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Early Year Notes > Neuro > Flashcards

Neuro Flashcards

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1
Q

What is the anterior circulation of the cerebral vasculature responsible for supplying

A

Cerebrum

Ophthalmic artery

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2
Q

What is the posterior circulation of the cerebral vasculature responsible for supply

A

Occipital lobes

Cerebellum

Brainstem

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3
Q

What are the two sets of blood supply to the cerebral vasculature

A

Paired internal carotid arteries (ICA)

Paired vertebral arteries

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4
Q

Where does the paired internal carotid arteries (ICA) arise from

A

Arise at C4 at the bifurcation of the left and right common carotid arteries

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5
Q

Describe the route of the paired internal carotid arteries (ICA)

A
  1. Arise at C4 at the bifurcation of the left and right common carotid arteries
  2. Enter via the carotid canal of the temporal bone and move superiorly within the carotid sheath
  3. Pass through the cavernous sinus (in the cranial cavity)
  4. Distal to the sinus gives rise to branches. Then continues to middle cerebral artery
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6
Q

Name what the paired internal carotid arteries give rise to distal to the cavernous sinus

A

Ophthalmic artery
Posterior communicating artery
Anterior choroidal artery
Anterior cerebral artery

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7
Q

What does the ophthalmic artery supply

A

Structures of the orbit

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8
Q

What does the posterior communicating artery act as

A

Acts as an anastomotic ‘connecting vessel’ in the circle of willis

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9
Q

What does the anterior choroidal artery supply

A

Structures in the brain important for motor control and vision

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10
Q

What classification is used for ICA segments

A

Bouthillier classification

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11
Q

Describe the Bouthillier classification of ICA segments

A

C1 = cervical
C2 = petrous
C3 = lacerum
C4 = cavernous
C5 = clinoid
C6 = ophthalmic (supraclinoid)
C7 = communicating (terminal)

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12
Q

Where does the paired vertebral arteries arise from

A

Subclavian arteries - medial to the anterior scalene muscle

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13
Q

Describe the route of the paired vertebral arteries

A
  1. Arise from the subclavian arteries - medial to the anterior scalene muscle
  2. Ascend posterior aspect of the neck - through foramen transversarium at level of C6
  3. Enter the cranial cavity via foramen of magnum (C1)
  4. Within the cranial vault - some branches are given off
  5. Converge to form the basilar artery at the base of the pons (terminates by bifurcating into the posterior cerebral arteries)
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14
Q

Describe the foramen transversarium

A

Holes in the transverse processes of the cervical vertebrae at the level of C6

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15
Q

At what level is the foramen of magnum

A

C1

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16
Q

What are the branches given off by the paired vertebral arteries within the cranial vault

A

Meningeal branch

Anterior and posterior spinal arteries

Posterior inferior cerebellar artery

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17
Q

What does the meningeal branch supply

A

The falx cerebelli (sheet of the dura mater)

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18
Q

What does the anterior and posterior spinal arteries supply

A

The spinal cord - spanning its entire length

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19
Q

What does the posterior inferior cerebellar artery supply

A

The cerebellum

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20
Q

How many segments is the vertebral artery divided into

A

4

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21
Q

Name the 4 segments of the vertebral artery

A

V1 = preforaminal
V2 = foraminal
V3 = Atlantic, extradural, extraspinal
V4 = intradural, intracranial

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22
Q

Where does the circle of willis start

A

Where the internal carotid and vertebral arteries join (cranial vault)

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23
Q

Describe the contributors of the circle of willis

A

Paired ICAs and the basilar artery (gives rise to the cerebral arteries)

Then joined by the anterior and posterior communicating arteries

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24
Q

What does the anterior cerebral arteries supply

A

The anteromedial portion of the cerebrum

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25
What does the middle cerebral arteries supply
Majority of the lateral part of the brain (situated laterally)
26
What does the posterior cerebral arteries supply
Medial and lateral parts of the posterior cerebrum
27
What are the 3 main arteries of the circle of willis
Anterior cerebral artery Middle cerebral artery Posterior cerebral artery
28
Describe the anatomy of the anterior cerebral artery
Terminal branch of the internal carotid arteries (located immediately proximal to the origin of the middle cerebral arteries)
29
Describe the function of the supply of the anterior cerebral artery
Medial frontal lobe = motor Parietal lobe = sensation
30
Describe lesions to anterior cerebral artery
Contralateral hemiparesis and hemiplegia Affects lower limb > upper limb
31
Define hemiparesis
One sided muscle weakness
32
Define hemiplegia
One sided paralysis
33
Describe the features of a middle cerebral artery lesion
Hemiparesis and hemiplegia Affects upper limb > lower limb Hemianopia
34
Define hemianopia
Due to lesions in the visual pathway = loss of vision Part of middle cerebral artery
35
Describe symptoms of a lesion affecting the Wernicke's area
Located in the temporal love - involved in speech comprehension
36
Describe symptoms of a lesion in the Broca's area
Located in the frontal lobe - responsible for speech production
37
Where is Brocas area located
Frontal lobe
38
Where is responsible for speech production
Brocas area
39
Where is Wernicke;s area located
Temporal lobe
40
Where is involved in speech comprehension
Wernicke's area
41
What artery supplies Brocas and Wernicke's area
Middle cerebral artery
42
Where is the visual cortex located
Occipital lobe
43
What would a lesion in the posterior cerebral artery present as
Contralateral homonymous hemianopia with macular sparing
44
What artery supplies the visual cortex
Posterior cerebral artery
45
What is terminal branch of the basilar artery
Posterior cerebral artery
46
Define visual agnosia
Neurological condition that affects how your brain processes what you see
47
Where do basilar artery run
Superiorly within the central groove of the pons
48
Name one branch of the basilar artery
Pontine artery = supplies the pons
49
What artery supplies the pons
Pontine arteries
50
Where does the basilar artery end
Eventually anastomoses with the circle of willis via the posterior cerebral arteries and posterior communicating arteries
51
Describe the location of the cavernous sinus
Within the middle cranial fossa, either side of the sella turcica of the sphenoid bone (which contains the pituatory gland) enclosed by two layers of dura mater
52
What two layers of dura mater enclose the cavernous sinus
Endosteal and meningeal layer
53
Describe the cavernous sinus
Channels between the two layers of dura mater responsible for venous drainage of the brain, skull, orbit and internal ear
54
Name the anterior border of cavernous sinus
Superior orbital fissure
55
Name the posterior border of the cavernous sinus
Petrous part of the temporal bone
56
Name the medial border of the cavernous sinus
Body of the sphenoid bone
57
Name the lateral border of the cavernous sinus
Meningeal layer of the dura mater running from the roof to the floor of the middle cranial fossa
58
Name the roof of the cavernous sinus
Meningeal layer of the dura mater that attaches to the anterior and middle clinoid processes of the sphenoid bone
59
Name the floor of the cavernous sinus
Endosteal layer of the dura mater that overlies the base of the greater wing of the sphenoid bone
60
Where is the only site in the body where an artery passes completely through a venous structure? What is this artery?
Cavernous sinus Internal carotid
61
Name what travels THROUGH the cavernous sinus
1. Abducens nerve (CNV1) 2. Carotid plexus (post ganglionic sympathetic nerve fibres) 3. Internal carotid artery (cavernous portion)
62
Name what travels through the lateral walls of the cavernous sinus
Oculomotor nerve (CNIII) Trochlear nerve (CNIV) Ophthalmic (V1) and maxillary (V2) branches of the trigeminal nerve
63
What 2 structures gain access to the cavernous sinus posteriorly
Internal carotid artery (cavernous portion) Carotid plexus - post ganglionic sympathetic nerve fibres
64
65
Define the O TOM in the mnemonic for the contents of the cavernous sinus (O TOM CAT)
OTOM refers to the lateral wall contents from superior to inferior Oculomotor nerve Trochlear nerve Ophthalmic branch Maxillary branch
66
Define the CAT in the mnemonic for the contents of the cavernous sinus (O TOM CAT)
CAT refers to the horizontal contents from medial to lateral Carotid plexus (post ganglionic sympathetic nerve fibres) Abducens nerve Trochlear nerve
67
What does the dural sinus system of the cavernous sinus receive venous drainage from
Ophthalmic veins (superior and inferior) Central vein of the retina Sphenoparietal sinus Superficial middle cerebral vein Pterygoid plexus
68
Name the potential route of spread of infection from extracranial to an intracranial site
Superior ophthalmic vein forms an anastomosis with the facial vein
69
Where does the superior and inferior ophthalmic veins enter the cavernous sinus
Via the superior orbital fissure
70
Describe the drainage of the central vein of the retina
Drains into the superior ophthalmic veins or directly into the cavernous sinus
71
Describe the drainage of the sphenoparietal sinus
Empties into the anterior aspect of the cavernous sinus
72
Describe the drainage of the superficial middle cerebral vein
Contributes to the venous drainage of the cerebrum
73
Where is the pterygoid plexus located
Within the infratemporal fossa
74
Describe the drainage of the cavernous sinus
Empty into the superior and inferior petrosal sinuses where they join the sigmoid sinus Ultimately into the internal jugular vein
75
How are the left and right cavernous sinus connected
In the midline by the anterior and posterior intracavernous sinuses - they travel through the sella turcica of the sphenoid bone
76
Define cavernous sinus thrombosis
Formation of a clot within the cavernous sinus
77
What is the most common cause of a cavernous sinus thrombosis
Infection ## Footnote Typically spreads from an extracranial location e.g. paranasal sinus or 'danger zone' of the face Can spread due to anastomosis between the facial vein and superior ophthalmic veins
78
Name the clinical features of cavernous sinus thrombosis (5)
Headache Unilateral periorbital oedema Proptosis (eye bulging) Photophobia Cranial nerve palsies
79
What is the nerve most affected by cavernous sinus thrombosis
Abducens nerve
80
Name the treatment for cavernous sinus thrombosis
Antibiotics | Can rapidly progress to meningitis
81
Where do cerebral veins drain
Into the dural venous sinuses with the subarachnoid space
82
What do cerebral veins lack
Muscular walls and valves
83
Where are superficial veins primarily
In the cerebral cortex
84
Where do superficial veins drain
Into the superior sagittal sinus
85
What do the superficial veins of the brain compromise of
Sagittal sinuses Cortical veins ## Footnote Divided into superior, middle and inferior groups.
86
Name the cortical veins of the superficial veins of the brain
1. Superior anastomotic vein of Trolard 2. Superficial middle cerebral vein (Sylvian vein) 3. Inferior anastomotic vein of Labbe
87
Describe the superior anastomotic vein of Trolard
Connects the superior sagittal sinus with superficial middle cerebral vein Is the smallest of the superficial cortical veins
88
Describe the superficial middle cerebral vein (Sylvian vein)
Courses along the sylvian fissure (lateral sulcus) picking up veins from surrounding operculum (brain region surrounding the lateral sulcus) as it runs postero-anteriorly Drains into the cavernous sinus after curving around the anterior temporal lobe
89
What is another name for the superficial middle cerebral vein
Sylvian vein
90
What is another name for the lateral sulcus
Sylvian fissure
91
Define the location operculum
Brain surrounding the lateral sulcus
92
Describe the inferior anastomotic vein of Labbe
Connects the superficial middle cerebral vein with the transverse sinus ## Footnote Location varies = vulnerable to injury during craniotomy procedures

Early Year Notes (4 decks)

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