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Neuro I > Lecture 3: Head and Neck Vasculature I: Sinuses and Veins > Flashcards

Lecture 3: Head and Neck Vasculature I: Sinuses and Veins Flashcards

1
Q

Most of the CSF is produced by the ________ of the _______.

A

Most of the CSF is produced by the choroid plexuses of the lateral, third, and fourth ventricles

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2
Q

CSF is resorbed in the ______.

A

Arachnoid villi

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3
Q

Atrophy of the cerebral cortex may result in ______.

A

External Hydrocephalus

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4
Q

Occlusion of the cerebral aqueduct would result in _______ of the ______ and _________

A

Occlusion of the cerebral aqueduct would result in hydrocephalus of the 3rd and lateral ventricles

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5
Q

Occlusion of the right interventricular foramen would result in _____ of the _______.

A

Occlusion of the right interventricular foramen would result in Hydrocephalus of the Lateral Ventricle

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6
Q

Obstruction of the subarachnoid space at the level of the tentorial notch may result in _________.

A

Communicating Hydrocephalus

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7
Q

CSF enters the subarachnoid space via the ________ and ________.

A

Medial and Lateral Foramina

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8
Q

Secondary to a subarachnoid hemorrhage blood in the CSF may occlude the _______ and result in _________.

A

Secondary to a subarachnoid hemorrhage blood in the CSF may occlude the Arachnoid villi and result in secondary (chemical) Meningitis.

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9
Q

Retromandibular vein is formed by which 2 veins?

A

Superficial Temporal V. + Maxillary V.

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10
Q

Where is the Pterygoid plexus of veins and what does it drain into?

A
  • Extensive venous network located on lateral surface of the medial pterygoid muscle and surrounding lateral pterygoid muscle
  • Drains into: deep facial, maxillary, and retromandibular veins
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11
Q

What are the main differences between the superior bulb versus inferior bulb of the IJV; where is each located?

A
  • Superior bulb is in the jugular fossa and does not have a valve
  • Inferior bulb is posterior to the interval between sternoclavicular heads of the SCM, and has a valve
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12
Q

What are the Pericervical lymph nodes and where do they drain?

A
  • Form a “collar” of superficial LN’s around the base of head
  • Include the: occipital, mastoid, parotid, submandibular, buccal, and submental group
  • Drain directly into the: deep cervical LN’s
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13
Q

What are the Superficial Cervical LN’s; where are they found; where do they drain?

A
  • Two groups
  • Posterior Superficial Cervical LN’s adjacent to the external jugular vein in the posterior (lateral) triangle
  • Anterior Superficial Cervical LN’s adjacent to the anterior jugular vein in the anterior triangle
  • Both groups drain into the: deep cervical LN’s
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14
Q

Where are the Deep Cervical LN’s located; which 2 are most important; which group is related to the tonsils?

A
  • Located along the length of the IJV
  • Jugulo-digastric nodes = tonsillar

- Jugulo-omohyoid nodes

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15
Q

Where is the Thoracic duct located; where does it receive lymph from?

A
  • Runs in front of the anterior scalene and behind the left carotid sheath
  • Is located only on the left side of the root of the neck
  • Receives lymph from the left side of the head, and all of the body except the RUE and head
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16
Q

Where is the lateral ventricle and what forms its borders?

A
  • C-shaped, arc-shaped cavity in core of each cerebrum (right and left)
  • Corpus callosum forms the lateral walls, and the caudate nucleus in on its floor
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17
Q

What is the interventricular foramen of Monroe and why is it clinically significant?

A
  • Connects the lateral ventricles to the third ventricle
  • One of both foramina may be obstructed by tumors such as a choroid plexus ependymomas in the third ventricle
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18
Q

The thoracic fuct drains into the __________.

A

IJV/subclavian vein junction

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19
Q

The retromandibular vein has a direct relationship with the ______nerve.

A

Facial

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20
Q

The distal branches of the inferior thyroid artery have a direct relationship with the _______ nerve.

A

Recurrent laryngeal nerve

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21
Q

The _______ is embedded in the prevertebral fascia just posterior to the common carotid artery.

A

Cervical sympathetic chain

22
Q

Where is the third ventricle and what is it connected to?

A
  • Thin vertical chamber in the midline between the thalami
  • Continous with the lateral ventricles via the interventricular foramina
  • Continous with the fourth ventricle via the cerebral aqueduct
23
Q

A midbrain tumor such as astrocytomas may obstruct the cerebral aqueduct and lead to?

A

Hypertrophy of the lateral and third ventricles (supratentorial internal hydrocephalus)

24
Q

What is the central canal of the brain?

A

A cul-de-sac extending from the obex of the fourth ventricle to C5-8

25
Q

Pathologically, the central canal may enlarge and develop a cavity (syrinx) in the center of the cord (myelia), what is this condition called and what do patients complain of?

A
  • Syringomyelia
  • Complain of bilateral anesthesia of the shoulders and upper limbs
26
Q

The fourth ventricle is shaped like a four-sided pyramid and what are each of its sides continous with?

A
  • The third ventricle via the cerebral aqueduct
  • Cerebellomedullary cistern via the medial and lateral foramina
  • Blind-ending central canal at the obex, which becomes central canal of spinal cord
27
Q

The brain is floating in the CSF-filled _________ space, which is bounded by ______ and ________ mater

A

The brain is floating in the CSF-filled subarachnoid space, which is bounded by pia mater and arachnoid

28
Q

What is the cerebellomedullary cistern (cisterna magna)?

A

Large CSF-filled space just above the foramen magnum and posteior to the medulla

29
Q

How many mL of CSF in ventricles, in the entire system, and produced each day?

A
  • 20-25 mL in the ventricles
  • 140 mL in the system
  • 600-700 mL produced each day
30
Q

What is the Hydrocephaly?

A

Increase in cerebral mass and/or size due to presence of an excessive amount of CSF in the ventricular system, the subarachnoid space, or both

31
Q

External Hydrocephalus is an excessive accumulation of CSF where; what are the 2 types?

A
  • In the subarachnoid space
    1) Supratentorial is most commonly associated with senile atrophy of the cortex, i.e., Alzheimer’s disease
    2) Infratentorial is seen in combination with communicating hydrocephalus
32
Q

What is Internal Hydrocephalus often called, why?

A
  • Noncommunicating hydrocephalus, because it:
  • Does not drain into the subarachnoid space
33
Q

Internal Hydrocephalus may be caused by obstruction of what 3 strucutres?

A

1) Interventricular foramen (third ventricle choroid plexus ependymoma)
2) Cerebral aqueduct (midbrain astrocytoma)
3) Medial and lateral foramina (Arnold Chiari malformation, Dandy Walker Cyst)

34
Q

The superior sagittal sinus usually empties into the ______.

A

Right transverse venous sinus

35
Q

The sigmoid sinus empties into the _______ at the ________.

A

The sigmoid sinus empties into the IJV at the Jugular foramen

36
Q

The superior opthalmic vein empties into the ________.

A

The superior opthalmic vein empties into the Cavernous Sinus

37
Q

The veins of the spinal cord collectively drain into what, which is located in what space?

A
  • Drain into the internal venous plexus of Batson
  • Located in the epidural space
38
Q

What 2 major veins of the cerebral hemisphere drain into the Great Vein of Galen?

A

1) Internal Cerebral Vein
2) Basal Vein of Rosenthal

39
Q

What vein drains most of the deep cerebrum and what can obstruction of this vein lead to?

A
  • The great vein of Galen
  • Obstruction of this vein is usually fatal
  • May also become dilated and form a venous varix; a great vein varix may compress the pineal body and posterior commissure
40
Q

The superior sagittal sinus drains most of what part of the brain and drains into which vein?

A

Drains most of the cerebral cortex and empties into the right transverse sinus

41
Q

Where is the straight sinus formed, what major vein drains into it, and what does the straight sinus drain into?

A
  • Formed at the intersection of the falx and the tentorium
  • The great cerebral vein of Galen drains vital deep structures of the cerebrum and empties into the straight sinus
  • Straight sinus drains into the left transverse sinus
42
Q

The confluens receives venous drainage from what sinuses?

A

Superior sagittal, straight, and occipital sinuses

43
Q

In 2/3’s of the cases the superior sagittal sinus empties directly into the ________ sinus, and the straight sinus drains directly into the __________ sinus.

A
  • Supeior sagittal sinus empties directly into the right transverse sinus
  • Straight sinus drains directly into the left transverse sinus
44
Q

Thrombosis of the straight venous sinus or left transverse venous sinus results in?

A

Ischemia and/or necrosis of structures in the deep cerebrum. This is usually fatal

45
Q

What is a falx herniation?

A
  • Falx cerebri only partially separates the cerebral hemispheres, so unilateral space-occupying lesions of the cerebrum may cause the cingulate gyrus to herniate across the midline beneath the free edge of the falx
  • Midline shift
46
Q

What is a Tentorial or Uncal Herniation?

A
  • Profuse, high-pressured bleeding rapidly expands the epidural space, thereby pressing upon adjacent cerebral hemisphere and herniating the cerbrum under the falx cerebri (falx herniation) and/or through the tentorial notch (tentorial or uncal herniation)
  • Compresses and displaces the midbrain
  • Bilateral compression of the midbrain reticular formation results in progressive decrease in the level of conciousness
47
Q

What is Tonsilar Herniation?

A
  • Space expanding or occupying masses in the posterior cranial fossa may cause the cerebellar tonsil to herniate through the foramen magnum, which can compress the lower medulla/upper cervical spinal cord.
  • Seen in Arnold-Chirari Malformation
48
Q

A fracture of the pterion may rupture which artery and lead to?

A
  • Middle meningeal artery
  • Epidural hematoma
  • Profuse high-ressure bleeding rapidly expans the epidural space, and may cause a midline shift of cerebral hemispheres (falx herniation) and/or an uncal herniation
49
Q

Increased intracranial pressure applies a cuff-like pressure to the small veins on the optic nerve via of the adjacent subarachnoid extension; what can this lead to?

A

Decreased venous drainage from the retina results in edema of the retina and swelling of the optic disc (papilledema)

50
Q

Thrombosis of the posterior portion of the superior venous sinus or right transverse venous sinus results in?

A

Cortical ischemia and/or necrosis

51
Q

All of the major blood vessesl supplying the CNS pass through or course in the subarachnoid space, rupture of one of these vessesl in this space is called; clinically how can you determine this?

A
  • Subarachnoid Hemorrhage
  • Indicated by the presence of erythrocytes in the CSF
  • CSF is usually sampled by inserting a needle into either the cerebellomedullary or lumbar cisterns
52
Q

Trauma to which veins may lead to rupture and a Subdural Hematoma?

A
  • Cerebral (bridging) veins
  • May rupture as they cross the subdural space
  • Same signs and symptoms as epidural hematomas, but their onset may be delayed for days or weeks

Neuro I (15 decks)

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