Neurology 🧠

Question 1

Middle meninges artery (5M):

Answer 1

1- branch of Maxillary artery
2- enter Middle cranial fossa
3- through foremen spinosuM
4- anastomose with ophthalMic artery ( the direct communication btw ICA and ECA is through ophthalMic from ICA and Middle meningeal from ECA).
5- trauma to the teMporal bone might lead to epidural hg at the temproparietal area as the artery exit the skull through this foremen that is located in the teMporal bone

In trauma if injured due to skull fracture it causes epidural hemorrhage
(Subdural Hg cozied by shearing of bridging veins —> vein is lower lvl than the artery so subdural with vein and epidural with artery.

Question 2

Branches of vertebral artery:

Branches of basilar artery:

Answer 2

Branches of vertebral artery:
V1 (preforaminal): muscular and spinal branches.
V2 (foraminal): muscular and spinal branches + Anterior meningeal artery
V3 (extradural): posterior meningeal artery
V4 (intradural=intracranial): ant spinal + post spinal + medullary branches + PICA

NB: PICA can be raising from extradural segment V3 as normal variant

Branches of basilar artery:
AICA + pontine branches + labyrnethine artery + SCA + PCA

Question 3

Segments of carotid artery

Parts of vertebral artery

Answer 3

Segments of carotid artery:
C1 Cervical 
C2 Petrous
C3 Laceral
C4 Cavernous 
C5 Clinoid
C6 Supraclinoid (ophthalmic)
C7 Communicating

Segments of vertebral artery:
V1 Preforaminal
V2 Foraminal
V3 Extradural
V4 Cranial (intradural)

Question 4

Segments of facial nerve:

Answer 4

F1 Intracranial
F2 Meatal
F3 Labyrnethine
F4 Tympanic (horizontal) seen in the middle ear cavity at the lvl of oval window
F5 Mastoid (vertical)
F6 Extratemporal

Mastoid segment give Chorda tympani that supply the anterior 2/3 of the tongue

Question 5

Limbic system parts:

Answer 5

Mammillary bodies
Fornix
Amygdaloid
Hippocampus (dentate Gyri) gyri NOT nucleus 
Parahippocampus
Hypothalamus
Cingulate Gyri

Question 6

Pituitary gland measurements:

Answer 6

Stalk : 3 mm
AP : 8 mm
Length : 9 mm
TV : 12 mm

Question 7

Brain venous system:

Answer 7

Sinuses:
Superior Sagittal, inferior Sagittal, straight, transverse and sigmoid sinuses.

Superficial cerebral veins:
These veins are very variable. They drain to the nearest
dural sinus – thus the superolateral surface of the hemisphere drains to the superior sagittal sinus and the posteroinferior aspect drains to the transverse sinus These named veins are variably seen:
• The superior anastomotic vein (of Trolard), which runs from the posterior end of the lateral sulcus
posterosuperiorly to the superior sagittal sinus in the
parietal region
•The inferior anastomotic vein (of Labbé), which runs
posteroinferiorly from the posterior end of the lateral
sulcus to the transverse sinus
•The superficial middle cerebral vein, which runs
anteriorly along the lateral sulcus to drain via the sphenoid sinus to the cavernous sinus

Deep cerebral veins:
Several veins unite just behind the interventricular foramen (of Monro) to form the internal cerebral vein The largest are:
•the choroid vein, which runs from the choroid plexus of
the lateral ventricle;
* the septal vein, which runs from the region of the septum pellucidum in the anterior horn of the lateral ventricle;
•the thalamostriate vein, which runs anteriorly in the floor of the lateral ventricle in the thalamostriate groove
between the thalamus and the lentiform nucleus.
The point of union of these veins is called the venous angle, which marks the posterior margin of the interventricular foramen .

The internal cerebral veins of each side run posteriorly in
the roof of the third ventricle and unite beneath the splenium of the corpus callosum to form the great cerebral vein.
The great cerebral vein (of Galen) is a single short (1–2 cm), thick vein that passes posterosuperiorly behind the splenium of the corpus callosum in the quadrigeminal cistern. It receives the basal veins and posterior fossa veins and drains to the anterior end of the straight sinus where this unites with the inferior sagittal sinus.

The basal vein (of Rosenthal) begins at the anterior perfo-rated substance by the union of three veins:
•the anterior cerebral vein, which accompanies the anterior cerebral artery;
•the deep middle cerebral vein from the insula;
•the striate veins from the inferior part of the basal ganglia via the anterior perforated substance.
The basal vein of each side passes around the midbrain to join the great cerebral vein. So it does NOT participate in the formation of great vein of Galen.

Question 8

Jugular foremen:

Answer 8

Divided by jugular spine into:
Pars nervousa:
located anteriomedially.
contain IX CN and inferior Petrosal sinus.

Pars vascularis:
located posteriolateral.
Contain jugular bulb and X and XI CN

Question 9

Venous angle :

Sylvian triangle:

Answer 9

Venous angle formed by:
Thalamostriate + septa the + choroidal veins behind Forman’s of Monro

Sylvian angle formed by:
Branches of McA (the only artery pass at sylvian fissure is the MCA)