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Preclineazy Megan Hodgson Preclineazy UPCOMING SCHEDULE 11 THOCTOBER Embryology, 20THOCTOBER 21 OCTOBER Genetics & (Basic Clinical (Basic Clinical Congenital Sciences) Sciences) Abnormalities 8THNOVEMBER 16THNOVEMBER 25 OCTOBER Viral immunology, (Basic Clinical Pregnancy & birth basics of paediatrics Sciences) NEUROLOGY Overview of the Structure of the Nervous System (CNS & PNS) Spinal Tracts Anatomy of the Brain Arterial Blood Supply of the Brain CSF FlowOverview of the Structure of the Nervous System STRUCTURE OF THE NERVOUS SYSTEM Central Nervous System Peripheral Nervous (CNS) System (PNS) Spinal Brain Cord Sensory Motor Autonomic Somatic Sympathetic Parasympathetic EntericCentral Nervous System Cells Peripheral Nervous System Cells Oligodendrocytes Schwann cells Astrocytes Satellite cells Microglia Spinal Tracts 3 main tracts: 2 ascending (sensory) & 1 descending (motor) SENSOR Y TRACTS MOTOR TRACTS 1 ORDER NEURONES: PERIPHERAL NERVE → POSTERIOR GREY HORN OF SPINAL CORD / MEDULLA 2DORDER NEURONES: POSTERIOR GREY HORN OF SPINAL CORD / MEDULLA → SUBCORTEX 3RDORDER NEURONES: SUBCORTEX → CORTEX 1ST ORDER NEURONES ALWAYS REMAIN IPSILATERAL (SAME SIDE) TO THE SIDE THEY ENTER THE SPINAL CORD ON, AND THEY SYNAPSE WITH THE 2ND ORDER NEURONE JUST BEFORE THE PATHWAY DECUSSATES Dorsal Root Ganglion Dorsal Column-Medial Lemniscal Pathway Sensory Information rd 3 order Internal neurone Capsule Fine touch Thalamus Vibration Proprioception (joint sense) 2 order neurone Medulla Decussation 1 order Medulla oblongata neurone Spinothalamic (Anterolateral) Pathway Sensory Information * Lateral: Pain & Temperature Anterior: Crude touch & Pressure Decussation * Level of the spinal cord it enters * (±1-2 spinal levels) SENSOR Y TRACTS MOTOR TRACTS 1 ORDER NEURONES: PERIPHERAL NERVE → POSTERIOR UPPER MOTOR NEURONES: CORTEX → ANTERIOR HORN CELL IN HORN OF SPINAL CORD / MEDULLA THE ANTERIOR (VENTRAL) HORN OF THE SPINAL CORD 2NDORDER NEURONES: POSTERIOR GREY HORN OF SPINALLOWER MOTOR NEURONES: ANTERIOR HORN CELL IN THE CORD / MEDULLA → SUBCORTEX ANTERIOR (VENTRAL) HORN OF THE SPINAL CORD → EFFECTOR ORGAN 3RORDER NEURONES: SUBCORTEX → CORTEX 1ST ORDER NEURONES ALWAYS REMAIN IPSILATERAL (SAME MOTOR SIDE) TO THE SIDE THEY ENTER THE SPINAL CORD ON, AND CORTEX THEY SYNAPSE WITH THE 2ND ORDER NEURONE JUST BEFORE THE PATHWAY DECUSSATES UMN Dorsal Root Ganglion LMN Anterior Horn Cell Muscle Corticospinal Tract Motor Information Internal UMN Capsule Motor control to the musculature of the body (i.e. skeletal muscles) Decussation Lateral corticospinal tract: Medulla Anterior corticospinal tract: Level ofN the spinal cord it exitsAnatomy of the Brain Central Sulcus MOTOR Longitudinal Fissure Frontal CREATING SPEECH SOLVING, CONCENTRATION, JUDGEMENTTY, BEHAVIOUR, PROBLEM Parietal- occipital SENSATION OF PAIN, TOUCH, TEMPERATURE, PROPRIOCEPTION sulcus Parietal SPACIAL PERCEPTION HEARING Temporal MEMORY FORMATION UNDERSTANDING LANGUAGE Occipital INTERPRETATION OF LIGHT & COLOUR VISCERAL SENSATION – SENSE OF INTERNAL BODY STATE Sulcus / Insula EMOTIONAL BEHAVIOUR AND PROCESSING Sylvian Fissure TASTE Pre-occipital notch DESIRES, CRAVINGS & ADDICTION Lobes of the Brain Memory Aid: Memory Aid: Sulci ~ Sulk (to be Parents (‘parietal’) always (Anatomy) sad/depressed) think they are superior!PRIMARY MOTOR PRECENTRAL GYRUS – IMMEDIATELY CORTEX ANTERIOR TO CENTRAL SULCUS MUSCLE MOVEMENT PRIMARY POSTCENTRAL GYRUS – IMMEDIATELY SENSORY POSTERIOR TO CENTRAL SULCUS CORTEX RECEIVES INFORMATION ABOUT SENSATION OF PAIN, TOUCH, TEMPERATURE, PROPRIOCEPTION LEFT HEMISPHERE, FRONTAL LOBE BROCA’S AREA PRODUCTION OF SPEECH WERNICKE’S LEFT HEMISPHERE, POSTERIOR AREA SUPERIOR TEMPORAL LOBE COMPREHENSION OF SPEECH PREMOTOR SUPERIOR FRONTAL LOBE, ANTERIOR CORTEX TO PRIMARY MOTOR CORTEX PLANNING MOVEMENT PREFRONTAL ANTERIOR FRONTAL LOBE CORTEX HIGHER ORDER FUNCTIONS: PERSONALITY, BEHAVIOUR, PROBLEM SOLVING, CONCENTRATION, JUDGEMENT PRIMARY SUPERIOR TEMPORAL GYRUS OF AUDITORY TEMPORAL LOBE CORTEX HEARING Functional Areas of the Brain PRIMARY VISUAL OCCIPITAL LOBE CORTEX VISION (Physiology) Cerebellum • Main Function: FINE-TUNING MOVEMENT • Other Functions: Motor learning, Balance/posture, emotion regulation, attention & language • Cerebellar Dysfunction → DANISH: • Dysdiadochokinesis • Ataxia • Nystagmus • Intention tremor • Slurred speech • Hypotonia Brainstem • Composed of: • Midbrain • Pons • Medulla Oblongata • Functions: • Connects Brain & Spinal Cord • Origin of CN III - XII • Autonomic functions (e.g. circadian rhythm, respiratory centre, cardiac centre) Arterial Blood Supply of the BrainCIRCLE OF WILLIS CEREBRAL ARTERIES ACA MCA PCA AUDITORY CORTEX (HEARING) PREFRONTAL CORTEX BROCA’S AREA (PRODUCING SPEECH) PRIMARY MOTOR & WERNICKE’S AREA (UNDERSTANDING SPEECH) VISION PRE-MOTOR CORTEX FOR LOWER LIMB PRIMARY MOTOR AND PRE-MOTOR AREA FOR UPPER LIMB AND TRUNKCSF CSF: Function, Generation & Flow Functions of CSF Generation of CSF Protection Ependymal cells of Choroid Plexus Buoyancy lining the Lateral ventricles & 3 rd Chemical Stability Ventricle Flow of CSF rd Lateral Ventricles Interventricular foramina (foramen of Mo3 ventricle Subarachnoid space 4 Ventricle Cerebral aqueductMeninges Meninges & Extradural space Reabsorption DURA MATER (periosteal layer) of CSF (meningeal layerCSF Subdural space ARACHNOID MATER Subarachnoid space PIA MATER Q U E S T I O N 1 Mr Buckland presents in A&E after being stabbed Loss of touch, vibration, proprioception and motor function on the LEFT. Pain and temperature A in his back. A CT scan of his spinal column reveals sensation loss on the RIGHT the knife has cut the right half of his spinal Loss of touch, vibration and proprioception on the B RIGHT. Pain, temperature and motor function loss on column. the LEFT Loss of touch, vibration, proprioception and motor What are the most likely sensory & motor C function on the RIGHT. Pain and temperature sensation loss on the LEFT deficits seen? Loss of touch, vibration, proprioception D and motor function on the RIGHT only E Pain and temperature sensation loss on the LEFT only ANSWER ON THE ZOOM POLL Q U E S T I O N 1 Mr Buckland presents in A&E after being stabbed Loss of touch, vibration, proprioception and motor A fun ti n n the LEFT.NOiA Cd te erature in his back. A CT scan of his spinal column reveals sensation loss on the RIGHT the knife has cut the right half of his spinal Loss of touch, vibration and proprioception on the B RI ESO. PAGEAL SQ AMOUS C LL tor fuRCINO ssAon column. the LEFT Loss of touch, vibration, proprioception and motor C function on the RIGHT. Pain and temperature What are the most likely sensory & motor sensation loss on the LEFT deficits seen? D Loss of touch, vibration, proprioception and motor function on the RIGHT only Dorsal Column (S) Pain and temperature sensation loss on E HIATAL HERNIA the LEFT only Corticospinal (M) Spinothalamic - anterior & lateral (S) Q U E S T I O N 2 A 56-year-old woman has been rushed into A&E A LATERAL VENTRICLE after a severe headache, vomiting & losing consciousness. This was due to a rapid increase in B FORAMEN OF MONRO interventricular pressure in the system of ventricles in the brain. C 3RD VENTRICLE Where is the CSF obstruction most likely to be? D CEREBRAL AQUEDUCT E 4TH VENTRICLE ANSWER ON THE ZOOM POLL Q U E S T I O N 2 A 56-year-old woman has been rushed into A&E A LATERAL VENTRICLE after a severe headache, vomiting & losing consciousness. This was due to a rapid increase in B FORAMEN OF MONRO interventricular pressure in the system of ventricles in the brain. C 3rdVENTRICLE Where is the CSF obstruction most likely to be? D CEREBRAL AQUEDUCT E 4THVENTRICLE PLEASE FILL OUT THE FEEDBACK FORM PLEASE TUNE IN TO OUR REMAINING SESSIONS THIS WEEK! @OSCEazyOfficial @osceazyofficial OSCEazy Osceazy@gmail.com