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NE Exam 2 > 14: Ventricular System, SC, Damage To Brain > Flashcards

14: Ventricular System, SC, Damage To Brain Flashcards

1
Q

What causes epidural vs subdural hematoma?

A

Epidural: middle meningeal rupture
Subdural: cerebral bridging veins rupture

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2
Q

What happens in the brain during an epidural hematoma?

A

Midline shift of cerebral hemispheres -> falx and/or uncal herniations

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3
Q

S/S epidural hematoma vs subdural

A

Epidural: initial unconsciousness with rapid recovery, papilledema, lethargy, SZR, HA
Subdural: same as epidural, but can be delayed for days/weeks

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4
Q

What causes subarachnoid hemorrhage

A

Rupture of any major blood vessel in brain

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5
Q

What would lead you to suspect a subarachnoid hemorrhage

A

RBCs in CSF on LP

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6
Q

Two things that can occur Post-SAH

A
  1. Arachnoid villi become clogged -> transient hydrocephalus

2. Hemolyzed RBCs in CSF -> secondary (chemical) meningitis

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7
Q

Two types of uncal herniations

A

Falx (subfalcine), transtentorial

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8
Q

Falx herniation

A

Cerebrum herniates under falx cerebri

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9
Q

Transtentorial herniation

A

Cerebrum herniates through tentorial notch

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10
Q

S/S uncal herniation

A

Progressive decrease in consciousness

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11
Q

What A can be occluded in an uncal herniation, and what can that cause?

A

PCA occlusion -> ischemic necrosis of primary visual cortex -> contralateral homonymous hemianopsia with macular sparing

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12
Q

Tonsillar herniation

A

Mass in posterior cranial fossa -> cerebellar tonsil herniates through foramen magnum

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13
Q

What is compressed in tonsillar herniation

A

Lower medulla, upper cervical SC

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14
Q

What condition can cause tonsillar herniation

A

Arnold-Chiari malformation

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15
Q

Ischemic penumbra

A

Tissue surrounding the core ischemic territory - is too ischemic to function, but is critically viable and can be rescued with stroke therapy

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16
Q

Central cord syndrome: caused by

A

ASpA disruption

17
Q

Central cord syndrome - what happens to the SC?

A

Central necrosis and cavitation, development of a syrinx

18
Q

S/S central cord syndrome, anterior, and posterior

A

Central: abrupt onset neurological S/S with amelioration
Anterior: motor paralysis below lesion, loss of pain and temp
Posterior: loss of proprioception and vibration below lesion

19
Q

What can cause anterior cord syndrome

A

Flexion injuries, injury to ASpA

20
Q

Lining of ventricular system

A

Ependymal cells

21
Q

What separates the two lateral ventricles

A

Septum pellucidum

22
Q

lateral ventricle: anterior horn, body, posterior horn, inferior horn locations

A

Anterior horn: frontal lobe
Body: parietal lobe
Posterior: occipital lobe
Inferior: temporal lobe

23
Q

Third ventricle location

A

Between thalami

24
Q

Fourth ventricle shape

A

Four-sided pyramid

25
Q

Fourth ventricle location

A

Between cerebellum + pons

26
Q

Base and apex of fourth ventricle

A

Base: formed by tegmentum of
Metencephalon
Apex: towards cerebellum

27
Q

Where does the obex lead from the fourth ventricle?

A

A blind-ended central canal

28
Q

What layer of meninges is related to choroid plexus

A

Pia mater

29
Q

Hydrocephalus

A

Increase in cerebral size/mass due to excess CSF in ventricular system, subarachnoid space, or both

30
Q

Clinical signs of hydrocephalus

A

Strabismus (abducens palsy), sundown gaze, papilledema

31
Q

External hydrocephalus

A

Excess CSF in subarachnoid space + enlargement of space due to compression of CNS

32
Q

Two types of external hydrocephalus

A

Supratentorial external and infratentorial external

33
Q

Supratentorial external hydrocephalus is associated with what?

A

Senile atrophy of cortex (ex: Alzheimer’s)

34
Q

Internal hydrocephalus is also called what?

A

Non-communicating hydrocephalus

35
Q

What causes internal hydrocephalus

A

Obstruction somewhere in ventricular system

36
Q

What does internal hydrocephalus cause?

A

Dilation of ventricles proximal to obstruction

37
Q

Communicating hydrocephalus

A

Infratentorial external hydrocephalus + internal hydrocephalus

38
Q

Obstruction in communicating hydrocephalus

A

Obstruction in space between tentorial notch and midbrain, the only communication of CSF from posterior cranial fossa to supratentorial region

39
Q

What happens in communicating hydrocephalus?

A

Hypertrophy of ventricles + accumulation of CSF in infratentorial area

NE Exam 2 (20 decks)

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