Meninges And Blood Flow Flashcards

1
Q

CSF Functions

A

Provides buoyancy to protect against sudden movements

Constant pressure

Antibacterial

Controls extracellular fluid of brain

Clears waste and toxins during sleep

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2
Q

Circumventricular organs

A

Regions where the blood-brain barrier is interrupted so that brain can respond to changes in blood chemistry

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3
Q

Meninges in order

A

Outside in:
Dura (periosteal, meningeal)
Arachnoid
Pia

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4
Q

Cisterns

A

Enlarged subarachnoid space where CSF collects

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5
Q

Lumbar puncture is contraindicated if there is increased intracranial pressure because

A

If there is a mass in the brain, do not want to pull fluid because it could cause a vacuum and thus herniation of brain

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6
Q

Lumbar puncture in adults vs. children

A

In adults: L3-L4
In children: L4-L5

Difference is because spinal cord is goes down to further vertebrae in children than in adults. Changes as child grows.

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7
Q

Falx cerebri

A

Inner dural fold separating cerebral hemispheres

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8
Q

Falx cerebelli

A

Inner dural fold separating two hemispheres of cerebellum

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9
Q

Tentorium cerebelli

A

Inner dural fold separating the posterior cerebral hemispheres and the cerebellum

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10
Q

Posterior fossa

A

Cavity formed by occipital bone as base and tentorium cerebelli as roof, which contains the cerebellum and the brainstem

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11
Q

Tentorial notch

A

Narrow opening in tentorium cerebelli where midbrain passes through

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12
Q

Epidural hematoma

A

usually caused by trauma causing the middle meningeal artery to break

Period of lucidity before brain herniation

Lens shape on MRI

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13
Q

Subdural hematoma

A

Retraction of brain (in older people) puts tension on bridging veins, which may cause them to rupture

Crescent shape on MRI

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14
Q

Subarachnoid hemorrhage

A

Bleeding into subarachnoid space usually due to trauma

In non-trauma cases, cased by A-V malformation or ruptured aneurysm

Sudden onset of severe headache

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15
Q

Most common site of aneurysm

A

Branch points of arteries

In men: anterior communicating artery

In women: posterior communicating artery

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16
Q

Causes of increased intracranial pressure

A
Tumor
Hemorrhage
Abscess
Edema
Hydrocephalus
Infection
17
Q

Symptoms of Increased Intracranial pressure

A
Headache
Altered mental status
Nausea, vomiting 
Downward looking eyes
Papilledema 
Visual loss
Diplopia 
Cushing's triad 
Skull expansion (in children)
18
Q

Cushing’s triad

A

Symptom of increased intracranial pressure

Causes hypertension, bradycardia, and irregular respirations

19
Q

Transtentorial and Central Herniation

A

Aka uncal herniation

Uncus of temporal lobe herniates through tentorial notch

Triad of symptoms: blown pupil (ipsilateral), hemiplasia (contralateral), and coma

Pupillary response due to the compression of CN III

Coma if there is distortion of midbrain reticular formation that impairs consciousness

20
Q

Subfalcine herniation

A

Herniation of parts of brain under the falx cerebri

21
Q

Tonsillar herniation

A

Cerebrum herniates through foramen magnum, compressing the medulla, which may lead to respiratory arrest, blood pressure instability, and death

22
Q

Hydrocephalus definition and types

A

When there is excess CSF due to overproduction (tumor in choroid plexus), obstructed flow in the ventricles or subarachoid space, or decreased reabsorption by arachnoid granules.

Communicating hydrocephalus: lateral ventricles can still communicate with subarachnoid space

Non-communicating hydrocephalus: flow is obstructed within the ventricular system

23
Q

Symptoms of hydrocephalus

A

Headache (especially in the morning because CSF is resorbed less efficiently when lying down)

Neck pain

Decreased cognitive function

Vomiting

Papilledema

Drowsiness

Failure to upward gaze

24
Q

Ventriculoperitoneal shunt

A

Tube inserted surgically to let CSF drain out of brain and into abdomen where body can resorb it in order to prevent hydrocephalus and brain damage.

25
Q

Chairi malformation

A

Congenital hindbrain abnormalities associated with downward displacement of cerebellum, brainstem, or craniocervial junction

Causes hydrocephalus because CSF cannot flow through foramen magnum due to compression

Most have a genetic basis

26
Q

Chairi Malformation I

A

Most common

Cerebellar tonsils dip below foramen magnum

Causes sringomyelia and compression of brainstem

Symptoms include headache, ataxia, and impaired movement

27
Q

Chairi II

A

Aka Arnold chairi malformation

Less common

Significant hernia through foramen magnum causing aqueductal stenosis and hydrocephalus

Usually with meningomyocele

28
Q

Normal pressure hydrocephalus

A

Cause not totally understood: could be due to impaired reabsorption or subarachnoid hemorrhage

Classical triad of symptoms: gait disturbance, dementia, urinary incontinence

29
Q

Anterior circulation arises from …

A

Internal carotid

30
Q

Posterior circulation arises from …

A

Vertebral artery