3- Clinical Neuroanatomy Flashcards
Pt presents s/p head trauma. Hx reveals he initially “seemed okay” (lucid interval) but has since rapidly deteriorated. What brain injury should you be concerned for and what might you note on CT w/o contrast?
Epidural hematoma affecting middle meningeal artery (fast + dangerous)
CT = lens shape
Pt presents w/ hx of non-direct head trauma (ex whiplash). Reports HA, confusion, speech problems, and drowsiness over the next 2-3 weeks following injury. CT w/o contrast reveals a cresent shape. What are you concerned for?
Subdural hematoma affecting bridging veins (slow bleed- venous)
Pt presents with sudden onset HA described as “worst HA of life”. On exam pt rapidly deteriorates and becomes comatose. What are you concerned for?
Subarachnoid hemorrhage, aneurysm (fast bleed)
Pt presents w/ neural complaint. CT w/o contrast shows “crab of death”. What are you concerned for?
Subarachnoid hemorrhage, aneurysm
CT showing effacement of ventricles is commonly due to what?
Mass effect
CT showing enlarged temporal horns is indicative of what?
Blocking of ventricles/ buildup of CSF
What provides the anterior blood supply to the brain?
Carotids
(R from brachiocephalic/ aorta, L from aorta)
What provides the posterior blood supply of the brain?
Vertebral arteries
(join to form basilar arteries, arise from subclavian arteries)
What connects both the anterior + posterior AND L + R blood circulations of the brain?
Circle of Willis
(compensatory capabilites)
Pt presents with ophthalmoplegia (eye movement paralysis, CN III, IV, VI) or decreased facial sensation (CN V1/V2). You are concerned for a lesion/ pathology in what part of the brain?
Cavernous sinus
Pt presents with eye pain and double vision. On PE you note an orbital bruit. Other PE findings may include: proptosis, chemosis, extra-ocular movement paralysis, and decreased facial sensation. What are you concerned for?
Carotid- cavernous fistula
How might a deficit in the anterior cerebral artery (ACA) present?
LE manifestation
Pt presents with deficits to face/ arm > leg (MCA) OR leg > face/ arm (ACA). You should be concerned for a lesion where?
UMN- cortical lesion
Pt presents with equal deficits to face, arm and leg. You should be concerned for a lesion where?
UMN- subcortical lesion
The center of the cerebellum is responsible for coordination where?
Head and trunk
The lateral portion of the cerebellum is responsible for coordination where?
Extremities
CNs II-XII have what type of innervation?
Ipsilateral (same side)
What CNs originate from the midbrain?
II, III, IV
What CNs originate from the pons?
V, VI, VII
What CNs originate from the junction of the pons and medulla?
VIII