Case 5 - Stroke Flashcards
What lobe does the sylvian fissure seperate?
Temporal lobe
What is the anterior circulation of the brain derived from and where do these arteries enter?
Left and right internal carotid arteries - enter via carotid canals
What do the internal carotid arteries give rise to? Give their functions
- Ophthalmic artery: supplies all structures in orbit, as well as nose, face and meninges
- Posterior communicating artery: connects ICA with posterior cerebral artery
- Anterior cerebral artery: supplies blood to frontal and parietal lobes
What does the ICA continue as and where does this extend?
Continues as middle cerebral arteries
Extends to lateral cerebral cortex
Where does the posterior circulation supply?
Occipital lobes, cerebellum, brainstem
What is the posterior circulation of the brain derived from and where do these arteries enter?
Vertebral arteries - enter through foramen magnum
What are the branches of the vertebral arteries and where do they supply?
- Posterior inferior cerebellar artery: largest, supplies the cerebellum
- Anterior and posterior meningeal arteries: supply dura mater
- Anterior and posterior spinal arteries: supplies spinal cord along its length
What does the vertebral artery continue as?
The L and R converge to form the basilar artery at the base of the pons
Where does the middle cerebral artery supply?
Enters sylvian fissure, supplies the lateral surface of cortex (lateral temporal, parietal and frontal lobes), including the basal ganglia and internal capsule
Where does the anterior cerebral artery supply?
Medial frontal and parietal lobes, including the corpus calosum and parts of the basal ganglia
Where does the posterior cerebral artery supply?
Occipital and temporal lobes, as well as the thalamus and midbrain
Name the nuclei for cranial nerves 1 and 2
CN I: olfactory bulb
CN II: lateral geniculate nucleus
List the 4 cranial nerve nuclei found in the midbrain
Edwinger- westphal nucleus
Oculomotor nucleus
Trochlear nucleus
Mesencephalic nucleus - extends from pons to midbrain
List the 4 nuclei found in the pons
Trigeminal motor nucleus
Abducens nucleus
Facial motor nucleus
Chief nucleus (trigeminal)
Name the nuclei found at the pons-medullary junction
Vestibular and cochlear nuclei
List the 5 nuclei found in the medulla
Spinal nucleus
Nucleus solitarius
Nucleus ambiguus
Dorsal motor nucleus of vagus
Hypoglossal nucleus
What cranial nerves synapse at the nucleus solitarius? What fibres does it contain?
9th, 7th, 10th cranial nerves (glossopharyngeal, facial, vagus)
- Think ‘Non Stop Training’
Contains sensory fibres
List the 3 areas involved in language and their location
Brocas area= frontal lobe
Wernickes area= temporal and inferior parietal lobe
Angular gyrus = parietal lobe
What connects Broca’s and Wernicke’s areas?
Arcuate fasciculus
What is the role of Broca’s area?
Speech production and articulation. Controls ability to articulate ideas, and use words accurately in spoken language
What would damage of Broca’s area lead to?
Words being poorly articulated = expressive (non-fluent) dysphasia, i.e. deficits in speech production although comprehension would be good
What is the role of Wernicke’s area?
Critical language area, primarily involved in comprehension and language processing
What would damage to Wernicke’s area lead to?
Speech devoid of meaning, i.e. receptive dysphasia (fluent) - language production is in tact but comprehension isn’t. Patients usually unaware of their difficulties
What is the role of the angular gyrus?
Allows us to associate multiple types of language-related information, i.e. visual, auditory and sensory. Allows us to associate perceived words with images and ideas