2 Blood Supply and Ventricular Supply - B Flashcards
(97 cards)
1
Q
what is a cause of median and lateral aperature obstructions
A
arnold-chiari malformation or dandy-walker cyst (CSF buildup in the lateral, 3rd, and 4th ventricles)
2
Q
occlusion in the temporal branches of the middle cerebral a cause
A
inability to localize sounds
3
Q
what do the branches of the parieto-occipital a supply
A
visual association cortex
4
Q
the middle cerebral a (internal carotid branch) suppplies
A
medial and lateral striate/thalamostriate
- internal capsule
- corpus striatum
- thalamus
5
Q
occlusion in the angular artery of the middle cerebral a causes
A
wernicke’s aphasia
- fluent in speech but can’t understand spoken and written comprehension
- circumlocute with inappropriate word choices and new word creations
- receptive language disorder
6
Q
occlusions in the frontal branches of the middle cerebral a can cause
A
broca’s aphagia - understanding speech but unable to recipricolly communicate
7
Q
labyrinthinitis is
A
- atherosclerosis or inflammation of the labyrinthine a resulting in irritation of hte vestibulocochlear apparatus
- disturbs equilibrium and or hearing
8
Q
what is the progression of an epidural hematoma
A
- traumatic event
- unconcious but rapid recovery
- hematoma presses on cerebral hemisphere
- causes uncal herniation
9
Q
the pontine aa are branches off of
A
basilar a
10
Q
what is frequently a cause of vasular insufficiency to globus pallidus and hippocampus in eldery
A
anterior choroidal a
11
Q
what is a cause of obstruction of the cerebral aqueduct
A
midbrain astrocytoma (build up in the lateral and 3rd ventricles)
12
Q
where does the internal cerebral v go
A
- runs next to the parahippocampal gyrus
- receives thalamostriate and anterior septal vv
- drains into the great v of galen and then to the straight sinus
13
Q
how do you treat an epidural hematoma
A
evacuate the hematoma
14
Q
where is the 3rd ventricle
A
between thalami
15
Q
where does the great vein of galen go
A
- runs next to the posterior portion of the corpus callosum
- receives the internal cerebral v and basal v of rosenthal
- drains into straight sinus
16
Q
what are the clinical signs of hydrocephalus in adults
A
increased intracranial pressure
papillaedema
abducens palsy (eye facing medially - lost lateral rectus m)
17
Q
what is responsible for draining blood from the spinal cord
A
baston’s plexus
- located in the epidural space
- empties into intervertebral vv and then segmental vv
18
Q
what does the anterior spinal a supply
A
most of the central gray matter of the cord and the anteromedial portion of white matter
19
Q
what occurs with thrombosis of superior sagittal sinus or right transverse sinus
A
cortical ischemia and or necrosis
20
Q
the cerebral aa run in subarachnoid space and their branches penetrate into brain parenchyma and are surrounded by what
A
virchow robin space and pia mater
21
Q
what do the temporal branches of the posterior cerebellar a supply
A
inferior temporal cortex
22
Q
what type of hydrocephalus is most commonly associated with senile atrophy of the cortex (alzheimers)
A
supratentorial external hydrocephalus
23
Q
the posterior circulation of the brain is handled by
A
vertebral a
- anterior spinal a
- posterior spinal aa
- posterior inferior cerebellar a
basilar a
- anterior inferior cerebellar a
- labyrinthine a
- superior cerebellar a
- posterior cerebal a
24
Q
what connects the 3rd and 4th ventricles
A
cerebral aqueduct
25
what is internal hydrocephalus
noncommunicating type where CSF cannot drain into the subarachnoid space
-results in dilation of ventricles proximal to obstruction
26
why do we find erythrocytes in CSF
subarachnoid hemorrhage
27
what occurs with occlusion of the great v of galen
usually fatal since it drains deep brain
28
occlusion of the posterior inferior cerebellar a causees
lateral medullary syndrome/wallenberg syndrome
29
what is a cause of interventricular foramen obstruction
3rd ventricle choroid plexus ependymoma (backs up into lateral ventricle)
30
how is a subdural hematoma different from a epidural hermatoma
more insidious onset
-can have lethary, seizures, or headaches
31
what causes communicating hydrocephalus
obstruction of the narrow space between the tentorial notch and midbrain
-caused by adhesions in subarachnoid space secondary to:
-- previous inflammation (infantile meningitis)
--cerebral edema
--uncal herniation
32
what do the penetrating branches of the posterior cerebral a supply
- internal capsule
- thalamus
- choroid plexus of the lateral ventricle
- upper midbrain
33
where is the BBB absent
- pineal body
- area postrema
- median eminence of the hypothalamus
34
which AA supply the brain and where do they run
internal carotid and vertebral aa; subarachnoid space and then give off cerebral aa
35
the 2 posterior spinal a branch off of what
vertebral or pica
36
what is hydrocephalus
increase in cerebral mass/size due to CSF
present in:
- ventricular space
- subarachnoid space
- or both
37
what does the anterior choroidal a supply
- choroid plexus of lateral ventricle
- internal capsule
- basal ganglia
- thalamus
- rostral midbrain
38
the posterior inferior cerebellar a supplies
- posterior inferior portion of cerebellum
- posterolateral aspect of the medulla
- choroid plexus of the fourth ventricle
39
what is the difference b/n and epidural hematoma and subdural hematoma
epidural is arterial blood; subdural is venous
40
what is communicating hydrocephalus
combination of infratentorial external hydrocephalus and internal hydrocephalus
41
the anterior inferior cerebellar a is located
in the pontobulbar sulcus
42
what are the symptoms of central cord syndrome
--central necrosis and cavitation of the spinal cord
-sensory and motor deficits to UE\>LE and distal musculature\> proximal
43
what is the major supply to the inferior 2/3 of the spinal cord
great anterior artery of adamkiewicz
44
what does the posterior pericallosal a (of the posterior cerebral a) supply
anastomoses with anterior pericallosal a of the anterior cerebral a
45
what happens when the great anterior artery of adamkiewicz is compromised
ischemic necrosis of spinal chord (partial or complete transection)
46
what allows CSF to go from teh 4th ventricle to the subarachnoid space of the spinal cord
foramen of magendie
47
what does the great anterior artery of adamkiewicz arise from
left inferior intercostal or superior lumbar aa and contributes to the anterior spinal a
48
how do the pontine aa branch to their locations
pie-wedge like
-this is seen also with the necrosis they cause
49
in communicating hydrocephalus, CSF cannot move over brain and be absorbed at arachnoid villi to go into the superior saggital sinus, what does this cause
- hypertropy of ventricles (internal hydrocephalus)
- accumulation of CSF in infratentorial space (external hydrocephalus)
50
what occurs with thrombosis of straight sagittal sinus or left transverse sinus
-ischemia and/or necrosis of deep brain (usually fatal)
51
the anterior cerebral a supplies what
runs next to the olfactory and optic nn and supplies:
- anterior 2/3 of the medial side and supero-lateral portion of the hemisphere
- paracentral lobule region (sensation and motor to LE)
52
where are athe lateral ventricles
between each cerebral hemisphere
53
epidural hematoma is d/t
fracture of the pterion that ruptures the meningeal a
-runs b/n dura mater and skull
54
occlusion of the anterior cerebral a affects what
paracentral lobule region and causes contralateral paresis and/or paraesthesia of leg and foot
55
the posterior cerebral a has what branches
- penetrating branches
- temporal branches
- perieto-occipital a
- calcarine a
- posterior pericallosal a
56
the uncus is a part of what lobe
temporal
57
what occurs with a great vein of galen varice
may compress pineal body and posterior commissure
58
where does the basal v of rosenthal go
- runs next to the cerebral peduncle
- receives middle deep cerebral and anterior cerebral vv
- drains into the great v of galen and then to straight sinuses
59
what does the calcarine a of the posterior cerebral a supply
primary visual cortex
60
uncal herniation is when
uncus hernaites through tentorial notch (opening in tentorium cerebelli)
61
occlusions in the parietal branches of the middle cerebral a cause
interpretive disorders and body neglect
62
what are some symptoms of uncal herniation
unilateral dilating pupil
-CN 3 compression (down and out)
late sx
- contralateral hemiparesis and respiratory compromise
- kernohans notch
63
the superior cerebellar a supplies
- superior lateral portion of cerebellum
- deep cerebellar nuclei
- part of pons and midbrain
64
what are the branches of the middle cerebral a
central a - primary motor and somesthetic cortices
frontal brs - premotor and prefrontal cortices as well as broca's area in dominant hemisphere
parietal brs - association cortex
temporal brs - primary auditory cortex
angular a - supramarginal and angular regions as well as wenicke's area in dominant hemisphere
65
what is tonsilar herniation
acute and rapidly fatal
- cerebellar tonsils herniate through foramen magnum
- compresses medulla and leads to respiratory arrest
66
the anterior inferior cerebellar a supplies
- anterior inferior portion of cerebellum
- superior and middle cerebellar peduncles
- part of brainstem
67
the anterior cerebral a has what branches
- recurrent a of heubner
- anterior communicating a
- cortical branches
---anterior pericallosal a
---callosomarginal a
68
why is the anterior choroidal a prone to thrombosis
long course in subarachnoid space
69
spinal cord trauma may interrupt blood to spinal cord especially if supplied by 2 arterial supplies such as
at C2-3, T1-4, and L1 (at the enlargements)
70
where are the obstruction sites of internal hydrocephalus
interventricular foramen
cerebral aqueduct
medial and lateral aperatures
71
the blood brain barrier is made of what structures
- endothelial cell layer
- basement membrane
- pericyte
- foot processes of astrocytes and oligodendrocytes
72
what are the clinical signs of hydrocephalus in infants and young children
increased intracranial pressure which can enlarge sutures
papilledema
73
what connects the lateral and 3rd ventricle
foramen of monro
74
what can compromise the great anterior artery of adamkiewicz
thoracolumbar fracture or surgical repair of AAA
75
the posterior inferior cerebellar a is a branch of
the vertebral a
76
the labyrinthine a is a branch of
basilar a or off AICA (anterior inferior cerebellar a)
77
what are the symptoms of a falx herniation
- headache
- contralateral leg weakness
- sometimes no clinical symptoms
78
which plexus forms the majority of the csf
lateral and 4th ventricle
79
the pontine aa supply
medial and lateral aspects of the pons
80
what happens with a falx herniation
cingulate gyrus can herniate
81
what is external hydrocephalus
communicating hydrocephalus (too much CSF in the subarachnoid space)
-the ventricles are normal sized
82
what symptoms can occur as a result of a posterior cerebral a occlusion
ischemic necrosis of the primary visual cortex
-causes contralateral homonymous hemianopsia with macular sparing
83
where is the 4th ventricle
between the cerebellum and pons
84
what is kernohans notch
uncal herniation causes pressure on the ipsilateral brain stem
- contralateral limb weakness
- increased pressure pushes brainstem into tenotorium cerebelli
85
the superior cerebellar a is located posterior to
CN 3
86
where does the straight sagittal sinus normally drain to
left transverse sinus
87
what is the main a of the internal ear
labyrinthine a
88
the posterior spinal aa supply
- dorsal roots and about 75% of the posterior columns
- along with radicular aa they supply peripheral margins of the cord
89
what causes central cord syndrome
disruption of blood flow to the anterior spinal a
- caused by:
- thrombosis or hyperextension of the neck
- ischemia of the central region of the cord
90
where does the superior sagittal sinus typically drain to
right transverse sinus
91
what aa make up the circle of willis
92
what makes up the anterior circulation of the brain
internal carotid and branches
- opthalamic a
- anterior choroidal a
- anterior cerebral a
- middle cerebral a
93
what is associated with children and elderly for subdural hematomas
- children - skull fracture
- elderly - fragile blood vessels
94
what makes CSF
ependymal cells of the choroid plexuses
95
where do we pull CSF
L4-5
96
what can cause posterior cerebral a occlusion
thrombosis and uncal herniation
97
what is the anterior inferior cerebellar a close to
CN 6, 7, 8, and the flocculus of the cerebellum
