session 1

Question 1

superficial to deep what is the order of the meninges?

Answer 1

dura mater arachnoid mater pia mater

Question 2

describe the dura mater.

Answer 2

It has 2 layers endosteal which is fused to the periosteum and inner meningeal layer.

Question 3

how are dural sinuses formed?

Answer 3

-the separation of the endosteal and inner meningeal layers. -these are lined by endothelial cells

Question 4

what are the 4 points the endosteal and inner menigeal layers separate to form sinuses?

Answer 4

1. falx cerebri - divides 2 cerebral hemispheres contains superior and inferior sagital sinuses 2. tentorium cerebelli - separates cerebrum from cerebellum and contains transverse sinus 3. falx cerebelli - separates cerebellar hemispheres 4. diaphragma sella - forms the roof of the pituitary fossa and provides blood supply to the pituitary gland

Question 5

what makes up the blood brain barrier?

Answer 5

endothelial cells

basement membrane - formed from pia

Astrocytic end feet

Question 6

what part of the brain does the anterior cerebral artery supply?

Answer 6

medial aspects of the brain and the corpus callosum

Question 7

what part of the brain does the middle cerebral artery supply?

Answer 7

supplies majority of the lateral surface of the hemispheres

Question 8

what part of the brain does the posterior cerebral artery supply?

Answer 8

supplies the posterior parts of the brain and the inferior parts of the lateral brain

(yellow)

Question 9

what are the percentages of blood supplied to the brain by the internal carotids & vertebral arteries?

Answer 9

80% internal carotids and 20% vertebral arteries

Question 10

what are the most common sites for berry aneurysms?

Answer 10

most common in the anterior communicating arteries

Question 11

what drains into the straight sinus?

Answer 11

inferior saggital sinus

Question 12

what drains into the transverse sinus?

Answer 12

superior saggital sinus, ocipital sinus and straight sinus

Question 13

where does the transverse sinus drain into?

Answer 13

sigmoid sinus

Question 14

how does venous blood leave the brain?

Answer 14

leaves through the internal jugular through the jugular foramen

Question 15

what are the three functions of CSF?

Answer 15

1. cushioning 2. transport of nutrients 3. supporting - the mass of the brain effectively floats in the skull

Question 16

how does CSF return back blood?

Answer 16

projections of arachnoid mater goes through the endosteal layer of the dura mater in the superior saggital sinus. these are called arachnoid granulations

Question 17

what produce CSF? where would you find them?

Answer 17

choroid plexuses on the floor of the lateral ventricles, the roof of the third ventricle and the roof of the fourth ventricle

Question 18

how does CSF leave the ventricles and enter the sub arachnoid space?

Answer 18

when it reaches the 4th ventricle it can enter the sub arachnoid space through either the lateral (lushke) or median (megendi) aperture

Question 19

what structures pass through the cavernous sinus?

Answer 19

OTOMCat occulomtor trochlear opthalmic branch of trigeminal maxillary branch of the trigeminal internal carotid artery abducent

Question 20

how does CSF get from the lateral ventricles to the 3rd ventricle?

Answer 20

through the interventricular foramina (foramina of monro)

Question 21

how does CSF get from the 3rd to 4th ventricle??

Answer 21

through the cerebral aqueduct (aqueduct of Sylvius)

Question 22

What is the top nerve in the cavernous sinus?

Answer 22

Occulomotor

Question 23

What is the blood vessel passing through the cavernous sinus? What nerve is closely related to it?

Answer 23

Internal carotid artery
Abducens

Question 24

What are the bottom 2 nerves passing laterally and inferiorly in the cavernous sinus?

Answer 24

Maxillary and opthalmic branch of the trigeminal (superior to inferior)

Question 25

What would you see clinically in a patient with a venous thrombosis in the cavernous sinus?

Answer 25

Headache - cos raised ICP

opthalmopgeia (CN 3,4 and 6)

orbit swelling - increase in pressure with no drainage

ptosis (drooping of the eyelid) (CN V2)

facial numbness (CN V1+2)

maybe seizure

maybe LOC

Question 26

Where is Broca’s area located?

Answer 26

inferior frontal gyrus - usually left (dominant)

Question 27

What is the blood supply to Broca’s area? What symptoms do you get when there is a stroke in this area?

Answer 27

Left middle cerebral artery - expressive aphasia - an inability to form language (spoken or written)

displays effortful speech

Question 28

Where is wernicke’s area?

Answer 28

superior temporal gyrus - usually left (dominant)

Question 29

What sulcus is the primary occipital cortex found around?

Answer 29

Calcrine sulcus

Question 30

What makes up the limbic system?

Answer 30

hippocampus, fornix, mamillary bodies, thalamus, hypothalamus, cingulate gyrus

Question 31

What role does the limbic system have?

Answer 31

Emotions, memory, behaviour and olfaction.

HC - long term memory formation

amygdala - significant stimuli eg fight or flight

Question 32

where is the nucleus accumbens? what is it’s role?

Answer 32

rostral to the preoptic hyptothalamus

reward centre of the brain - dopamine and serotonin intereactions

Question 33

if you have a left middle cerebral artery infarct what clinical features would you see?

Answer 33

expressive dysphasia, right sided spastic hemiparesis, right sided sensory deficit, right hemispatial neglect

Question 34

What vessel do the vertebral arteries arise from?

Answer 34

Subclavian artery

Question 35

What makes up the posterior circulation?

Answer 35

Posterior cerebral artery + Vertebral arteries

Question 36

what does an extra dural haemorrhage look like on a CT scan?

Answer 36

Lemon shaped

Question 37

What does a subdural haematoma look like on a CT scan ?

Answer 37

Banana shaped

Question 38

What is the function of the insular?

Answer 38

emotion, homeostasis, perception, motor control, self-awareness, cognitive functioning and interpersonal experience.