CNS Blood Supply - Ch 19 LE

Question 1

Cerebrospinal fluid system composed of

Answer 1

Ventricle, meninges, CSF

Question 2

Lateral ventricles

Answer 2

paired, extend into each lobe

Question 3

Lateral ventricles - walls formed by

Answer 3

caudate nucleus, thalamus, and corpus callosum

Question 4

Third ventricle

Answer 4

slit in the middle of the diencephalon

Question 5

Fourth ventricle

Answer 5

posterior to the pons and medulla, anterior to the cbm

Continues into central canal

Question 6

Dura mater

Answer 6

firmly bound to inside of skull and arachnoid

Question 7

Pia mater extends into the

Answer 7

spinal cord as denticulate ligaments

Question 8

Formation and circulation of CSF - what secretes most of CSF

Answer 8

choroid plexus

Question 9

CSF flows from

Answer 9

Lateral ventricles to third to fourth to subarachnoid space

Question 10

CSF is absorbed by

Answer 10

arachnoid villi and project into venous sinuses

Question 11

Epidural and subdural hematoma - due to

Answer 11

trauma

Question 12

Epidural hematoma progress

Answer 12

rapidly

Question 13

Subdural hematomas progress

Answer 13

slowly

Question 14

Hydrocephalus is what

Answer 14

CSF circulation is blocked and pressure builds in ventricles

Question 15

TIA

Answer 15

Brief loss of function with full recovery in 24 hrs

Inc. likelihood of stroke

Question 16

Completed stroke

Answer 16

neuro deficits last longer than 1 day and are stable

Question 17

Progressive stroke

Answer 17

Ischemic stroke with deficits that increase over time

Question 18

Brain infarction

Answer 18

when an embolus or thrombus lodges in a vessel, stopping blood flow

Question 19

Brain infarction - most rapid and spontaneous recovery occurs when

Answer 19

during 1st and 2nd weeks after stroke

Question 20

Lacunar infarcts - occur where

Answer 20

Occur in deep small arteries

Question 21

Lacunar infarcts - most often occur in

Answer 21

BG, Internal capsule, thalamus, and brainstem

Question 22

Lacunar infarcts develop ___
Motor or sensory?
Recovery?

Answer 22

slowly
Either purely motor or sensory
Good recovery

Question 23

Outcome determined by

Answer 23

Time course
Location
BP at time of occlusion
Individual variations in collateral connections

Question 24

Hemorrhage - sx worse

Answer 24

within first few hours and then as swelling dec, the sx get better

Question 25

Subarachnoid hemorrhage

Answer 25

Causes HA and brief loss of consciousness

Question 26

Subarachnoid hemorrhage - deficits are

Answer 26

progressive - due to continued bleeding or secondary to hydrocephalus

Question 27

Vertebral artery can be caused by

Answer 27

abrupt neck rotations or hyperextension

Question 28

Vertebral artery s/s

Answer 28

pain, usually at posterior neck

Question 29

Vertebrobasilar artery - main sx

Answer 29

gait and limb ataxia
limb weakness
oculomotor palsies
oropharyngeal dysfunction

Question 30

Intracranial vertebral arteries main sx

Answer 30

dizzy, difficulty walking, nausea, vomiting, dysarthria, HA

Question 31

Basilar artery - complete occlusion

Answer 31

death because effects brainstem

Question 32

Basilar artery - partial occlusion can cause

Answer 32

tetraplegia (desc motor tracts)
loss of sensation
coma
CN signs

Question 33

Basilar artery - severe partial occlusion

Answer 33

locked in syndrome

Question 34

Anterior cerebral artery

Answer 34

personality chages
contralateral hemiplegia
hemisensory loss
More severe LE

Question 35

Middle cerebral artery

Answer 35

homonymous hemianopia 
contralateral hemiplegia
hemisensory loss
More severe UE
Language impairment
Difficulty with spatial relationships
Maybe neglect

Question 36

Posterior cerebral artery - affecting mdbrain

Answer 36

contralateral hemiparesis and eye mvmnt paresis or paralysis of oculomotor nerve mm

Question 37

Posterior cerebral artery - affecting thalamus

Answer 37

severe pain, contralateral hemisensory loss, flaccid hemiparesis

Question 38

Posterior cerebral artery - affects hippocampus

Answer 38

declarative memory

Question 39

Watershed area

Answer 39

UE paresis and paresthesias

Question 40

AVM rupture

Answer 40

Subdural hematoma
Intracerebral hemorrhage
or both

Question 41

Aneurysm

Answer 41

Dilation of artery or vein wall

Question 42

Aneurysm - which is most common

Answer 42

Saccular aneurysms

Question 43

Aneurysm - bleeding occurs in subarachnoid space =

Answer 43

subdural hematoma

Question 44

BBB pros

Answer 44

prevent pathogens from entering

Question 45

BBB cons

Answer 45

prevent certain drugs and protein antibiotics from entering

Question 46

BBB absent

Answer 46

in locations that sample blood or secrete into bloodstream - parts of hypothalamus and areas around 3 and 4 ventricles

Question 47

Cerebral blood flow - osygen icnreases from

Answer 47

brainstem to cerebral cortex

Cerebral cortex is more vulnerable to hypoxia

Question 48

Cerebral arteries regulate blood flow based on

Answer 48

BP and metabolites

Question 49

Cerebral edema sx

Answer 49

HA, weakness, disorientation, memory loss, hallucinations, psychotic bx, coma

Question 50

Inc in intracranial pressure sx

Answer 50

Vomit, nausea, HA, drowsy, frontal lob gait ataxia, visual and eye mvmnt deficits

Question 51

Uncal herniation

Answer 51

space occupying lesion in temporal lobe moves the uncus medially
COmpresses midbrain

Question 52

Central herniation

Answer 52

Space occupying lesion in cerebrum places pressure on diencephalon
Will stretch basilar artery and cause brainstem ischemia and edem

Question 53

Tonsillar herniation

Answer 53

cerebellar tonsils force through foramen magnum

compress brainstem

Question 54

Lab eval for cerebral blood flow

Answer 54

PET scan

Angiography

Question 55

Venous system

Answer 55

cerebral veins that drain into dural sinuses and eventually into IJV