LECTURE 4- circulations to the brain and spinal cord Flashcards

1
Q

where is the CSF formed

A

in the ventricles (choroid plexus)

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2
Q

where does the CSF flow

A

between ventricles and into subarachnoid space

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3
Q

what is the function of the csf and meninges

A

provide shock absorption to brain

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4
Q

where is the csf absorbed into

A

the venous system

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5
Q

what is below the 2 C shaped lateral ventricles of the brain

A

thalamus

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6
Q

what is above the body of the 2 C shaped lateral ventricles of the brain

A

corpus callosum

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7
Q

what connects the 2 c shaped lateral ventricles and the 3rd ventricle

A

interventricular foramina (foramina of monro)

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8
Q

where is the 3rd ventricle

A

narrow in midline of diencephalon

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9
Q

what is teh 3rd ventricle surrounded by

A

thalamus and hypothalamus

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10
Q

what connects the 3rd and 4th ventricle together

A

cerebral aqueduct (aqueduct of sylvius)

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11
Q

where is the 4th ventricle

A

posterior to pons and medulla and anterior to cerebellum

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12
Q

where does the 4th ventricle connect to

A

central canal of SC

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13
Q

where does the 4th ventricle drain to

A

subarachnoid space

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14
Q

the 4th ventricle draining into the subarachnoid space thru ______ and midline of foramen of magendie

A

2 lateral foramina (foramina of luschka)

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15
Q

what is the outer layer firmly attached to inside of skull and inner layer attached to arachnoid

A

dura mater

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16
Q

the inner and outer layers of the dura mater fuse except at the

A

dural sinuses

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17
Q

what does the dural sinuses collect

A

CSF and venous blood

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18
Q

the inner layer of the dura mater has 2 dense projections called

A

flax cerebelli and tentorium cerebelli

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19
Q

what does teh flax cerebri seperate

A

the l and r hemispheres

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20
Q

what does the tentorium cerebelli separate

A

cerebellum from the hemispheres

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21
Q

what has grandulations that go thru dura into venous sinuses to allow CSF to flow into them

A

arachnoid mater

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22
Q

what is tightly fixed to the brain and SC surfaces

A

pia mater

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23
Q

the pia mater is connected to arachnoid through what

A

arachnoid trabeculae (collagen fibers ) to allow suspension of brain in CSF

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24
Q

what secretes the most CSF

A

choroid plexuses

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25
Q

what are the 3 layers of the formations of CSF

A

web of capillaries , connective tissue and epithelial cells

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26
Q

what is filtered and transported through the 3 layers to form CSf

A

blood

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27
Q

CSF is a what substance

A

protein rich

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28
Q

what is most often due to fx of parietal or temporal bones tearing middle meningeal artery

A

epidural hematoma

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29
Q

what type of shape is an epidural hematoma

A

lens

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30
Q

is an epidural hematoma a quick accumulations of blood

A

yes

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31
Q

what is most often due to venous bleed

A

subdural hematoma

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32
Q

what type of deterioration is a subdural hematoma

A

slow , progressive

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33
Q

what type of deterioration is a epidural hematoma

A

quick

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34
Q

hydrocephalus can be

A

congenital or acquired

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35
Q

what is an abnormal build up of CSF in the ventricles

A

hydrocephalus

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36
Q

infants with hydrocephalus that have no fused skulls will have

A

enlarged heads

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37
Q

children/adults with fused skulls and hydrocephalus will have

A

excessive pressure especially of white matter

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38
Q

triad of symptoms of children/ adults with hydrocephalus is

A

worsening gait , incontinence , or cognitive defects

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39
Q

what is it when the ventral system is intact but there is blockage caudal to 4th ventricle

A

communicating hydrocephalus

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40
Q

what is noncumunicating/ obstructive hydrocephalus

A

blockage within ventricular system (usually cerebral aqueduct)

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41
Q

what is it called when there is inflammation of the meninges

A

meningitis

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42
Q

if someone has meningitis when does pain increase

A

upright position , with head movement , and sneezing and coughing

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43
Q

what is located on the medial side of the homuncules

A

the lower extremity

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44
Q

what is located on the lateral aspect of the homunclues

A

face and UE

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45
Q

if there is a blockage inside the circle of willis can the circulation be fixed

A

yes

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46
Q

what dies the circle of willis form around

A

optic chiasm and pituitary gland

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47
Q

what artery goes into the medulla

A

vertebral artery

48
Q

how much foes the anterior spinal artery supply the sc

A

> 1/2 of SC

49
Q

how many arteries supple to anterior and posterior SC

A

1 from anterior and 2 for posterior

50
Q

what is it called when arteries connect to abnormal vessels rather than capillaries to veins

A

arteriovenous malformation

51
Q

is AVM congenital or acquired

A

congenital

52
Q

what are the symptoms of AVM

A

local pain

53
Q

is AVM symptomatic or asymptomatic

A

can be asymptomatic till rupture

54
Q

where is AVM found

A

anywhere in the body

55
Q

what is a thin walled outpouching from artery or vein

A

aneurysm,

56
Q

where is an aneurysm found

A

anywhere in circulatory system

57
Q

what type of aneurysm is more common

A

saccular

58
Q

what is the difference between a saccular and fusiform aneurysm

A

saccular is one side of a blood vessel and fusiform is both sides of a blood vessel

59
Q

what is a specialized barrier between capillary endothelium of CNS and extracellular space

A

blood brain barrier

60
Q

what is the permeability of the blood brain barrier

A

less than regular capillaries so large molecules can’t enter

61
Q

why is it beneficial that the blood brain barrier is less permeable

A

prevents lots of pathogens from entering CNS

62
Q

why is it bad that the blood brain barrier is less permeable

A

prevents certain drugs and proteins antibodies from entering

63
Q

where is the blood brain barrier absent

A

parts of hypothalamus and areas close to 3rd and 4th ventricle

64
Q

what increases form brain stem to vertebral cortices

A

O2

65
Q

what is more vulnerable to O2 loss than life centers of brain stem

A

cortex

66
Q

cerebral artieres autoregualte local blood flow dependent on what

A

blood pressure and metabolism

67
Q

what happens if BP, O2 or pH levels are low or CO2 or lactic acid is high

A

dilation

68
Q

what happens if BP, O2 or pH levels are high or CO2 or lactic acid is low

A

constriction

69
Q

what is it called when there is excessive fluid in brain tissue

A

cerebral edema

70
Q

what are some common causes of cerebral edema

A

TBI, heart attack or height altitude cerebral edema

71
Q

why is cerebral edema progressive

A

bc fluid pressure causes ischemia

72
Q

what does ischemia causes

A

arterioles to dilate

73
Q

what happens when arterioles dilate

A

increases capillary pressure and permeability

74
Q

what is it called when there is pressure within the skull

A

intracranial pressure

75
Q

how is intracranial pressure measured

A

by monitor in lateral ventricles

76
Q

what is the normal range of intracranial pressure

A

5-15 mm HG

77
Q

pressure against the flax cerebri is called what brain herniation

A

cingulate

78
Q

pressure against the flax cerebri likely to cause what

A

contractural problems with LE

79
Q

what brain hernimation is pressure against the midbrain which causes CN 3 dysfunction and loss of consciousness

A

uncal

80
Q

what brain hernimation is pressure against the diencephalon moving it , midbrain and pons down

A

central

81
Q

which brain hernimation stretches basilar artery with brain stem ischemia/edma

A

central

82
Q

which brain hernimation is pressure of cerebellar tonsils putting on brain stem

A

tonsillar

83
Q

putting pressure on the brain stem impairs what

A

consciousness and 4th ventricle

84
Q

where does the sc and medulla drain into

A

small veins into radicular veins into epidural venous plexus

85
Q

where do cerebral veins drain into

A

dural sinuses into internal jugular veiin

86
Q

superficial veins drain cortex and neighboring white matter into

A

superior sagittarius sinus

87
Q

deep cerebral veins drain basal ganglia, diencephalon, adjacent white matter into

A

straight sinus

88
Q

superior sagittarius and straight sinuses meet at

A

confluence of sinuses

89
Q

where foes the transverse sinuses arise from and drain into

A

confluence and internal jugular vein

90
Q

what stroke is brief localized loss of brain function

A

transient ischemic attach

91
Q

how long is a TIA resolved

A

within 24 hours

92
Q

is it recommended for a person to seek medical attention with a TIA

A

yes bc can lead to bigger stroke

93
Q

what is a brain attack

A

a stroke

94
Q

how long does a cerbrovascular accident last

A

longer than a day

95
Q

what is an embolus stroke

A

clot from somewhere else

96
Q

what is a sudden quick loss of function in a stroke

A

embolus stroke

97
Q

what is a thrombus stroke

A

narrowing and/or clot in area invovled

98
Q

T/F: a thrombus stroke is gradual worsening or function

A

true

99
Q

80% of all strokes are

A

infarcts (blood being blocked)

100
Q

what artery does most strokes affects

A

middle cerebral artery

101
Q

what is a small deep circulation infarcts

A

lacunae infarcts

102
Q

what is a hemorrhage

A

rupture of a vessel

103
Q

20% of strokes are

A

hemorrhage strokes

104
Q

hemorrhage damage is due to

A

downstream loss of blood to brain areas
pressure of extra cellular blood accumulation
blood where not supposed to be is irritant to brain tissues

105
Q

complete blockage of what artery will cause death due to ischemia of brainstorm with vital functions

A

basilar artery

106
Q

partial bloackage of the basilar artery can causes

A

tetrapelgia , numbness, loss of consciousness, cranial nerve damage

107
Q

what arteries are prone to shear force injuries

A

vertebral

108
Q

a stroke in the anterial cerebral artery causes hemiparesis loss to contra lateral side of what body parts

A

Lower limb

109
Q

what else changes with a stroke in the anterial cerebral artery

A

personality changes

110
Q

a stroke in the middle cerebral artery can causes hemiparesis loss to contractural side of which body parts

A

face and UE

111
Q

if there is a stroke in teh middle cerebral artery on the L brain what will be affected

A

language

112
Q

is there is a stroke in the middle cerebral artery on the R brain what will be damaged

A

spatial relationships
neglect
nonverbal communication

113
Q

what artery supplies the midbrain , diencephalon, hippocampus , thamalus

A

posterior cerebral artery

114
Q

if there is a stroke in the posterior cerebral artery what will be damage

A

eye movements
cortical blindness

115
Q

what areas are vulnerable to ischemia

A

watershed areas