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Flashcards in Ventricular System and Blood Vessels Deck (80):
0

Imaginary T shaped axis which defines the way sections are discribed in the brain

neuraxis

vertical componenet extends through central aspect of spinal cord and brainstem to level of diechephalon
horizontal component extends from the frontal to occiptital poles of the cerebral hemispheres on midline

1

diffuse axonal shearing

when brain bumps up agains skull, get contusions, hemorrhaging and diffuse axonal shearing
= when axons pulled away from where they are supposed to be. disconnected from environment

2

Contralateral

refers to sensory or motor deficits occuring on the opposite side of the causative lesion

3

ipsilateral

refers to sensory or motor deficits occuring on the same side as the causative lesion

4

Modality

various sensory stimuli, working in isolation or combination, may elicit a particular form of sensation depending upon the number and type of receptors and teh receptor patterns or fields.

5

Somatotopic

some sensory or motor pathways convey their fibers in a highly organized, laminated fashion as they ascend or descend to dpecific regions of the cortex or body

6

cartoon representation of exaggerated proportions of the cortical map

homunclus

7

nucleus

aggregation of neuronal cell bodies in the CNS

8

ganglion

aggregation of neuronal cell bodies in the PNS

9

cortex

sheet like layer of gray matter covering the cerebral hemispheres.

10

Other names for gray matter

body, column, center, lamina

11

Funiculus

white matter
bundle of nerve fibers, nothing in particular

12

fasciculus

bundle of nerve fibers belonging to a particular system in the CNS
white matter

13

tract

specifically defined fasciculus of nerve fibers that have common origin, termination and function
white matter

14

Leminiscus

bundle of crossed, secondary nerve fibers in a CONSCIOUS SENSORY PATHWAY

(conveys information from the opposite side of the body)
white matter

15

What important things are found in the subarachanoid space

CSF and major arteries.

if you rupture an artery here, you bleed into subarachnoid space, blood present in CSF

16

Falx herniation

with unilateral space-occupying lesions of the cerebrum
herniate across midline beneath free edge of falx
may not present clinical deficits associated with herniation

17

Epidural hematoma

rupture of meningeal vessel
pt post-traumatic history is unconsciousness followed by rapid recovery
after a few hours, increase in supratentorial cranial volume causes herniation
profuse high-pressured bleeding, rapidly extends epidural space.
falx herniation or tentorial herniation
TX - emergency operation to evacuate the hematoma

18

tentorial herniation (aka_____)

uncal herniation
through the tentoial notch
displaces the midbrain, bilateral compression of the midbrain reticular formation results in progressive decrease in the level of consciousness

19

subdural hematoma

head trauma may cause cerebral veins to rupture as the cross subdural space
these veins are vulnerable to sheer forces created between movement of brain versus dura
space occupying hematoma in subdural space
signs and symptoms are same as epidural hematomas, but time onset may be delayed for days or weeks.
progression of signs and symptoms much more insididous. due to slower accumulation
can have acute onset

display various states of lethargy, seizures, or headaches.
inchildren associated with skull fracture, in elderly minor head trauma may result in subdural hematoma due to more fragile blood vessels

20

Trauma to the midbrain

result may be some degree of temporary or permanent coma, depending upon the amount of damage to the midbrain reticular formation.
RF is essential for consciousness

21

in most cases the superior sagittal sinus empties into

right tranverse sinus

22

in most cases the straigh sinus drains directly into

left transverse sinus

23

thrombosis of the posterior portion of the superior venous sinus or right transverse venous sinus results in

cortical ischemia and or necrosis

24

thrombosis of the posterior portion of th straight venous sinus or left tranverse venous sinus results in

ischemia and or necrosis of structures in the deep cerebrum. this is usually fatal.

25

Papilledema

increased ICP applies a cuff-like pressure to small veins on optic nerve, via the adjacent subarachnoid extension.
decreased drainage from retina results in edema of the retina and selling of optic disc

26

Subarachnoid hemorrhage

all major blood vessels of CNS pass through the subarachnoid space. rupture in the space is called subarachnoid hemmorhage, indicated by presence of erythrocytes in CSF.

cerebral contusion may also result in subarachnoid hemorrhage

27

what are the two subarachnoid cisterns

cerebellomedullary cistern (cisterna magna) - just above foramen magnum and posterior to the medulla
superior cistern (cisterna ambiens) - located posterior to pineal gland

28

where is CSF resorbed

at arachnoid villi that protrude into the superior saggital sinus

29

how much csf is prduced each day

600-700 ml

30

arachnoid villi protrude where

into the venous lacunea

31

arachnoid villi have what functional stucture

small, pressure controlled valves, which drain most of the CSF, active and passive trasport

32

What is the pressure of the CSF

100-200ml of water

33

If CSF doesn't get out of the ventricular system, you get

hydrocephalus

34

Can treat hydrocephalus with a shunt. they have to be replaced every so often because why?

glial cells clog the shunt

35

external hydrocephalus is defined as

excessive accumulation of CSF in subarachnoid space with
expansion of subarachnoid space that compresses the CSF

36

External hydrocephalus may be associated with one or both of what kinds of hydrocephalus?

Supratentorial external hydrocephalus
infratentorial external hydrocephalus

37

Supratentorial external hydrocephalus is most commonly associated with what

senile atrophy of the cortex ie alzheimer's

38

infratentorial external hydrocephalus is seen in combination with what

communicating hydrocephalus

39

Internal hydrocephalus is sometimes called

noncommunicating hydrocephalus

40

internal hydrocephalus is due to

obstruction completely within the ventricular system

41

internal hydrocephalus results in

dilation of the ventricle(s) proximal to the obstruction

42

Communicating hydrocephalus is a combination of

infratentorial external hydrocephalus
and
inteernal hydrocephalus

43

in communicating hydrocephalus, obstruction of the subarachnoid space at the level of__________ may prevent the flow of CSF from _________ to ______ regions

the tentorial notch
infratentorial
supratentorial

this space may become obstructed due to adhesions and fibrosis in the subarachnoid spaces from past inflamation, cerebral edema or uncal herniation

44

In communicating hydrocephalus, CSF is free to move throug ________, but it cannot move_____

the ventricular system into the infratentorial subarachnoid space,
but it cannot circulate over the cerebrum to be resorbed at the arachnoid villi adjacent to and in the superior saggital sinus.

45

The result of communicating hydrocephalus

hypertrophy of the ventricles (internal hydrocephalus) and accumulation of CSF in the infratentorial subarachnoid space (external hydrocephalus)

46

TX of communicating hydrocephalus

shunt inserted into the cerebellomedullary cistern to train excess CSF.

47

In global ischemia, you run the risk of

watershed infarction

48

Cerebral attempt at compensation

when one blood vessel doesnt work, another may hyperperfuse
where the arterial "trees" overlap, tissue needs BF from both arteries. One trie dies, and the other must supply MORE blood --> hyperperfusion

49

Ischemic penumbra happens at around what level of regional cerebral blood flow

10-20 ml/100 gm tissue/min

50

What is the watershed region/ ischemic penumbra

following focal ischemia (stroke) the tissue surrounding the core ischemich territory that is too ischemic to function, yet critically viable

51

What is stroke therapy directed at? what is the mechanism?

Stroke therapy is directed at rescuing the ischemic penumbra (watershed region)

by improving tissue acidosis and oxygen delivery
Ca channel and NMDA receptor blocking drugs may prevent further neuronal damager

52

Cerebral blood vessels can autoregulate on a small scale. but what happens when the cerebral blood flow falls too low

autoregulation dysfunction and edema due to ischemic tissue acidosis and resultant "luxury perfusio" of adjacent normal tissue

53

Blood brain barrier is normally absent where

pineal body
area postrema
median eminence of the hypothalamus

54

Chemotherapy disrupts

the bbb in order to get large molecules in.

55

Two adjectives to describe the normal formation of the circle of willis

asymmetrical and incomplete

56

Rigidity

increased resistance to movement in all directions

57

Spasticity

increased resistance to passive movement in one direction

58

Anterior choroidal artery

supplies choroid plexus of lateral ventricle, basal ganglia, internal capsule, thalamus and rostral midbrain.
historical significance in neurosurgery (cooper saw decreased rigidity and tremors contralaterally in parkinson's patients)

59

Penetrating arteries of the ACA supply

internal capsule and the corpus striatum (globus pallidus, putamen and caudate)

60

cortical branches of the ACA supply

anterior 2/3 of the medial side and supero-lateral portion of the hemisphere

right down center of forehead
area that supplies motor to leg and food (contralateral)

61

Penetrating branches of the MCA are called
they supply

medial and lateral striate or thalamostriate arteries
internal capsule, corpus striatum and thalamus

62

Cortical branches of the MCA supply

lateral aspect of the hemisphere
area that supply innervation to arm, forearm, hand, head
broca's and wernicke's areas
auditory

63

Dominance of hemisphere is established by

what side has language function

64

Broca's aphasia is a language ________ disorder

expression disorder

65

Broca's aphasia

nonfluent aphasia
dont talk a lot, swear
motor language disorder
characterized by cryptic, telegraphic speech, frustration in initiation of speech motor patterns

66

Wernicke's aphasia is a ______ aphasia

receptive

67

wernicke's aphasia

receptive language disorder
fluent (talkative)
lack content or meaning in their spoken and written comprehension of language.
inappripriate word choices and neologisms
internal voice just as messed up as your rambling voice

68

arteries that supply the spinal cord

anterior spinal artery
posterior spinal arteries
great anterior artery of adamiewicz

69

Central Cord Syndrome

result of disruption of blood flow to the anterior spinal artery
ischemia of central region of spinal cord
characterized by central necrosis and cavitation of the spinal cord and development of a syrnx

70

How are centrla cord syndrome and syringomyelia

by the onset of the neurological signs and symptoms
CCS has an abrupt onset with some amelioration of s/s
syringomyelia has a slow progressively worsening scenario

71

The great anterior artery of adamkiewicz usually arises from and contributes to

left intercostal or superior lumbar arteries,
anterior spinal artery

72

great anterior artery of adamkiewicz is the major supply to

the inferior two thirds of the spinal cord

73

clinical significance of great anterior artery of adamkiewicz

may be compromised secondary to thoracolumbar fracture or surgical repair of AAA.

can result in pt paralyzed from waist down, no bladder or bowel control

74

All the blood from the brain empties where

dural venous sinuses.

75

The ACA supplies what critical cortical area

paracentral lobule

76

The MCA supplies what critical cortical areas

primary motor cx
premotor cx
broca's speech area
primary somesthetic cx
primary auditory cx
Wernicke's area

77

The PCA supplies what critical cortical area

primary visual cx

78

the ASpA has penetrating branched that supply

the central portion of the spinal cord

79

The PSppA has penetrating branches that supply

posterior 1/3 of the spinal cord.