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Anatomy BLOCK 3 > Brain, Blood Supply, And Cranial Meninges > Flashcards

Brain, Blood Supply, And Cranial Meninges Flashcards

1
Q

What makes up the brain stem?

A
  • medulla oblongata
  • pons
  • midbrain
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2
Q

What are the parts of the brain?

A
  • brainstem
  • cerebellum
  • diencephalon
  • telencephalon (cerebral hemispheres)
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3
Q

What are the parts of the diencephalon

A

Thalamus

Hypothalamus

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4
Q

What are the parts of the medulla?

A
  • anterior median fissure
  • pyramids
  • olive
  • pre-olivary sulcus
  • retro-livery sulcus
  • medullopontine sulcus
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5
Q

Anterior median fissure of the medulla

A

Continuous inferiorly with anterior median fissure of spinal cord

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6
Q

Pyramids of medulla

A

Two longitudinal columns ( one on each side of the anterior median fissure)

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7
Q

Olive of the medulla

A

Oval elevation lateral to upper part of pyramid

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8
Q

Pre-olivary sulcus of the medulla

A

Located between the pyramid and the olive

Attachments of rootlets of hypoglossal nerve (CN XII)

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9
Q

Retro-olivary sulcus of the medulla

A
  • located posterior to olive
  • attachment of rootlets of glossopharyngeal (CN IX) and vagus (CN X) nerves (in line with attachment of rootlets of accessory nerve/CN XI)
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10
Q

Medullopontine sulcus of the medulla

A

Nerves that attaché (from medial to lateral)

  • abducens (CN VI)
  • facial nerve (CNVII)
  • vestibulocochlear (CN VIII)
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11
Q

Pons

A

-trigeminal nerve (CN V) attaches to anterior surface of pons

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12
Q

Midbrain

A 
cerebral crura (cerebral peduncles)
-two columns of descending fibers (one on each side)
Occulomotor nerve (CN III) attaches to medial border of cerebral crus
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13
Q

4th ventricle

A
  • posterior surface of brainstem

- cavity between cerebullum (posteriorly) and pons and upper medulla (anteriorly)

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14
Q

When can the posterior surface of the brainstem be viewed completely?

A

When cerebellum is removed by cutting 3 pairs of cerebellar peduncles (superior, middle, and inferior) that connect cerebellum to brainstem

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15
Q

What is the posterior surface of the lower medulla similar to?

A

Posterior surface of cervical and upper thoracic spinal cord

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16
Q

Posterior surface of upper medulla and posterior surface of pons form what?

A

The floor of 4th ventricle, called the rhomboid fossa

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17
Q

What are the elevations of the posterior surface of midbrain?

A

Two superior colliculi
-part of visual system
Two inferior colliculi
-part of the auditory system

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18
Q

What is the only cranial nerve attaches to posterior surface of brainstem?

A 
Trochlear nerve (CN IV)
-emerges immediately below inferior colliculus
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19
Q

What are the right and left cerebral hemispheres separated by?

A

Longitudinal fissure

  • separation is incomplete
  • at bottom of longitudinal fissure, there is a large bundle of fibers (corpus callosum) that connects right and left hemispheres
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20
Q

How many lobes does each hemisphere have?

A

5

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21
Q

What are the lobes that each hemisphere contains?

A
  • frontal
  • parietal
  • temporal
  • occipital
  • insular
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22
Q

Which lobe is hidden in the lateral sulcus?

A

Insular

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23
Q

What separates the frontal and parietal lobes?

A

Central sulcus

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24
Q

What separates the temporal lobe from frontal and parietal lobe?

A

Lateral sulcus

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25
What two arteries provided the arteries last supply of the brain?
- vertebral arteries | - internal carotid arteries
26
What part of the subclavian does the vertebral artery come off of?
1st branch
27
Where does the vertebral artery enter the cranial cavity?
Foramen magnum
28
Where do the right and left vertebral arteries join each other?
At medullopontine sulcus to form basilar artery
29
How does the basilar artery run?
Along midline of anterior surface of pons and ends at upper end of pons by dividing into right and left posterior cerebral arteries (terminal branch)
30
What do the vertebral and basilar branches supply?
-spinal cord -brainstem -cerebellum -posterior parts of cerebral hemispheres (Essentially entire brainstem and occipital lobe)
31
Where does the internal carotid artery start?
Begins at bifurcation of common carotid artery
32
What are the parts of the internal carotid artery
- cervical - petrous - cavernous - cerebral
33
Cervical part of the internal carotid artery
From origin to base of skull
34
Petrous part of internal carotid artery
Within carotid canal in petrous part of temporal bone
35
Cavernous part of internal carotid artery
Within cavernous sinus (dural venous sinus located in middle cranial fossa, one on each side of sella turcica)
36
Cerebral part of internal carotid artery
After it exits cavernous sinus to its termination, where it divides into anterior and middle cerebral arteries
37
Internal carotid artery branches
- ophthalmic - posterior communicating artery - anterior cerebral artery - middle cerebral artery
38
How does the ophthalmic artery enter the optic canal;?
Together with optic nerve
39
What connects the internal carotid and posterior cerebral arteries?
Posterior communicating artery
40
What are the right and left cerebral arteries connected to each other by?
Communicating artery
41
What surface of brain is circle of willis on?
Ventral
42
What are the components of the circle of willis?
- anterior communicating artery (tiny) - anterior cerebral artery - internal carotid artery - positive or communicating artery - posterior cerebral artery
43
What is the purpose of the circle of willis?
Serves as a potential vascular shunt, assisting in development of collateral circulation if one of the proximal vessels is occluded
44
What are the laters of the dura mater of the brain?
- periosteal/endosteal (outer later) | - meningeal (inner layer)
45
Periosteal/endosteal layer of the dura mater
- outer layer | - covers inner surface of skull bones
46
Meningeal layer of the dura mater
- inner layer - dura mater proper - faces brain
47
Relationship of the periosteal/endosteal and the meningeal layers of the dura mater
Two layers are closely united, except where they separate to form dural venous sinuses
48
Falx cerebri
- Dural septa formed by the meningeal layer - sickle-shaped fold that lines in midline between right and left cerebral hemispheres - from front to back
49
Tentorium cerebelli
- crerbellum lives under this - crescent shaped for that roofs over posterior cranial fossa (separates cerebellum from occipital lobes of cerebral hemispheres) - tentorial notch opening filled mostly by midbrain
50
Falx cerebelli
Small sickle shaped fold in posterior cranial fossa that projects between right and left cerebellar hemispheres
51
Diaphragma sellae
Small circular fold that forms roof of sella turcica (has small opening for pituitary stalk)
52
Where are the dural venous sinuses located?
Between inner and outer laters of dura mater
53
What do dural venous sinuses receive blood from?
Brain as well as CSF from subarachnoid space
54
Where does the blood collected in the dural venous sinuses drain into?
Internal jugular veins
55
What are the dural venous sinuses?
- superior sagittal sinus - inferior sagittal sinus - straight sinus - transverse sinus - sigmoid sinus - occipital sinus - cavernous sinus - superior petrosal sinus - inferior petrosal sinus - sphenoparietal sinus
56
Superior sagittal sinus
- runs along upper border of falx cerebri - begins anteriorly at foramen cecum - terminates posteriorly in confluence of sinuses (over internal occipital protuberance)
57
Inferior sagittal sinus
-runs along lower, free border of falx cerebri, joins great cerebral vein (of Galen) to form straight sinus
58
Straight sinus
- runs in midline along junction of falx cerebri and tentorium cerebelli - terminates posteriorly in confluence of sinuses
59
Transverse sinus
- begins in confluence of sinuses and runs along posterior border of tentorium cerebelli - when it reaches petrous part of temporal bone, it turns down to become continuous with sigmoid sinus
60
Sigmoid sinus
- direct continuation of transverse sinus | - terminates in jugular foramen where is becomes continuous with internal jugular vein
61
Occipital sinus
- small sinus that runs along posterior border of falx cerebelli - ends superiorly in confluence of sinuses and inferiorly communicated with internal vertebral venous plexus (within vertebral canal)
62
Where is the cavernous sinus located?
In middle cranial fossa, one on each side of sella turcica
63
What does the cavernous sinus drain?
Contents of orbit, parts of cerebral hemisphere, pituitary gland, and sphenoparietal sinus
64
What two structures are located within the cavernous sinus?
Internal carotid artery and abducens nerve
65
What runs within lateral walls of the cavernous sinus?
CN III, IV, and V1 and V2 divisions of trigeminal nerve
66
What is the canvernous sinus drained by?
Posteriorly by superior and inferior petrosal sinuses
67
Superior petrosal sinus
- runs along superior border of petrous part of temporal bone - connects cavernous sinus with terminal part of transverse sinus
68
Inferior petrosal sinus
- runs along inferior border of petrous part of temporal bone (between petrous part and occipital bone) - connects cavernous sinus with internal jugular vein
69
Sphenoparital sinus
Small sinus that runs along posterior border of lesser wing of sphenoid, then drains into cavernous sinus
70
What is the age of peak incidence of a primary parenchymal hemorrhage?
60
71
What is a primary brain parenchymal hemorrhage?
Rupture of small intraparenchymal vessel
72
What is the most common underlying cause of primary brain parenchymal hemorrhage?
Hypertension (15% of deaths with chronic HTN)
73
What are the most common sites in order of a primary brain parenchymal hemorrhage?
Basal ganglia Thalamus Pons Cerebellum
74
Location and size of primary brain parenchymal hemorrhage
Determine clinical manifestations
75
What is the most frequent cause of clinically significant subarachnoid hemorrhage?
Rupture of a saccular aneurysm
76
Where do 90% of saccular aneurysms occur?
In the anterior circulation
77
How often do multiple aneurysms occur in saccular aneurysms?
20-30%
78
Risk of bleeding increases with that in saccular aneurysms?
Size
79
What percentage of people die with firstly rupture during saccular aneurysm?
25-50%
80
What is likely to cause "the worst headache of your life?"
Saccular aneurysm
81
What is the most common site of saccular aneurysm?
Branch of anterior communicating and anterior cerebral
82
What is the breakdown of how saccular aneurysms affect people?
1/3 die 1/3 survive and have second one 1/3 will be totally fine
83
Morphology of saccular aneurysms
- thin walled out pouching of an artery - muscular wall and internal elastic lamina are absent from sac - sac is thickened hylainized intima
84
What is absent from the sac in an saccular aneurysm?
Internal elastic Lamina and muscular wall
85
What is the sac thickened by in saccular aneurysm?
Hyalinized intima
86
What is an epidural hematoma?
- torn vessel in the dura | - middle meningeal artery
87
What is usually associated with an epidural hematoma>?
Skull fracture
88
What happens with a epidural hematoma?
- blood under arterial pressure separates dura from inner surface of the skull - smooth inner contour that compresses the brain - patients can be lucid for several hours between trauma and development of neurological signs - neurosurgical emergency
89
Sub dural hematoma
Tearing of bridging veins caused by rapid movement of the brain
90
Where is the bleeding occurring in a sub dural hematoma?
Sub dural space
91
Where is a sub dural hematoma most common?
Over lateral aspect of cerebral hemispheres | -10% bilateral
92
Increased risk of subdural hematoma
- brain atrophy-stretched veins | - infants-thin walled veins
93
When does subdural hematoma become manifest?
Within 48 hours of injury
94
What are the signs of a subdural hematoma
- attributable to pressure on the brain - headache, confusion, sometimes localizing - progressive neurological deterioration, rarely with acute decompensation
95
Bleeding of a subdural hematoma
Usually self-limited
96
If the subdural hematoma is not evacuated
Hematoma will organize over time - fibroblasts grow from dura - granulation tissue matures and forms 'subdural membranes'
97
Chronic subdural hematoma
Subdural hematoma often rebleed
98
How are symptomatic subdural hematomas treated?
By removing the organizing blood and tissue

Anatomy BLOCK 3 (13 decks)

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