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Early Year Notes > Neuro > Flashcards

Neuro Flashcards

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
Q

What does the middle cerebral arteries supply

A

Majority of the lateral part of the brain (situated laterally)

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26
Q

What does the posterior cerebral arteries supply

A

Medial and lateral parts of the posterior cerebrum

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27
Q

What are the 3 main arteries of the circle of willis

A

Anterior cerebral artery
Middle cerebral artery
Posterior cerebral artery

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28
Q

Describe the anatomy of the anterior cerebral artery

A

Terminal branch of the internal carotid arteries (located immediately proximal to the origin of the middle cerebral arteries)

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29
Q

Describe the function of the supply of the anterior cerebral artery

A

Medial frontal lobe = motor

Parietal lobe = sensation

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30
Q

Describe lesions to anterior cerebral artery

A

Contralateral hemiparesis and hemiplegia

Affects lower limb > upper limb

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31
Q

Define hemiparesis

A

One sided muscle weakness

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32
Q

Define hemiplegia

A

One sided paralysis

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33
Q

Describe the features of a middle cerebral artery lesion

A

Hemiparesis and hemiplegia

Affects upper limb > lower limb

Hemianopia

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34
Q

Define hemianopia

A

Due to lesions in the visual pathway = loss of vision

Part of middle cerebral artery

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35
Q

Describe symptoms of a lesion affecting the Wernicke’s area

A

Located in the temporal love - involved in speech comprehension

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36
Q

Describe symptoms of a lesion in the Broca’s area

A

Located in the frontal lobe - responsible for speech production

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37
Q

Where is Brocas area located

A

Frontal lobe

38
Q

Where is responsible for speech production

A

Brocas area

39
Q

Where is Wernicke;s area located

A

Temporal lobe

40
Q

Where is involved in speech comprehension

A

Wernicke’s area

41
Q

What artery supplies Brocas and Wernicke’s area

A

Middle cerebral artery

42
Q

Where is the visual cortex located

A

Occipital lobe

43
Q

What would a lesion in the posterior cerebral artery present as

A

Contralateral homonymous hemianopia with macular sparing

44
Q

What artery supplies the visual cortex

A

Posterior cerebral artery

45
Q

What is terminal branch of the basilar artery

A

Posterior cerebral artery

46
Q

Define visual agnosia

A

Neurological condition that affects how your brain processes what you see

47
Q

Where do basilar artery run

A

Superiorly within the central groove of the pons

48
Q

Name one branch of the basilar artery

A

Pontine artery = supplies the pons

49
Q

What artery supplies the pons

A

Pontine arteries

50
Q

Where does the basilar artery end

A

Eventually anastomoses with the circle of willis via the posterior cerebral arteries and posterior communicating arteries

51
Q

Describe the location of the cavernous sinus

A

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
Q

What two layers of dura mater enclose the cavernous sinus

A

Endosteal and meningeal layer

53
Q

Describe the cavernous sinus

A

Channels between the two layers of dura mater responsible for venous drainage of the brain, skull, orbit and internal ear

54
Q

Name the anterior border of cavernous sinus

A

Superior orbital fissure

55
Q

Name the posterior border of the cavernous sinus

A

Petrous part of the temporal bone

56
Q

Name the medial border of the cavernous sinus

A

Body of the sphenoid bone

57
Q

Name the lateral border of the cavernous sinus

A

Meningeal layer of the dura mater running from the roof to the floor of the middle cranial fossa

58
Q

Name the roof of the cavernous sinus

A

Meningeal layer of the dura mater that attaches to the anterior and middle clinoid processes of the sphenoid bone

59
Q

Name the floor of the cavernous sinus

A

Endosteal layer of the dura mater that overlies the base of the greater wing of the sphenoid bone

60
Q

Where is the only site in the body where an artery passes completely through a venous structure?

What is this artery?

A

Cavernous sinus

Internal carotid

61
Q

Name what travels THROUGH the cavernous sinus

A
  1. Abducens nerve (CNV1)
  2. Carotid plexus (post ganglionic sympathetic nerve fibres)
  3. Internal carotid artery (cavernous portion)
62
Q

Name what travels through the lateral walls of the cavernous sinus

A

Oculomotor nerve (CNIII)

Trochlear nerve (CNIV)

Ophthalmic (V1) and maxillary (V2) branches of the trigeminal nerve

63
Q

What 2 structures gain access to the cavernous sinus posteriorly

A

Internal carotid artery (cavernous portion)

Carotid plexus - post ganglionic sympathetic nerve fibres

64
Q
A
65
Q

Define the O TOM in the mnemonic for the contents of the cavernous sinus (O TOM CAT)

A

OTOM refers to the lateral wall contents from superior to inferior

Oculomotor nerve
Trochlear nerve
Ophthalmic branch
Maxillary branch

66
Q

Define the CAT in the mnemonic for the contents of the cavernous sinus (O TOM CAT)

A

CAT refers to the horizontal contents from medial to lateral

Carotid plexus (post ganglionic sympathetic nerve fibres)
Abducens nerve
Trochlear nerve

67
Q

What does the dural sinus system of the cavernous sinus receive venous drainage from

A

Ophthalmic veins (superior and inferior)

Central vein of the retina

Sphenoparietal sinus

Superficial middle cerebral vein

Pterygoid plexus

68
Q

Name the potential route of spread of infection from extracranial to an intracranial site

A

Superior ophthalmic vein forms an anastomosis with the facial vein

69
Q

Where does the superior and inferior ophthalmic veins enter the cavernous sinus

A

Via the superior orbital fissure

70
Q

Describe the drainage of the central vein of the retina

A

Drains into the superior ophthalmic veins or directly into the cavernous sinus

71
Q

Describe the drainage of the sphenoparietal sinus

A

Empties into the anterior aspect of the cavernous sinus

72
Q

Describe the drainage of the superficial middle cerebral vein

A

Contributes to the venous drainage of the cerebrum

73
Q

Where is the pterygoid plexus located

A

Within the infratemporal fossa

74
Q

Describe the drainage of the cavernous sinus

A

Empty into the superior and inferior petrosal sinuses where they join the sigmoid sinus

Ultimately into the internal jugular vein

75
Q

How are the left and right cavernous sinus connected

A

In the midline by the anterior and posterior intracavernous sinuses - they travel through the sella turcica of the sphenoid bone

76
Q

Define cavernous sinus thrombosis

A

Formation of a clot within the cavernous sinus

77
Q

What is the most common cause of a cavernous sinus thrombosis

A

Infection

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
Q

Name the clinical features of cavernous sinus thrombosis (5)

A

Headache
Unilateral periorbital oedema
Proptosis (eye bulging)
Photophobia
Cranial nerve palsies

79
Q

What is the nerve most affected by cavernous sinus thrombosis

A

Abducens nerve

80
Q

Name the treatment for cavernous sinus thrombosis

A

Antibiotics

Can rapidly progress to meningitis

81
Q

Where do cerebral veins drain

A

Into the dural venous sinuses with the subarachnoid space

82
Q

What do cerebral veins lack

A

Muscular walls and valves

83
Q

Where are superficial veins primarily

A

In the cerebral cortex

84
Q

Where do superficial veins drain

A

Into the superior sagittal sinus

85
Q

What do the superficial veins of the brain compromise of

A

Sagittal sinuses

Cortical veins

Divided into superior, middle and inferior groups.

86
Q

Name the cortical veins of the superficial veins of the brain

A
  1. Superior anastomotic vein of Trolard
  2. Superficial middle cerebral vein (Sylvian vein)
  3. Inferior anastomotic vein of Labbe
87
Q

Describe the superior anastomotic vein of Trolard

A

Connects the superior sagittal sinus with superficial middle cerebral vein

Is the smallest of the superficial cortical veins

88
Q

Describe the superficial middle cerebral vein (Sylvian vein)

A

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
Q

What is another name for the superficial middle cerebral vein

A

Sylvian vein

90
Q

What is another name for the lateral sulcus

A

Sylvian fissure

91
Q

Define the location operculum

A

Brain surrounding the lateral sulcus

92
Q

Describe the inferior anastomotic vein of Labbe

A

Connects the superficial middle cerebral vein with the transverse sinus

Location varies = vulnerable to injury during craniotomy procedures

Early Year Notes (4 decks)

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