TEST 1 review

Question 1

Position of 4th ventricle

Answer 1

Posterior to Pons

anterior to cerebellum

Question 2

Choroid Plexus

Answer 2

1) Produce CSF
2) Located
- inferior and body of lateral ventricle
- 3rd
- 4th ventricles

Question 3

CSF

Answer 3

1) Comes from blood (Plasma)
2) Average adult~150 cc of CSF at one time
- Produce 500cc CSF/day
- turned over 3-4 times daily

Question 4

Trigone Area

Answer 4

1) If calcified=Glomus
- calcified choroid plexus
2) 25% of 20+ y.o will have some degree of calcification
3) appears radio-opaque on x-ray

Question 5

Median Aperature

Answer 5

1) Foramen of Magendie
2) Not bilateral
3) empties into cisternal magna
- located at base of occipital bone

Question 6

Lateral Aperature

Answer 6

1) Foramen of lushka
2) Bilatreral
3) empties into pontine cistern

Question 7

Supratentorial Fossa

Answer 7

1) Area above tentorium cerebelli

Question 8

Infratentorial Fossa

Answer 8

area below tentorium cerebelli

Question 9

Leptomeningitis

Answer 9

1) pia mater + arachniod membrane inflamed

2) Bacterial mostly likely to cause

Question 10

Diaphragma Sellae

Answer 10

surrounds pituitary gland

Question 11

Diploic Vein

Answer 11

1) Provides venous drainage between the skull into sinus system

Question 12

Emissary Vein

Answer 12

1) blood between scalp and sinuses-> venous system

Question 13

Scalp Laceration

Answer 13

1) Serious Threat
2) Infection being spread into cranial vault through emissary veins
3) Results in Sepsis

Question 14

Subgaleal Hematoma

Answer 14

1) b/w connective tissue and skull
2) trauma and newborns
3) emissary vein
4) Slow forming
3) heals on own most of time

Question 15

Bridging Vein

Answer 15

1) supplies blood from venous sinuses
2) Causes:
- Increase in age causes decrease in elasticity of bridging veins
- dehydration
3) Subdural Hematoma
- b/w dura and arachnoid

Question 16

Epidural Hematoma

Answer 16

AKA extradural hematoma

1) Location
- b/w skull and dura
2) Cause:
- trauma
3) Meningeal A. rupture
4) Fast forming
5) Very urgent due to Increase ICP

Question 17

Subdural Hematoma

Answer 17

1) Location
- b/w dura and arachnoid membrane
2) Cause:
- trauma in elderly (fall)
3) Cerebral vein/ Bridging vein
4) Slow forming
5) Clincal urgency depends

Question 18

Subarachnoid Hematoma

Answer 18

1) Location
- b/w arachnoid and pia
2) Trauma or ruptured aneurysm
3) Cerebral A.
4) Fast forming
5) EMERGENCY

Question 19

Middle Meningeal Artery

Answer 19

1) Branches of maxillary artery
2) Foramen Spinosum
3) splits and anterior and posterior
- anterior goes through pterion
4) Buried in dura mater
5) Suppliees the Calvaria (dura and bone)

Question 20

What is the most common non trauma subarachnoid hemorrhage?

Answer 20

1) Saccular Aneursym

- Middle cerebral artery

Question 21

Aneurysms

Answer 21

1) Saccular
- occurs at Jxn of blood vessel
- very likely to rupture
2) Fusiform
- unlikley to rupture
3) Rupture can lead to stroke
- Middle Cerebral A.

Question 22

True Aneurysm vs Pseudoaneurysm

Answer 22

1) True-comprises all 3 layers
- Tunica Intima (inner most)
- Tunica Media (middle)
- Tunica Adventia (outer)
2) Pseudo-doesn’t involve all 3 layers
- separation between tunica Media and Tunica Adventitia
- can be painful but don’t rupture
- due to trauma

Question 23

Thalamostriate Vein

Answer 23

1) Lateral Ventricle
2) Drains the contents of lateral ventricle into interventricular foramen
3) Splits to form septal vein and internal cerebral vein

Question 24

Septal Vein

Answer 24

1) Connected to thalamostriate vein

2) not in lateral ventricle

Question 25

What are the 4 arteries that supply the brain

Answer 25

1) L and R vertebral Arteries | 2) L and R internal carotid arteries

Question 26

Anterior Cranial Fossa contains:

Answer 26

1) CN 1 | 2) Part of CN2

Question 27

Middle Cranial Fossa contains:

Answer 27

1) Part of CN2, 5, 6 2) CN 3 and 4 3) Midbrain Diencephalon temporal lobe cavernous sinus internal carotide artery middle cerebral artery

Question 28

Posterior Cranial Fossa

Answer 28

Part of CN 5, 6 | ALL of CN 7-12

Question 29

Lamina Terminalis

Answer 29

1) Rostral wall of 3rd ventricle | - space between thalami

Question 30

Septum pellucidum

Answer 30

1) Forms the medial wall of the anterior horn of lateral ventricles

Question 31

Cavernous Sinus Syndrome

Answer 31

1) Aneursym or space occupying lesion in cavernous sinus 2) ipsilateral paralysis of eye movement (3,4, 6) ipsilateral sensory issues across forehead, nose and cheeks

Question 32

CINE MRI

Answer 32

1) Measures CSF not blood 2) traditional MRI w/wristband or EKG to measure heart rate 3) each time heart beats, CSF forced out of brain->spine 4) Shows CSF as it moves

Question 33

Glasgow Coma Scale

Answer 33

1) Measures motor response(6), verbal response(5), and eye opening (4) 2) add all 3 up - max score =15 - higher number higher functionality

Question 34

CT

Answer 34

Computated Tomography 1) x-ray imaging-tissue density -higher atomic number-greater ability to stop x-rays 2) Hounsfield units (CT numbers) -attenuation intensities 3) Lesion or deficit in CT= hyperdense=White -ex: acute subarachnoid hemorrhage Hypodense=black Isodense- same shade b/w region and brain

Question 35

Advantages and disadvantages of CT

Answer 35

``` Advantages 1) quickly done -important in trauma 2) clearly shows acute and subacture hemorrhages into meningeal spaces and brain 3) Children in trauma cases 4)Show bone- Skull fractures 5( Less expensive than MRI ``` Disadvantages 1) doesn't show: - acute or subacute infarcts - ischemia - brain edema 2) doesn't differentiate white matter from gray matter within brain clearly (VS MRI) 3) Exposed to Ionzing Radiation

Question 36

MRI

Answer 36

Magnetic Resonance Imagine 1) Body tissue has proportionately high amounts of protons 2)Protons-function as tiny magnets + nucleus - negative electron shell -forms N and S poles 3) Radiofrequency pulse of radio waves into patient (protons) -frequency of RP= spinning protons-> proton absorb energy from radio wave -some protons canceled out -magnetic effects and energy increases in some 4) 2 types of MRI-relate to effect of RP on protons -MR1/T1-canceled out protons return to original magnetic strength -MR2/T2-protons at higher levels loser energy more rapid

Question 37

MRI: T1 vs T2 - hyperintense - hypointense - isointense

Answer 37

Hyperintense - T1- shift more towards fat (more white) - T2-shift more toward CSF (white) Hypodense: -T1/T2=darker than air or bone Isotense: T1/T2-same

Question 38

Advantage/disadvantage of MRI

Answer 38

Advantage: 1) visualize a wide variety of abnormalities within brain 2) shows more detail of the brain Disadvantages: 1) Does not show acute or subacute subarachnoid hemorrhage in the substance of the brain 2) Longer to due - not useful in acute or trauma situations - more expensive - scan is loud and may require sedation in children

Question 39

Ischmia

Answer 39

1) to keep blood (occluded arteries) from blood tissue

Question 40

What courses through the internal acoustic meatus?

Answer 40

``` Labyrinthine Artery CN 7 (facial nerve-muscles of facial expression) CN8 (vestibulocochlear-sense of balance) ```

Question 41

Lesion against internal acoustic meatus?

Answer 41

1) balance issues | 2) paralysis of face

Question 42

What courses through jugular foramen?

Answer 42

Internal Jugular Vein CN9-glossopharyngeal CN10-vagus CN11-accessory

Question 43

What three structures course through foramen magnum?

Answer 43

1) Vertebral Artery 2) Spinal Cord 3) Accessory Nerve

Question 44

Respiratory Center in Brainstem

Answer 44

1) Pons/medulla 2) sends axons down spinal cord and synapse on phonic nerves 3) pacemaking of respiratory rate

Question 45

Tonsilar Herniation

Answer 45

1) Space occupying lesion in PCF=Increased ICP - Tonsil of cerebellum herniates through foramen magnum 2) Can disconnect communication b/w respiration center and the neurons of phrenic nerve - patient can't breath=DEATH 3) High cervical trauma

Question 46

Mirror Neurons

Answer 46

1) facilitates teaching of movements - watching others - more efficient in learning motor movements