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PBL Spring 2015 - Block 2 > NEURO 5 > Flashcards

NEURO 5 Flashcards

(70 cards)

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1
Q

Cervicomedullary junction

A

occurs at level of foramen magnum, where spinal cord meets medulla

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2
Q

anterior fossa

A

contains frontal lobe, seperated by lesser wing of sphenoid

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3
Q

middle fossa

A

contains temporal lobe separated by petrous ridgee and sheet of meninges

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4
Q

posterior fossa

A

contains cerebellum and brainstem

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5
Q

SCALP

A 
skin
CT
aponeurotica
loose CT
pericranium = periosteum
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6
Q

2 fibrous layers of dura

A

periosteal - inner surface of skull

meningeal layer - inner layer

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7
Q

Falx cerebri

A

sheet of dura from roof of cranium that seperates Right and left

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8
Q

tentorium cerebelli

A

covers upper surface of cerebellum

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9
Q

Midbrain passes through tentorium cerebelli via

A

tentorial incisura/notch

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10
Q

epidural space

A

potential space located between inner surface of skull and tightly adherent dura

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11
Q

Middle meningeal artery enters skull through

A

foramen spinosum

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12
Q

middle meningeal artery is branch of

A

external carotid

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13
Q

middle cerebral artery is branch of

A

internal carotid

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14
Q

subdural space

A

potential space between dura and arachnoid

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15
Q

Bridging veins transverse which space

A

subdural

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16
Q

subarachnoid space

A

CSF filled space between arachnoid and pia

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17
Q

dural sinuses drain

A

sigmoid sinuses to internal jugular veins

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18
Q

Frontal horn of lateral ventrical begins

A

foramen of monro

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19
Q

location of lateral ventricles

A

within the cerebral hemisphere

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20
Q

Atrium of lateral ventricle

A

at convergence w/ occipital horn, temporal horn and lateral ventricle

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21
Q

Third ventricle location

A

thalamus and hypothalamus

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22
Q

Fourth ventricle location

A

pons, medulla, cerebellum

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23
Q

How does the third ventricle communciate w/ fourth ventricle

A

cerebral aqueduct = aqueduct of sylvius

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24
Q

2 foramina CSF levels through

A

lateral foramina of Luschka

midlien foramen of Magendie

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25
CSF is reabsorbed by
arachnoid granulations, arachnoid villus cells mediate one-way bulk transport
26
normal total volume of CSF
150 cc
27
how fast is CSF produced
20 cc/hours | 150 cc/day
28
ambient cistern
lateral to midbrain
29
quadrigeminal cistern
posterior to midbrain
30
interpeduncular cistern
ventral surface of midbrain
31
3rd nerve exits midbrain through
interpeduncular fossa/cistern
32
prepontine cistern
ventral to pons
33
what is contained within prepontine cistern
basilar artery and 6th nerve
34
cistern magna
cerebellomedullary, largest located beneath cerebellum near foramen magnum
35
lumbar cistern
contains cauda equina, site for lumbar puncture
36
What permeates across BB easily
lipid-soluble substances, O2, CO2
37
Brain is interrupted in specialized regions called
circumventricular organs, allows changes in remaining body to seep through Includes median eminence and neurohypophysis
38
are postrema
paired circumventricular organ, along caudal wall of fourth ventricle in medulla = chemotactic trigger zone
39
pineal
involved in melatonin-related circadian rhythms
40
vasogenic edema
excessive extracellular fluid
41
cytotoxic edema
intracellular fluid accumulation
42
normal intracranial pressure
<15 mm Hg
43
Transtentorial herniation
middle temporal lobe - uncus through tentorial notch blown pupil, hemiplegia, coma blown pupil IL, hemiplegia usually CL
44
Kernohan's phenomenon
occurs in transtentorial herniation, CL corticospinal tract is compressed, causes IL hemiplegia
45
Central herniation
Central downward displacement of brainstem, associated with increased intracranial pressure, pushes on abducens nerve lateral rectus palsy, bilateral uncal herniation
46
Tonsillar herniation
cerebellar tonsils downard through foramen magnum, associated w/ compresseion of medulla = respiratory arrest, blood pressure instability, death
47
Subfalcine herniation
unilateral mass lesion can cause cignulate gyrus to herniate beneath the falx cerebri
48
``` Epidural hematoma Location Cause clinical features Radiologic appearance ```
between dura and skull = potential rupture of middle meningeal artery can be lucid, leads to herniation and death looks like biconvex disc along border
49
``` Subdural hematoma Location Cause clinical features Radiologic appearance ```
potential space between dura and arachnoid rupture of bridging veins Chronic: elderly, vague headaches, cognitive impairment, unsteady gait, focal seizures Acute: high impact forms cresent shaped hematoma
50
Radiologic of acute subdural hematoma
Hyperdense Isodense 1-2 weeks hypodense 3-4 weeks mixed bleeding - occassional bleeding
51
hematocrit effect
subural hematoma w/ mixed density hematoma causing acute blood to settle to the bottom
52
``` Subarachnoid hemorrhage Location Cause clinical features Radiologic appearance ```
CSF space between arachnoid and pia non traumatic: worst headache of my life, rupture of aneurysm or AVM, includes saccular/berry aneurysms PComm aneurysm can cause third nerve palsy normally causes nuchal rigidity, headache, photophobia, impaired consciousness , vasospasm traumatic: severe headaches blood in sulci following contours of pia
53
Mostc ommon locations of berry aneurysms
``` AComm = 30% Pcomm = 25% MCA = 20% vertebrobasilar system = 15% fusiform aneurysm (main vessel itself) ```
54
what should be performed before lumbar puncture
CT, if increased pressure, removal of CSF can increase bleeding
55
when testing for subarachnoid hemorrhage how should CT be performed
without contrast
56
Triple H therapy
for subarachnoid hemorrhage hypertension hypervolemia hemodilution
57
``` Intracerebral or intraparenchymal hemorrhage Location Cause clinical features Radiologic appearance ```
within brain parenchyma traumatic: contusions in temporal or frontal poles nontraumatic: hypertention (most common), brain tumors, secondary hemorrhage, vascular malformations, blood coagulation abnormalitis, infections
58
coup injury
contusion on side of impact
59
contrecoup injury
contusion on opposite side of impact
60
what 2 factors increase chance of hypertensive hemorrhage
lipohyainosis | microaneurysms of Charcot-Bouchard
61
Most common location of hypertensive hemorrhage
basal ganglia, thalaus, cerebellum, pons
62
where does bleeding occur in lobar hemorrhage
occipital, parietal, temporal or frontal lobe
63
most common cause of lobar hemorrhage
amyloid angiopathy
64
cavernomas
abnormally dilated vascular cavities lined by one layer of vascular endothelium
65
Hemorrhage in ___ results in Battle's sign
subcutaneous tissues
66
hemorrhage in ___ results in goose egg = subgaleal hemorrhage
external periosteum and galea aponeurotica
67
CSF for Acute Bacterial meningitis WBC Protein Glucose
increased w/ polymorphonuclear leukocytes increased reduced
68
CSF for Viral+ Aseptic meningitis WBC Protein Glucose
increased w/ lymphocytes increased normal
69
CSF for herpes meningoencephalitis WBC Protein Glucose
increased or decreased, usually lymphocytes increased normal or reduced
70
CSF for tuberculous meningitis WBC Protein Glucose
increased, usually lymphocytes increased reduced

PBL Spring 2015 - Block 2 (11 decks)

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