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Year 2 Neuro > 4 - Anatomy of Bloodflow in the CNS and Consequences of Disruption > Flashcards

4 - Anatomy of Bloodflow in the CNS and Consequences of Disruption Flashcards

1
Q

What percentage of cardiac output goes to the brain?

A

10-20%

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2
Q

What percentage of liver glucose does the brain use?

A

66%

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3
Q

State the two main sources of blood supply to the brain?

A 
Vertebral arteries (posteriorly)
Internal carotid arteries (anteriorly)
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4
Q

Generally, what do the external and internal carotids supply?

A

external carotid - supplies the face

internal - Ames its way up tot the skull and supplies the cerebral hemispheres

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5
Q

State the major artery that the vertebral arteries branch off and describe the path of the vertebral arteries to the brain.

A

Subclavian artery
The vertebral arteries pass through the transverse foramina of the cervical vertebrae and through the foramen magnum into the brain

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6
Q

Draw the circle of Willis.

A

DO NOT FORGET the superior cerebellar artery and the anterior inferior cerebellar arteries

(cerebral arteries are the main feed arteries to the brain)

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7
Q

What are the 2 arteries that enter at the the brain posteriorly?

A

vertebral arteries

from the foramen magnum

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8
Q

What artery is formed from the joining o the 2 vertebral arteries?
What does this artery then go to form when it bifurcates?

A

basilar artery

bifurcates to form the posterior cerebral artery

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9
Q

Give the order of venous drainage of blood in the brain?

A

cerebral veins
venous sinuses
dura mater
internal jugular veins

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10
Q

State the names of the venous sinuses that are at the top and bottom of the falx cerebri.

A

Superior sagittal sinus

Inferior sagittal sinus

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11
Q

Which sinus runs along the top between 2 folds of dura?

A

superior sagittal sinus

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12
Q

What is the name given to the place where all the sinuses meet?

A

Confluence of sinuses

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13
Q

What connects the inferior sagittal sinus to the confluence of sinuses?

A

Straight sinus

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14
Q

What vessel does the inferior sagittal sinus join with to form the straight sinus?

A

Great cerebral vein

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15
Q

Which sinus ascends to join the confluence of sinuses?

A

Occipital sinus

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16
Q

Which two sinuses run along the temporal bone?

Superior petrosal sinus

A

Inferior petrosal sinus

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17
Q

Which main sinus drains into the internal jugular vein through the jugular foramen?

A

Sigmoid sinus

18
Q

Which sinus connects the confluence of sinuses to the sigmoid and superior petrosal sinuses?

A

Transverse sinus

19
Q

Which sinus runs along the sphenoid and parietal bones?

A

Sphenoparietal sinus

20
Q

Which sinuses run on either side of the pituitary stalk?

A

Anterior and posterior intercavernous sinuses

21
Q

Which extension of dura mater separates the cerebellum from the inferior portion of the occipital lobe?

A

Tentorium cerebelli

22
Q

Define Stroke.

A

A rapidly developing focal disturbance of brain function of presumed vascular origin that lasts more than 24 hours

23
Q

Define Transient Ischaemic Attack (TIA).

A

A rapidly developing focal disturbance of brain function of presumed vascular origin that resolves completely within 24 hours

24
Q

What percentage of strokes are caused by infarction and what percentage are caused by haemorrhage?

A

85% infarction

15% haemorrhage

25
Q

State two causes of occlusions.

A

Thrombus

Embolus

26
Q

Describe the perfusion fields of the brain.

A

The anterior cerebral artery supplies the medial part of both hemispheres

The middle cerebral artery extends laterally and emerges through the lateral fissure between the frontal and temporal lobes – it supplies the front 2/3 of the lateral part of the hemisphere

The posterior cerebral artery supplies the medial and lateral parts of the posterior part of the hemisphere

27
Q

Describe the location of the leg in the motor and sensory homunculus compared to the arm.

A

Leg is more MEDIAL

28
Q

Describe the features of a disturbance in the anterior cerebral artery.

A

Contralateral hemiplegia in the LEG more than the arm
Disturbance of intellect and executive function
Loss of appropriate social behaviour

29
Q

Describe the features of a disturbance in the middle cerebral artery.

A

This is a CLASSIC STROKE
Contralateral hemiplegia in the ARM more than the leg
Contralateral hemisensory deficits
Hemianopia
Aphasia (can’t speak) – left-sided lesion of the middle cerebral artery will result in aphasia because the language centres are more on the left side than the right

30
Q

Describe the features of a disturbance in the posterior cerebral artery.

A

The posterior cerebral artery supplies the occipital lobe, which is where the primary visual cortex is located
This causes visual defects such as homonymous hemianopia and visual agnosia (unable to recognise what you are seeing)

31
Q

Which parts of the brain are involved in speech and understanding language?

A

Broca’s area – speech

Wernicke’s area – understanding language

32
Q

What are lacunar infarcts?

A 
Small spaces (lacunae) that appear in the brain due to small vessel occlusion 
The clinical deficit is dependent on the location of the small vessel occlusion 
Hypertension can cause lacunar infarcts
33
Q

State the four types of haemorrhagic stroke and their likely causes.

A

Extradural – rapid onset – caused by trauma
Subdural – slow onset – caused by trauma
Subarachnoid – usually caused by ruptures aneurysms
Intracerebral – usually due to spontaneous hypertensive rupture of small vessels

34
Q

What is the difference between the dura in the vertebral column compared to the brain?

A

The dura in the vertebral column has ONE layer whereas the dura in the skull has TWO layers

35
Q

What are the two layers of dura in the skull called?

A

Periosteal and Meningeal

36
Q

What are the arachnoid granulations?

A

projections of the arachnoid membrane into the dural sinuses that allow CSF entrance from the subarachnoid space into the venous system

37
Q

What are emissary veins?

Why are they important?

A

veins that connect the extracranial venous system with the intracranial venous sinuses
They connect the veins outside the cranium to the venous sinuses inside the cranium.
i.e. they pass through the top of the skull

they are important because they are another route of infection. infection of the scalp can spread through these veins and cause meningitis

38
Q

Does subdural and extradural space exist?

A

extradural space does not exist
subdural scape does exist
CSF is in subarachnoid space

39
Q

What is the name given to the fold of dura that extends between the medial surfaces of the two hemispheres?

A

Falx Cerebri

40
Q

Why are extradural haemorrhages more rapid onset than subdural haemorrhages?

A

Extradural haemorrhages are caused by rupture of a meningeal ARTERY (high pressure) whereas subdural haemorrhages are caused by rupture of veins in the skull

Year 2 Neuro (16 decks)

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