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PBL Spring 2015 - Block 2 > NEURO 5 > Flashcards

NEURO 5 Flashcards

1
Q

Cervicomedullary junction

A

occurs at level of foramen magnum, where spinal cord meets medulla

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2
Q

anterior fossa

A

contains frontal lobe, seperated by lesser wing of sphenoid

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3
Q

middle fossa

A

contains temporal lobe separated by petrous ridgee and sheet of meninges

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4
Q

posterior fossa

A

contains cerebellum and brainstem

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5
Q

SCALP

A 
skin
CT
aponeurotica
loose CT
pericranium = periosteum
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6
Q

2 fibrous layers of dura

A

periosteal - inner surface of skull

meningeal layer - inner layer

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7
Q

Falx cerebri

A

sheet of dura from roof of cranium that seperates Right and left

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8
Q

tentorium cerebelli

A

covers upper surface of cerebellum

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9
Q

Midbrain passes through tentorium cerebelli via

A

tentorial incisura/notch

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10
Q

epidural space

A

potential space located between inner surface of skull and tightly adherent dura

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11
Q

Middle meningeal artery enters skull through

A

foramen spinosum

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12
Q

middle meningeal artery is branch of

A

external carotid

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13
Q

middle cerebral artery is branch of

A

internal carotid

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14
Q

subdural space

A

potential space between dura and arachnoid

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15
Q

Bridging veins transverse which space

A

subdural

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16
Q

subarachnoid space

A

CSF filled space between arachnoid and pia

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17
Q

dural sinuses drain

A

sigmoid sinuses to internal jugular veins

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18
Q

Frontal horn of lateral ventrical begins

A

foramen of monro

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19
Q

location of lateral ventricles

A

within the cerebral hemisphere

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20
Q

Atrium of lateral ventricle

A

at convergence w/ occipital horn, temporal horn and lateral ventricle

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21
Q

Third ventricle location

A

thalamus and hypothalamus

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22
Q

Fourth ventricle location

A

pons, medulla, cerebellum

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23
Q

How does the third ventricle communciate w/ fourth ventricle

A

cerebral aqueduct = aqueduct of sylvius

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24
Q

2 foramina CSF levels through

A

lateral foramina of Luschka

midlien foramen of Magendie

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25
Q

CSF is reabsorbed by

A

arachnoid granulations, arachnoid villus cells mediate one-way bulk transport

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26
Q

normal total volume of CSF

A

150 cc

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27
Q

how fast is CSF produced

A

20 cc/hours

150 cc/day

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28
Q

ambient cistern

A

lateral to midbrain

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29
Q

quadrigeminal cistern

A

posterior to midbrain

30
Q

interpeduncular cistern

A

ventral surface of midbrain

31
Q

3rd nerve exits midbrain through

A

interpeduncular fossa/cistern

32
Q

prepontine cistern

A

ventral to pons

33
Q

what is contained within prepontine cistern

A

basilar artery and 6th nerve

34
Q

cistern magna

A

cerebellomedullary, largest located beneath cerebellum near foramen magnum

35
Q

lumbar cistern

A

contains cauda equina, site for lumbar puncture

36
Q

What permeates across BB easily

A

lipid-soluble substances, O2, CO2

37
Q

Brain is interrupted in specialized regions called

A

circumventricular organs, allows changes in remaining body to seep through

Includes median eminence and neurohypophysis

38
Q

are postrema

A

paired circumventricular organ, along caudal wall of fourth ventricle in medulla = chemotactic trigger zone

39
Q

pineal

A

involved in melatonin-related circadian rhythms

40
Q

vasogenic edema

A

excessive extracellular fluid

41
Q

cytotoxic edema

A

intracellular fluid accumulation

42
Q

normal intracranial pressure

A

<15 mm Hg

43
Q

Transtentorial herniation

A

middle temporal lobe - uncus through tentorial notch

blown pupil, hemiplegia, coma

blown pupil IL, hemiplegia usually CL

44
Q

Kernohan’s phenomenon

A

occurs in transtentorial herniation, CL corticospinal tract is compressed, causes IL hemiplegia

45
Q

Central herniation

A

Central downward displacement of brainstem, associated with increased intracranial pressure, pushes on abducens nerve

lateral rectus palsy, bilateral uncal herniation

46
Q

Tonsillar herniation

A

cerebellar tonsils downard through foramen magnum, associated w/ compresseion of medulla = respiratory arrest, blood pressure instability, death

47
Q

Subfalcine herniation

A

unilateral mass lesion can cause cignulate gyrus to herniate beneath the falx cerebri

48
Q 
Epidural hematoma
Location
Cause
clinical features
Radiologic appearance
A

between dura and skull = potential

rupture of middle meningeal artery

can be lucid, leads to herniation and death

looks like biconvex disc along border

49
Q 
Subdural hematoma
Location
Cause
clinical features
Radiologic appearance
A

potential space between dura and arachnoid

rupture of bridging veins

Chronic: elderly, vague headaches, cognitive impairment, unsteady gait, focal seizures

Acute: high impact

forms cresent shaped hematoma

50
Q

Radiologic of acute subdural hematoma

A

Hyperdense
Isodense 1-2 weeks
hypodense 3-4 weeks
mixed bleeding - occassional bleeding

51
Q

hematocrit effect

A

subural hematoma w/ mixed density hematoma causing acute blood to settle to the bottom

52
Q 
Subarachnoid hemorrhage
Location
Cause
clinical features
Radiologic appearance
A

CSF space between arachnoid and pia

non traumatic: worst headache of my life, rupture of aneurysm or AVM, includes saccular/berry aneurysms
PComm aneurysm can cause third nerve palsy
normally causes nuchal rigidity, headache, photophobia, impaired consciousness , vasospasm

traumatic: severe headaches

blood in sulci following contours of pia

53
Q

Mostc ommon locations of berry aneurysms

A 
AComm = 30%
Pcomm = 25%
MCA = 20%
vertebrobasilar system = 15%
fusiform aneurysm (main vessel itself)
54
Q

what should be performed before lumbar puncture

A

CT, if increased pressure, removal of CSF can increase bleeding

55
Q

when testing for subarachnoid hemorrhage how should CT be performed

A

without contrast

56
Q

Triple H therapy

A

for subarachnoid hemorrhage
hypertension
hypervolemia
hemodilution

57
Q 
Intracerebral or intraparenchymal hemorrhage
Location
Cause
clinical features
Radiologic appearance
A

within brain parenchyma

traumatic: contusions in temporal or frontal poles
nontraumatic: hypertention (most common), brain tumors, secondary hemorrhage, vascular malformations, blood coagulation abnormalitis, infections

58
Q

coup injury

A

contusion on side of impact

59
Q

contrecoup injury

A

contusion on opposite side of impact

60
Q

what 2 factors increase chance of hypertensive hemorrhage

A

lipohyainosis

microaneurysms of Charcot-Bouchard

61
Q

Most common location of hypertensive hemorrhage

A

basal ganglia, thalaus, cerebellum, pons

62
Q

where does bleeding occur in lobar hemorrhage

A

occipital, parietal, temporal or frontal lobe

63
Q

most common cause of lobar hemorrhage

A

amyloid angiopathy

64
Q

cavernomas

A

abnormally dilated vascular cavities lined by one layer of vascular endothelium

65
Q

Hemorrhage in ___ results in Battle’s sign

A

subcutaneous tissues

66
Q

hemorrhage in ___ results in goose egg = subgaleal hemorrhage

A

external periosteum and galea aponeurotica

67
Q

CSF for Acute Bacterial meningitis
WBC
Protein
Glucose

A

increased w/ polymorphonuclear leukocytes
increased
reduced

68
Q

CSF for Viral+ Aseptic meningitis
WBC
Protein
Glucose

A

increased w/ lymphocytes
increased
normal

69
Q

CSF for herpes meningoencephalitis
WBC
Protein
Glucose

A

increased or decreased, usually lymphocytes
increased
normal or reduced

70
Q

CSF for tuberculous meningitis
WBC
Protein
Glucose

A

increased, usually lymphocytes
increased
reduced

PBL Spring 2015 - Block 2 (11 decks)

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