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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
Which lobe is most epileptic
Temporal
26
Temporal Lobe
Long term memory, hearing and sound interpretation, wernicke's area
27
Wernicke's area
Receptive aphasia
28
Temporal perfusion
MCA (superior and medial portions) and PCA (inferior and posterior portions, less so)
29
Occipital lobe
Visual processing, convergent end points of optic tracts
30
Occipital lobe perfusion
PCA
31
Cerebellum
Motor coordination, balance Contains 50% of neurons in brain (gray matter) Lies in posterior fossa
32
Cerebellar perfusion
PICA, AICA, SCA Off basilar and vertebral arteries
33
Considerations with cerebellar damage
Swelling can cause herniation or obstructive hydrocephalus to the 4th ventricle Damage (e.g., ataxia) will show on the ipsilateral side
34
Basal ganglia
Detailed motor coordination Suppression of unwanted movement (i.e., tremors, parkinson's) Contains Substantia Nigra Deep subcortical tissue (nuclei)
35
Hypertensive strokes affect what areas of the brain most easily
Basal ganglia and pons Small blood vessels can't withstand the pressure
36
Substantia Nigra
Dopamine site Tissue death can cause Parkinson's
37
Basal ganglia perfusion
Lenticulostriate arteries off the MCA
38
Diencephalon
Contains pituitary gland, thalamus, and hypothalamus
39
Thalamus
Relays sensation, spacial sense, and motor signals Regulates consciousness, sleep, and alertness Damage can cause lethargy and motor/sensory deficits
40
Hypothalamus
Controls body temperature, hunger and thirst, fatigue, sleep/circadian cycles, emotions
41
Pituitary Gland
Houses and secretes hormones that regulate growth and metabolism
42
Internal Capsule
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
Limbic system
Contains hippocampus and amygdala Primitive behaviors, filter for concentration Damage can cause inability to create new memories (amnesia, forgetfulness)
44
Brainstem perfusion
Basilar artery
45
Brainstem
Regulates pulse, BP, breathing Connects cerebrum with spinal cord Contains midbrain, pons, medulla
46
Midbrain and associated cranial nerves
Movements coordinated with visual input CN III and IV
47
Pons and associated cranial nerves
Arousal, respiratory centers CN V-VIII
48
Medulla and associated cranial nerves
Autonomic function, vasomotor Relay between brain and spinal cord CN IX-XII
49
Why does cell death occur so quickly in the brain
There are no glucose or oxygen reserves
50
Vertebral arteries supply which vessel in the brain
Basilar artery Posterior brain
51
Internal carotid arteries supply which vessels in the brain
ACA/ACOM, MCA, PCA/PCOM Anterior brain
52
Anterior communicating artery (ACOM)
Connects both hemispheres' ACAs, providing collateral blood flow at top of Circle of Willis
53
Circle of Willis
Collateral circulation Stems from ICA at the base of the brain
54
Who will have the best outcomes when it comes to the need for collateral circulation
Older people who have slow growing blockages, giving the brain time to develop more vessels into the Circle of Willis and maintain perfusion
55
Middle Cerebral Artery (MCA)
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
Anterior Cerebral Artery (ACA)
Supplies superior portion of frontal lobe (portion of motor strip that controls lower extremities), medial portion of parietal lobe
57
Blockage of ACA
See unilateral leg weakness/feeling "off" (affects personality, LE movement,logical thought)
58
Basilar Artery
Forms from the vertebral arteries at the level of the pons Supplies portions of cerebellum (AICA, SCA), brainstem, pontine perforators Branches into PCAs
59
Posterior Communicating Artery (PCOM)
Connects the PCAs to the ICA as part of the Circle of Willis
60
Pontine Perforators
Arteries off the Basilar Artery that supply the pons
61
Posterior Cerebral Artery (PCA)
Supplies occipital lobe, inferior and lateral portions of temporal lobes, thalamus, midbrain, visual cortex
62
Cerebral Venous Sinuses
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
Complications of thrombus in Cerebral Venous Sinuses
Venous infarct/hemorrhage; Headache, N/V, seizures Seen more in younger people, especially with oral contraceptive use
64
Cranial Nerve I
Olfactory Sensory Sense of smell
65
Cranial Nerve II + how to test
Optic Sensory Sense of sight (peripheral and central) (info from retina to brain) Test with visual threat/4 quadrants
66
Cranial Nerve III + how to test
Oculomotor Motor Pupillary reaction and upward eye movement (midbrain) Test with pupillary reaction, or if there's ptosis, lack of upward eye movement
67
Cranial Nerve IV + how to test
Trochlear (superior oblique) Motor Downward/adduction eye movement (towards nose) Test with following finger to nose/vertical gaze paresis, complaints of diplopia
68
Cranial Nerve V
Trigeminal Sensory and Motor Facial sensation and chewing
69
Trigeminal Neuralgia
Shockline pain Affects CN V

CNRN Certification (6 decks)

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