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CNRN Certification > Anatomy and Physiology > Flashcards

Anatomy and Physiology Flashcards

1
Q

Which bones of the skull are thickest

A

Frontal and occipital

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2
Q

Which area of the brain is at highest risk for contusion

A

Frontal lobe

Inside of Frontal bone has a rough inner surface

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3
Q

Monroe-Kellie hypothesis

A

Brain 80%
CSF 10%
Blood 10%

No room for expansion

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4
Q

Arachnoid villi

A

Reabsorb CSF from ventricles into sinuses formed by dura mater

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5
Q

Choroid plexus

A

CSF production, in Pia Mater

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6
Q

Cerebral vasospasm

A

Blood in spaces where it shouldn’t be (i.e. in SAH) irritates the brain and surrounding blood vessels, causing severe narrowing of blood vessels and can cause areas of ischemia similar to stroke

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7
Q

Meninges (Spine)

A

Dura mater - thick, nonelastic, covers spinal nerves as they leave spinal canal
Arachnoid mater - Contains CSF
Pia Mater - Vascular, thicker in spine

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8
Q

Cerebral Spinal Fluid

A

Acts as a cushion

Produced by choroid plexus
Absorbed by arachnoid villi
Returned to circulation through venous sinuses

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9
Q

CSF absorption is affected by what

A

Pressure

normal ~20cc/hr

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10
Q

Order of meninges (spine and brain)

A

Dura - outer
Arachnoid - middle
Pia - inner

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11
Q

Dura Mater

A

Nonelastic, thick

Covers spinal nerves as they leave spinal canal

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12
Q

Arachnoid Mater

A

Large blood vessels (supply brain and spine) and CSF in subarachnoid space

Where LPs are done

Contains arachnoid villi

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13
Q

Pia Mater

A

Vascular, adheres to brain, contains choroid plexus

Thin layer, but thicker in spine

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14
Q

White matter

A

Myelinated neurons

Connects gray matter to increase conduction speeds

Majority of the inner parts of brain

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15
Q

Gray matter

A

Cell bodies, synapses
Unmyelinated

Lines the brain

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16
Q

Post-cardiac arrest brain changes

A

Gray matter receives 90% of O2 delivered to brain

Can contribute to poor outcomes with prolonged hypoxemia

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17
Q

Corpus callosum

A

Thick band of nerve fibers that relays information from one side of the brain to the other

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18
Q

Role of corpus callosum in seizures

A

Can contribute to generalized seizures by sharing the seizure impulses from one side of the brain to the other

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19
Q

Broca’s area

A

In frontal lobe, on the dominant side (left in most people)

Expressive aphasia

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20
Q

Frontal lobe perfusion

A

MCA and ACA

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21
Q

Frontal lobe

A

Personality, judgement, inhibition, short term memory, broca’s area

Ends with motor strip

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22
Q

Central sulcus

A

Landmark on CT

Separates frontal lobe and parietal lobe, in between motor (frontal) and sensory (parietal) strips

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23
Q

Parietal lobe

A

Proprioception, spacial perception, sensory interpretation

Begins with sensory strip

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24
Q

Parietal lobe perfusion

A

MCA (medial and lateral portions) and ACA (superior portions)

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25
Q

Which lobe is most epileptic

A

Temporal

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26
Q

Temporal Lobe

A

Long term memory, hearing and sound interpretation, wernicke’s area

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27
Q

Wernicke’s area

A

Receptive aphasia

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28
Q

Temporal perfusion

A

MCA (superior and medial portions) and PCA (inferior and posterior portions, less so)

29
Q

Occipital lobe

A

Visual processing, convergent end points of optic tracts

30
Q

Occipital lobe perfusion

A

PCA

31
Q

Cerebellum

A

Motor coordination, balance

Contains 50% of neurons in brain (gray matter)
Lies in posterior fossa

32
Q

Cerebellar perfusion

A

PICA, AICA, SCA

Off basilar and vertebral arteries

33
Q

Considerations with cerebellar damage

A

Swelling can cause herniation or obstructive hydrocephalus to the 4th ventricle

Damage (e.g., ataxia) will show on the ipsilateral side

34
Q

Basal ganglia

A

Detailed motor coordination
Suppression of unwanted movement (i.e., tremors, parkinson’s)
Contains Substantia Nigra

Deep subcortical tissue (nuclei)

35
Q

Hypertensive strokes affect what areas of the brain most easily

A

Basal ganglia and pons

Small blood vessels can’t withstand the pressure

36
Q

Substantia Nigra

A

Dopamine site

Tissue death can cause Parkinson’s

37
Q

Basal ganglia perfusion

A

Lenticulostriate arteries off the MCA

38
Q

Diencephalon

A

Contains pituitary gland, thalamus, and hypothalamus

39
Q

Thalamus

A

Relays sensation, spacial sense, and motor signals
Regulates consciousness, sleep, and alertness

Damage can cause lethargy and motor/sensory deficits

40
Q

Hypothalamus

A

Controls body temperature, hunger and thirst, fatigue, sleep/circadian cycles, emotions

41
Q

Pituitary Gland

A

Houses and secretes hormones that regulate growth and metabolism

42
Q

Internal Capsule

A

High concentration of sensory and motor functions

Subcortical white matter

Damage won’t see cortical symptoms (e.g., aphasia) only motor and sensory deficits

43
Q

Limbic system

A

Contains hippocampus and amygdala

Primitive behaviors, filter for concentration

Damage can cause inability to create new memories (amnesia, forgetfulness)

44
Q

Brainstem perfusion

A

Basilar artery

45
Q

Brainstem

A

Regulates pulse, BP, breathing

Connects cerebrum with spinal cord

Contains midbrain, pons, medulla

46
Q

Midbrain and associated cranial nerves

A

Movements coordinated with visual input

CN III and IV

47
Q

Pons and associated cranial nerves

A

Arousal, respiratory centers

CN V-VIII

48
Q

Medulla and associated cranial nerves

A

Autonomic function, vasomotor

Relay between brain and spinal cord

CN IX-XII

49
Q

Why does cell death occur so quickly in the brain

A

There are no glucose or oxygen reserves

50
Q

Vertebral arteries supply which vessel in the brain

A

Basilar artery

Posterior brain

51
Q

Internal carotid arteries supply which vessels in the brain

A

ACA/ACOM, MCA, PCA/PCOM

Anterior brain

52
Q

Anterior communicating artery (ACOM)

A

Connects both hemispheres’ ACAs, providing collateral blood flow at top of Circle of Willis

53
Q

Circle of Willis

A

Collateral circulation

Stems from ICA at the base of the brain

54
Q

Who will have the best outcomes when it comes to the need for collateral circulation

A

Older people who have slow growing blockages, giving the brain time to develop more vessels into the Circle of Willis and maintain perfusion

55
Q

Middle Cerebral Artery (MCA)

A

Largest branch off ICA, most likely to be occluded

Supplies majority of frontal lobe, anterior portion of parietal lobe, majory of temporal lobe, Lenticulostriate arteries

56
Q

Anterior Cerebral Artery (ACA)

A

Supplies superior portion of frontal lobe (portion of motor strip that controls lower extremities), medial portion of parietal lobe

57
Q

Blockage of ACA

A

See unilateral leg weakness/feeling “off” (affects personality, LE movement,logical thought)

58
Q

Basilar Artery

A

Forms from the vertebral arteries at the level of the pons

Supplies portions of cerebellum (AICA, SCA), brainstem, pontine perforators

Branches into PCAs

59
Q

Posterior Communicating Artery (PCOM)

A

Connects the PCAs to the ICA as part of the Circle of Willis

60
Q

Pontine Perforators

A

Arteries off the Basilar Artery that supply the pons

61
Q

Posterior Cerebral Artery (PCA)

A

Supplies occipital lobe, inferior and lateral portions of temporal lobes, thalamus, midbrain, visual cortex

62
Q

Cerebral Venous Sinuses

A

In Dura, forms major venous drainage pathways from brain; valveless

Receives blood from brain through cerebral veins AND CSF from subarachnoid space
Empties into jugular veins and into systemic circulation

63
Q

Complications of thrombus in Cerebral Venous Sinuses

A

Venous infarct/hemorrhage; Headache, N/V, seizures

Seen more in younger people, especially with oral contraceptive use

64
Q

Cranial Nerve I

A

Olfactory
Sensory
Sense of smell

65
Q

Cranial Nerve II + how to test

A

Optic
Sensory
Sense of sight (peripheral and central) (info from retina to brain)

Test with visual threat/4 quadrants

66
Q

Cranial Nerve III + how to test

A

Oculomotor
Motor
Pupillary reaction and upward eye movement (midbrain)

Test with pupillary reaction, or if there’s ptosis, lack of upward eye movement

67
Q

Cranial Nerve IV + how to test

A

Trochlear (superior oblique)
Motor
Downward/adduction eye movement (towards nose)

Test with following finger to nose/vertical gaze paresis, complaints of diplopia

68
Q

Cranial Nerve V

A

Trigeminal
Sensory and Motor
Facial sensation and chewing

69
Q

Trigeminal Neuralgia

A

Shockline pain

Affects CN V

CNRN Certification (6 decks)

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