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Neuro > Lecture 9 > Flashcards

Lecture 9 Flashcards

1
Q

Arteries of the anterior system

A
  • left internal carotid
  • right internal carotid
  • middle cerebral artery
  • anterior communicating artery
  • anterior cerebral artery
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2
Q

arteries of the posterior system

A
  • left and right vertebral artery
  • posterior cerebral artery
  • anterior spinal artery
  • basilar artery
  • anterior inferior cerebellar artery
  • posterior inferior cerebellar artery
  • pontine arteries
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3
Q

where do the below arteries of the posterior system supply?

  • Superior cerebellar artery
  • Basilar artery
  • Pontine arteries
  • Anterior inferior cerebellar artery
  • Posterior inferior cerebellar artery
A
  • sup. cerebellum, sup. pons, and inf midbrain
  • anterior pons
  • anterior pons
  • ant. inf. cerebellum, and inf. pons
  • post. inf. cerebellum and lateral medulla
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4
Q

blockage of what artery leads to locked in syndrome

A

basilar artery (block to anterior pons)

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5
Q

Where do the below arteries of the anterior system supply?

  • anterior cerebral artery
  • middle cerebral artery
A
  • medial surface of cerebral hemisphere, medial frontal and parietal lobes and corpus callosum
  • lateral surface of cerebral hemisphere and basal ganglia
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6
Q

The left and right anterior cerebral arteries are connected by a small artery called the ?

A

anterior communicating artery

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7
Q

The common carotid artery branches off to form _____?The subclavian arteries branch off to form ______?

A

Internal carotid arteries –> supplying anterior system

Vertebral arteries —> supplying posterior system

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8
Q

Damage to the anterior cerebral artery leads to

A

1) Somatosensory- motor deficits of legs on the contralateral side
2) Prefrontal cortex–> cog deficits (personality changes & problems with EF)

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9
Q

Damage to the middle cerebral artery leads to

A

1) Somatosensory- motor deficits of arms on the contralateral side
2) left hemisphere–> Expressive aphasia (frontal lobe- Broca)/ receptive aphasia (temporal lobe- Wernickes)
3) Right parietal lobe–> left neglect syndrome
4) Prefrontal cortex–> cog deficits (personality changes & problems with EF)

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10
Q

The vertebral arteries give rise to what 3 branches?

A

1) Posterior spinal artery
2) Anterior spinal artery
3) Posterior inferior cerebellar artery (PICA)

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11
Q

The posterior spinal artery supplies?

The anterior spinal artery supplies?

A

Post: posterior 1/3 of spinal cord (dorsal columns)
Ant: Anterior + lateral 2/3 of spinal cord

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12
Q

Anterior spinal artery fuses together to form _____, which runs down the ______.

A

midline artery

anterior median fissure of spinal cord

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13
Q

Stroke in the posterior spinal artery leads to

A

Posterior Cord Syndrome

  • loss of discriminative touch, proprioception and vibration on the IPSILATERAL side below level of stroke
  • pain and temperature NOT affected
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14
Q

Stroke in the anterior spinal artery leads to

A

Anterior Cord Syndrome:

  • loss of motor control below level of stroke
  • loss of pain & temperature sensation below level of stroke
  • Autonomic fxn often affected
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15
Q

Where do the vertebral arteries come together to form the basilar artery?

A

Junction of the pons & medulla

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16
Q

Basilar artery gives rise to (3)

A

1) Anterior inferior cerebella arteries (AICA)
2) superior cerebellar arteries
3) Many pontine arteries (supply pons)

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17
Q

At level of midbrain basilar artery splits to form the ______. What does it supply? What would occur if the structure were damaged?

A

Two posterior cereBRAL arteries

Supplies occipital lobe and inferior parts of temporal lobe (incl hippocampus)

Damage:

  • Occipital lobe: visual deficits in the contralateral visual field (contralateral homonymous hemianopsia)
  • Hippocampus: memory deficits
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18
Q

The posterior and anterior spinal arteries receive blood from the (2)

A

1) Vertebral artery

2) Radicular arteries (off the intercostal arteries)

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19
Q

The diencephalon and BG receive blood from (3)

A

1) Medial striate arteries
2) Lateral striate arteries
3) thalamoperforate and thalamogeniculate arteries

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20
Q

What connects the anterior system and the posterior system of arteries? What does it form?

A

Posterior communicating artery

Circe of Willis

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21
Q

Describe the benefit of an anastamosis

A

Provides an alternate route for blood flow in case of blockage of an artery

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22
Q

Identify what arteries are included in the circle of Willis (10)

A

1) Anterior communicating artery
2) Left anterior cerebral artery
3) Left internal carotid artery
4) Left posterior communicating artery
5) left posterior cerebral artery
6) Basilar artery
7) Right posterior cerebral artery
8) Right posterior communicating artery
9) Right internal carotid artery
10) Right anterior cerebral artery

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23
Q

Where are the venous sinuses located?

A

Between layers of dura mater

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24
Q

____, ____ and _____ form the confluence of sinuses

A

superior, straight, occipital sinuses

25
Q

T or F: blood from the transverse and sigmoid sinuses drain into the confluence of sinuses

A

F: blood –> confluence of sinuses –> transverse –> sigmoid sinus–> jugular foramen

26
Q

T or F: The deep venous system consists of veins that lie next to the arteries in the sulci of the cerebral cortex

A

F: superficial venous system

27
Q

Describe blood flow of the deep venous system

A

Centre of brain –> venous sinuses

28
Q

The largest deep vein is _____ and it empties into the _____ sinus.

A 
great vein (vein of Galen)
straight sinus
29
Q

Main function of CFS

A

cushion the brain

30
Q

Problems with production, circulation and reabsorption of CSF can result in _____

A

Hydrocephalus : excess CSF leading to increased intracranial pressure

31
Q

CSF is produced in the ____ _____ of all ventricles

A

Choroid plexus

32
Q

Describe the flow of CSF within the ventricles/ around the brain & spinal cord

A

CSF flows from the subarachnoid space via

  • the lateral apertures of the 4th ventricles (foramina of Luschka),
  • median aperture of the 4th ventricle (foramen of Magendie)
  • central canal of the spinal cord

Reabsorbed by the arachnoid granulations –> emptied into superior sagittal sinus (with venous blood)

33
Q

Describe an ischemic stroke and the various types of atherosclerotic changes

A

Occluded (blocked) artery shutting off blood supply to a region of the brain

Thrombus: blood clot formed within vessel
Embolus: foreign matter (blood clot) carried along in the bloodstream

34
Q

Region of dead tissue affected by a stroke

A

Infarct

35
Q

T or F: Transcient ischemic attack are similar to strokes but symptoms only last for minutes to hours

A

T (no acute infarct)

36
Q

Rupture of an aneurysm or blood vessel can cause ____ _____

A

hemorrhagic stroke

37
Q

Malformation of confined large anastomoses between arteries and veins

A

Arteriovenous malformation (AVM)

Tangle = increased risk for bleed

38
Q

Tear to middle meningeal artery can lead to ___ _______, which leads to potential bleeding between ____ and _____. Name symptoms (3)

A

Epidural hemorrhage
dura and skull

Sx:

1) headache
2) loss of consciousness
3) possible impingement of CN III // loss of pupillary light reflex

39
Q

T or F: Artery bleeds have higher mortality rates compared to veins. Why?

A

T: arterial = increased pressure

40
Q

Shearing of the cerebral veins entering the dural sinuses causes ______ ______. Often due to ______.

A 
subdural hematoma (between dura & arachnoid- not usually present) 
trauma --> fluctuating symptoms depending on speed of bleed
41
Q

Subarachnoid hemorrhage is caused by bleeding between ____ and ____ . Symptoms (3)

A

arachnoid
pia mater

high mortality rate: circle of willis

Sx:

  • headache
  • loss of consciousness
  • possible loss of pupillary light reflex (CN III)
42
Q

Bleeding directly into brain tissue

A

Intracranial hemorrhage

Sx depends on area affected/ size of bleed

43
Q

Sx of subdural hematoma

A

often seem drunk

  • headaches
  • confusion
  • varies depending on speed/ location of bleed
44
Q

Neuroplasticity plays a role (4) after injury/ disease

A

development
memory
learning
recovery

45
Q

A strengthening or weakening of the synaptic connections between neurons

A

Synaptic plasticity

46
Q

3 subcellular mechanisms for synaptic plasticity

A

Increased or decreased

1) release of neurotransmitter
2) # of neurotransmitter receptors
3) sensitivity of neurotransmitter receptors

47
Q

What is synaptogensesis?

A

Formation of new synapses

Contact between presynaptic & postsynpatic neurons + appropriate molecules = new synapse

48
Q

Regeneration

A

Damaged axons regrow and re-establish original connections

49
Q

Axon sprouting

A

Axons from undamaged portions of neurons form new branches

50
Q

Reactive synaptogenesis

A

synapse formation in response to a stimulus (e.g. damaged neuron)

51
Q

Describe the Wallerian degeneration process

A

In the PNS the distal portion of the axon will break down and macrophages clean up the debris

Meanwhile, the medial (healthy) portion of the axon that is connected to the cell body will heal and begin to regrow

52
Q

What are 2 factors that influence the success of Schwann cells regenerating to original target?

A

1) intact neurolemmal tube

2) supply of growth factor

53
Q

Why is it more difficult for regeneration/ axon sprouting to occur in the CNS?

A

1) Oligodendrocytes do not form a neurolemmal tube
2) inhibitory axon growth effect
3) astrocytes form gliotic scar tissue around damaged area = physical barrier to growth

54
Q

T or F: in adult brains axon sprouting consists of the formation of new pathway formations

A

F: increase in inputs that already exist

55
Q

What are the 3 neuroplastic changes that can occur in the cerebral cortex?

A

1) Use- dependent: Learning alters body representation in motor/ sensory cortex
- most used = largest representation
2) Connection- dependent: reorganization of cortex based on adjacent muscles being used
3) After damage to brain: adjacent areas or contralesional areas can take over motor control

56
Q

Humans that have an increased somatosensory cortex related to their fingers that read braille is an example of what neuroplastic change?

A

Use- dependent

*motor and sensory maps can change

57
Q

Describe the process of secondary connections becoming “unmasked”

A

One area of the cortex may have connections to several parts of the body. Therefore when the primary input fibers are damaged, the secondary connections can be unmasked to become the main input.

sensory and motor

58
Q

Describe the process of “learned non-use”

A

reorganization of the map after injury. Eliminating the areas of non-use to be remapped by areas of undamaged use areas –> can limit person’s functional recovery // important to still use affected areas

Tx: Constraint Induced therapy

59
Q

Factors influencing recovery post stroke

A

1) size of infarct
2) age
3) rehab - use it or lose it
4) timing and intensity of rehab

Neuro (10 decks)

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