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Neuroanatomy > General features of Brain, Meninges & Blood supply > Flashcards

General features of Brain, Meninges & Blood supply Flashcards

1
Q

define the following terminology

  1. unilateral/bilateral
  2. afferent/efferent
  3. ipsilateral/contralateral
A
  1. unilateral - 1 hemisphere /bilateral - 2 hemisphere
  2. afferent - ascending signals/projections(coming into the brain) /efferent - descending signals/projections (going away from the brain)
  3. ipsilateral - same hemisphere /contralateral - alternate hemisphere
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2
Q

what is the significance of contralateral brain?

A

it is the alternate hemisphere and controls most of the movements and sensations of the brain but NOT all of them

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3
Q

what is the significance of these fissures?

  1. median long fissure/longitudinal fissure (falx cerebri within)
  2. lateral sulcus
  3. central sulcus
A
  1. median long fissure - divides it into 2 hemisphere
  2. lateral sulcus - divides the frontal and temporal lobe
  3. central sulcus - divides the frontal and parietal lobe
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4
Q

what is gyri and sulci?

A

gryi - hills

sulci - valleys

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5
Q

what does the grey and white matter represent?

A

grey matter - cell bodies

white matter - axons; nerve fibres

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6
Q

in how many ways can the brain be divided?

A
  1. anterior/posterior
  2. dorsal/ventral
  3. rostral/caudal
  4. superior/inferior
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7
Q

what does the anterior and posterior part of brain correspond to? (AR-PC)

A

anterior - rostral

posterior - caudal

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8
Q

what is the function of frontal lobe

  • premotor area
  • precentral gyrus
  • posterior ventrolateral (mainly left)
A
  • involved in motor function, problem solving, spontaneity, memory, language, judgement, personality, impulse control, social and sexual behaviour
  • anterior part/ pre-frontal gyrus - higher cognitive functions and. determination of personality
  • posterior part - motor and premotor area
  • inferior frontal gyrus - broca’s area - imp. for language production and comprehension
  • premotor area - general movements, connections to BG and eye movements
  • precentral gyrus - somatotopically/ topographically organised movement e.g. homunculus brain
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9
Q

what is the function of parietal lobe

  • define the two types and its function
  • supra marginal and angular gyrus
  • inferior post central sulcus
A
  • somatosensory
  • two parietal lobes: dominant and non-dominant
  • dominant lobe (left) - perception, interpretation of sensory info and formation of idea of complex and meaningful response
  • non-dominant lobe (right): visuospatial functions
  • supra marginal and angular gyrus (posterior parietal)- mathematical operations
  • Inferior postcentral sulcus - gustatory (sense of taste)
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10
Q

what is the function of occipital lobe and what does the damage result in?

A
  1. vision - visual information
  2. Damage - partial or complete blindness
  3. Somatotopically arranged
  4. Cortical blindness
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11
Q

what is the function of temporal lobe and what does it consist of?

A
  • primary auditory cortex, hippocampus, amygdala
  • superior temporal gyrus (of left hemisphere): Wernicke’s area - understanding of spoken words
  • lateral sulcus (sylvan fissure) - auditory cortex
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12
Q

why is cerebellum called the largest part of the hindbrain?

A
  • 10% of brain volume

- majority of neutrons (3.6x no. in neocortex)

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13
Q

what is the function of cerebellum? and what does the damage to cerebellum result in?

A
  • function - coordination of movement and balance
  • damage - DANISH
    D - dysdiadocokinesis
    A - ataxia
    N - nystagmus
    I - intention tremor
    S - slurred speech
    H - hypotonia
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14
Q

what is the function of thalamus and basal ganglia?

A
  • Thalamus – filter, relay, independent nuclei (relay station)
  • Basal ganglia – modulator, motor and cognitive pattern generator, ‘chunking’
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15
Q

thalamus and BG are white matter?

True or False

A

False, they are deep grey matter nuclei

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16
Q

what is the primary characteristic of the following

  1. frontal lobe
  2. parietal lobe
  3. temporal lobe
  4. occipital lobe
  5. cerebellum
  6. brainstem
A
  1. frontal lobe - primary motor cortex and pre-frontal cortex
  2. parietal lobe - primary somatosensory cortex and association cortex
  3. temporal lobe - primary auditory cortex, auditory association cortex (WERNICKE’s area), hippocampus and amygdala
  4. occipital lobe - primary visual cortex and visual association cortex
  5. cerebellum - motor control of equilibrium, posture and muscle tones and movement coordination
  6. brainstem - ascending and descending tracts, cranial nerve nuclei and the reticular formation
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17
Q

where are these structures found?

  1. insula
  2. opercula (lips)
A
  1. insula - forms the floor of lateral sulcus

2. opercula - part of the frontal, parietal and temporal that lies over the insula

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18
Q

what is the corpus callosum and its function?

A

there are a large bundle of white matter (fibres, tracts running along) that connect the two hemispheres

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19
Q

where can you find the following?

  1. olfactory tracts
  2. optic nerves/ optic chiasma
  3. mammillary bodies
  4. hypothalamus
  5. crura cerebri of cerebral peduncles
A
  1. olfactory tracts - runs on the inferior surface of the frontal lobe
  2. optic nerves/ optic chiasma - the optic nerves run backwards and medially converging in the midline to form to form ‘optic chiasma’ and then run backwards and laterally to form optic tracts (nerves-> chiasma -> tracts)
  3. mammillary bodies - two round eminences behind the optic chiasma
  4. hypothalamus - behind the optic chiasma up to and including the mammillary bodies
  5. crura cerebri of cerebral peduncles - two large masses of white matter emerging from the back of mammillary body on each side from cerebral hemisphere. they pass backwards coverage at the midline at the upper border of pons
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20
Q

what are the other names for

  1. anterior speech area
  2. posterior speech area
A
  1. anterior speech area - Broca’s area

2. posterior speech area - wernickle’s area

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21
Q

name the cranial meninges

A
  1. pia
  2. archanoid
  3. dura
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22
Q

how many layers does the dura have and name them

A

the dura has two layers

  1. outer endosteal layer - lies inferior of skull
  2. inner meninges layer - completely envelopes the CNS
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23
Q

Mostly the two layers of dura matter is fused

True or False

A

True

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24
Q

describe dural venous sinuses

A
  • the system of communicating blood filled spaces where the dural fold attaches to the skull
  • sinuses connect major cerebral veins to the internal jugular vein to drain out the blood
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25
Q

when is the cranial cavity divided into three areas and what are those areas?

A

mostly the dural folds are fused together however, at times the inner layer separates from the skull to form dural folds which support the subdivisions of the brain and divide the cranial cavity into three area - right and left hemispheres and the posterior cranial fossa

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26
Q

what is subarchanoid cisterns and what does it consist of?

A
  • the space between arachnoid and pia matter when the arachnoid spans over the gyri is called subarachnoid cisterns
  • cisterns -> calcify -> arachnoid granulations
  • it consists of CSF
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27
Q

how to identify the following

  1. foramen of magendie
  2. foramen of luschka
A
  1. foramen of magendie - it is the midline communication b/w the 4th ventricle and subarchanoid space
  2. foramen of luschka - it is the lateral communication b/w the 4th ventricle and subarchanoid space
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28
Q

name the location of these cisterns

  1. cerebellomedullary cistern
  2. pontine cistern
  3. interpenducular cistern
A
  1. cerebellomedullary cistern - lies in the angle formed by the dorsal surface of the medulla and the inferior surface of the cerebellum
  2. pontine cistern - lies in the ventral surface of the pons
  3. interpenducular cistern - consists of circle of willis
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29
Q

is the pia matter visible to naked eye? and what is its main role?

A
  • it is indistinguishable with the naked eye

- it is functionally v. imp because it forms a part of the BBB

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30
Q

what are the different types of haemorrhage? define them

A
  1. extra dural - the space b/w the skull and dura
  2. subdural - the space b/w the dura and arachnoid
  3. subarachnoid - the space b/w the archanoid and pia
  4. intracerebral
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31
Q

where is the haemorrhage in

  1. extra dural
  2. subdural
  3. subarachnoid
A
  1. extra dural - haemorrhage is from the meningeal arteries
  2. subdural - haemorrhage is a result of tears in the bridging veins
  3. subarachnoid - (traumatic sub arachnoid haemorrhage or) after rupture of berry aneurysm; blood surrounds the brain and fills the sulci, mainly near the site of injury/anuerysm
32
Q

when does chronic subdural haemotoma occur?

A

it is a type of subdural haemorrhage that occurs 4-8 weeks following mild/moderate head injury in elderly

33
Q

what are the symptoms of an subarachnoid haemmorhage?

A

sudden severe head ache and high mortality rate!

34
Q

what are the two types of meningitis and its prognosis ?

A
  1. viral meningitis - usually, mild and self limiting

2. bacterial meningitis - requires urgent treatment or will lead to brain damage or death

35
Q

name one symptom which is only associated with bacterial meningitis and not meningitis?

A

the rash is usually associated with bacterial meningitis which is a sign of meningococcal septicaemia (infection in the blood not meninges) and not meningitis

36
Q

what are the differences b/w arteries and veins?

A 
1. Colour 
Arteries - paler 
Veins - Darker 
2. Walls 
Arteries - thick + muscular walls 
Veins - thin + fragile walls 
3. Durability 
Arteries - not torn easily 
veins - easily torn
37
Q
  • what is the blood brain barrier?

- what is its function?

A
  • the physiological barrier b/w circulating blood and brain tissue is called BBB
  • function: prevents the entry of some substances from the circulating blood into the nervous tissue
38
Q

what are 3 main anatomical elements of BBB

A
  1. endothelial cells of capillaries
  2. astrocytic end feet (themselves)
  3. basement membrane which lies in b/w the endothelial cells and astrocytic end feet
39
Q

what is the basement membrane in the BBB formed of?

A

it is formed from the true basement membrane and Pia

40
Q

which two vessels bring the arterial blood to the brain within the skull?

A
  1. internal carotid artery

2. vertebral arteries

41
Q

distinguish internal carotid artery and vertebral arteries on the basis of

  1. blood supply
  2. area the blood is supplied to
A 
1. blood supply 
ICA - 80%
VA - 20%
2. area the blood is supplied to
ICA - anterior and midline cerebrum and diencephalon
VA - posterior cerebrum
42
Q

what is anterior circulation?

A

the cerebral circulation in the anterior and middle cerebral artery is called anterior circulation and it is clinically important

43
Q

what is the role of these arteries?

  1. ICA (internal carotid artery)
  2. anterior cerebral artery
  3. middle cerebral artery
  4. anterior communicating artery
  5. posterior communicating artery
A
  1. ICA (internal carotid artery) - divides into the terminal branches - anterior and middle cerebral artery
  2. anterior cerebral artery - supplies medial aspects of hemisphere + corpus callosum
  3. middle cerebral artery - supplies lateral surface of hemisphere + deep structures of anterior part of cerebral hemisphere via anterior perforating branches
  4. anterior communicating artery - connects the two anterior cerebral arteries + provides anterior perforating branches
  5. posterior communicating artery - connects the ICA and vertebra basilar system via posterior cerebral artery
44
Q

name the largest terminal branch of internal carotid artery

A

middle cerebral artery

45
Q

name the exit points of these arteries

  1. ethmoid artery and vein
  2. ophthalmic artery
  3. superior ophthalmic vein
  4. internal carotid artery
  5. middle meningeal artery
  6. labyrinthine artery
  7. internal jugular vein
  8. vertebral arteries
A
  1. ethmoid artery and vein - ethmoidal foramen
  2. opthalmic artery - optic canal
  3. superior opthalmic vein - SOF
  4. internal carotid artery - foramen lacerum
  5. middle meningeal artery - foramen spinousum
  6. labyrinthine artery - internal acoustic meatus
  7. internal jugular vein - jugular foramen
  8. vertebral arteries - foramen magnum
46
Q

what forms the posterior circulation?

A

vertebral-basilar arteries + their branches and posterior cerebral artery together form the posterior circulation

47
Q

what is the role of circle of willis?

A

it links the anterior and posterior circulations

48
Q

name the arterial branches arising from

  1. vertebral arteries
  2. basilar artery
A
  1. vertebral arteries - posterior inferior cerebellar artery
  2. basilar artery - anterior inferior cerebellar artery + superior cerebellar artery + posterior cerebral artery
49
Q
  1. what is berry aneurysm?
  2. how does it result in haemorrhage and which type of haemorrhage?
  3. where does it commonly occur?
A
  1. it is congenital sac-like out pouching of an intracranial artery
  2. they progressively enlarge until they suddenly rupture resulting in subarachnoid or intracerebral haemorrhage
  3. commonly occurs at the branching points around circle of willis specially the anterior communicating artery (which lies in the subarachanoid space)
50
Q

what are the characteristics of stroke?

A
  • either ischaemic or haemorrhagic (intracerebral or subarchanoid)
  • rapid onset of focal neurological deficit lasts more than 24 hours (TIA resolves with in 24 hours)
  • third most common cause of death
51
Q

how does the cerebral veins differ from other veins in the body?

A

they differ from the rest because they first drain into the dural venous sinuses instead of instead draining back to the heart from the brain

52
Q

where can you find the major venous sinuses?

A

easily identified in attached borders of

  1. falx cerebri
  2. tentorium cerebelli
  3. floor of cranial cavity
53
Q

what are the four main veins and sinuses found?

A
  1. superior anastomotic vein (separates anterior and posterior region in upper part of brain)
  2. inferior anastomotic vein (separates anterior and posterior part in the lower half of brain)
  3. superficial cerebral veins (branches from superior saggital sinus)
  4. superficial middle cerebral veins (runs along the lateral fissure, long thick medial vein separating frontal and temporal)
54
Q

where can you find these sinuses?

  1. superior sagittal sinuses
  2. inferior sagittal sinuses
A
  1. superior sagittal sinuses - at the superior border of falx cerebri
  2. inferior sagittal sinuses - at the inferior margin of falx cerebri
55
Q

where can you find these sinuses?

  1. straight sinus
  2. transverse sinus
  3. signmoid sinus
A
  1. straight sinus - in the midline of tentorium cerebelli
  2. transverse sinus - in the posterior fixed region of tentorium cerebelli; b/w tentorium cerebelli & occipital bone at 90
  3. sigmoid sinus - a deep groove in the mastoid part of temporal bone; S shaped
56
Q

what is the significance of cavernous sinuses?

A
  • it consists of 5 cranial nerves + the internal carotid artery + sphenoid bone
  • as well as its proximity to the pituitary gland
  • altogether, it is is clinically significant
57
Q

what are emissary veins?

why are they important?

A
  • it is the mode of communication b/w intracranial venous sinuses and the veins outside the skull
  • they are important because they could be possible route for infection and inflammation to spread into the cranial cavity from the outside the skull
58
Q

what is venous sinuses thrombosis?
what causes it?
what can it result into?
what are its clinical manifestations?

A
  • it is a blood clot in the dural venous sinuses which drains out blood from the brain
  • causes: clotting disorders, ear infection (septic venous thrombosis) and rare childbirth complication
  • obstruction of venous draining results in cerebral oedema and raised intracranial pressure
  • clinical manifestations: can present as a combination of headache with focal epileptic seizures, motor deficit and deterioration in consciousness
59
Q

where is CSF produced? outline its pathway in the ventricular system

A
  • CSF is produced in the choroid plexus of lateral ventricles
  • Pathway: lateral ventricles -> inter ventricular foramen (of Munroe) -> IIIrd ventricle -> cerebral aqueduct -> IVth ventricle -> foramen of magendie and luschka -> subarachnoid space/ obex into the central canal of SC
60
Q

how does the 4th ventricle communicate with the subarachnoid space?

A

it communicates via the median foramen of magendie and laterally via formina of luschka with the subarachnoid space

61
Q

what cells does the choroid plexus consist of ?

what is the function of choroid plexus?

A
  • ependymal cells

- produces CSF in lateral ventricles

62
Q

what prevents the passage of fluid from extracellular space of chorioid plexus into the ventricle?

A

tight junctions however extracellular fluid can only enter via the. choroidal cells themselves

63
Q

which cells are found in the CSF-brain barrier?

A

ependymal cells

64
Q

what is arachnoid villi and arachnoid granulations ?

A
  • villi: these are tufts of arachnoid matter via which the CSF gets reabsorbed into the venous drainage system
  • granulations: over time with increasing age these villi tend to calcify to form granulations
65
Q

which areas of the dominant lobe in the parietal lobe responsible for language and mathematical operations?

A

supra marginal and angular gyrus, posterior parietal

66
Q

where can you find the falx cerebri?

A

an arched crescent shape of dura lying in the longitudinal fissure b/w the cerebral hemispheres

67
Q

what is a homunculus brain?

A

distorted representation of the human body, based on a neurological “map” of the areas and proportions of the human brain dedicated to processing motor functions, or sensory functions, for different parts of the body

68
Q

what is the function of dura matter?

A
  1. mechanical role - stop the brain from moving around the skull
  2. formation of venous sinuses
69
Q

what is the difference b/w extradural-subdural and subarachnoid-intracerebral haemorrhages?

A

extradural-subdural - usually due to TBI or RTA

subarachnoid-intracerebral - usually due to stroke or vascular events

70
Q

how does a subdural haemorrhage appear on a CT?

A

crescent shaped

71
Q

how can you identify the major cerebral veins that drain to the internal jugular vein?

A
  • can identify them to the attached borders of
    1. falx cerebri - superior and inferior saggiata sinus
    2. tentorium cerebelli - straight, transverse and sigmoid sinus
    3. floor of cranial cavity
72
Q

what is meningitis?

what are its symptoms?

A
  • it is the inflammation of meninges caused by infection

- symptoms: triad of NHP: neck stiffness, headache and photophobia, sometimes, nausea/vomiting and fever

73
Q

what is amaurosis fugax, its cause and its consequnce?

A
  • temporary loss of vision in one eye - like view across one eye
  • cause: part of carotid plaque breaks off and occludes the central retinal artery
    consequences: warning of thrombus of ICA - potential for impending stroke
74
Q

what is the function of the following?

  1. limbic system (Mobe)
  2. hippocampus
  3. amygdala
  4. nucleus accumbens
A
  1. limbic system - emotions, memory, behaviour, olfactory
  2. hippocampus - long term memory formation
  3. amygdala - motivationally significant stimuli: fear and reward
  4. nucleus accumbens - sexual arousal and high experience in recreational drugs
75
Q

how does the limbic system mediate its effect?

A

influences the endocrine system and ANS and is highly connected with the brain pleasure centre - Nucleus accumbens

76
Q

what are the consequences of space occupying lesion?

A
  • herniation in
    1. cingulate (under flax cerebri)
    2. parahippocampal gyrus (tentorial)
    3. cerebellar tonsils (through foramen magnum)

Neuroanatomy (16 decks)

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