Conical and Brachial Plexus Quiz
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Questions and Answers

What is the main function of tight junctions in the blood-brain barrier?

  • To increase blood flow to the brain
  • To transport antibodies across the barrier
  • To allow free passage of all substances
  • To seal together endothelial cells of capillaries (correct)

Which type of substance crosses the blood-brain barrier via active transport?

  • Carbon dioxide
  • Proteins
  • O2
  • Glucose (correct)

What do astrocytes secrete to maintain tight junction permeability?

  • Hormones
  • Neurotransmitters
  • Chemicals (correct)
  • Cytokines

What can lead to a breakdown of the blood-brain barrier?

<p>Trauma and inflammation (B)</p> Signup and view all the answers

What is the approximate total volume of cerebrospinal fluid (CSF) in adults?

<p>80 – 150 mL (D)</p> Signup and view all the answers

Which of the following does cerebrospinal fluid (CSF) NOT usually contain?

<p>High levels of antibodies (A)</p> Signup and view all the answers

Which substances are most likely to cross the blood-brain barrier slowly?

<p>Creatinine and urea (C)</p> Signup and view all the answers

What is one of the protective functions of cerebrospinal fluid?

<p>Protecting from chemical and physical injuries (A)</p> Signup and view all the answers

What is the primary function of the denticulate ligaments?

<p>To anchor the spinal cord and protect against displacement (D)</p> Signup and view all the answers

Which arteries are primarily responsible for supplying blood to the brain?

<p>Internal carotid and vertebral arteries (A)</p> Signup and view all the answers

What percentage of total body weight does the brain represent in adults?

<p>2% (C)</p> Signup and view all the answers

What is a consequence of low glucose levels in the blood entering the brain?

<p>Dizziness and loss of consciousness (A)</p> Signup and view all the answers

How does the brain produce ATP?

<p>From glucose and oxygen (B)</p> Signup and view all the answers

What may happen after a total deprivation of oxygen to the brain for about 4 minutes?

<p>Permanent neuronal injury (B)</p> Signup and view all the answers

Which of the following statements about the blood-brain barrier is true?

<p>It protects the brain from harmful substances. (C)</p> Signup and view all the answers

What happens if there is a brief slowing of blood flow to the brain?

<p>Disorientation or lack of consciousness (C)</p> Signup and view all the answers

What is the primary symptom of Pronator Teres Syndrome?

<p>Achiness in the anterior forearm (A)</p> Signup and view all the answers

What typically leads to Anterior Interosseous Syndrome?

<p>Entrapment of the median nerve (D)</p> Signup and view all the answers

Which condition is associated with Tardy Ulnar Palsy?

<p>Late onset nerve palsy after elbow fracture (D)</p> Signup and view all the answers

Which anatomical structure is primarily involved in Ligament of Struthers syndrome?

<p>Tiny ligament from the humerus to the medial epicondyle (D)</p> Signup and view all the answers

What symptom is associated with a positive Froment's sign?

<p>Weakness in finger adduction (B)</p> Signup and view all the answers

Which factor is a common etiology for ulnar nerve lesions?

<p>Resting elbows on hard surfaces (B)</p> Signup and view all the answers

Which nerve is affected in Meralgia Paresthetica?

<p>Lateral femoral cutaneous nerve (A)</p> Signup and view all the answers

What is the major consequence of femoral nerve injury?

<p>Inability to extend the knee (C)</p> Signup and view all the answers

What muscle is primarily impaired in Anterior Interosseous Syndrome?

<p>Flexor pollicis longus (D)</p> Signup and view all the answers

What is a typical presentation of Ulnar Claw Hand?

<p>Hyperextension of the little finger and ring finger (D)</p> Signup and view all the answers

What occurs as a result of repeated trauma leading to thickening of the retinaculum?

<p>Nerve compression in the wrist (B)</p> Signup and view all the answers

What indicates a lesion of the Obturator nerve?

<p>Inability to adduct the thigh (B)</p> Signup and view all the answers

What is a common cause of compression leading to Handle Bar Palsy?

<p>Cycling with a tight grip (A)</p> Signup and view all the answers

Which layer of the meninges is known as the tough mother?

<p>Dura mater (B)</p> Signup and view all the answers

What does the subarachnoid space contain?

<p>Cerebrospinal fluid (A)</p> Signup and view all the answers

Which structure anchors the spinal cord to the coccyx?

<p>Filum terminale (C)</p> Signup and view all the answers

In which anatomical region are the lateral grey horns primarily found?

<p>Thoracic spine (B)</p> Signup and view all the answers

What type of axons are found in the anterior (ventral) root of spinal nerves?

<p>Motor axons (B)</p> Signup and view all the answers

Which meningeal layer is described as being avascular and contains delicate fibers?

<p>Arachnoid mater (C)</p> Signup and view all the answers

What is the function of the denticulate ligaments?

<p>Protect against sudden displacement of the spinal cord (D)</p> Signup and view all the answers

Which of the following statements accurately describes the cauda equina?

<p>It's the bundle of spinal nerves at the end of the spinal cord resembling a horse's tail. (C)</p> Signup and view all the answers

How are spinal nerves classified?

<p>Mixed nerves containing both sensory and motor axons (B)</p> Signup and view all the answers

What are rootlets in the context of spinal nerves?

<p>Bundles of axons off the root (C)</p> Signup and view all the answers

Which of the following structures connects the white matter of the left and right sides of the spinal cord?

<p>Anterior white commissure (A)</p> Signup and view all the answers

What is the outer covering of an entire spinal nerve called?

<p>Epineurium (B)</p> Signup and view all the answers

Where does the spinal cord typically end in adults?

<p>Between L1 and L2 (C)</p> Signup and view all the answers

What condition is characterized by pain and paresthesias into the sole of the foot, often misdiagnosed as plantar fasciitis?

<p>Tarsal tunnel syndrome (A)</p> Signup and view all the answers

Which virus is responsible for both chickenpox and shingles?

<p>Varicella zoster virus (D)</p> Signup and view all the answers

What is often the initial trigger for an outbreak of herpes zoster?

<p>Weak immune system (B)</p> Signup and view all the answers

Which symptom is NOT typically associated with neuritis?

<p>Sudden excruciating pain (D)</p> Signup and view all the answers

What type of pain is specifically characterized by recurrent attacks triggered by specific stimuli?

<p>Neuralgia (D)</p> Signup and view all the answers

Which of the following nerves is commonly affected by intercostal neuralgia?

<p>Trigeminal nerve (C)</p> Signup and view all the answers

Which describes the typical skin manifestation of herpes zoster?

<p>Rash followed by vesicles that crust over (A)</p> Signup and view all the answers

What is the time frame for skin lesions from herpes zoster to resolve?

<p>Up to 1 month (D)</p> Signup and view all the answers

What is a common cause of intercostal neuralgia?

<p>Herpes Zoster (D)</p> Signup and view all the answers

Which structure is specifically affected in neuritis?

<p>Sheath and connective tissue (D)</p> Signup and view all the answers

What is the typical character of pain associated with chronic inflammation of a nerve?

<p>Dull and constant (D)</p> Signup and view all the answers

What is the effect of movement on neuralgia pain?

<p>Increases the pain (D)</p> Signup and view all the answers

Which symptoms are most likely to worsen in patients with tarsal tunnel syndrome?

<p>After prolonged standing or walking (D)</p> Signup and view all the answers

What aspect of the spinal cord is emphasized in its basic function?

<p>Transmission of sensory information (C)</p> Signup and view all the answers

What is the primary function of the posterior (dorsal) ramus?

<p>Innervate muscles and skin of the posterior trunk (C)</p> Signup and view all the answers

Which ramus is primarily involved with the autonomic nervous system?

<p>Rami communicantes (C)</p> Signup and view all the answers

What is a key feature of Axonotmesis?

<p>Prolonged, severe compression with Wallerian degeneration (D)</p> Signup and view all the answers

What symptoms are typically associated with compression syndromes of peripheral nerves?

<p>Numbness and tingling (C)</p> Signup and view all the answers

Which structure does the cervical plexus NOT typically supply?

<p>Forearm flexors (A)</p> Signup and view all the answers

Erb-Duchenne Palsy results from injury to which spinal nerve roots?

<p>C5 - C6 (A)</p> Signup and view all the answers

Which of the following statements is true concerning neurotmesis?

<p>Involves damage to the endoneurium (B)</p> Signup and view all the answers

Which nerve is NOT part of the brachial plexus?

<p>Femoral nerve (B)</p> Signup and view all the answers

Which condition would most likely result from prolonged leaning on a hard surface?

<p>Mononeuropathy (B)</p> Signup and view all the answers

What is NOT a potential cause of peripheral nerve lesions?

<p>Viral infections (B)</p> Signup and view all the answers

Which nerve is responsible for innervating the diaphragm?

<p>Phrenic nerve (B)</p> Signup and view all the answers

What is a common result of Klumpke's paralysis?

<p>No sensation in hand and wrist (B)</p> Signup and view all the answers

Which branch of the cervical plexus innervates the skin over the anterior neck?

<p>Transverse cervical nerve (A)</p> Signup and view all the answers

What is the role of the olive in the central nervous system?

<p>It receives sensory input and helps coordinate motor skills. (D)</p> Signup and view all the answers

Which function is associated with the gracile nucleus and cuneate nucleus?

<p>Relaying touch, pressure, and proprioception sensations. (C)</p> Signup and view all the answers

Which center is responsible for triggering the vomiting reflex?

<p>Vomiting Center (B)</p> Signup and view all the answers

What is the primary function of the gustatory nucleus?

<p>Receiving taste signals from the tongue. (B)</p> Signup and view all the answers

Where is the medullary rhythmicity area located and what does it adjust?

<p>In the medulla oblongata; it adjusts the rhythm of breathing. (B)</p> Signup and view all the answers

Which of the following is a potential cause of compression in the brachial plexus?

<p>Prolonged poor positioning (C)</p> Signup and view all the answers

What anatomical structures are involved in Anterior Scalene Syndrome?

<p>Anterior scalene, middle scalene, rib 1 (A)</p> Signup and view all the answers

Which symptom is commonly associated with brachial plexus compression?

<p>Tingling in the arm (D)</p> Signup and view all the answers

What types of changes may indicate trophic effects due to blood vessel compression?

<p>Swelling, shiny red skin (C)</p> Signup and view all the answers

Which of the following conditions can lead to compression of the brachial plexus?

<p>Cervical rib (B)</p> Signup and view all the answers

How does poor posture contribute to brachial plexus issues?

<p>It can create external compression. (B)</p> Signup and view all the answers

Which condition could potentially exacerbate symptoms in the brachial plexus region?

<p>Diabetes Mellitus (A)</p> Signup and view all the answers

What anatomical relationship does the brachial plexus have with the subclavian artery?

<p>It travels in the same sheath as the artery. (B)</p> Signup and view all the answers

What is the primary function of the pia mater in relation to the brain and spinal cord?

<p>Adhere to the surface and supply blood (A)</p> Signup and view all the answers

Which statement accurately describes the denticulate ligaments?

<p>They extend from the pia mater to anchor the spinal cord. (C)</p> Signup and view all the answers

What percentage of the body's oxygen and glucose does the brain consume?

<p>20% (B)</p> Signup and view all the answers

What condition may occur if blood entering the brain has a low glucose level?

<p>Dizziness (A)</p> Signup and view all the answers

What occurs if there is a brief interruption in blood flow to the brain?

<p>Disorientation or lack of consciousness (A)</p> Signup and view all the answers

Which arteries are primarily responsible for draining blood from the brain?

<p>Dural venous sinuses (B)</p> Signup and view all the answers

How long can oxygen deprivation to the brain occur before causing permanent injury?

<p>4 minutes (A)</p> Signup and view all the answers

Which statement about glucose storage in the brain is correct?

<p>Glucose must be continuously supplied to the brain. (C)</p> Signup and view all the answers

What condition is characterized by difficulty in opposition and a wasting of the thenar eminence?

<p>Ape Hand (B)</p> Signup and view all the answers

Which symptom is associated with Carpal Tunnel Syndrome?

<p>Pain that wakes a person at night (C)</p> Signup and view all the answers

What is the common etiology of median nerve damage?

<p>Fracture at the elbow (A)</p> Signup and view all the answers

The 'Oath Hand' presentation is typically seen in which condition?

<p>Median nerve damage (C)</p> Signup and view all the answers

Which structure forms the roof of the carpal tunnel?

<p>Flexor retinaculum (D)</p> Signup and view all the answers

Which digits are affected by altered sensation due to median nerve lesions?

<p>1, 2, 3 and half of 4 (D)</p> Signup and view all the answers

How many tendons of the flexor digitorum superficialus pass through the carpal tunnel?

<p>4 (A)</p> Signup and view all the answers

Which branch of the median nerve is responsible for motor innervation in muscle weakness associated with carpal tunnel syndrome?

<p>Deep branch (C)</p> Signup and view all the answers

Which of the following conditions involves compression of the median nerve at the wrist?

<p>Carpal Tunnel Syndrome (B)</p> Signup and view all the answers

What is a distinguishing feature of the carpal tunnel?

<p>Formation by carpal bones (A)</p> Signup and view all the answers

What is a common characteristic of pain associated with neuritis?

<p>Constant dull pain (A)</p> Signup and view all the answers

Which condition is characterized by inflammation of the nerve sheath and connective tissue?

<p>Neuritis (B)</p> Signup and view all the answers

What often triggers an attack in cases of neuralgia?

<p>Direct stimulation of a trigger zone (C)</p> Signup and view all the answers

Which virus is responsible for the condition known as herpes zoster?

<p>Varicella zoster virus (B)</p> Signup and view all the answers

What is a characteristic symptom of intercostal neuralgia?

<p>Recurrent excruciating pain along the ribs (B)</p> Signup and view all the answers

What is the primary symptom that differentiates symptoms of compressive neuropathies from those of plantar fasciitis?

<p>Numbness and tingling in the foot (C)</p> Signup and view all the answers

What typically occurs in herpes zoster when the virus reactivates?

<p>It causes demyelination and degeneration (C)</p> Signup and view all the answers

Which nerves are most commonly affected by herpes zoster?

<p>Thoracic and trigeminal nerves (A)</p> Signup and view all the answers

Which symptom is often reported after long periods of standing or walking in conditions like tarsal tunnel syndrome?

<p>Pain radiating through the foot and toes (A)</p> Signup and view all the answers

What is a common initial symptom of shingles that follows the reactivation of the varicella zoster virus?

<p>Deep, burning pain along specific dermatomes (B)</p> Signup and view all the answers

Which condition may be misdiagnosed as plantar fasciitis due to similar symptoms?

<p>Tarsal tunnel syndrome (A)</p> Signup and view all the answers

Which factor is commonly associated with the development of intercostal neuralgia?

<p>Chronic illnesses like diabetes (D)</p> Signup and view all the answers

What is a notable sign of a trigger zone in neuralgia?

<p>Pain upon light touch (A)</p> Signup and view all the answers

What can cause a generalized inflammatory response in herpes zoster once the virus reactivates?

<p>Dysfunction of the immune system (D)</p> Signup and view all the answers

What is the primary cause of pain in chronic conditions associated with nerve compression?

<p>Mechanical irritation and inflammation of the nerve (A)</p> Signup and view all the answers

What type of reflex is the Stretch Reflex classified as?

<p>Monosynaptic reflex arc (A)</p> Signup and view all the answers

Which reflex protects a muscle from damage due to excessive tension?

<p>Tendon reflex (D)</p> Signup and view all the answers

What initiates the Flexor (withdrawal) Reflex?

<p>Stepping on a sharp object (A)</p> Signup and view all the answers

What type of reflex arc does the Crossed Extensor Reflex possess?

<p>Contralateral reflex arc (B)</p> Signup and view all the answers

Which part of the brain is continuous with the spinal cord?

<p>Brain stem (D)</p> Signup and view all the answers

What is the primary function of muscle spindles?

<p>Monitor muscle tone (B)</p> Signup and view all the answers

What type of reflex is characterized by the simultaneous contraction of one muscle and relaxation of its antagonist?

<p>Reciprocal innervation (A)</p> Signup and view all the answers

Which structure is located above the brain stem?

<p>Thalamus (A)</p> Signup and view all the answers

What is the main purpose of the Golgi tendon organs (GTO)?

<p>Detect muscle tension (D)</p> Signup and view all the answers

What protective coverings surround the brain?

<p>Cranial meninges and cranium (D)</p> Signup and view all the answers

Which part of the brain is the largest and sits on the Diencephalon?

<p>Cerebrum (A)</p> Signup and view all the answers

What is the main function of the reciprocal innervation during a reflex action?

<p>To coordinate opposite muscle actions (B)</p> Signup and view all the answers

What occurs when muscle spindles detect stretching of a muscle?

<p>Contraction of the same muscle (C)</p> Signup and view all the answers

Which part of the central nervous system includes the Medulla Oblongata, Pons, and Midbrain?

<p>Brain Stem (B)</p> Signup and view all the answers

Flashcards

Meninges

Three connective tissue layers that surround the spinal cord.

Dura Mater

Outermost meninx; tough and strong connective tissue.

Arachnoid Mater

Middle meninx; delicate, has spider web-like fibers.

Pia Mater

Innermost meninx; thin and transparent; adheres to the spinal cord.

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Subarachnoid Space

Space between arachnoid and pia mater; contains cerebrospinal fluid (CSF).

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Spinal Cord Length

Extends from the medulla oblongata to the lumbar region (L1-L2).

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Cervical Enlargement

Widening of the spinal cord in the cervical region; nerves to arms.

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Lumbar Enlargement

Widening of the spinal cord in the lumbar region; nerves to legs.

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Conus Medullaris

Cone-shaped end of the spinal cord.

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Filum Terminale

Thin thread-like extension of pia mater that anchors the conus medullaris.

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Cauda Equina

Bundle of spinal nerve roots at the end of the spinal cord; resembles a horse's tail.

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Spinal Nerves

Paths of communication between spinal cord and specific body parts; sensory and motor.

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Posterior Root Ganglion

Swelling on the posterior root; contains cell bodies of sensory neurons.

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White Matter

Bundles of myelinated axons in the spinal cord; carry signals.

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Grey Matter

Unmyelinated axons, cell bodies, and neuroglia in the spinal cord; processing takes place here.

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Posterior Ramus

Part of a spinal nerve that supplies muscles and skin of the posterior trunk.

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Anterior Ramus

Part of a spinal nerve that supplies muscles and structures of limbs, and skin of anterior and lateral trunk.

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Meningeal Ramus

A branch of a spinal nerve that re-enters the vertebral canal to supply vertebrae, ligaments, blood vessels and meninges.

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Rami Communicantes

Branches of spinal nerves involved in the autonomic nervous system.

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Plexuses

Networks formed by axons from anterior rami of spinal nerves (except thoracic nerves).

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Intercostal Nerves

Anterior rami of spinal nerves T1-T12, supplying chest wall and abdominal muscles, and overlying skin.

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Neurapraxia

Mild nerve injury, causing a conduction block, reversible, no fiber break.

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Axonotmesis

Severe nerve injury, causing axon degeneration, but endoneurium intact.

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Neurotmesis

Severe nerve injury, damaging endoneurium. Hard to regenerate.

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Mononeuropathy

A single peripheral nerve is affected.

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Polyneuropathy

Several peripheral nerves are involved.

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Erb-Duchenne Palsy

Brachial plexus injury affecting C5-C6 roots.

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Klumpke's Palsy

Brachial plexus injury affecting C8-T1 roots, causing claw hand.

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Horner's Syndrome

4 symptoms: miosis, ptosis, anhydrosis, enophthalmos.

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Thoracic Outlet Syndrome

Compression of brachial plexus & blood vessels in thoracic outlet.

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What is Pia Mater?

The innermost layer of meninges surrounding the brain and spinal cord, characterized by its thin, transparent nature and adherence to the brain's surface. It has a rich blood supply for nourishing the brain.

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What is the function of Denticulate Ligaments?

Extensions of the pia mater that suspend the spinal cord within the vertebral canal, preventing sudden displacement and providing lateral support.

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What are the main blood supply routes to the brain?

Blood flow to the brain is primarily supplied by the internal carotid arteries and the vertebral arteries.

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How does blood leave the brain?

Blood exits the brain through the dural venous sinuses, which funnel into the internal jugular vein.

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What is the brain's energy consumption?

Despite being only 2% of the body's weight, the brain consumes around 20% of the total oxygen and glucose.

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What happens when the brain's glucose supply is low?

Low glucose levels can lead to mental confusion, dizziness, convulsions, and loss of consciousness.

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What is the effect of interrupted blood flow to the brain?

Even a brief slowdown in blood flow can cause disorientation or unconsciousness. Prolonged interruption can lead to permanent brain damage.

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What components make up the Blood-Brain Barrier?

The Blood-Brain Barrier is formed by specialized cells tightly joined together, controlling what substances pass between the bloodstream and the brain.

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What is a ganglion?

A collection of nerve cell bodies outside the central nervous system, often associated with a nerve.

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What is neuritis?

Inflammation of a nerve.

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What is the difference between neuritis and neuralgia?

Neuritis is inflammation of a nerve, usually affecting the sheath and connective tissue, while neuralgia is nerve pain characterized by recurrent attacks of excruciating pain.

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What causes neuritis?

Neuritis can be caused by secondary pathologies like diabetes, trauma, or exposure to toxins.

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What is neuralgia?

Nerve pain with recurrent attacks of sudden, intense pain along the distribution of the nerve.

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What is a trigger zone in neuralgia?

An area that, when stimulated, causes an attack of neuralgia.

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What are the most common nerves affected by neuralgia?

The trigeminal and intercostal nerves are often involved in neuralgia.

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What is intercostal neuralgia?

Neuralgia affecting the intercostal nerves that travel between the ribs.

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What can cause intercostal neuralgia?

Diabetes and herpes zoster can lead to intercostal neuralgia.

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What is the connection between chicken pox and herpes zoster?

Both are caused by the varicella zoster virus.

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How does herpes zoster develop?

After recovering from chicken pox, the varicella zoster virus becomes dormant in sensory ganglia and can reactivate later in life, causing shingles.

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What are the symptoms of herpes zoster?

Shingles causes a rash, vesicles, and intense pain along the affected nerve dermatome.

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Why is herpes zoster more common in older adults?

It is often associated with a weakened immune system.

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What is the significance of the dorsal root ganglion?

The dorsal root ganglion contains the cell bodies of sensory neurons.

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What happens to the spinal cord in herpes zoster?

The virus causes inflammation, demyelination, and degeneration of the nerve.

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What are the two main functions of the spinal cord?

The spinal cord is responsible for transmitting signals between the brain and the body, and for controlling reflexes.

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Blood-Brain Barrier

A highly selective barrier that controls the passage of substances between the blood and the brain's extracellular fluid.

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Tight Junctions

Special junctions that seal together the endothelial cells of brain capillaries, forming a tight barrier to prevent most molecules from crossing.

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What substances cross the blood-brain barrier?

Water-soluble substances like glucose and creatinine can cross slowly, but lipid-soluble substances like oxygen, carbon dioxide and alcohol cross easily. Proteins and most antibiotics cannot cross.

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Astrocytes and the BBB

These star-shaped cells press up against brain capillaries and release chemicals that help maintain the barrier's permeability.

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Cerebrospinal Fluid (CSF)

A clear fluid that circulates around the brain and spinal cord, providing protection and transport of nutrients and wastes.

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CSF Circulation

CSF continuously flows through the cavities within the brain and spinal cord as well as around the brain and spinal cord in the subarachnoid space.

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CSF Composition

Mostly composed of water, it also contains small amounts of glucose, proteins, lactic acid, urea, ions, and some white blood cells.

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Functions of CSF

It protects the brain and spinal cord from chemical and physical injuries, and transports nutrients and waste between the blood and the nervous system.

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Pronator Teres Syndrome

Compression of the median nerve at the proximal attachment of the pronator teres muscle. Causes aching in the anterior forearm, numbness in the thumb and index finger, and some weakness in the thenar muscles.

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Anterior Interosseous Syndrome

Entrapment of a branch of the median nerve (deep branch) as it passes between the heads of the pronator teres muscle. Primarily affects deep forearm muscles. Causes pain and motor loss of flexor pollicis longus, lateral half of FDP, and pronator quadratus, resulting in paralysis of thumb and index finger flexors.

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Ligament of Struthers

A small ligament extending from an abnormal spur on the humerus to the medial epicondyle, which can compress the median nerve above the elbow.

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Tardy Ulnar Palsy

Ulnar nerve palsy that develops years after an elbow fracture, associated with callus formation or a valgus deformity.

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Handle Bar Palsy

Compression of the ulnar nerve at the tunnel of Guyon, often caused by pressure from resting hands on handlebars during cycling.

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Ulnar Nerve Lesions: Pathway

The ulnar nerve travels from underneath the coracoid process, runs directly medial to the humerus, behind the medial epicondyle, through the ulnar groove, under the flexor carpi ulnaris muscle, over the flexor retinaculum, and finally between the pisiform bone and the hook of the hamate bone (Guyon's canal).

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Froment's Sign

A test for ulnar nerve damage. The patient tries to hold a piece of paper between their thumb and index finger. If they can't, they use flexor pollicis longus (instead of adductor pollicis) to flex the thumb.

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Ulnar Claw Hand

A deformity caused by ulnar nerve damage, characterized by hyperextension of the MCP joints and flexion of the IP joints of the little and ring fingers.

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Iliohypogastric Nerve

Origin: L1. Distribution: Anterior and lateral abdominal muscles, inferior abdominal muscles, and lateral gluteal muscles.

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Ilioinguinal Nerve

Origin: L1. Distribution: Anterior and lateral abdominal muscles, anterior, superior, and medial thigh; genitals.

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Genitofemoral Nerve

Origin: L1-L2. Distribution: Cremaster muscle, anterior, superior, and middle thigh; genitals.

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Lateral Cutaneous Nerve of Thigh (Lateral Femoral Cutaneous)

Origin: L2-L3. Distribution: Lateral thigh (slightly posteriorly and anteriorly).

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Femoral Nerve

Origin: L2-L4. Distribution: Quads, sartorius (anterior thigh muscles), anterior and medial thigh, medial leg, and foot.

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Obturator Nerve

Origin: L2-L4. Distribution: Adductor muscles, medial thigh.

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Meralgia Paresthetica

Entrapment of the lateral femoral cutaneous nerve near the anterior superior iliac spine (ASIS) as it passes under the inguinal ligament. Causes pain and numbness on the lateral thigh.

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Brachial Plexus Location

The brachial plexus travels with the subclavian artery between the anterior and middle scalene muscles, but not with the subclavian vein.

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Subclavian Vein Location

The subclavian vein joins the brachial plexus and subclavian artery after they pass through the scalene muscles.

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Thoracic Outlet Syndrome: Causes

Thoracic outlet syndrome can be caused by internal compression (bone spurs, cervical rib), external compression, prolonged poor positioning, poor posture, systemic conditions, trauma, joint subluxation, and pregnancy.

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Thoracic Outlet Syndrome: Symptoms

Symptoms include pain, numbness, weakness, tingling in the arm and upper thoracic area, and sometimes skin changes due to lack of blood flow.

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Anterior Scalene Syndrome Location

Compression of the brachial plexus and subclavian artery occurs between the anterior and middle scalene muscles, in the interscalene triangle.

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Interscalene Triangle

The interscalene triangle is a space defined by the anterior scalene, middle scalene, and rib 1. It is a critical area for thoracic outlet syndrome.

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Thoracic Outlet Syndrome Structures

The brachial plexus and subclavian artery pass through the interscalene triangle, but the subclavian vein does not.

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Thoracic Outlet Syndrome: Importance

Thoracic outlet syndrome is an important condition because it can significantly impact arm function, strength, and sensation.

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Medullary Rhythmicity Area

Located in the medulla oblongata, it regulates the basic breathing rhythm in coordination with areas in the pons. It controls the rate and depth of respiration.

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Olive

A swelling located on the ventral surface of the medulla oblongata, containing the inferior olivary nucleus, which plays a crucial role in motor learning and coordination. Receive input from the cortex, red nucleus, and spinal cord, and project to the cerebellum.

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Gracile & Cuneate Nuclei

Located in the medulla, they receive sensory information from the spinal cord, specifically touch, pressure, vibration, and proprioception. They are responsible for conscious awareness of these sensations.

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Gustatory Nucleus

Located in the medulla, it receives taste information from the tongue via the facial, glossopharyngeal, and vagus nerves. This input is crucial for taste perception.

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Cochlear Nucleus

Located in the medulla, it receives auditory information from the inner ear via the cochlear nerve. This is the first relay station in the auditory pathway leading to the brain.

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Denticulate Ligaments

Extensions of the pia mater that suspend the spinal cord in the vertebral canal. They protect the cord from sudden displacement and provide lateral support.

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Brain Blood Flow: Main Arteries

Blood flows to the brain primarily through two major arteries: the internal carotid arteries and the vertebral arteries.

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Brain Blood Flow: Drainage

Blood leaves the brain through the dural venous sinuses, which connect to the internal jugular vein.

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Brain Energy Consumption

Despite being only 2% of the body's weight, the brain uses 20% of the total oxygen and glucose supplied to the body.

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Low Glucose in Brain

Low glucose levels in the brain can cause mental confusion, dizziness, convulsions, and loss of consciousness.

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Interrupted Brain Blood Flow

Even a brief slowing of blood flow to the brain can cause disorientation or unconsciousness. Prolonged interruption can lead to permanent brain damage.

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Blood-Brain Barrier (Components)

The blood-brain barrier is made up of specialized brain capillary cells tightly joined together, controlling the passage of substances between the blood and the brain's extracellular fluid.

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Ganglion

A benign, fluid-filled cyst that often develops near tendons or joints. Can be caused by repetitive motion or injury.

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Neuritis

Inflammation of a nerve, primarily affecting the connective tissue and sheath. It can cause constant, dull pain, numbness, and tingling.

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Neuralgia

Recurring episodes of intense, sharp nerve pain, often with a trigger zone.

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Trigger Zone

Area of skin supplied by a nerve, stimulation of which triggers neuralgia attacks.

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Intercostal Neuralgia

Nerve pain affecting intercostal nerves, causing pain between the ribs.

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Herpes Zoster (Shingles)

Reactivation of the varicella-zoster virus, causing a painful rash and blisters along a dermatome.

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Dorsal Root Ganglion

Collection of sensory neuron cell bodies located in the spinal nerve roots.

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Dermatome

Area of skin supplied by a specific spinal nerve.

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Valgus Deformity

A bony deformity where the distal part of a bone is angled outward, often caused by flat feet in runners.

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Chronic Inversion

Repetitive turning of the ankle inward, potentially leading to injury.

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Spinal Cord Physiology: Function 1

Transmitting signals between the brain and the body, enabling communication and control of functions.

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Spinal Cord Physiology: Function 2

Controlling reflexes, allowing for rapid, automatic responses to stimuli.

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Stretch Reflex

A monosynaptic reflex arc that causes contraction of a skeletal muscle in response to stretching of that muscle. It helps prevent overstretching and injury.

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Muscle Spindles

Sensory receptors located within muscle bellies that monitor changes in muscle length.

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Tendon Reflex

A polysynaptic reflex arc that causes relaxation of a muscle when there is excessive tension on the tendon. It helps prevent tendon tearing.

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Golgi Tendon Organs (GTO)

Sensory receptors found near the junction of a muscle and tendon, monitoring muscle tension.

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Flexor (Withdrawal) Reflex

A polysynaptic reflex arc that causes withdrawal of a limb from a painful stimulus. It's a protective reflex.

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Crossed Extensor Reflex

A contralateral reflex that occurs simultaneously with the flexor reflex. When one leg flexes, the other extends to maintain balance.

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Intersegmental Reflex Arc

A reflex in which a single sensory neuron activates multiple motor neurons in different spinal cord segments.

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Reciprocal Innervation

A mechanism where simultaneous contraction of one muscle is accompanied by relaxation of its antagonist muscle.

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Brain Stem

The lower part of the brain that connects to the spinal cord. Contains the medulla oblongata, pons, and midbrain.

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Cerebellum

Located posterior to the brain stem, this part of the brain coordinates movement, balance, and posture.

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Diencephalon

Located superior to the brain stem, this part of the brain contains the thalamus, hypothalamus, and epithalamus.

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Cerebrum

The largest part of the brain, responsible for higher-level functions like thinking, learning, and memory.

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Cranial Meninges

Three connective tissue layers that surround and protect the brain. Continuous with the spinal meninges.

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Epidural Space

The space between the dura mater and the vertebral canal, which is present around the spinal cord but not around the brain.

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Median Nerve Lesions: Pathway

The median nerve runs down the medial humerus, underneath the biceps, then passes near the medial epicondyle. It travels under the pronator teres muscle, where it splits into deep and superficial branches, which supply different muscles in the hand.

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Median Nerve Lesions: Symptoms

Median nerve damage can lead to the 'Ape Hand' where the thumb is unable to oppose the fingers, causing difficulty with grasping objects. The 'Oath Hand' exhibits inability to flex the 4th and 5th digits, affecting fist formation. Other symptoms include weak wrist flexion, thumb movement issues, and altered sensation in the thumb, index, middle fingers, and half of the ring finger.

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Carpal Tunnel Syndrome

A condition where the median nerve is compressed in the carpal tunnel at the wrist. This is the most common entrapment condition in the arm.

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Carpal Tunnel Syndrome: Symptoms

Symptoms include numbness and tingling in the thumb, index, middle, and half of the ring finger mostly at night, often waking the patient. Weakness, clumsiness in the thumb and fingers may occur with progressing severity and can potentially lead to thenar muscle wasting.

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What Structures Pass Through the Carpal Tunnel?

The carpal tunnel contains the median nerve, flexor digitorum superficialis tendons (4), flexor digitorum profundus tendons (4), and flexor pollicis longus tendon (1).

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Study Notes

Conical and Brachial Plexus

  • Conical and brachial plexuses are complex networks of nerves.
  • These networks are formed by the ventral rami of spinal nerves.
  • The nerves in these plexuses innervate various parts of the body.
  • Specific nerves originate from the brachial plexus, crucial for upper limb movement and sensation.

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Description

Test your knowledge on the conical and brachial plexuses, which are vital networks of nerves formed by the ventral rami of spinal nerves. This quiz covers their structure and the body parts they innervate. Understand the complexity of these nerve networks and their importance in human anatomy.

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