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AA Sal Neuro > General neuro > Flashcards

General neuro Flashcards

1
Q

4 sutures of skull

Which suture closes first?

A

Metopic (in front), Lamboid (in back), Coronal, Saggital.

Metopic closes first - Male pattern baldness happens first

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2
Q

Which suture is most likely to close abnormally? What are french names for this? (2 names

A

Saggital (boat shaped head). Scaphocephaly, Dolichocephaly

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3
Q

What two canals are connected to this canal?

A

Pterygopalatine fossa (PTF) is the canal

Foramen rotundum (posterior), Spenopalatine foramen (medial)

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4
Q

Foramen Rotundum what runs in it? Relation to PTF?

A

Runs horizonal anteriorly to connect with the posterior aspect of PTF.

R2V2.

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5
Q

Foramen Ovale (relation to Spinosum)

Name these other canals

A

Shaped like oval on axial scan. Anteromedial.

(stilleto heel visual)

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6
Q

Foramen Spinosum (position, related to ovale)

A

posterolateral to foramen ovale

Stilleto heel visual

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7
Q

Relation of Vidians, ovale, and spinosum on axial. (visual to help remember Ovale and Spinosum)

A

From lateral to medial it goes SOV. On axial view, Ovale and Spinosum look like the imprint of a woman’s high heel shoe, which is pointed inwards. (ovale I ball of foot, spinosum is heel). The feet are pointed towards Viridans canal.

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8
Q

On Coronal plane, Anterior cliniod process is seen on slices which contain which foramen?

A

Foramen Rotundum. (and also likely Vidians canal)

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9
Q

Relationship of Rotundum and Vidians canal on coronal views

A

Rotundum is lateral, Vidians is medial. V in the middle

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10
Q

Juvenile angiofibroma starts where?

A

Sphenopalaine foramen. It then extends to Ptf.

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11
Q

JNA is fed by branches of which artery?

A

ECA

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12
Q

Fetal Pcomm frequencey and clinical significance

Also what is relation of PCOMM to CN3 normally, and what is in fetal pcomm?

A

30% prevalance. Stroke from ICA may hit both MCA and PCA distribution.

Normally fetal pcomm is medial/superior to CN3, but with Fetal Pcomm, it is lateral/superior

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13
Q

Most common persistent fetal connection b/w vertebrobasilar and carotid systems? Associated complication and associated sign?

A

Persistent trigeminal artery. This may be prone to aneurysm. Tau sign (seen as the vessel is coming off of the carotid)

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14
Q

Things that connect with pterygopalatine fossa

A

Rotundum, IOF, greater palatine canal, spenopalatine foramen, infratemporal fossa, viridans canal.

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15
Q

Superior ofbiral fissure contains lots of nerves (Need 3,4,6 for looking)

A

3,4,6, Lacrimal, frontal, nasocilliary (V1)

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16
Q

Cavernous sinus contains what? What are medial structure

A

CN2, 3, 4, 6, V1, V2. Internal carotid.

Abducens and internal carotid are medial

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17
Q

What passes through the optic canal?

A

CN2- opthalmic artery

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18
Q

What passes through the hypoglossal canal? Where is hypoglossal canal in relation to occipital condyle?

A

Hypoglossal nerve (CN12)

medial and superior to occipital condyle

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19
Q

What traverses the jugular foramen?

Pars vascularis?

Pars nervosa?

A

Pars vascularis:- Jugular vein- CNs 10 & 11 (go with the vessels)- posterior meningeal branch of ascending pharyngeal artery

Pars nervosa:- CN 9 (Nine is longer, goes alone in Nervosa)- inferior petrosal sinus venous return

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20
Q

What traverses the foramen spinosum?

A

Middle meningeal artery

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21
Q

What traverses the foramen rotundum?

A

CN V2 “R2V2”

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22
Q

What traverses the superior orbital fissure?

A

CNs V1, 3, 4, 6

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23
Q

What traverses the foramen ovale?

A

CN V3, accessory meningeal artery

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24
Q

Stylomastoid canal

A

CN 7

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25
Q

What is “dural ring” in ICA course

A

It is where the ICA enters dural cavity. It is at the border of segements 5 and 6 of ICA. Anything above Dural ring, Like segments C6, C7, is “subarachanoid”

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26
Q

What are the segments of the ICA?

A

C1 : cervical - C2 : petrous - C3 : lacerum - C4 : cavernous - C5 : clinoid - C6 : ophthalmic - C7 : communicating

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27
Q

2 branches from ICA C2

2 branches from ICA C4

2 branches from ICA C6

4 branches from ICA C7

A

C2: Carotidotympanic artery, viridian artery

C4: Meningohypophyseal trunk, inferolateral trunk

C6: Opthalmic artery, superior hypophyseal artery

C7: Pcomm, Anterior choroidal, anterior cerebral, middle cerebral

28
Q

ECA branches (8 branches, some anatomists like freaking out poor med students)

A

Superior thyroid, ascending pharyngeal, lingual, facial, occipital, posterior auricular, maxillary, superficial temporal

29
Q

Where does vertebral artey enter the foramen?

A

C6 level

30
Q

Facial nerve segments (I love going to makeover parties)

A

Intracranial, labinthine, geniculate ganglion, tympanic, mastoid, parotid

31
Q

5 branches of facial nerve

A

Temporal, zygomaatic, buccal, mandibular, cervical

32
Q

What is this? What lives here?

A

Meckel’s cave,

trigeminal ganglion, posterolateral to cavernous sinus

33
Q

Canal that transmits CN VI to cavernous sinus

A

Dorello’s canal transmits abducens from prepontine cistern to cavernous sinus

34
Q

Sinus drainage patterns

Maxillary

sphenoid

frontal

ethmoid (anterior, middle, ethmoid)

A

Maxillary: MMMiddle meatus

Sphenoid: roof of nasal cavity (through spenoethmoidal recess)

Frontal: middle meatus via the frontonasal duct.

Ethmoid: anterior - middle meatus.

Middle - ethmoid bulla.

Posterior - superior meatus

35
Q

Name, significance?

A

Haller air cell

Air cell which is inferomedial to orbit. Can obstruct meatus and cause obstruction/sinusitis

36
Q

Communicating hydrocephalus - 2 causes

A

SAH, normal pressure hydrocephalus

37
Q

Ddx - diffusion restriction (6) (stroke + 3 infectious + 2 ‘masses”)

A

Acute stroke, bacterial abscess, cellular tumors, epidermoid cyst, herpes encephalitis, Creutzfeldt

38
Q

Ddx for multiple dark spots on GRE (5)

A

Hypertensive microbleeds,cerebral amyloid angiopathy, familial cerebral cavernous malformations, axonal shear injury, multiple hemorrhagic mets

39
Q

CNS regions that do not have a BBB

A

Choroid plexus, pituitary and pineal glands, Tuber Cinerum (controls circadian rhythm, located in the inferior hypothalmus). Area postrema (controls vomiting, located at inferior aspect of 4th ventricle)

40
Q

Type of brain enhancement patterns (4 intra-axial, 2 extra-axial)

A

Periventricular, Gyriform, nodular subcortical, ring, pachymeningeal (dural), leptomeningeal (pia-arachnoid.

41
Q

Periventricular enhancement (enhancement of subependymal surface) 2 neoplastic, 1 infectious, 1 demyelinating

A

Primary CNS lymphoma, infectious ependymitis (CMV. Linear enhancement along margins of ventricles). Primary lial tumors, multiple sclerosis.

42
Q

Gyriform enhancement ( I’s - 2 infection, ischemia, or idiopathic)

A

Herpes encephalitis, Meningitis, Subacute infarct, PRES.

43
Q

Nodular subcortical enhancement

A

Hematogenous disseminated metastatic disease. Venous dissemination of mets (pelvic malignancy spread via the Batson prevertebral venous plexus) leads to posterior fossa disease by transit through the retroclival venous plexus.

44
Q

Ring enhancement (Magic Dr)

A

Mets, abscess, glioma, infarct, contusion, demyelinating (incomplete ring), radiation

45
Q

Pachymeningeal enhancement (HaPPy GM)

A

Intracranial hypotension, postoperative, post lumbar puncture, meningeal neoplasm, granulomatous disease (sarcoid, TB, fungal)

46
Q

Leptomeningeal enhancement (2 infectious, cancer, anatomic structure)

A

meningitis, leptomeningeal carcinomatosis (GEMCLOG), viral encephalitis, slow vascular flow

47
Q

Leptomeningeal carcinomatosis ddx (GEMCLOG)

A

Glioblastoma, ependymoma, medulloblastoma, Choroid plexus tumor, lymphoma, oligodendrioglioma, germinoma

48
Q

Ddx Flair hyperintensity in subarachanoid space (4)

A

Meningitis, leptomeningeal carcinomatosis, SAH, Patient on oxygen or propofol therapy.

49
Q

3 emergent complications of tumor (3 H”s)

A

Hemorrhage, hydrocephalus, herniation

50
Q

Approach to focal brain lesion

A

Any complications, intra or extra-axial, specific location, enhancement, is there more than 1 lesions, distinctive MRI findings.

51
Q

Tumors that are hypointense on T2 (type of met. 4 hypercellular tumors)

A

Mets with desiccated mucin (GI), hypercellular tumors (lymphoma, medulloblastoma, germinoma, some glioblastomas

52
Q

Tumors that are Hyperintense on T1

A

Melanoma, fat containing teratoma, hemorrhagic mets (CTMR BB)

53
Q

4 Glial cells

A

Astorcyte, oligodendrocyte, ependymal cell, choroid plexus cell.

54
Q

4 types of herniation

A

Subfalcine herniation Downward uncal (transtentorial) herniation Upward transtentorial herniation, Cerebellar tonsillar herniation

55
Q

Downward transtentorial herniation - what lobe is effected

A

Inferomedial displacement of medial temporal lobe (uncus) through temporal notch

56
Q

Uncal (downward tentorial) herniation - 4 structure effected

A

Ipsilateral CN3 (pupillary dilatation and down/out)

Compression of ipsilateral PCA

Upper brainstem sheared (duret hemorrhages)

Compression of contralateral cerebral peduncle (ipsilateral hemiparesis)

57
Q

Subfalcine herniation (what lobe involved, what 2 things can be compressed)

A

Cingulate gyrus slides underneath falx rarely causes compression of ACA Foramen of monro obstruction

58
Q

Upward transtentorial herniation. Main complication

A

superior herniation of cerebellar vermis due to posterior fossa mass. Main complication is aqueductal compression and hydrocephalus

59
Q

Cerebellar tonsillar herniation. How can this be fatal.

A

Tonsils through foramen magnum. Compression of medullary respiratory centers can be fatal.

60
Q

2 most common Ring enhancing lesions

A

Neoplasm, abscess.

61
Q

T 1 hyperintense in the brain (3 common ones, 3 less common, 2 that overlap w/ T2)

A

A) Gad, fat, proteinacious substance

B) Melanin, mineralization, slow flowing blood

C) paramagnetic stages of blood, calcium

62
Q

T2 hypointense in the brain (3 main things, 2 overlap with T1, 1 normal findings)

A

A: Fibrous lesions, highly celullar tumor (lymphoma, medulloblastoma) Dessicated Mucin) B: Paramagnetic stages of blood, calcification C: vascular flow void

63
Q

Hemorrhagic mets (MR CT and for good measure, BB)

A

Melanoma, RCC, choriocarcinoma, Thyroid. Also because of how common they are; breast and bronchogenic.

64
Q

Name these atlanto-axial ligaments

  • Ligament that hugs the dens to the atlas
  • Ligament that is continuation of PLL to Clivus
  • ligament that connects sids of dens to condylar tubercles.
A
  • Cruciate Ligament (made of transvere ligament and other fibers)
  • Tectorial membrane
  • Alar ligament
65
Q

describe superior and inferior colliculi (corpora quadrigemina), facial colliculi

A

Superior and inferior colliculi are at the level of the midbrain. Facial colliculi is at level of pons.

superior colliculi: preliminary visual processing and control of eye movements. (superior is for seeing)

inferior colliculi: auditory processing. (Linferior is for Listening)

Facial colliculi is at the level of the pons and it is the CN7 fibers curving around the abducens nerve.

66
Q

“extraventricular obstructive hydrocephalus” occurs to obstruction where?

A

obstruction distal to 4th ventricle outlet foramina.

AA Sal Neuro (7 decks)

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