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Neuro I > Ventricular System and Blood Vessels > Flashcards

Ventricular System and Blood Vessels Flashcards

0
Q

diffuse axonal shearing

A

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

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1
Q

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

A

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

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2
Q

Contralateral

A

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

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3
Q

ipsilateral

A

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

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4
Q

Modality

A

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.

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5
Q

Somatotopic

A

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

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6
Q

cartoon representation of exaggerated proportions of the cortical map

A

homunclus

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7
Q

nucleus

A

aggregation of neuronal cell bodies in the CNS

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8
Q

ganglion

A

aggregation of neuronal cell bodies in the PNS

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9
Q

cortex

A

sheet like layer of gray matter covering the cerebral hemispheres.

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10
Q

Other names for gray matter

A

body, column, center, lamina

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11
Q

Funiculus

A

white matter

bundle of nerve fibers, nothing in particular

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12
Q

fasciculus

A

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

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13
Q

tract

A

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

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14
Q

Leminiscus

A

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

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

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15
Q

What important things are found in the subarachanoid space

A

CSF and major arteries.

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

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16
Q

Falx herniation

A

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

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17
Q

Epidural hematoma

A

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

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18
Q

tentorial herniation (aka_____)

A

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

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19
Q

subdural hematoma

A

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

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20
Q

Trauma to the midbrain

A

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

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21
Q

in most cases the superior sagittal sinus empties into

A

right tranverse sinus

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22
Q

in most cases the straigh sinus drains directly into

A

left transverse sinus

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23
Q

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

A

cortical ischemia and or necrosis

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24
Q

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

A

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

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25
Q

Papilledema

A

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

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26
Q

Subarachnoid hemorrhage

A

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

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27
Q

what are the two subarachnoid cisterns

A 
cerebellomedullary cistern (cisterna magna) - just above foramen magnum and posterior to the medulla
superior cistern (cisterna ambiens) - located posterior to pineal gland
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28
Q

where is CSF resorbed

A

at arachnoid villi that protrude into the superior saggital sinus

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29
Q

how much csf is prduced each day

A

600-700 ml

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30
Q

arachnoid villi protrude where

A

into the venous lacunea

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31
Q

arachnoid villi have what functional stucture

A

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

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32
Q

What is the pressure of the CSF

A

100-200ml of water

33
Q

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

A

hydrocephalus

34
Q

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

A

glial cells clog the shunt

35
Q

external hydrocephalus is defined as

A

excessive accumulation of CSF in subarachnoid space with

expansion of subarachnoid space that compresses the CSF

36
Q

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

A

Supratentorial external hydrocephalus

infratentorial external hydrocephalus

37
Q

Supratentorial external hydrocephalus is most commonly associated with what

A

senile atrophy of the cortex ie alzheimer’s

38
Q

infratentorial external hydrocephalus is seen in combination with what

A

communicating hydrocephalus

39
Q

Internal hydrocephalus is sometimes called

A

noncommunicating hydrocephalus

40
Q

internal hydrocephalus is due to

A

obstruction completely within the ventricular system

41
Q

internal hydrocephalus results in

A

dilation of the ventricle(s) proximal to the obstruction

42
Q

Communicating hydrocephalus is a combination of

A

infratentorial external hydrocephalus
and
inteernal hydrocephalus

43
Q

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

A

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
Q

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

A

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
Q

The result of communicating hydrocephalus

A

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

46
Q

TX of communicating hydrocephalus

A

shunt inserted into the cerebellomedullary cistern to train excess CSF.

47
Q

In global ischemia, you run the risk of

A

watershed infarction

48
Q

Cerebral attempt at compensation

A

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
Q

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

A

10-20 ml/100 gm tissue/min

50
Q

What is the watershed region/ ischemic penumbra

A

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

51
Q

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

A

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
Q

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

A

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

53
Q

Blood brain barrier is normally absent where

A

pineal body
area postrema
median eminence of the hypothalamus

54
Q

Chemotherapy disrupts

A

the bbb in order to get large molecules in.

55
Q

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

A

asymmetrical and incomplete

56
Q

Rigidity

A

increased resistance to movement in all directions

57
Q

Spasticity

A

increased resistance to passive movement in one direction

58
Q

Anterior choroidal artery

A

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
Q

Penetrating arteries of the ACA supply

A

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

60
Q

cortical branches of the ACA supply

A

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
Q

Penetrating branches of the MCA are called

they supply

A

medial and lateral striate or thalamostriate arteries

internal capsule, corpus striatum and thalamus

62
Q

Cortical branches of the MCA supply

A

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

63
Q

Dominance of hemisphere is established by

A

what side has language function

64
Q

Broca’s aphasia is a language ________ disorder

A

expression disorder

65
Q

Broca’s aphasia

A

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

66
Q

Wernicke’s aphasia is a ______ aphasia

A

receptive

67
Q

wernicke’s aphasia

A

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
Q

arteries that supply the spinal cord

A

anterior spinal artery
posterior spinal arteries
great anterior artery of adamiewicz

69
Q

Central Cord Syndrome

A

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
Q

How are centrla cord syndrome and syringomyelia

A

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
Q

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

A

left intercostal or superior lumbar arteries,

anterior spinal artery

72
Q

great anterior artery of adamkiewicz is the major supply to

A

the inferior two thirds of the spinal cord

73
Q

clinical significance of great anterior artery of adamkiewicz

A

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
Q

All the blood from the brain empties where

A

dural venous sinuses.

75
Q

The ACA supplies what critical cortical area

A

paracentral lobule

76
Q

The MCA supplies what critical cortical areas

A 
primary motor cx
premotor cx
broca's speech area
primary somesthetic cx
primary auditory cx
Wernicke's area
77
Q

The PCA supplies what critical cortical area

A

primary visual cx

78
Q

the ASpA has penetrating branched that supply

A

the central portion of the spinal cord

79
Q

The PSppA has penetrating branches that supply

A

posterior 1/3 of the spinal cord.

Neuro I (30 decks)

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