Module 6

Question 1

A horizontal cut through the brain is ______ to the horizon.

Answer 1

parallel.

Question 2

Grey matter is primarily composed of…

Answer 2

cell bodies, dendrites, and non-myelinated axons.

Question 3

What is the choroid plexus responsible for producing inside the brain?

Answer 3

Cerebral Spinal Fluid. highly vascular. Throughout the ventricles. Excretes CSF from vascular system to ventricular system.

Question 4

the basal ganglia are important for…

Answer 4

automatic programming of voluntary motor functions. Helps refine movement.

Question 5

What is the first area of the brain to degenerate in Huntington’s disease?

Answer 5

the caudate nucleus.

Question 6

What is the insula involved with?

Answer 6

taste, gustation, social cognition and emotion (compassion, empathy).

Question 7

What is another name for the optic radiations?

Answer 7

the geniculostriate pathway, which runs from the lateral geniculate nucleus to the striate or primary visual cortex.

Question 8

What is another name for the primary visual area?

Answer 8

Brodmann’s area 17, or the striate cortex, or area V1.

Question 9

The inferior colliculi play a role in…

Answer 9

auditory processing, specifically sound localization.

Question 10

What is another name for the cerebral crura?

Answer 10

cerebral pinochles.

Question 11

The amygdala is part of the _______ system and is important for ________ processing.

Answer 11

limbic; emotional.

Question 12

What type of emotional experiences does the amygdala support?

Answer 12

emotionally charged memories, like being frightened by working with the hippocampus, which records the facts, and the amygdala records the emotions attached to them. It is also responsible for aggressive behavior (sympathetic nervous system activation) and sexual behaviors.

Question 13

Episodic memory includes ________ and _______ coordinates of what happened.

Answer 13

spatial; temporal.

Question 14

Semantic and episodic memory together are called

Answer 14

declarative memory.

Question 15

Where is declarative memory stored?

Answer 15

in the hippocampus.

Question 16

What structure other than the hippocampus is important in declarative memory?

Answer 16

the mammillary bodies.

Question 17

The fusiform gyrus is important for ______ recognition and a section of it is called the fusiform ____ area.

Answer 17

facial; face.

Question 18

The brain has the consistency of about what?

Answer 18

an overripe peach.

Question 19

The meninges are…

Answer 19

a three layered sac that serves to protect the brain and spinal cord from damage as a shock absorbing system and circulation of complex molecules for a variety of functions.

Question 20

True or false. the CSF flows outside to inside.

Answer 20

False. it flows from the inside out.

Question 21

What are the three layers of the meninges called?

Answer 21

Derma mater (tough material)
arachnoid layer (in between in thickness and toughness. Fibers and some blood vessels) 
subarachnoid space (so not considered a layer, but where the CSF circulates)
pia mater (attaches directly to the cortex) difficult to see, thin, transparent.

Question 22

True or False. Cerebral spinal fluid is the same as blood plasma minus the floating products.

Answer 22

True.

Question 23

Tract the path of CSF through the brain.

Answer 23

Created in the choroid plexus, from lateral ventricles, to third, to fourth, then around the top of the brain to be reabsorbed.

Question 24

Explain reabsorption of CSF.

Answer 24

at the top of the brain, near the venous sinus, which is a large sinus front to back. Holds venous blood that’s deoxygenated, ready to return to the heart to be reoxygenated by the pulmonary circuit. The CSF that is in the subarachnoid space flows across the villi or arachnoid granulations, go right into blood supply and are reabsorbed.

Question 25

How much CSF do we make a day?

Answer 25

500 ml each day.

Question 26

The system can only hold how many ml of CSF, and what does that mean?

Answer 26

125 ml of CSF which means we need to reabsorb 4x as much as the system holds in order to keep up with reproduction.

Question 27

What happens if reabsorption is not happening appropriately?

Answer 27

The ventricles will expand and cause disorders or death.

Question 28

Obstructive hydrocephalus is…

Answer 28

closing off of circulation which CSF is made but no longer reabsorbed. This is a medical emergency.

Question 29

How is OH treated?

Answer 29

skull prepped, head shaved, betadine is placed on skull for sterilization, an incision is made into scalp to reveal bone and a hole is drilled into their head (burr hole) and a tube is placed at the side of head called an external ventriculostomy. Allows CSF above the point of obstruction is ventilated into a bag, then the head will be fixed as necessary (like removing the blood clot) to make certain nothing is wrong, then the ventriculostomy can be removed.

Question 30

What is normal pressure hydrocephalus?

Answer 30

produces dementia.
Not sudden or acute.
a very slow increase in pressure with compensation then pressure again.
demented within a few months (too rapid)
incontinence (new)
gait changes (DIG)
in the fall, he hit his head on the stump of a tree. Went down but not unconscious (saw stars w headache).
Due to brain atrophy that occurs naturally with age, there was more space in the arachnoid space (10% less volume). As the brain shrinks, things stretch. In a young brain its ok, but in elderly, this can lead to tears in blood vessels. This will cause some blood to enter the subarachnoid space. RBC’s can’t pass through the membrane and pack against it and it results in a reduced rate of reabsorption of CSF.
MRI to show ventricles were enlarged.
Fix: ventriculoperitoneal shunt

Question 31

What is a ventriculoperitoneal shunt?

Answer 31

a shunt is placed in the ventricles that runs to the peritoneal cavity in the stomach.

Question 32

How is a ventriculoperitoneal shunt inserted?

Answer 32

incise scalp, small hole, cut through dura mater, then place a tube so end is inside the lateral ventricle. Right, non language hemisphere as it goes through brain matter. the tube comes up to a quarter sized reservoir placed with a valve that can open and closed. While it is open, the valve will allow drainage of CSF and while closed, it will not allow drainage. Another tube is placed internally by tunneling down the skull, behind the ear, right beneath the skin of the neck above the muscle, then down past the clavical and thorax to drain into the peritoneal cavity. Surgeons creates a stab wound and tube is placed in there through the hole created so CSF can drain into various systems.

Question 33

If not caught right away, unfortunately, the longer the delay…

Answer 33

the less recovery you get. 5% of all cases of dementia are normal pressure hydrocephalus.

Question 34

If caught right away, the symptoms of normal pressure hydrocephalus…

Answer 34

can fully remit.

Question 35

What connects the lateral ventricles to the third ventricle?

Answer 35

interventricular foramen (of Monroe)

Question 36

What separates the right and left Thalamus and hypothalamus?

Answer 36

the third ventricle.

Question 37

What are the other two names for the cerebral aqueduct?

Answer 37

mesencephalic aqueduct and Aqueduct of Sylvias

Question 38

what separates the pons and medulla from the cerebellum?

Answer 38

the fourth ventricle.

Question 39

How does the fourth ventricle communicate to the subarachnoid space?

Answer 39

the lateral apertures of luscka? and median aperture of mejendi?

Question 40

What filters the CSF from the subarachnoid space into the dural venous sinus/superior sagital sinus.

Answer 40

the arachnoid granulations

Question 41

Meningitis is…

Answer 41

an inflammation or swelling of meninges. can be viral (most common), fungal, bacteria, parasitic, consequence of cancer or reaction to drugs. Flulike symptoms, but will advance pretty quickly. Severe headache different from normal. Stiff neck and seizures. Confusion as well.

Bacterial is the most dangerous. Advances rapidly and immediate treatment is necessary. Spread by congregate living.

Can produce hearing loss or deafness, cognitive symptomology such as poor memory.

Question 42

a Meningioma is…

Answer 42

an intercranial tumor of the meninges. most common of the intercranial tumors. originates in cells in the arachnoid membrane. Almost always benign. Grow in place, have defined borders. Rare with malignant that it can invade brain tissue. Most sig risk factor is advancing age. Ionizing radiation is also a factor (dental x-rays).
Treatable via surgery. craniotomy if on surface. cut out area involved and filled with artificial tissue.
If in the falx cerebri (curtain that extends into the longitudinal fissure) can be more difficult to get at.
Tentorium cerebelli is a section of meninges under the cerebral hemispheres and over the cerebellar hemispheres, keeping them separate, and tumors can be difficult to remove.
Radiation is possible if surgical treatments are not.