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H_N General (Week1) (Nerves (Cranial Nerves(1-12) (10 Vagus (Thoraic &…

- - - - Viscera (Unconscious)
        
        Visceral Reflex (Beyond Conscious Awareness)
        
        Homeostasis (BP - picked up by barroreceptive --> CN9/10 --> hormones affect cardiac & smooth muscles)
        
        Esophageal Sphincter
        
        Respiratory/Urinary/Digestive
        
        Visceral/Referred Pain (Reach Consciousness)
        
        Eg. Ischemic Heart - Referred Shoulder, Arm, Forearm
        
        Appendicitis - Referred Umbilicus
        
        Stomach Pain - Referred Epigastric
      - Somatic (Conscious)
        
        Knee jerk
    - - Somatic (also got reflex)
        
        Skeletal Muscle
      - Autonomic/Visceral (Interchangable)
        
        Sympathetic
        
        Parasympathetic
        
        Gland
        
        1.Exocrine
        
        Muscle
        
        2.Smooth
        
        3.Cardiac
  - - - Supply muscles that appear like pulley
    - - Mostly sensory Supplies Front of Head
        
        Opthalamic
        
        Maxillary
        
        Mandibular (Motor & Sensory)
        
        Muscles of Mastication
    - - Balance/Posture & Hearing
    - - Parasympathetic: Heart Lung Esophagus Stomach Small Intestine Prox. 2/3 of Colon
      - Larynx (Main Sensory)
        Pharynx (Minor)
    - - Sternocleomastoid
      - Trapezius
    - - Facial Nerve (Mixed, mostly motor) - TZBMC
        
        Temporal
        
        Corrugator Supercilii
        
        Obicularis Occuli
        
        Frontalis
        
        Cervical
        
        Platysma
        
        Zygomatic
        
        Upper Oral Muscles
        
        Obicularis Occuli
        
        Mandibular
        
        Lower Lip
        
        Buccal
        
        Depressor Anguli Oris
        
        Buccinator
        
        Upper Lip
  - - - Dorsal Root Ganglion
    - - Autonomic Ganglion
    - - Cervical Plexus (Mixed) Anterior Rami of C1-C4 spinal nerves Supplies Back of Head + Neck - PASTGL
        
        Sensory (Cutaneous)
        
        Greater Auricular (C2&3)
        
        Outer Ear
        
        Ear Canal
        
        Lesser Occipital (C2)
        
        Skin & Sculp Posteriosuperior to auricle
        
        Transverse (C2&3)
        
        Anterior Region of Neck
        
        Supraclavicular (C3&4)
        
        Skin above and below auricle
        
        Muscular
        
        Ansa Cervicalis (C1-3)
        
        Mixed
        
        Phrenic (C3-5)
        
        Diaphragm / Mediastinum Pleural
        
        Pericardium
        
        Superficial to Scalene Anterior
        
        Referred pain for pericardium/diaphragm (Supraclavicular)
      - Brachial Plexus Anterior Rami of C5-C8 and T1
    - - Dorsal Rootlets (Sensory)
        
        Dorsal Root (DRG)
      - Ventral Rootlets (Motor)
        
        Ventral Root
        
        Fused into Spinal Nerve
        
        Dorsal Ramus (to small part of back)
        
        Ventral Ramus
  - - - Location: Within vertebral canal (C2/3 - L1/2 vertebral level)
      - Enlargements: Cervical (C5-T1), Lumber (L2-S2) Density of cell bodies
        
        Brachial Plexus
        
        Lumbo-Sacral Plexus
      - Regions
        
        Conus Medularis (Cone shaped tail end)
        
        Cauda equina (Caudal continuation of spinal nerves)
        
        Thoraic 5 Nerves(T1-T9)
        
        Cervical 8 Nerves (C1-C7)
        
        Lumbar 5 Nerves (T10-T11)
        
        Sacral 5 Nerves (T12-L2)
      - Components
        
        Meninges (Function protection)
        
        Pia Mater (Connected to cord)
        
        Arachnoid Mater
        
        Dura Mater
        
        Extra Dura Space
        
        Sub Dura Space
        
        Sub Arachnoid Space (Contain CSF)
        
        Grey Matter (H-shape) Cell Bodies
        
        Dorsal Horn (Sensory)
        
        Ventral Horn (Motor)
        
        Lateral Horn (Autonomic motor) [T1-L2 Sympathetic] [S2-S4 Parasympathetic]
        
        White Matter
        
        Ascending Axons Tracts (Sensory)
        
        Descending Axons Tracts (Motor)
    - - Components
        
        Main Parts
        
        Cerebrum (CN1-2)
        
        CN1 & CN2 (Inferior surface of frontal lobe)
        
        Diencephalon (grey matter)
        
        Thalamus
        
        Integration Centre (Sensory/Motor/Cognitive)
        
        Hypothalamus
        
        Control (Endocrine/Autonomic/Sexual/Bio-clock)
        
        Cerebellum
        
        Coordinates voluntary movement (smooth, balance, accuracy)
        
        Controls: Tone, Posture, Equilibrium
        
        Brainstem (CN3-12) (Awakeness, VItal Centres)
        
        Midbrain
        
        CN3 & CN4
        
        Pons
        
        CN5 (Mid pontine level)
        
        Medulla Oblongata
        
        CN9, CN10, CN11 & CN12
        
        Pontine Medulla Junction
        
        CN6, CN7 & CN8
        
        Limbic System (Side of thalamus/temporal)
        
        Hippocampus
        
        Amygdala
        
        Cingulate Gyrus
        
        Emotion/Behaviour/Long term memory, olfaction
        
        Ventricular system: Produces CSF >> Continuous with central canal of spinal cord
        
        Lateral Ventricle (Large, C shaped, 1 for each hemisphere)
        
        3rd Ventricle (Separate R/L thalamus)
        
        4th Ventricle (Separate brainstem from cerebellum)
        
        Lobes
        
        Frontal (Motor)
        
        Parietal (Sensory)
        
        Temporal (Hearing)
        
        Occipital (Sight)
        
        Cerebral Cortex
        
        Outer Gray Matter
        
        Valley groove = Sulcus/Fissure (deep)
        
        Gyrus (Ridge)
        
        Central Sulcus
        
        (1o Motor Cortex) Pre-central gyrus (Frontal/Motor)
        
        (1o Sensory Cortex) Post-central gyrus (Parietal/Sensory)
        
        (2o Motor Cortex) Pre-central gyrus (Frontal/Motor)
        
        (2o Sensory Cortex) Post-central gyrus (Parietal/Sensory)
        
        Lateral Fissure
        
        (1o Auditory Cortex) Superior temporal gyrus (Hearing) "41/42"
        
        (2o Auditory Cortex) Sensory Speech (Wernicke's)
        
        (Motor Speech) Broca's Region
        
        Calcarine Sulcus
        
        Longitudinal Fissure
        
        Corpus Callosum (White matter) connects R/L Hemisphere
        
        Pre-frontal Cortex
        
        Homunculus: Representation of body parts on surface of brain (Contralateral)
        
        Motor Homunculus (Size by dexterity)
        
        Sensory Homunculus (Size by sensitivity)
        
        Distribution
        
        Lateral Cerebrum: Face/Oropharynx
        
        Medial Cerebrum: Torso/Upper Limb
        
        Longitudinal Fissure: Lower Limb
        
        *Exceptions: Sensory additional - digestive tract + external genitalial
    - - Grey matter: Cell body mass
      - White matter: The type of fat in myelin (axon bundle)
      - Nucleus: aggregation of cell bodies in CNS
      - Ganglion: aggregation of cell bodies in PNS
        
        Sensory ganglion
        
        Eg. DRG
        
        Eg. Trigeminal
        
        Autonomic ganglion
  - - - Thoraic (T1-T9)
        
        Spinous Process Point Downwards + Slender
        
        Heart Shaped Body
      - Cervical (C1-C7)
        
        Spinous Process Bifid
        
        Transverse Foramen (Contains Veterbral Artery/Vein)
      - Lumbar (T10-T11)
        
        Kidney Shaped Body
        
        Spinous Process Point Horizontal + Broad
      - Sacral (T12-L2)
      - Coccyx
      - Intervertabral Disc: Fibrocartilage gel to distribute body weight
      - Intervertabral Foramen for Spinal Nerve
      - Posterior Horn (Slimmer)
  - - - Satellite
        
        Nutrition & maintenance
        
        Comparable to Astrocytes?
      - Schwann
        
        Formation of Myelin Sheath
        
        Comparable to Oligodendrocytes
    - - Glial Cells
        
        Oligodendrocytes
        
        Nutrition & maintenance
        
        Formation of Myelin Sheath
        
        Astrocytes
        
        Contribute to bloodbrainbarrier(BBB)
        
        Phagocytosis
        
        Isolation of synapses
        
        Microglia
        
        Defense Mechanism
        
        Phagocytosis & Immune Respone
      - Neurons
- - - - Scalene Anterior
        
        From:Anterior Tubercle Transverse Process of C3/4/5/6
        
        To: Scalene tubercle on 1st Rib
        
        Phrenic nerve ant. to scalene anterior
      - Scalene Medius
        
        Largest/Longest
        
        From: Posterior Tubercle Transverse Process of C2/3/4/5/6/7
        
        To: Tubercle/Subclavian Groove 1st Rib
      - Scalene Posterior
  - - - Sternocleomastoid
        
        Bilateral: Flex neck, Extend head
        
        Lateral flexion of head
        
        Rotation of head to opposite side
      - Platysma (Superficial)
      - Strap Muscles / Infrahyoid (Deep) supplied by cervical plexus
        
        Sternohyoid
        
        Sternothyroid
        
        Thryohyoid
        
        Omohyoid
      - Trapezius
- - - - Lingual
      - Ascending Pharyngeal
      - Facial
      - Superior Thyroid
      - Superficial Temporal (Terminating) - Up
      - Posterior Auricular
      - Occipital
      - Maxillary (Terminating) - Forward
- - - - Elevation: Mandible Up
      - Depression: Mandible Downward
      - Protrusion: Mandible Forward
      - Retrusion: Mandible backward
      - Excursion Mandible Side
      - Ipsilateral (Same Side) Like right muscle chew right food
      - Contralateral (Opposite Side)
    - - Jaw Elevators
        
        Temporalis (Fan-shaped)
        
        Relations:
        
        Origin:
        
        Insertion:
        
        Action:
        
        Medial/Interal Pterygoid
        
        Origin:
        
        Insertion
        
        Superior Belly - Lateral/External Pterygoid
        
        Origin:
        
        Insertion:
        
        Development:
        
        Masseter (Quadrilateral)
        
        Deep
        
        Origin:
        
        Insertion:
        
        Palpation:
        
        Superficial
        
        Origin:
        
        Insertion:
        
        Palpation
        
        Relations: Superficial (1) Parotid Gland (2) Transverse Facial Artery (3) Facial Nerve
        
        Fascia:
        
        Development: 1st Arch Innervation: 5 Blood supply: Masseteric from Maxillary & Transverse Facial from Superficial Temporal
        
        Action: (1) Elevation (2) Ipsilateral (3) Retrusion
        
        Pathology: (1) Hypertrophy (2) Myalgia
      - Jaw Depressors
        
        Anterior Digastric
        
        Geniohyoid
        
        Mylohyoid
        
        Inferior Belly - Lateral/External Pterygoid
        
        Origin:
        
        Insertion: