Vasculature, Ventricles, & Meninges Flashcards

1
Q

Blood Supply to CNS

A
Provided by many components:
Acomm
ACA
MCA
Pcomm
PCA
SCA
PICA
AICA
ASA
Pontine Arteries
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2
Q

Acomm

A

Anterior communicating artery
Single
A blood vessel that connects the left and right anterior cerebral arteries across the longitudinal fissure.

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3
Q

ACA

A

Anterior cerebral artery
Pair
Supplies oxygenated blood to most midline portions of the frontal lobes and superior medial parietal lobes.
Arise from the internal carotid artery and are part of the circle of Willis.

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4
Q

MCA

A

Middle cerebral artery
Largest branch of the internal carotid.
Supplies a portion of the frontal lobe and the lateral surface of the temporal and parietal lobes.

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5
Q

Pcomm

A

Posterior communicating artery
At the base of the brain that form part of the circle of Willis.
Connects the three 3 arteries of the same side.

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6
Q

PCA

A

Posterior cerebral arteries
Arise from the basilar artery
Pair
Supply oxygenated blood to the occipital lobe

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7
Q

SCA

A

Superior Cerebellar artery
Pair
Runs laterally, winds around the cerebral peduncle of the midbrain to reach the upper surface of the cerebellum.

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8
Q

PICA

A

Posterior inferior cerebellar artery
Pair
Largest branch of the vertebral artery.
One of three arteries that supplies blood to the cerebellum

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9
Q

AICA

A

Anterior inferior cerebellar artery
Pair
One of three arteries that supplies blood to the cerebellum.
Arises from the basilar artery on each side at the level between the medulla oblongata and the pons.

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10
Q

ASA

A

Anterior spinal artery
Supplies the anterior portion of the spinal cord.
Arises from branches of the vertebral arteries and courses along the anterior aspect of the spinal cord.

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11
Q

Pontine Arteries

A

Number of small vessels which come off at right angles from either side of the basilar artery.
Supply the pons and adjacent parts of the brain.

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12
Q

Blood Supply of the Posterior Brain

A

Everything from Prom and below (dorsal side and back)

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13
Q

Exterior Regions of Supply

A

Anterior Cerebral - anterior and dorsal region
Middle Cerebral - middle & small point region
Posterior Cerebral - posterior and ventral
*see picture

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14
Q

Interior Regions of Supply

A

Largest amount of cortex is supplied by MCA
Branches of all cortical arteries run deep into cortex to reach subcortical structures.
*see picture

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15
Q

Watershed Zones

A

Regions of overlap in blood supply to cortical areas.
Contain terminal vessels of both arteries.
Highly susceptible to injury if both artier are impacted.
They help because if one area is damaged, there is still blood supply available.

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16
Q

Blood Brain Barrier

A

Very few things can cross it.
Bacteria is kept out (for the most part)
Except for Meningitis - which is inflammation of the meninges due to bacteria

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17
Q

Spinal Segment

A

A spinal area and all of it’s roots

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18
Q

Spinal Arteries

A
Supplied by 3 major arteries
One Anterior Spinal A.
Two Posterior Spinal A.
but
Most supply comes from small branches that join the ASA and PSA to nerves and the spinal cord.
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19
Q

ASA

A

Anterior Spinal A.
Single
A branch right off vertebral arteries.
Serves 2/3 of cord even though only one.

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20
Q

PSA

A

Posteror Spinal A.
Pair
Derives from either vertebral artery or cerebellar arteries.

21
Q

Small Branches that join the ASA & PSA to nerves and the spinal cord

A

Segmental Medullary Arteries
Branch that comes off the aorta and serves a spinal segment

Artery of Adamkiewicz
Great Anterior Segmental Medullary Artery
Serves specific thoracic region

22
Q

What serves nerve roots?

A

Radicular Arteries

think “radiate”

23
Q

What protects the nervous system?

A

Meninges.
Membranes that cover the brain and spinal cord.
Protective coating made up of many layers.

24
Q

Types of Meninges

A

Dura mater
Arachnoid
Pia mater

25
Q

Dura mater

A

Outermost

Tough, hard to tear, thick, leathery, external barrier or sac.

Two layers:
Periosteum (on bone)
Meningeal (internal) - can fold on itself to protect regions.

26
Q

Arachnoid

A

Middle

Wispy, web-like, small tiny fibers, falls apart easily.

Provides space for fluid and vessels to flow.

27
Q

Pia mater

A

Innermost

Sticky, hard to remove.

Adheres to the tissue, follows every “nook and cranny” of cortex = sulci and gyri

28
Q

Meningeal Sheets

A

Continuation of dura mater.

Thick sheets of dura mater that separate cerebral and cerebellar structures.
Three of them:
Falx Cerebri
Falx Cerelli
Tentorium Cerebelli
29
Q

Falx Cerebri

A

Separates LEFT & RIGHT cerebral hemispheres (more dorsal)

30
Q

Falx Cerebelli

A

Separates LEFT & RIGHT cerebellar hemispheres (more ventral)

31
Q

Tentorium Cerebelli

A

Separates cerebrum from cerebellum

transverse orientation

32
Q

Confluence of Sinuses

A

Everything inferior has one left and one right.

Connecting point of the superior sagittal sinus, straight sinus, and occipital sinus.

Found deep to the occipital protuberance of the skull.

Blood arriving at this point then proceeds to drain into the left and right transverse sinuses.

33
Q

Cavernous

A

Only have one, but petrosals are double.

34
Q

Blood Flow Through Sinuses

A

A mesh network of veins like a plexus.
Flows superior to inferiorly towards interval jugular vein.
(some people the inferior petrosal sinus dumps into the sigmoid first then internal jugular, but others it dumps into internal jugular only)
*see powerpoint

35
Q

Straight Sinus

A

Only have one.

Runs anterior to posterior

36
Q

Sinuses

A

Spaces in dura mater that allow blood flow but they are NOT veins.

37
Q

Venous Return:

Veins and Dural Sinuses

A

Superficial veins will dump into the dural sinuses which drain to jugular and exits cranium.

38
Q

CSF

A

Cerebrospinal Fluid
Provides protection for the CNS:
cushions, intracranial pressure, lubrication, waste removal, etc.
125 cc in system at any time
(but body makes 500cc per day)
Fills the ventricles in the brain; we are constantly generating and dumping.
*we have fluid cushion internally and externally in the brain

39
Q

Ventricles of the Brain

Names & General Function

A
Act as a balloon and ensures the brain doesn't collapse.
Lateral Ventricles
Interventricular foramen
Third Ventricle
Aqueduct of Midbrain
Fourth Ventricle
40
Q

What connects the lateral ventricles to the third ventricle?

A

Intraventricular foramen (of Monroe)

41
Q

What connects the third ventricle to the fourth ventricle?

A

Aqueduct of Midbrain (Sylvius).

Allows fluid to travel

42
Q

Lateral ventricles

A

Pair.

Largest and cover most of cortex region

43
Q

Lushka Foramen

A

(Lateral)
Pair.
Allows fluid to come out sideways, laterally.

44
Q

Median Aperature

A

(Magendie)
Single.
Lets fluid out of brainstem

45
Q

Arachnoid Villlus

A

Will absorb CSF and allow it to get to sinuses.

46
Q

What are the sinuses for CSF?

A
Intraventricular Foramen (Monroe) - one
Lateral Aperature (Lushka) - two
Median Aperature (Magendie) - one
Cerebral Aqueduct (Sylvius) - one
47
Q

What occurs if there is excess CSF in the brain?

A

It pushes on the brain, interiorly and/or exteriorly causing swelling and damage.

48
Q

8 Steps in CSF Flow

A

1) C.P. produces CSF in each lateral ventricle
2) Flows through IVF into 3rd ventricle
3) C.P. in 3rd ventricle adds more CSF
4) CSF flows down cerebral aqueduct to 4th v.
5) C.P. in 4th ventricle adds more CSF
6) CSF flows out two lateral apertures and one median aperture
7) CSF fills subarachnoid space and bathes external surfaces of brain and spinal cord
8) Arachnoid villi CSF is reabsorbed into venous blood of dural venous sinuses

49
Q

Choroid Plexus

A

Located in several areas.
Primarily between lateral and 3rd ventricles.
Produces CSF Fluid.
Fluid flows downward (in chart)
Fluid will exit via the median aperture heading outward to brain and spinal cord.