ventricular system and blood vessels

Question 1

the anterior cerebral artery is needed for

Answer 1

sensory and motor to legs

Question 2

if you block the middle cerebral artery you lose

Answer 2

auditory speech, and sensroy and motor to arms

Question 3

if you lose the posterior cerebral artery you lose

Answer 3

vision

Question 4

define somatotopic

Answer 4

some sensory or motor pathways convey their fibers in a highly organized laminated fashion as they ascend or descend to specific regions of cortex or body

Question 5

what is a homunculus

Answer 5

cartoon representation of exaggereated proporitons of the cortical map

Question 6

what is a funiculus

Answer 6

general term for large, cord-like bundle of nerve fibers

Question 7

what is a fasciculus

Answer 7

bundle of nerve fibers which belong to a particular system in the CNS, may be a tract

Question 8

what is a tract

Answer 8

a fasciculus comprised of nerve fibers that have a comon origin, termination, and function

Question 9

what is a lemniscus

Answer 9

bundle of crossed, secondary nerve fibers in a conscious sensory pathway (example: pain and temp, proprioception)
-lesion of a lemniscus results in contralateral deficits

Question 10

what happens when the subarachnoid space is gone

Answer 10

the arachnoid membrane collapses on the membrane of the brain
-see veins at first bc arteries are much deeper

Question 11

falx herniation

Answer 11

bc the falx only partially separates the cerebral hemispheres, part of the cerebral hemisphere may be pushed to the other side under the free edge

Question 12

where does the pooling of an epidural hematoma occur

Answer 12

between the endosteum and the dura matter

Question 13

epidural hematoma clinical presentation

Answer 13

intial unconsciousness followed by rapid recovery

• after a few hours, increase in supratentorial cranial volume causes displacement of the brain tissue
• bleeding expands to epidural space, presses on cerebral hemisphere and herniates cerebrum under falx cerebri and or through the tentorial notch (tentorial or uncal herniation)

Question 14

subdural hematoma clinical presentation

Answer 14

head trauma ma cause cerebral veins to rupture as they cross subdural space
-same signs and symptoms as epidural hematoma but the temporal onset may be delayed for days or weeks

Question 15

trauma to the midbrain can cause what

Answer 15

• sharp edge of incisura (free edge of tnentorium) to lacerate or contuse the brainstem
• result can be temporary or permanent coma

Question 16

dural venous sinuses: straight venous sinus drains directly into ___, drains what

superior sagittal sinus empties directly into ___ in 2/3 of cases and drains what

-which system being comprimised is more dangerous?

Answer 16

straight venous sinus–>left transverse sinus
-drains core of the cerebrum structures

superior sagittal sinus empties into right transverse sinus and drains cortical region of brain

-left side being compromosed can lead to death

Question 17

papilledema

Answer 17

increased intracranial pressure applies pressure to small veins on optic nerve, decresed drainage from retina results in edema of retina and swelling of optic disc

Question 18

subarachnoid hemorrhage?

-all major BVs supplying CNS pass through or course in ___

Answer 18

subarachnoid space
if you rupture one of these vessels = subarachnoid hemorrhage
-indicated by erythrocytes in the CSF
-also area that was suppose to get this blood will be ischemic

Question 19

external hydrocephalus

Answer 19

accumulation of CSF in subarachnoid space with enlargement of that space by compression of the CNS
-may be supratentorial, infratentorial, or both

Question 20

supratentorial external hydrocephalus

Answer 20

associated with senile atrophy of cortex, e.g. alzheimer’s disease

Question 21

infratentorial external hydrocephalus

Answer 21

seen in combination with communicating hydrocephalus

Question 22

internal hydrocephalus

Answer 22

non communicating hydrocephalus bc CSF cannot drain into subarachnoid space
-obstruction in ventricular pathway, everything proximal to obstruction will be enlarged

Question 23

obstruction of medial foramina in internal hydrocephalus name

Answer 23

arnold chiari malformation

Question 24

lateral foramina blok in internal hydrocephalus

Answer 24

dandy walker cyst

Question 25

results of communicating hydrocephalus

Answer 25

often in combo with infratentorial external and internal hydrocephalus - hypertrophy of the ventricles - CSF in the infratentorial subarachnoid space

Question 26

where can CSF not get to in communicating hydrocephalus and what is blocked

Answer 26

narrow space btwn tentorial notch and midbrain is obstructed due to adhesions and firbosis from past inflammation -cannot get to the cerebrum to be resorbed at arachnoid villi adjacent to and in the superior sagittal sinus

Question 27

what is the watershed area

Answer 27

overlapping area on the brain that needs arterial supply from more than one source -no anastomoste

Question 28

ischemic penumbra, what is it

Answer 28

following focal ischemia, the tissue surrounding core ischemic area is viable - storke therpay directed at rescuing area by imporviing tissue acidosis and O2 delivaery - calcium channel and NMDA receptor blocking could treat

Question 29

what kind of dysfunction occurs with ischemic penumbra

Answer 29

autoregulation dysfunction and edema due to ischemic tissue acidosis, and resultant luxury perfusion of adjacent normal tissue

Question 30

central canal is what and what condition can be associated

Answer 30

extends from obex of fourth ventricle - can enlarge and develop a cavity in center of cord = syringomyelia - bilateral anesthesia of shoulder and upper limbs

Question 31

what is a communicating hydrocephalus a combination of

Answer 31

external infratentorial and internal hydrocephalus

Question 32

the penetrating branches of what artery supply the internal capsule and basal ganglia

Answer 32

posterior communicating artery

Question 33

where is the anterior choroidal artery and what is it involved with

Answer 33

near ICA and posteior communicating junction | -role in parkinsons

Question 34

which artery has the highest incidence of cerebral aneurysms?

Answer 34

the anterior cerebral artery

Question 35

where is the ACA and what may it anastomose with?

Answer 35

near olfactory and optic nerve | -may anastomse with posterior cerebral artery via pericallosal artery

Question 36

the penetrating branch of the ACA is called the ______ and supplies the _____ and ____

Answer 36

recurrent artery of heubner | supplies internal capsule and corpus striatum

Question 37

occlusions of the ACA may result in

Answer 37

ontralateral paresis and or paraesthesia of leg and foot

Question 38

which penetrating branch of the MCA is prone to rupture? | it is a _____ striate artery

Answer 38

artery of cerebral hemrrhage | -lateral striate

Question 39

MCA cortical branches

Answer 39

central artery | frontal branches

Question 40

thrombosis of central artery would lead to what

Answer 40

contralateral paralysis or paraesthesisa of face and upper 1/2 of body

Question 41

what artery supplies broca's area

Answer 41

frontal branches | -cortical branch off MCA

Question 42

what artery is compromised in central cord syndrome

Answer 42

anterior spinal artery

Question 43

what is central cord syndrome

Answer 43

disruption of blood flow to anterior spinal artery = ischemia of central region of spinal cord -loss of motor function and sometimes sensation below level of occlusion

Question 44

the two posterior spinal arteries are branches off ___ or ___

Answer 44

vertebral arteries or PICA

Question 45

what arteries supply the peripheral margins of the spinal cord

Answer 45

the posteior spinal arteries and the radicular arteries

Question 46

whatr artery is the major supply to the inferior 2/3 of the spinal cord and contributes to the anterior spinal artery

Answer 46

great anterior artery of adamkiewicz

Question 47

what may compromise the great anterior artery of adamkiewicz

Answer 47

thoracolumbar fracture or surgical repair of AAA

Question 48

what does the PICA supply and thrombosis of it results in what

Answer 48

supplies posterior inferior portion of cerebellum, posterolateral aspect of medulla choroid plexus of fourth ventricle -thrombosis = lateral medullary (wallenberg) syndrome

Question 49

what are the signs of wallenberg syndrome and what artery involved

Answer 49

PICA and horseness, dysphagia, loss gag | IX and X

Question 50

cortical area of anterior cerebral artery

Answer 50

paracentral lobule

Question 51

cortical area of middle cerebral artery

Answer 51

``` primary motor primary auditory primary somesthetic broca wernicke premotor ```

Question 52

cerebral venous drainage path

Answer 52

internal cerebral vein and basal vein drain into the great vein of Galen - Galen drains into straight sinus - striaght sinus goes into left transverse sinus - left transverse sinus goes into IJV