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cerebral vasculature, anatomy of the skull, CNs Flashcards

circle of willis, sinuses and veins, lobes and arterial supply, the cavernous sinus, stroke, cranial foramen, facial bones

1
Q

what are the 2 feeder arteries into the circle of willis?

A
  1. internal caroitids (anterior, 80%)

2. vertebrals (posterior, 20%)

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2
Q

which arteries supply to the cerebellum in the circle of willis?

A
  1. superior cerebellar
  2. ANTERIOR inferior cerebellar
  3. POSTERIOR inferior cerebellar
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3
Q

what does the anterior communicating artery connect in the circle of willis?

A
  • the 2 anterior cerebral arteries
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4
Q

what does the posterior communicating artery connect in the circle of willis?

A
  • the Internal Carotid and Vertebro-Basilar systems via the POSTERIOR CEREBRAL ARTERY
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5
Q

where do vertebral arteries arise from?

A

subclavian

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6
Q

how does the internal carotid enter the cranium?

A
  • through the the foreamen lacerum
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7
Q

how does the internal jugular enter the cranium?

A
  • jugular foramen
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8
Q

how do the vertebral arteries enter the cranium?

A
  • through foramen magnum
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9
Q

where do vessels lie in the brain ?

A

subarachnoid space

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10
Q

what territory does the anterior cerebral artery supply?

A
  • medial surface of each hemisphere
  • most of the frontal lobe
  • most of the corpus callosum
  • some deep structures

it ges above the corpus callosum

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11
Q

what happens if a stroke affects the anterior cerebral artery supply?

A

problems with walking, and bladder control

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12
Q

what territory does the middle cerebral artery supply?

A
  • most of lateral aspect of each hemisphere
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13
Q

what happens if a stroke affects the middle cerebral artery supply?

A
  • supplies most of motor cortex so MCA stroke would cause hemiparesis (weakness of one side)
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14
Q

what territory does the posterior cerebral artery supply?

A
  • occipital lobe
  • inf + post temporal lobe
  • thalamus
  • choroid plexus
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15
Q

what happens if a stroke affects the posterior cerebral artery supply?

A
  • visual defects (contralateral)
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16
Q

what 3 steps are involved in drainage of blood from the brain?

A
  1. blood drains from veins
  2. into dural venous sinuses
  3. into internal jugular (takes towards heart)
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17
Q

what are the different types of vein found in the brain?

A
  1. emissary (drain from outside skull eg. scalp)
  2. diploic (drains bones in skull)
  3. cerebral (drains cerebrum )
  4. cerebellar (drains cerebellum)
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18
Q

what is the name for the sinuses of the Brain? where are they found?

A
  • dural venous sinuses

- in between the peristeal and meningeal layers of the dura mater

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19
Q

which dural venous sinuses lie within the falx cerebri?

where do they converge?

A
  • straight
  • superior sagittal (in top of falx cerebri)
  • inferior sagittal (in bottom of falx cerebri)

converge at confluence of sinuses

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20
Q

after the confluence of sinuses, what is the drainage route?

A
  1. confluence
  2. transverse
  3. sigmoid
  4. internal jugular vein
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21
Q

what areas of the brain are most vulnerable to reduction in perfusion?

A

the watershed areas

  • these are areas on the borders/junctions between cerebral vascular territories
  • here the tissue is the furthest from arterial supply
  • therefore if there is a reduction in blood flow, these areas will be affected the most
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22
Q

what makes the dural venous sinuses structurally different to veins?

A
  • contain no valves
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23
Q

what is the straight sinus a continuation of?

A
  • the great cerebral vein
  • the inferior sagittal sinus

together they form the straight sinus

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24
Q

what is the pathway for the drainage of deep brain areas?

A
  • various cerebral veins
  • GREAT CEREBRAL VEIN
  • straight sinus
  • confluence
  • transverse
  • sigmoid
  • internal jugular
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25
what is the pathway for the drainage of superficial areas of brain?
either cerebral veins drain into superior sagittal sinus OR the transverse sinus OR the cavernous sinus
26
what is the pathway for the drainage of ophthalmic veins?
1. ophthalmic veins 2. cavernous sinus 3. superior and inferior petrosal sinuses 4. internal jugular
27
weakness in arterial branches can lead to what? which arterial branch has the biggest tendency to weaken in this way?
- Berry Aneurysm (congenital sac-like out pouching of an inter- cranial artery) - progressively enlarge until rupture = haemorrhage. - most commonly occur on the branching points around the circle of Willis (anterior communicating artery)
28
where is the cavernous sinus located?
- within the middle cranial fossa, - on either side of the sella turcica  - on the sphenoid bone (which contains the pituitary gland).
29
within which dura mater layers are the cavernous sinus located?
- They are enclosed by the endosteal and meningeal layers of the dura mater. (double fold)
30
which structures pass through the cavernous sinus (on way to orbit)
``` Maxillary CNV2 Ophthalmic CNV1 Oculomotor CN3 Carotid (internal artery) Abducens CNVI Trochlear IV ```
31
name the 6 bones of the cranial base
``` frontal ethmoid sphenoid temporal parietal occipital ```
32
what are the 2 parts of the ethmoid bone?
1. cribriform plate - 2 plates | 2. crista galli - spine that separates the 2 plates, falx cerebri connects to
33
what are the 2 parts of the sphenoid bone?
- lesser wing (edge of wing) | - greater wing (bigger SA, looks like butterfly wing)
34
how many cranial fossa are there? order of depth?
1. anterior (shallow) 2. middle (deep) 3. posterior (deepest)
35
which bones make up the anterior fossa?
- frontal bone - ethmoid bone (cribriform plate + crista galli) - sphenoid bone
36
which bones make up the middle fossa?
sphenoid bone temporal bone (petrous + squamous) parietal bone
37
which bones make up the posterior fossa?
sphenoid bone parietal bone temporal bone occipital bone
38
what lobes/structures are in the anterior fossa?
- frontal lobe - cribriform plate - falx cerebri attached to crista galli of ethmoid bone
39
what lobes/structures are in the middle fossa?
- temporal lobe - parietal lobe - occipital lobe - superior orbital fissure - the optic canal - pituitary fossa - sella turcica - foreamen x4
40
what are the 2 parts of the temporal bone?
petrous part - the bony ridge squamous part - the flat part
41
what is the sella turcica?
- a saddle-shaped depression - in the body of the sphenoid bone - cavernous sinus is located on either side of it aka. hypophyseal fossa
42
which 4 foreamen are in the middle cranial fossa?
foreamen ... - rotundum - ovale - lacerum - spinousum
43
what lobes/structures are in the posterior fossa?
- the cerbellum (covered by tetorium cerebelli) - pons + medulla - foreamen magnum - hypoglossal canal - internal acoustic meatus
44
what is the tentorium cerebelli attached to?
- the occipital bone - the cerebellum - within posterior cranial fossa
45
what structure(s) exit the cranium via the ethmoidal foramen (cribriform plates) ?
CN I
46
what structure(s) exit the cranium via the superior orbital fissure?
CN III CN IV CN VI CN V1
47
what structure(s) exit the cranium via the optic canal?
CN II
48
what structure(s) exit the cranium via the foramen rotundum ?
CN V2
49
what structure(s) exit the cranium via the foramen ovale ?
CN V3
50
what structure(s) exit the cranium via the foramen spinosum ?
meningeal arteries
51
what structure(s) exit the cranium via the internal acoustic meatus?
CN VII | CN VIII
52
what structure(s) exit the cranium via the hyperglossal canal?
CN XII
53
what structure(s) exit the cranium via the foramen magnum?
vertebral arteries ant/post spinal arteries spinal cord
54
what structure(s) exit the cranium via the jugular foramen?
CN IX CN X CN XI
55
which bones form the cranial roof/clavarium
- frontal - occipital - 2 parietal
56
what are the 14 facial bones?
pairs: - zygomatic - lacrimal - nasal - Inferior nasal conchae - palatine - maxilla singular: - vomer - mandible
57
what do the zygomatic bones form on the face?
- cheek bones
58
what do the lacrimal bones form on the face?
- medial wall of the orbit | - smallest facial bones
59
what do the palatine bones form on the face?
- at rear oral cavity | - forms part of hard palate
60
what do the maxilla bones form on the face?
- upper jaw | - hard palate
61
what does the vomer bone form on the face?
- posterior aspect of the nasal septum.
62
what does the mandible bone form on the face?
- jaw
63
in what nervous system are the cranial nerves part of?
- peripheral nervous system
64
where does CN I and II originate from?
- cerebrum
65
describe the innervation supplied by CN I?
- sensory - to nasal cavity receptors - for olfaction
66
describe the innervation supplied by CN II?
- sensory - to receptors in the retina - for vision
67
what are the problems that can arise with CN I? (1)
- anosmia (loss or change of sense of smell)
68
what are the problems that can arise with CN II? (3)
- defects of the visual field - defects in colour vision - pupillary defects
69
where does CN III originate from?
- the brainstem - between the cerebral peduncles of the midbrain ie. Midbrain-pontine junction
70
describe the innervation supplied by CN III?
- motor to extra ocular muscles: SR,IR,MR,IO + levator palpebrae superiosis - parasympathetic to pupillary sphincter to constrict pupil during accommodation
71
what are the problems that can arise with CN III? (2)
- Ptosis (eye lid droop) | - oculomotor nerve palsy (down+ out eye)
72
where does CN IV originate from?
- from the posterior brainstem - attaches just inferior to the inferior colliculus of the midbrain ONLY POSTERIOR CN
73
describe the innervation supplied by CN IV?
- motor - to SO extra ocular muscle - looking down and out (depresses and abducts)
74
what are the problems that can arise with CN IV? (1)
- trochlear nerve palsy | - patients often tilt head forward to compensate
75
where does CN V originate from?
- pons (brainstem) | - medial to the middle cerebellar peduncle
76
describe the innervation supplied by CN V1?
``` ophthalmic sensation to upper 1/3 face - scalp - forehead - orbit and eyeball - nose ```
77
describe the innervation supplied by CN V2?
``` maxillary sensation to middle 1/3 face - Cheeks, - lower eye lid, - nasal mucosa, - upper lip, upper teeth and palate ```
78
describe the innervation supplied by CN V3?
``` mandibular sensation to lower 1/3 face - lower jaw, - anterior 2/3 tongue (general sensation) - lower face ``` motor to muscles of mastication (chewing)
79
what are the problems that can arise with CN V?
- stabbing facial pains (trigeminal neuralgia) | - problems with chewing
80
where do CN VI, VII, VIII originate from?
- brainstem | - the Pontine-medulla junction
81
describe the innervation supplied by CN VI?
- motor - LR extra ocular muscle - abduction of eyeball
82
what are the problems that can arise with CN VI?
abducens nerve palsy - unposed adduction by MR - have diplopia
83
describe the innervation supplied by CN VII?
``` SENSORY - ant 2/3 tongue (taste) - external ear sensation MOTOR - muscles of facial expression PARASYMPATHETIC - glands (lacrimal submandibular, sublingual salivary, mucous glands of mouth and nose) ```
84
what are the problems that can arise with CN VII?
- facial nerve palsy - can't smile, blink etc. - often one sided
85
describe the innervation supplied by CN VIII?
sensory to inner ear | - hearing & balance
86
what are the problems that can arise with CN VIII?
hearing loss
87
where do CN IX,X,XI originate from?
posterior to the olive of the medulla oblongata
88
describe the innervation supplied by CN IX?
``` SENSORY - post 1/3 tongue (touch+taste) - external ear and middle ear - carotid sinus - most of pharynx MOTOR - stylopharyngeus muscle of the pharynx (swallowing, gag reflex) PARASYMPATHTIC - parotid salivary gland ```
89
what are the problems that can arise with CN IX?
- difficulty swallowing - impairment of taste and sensation over the posterior 1/3 of tongue - an absent gag reflex - dysfunction of the parotid gland.
90
describe the innervation supplied by CN X?
``` MOTOR - soft palate muscles - pharynx muscles - larynx muscles SENSORY - skin of ext. acoustic meatus - internal surfaces of larynx & laryngo pharynx - heart (visceral sensation) - abdominal organs (visceral sensation) - taste to epiglottis and root of tongue PARASYMPATHETIC - smooth muscle of trachea, bronchi, GI tract (diminishes bowel movements) - regulates heart rhythm ```
91
what are the problems that can arise with CN X?
- hoarse voice (irritated left recurrent laryngeal, which is a branch ) - difficulty swallowing - irregular heart rhythm - Uvula deviation away from the affected side - loss of gag reflex
92
what are the similarities between CN IX and X?
both are involved in taste, pharynx (sensory and motor) both can cause an absent gag reflex, difficulty swallowing
93
describe the innervation supplied by CN XI?
motor to: - sternocleidomastoid and trapezius muscles. (shrug shoulders, move head)
94
what are the problems that can arise with CN XI?
- weakness of trapezius muscles
95
describe the innervation supplied by CN XII?
- motor to extrinsic and intrinsic muscles of the tongue | - except the palatoglossus (soft palate, X)
96
where does CN XII originate from?
- Anterior to the olive of the medulla oblongata | brainstem
97
what are the problems that can arise with CN XII?
Hypoglossal nerve palsy - sticks out tongue, - it deviates or points toward the side that is damaged. T

1 neuro (2 decks)

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