Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro Exam 2 > 3. Blood supply, hemorrhage & herniation > Flashcards

3. Blood supply, hemorrhage & herniation Flashcards

1
Q

What are the parts of the internal carotid A? & what are their characteristics

A
  1. Cervical: bifurcation to carotid canal
  2. Petrous: carotid canal in petrous part of temporal B
  3. Cavernous: in cavernous sinus, surrounded by sym plexus (CN 3, 4, V1, 6)
  4. Cerebral part
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the parts of the Vertebral A & what are the respective characteristics?

A
  1. Cervical part: transverse foramina of C1-C6
  2. Atlantic part: lay on C1 - pass dura/arachnoid & pass thru foramen magnum
  3. Intracranial part: cranium, unite at caudal border of pons to form basilar A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is vertebral insufficency & what causes it?

A

reduced blood flow from vertebral A to brain (2 possible ways)

  1. extreme hyperextension of head: compress vertebral A btn C1 & occipital bone
  2. extreme rotation of head (Bow Hunters syndrome): torsion and narrowing of vessel as you turn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when will the subclavian A “steal” blood from the vertebral A

A

occlusion of subclavian A proximal to vertebal A

= Subclavian Steel Syndrome

instead of blood flowing up after the 2 vertebral As converging, it goes back down to feed into the subclavian A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the relationships of CNs & the Circle of Willis?

A
  • CN II - near ICA & Anterior Communication A
  • CN III - inbtn Posterior Cerebral A, Superior Cerebellar A & close to Posterior Communicating A
  • CN V: sup cerebellar A
  • CN VI - near labyrinthine & AICA (Ant Inf. Cerebellar A)
  • CN VII: AICA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the characterisitics of the Circle of Willis?

A

= ring of 9 As that supply the cerebral hemisphere ( 6 large As anastomose via 3 small As)

= 2 Ant. Cerebral As, 2 Post. Cerebral A & 2 Internal Carotid As

=via 1 Ant. Communicating A & 2 Post. Communicating As

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does the Anterior Cerebral A (ACA) supply?

A

most of the medial & superior surface of the frontal & parietal lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does the Middle Cerebral A (MCA) supply?

A

lateral surface of the frontal & parietal lobes

and superior part of the temporal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Wht does the Posterior Cerebral A (PCA) supply

A

occipital lobe and inferior temporal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How are cerebral As susceptible to damage?

A

at border zones: btn As = area where terminal branches reside

damage when –> sudden systemic hypotension or hypoperfusion

anterior border zone - motor/sensory/language/behavior probs

posterior border zone - visual/language probs

*RMR brain has poor anastomoses*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the names of the segments of the ACA?

A
  1. Precommunicating: ICA to AcomA (anterior communicating A)
  2. Infracallosal: AcomA to the jxn of rostrum & genu of corpus callosum (below corpus callosum)
  3. Precallosal: arch around genu
  4. Supracallosal: superior to corpus callosum
  5. Postcallosal: caudal to corpus callosum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the segments of the MCA?

A
  1. Sphenoidal/horizontal: ICA to bifurcation at insula
    1. –> Lenticulostriate A comes off of M1
  2. Insular: in front of insula (circular sulcus of insula)
  3. Opercular: operculum area (external surface of lateral fissure)
  4. Cortical: on cortex - thru lateral sulcus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the segments of the PCA?

A
  1. Basilar bifurcation to PcomA (posterior communicating A)
  2. PcomA to around midbrain
  3. Quadrigeminal: w/i quadrigeminal cistern (*location of superior & inferior colliculi*)
  4. Cortical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What space is btn the cranium and periosteal dura

A

Epidural (extradural space) = potential!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What space is at the dura-arachnoid interface?

A

Subdural = potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the “real space” btn the meninges? What does it contain

A

Subarachnoid space: btn arachnoid & pia

contains CSF, Circle of Willis & Vs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What type of hemorrhage has MCA as the source?

A

Intracerebral (subpial) hemmorrhage

  • 2-3% of all head injuries
    clinical: HTN or degenerative arterial disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the causes of Herniation syndromes?

A

Hemorrhage

Mass/tumor

Trauma

Abscess

Infection

Metabolic conditions

=overall increased ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the divisions of herniation syndromes?

A
  1. Supratentorial compartment: divided into right/left by falx cerebri
  2. Infratentorial compartment: below tentorium cerebelli
  3. Tentorial Notch: continuation of supra & infratentorial compartment

(supra / infratentorial compartment seperated by tentorium cerebelli)

20
Q

What are the characteristics of Subfalcine Herniation

A

(AKA cingulate/falcine/falx herniation)

= Supratentorial compartment - f_alx cerebri shifted bc of mass & then displace brain tissue underneath_

  • May compress ACA (frontal/parietal lobes) => lower limb probs, both motor & sensory
  • May turn into transtentorial herniation
21
Q

What are the characteristics of transtentorial herniation?

A

(AKA central herniation)

=brain displaced down toward tentorial notch bc increased pressure in supratentorial compartment

-hurts upper brainstem, CN III & maybe lower structures (& maybe basilar A and PCA)

(CN III compromised = parasym fibers not working –> dilated eyes bc cant constirct)

Decorticate/Decerebrate rigidity

22
Q

What can the Uncal Herniation Impinge?

A

Impinge midbrain

-uncus & parts of parahippocampal gyrus extend over edge of tentorium cerebelli & thru tentorial notch

23
Q

Which herniation compressed the medulla and the upper cervical sp. cord?

A

Tonsillar Herniation

  • cerebellar tonsils thru foramen magnum
  • medulla contains cardio & resp centers –> damage = dont breath & no heart rate
24
Q

What comes off of ICA

A

ACA, MCA & PComA

25
Q

what comes off MCA

A

lenticulostriate A & ant. choroidal A

MCA is NOT apart of circle of willis!!!

26
Q

What comes off of basilar A

A

AICA,

Labyrinthine A,

Superior Cerebellar A

& PCA

27
Q

what comes off the vertebal A

A
  • anterior spinal A (supply sp. cord & medulla)
  • PICA (give off posterior spinal A & supply sp cord & medulla)
28
Q

where is CN II located & how can it be injured

A

close to ICA, ACA & AcomA

-aneurysm of any of these = compression –> visual defects

29
Q

where is CN III located & how can it be injured

A

btn PCA & superior cerebellar A

close to PComA

-aneurysm in any of these –> compress –> oculomotor palsy

30
Q

Where is CN V located & how can it be injured

A

close to superior cerebellar A

-if aberrant loops –> irritate N –> trigeminal neuralgia

31
Q

Where is CN VI located and how can it be injured

A

btn labyrinthine A & AICA

-aneurysm of either of these –> compression–> abducens N palsy

32
Q

where is CN VII located & how can you injure it

A

close to AICA

-aberrant loops –> compress –> all facial N defects

33
Q

what A’s supply the medulla

A

Ant. spinal A (medial)

Post. spinal A (dorsal)

PICA (lateral)

AICA (cochlear nuclei)

vertebral A & paramedian branches basilar A (upper medulla, medial)

34
Q

what is supplies the medial medulla

A

ant. spinal a

= hypoglossal nucleus, medial lemniscus, pyramid

35
Q

What supplies to lateral medulla

A

PICA

36
Q

what As supply the Pons

A

branches of basilar A

-paramedian branch = medial

long circumferential branch = lateral

37
Q

what supplies the medial pons?

A

paramedian branch of the basilar A

38
Q

what supplies the lateral pons?

A

long circumferential branches of the basilar A

39
Q

what As supply the midbrain?

A

many of the As from PCA

P1 (paramedian branch) = medial

P3 (quadrigeminal branch) = lateral

40
Q

what supplies the medial midbrain

A

P1 segment of PCA

41
Q

What As supply the forebrain? (3 big ones mentioned in class)

A
  1. thalamogeniculate branches of PCA ==> lateral/medial geniculate nucleus
  2. lenticulostriate As & anterior choroidal A ==> internal capsule
42
Q

what is the blood supply to the spinal cord

A
  • (2) posterior spinal As- dorsal (posterior) columns & corticospinal tract
  • Anterior spinal A –> sulcal A - doral/ventral horns & corticospinal tract
43
Q

In epidural hematomas:

  1. you are bleeding into ______
  2. the common site of injury is ______ & the source of bleed is _______
  3. you feel ___________
  4. the CT shows _______
A
  1. bleeding into epidural space (potential space) btn skull & dura
  2. common site = pterion &/or squamous part of temporal B & source = middle meningeal A
  3. you feel poorly/unconscious for a little bit –> then feel better –> then rapid decline
  4. CT shows lens shape

treat: surgically

44
Q

Which hematoma is a result of venous bleeds?

A

Subdural Hematomas

Source: venous blood; cortical Vs like BRIDGING Vs that open up into superior sagittal sinus

  1. bleed btn dura & arachnoid
  2. due to head strike, fall, car accident
  3. causes a slow accumulation of blood b/c of pressure; self limiting (may occur after lumbar puncture)
  4. CT = crescent
45
Q

What are the clinical signs & source of bleeding for subarachnoid hemorrhages

A

clinical signs “worst headache ever” ; deteriorating levels of consciousness (CT = spider like)

source = ARTERIAL blood - circle of willis (commonly with rupture of aneurysm)

46
Q

what are the two possible ways uncal herniations can be a problem

A
  1. damage cerebral pedencle & CN III on same side –> CN III prob same side and motor deficit opp side
  2. Kernoham phenomenon: herniation shifts midbrain & affects CN III on side of herniation but also cerebral peduncle on OPP side of herniatio –> CN III & motor deficit on SAME SIDE!
47
Q

What is a Subpail hemorrhage

A

aka intracerebral/ intraparanchymal/ hemorragic stroke

= bleeding w/i brain tissue (stroke)

Source: MCA

risk factors: HTN, degnerative arterial disease, genetics, smoking

Neuro Exam 2 (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions