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18. Nervous System > 12. Arterial Supply to the Brain > Flashcards

12. Arterial Supply to the Brain Flashcards

1
Q

What is the blood supply of the brain?

A

Anastamoses between internal carotid arteries and vertebral arteries at the circulus arteriosus and circle of Willis.

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2
Q

How does the Circle of Willis provide some redundancy in the blood supply of the brain?

A

Sufficient anastamosis so if one artery is blocked, sufficient blood supply can still reach the area to perfuse it.

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3
Q

What is the course of the ICA?

A

Runs in carotid canal of petrous temporal bone, passes through cavernous sinus, enters middle cranial fossa and divides.

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4
Q

What is the course of the vertebral arteries?

A

Ascend through the transverse foramen in upper 6 cervical vertebrae and enters the posterior cranial fossa via foramen magnum.

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5
Q

What do the anterior cerebral arteries supply?

A

Medial surface of the frontal and parietal lobes, continue to parieto-occipital sulcus to supply leg area of motor and somatosensory cortex.

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6
Q

What do the middle cerebral arteries supply?

A

Lateral surface of the cerebral cortex. Most of the dorsilateral surface, the motor and sensory area of the central sulcus and supplies speech and language areas.

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7
Q

What do the posterior cerebral arteries supply?

A

Inferior surface of the brain and the occipital lobes.

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8
Q

What supplies the pons and adjacent regions of the brain?

A

The pontine arteries.

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9
Q

What is the arterial supply of the cerebellum?

A

Superior cerebral artery, anterior inferior cerebellar artery, and posterior inferior cerebellar artery.

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10
Q

What is the general venous drainage of the brain?

A

Cerebral veins and venous sinuses, drain into internal jugular vein.

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11
Q

Where the external/bridging cerebral veins?

A

In the subarachnoid space.

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12
Q

Where are the internal cerebral veins?

A

Emerge from transverse fissure.

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13
Q

What arteries supplies the spinal cord?

A

Dorsal column supplied by posterior spinal arteries. The rest supplied by anterior spinal artery.

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14
Q

What are the three membrane of the meninges?

A

Dura mater, arachnoid mater, and pia mater.

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15
Q

What are the layers of the dura mater?

A

Bilaminar - periosteal layer and meningeal layer.

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16
Q

What forms the falx cerebri?

A

The meningeal dura mater is infolded between the two hemispheres.

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17
Q

Where does the falx cerebri attach?

A

From crista galli anteriorly to the tentorium cerebelli.

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18
Q

Where is the tentorium cerebelli?

A

Roofs the posterior cranial fossa and separates the cerebellum and the cerebral occipital lobes.

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19
Q

What is the role of the tentorium cerebelli?

A

Vertical reinforcement to the cerebrum and divides the brain into supratentorial and infratentorial regions.

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20
Q

What is the free edge of the tentorium cereblli?

A

Concave anteromedial border that produces the tentorial notch.

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21
Q

What does the brainstem extend from the posterior to middle cranial fossa through?

A

The tentorial notch.

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22
Q

What is the arterial supply to the dura mater?

A

Mainly middle meningeal artery.

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23
Q

What is the venous drainage of the dura mater?

A

Emissary veins, dural venous sinuses.

24
Q

Describe the arachnoid mater.

A

Delicate impermeable, avascular membrane bridging the sulci and fissures pressed against the inner surface of the dura by CSF pressure.

25
Q

What is the innermost fibrous layer of the meninges?

A

Pia mater.

26
Q

Describe the pia mater.

A

Innermost fibrous layer, tightly clings to contours of the brain, impermeable to fluids.

27
Q

What makes up the leptomeninges?

A

Pia and arachnoid mater.

28
Q

Where is the subarachnoid space?

A

Between the pia and arachnoid mater.

29
Q

What does the subarachnoid space contain?

A

CSF, cerebral arteries and veins.

30
Q

What bridges the subarachnoid space?

A

Trabeculae.

31
Q

What are arachnoid granulations?

A

Collections of arachnoid villi that protrude through meningeal layer of the dura mater into dural venous sinuses.

32
Q

What is the role of arachnoid granulations?

A

Allow reabsorption of CSF into venous circulation from subarachnoid space.

33
Q

What is the dural sac?

A

Long tubular sheath of dura mater that runs within the vertebral canal from the foramen magnum to below the conus medullaries.

34
Q

What anchors the dural sac in position?

A

Filum terminale.

35
Q

What is the lumbar cisterna?

A

Enlargement of the dural sac caudal to the conus medullaris.

36
Q

What separates the spina dura mater from the periosteum and ligaments that form the vertebral canal?

A

Epidural space.

37
Q

Where does the epidural space run from and to?

A

The length of the vertebral canal to lateral at the IV formaina.

38
Q

What is samples in lumbar punctures?

A

Subarachnoid space’s CSF fluid.

39
Q

What is a lumbar puncture used for?

A

Diagnosis of CNS disorders.

40
Q

Where is a lumber puncture taken?

A

Between L3 and L4 vertebrae, through supraspinous ligament, ligamentum flavum, then punctures dura mater and arachnoid mater to enter lumber cisterm.

41
Q

How is epidural anaesthesia administered?

A

Agent into epidural space to bathe nerve roots.

42
Q

What secretes CSF?

A

Choroid plexus cells that line the ventricles.

43
Q

What is the movement of CSF through the ventricles?

A

Lateral ventricles to the third ventricle via the foramina of Monro. Third to fourth ventricle via the cerebral aqueduct. Fourth ventricle to subarachnoid space via foramen of Luschka/median aperture or cistern magna via foramen of Magendie/lateral aperture.

44
Q

Where does the CSF travel once in the subarachnoid space?

A

Rostrally over the cerebral hemispheres to enter arachnoid villi. Flows into dural venous sinuses.

45
Q

What is the contents of CSF?

A

Less protein than normal blood serum, slightly less glucose, Ca2+, K+ and slightly more Na+, Cl-, Mg2+.

46
Q

What are the functions of CSF?

A

Buoyant effect on brain and spinal cord so they float, cushioning effects for CNS to dampen effect of trauma, removes metabolites for CSF, stable ionic environment for CNS.

47
Q

What is hydrocephalus?

A

Increase in CSF volume within ventricular system.

48
Q

What causes hydrocephalus?

A

Blocked CSF circulation or absorption.

49
Q

What are the results of hydrocephalus?

A

Increased ventricular pressure and ventricular dilation. Compression on adjacent neural tissue.

50
Q

What are the two types of hydrocephalus?

A

Non-communicating (obstructive), and communicating (non-obstructive) hydrocephalus.

51
Q

What is non-communicating hydrocephalus?

A

Movement of CSF out of ventricular system impeded so it can’t enter subarachnoid space.

52
Q

What can cause non-communicating hydrocephalus?

A

Tumour or Dandy-Walker syndrome.

53
Q

What is communicating hydrocephalus?

A

Reabsorption of CSF into dural venous sinuses is impeded due to functional impairment at the arachnoid villus.

54
Q

What can cause communicating hydrocephalus?

A

Haemorrhage or meningitis.

55
Q

How can the two types of hydrocephalus be distinguished from each other?

A

Tracer dye injected into lateral ventricle. If dye appears in spinal tract, it’s communicating. If it doesn’t, then non-communicating

18. Nervous System (17 decks)

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