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PTH9111 Test 2 > Lecture 22- Cerebral Vascular and Cerebrospinal Fluid > Flashcards

Lecture 22- Cerebral Vascular and Cerebrospinal Fluid Flashcards

1
Q

T or F: Cerebral blood flow is locally regulated to ensure constant blood flow

A

T

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2
Q

In what 2 ways can metabolites influence blood flow

A
  1. Hypoxia/Hypercarbia -> Vasodilation and increased blood flow
  2. Hypocarbia -> vasoconstriction and decreased blood flow
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3
Q

How can you reduce intracranial pressure that occurs from a brain bleed, stroke, tumor, aneurysm or high blood pressure

A

Hyperventilation to decrease carbon dioxide and reduce blood flow and intracranial pressure

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4
Q

What is the blood brain barrier

A

Barrier between vascular system and brain to prevent substances from entering cerebral space

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5
Q

How do substances pass the blood brain barrier

A

Depends on molecular size, lipid miscibility and degree of ionic dissociation to go through tight junctions

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6
Q

What 3 diseases result from leaky blood brain barrier

A
  1. Epilepsy
  2. Alzheimer’s disease
  3. MS
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7
Q

What are the 2 starting points for cerebral blood supply and their respective arteries

A
  1. Anterior blood supply -> carotid artery
  2. Posterior Blood Supply -> Vertebral artery
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8
Q

The anterior blood supply is made up of what 2 carotid arteries

A
  1. Right Common Carotid Artery
  2. Left Common Carotid Artery
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9
Q

Where does the right common carotid artery branch from

A

Brachiocephalic trunk

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10
Q

Where does the left common carotid artery branch from

A

Highest part of the aortic arch

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11
Q

2 roles of carotid body and sinus at branches of carotid artery

A
  1. Blood pressure and respiration
  2. Carotid pulse
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12
Q

Label the missing parts of the diagram of the anterior blood supply system

A
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13
Q

Function of the anterior communcating artery

A

Joins the two cerebral arteries and supplies part of corpus collosum that is an important blood source for 2 cerebral hemispheres

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14
Q

T or F: The anterior communicating artery is a frequent site for aneurysm formation

A

T

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15
Q

Function of the anterior cerebral artery

A

Supplies inferior and medial surface of frontal and parietal lobes

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16
Q

What would occur if there was a blockage of the anterior cerebral artery?

A

It would damage lower extremities as they are represented more medially in homunculus of brain

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17
Q

Function of the middle cerebral artery

A

Supplies lateral surface of frontal, parietal and temporal lobes

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18
Q

What 3 possibilities can occur if the middle cerebral artery is affected by a stroke

A
  1. Sensorimotor deficits in contralateral face and limbs
  2. Global Aphasia (dominant hemisphere) effecting language, auditory and visual comprehension
  3. Neglect Syndrome (nondominant hemisphere) causing individual to not recognize contralateral side of body
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19
Q

Label the diagram of the missing parts of the posterior blood supply system

A
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20
Q

Function of the posterior inferior cerebellar artery (PICA)

A

Supplies a large part of the cerebellum

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21
Q

What disease occurs and symptoms from a stroke of PICA

A

Wallenberg syndrome: ipsilateral loss of pain/temp of face, contralateral loss of pain/temp of neck, limbs and trunk, ipsilateral Horner syndrome (dropping of eyelid and constricted pupil), hoarseness, double vision, ipsilateral loss of taste, ipsilateral cerebellar ataxia

22
Q

What are the 3 sources of blood supply in the spinal cord

A
  1. Single anterior spinal artery
  2. Paired posterior spinal arteries
  3. Radicular and segmental branches
23
Q

What are the 3 key arteries from the posterior blood supply system of vertebral artery

A
  1. Anterior inferior cerebellar artery
  2. Pontine arteries
  3. Superior cerebellar arteries
24
Q

Function of superior cerebellar artery

A

Supplies dorsal surface of cerebellum and midbrain

25
Q

Function of pontine arteries

A

Supplies pons

26
Q

Function of anterior inferior cerebellar artery

A

Supplies cerebellum and pons

27
Q

Function of posterior cerebral artery

A

Supplies medial/interior surface of temporal and occipital lobe, small strip of lateral occipital lobe, and calcarine artery (supplies primary visual area)

28
Q

What happens if there is a stroke at the posterior cerebral artery

A

Contralateral homonymous hemianopsia (entire visual field of opposite side affected) and if damage occurs to dominant hemisphere-> reading and writing are impaired

29
Q

Label the missing parts of the circle of willis

A
30
Q

Function of the circle of Willis

A

Insurance policy so acts like cascular shunt to allow collateral circulation to brain should something become occluded

31
Q

Label which of the colored parts are more medial or lateral

A
32
Q

Label which of the colored parts are more medial or lateral

A
33
Q

Give a diagnosis and treatment to this case

A

Diagnosis: Hypoperfusion to left middle cerebral artery

Treatment: Mechanical thrombectomy with stent retriever performed to return blood flow

34
Q

what is a difference between systemic and cerebral veins?

A

cerebral veins are without valves or muscle tissue to assist and regulate flow

35
Q

sinuses of the brain empty into the :

A

internal jugular vein

36
Q

what are the 3 venous drainage sinuses of the brain?

A
  • Inferior sagittal sinus
  • Superior sagittal sinus
  • Transverse sinus
37
Q

all 3 sinuses of the brain drain into the ______ sinus

A

sigmoid

38
Q

what is cerebral venous sinus thrombosis? and causes/riskfactors

A

Blood clot forms in sinuses which Prevents blood from draining out – results in hemorrhage
- Caused by bacterial infections or malignancy
- Pregnancy and oral contraceptives are risk factors

39
Q

where are the sinuses located?

A

between the periosteal and meningeal layer of the dura mater

40
Q

what is the falx cerebri?

A

a dural fold that separates the right and left hemispheres

41
Q

what is the main role of dural folds

A

Provide support to the brain and dural venous sinuses

42
Q

what are the 3 dural folds in the human brain and where are they located?

A
  • Falx Cerebri – vertical, between two cerebral hemispheres
  • Tentorium Cerebelli – horizontal, between cerebral hemispheres and cerebellum
  • Falx Cerebelli – vertical, between cerebellar hemispheres
43
Q

T or F: the subarachnoid space contains the CSF, cerebral arteries and veins

A

true

44
Q

what are the 3 types of hemorrhage found in the brain? and which vasculature is usually involved in each?

A
  1. subarachnoid - cerebral arteries
  2. subdural - cerebral veins
  3. epidural - meningeal vessels running on the surface of the cranium
45
Q

3 functions of cerebrospinal fluid:

A
  1. Acts as a cushion for the brain
  2. Vehicle to remove metabolic waste
  3. Maintains stable ionic environment
46
Q

where is CSF produced?

A

by cells in the choroid plexus located in the lateral, third and fourth ventricles

47
Q

how much CSF does the choroid plexus produce in a day?

A

500mL (volume is 150mL but is replenished 3-4x per day to remove waste)

48
Q

describe the flow/pathway of CSF

A

Lateral ventricles → interventricular foramen → third ventricle → cerebral aqueduct → fourth ventricle → median/lateral aperture → subarachnoid space around brain and spinal
cord → absorbed into dural veinous sinuses

49
Q

what is hydrocephalus?

A

Obstruction of the CSF pathway causes stagnation of flow which Results in dilation of parts of the ventricular system due to abnormal collection of CSF

50
Q

what is the difference between obstructive and communicating hydrocephalus?

A

obstructive = within the ventricles, communicating = outside ventricles in subarachnoid space.

51
Q

what is the treatment for hydrocephalus?

A

A shunt (catheter that allows CSF to flow) can be inserted into the ventricle - end of the shunt can be secured in the peritoneal cavity or into the atrium of the heart

PTH9111 Test 2 (16 decks)

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