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Year 2: NeuroBiology > Lecture 2: Ventricular System and Blood Supply > Flashcards

Lecture 2: Ventricular System and Blood Supply Flashcards

1
Q

development of the brain and ventricles is a result of differentiation and replication of what type of cells

A

stem cells along the vesicle

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2
Q

during development, division of the telencephalons results in the formation of what

A

2 hemishperes

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3
Q

how is the choroid plexus formed in development

A

invasion of the arterioles into the ventricles

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4
Q

during development, separation of the telencephalons from the diencephalons forms what

A

3rd ventricle

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5
Q

how are the 4th ventricles formed during development

A

dorsal separation and expansion of the metencephalon and the myelencephalon

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6
Q

what lobe contains the anterior horn of the lateral ventricles

A

frontal/limbic

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7
Q

what lobe contains the atrium of the lateral ventricle

A

parietal/limbic

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8
Q

what lobe contains the posterior horn of the lateral ventricle

A

occipital

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9
Q

what lobe contains the body of the lateral ventricle

A

frontal/limbic

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10
Q

what lobe contains the inferior horn of the lateral ventricle

A

temporal/limbic

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11
Q

what is the bird eye of the 3rd ventricle

A

cerebral aqueduct?

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12
Q

what foramen is between the lateral and 3rd ventricle

A

interventricular foramen

(of Monro)

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13
Q

what foramen is between the 3rd and 4th ventricle

A

cerebral aqueduct

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14
Q

how does CSF enter the brain

A

in the ventricles through choroid plexus

here there is no tight junction of endothelial cells and so the CSF can enter

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15
Q

what is the maintained level of CSF in the brain

A

maintained ta 150 ml

active secretion of 200-500 ml per day

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16
Q

importance of buoyancy in the brain

A

no skeletal structure to support brain

brain would collapse w/o buoyancy

decreases gravity effects by 97%

acts as shock absorption

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17
Q

functions of the CSF around the brain aside from support/shock absorption

A

regulate the chemical environment (ion concentrations act as insulator to keep off unwanted action potentials)

waste exchange

nutrition is unlikely due to low levels of proteins/glucose found in CSF

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18
Q

how many times is CSF replaced daily

A

1-3x/day

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19
Q

what direction does CSF move during systole and diastole

A

systole: cranial to caudal; out of ventricles

diastole: caudal to cranial; drain to SSS and backflow TO ventricles

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20
Q

where in the sinuses does CSF drain

A

mainly into the SSS througharachnoid granulations

only travels the one way; it can’t flow back from the SSS

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21
Q

what happens if the flow of CSF is blocked

A

hydrocephalus

can place a cranial abdominal shunt

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22
Q

describe the path of CSF from the lateral ventricles to the SSS

A

-lateral ventricle
-through foramen of Monro
-into 3rd ventricle
-through cerebral aqueduct
-into 4th ventricle
-through foramen
-into subarachnoid space
-through arachnoid granulations
-into SSS

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23
Q

where is the epidural space

A

potential space between dura and cranium

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24
Q

2 layers of the dura mater

A

periosteal and meningeal

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25
Q

what is the falx cerebri and what does it separate

A

folding of meningeal layer of dura mater

separates 2 cerebral hemispheres

sagittal plane

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26
Q

what is the falx cerebelli

A

in posterior sulcus of cerebellum

sagittal plane

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27
Q

what is tentorium cerebelli

A

separates occipital/temporal loves from cerebellum

transverse plane

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28
Q

what is diaphragma sellae

A

separates hypophyseal fossa

transverse plane

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29
Q

where is the subdural space

A

between dura and subarachnoid

potential space

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30
Q

describe the arachnoid mater and its function

A

spider web like

tethers brain in cranium through the arachnoid trabeculae which allows for buoyancy

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31
Q

where is the subarachnoid space

A

between arachnoid and pia maters

true space

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32
Q

where is the pia mater

A

directly covers brain

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33
Q

where are the superior and inferior sagittal sinus

A

in superior and inferior falx cerebri respectively

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34
Q

where is the straight sinus

A

tentorium cerebelli

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35
Q

where is the occipital sinus

A

in falx cerebelli

36
Q

what is the confluence of sinuses

A

gathering of SSS, straight sinus, occipital sinus

37
Q

where dies the ISS drain to

A

flows horizontally bilaterally to the transverse sinus

38
Q

where is the transverse sinus

A

in the cavernous sinus

around the diaphragma sellae

39
Q

what innervates the anterior cranial fossa and all above the tentorium cerebelli level

A

V1 branch of the trigeminal n (CN V)

40
Q

what innervates the anterior/middle cranial fossa

A

V2 and V3 branch of the trigeminal n (CN V)

41
Q

what innervates the posterior cranial fossa

A

fibers from C2/C3 distributed by CN X and XII

42
Q

what innervation may contribute to cervicalgia and headaches/migraines

A

C2/C3 fibers along with CN X and XII

innervation to the posterior cranial fossa

43
Q

what innervates the arachnoid and pia mater

A

no sensory input to these areas!!

44
Q

describe the major blood supply to the brain

A

brain is 2% BW but 20% body’s blood supply

anterior division = branches from internal carotid a

posterior division = branches from vertebral basilar a

45
Q

name the 9 members of the circle of willis

A

Anterior communicating artery
Anterior cerebral artery x2
Internal carotid artery x2
posterior communicating artery x2
posterior cerebral artery x2

46
Q

what major artery is NOT involved in the circle of willis, but is close by

A

middle cerebral artery

47
Q

how much variation exists in the circle of willis in the human population

A

only 30% are “normal”

48
Q

what does the anterior cerebral artery supply in the brain

A

medial/superior frontal and parietal lobes

and the cingulate gyrus

49
Q

what does the middle cerebral artery supply

A

lateral frontal and parietal lobes

superior temporal lobe

50
Q

what does the posterior cerebral artery supply

A

inferior temporal lobe

occipital lobe

51
Q

what area of the brain is represented in the sensory and motor homonculus respectively

A

post central gyrus/primary somatosensory cortex

precentral gyri, primary motor cortex

52
Q

stroke symptoms for an anterior cerebral artery (ACA)

A

contralateral lower limb sensory/motor impairment

cognition/behavior/emotional problems

53
Q

stroke symptoms for a middle cerebral artery stroke (MCA)

A

MOST COMMON AND MORE FUNCTIONS COMPROMISED

cognition/behavior/emotion probs

contralateral UPPER limb/head sensory/motor impairment

lateralization of cerebrum (different symptoms depending on what side the stroke occurs)
-L: language and aphasia problems
-R: spatial orientation, L side neglect

54
Q

stroke symptoms for a posterior cerebral artery stroke (PCA)

A

contralateral visual impairment (homologous hemianopia)

memory/emotional/visual processing

55
Q

what artery supplies the thalamus

A

posterior cerebral artery branches (PCA)

56
Q

where does the middle striatal artery branch from

A

from the anterior cerebral artery

57
Q

where does the lenticulostriate artery branch from

A

middle cerebral artery

58
Q

what arteries supply blood to the basal nuclei and the internal capsule

A

medial striate artery and the lenticulostriate artery (branches from the ACA and MCA respectively)

59
Q

what does the anterior choroidal artery supply

A

the internal capsule

60
Q

what might you see with a stroke of the basal nuclei and the diencephalon

A

more functional loss compared to the cortical stroke

still affects the contralateral body hemisphere because there is no crossing in the forebrain

61
Q

stroke affecting the internal capsule might decrease the function of what

A

projection fibers in the brain; both afferent and efferent

62
Q

a stroke involving the thalamus or basal nuclei might present with what symptoms

A

cognition/psychomotor/affective symptoms

63
Q

a stoke involving the hypothalamus might have what symptoms

A

homeostasis may be affected

life and death in some cases

64
Q

main blood supply to the midbrain

A

posterior cerebral artery (PCA)

superior cerebellar artery (SCA)

65
Q

main blood supply to the pons

A

pontine branches of the Anterior inferior cerebellar artery (AICA)

66
Q

main blood supply to the medulla

A

posterior inferior cerebellar artery (PICA)

vertebral artery

67
Q

what might you see with a stroke to the brainstem

A

more functional loss compared to cortical stroke

ipsilateral face and CONTRALATERAL body hemisphere impairement - alternating hemiplegia

arousal and consciousness can be affected due to the ascending reticular activating system

68
Q

why does alternating hemiplegia occur with brainstem strokes

A

decussation of afferent and efferent fibers at different locations in the brainstem

when above decussation = contralateral body motor/sensory impairement

Cranial nerves 9,10, and 12 originating from the brainstem = ipsilateral functional loss

69
Q

what is the stem of life

A

brainstem

vital centeres located here

70
Q

the superior cerebellar artery (SCA) supplies what regions

A

anterior lobe and superior posterior lobe of cerebellum

Top 1/2

71
Q

what might you see with a stroke of the cerebellum

A

ipsilateral functional impairment

functions impaired mirror functions of cerebellum

72
Q

why does a cerebellar stroke exhibit ipsilateral functional impairement

A

tracts into the cerebellum decussate in the pons or medulla/SC (at middle and inferior cerebellar peduncle)

tracts out of cerenellum decussate in midbrain when ascending further into the brain (superior cerebellar peduncle) , BUT they stay ipsilateral when descending into the body (cerebellovestibular tracts)

73
Q

where is the emissary vein and how is this problematic with infections

A

in loose connective tissue layer of scalp

location means it can spread infection from the scalp to the meninges and brain

74
Q

how does fluid drain TO the dural venous sinus

A

from emissary vein scalp
to diploic veins in skull cap (calvaria)
to bridging veins
CSF is taken up via arachnoid granulations to SSS

75
Q

describe the flow of drainage in the dural venous sinus system

A

deep brain veins drain to the great cerebral vein
Great cerebral and ISS to straight sinus
straight, occipital and SSS drain to confluence of sinuses
to transverse sinus
transverse and cavernous drain to sigmoid sinus
all drain to internal jugular

76
Q

what is the dangerous triangle

A

transverse sinus and cavernous sinus drain to sigmoid sinus

area that makes it easy for infection to spread to the brain

77
Q

what is the pterion

A

weakest point in skull

merge of frontal/parietal/sphenoid bones

middle meningeal artery runs deep to it and supplies meninges

78
Q

what type of injury is common at the pterion

A

rupture of middle meningeal artery

bi-convex hematoma (doesnt cross suture lines)

“talk and die” medical emergency

herniation of brain structures crossing flax cerebri

need CT to check for brain hemorrhage; hemotoma from gray or white area

79
Q

what is a subdural hemorrhage

A

rupture of bridging vein

between meningeal layer of dura and arachnoid

separates the inner layer of the meningeal dura

crescent shape on imaging

caused via TBI i.e. shaken baby

80
Q

what is a subarachnoid hemorrhage

A

in the subarachnoid space between arachnoid and pia mater

area is fluid filled with CSF and blood vessels

caused by trauma/rupture of superficial blood vessel secondary to aneurysm

very common site for anuerysm

generally there isnt a big hematoma due to dilution via CSF

81
Q

what is an intraventricular hemorrhage

A

in ventricular system

malfunction of choroid plexus/neighboring arteriovenous malformation or TBI

no large hematoma due to CSF dilution

82
Q

what types of hemmorhages increase risk of hydrocephalus

A

subarachnoid and intraventricular

bleeding into the CSF filled areas increases fluid volume

83
Q

what is an intraparenchymal or intracerebral hemorrhage

A

stroke

caused by HBP and other predisposed factors:
-arteriovenous malformation
-cavernoma
-cavernous angioma
-drug abuse (screening required if under 55)

84
Q

what portion of strokes are hemorrhagic and how are they differentiated

A

13% of all strokes but 40% of deaths

disruption of blood vessels with bleeding: AVM/aneurysm

under 55 screened for drug abuse

85
Q

what portion of strokes are ischemic and how are they differentiated

A

87% of strokes, 60% of deaths

blockage of blood supply and hypoxia damage

can be transient

Year 2: NeuroBiology (10 decks)

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