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PT > PT9111 - Cerebrum, Vasculature and CSF > Flashcards

PT9111 - Cerebrum, Vasculature and CSF Flashcards

1
Q

How long does the brain continue to undergo myelination? Which regions are the last to become myelinated?

A

Until the third decade.
Frontal regions (executive functions).

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2
Q

What percentage of the frontal lobe makes up the cortex? What are its key areas?

A

40%
-Primary motor area
-Premotor area
-Supplementary motor area
-Frontal eye fields
-Broca’s area
-Prefrontal area

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3
Q

What are the four main functions of the frontal lobe?

A

-Movement control (planning and execution)
-Conjugate eye movements
-Speech production (broca’s area)
-Personality

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4
Q

What does Broca’s area do?

A

Processes information from the temporal cortex and writes a script for speech execution passed to primary motor cortex

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5
Q

What are the 5 personality changes associated with frontal lobe damage?

A

-Hypo-emotionality/de-energization
-Executive disturbances
-Disturbed social behaviour
-Emotional dysregulation
-Distress
-Decision making

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6
Q

What are symptoms of frontal lobe lesions?

A

-Hemiplegia (paralysis of one side of the body; contralateral to legion)
-Weakness
-Apraxia (unable to perform learned movements on command)
-Personality disorders
-Aphasia (Broca’s area)

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7
Q

What percentage of the cortex is made of the parietal lobe? What are its key areas?

A

20%.
-Primary somatosensory
-Secondary somatosensory
-Association areas

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8
Q

What are the functions of the parietal lobe?

A

Sensation (from thalamus) and interpreting somatosensory signals
-touch, pressure, vibration, position, temperature
-Integration of sensory information to allow for motor planning, learning, language, spatial recognition, and stereognosis

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9
Q

What are symptoms of parietal lobe lesions?

A

-Loss of sensation
-Sensory apraxia (cannot perceive objects purpose)
-Asomatognosia (denial of existence of body parts)
-Neglect syndrome (failure to recognize the opposite size of the body)

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10
Q

What percent of the cortex is made of the occipital lobe? What are the key areas?

A

15%
-Primary visual area
-Visual association area

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11
Q

What is the function of the occipital lobe?

A

Visual processing and interpretation (send information to other brain regions)

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12
Q

What are symptoms of occipital lobe lesions?

A

Blindness, colourblindness, inability to detect moving objects

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13
Q

What percent of the cortex is made of the temporal lobe? What are its key areas?

A

25%
-Primary auditory area
-Secondary auditory area
-Auditory association areas
-Emotions area
-Memory areas
-Speech (Wernicke’s area)

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14
Q

What are the functions of the temporal lobe?

A

-Translating and processing sounds and tones
-Phonological representation of words
-Semantic retrieval (meaning to words)
-Semantic memory (remembering thought or objectives that are common knowledge
-Visual perception and facial perception
-Declarative memory (remembering things that have happened or have been learned)
-Familiarity

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15
Q

What is the diencephalon? What are its key regions?

A

Division of the forebrain.
-Thalamus, Hypothalamus, Epithalamus, Subthalamus

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16
Q

What is the thalamus? What sensory information pass through it?

A

Two oval collections of nuclei.
All sensory information EXCEPT smell

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17
Q

What are the thalamic subdivisions and what are they responsible for?

A
  1. Medial genticulate nuclei - hearing
  2. Lateral genticulate nuclei - vision
  3. Ventral posterior nuclei - taste and somatic sensations (pressure)
  4. Anterior nucleus - emotions and memory
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18
Q

What is the main function of the diencephalon?

A

Primary relay and processing center for sensory information and autonomic control.

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19
Q

Through which fibers does cortical communication occur?

A

Intracortical fibers, association fibers, commissural fibers, and projection fibers

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20
Q

What do association fibers do?

A

Connect gyri and sulci from lobe to lobe in the same hemisphere (ex. superior longitudinal fasciculus)

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21
Q

What do intracortical fibers do?

A

Connect neurons in a localized area

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22
Q

What do commissural fibers do?

A

Connect homologous areas of the two hemispheres (ex. corpus collosum)

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23
Q

What do projection fibers do?

A

Connect cortex with subcortical nuclei
Corticofugal (efferent)
Corticopetal (afferent)

24
Q

What is lateralization of function in the diencephalon?

A

Contralateral representation of the body in each hemisphere.

Some functions are lateralized to one hemisphere (higher functions, dominant hemisphere - correlates with opposite of dominant hand)

25
Q

T/F: The gray matter receives greater supply than white matter.

A

True

26
Q

What is average cerebral blood flow? What is ischemic?

A

55ml/100g per minute
-Ischemia: 35ml/100g per minute

27
Q

What is the total intracranial blood turnover rate?

A

5-7x per minute

28
Q

Hypoxia and/or hypercarbia result in _____

A

vasodilation

29
Q

Hypocarbia results in _______

A

vasoconstriction

30
Q

What are factors that relate to passing through the BBB?

A

Molecular size, lipid miscibility, degree of ionic dissociation

31
Q

What is the purpose of the anterior communicating artery?

A

Joins the two anterior cerebral arteries and supplies of corpus collosum
-Important source of blood flow if one internal carotid is blocked

32
Q

What is the function of the anterior cerebral artery? What part of the somatotopy is affected?

A

Supplies inferior and medial surface of frontal and parietal lobes.
-Lower extremity (more medial)

33
Q

What is the function of the middle cerebral artery?

A

Supplies most of lateral surface of frontal, parietal, and temporal lobe.

34
Q

What happens if the middle cerebral artery becomes occluded?

A

-Sensorimotor deficits in the contralateral face and upper limb
-global aphasia in dominant hemisphere (receptive and expressive language, auditory and visual comprehension)
-Neglect syndrome

35
Q

What is the function of the posterior inferior cerebellar artery?

A

Supplies large parts of the cerebellum

36
Q

What syndrome results from stroke of the posterior inferior cerebellar artery? What are it’s symptoms?

A

Wallenberg syndrome:
-ipsilateral loss of pain and temperature sensation of the face
-contralateral loss of pain and temperature sensation in the limbs, trunk and neck
-ipsilateral Horner syndrome (drooping eyelid and constricted pupil)
-hoarseness, vertigo, double vision, ipsilateral cerebellar ataxia (coordination and balance impaired), ipsilateral loss of taste

37
Q

What arteries supply the spinal cord?

A

-single anterior spinal artery
-paired posterior spinal arteries
-radicular and segmental branches

38
Q

What does the superior cerebellar artery supply?

A

-Supplies dorsal surface of cerebellum and midbrain

39
Q

What do the pontine arteries supply?

A

Pons

40
Q

What does the anterior inferior cerebellar artery supply?

A

Superior cerebellum and pons

41
Q

What does the posterior cerebral artery supply?

A

The medial/inferior surface of temporal and occipital lobe; small strip on lateral surface occipital lobe
-Supplies the calcarine artery (primary visual area)

42
Q

What symptoms arise if stroke occurs in the posterior cerebral artery?

A

Contralateral homonymous hemianopsia (entire visual field on the opposite side of the stroke is affected)
-If damage occurs in dominant hemisphere, reading and writing are impaired

43
Q

What arteries make up the circle of willis? Where is it located?

A

Anterior communicating, anterior cerebral, internal carotid, posterior communicating, posterior cerebral, basilar
-Located on the ventral surface of the brain

44
Q

What is the purpose of the circle of willis?

A

Insurance policy; vascular shunt

45
Q

Where do the venous sinuses drain into?

A

Sigmoid sinus and then into the internal jugular vein. Then to brachiocephalic veins which merge to form the superior vena cava.

46
Q

What are the three venous sinuses?

A

-Inferior sagittal sinus
-Superior sagittal sinus
-Transverse sinus

47
Q

What happens when a cerebral venous sinus thrombosis occurs?

A

Hemorrhage; caused by bacterial infection or malignancy, pregnancy and oral contraceptives are risk factors

48
Q

Where are the venous sinuses located?

A

Between the periosteal and meningeal layer of the dura mater.

49
Q

What are the three dural folds? What are their function?

A

Provide support to the brain and dural venous sinuses
1. Falx Cerebri (vertical, cerebral)
2. Tentorium Cerebelli (horizontal, cerebellum)
3. Falx Cerebelli (vertical, cerebellar)

50
Q

What is a subarachnoid hemorrhage usually caused by?

A

-Cerebral arteries; often caused by aneurysm rupture

51
Q

What is a subdural hemorrhage usually caused by?

A

Cerebral veins

52
Q

What is an epidural hemorrhage usually caused by?

A

Meningeal vessels running on inside surface of cranium

53
Q

Where is CSF produced, what are its functions, and where is it found?

A

-Produced in cells of the choroid plexus located in lateral third and fourth ventricles
-Acts as a cushion, removes metabolic waste, and maintains a stable ionic environment
-Found in the subarachnoid space

54
Q

How much CSF is produced by the choroid plexus? What is the total volume and what is the turnover rate?

A

-Produces about 500mL per day
-Total volume is 150mL
-Replenished 3-4x/day

55
Q

What is the flow of CSF?

A

Lateral ventricles, interventricular foramen, third ventricle, cerebral aqueduct, fourth ventricle, median/lateral aperture, subarachnoid space around brain and spinal cord, absorbed into dural venous sinuses

56
Q

What is hydrocephalus?

A

-Obstruction of CSF pathway causing stagnation of flow; results in dilation of parts of ventricular system

57
Q

Whats the differences between obstructive and communicating hydrocephalus?

A

Obstructive is within ventricles (congenital malformation, tumor); communicating is outside the ventricles (ex. subarachnoid space; hemorrhage or infection)
Shunt can be inserted

PT (3 decks)

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