T2: Meninges & Arteries Flashcards
What is the most common side for a subarachnoid Hemorrhage?
A) Anterior Cerebral Artery B) Lenticulostriate branches of the MCA C) Anterior Communicating Artery D) Posterior Inferior Cerebellar Artery E) Posterior Cerebral Artery
FA
C) Anterior communicating artery is the most common location for the formation of a Beri annuyersum (40%). Beri annuyersums are the the largest cause of Subarachnoid Hemorrhaging. This particular hemorrhage can cause blindness due to extra pressure on the optic chiasim.
The brain receives what percentage of Cardiac Output?
A) 20% B) 55% C) 40% D) 15% E) 5%
FA
D) the brain receives 15% of the hearts total cardiac output.
A patient comes to you with weakness and lack of sensation in his right lower limb and foot. Upon imaging, you find that the patient has a cerebral infarction. Which of the following arteries, if damaged, would yield the patents symptoms?
A) Left Anterior Cerebral Artery B) Right Anterior Cerebral Artery C) Left Posterior Cerebral Artery D) Right Middle Cerebral Artery E) Left Middle Cerebral Artery
FA
A) the Left Anterior Cerebral artery would supply the left medial aspects of the Cortex, which are attributed to the motor functioning and sensation of the right lower limb. The Left Middle cerebral artery supplies the lateral aspects of the cortex, which involve the face, trunk, and arms. The Posterior Cerebral Artery primarily supples the occipital lobe, and thus is more involved in vision.
What artery forms the anastamoses between the posterior and anterior spinal medullary arteries? (MG)
A. Anterior communicating
B. Vaso vasorum
C. Vasocorona
D. Anterior radicular
C. Vasocorona
Anterior communicating artery is in the circle of Willis, not the spinal cord
Vaso vasorum refers to the “vessel of vessels” meaning they are the small vessels that supply blood to the walls of larger blood vessels
Anterior radicular is a branch of the segmental artery in the spinal cord
The gracile and cuneate tubercles are landmarks of the _____ and house ____. (MG)
A. Pons; tracts
B. Medulla oblongata; nuclei
C.Medulla oblongata; tracts
D. Pons; nuclei
B. Medulla oblongata; nuclei
They house the gracile and cuneate nuclei respectively
See anatomical landmarks of the dorsal brainstem DLA for more landmarks
A CT of your patient is reviewed by a radiologist. The report states thats there is periventricular hemorrhage of the arteries that supply basal ganglia and the anterior limb of the internal capsule. Which arteries is ruptured that supplies the blood flow to the affected area? (mm)
A) Lenticulostriate Arteries B) Middle Cerebral Artery C) Pontine Arteries D) Anterior Communicating Artery E) Striate Arteries
Answer: A- Lenticulostriate Arteries are early branches of the middle cerebral artery which target the basal ganglia and internal capsule. These arteries are PARTICULARLY VULNERABLE to rupture and are a MAJOR SOURCE OF INTRACEREBRAL (periventricular) HEMORRHAGE
E - Striate Arteries are early branches of the anterior cerebral artery and they supply the basal ganglia and anterior limb of the internal capsule as well. According to the lecture notes the Lenticulostriate’s are the more likely ones to rupture tho.
A 67 yr old patient 5’4” 250lb walks into your extremely lucrative family medical practice because he woke up this morning with a very painful headache after having vigorous sex. On the way in he needed to lean against your Ferrari because the pain was so profound, but his stiff neck made it even more painful. Upon examination you notice photophobia and decide to take him next door to the hospital for an immediate CT. In the CT you notice tree- like appearances following the sulci. What is this patients diagnosis? (mm)
A) Communicating Hydrocephalus B) Intracerebral Hemorrhage C) Subarachnoid Hemorrhage D) Ex Vacuo E) Multiple Sclerosis
Answer: C- Subarachnoid Hemorrhage. Vinette displays classical signs of this type. Profound Pain, Stiff Neck, Tree- Like appearance of blood following sulci, (and off of the UK’s NHS website photophobia)
B- would fill ventricles
A- Wet, wacky, wobbly (secondary to subarachnoid bleed)
D- Enlargement secondary to tissue loss no inc in csf
Your patient arrives in the hospital following a minor car accident where the car was literally shaken vigorously for some reason and her head was bobbing all over the place. She’s complaining of a headache because her brain was being shaken against which of the following?(mm)
A) Thin Avascular layer under the dura matter
B) Large valveless vessels in between the two dura layers
C) The folded meningeal layer between brain subdivisions
D) The highly vascular layer covering the outer surface of the brain
Answer: C- The folded meningeal layer between brain subdivisions aka the Falx Cerebri (or tentorium cerebelli)
A- this is the arachnid layer under the dura matter
B- these are the Dural venous sinuses
D- this is the Pia matter
A 74 year old female is brought into the ER. Her granddaughter reveals she tried to move some furniture in her apartment against advice, and started to speak incoherently and became weak and collapsed. CT reveals larger-than-normal hyperechoic region in the lateral ventricles. Characterize her condition. (MG)
A. Painless arachnoid hemorrorhage
B. Epidural hemorrhage
C. Severe Hypoglycemic episode
D. Hydrocephalus secondary to an arachnoid hemorrhage
D. Hydrocephalus secondary to an arachnoid hemorrhage
Arachnoid hemorrhages often involve the deticulate arteries aka the “arteries of stroke.” These cause the ventricles to fill with blood and cause hydrocephalus.
If you perform a lumbar puncture, you might fight blood in the CSF with arachnoid hemorrhages.
Side bar: This exact situation happened to my grandma. It’s coo bc she’s fine.
A 67 year old man has been experiencing headaches and confusion progressing for the past few weeks. A CT is done showing a crescent shaped hemorrhage which of the following vessels has been ruptured.
A. Cerebral Artery B. Penetrating Branches of Cerebral Artery C. Basilar Artery D. Delicate Veins E. Middle Meningeal Artery
RFA
D. Delicate Veins- The patient is suffering from a subdural hemorrhage as noted by the crescent shape of the hemorrhage and the time frame of weeks. In this hemorrhage type it is usually caused by the rupture of the delicate veins.
A. Cerebral Arteries- a rupture of a cerebral artery is characteristic of a Subarachnoid Hemorrhage
B. Penetrating Branches of Cerebral Artery- Intracranial Hemorrhage
C. Basilar Artery- rupture would cause death
E. Middle Meningeal Artery- Rupture of meningeal artery is characteristic of Epidural Hemorrhage
Which of the following regarding spinal arteries and Menges is false?
A. Menges lack periosteal dura
B. Has Denticulate ligaments formed from dura matter
C. Radicular Arteries follow the nerve roots
D. The Anastomosis of the Spinal Cord involve an arterial vasocorona
RFA
B. The Denticulate ligament is formed from Pia mater not Dura matter
Rodger a 71 year old retired man is taken to the hospital by his grandson do to loss of motor control. After test it is show he is suffering from Parkinsonism due to reduced blood flow from a vessel. Which vessel is most likely occluded?
A. Striate artery B. Posterior Cerebral Artery C. Basilar Artery D. Internal Carotid E. Labyrinthine Artery F. Pontine Artery
RFA
A. Striate Artery- the patient is suffering from Parkinsonism( Parkinson Disease like symptoms not due to Parkinson’s Disease). Like in Parkinson Disease this is due to damage or degradation of the Basal Ganglia which is supplied by the Striate Arteries.
Posterior Cerebral Artery- supplies medial temporal, occipital and parietal structures
Basilar Artery- the main connecting artery of the cerebral vessels damage to this is usually deadly
Internal Carotid- feeds the middle and anterior cerebral arteries. If this was blocked only the vertebrale arteries would be supplying the brain which would greatly decrease brain function.
Labyrinthine Artery- supplies occipital lobe and loss will cause blindness
Pontine Artery- supplies the Pons, loss will cause severe damage to most functions
Bob Saget was doing some sick skateboard moves brah down I-95, when suddenly he was hit by a dog with goggles driving a motorcycle. Emergency medical personnel quickly wheeled to the nearest MRI. Imaging revealed a lentiform hematoma, as well Subway Footlong™ in his trousers. What type of hemorrage does Bob Saget have?
A) Intracranial hemorrage B) Epidural hemorrhage C) Subarachnoid hemorrage D) Subdural hemorrage E) No hemorrage, just a big weight sack in his pants
B) Epidural hemorrage
Lentiform hematoma is another word for biconvex hematoma. Biconvex hematoma appears as football shaped under imaging and indicates an epidural hemorrage.
