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A1 > Brain Apex > Flashcards

Brain Apex Flashcards

1
Q

What forms grey and white matter?

A

Cell bodies form grey matter
Axons form white matter

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2
Q

3 types of neurons

A

Multipolar (most)
Pseudounipolar (dorsal root, cranial ganglion)
Bipolar (retina, ear)

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3
Q

What is a glial cell?

A

Nerve glue that supports neuronal function via conduction, environment, reuptake, and repair

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4
Q

Types of glial cells

A

Astrocytes
Ependymal
Oligodendrocytes
Microglia

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5
Q

Where do most brain tumors arise from?

A

Glial cells

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6
Q

Brain hemispheres functions

A

Frontal- motor
Parietal- somatic sensory
Occipital- sight
Temporal- speech and auditory

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7
Q

Brainstem contains;

A

Midbrain- auditory and visual tracts
Pons- autonomic integration and RAS
Medulla- autonomic integration

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8
Q

Brian hemispheres location

A

Frontal- front
Parietal- middle (superficial)
Occipital- back
Temporal- center (deep)

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9
Q

Cerebellum function

A

Archicererbellum- equilibrium
Paleocerebellum- muscle tone
Neopcerebellum- muscle movement (voluntary)

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10
Q

Branches of CN7 facial

A

Two zebras bit my carrot
Temporal
Zygomatic
Buccal
Mandibilar
Cervical

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11
Q

Branches of CN5 trigeminal

A

Opthalmic
Maxillary
Mandibular

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12
Q

CSF volume and rate of production

A

150ml
30ml/hr

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13
Q

Specific gravity and pressure of CSF

A

1.002-1.009
10mmHg

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14
Q

Where is CSF produced?

A

In the choroid plexus by the ependymal cells

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15
Q

Where is CSF reabsorbed?

A

Arachnoid villa in the superior sagittal sinus
Dependent on the pressure gradient between CSF and venous circulation

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16
Q

CSF flow in the brain

A

Love my 3 silly 4 lorn magpies
Lateral ventricles
Monro foramen
3rd ventricle
Sylvius aqueduct
4th ventricle
Luschka
Magendie

17
Q

Types of hydrocephalus

A

1- obstructive, most common
2- communicating- decreased csf absorption from arachnoid villa from ICH or overproduction of CSF- very rare

18
Q

Global CBF

A

45-55ml/100g/min (15% of cardiac output)
20- ischemia
<15- cell death

19
Q

CMRO2

A

3-3.8ml.O2/100g/min
60% for electrical activity
40% for cellular integrity

20
Q

How is CMRO2 affected by temperature?

A

Decreases by 7% for every 1 degree C decrease
EEG suppression occurs at 18-20 C

21
Q

What decreases CMRO2?

A

Hypothermia
Halogenated anesthetics
Propofol/ etom/ barbituates

22
Q

What increases CMRO2?

A

Hyperthermia (42 C destroys neurons)
Seizures
Ketamine
N2O

23
Q

What controls cerebral autoregulation?

A

Local metabolism
Myogenic mechanisms
Autonomic innervation

24
Q

What tampers with the effectiveness of autoregulation of cerebral perfusion?

A

Intracranial tumor
Head trauma
Volatile anesthetics

25
Q

5 determinants of cerebral blood flow

A

CMRO2
CPP
PaCO2
PaO2
Venous pressure

26
Q

Maximal vasoconstriction and vasodilation of CBF occurs when PaCO2 is ___

A

25 mmHg max vasoconstriction
80-100 mmHg max vasodilation

27
Q

How does PaO2 affect CBF?

A

PaO2 above 60 does not affect CBF
PaO2 < 60 vasodilates and increases CBF

28
Q

How does venous pressure affect CBF? Name examples

A

High venous pressure can reduce CBF drainage
Head compression
Increased ICP
Vena cava syndrome/ thrombosis

29
Q

Signs and symptoms of increased ICP

A

Seizure
Coma
Papilledema
Pupil dilation and non reactivity
N/v
Headache
Focal neuro deficit

30
Q

Monro kellie hypothesis

A

Equilibrium between the brain, blood, CSF
An increase in one requires a decrease in the others
Otherwise, pressure will rise

31
Q

Cushing triad

A

A sign of intracranial htn
HTN
Bradycardia
Irregular respirations

32
Q

Most common site of transtentorial herniation

A

Temporal uncus
Forced from supratentorial space into the infratentorial space and increases pressure on the midbrain

33
Q

What is the effect of D5 on CBF?

A

Glucose converts to lactic acid in the setting of intracranial htn
Dilating and increasing pressure

34
Q

How to manage CBV in the setting of intracranial htn?

A

Hyperventilation 30-35mmHg
Avoid hypoxemia <60mmHg
Avoid cerebral vasodilators (NTG, SNP)
Drugs that reduce CMRO2 (prop, thiopental)
Phenyl but no extreme htn otherwise edema
Neck >30 degrees
Reduce PEEP, coughing, straining

35
Q

How to decrease CSF?

A

Shunts (ventriculoatrial or ventriculoperitoneal)
Diamox
Lasix

36
Q

Within how many hours can IV recombinant TPA be given to a patient that has experienced an acute stroke?

A

4.5 hours

37
Q

CVA risk factors

A

HTN (most important)
smoking
DM
HLD
Alcohol intake-excessive
Elevated homocysteine level

38
Q

Target BP after ischemic CVA

A

185/110 to support CPP and Cerebral oxygenation

39
Q
A

A1 (125 decks)

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