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1 neuro > cerebral vasculature, anatomy of the skull, CNs > Flashcards

cerebral vasculature, anatomy of the skull, CNs Flashcards

circle of willis, sinuses and veins, lobes and arterial supply, the cavernous sinus, stroke, cranial foramen, facial bones

1
Q

what are the 2 feeder arteries into the circle of willis?

A
  1. internal caroitids (anterior, 80%)

2. vertebrals (posterior, 20%)

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2
Q

which arteries supply to the cerebellum in the circle of willis?

A
  1. superior cerebellar
  2. ANTERIOR inferior cerebellar
  3. POSTERIOR inferior cerebellar
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3
Q

what does the anterior communicating artery connect in the circle of willis?

A
  • the 2 anterior cerebral arteries
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4
Q

what does the posterior communicating artery connect in the circle of willis?

A
  • the Internal Carotid and Vertebro-Basilar systems via the POSTERIOR CEREBRAL ARTERY
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5
Q

where do vertebral arteries arise from?

A

subclavian

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6
Q

how does the internal carotid enter the cranium?

A
  • through the the foreamen lacerum
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7
Q

how does the internal jugular enter the cranium?

A
  • jugular foramen
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8
Q

how do the vertebral arteries enter the cranium?

A
  • through foramen magnum
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9
Q

where do vessels lie in the brain ?

A

subarachnoid space

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10
Q

what territory does the anterior cerebral artery supply?

A
  • medial surface of each hemisphere
  • most of the frontal lobe
  • most of the corpus callosum
  • some deep structures

it ges above the corpus callosum

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11
Q

what happens if a stroke affects the anterior cerebral artery supply?

A

problems with walking, and bladder control

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12
Q

what territory does the middle cerebral artery supply?

A
  • most of lateral aspect of each hemisphere
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13
Q

what happens if a stroke affects the middle cerebral artery supply?

A
  • supplies most of motor cortex so MCA stroke would cause hemiparesis (weakness of one side)
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14
Q

what territory does the posterior cerebral artery supply?

A
  • occipital lobe
  • inf + post temporal lobe
  • thalamus
  • choroid plexus
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15
Q

what happens if a stroke affects the posterior cerebral artery supply?

A
  • visual defects (contralateral)
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16
Q

what 3 steps are involved in drainage of blood from the brain?

A
  1. blood drains from veins
  2. into dural venous sinuses
  3. into internal jugular (takes towards heart)
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17
Q

what are the different types of vein found in the brain?

A
  1. emissary (drain from outside skull eg. scalp)
  2. diploic (drains bones in skull)
  3. cerebral (drains cerebrum )
  4. cerebellar (drains cerebellum)
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18
Q

what is the name for the sinuses of the Brain? where are they found?

A
  • dural venous sinuses

- in between the peristeal and meningeal layers of the dura mater

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19
Q

which dural venous sinuses lie within the falx cerebri?

where do they converge?

A
  • straight
  • superior sagittal (in top of falx cerebri)
  • inferior sagittal (in bottom of falx cerebri)

converge at confluence of sinuses

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20
Q

after the confluence of sinuses, what is the drainage route?

A
  1. confluence
  2. transverse
  3. sigmoid
  4. internal jugular vein
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21
Q

what areas of the brain are most vulnerable to reduction in perfusion?

A

the watershed areas

  • these are areas on the borders/junctions between cerebral vascular territories
  • here the tissue is the furthest from arterial supply
  • therefore if there is a reduction in blood flow, these areas will be affected the most
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22
Q

what makes the dural venous sinuses structurally different to veins?

A
  • contain no valves
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23
Q

what is the straight sinus a continuation of?

A
  • the great cerebral vein
  • the inferior sagittal sinus

together they form the straight sinus

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24
Q

what is the pathway for the drainage of deep brain areas?

A
  • various cerebral veins
  • GREAT CEREBRAL VEIN
  • straight sinus
  • confluence
  • transverse
  • sigmoid
  • internal jugular
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25
Q

what is the pathway for the drainage of superficial areas of brain?

A

either cerebral veins drain into superior sagittal sinus OR the transverse sinus OR the cavernous sinus

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26
Q

what is the pathway for the drainage of ophthalmic veins?

A
  1. ophthalmic veins
  2. cavernous sinus
  3. superior and inferior petrosal sinuses
  4. internal jugular
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27
Q

weakness in arterial branches can lead to what?

which arterial branch has the biggest tendency to weaken in this way?

A
  • Berry Aneurysm(congenital sac-like out pouching of an inter- cranial artery)
  • progressively enlarge until rupture = haemorrhage.
  • most commonly occur on the branching points around the circle of Willis (anterior communicating artery)
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28
Q

where is the cavernous sinus located?

A
  • within the middle cranial fossa,
  • on either side of thesella turcica
  • on the sphenoid bone (which contains the pituitary gland).
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29
Q

within which dura mater layers are the cavernous sinus located?

A
  • They are enclosed by the endosteal and meningeal layers of the dura mater. (double fold)
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30
Q

which structures pass through the cavernous sinus (on way to orbit)

A 
Maxillary CNV2
Ophthalmic CNV1
Oculomotor CN3
Carotid (internal artery) 
Abducens CNVI
Trochlear IV
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31
Q

name the 6 bones of the cranial base

A 
frontal 
ethmoid 
sphenoid 
temporal 
parietal 
occipital
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32
Q

what are the 2 parts of the ethmoid bone?

A
  1. cribriform plate - 2 plates

2. crista galli - spine that separates the 2 plates, falx cerebri connects to

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33
Q

what are the 2 parts of the sphenoid bone?

A
  • lesser wing (edge of wing)

- greater wing (bigger SA, looks like butterfly wing)

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34
Q

how many cranial fossa are there?

order of depth?

A
  1. anterior (shallow)
  2. middle (deep)
  3. posterior (deepest)
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35
Q

which bones make up the anterior fossa?

A
  • frontal bone
  • ethmoid bone (cribriform plate + crista galli)
  • sphenoid bone
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36
Q

which bones make up the middle fossa?

A

sphenoid bone
temporal bone (petrous + squamous)
parietal bone

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37
Q

which bones make up the posterior fossa?

A

sphenoid bone
parietal bone
temporal bone
occipital bone

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38
Q

what lobes/structures are in the anterior fossa?

A
  • frontal lobe
  • cribriform plate
  • falx cerebri attached to crista galli of ethmoid bone
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39
Q

what lobes/structures are in the middle fossa?

A
  • temporal lobe
  • parietal lobe
  • occipital lobe
  • superior orbital fissure
  • the optic canal
  • pituitary fossa
  • sella turcica
  • foreamen x4
40
Q

what are the 2 parts of the temporal bone?

A

petrous part
- the bony ridge
squamous part
- the flat part

41
Q

what is the sella turcica?

A
  • asaddle-shaped depression
  • in the body of the sphenoid bone
  • cavernous sinus is located on either side of it

aka. hypophyseal fossa

42
Q

which 4 foreamen are in the middle cranial fossa?

A

foreamen …

  • rotundum
  • ovale
  • lacerum
  • spinousum
43
Q

what lobes/structures are in the posterior fossa?

A
  • the cerbellum (covered by tetorium cerebelli)
  • pons + medulla
  • foreamen magnum
  • hypoglossal canal
  • internal acoustic meatus
44
Q

what is the tentorium cerebelli attached to?

A
  • the occipital bone
  • the cerebellum
  • within posterior cranial fossa
45
Q

what structure(s) exit the cranium via the ethmoidal foramen (cribriform plates) ?

A

CN I

46
Q

what structure(s) exit the cranium via the superior orbital fissure?

A

CN III
CN IV
CN VI
CN V1

47
Q

what structure(s) exit the cranium via the optic canal?

A

CN II

48
Q

what structure(s) exit the cranium via the foramen rotundum ?

A

CN V2

49
Q

what structure(s) exit the cranium via the foramen ovale ?

A

CN V3

50
Q

what structure(s) exit the cranium via the foramen spinosum ?

A

meningeal arteries

51
Q

what structure(s) exit the cranium via the internal acoustic meatus?

A

CN VII

CN VIII

52
Q

what structure(s) exit the cranium via the hyperglossal canal?

A

CN XII

53
Q

what structure(s) exit the cranium via the foramen magnum?

A

vertebral arteries

ant/post spinal arteries

spinal cord

54
Q

what structure(s) exit the cranium via the jugular foramen?

A

CN IX
CN X
CN XI

55
Q

which bones form the cranial roof/clavarium

A
  • frontal
  • occipital
  • 2 parietal
56
Q

what are the 14 facial bones?

A

pairs:
- zygomatic
- lacrimal
- nasal
- Inferior nasal conchae
- palatine
- maxilla

singular:
- vomer
- mandible

57
Q

what do the zygomatic bones form on the face?

A
  • cheek bones
58
Q

what do the lacrimal bones form on the face?

A
  • medial wall of the orbit

- smallest facial bones

59
Q

what do the palatine bones form on the face?

A
  • at rear oral cavity

- forms part of hard palate

60
Q

what do the maxilla bones form on the face?

A
  • upper jaw

- hard palate

61
Q

what does the vomer bone form on the face?

A
  • posterior aspect of the nasal septum.
62
Q

what does the mandible bone form on the face?

A
  • jaw
63
Q

in what nervous system are the cranial nerves part of?

A
  • peripheral nervous system
64
Q

where does CN I and II originate from?

A
  • cerebrum
65
Q

describe the innervation supplied by CN I?

A
  • sensory
  • to nasal cavity receptors
  • for olfaction
66
Q

describe the innervation supplied by CN II?

A
  • sensory
  • to receptors in the retina
  • for vision
67
Q

what are the problems that can arise with CN I? (1)

A
  • anosmia (loss or change of sense of smell)
68
Q

what are the problems that can arise with CN II? (3)

A
  • defects of the visual field
  • defects in colour vision
  • pupillary defects
69
Q

where does CN III originate from?

A
  • the brainstem
  • between the cerebral peduncles of the midbrain
    ie. Midbrain-pontine junction
70
Q

describe the innervation supplied by CN III?

A
  • motor to extra ocular muscles: SR,IR,MR,IO + levator palpebrae superiosis
  • parasympathetic to pupillary sphincter to constrict pupil during accommodation
71
Q

what are the problems that can arise with CN III? (2)

A
  • Ptosis (eye lid droop)

- oculomotor nerve palsy (down+ out eye)

72
Q

where does CN IV originate from?

A
  • from the posterior brainstem
  • attaches just inferior to the inferior colliculus of the midbrain

ONLY POSTERIOR CN

73
Q

describe the innervation supplied by CN IV?

A
  • motor
  • to SO extra ocular muscle
  • looking down and out (depresses and abducts)
74
Q

what are the problems that can arise with CN IV? (1)

A
  • trochlear nerve palsy

- patients often tilt head forward to compensate

75
Q

where does CN V originate from?

A
  • pons (brainstem)

- medial to the middle cerebellar peduncle

76
Q

describe the innervation supplied by CN V1?

A 
ophthalmic
sensation to upper 1/3 face 
- scalp 
- forehead 
- orbit and eyeball 
- nose
77
Q

describe the innervation supplied by CN V2?

A 
maxillary
sensation to middle 1/3 face 
- Cheeks, 
- lower eye lid, 
- nasal mucosa, 
- upper lip, upper teeth and palate
78
Q

describe the innervation supplied by CN V3?

A 
mandibular
sensation to lower 1/3 face
- lower jaw, 
- anterior 2/3 tongue (general sensation) 
- lower face

motor to muscles of mastication (chewing)

79
Q

what are the problems that can arise with CN V?

A
  • stabbing facial pains (trigeminal neuralgia)

- problems with chewing

80
Q

where do CN VI, VII, VIII originate from?

A
  • brainstem

- the Pontine-medulla junction

81
Q

describe the innervation supplied by CN VI?

A
  • motor
  • LR extra ocular muscle
  • abduction of eyeball
82
Q

what are the problems that can arise with CN VI?

A

abducens nerve palsy

  • unposed adduction by MR
  • have diplopia
83
Q

describe the innervation supplied by CN VII?

A 
SENSORY
- ant 2/3 tongue (taste) 
- external ear sensation 
MOTOR 
- muscles of facial expression 
PARASYMPATHETIC
- glands 
(lacrimal submandibular, sublingual salivary, mucous glands of mouth and nose)
84
Q

what are the problems that can arise with CN VII?

A
  • facial nerve palsy
  • can’t smile, blink etc.
  • often one sided
85
Q

describe the innervation supplied by CN VIII?

A

sensory to inner ear

- hearing & balance

86
Q

what are the problems that can arise with CN VIII?

A

hearing loss

87
Q

where do CN IX,X,XI originate from?

A

posterior to the olive of the medulla oblongata

88
Q

describe the innervation supplied by CN IX?

A 
SENSORY
- post 1/3 tongue (touch+taste)
- external ear and middle ear
- carotid sinus 
- most of pharynx 
MOTOR 
- stylopharyngeus muscle of the pharynx  (swallowing, gag reflex) 
PARASYMPATHTIC 
- parotid salivary gland
89
Q

what are the problems that can arise with CN IX?

A
  • difficulty swallowing
  • impairment of taste and sensation over the posterior 1/3 of tongue
  • an absent gag reflex
  • dysfunction of the parotid gland.
90
Q

describe the innervation supplied by CN X?

A 
MOTOR
-  soft palate muscles 
- pharynx muscles 
- larynx muscles 
SENSORY
- skin of ext. acoustic meatus 
-  internal surfaces of larynx & laryngo pharynx 
-  heart (visceral sensation) 
- abdominal organs (visceral sensation) 
- taste to epiglottis and root of tongue  
PARASYMPATHETIC
- smooth muscle of trachea, bronchi, GI tract 
(diminishes bowel movements)
- regulates heart rhythm
91
Q

what are the problems that can arise with CN X?

A
  • hoarse voice (irritated left recurrent laryngeal, which is a branch )
  • difficulty swallowing
  • irregular heart rhythm
  • Uvula deviation away from the affected side
  • loss of gag reflex
92
Q

what are the similarities between CN IX and X?

A

both are involved in taste, pharynx (sensory and motor)

both can cause an absent gag reflex, difficulty swallowing

93
Q

describe the innervation supplied by CN XI?

A

motor to:
- sternocleidomastoid andtrapezius muscles.

(shrug shoulders, move head)

94
Q

what are the problems that can arise with CN XI?

A
  • weakness of trapezius muscles
95
Q

describe the innervation supplied by CN XII?

A
  • motor to extrinsic and intrinsic muscles of the tongue

- except the palatoglossus (soft palate, X)

96
Q

where does CN XII originate from?

A
  • Anterior to the olive of the medulla oblongata

brainstem

97
Q

what are the problems that can arise with CN XII?

A

Hypoglossal nerve palsy

  • sticks out tongue,
  • it deviates or points toward the side that is damaged. T

1 neuro (2 decks)

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