palat" in their name are innervated by what CN?
vagus, except for TENSor veli palatini, "who was too TENSe" (innervated by V3)
what visual defect does lesion in right optic nerve cause?
right anopia
what visual defect does lesion in right optic tract cause?
left homo hemi
what visual defect does lesion in right Meyer's loop cause?
[Meyer's loop=temporal lobe]

left upper quadrantic anopia
what visual defect does lesion in right dorsal optic radiation cause?
[dorsal optic radiation=parietal lobe]

left lower quadrantic anopia
what causes left upper quadrantic anopia
temporal lobe lesion (Meyer's loop)
what causes left lower quadrantic anopia
parietal lobe lesion (dorsal optic radiation)
what causes these Sx:

on attempted lateral gaze
==>MR palsy
==>abducting eye has nystagmus

-convergence is nl
MLF syndrome (Medial Longitudinal Fasciculus, which MR goes thru)

"MS. MLF"--MLF syndrome often d/t MS

-convergence is nl b/c uses diff pathway than MR

normally:
-when looking left, left CN 6 fires, which contracts the left LR and stimulates the contralateral (right) nucleus of CN 3 via the right MLF to contract the right MR
MLF syndrome
"MS. MLF"--often d/t MS

(MLF=Medial Longitudinal Fasciculus, which Medial Rectus connects to)

on attempted lateral gaze
==>MR palsy
==>abducting eye has nystagmus

-convergence is nl

normally:
-when looking left, left CN 6 fires, which contracts the left LR and stimulates the contralateral (right) nucleus of CN 3 via the right MLF to contract the right MR
visual defect assoc w/MS
MLF syndrome

"MS. MLF"--often d/t MS

(MLF=Medial Longitudinal Fasciculus, which Medial Rectus connects to)

on attempted lateral gaze
==>MR palsy
==>abducting eye has nystagmus

-convergence is nl
"kuh kuh kuh" tests what CN
CN 10 (palate elevation)
"la la la" tests what CN
CN 12 (tongue)
"mi mi mi" tests what CN
CN 7 (lips)
Golgi tendon organs
monitor muscle tension

incr tension==>GTO sends inhibitor signal to alpha motor neurons

(e.g. makes you drop heavy suitcase you've been holding too long)