Ventricular System & Cerebral Vessels - Stephens 3/28

Question 1

In 2/3 of cases what does the superior sagittal sinus empty directly into?

Answer 1

Right transverse sinus

Question 2

In 2/3 of cases what drains into the left transverse sinus?

Answer 2

Straight sinus

Question 3

What are the 3 types of Herniations that may result from an Epidural Hematoma?

Answer 3

Falx
Uncal/tentorial
Tonsillar

Question 4

Bilateral compression of the midbrain reticular formation results in what?

Answer 4

Progressive decrease in the level of consciousness

Question 5

Where is an epidural hematoma located?

Answer 5

Between the endocranium and dura mater

Question 6

What causes an epidural hematoma?

Answer 6

Rupture of middle meningeal artery

Question 7

When does a subarachnoid hemorrhage occur?

Answer 7

Cerebral blood vessel ruptures in subarachnoid space

Question 8

What indicates a subarachnoid hemorrhage?

Sampled how?

Answer 8

Erythrocytes in the CSF

Lumbar puncture or cerbellomedullary cistern

Question 9

How does CSF flow out of the lateral ventricles?

Into where?

Answer 9

Interventricular foramen of Monroe

3rd ventricle

Question 10

From the 3rd ventricle where does CSF go?

To where?

Answer 10

4th ventricle

Cerebral aqueduct

Question 11

How does CSF get out of the 4th ventricle?

Answer 11

2 lateral apertures (Luschka)

1 medial aperture (Magendie)

Question 12

Absorption of CSF occurs in the arachnoid villi, adjacent to what?

Answer 12

Superior sagittal sinus

Question 13

What is papilledema?

What causes it?

Answer 13

DEC venous drainage from the retina results in edema of the retina and swelling of the optic disc

INC intracranial pressure on small veins of optic nerve

Question 14

Excessive accumulation of CSF in the subarachnoid space is called what?

Answer 14

External hydrocephalus

Question 15

External hydrocephalus can be of what 2 forms?

Associated problems?

Answer 15

Supratentorial external hydrocephalus - atrophy of coretx -> Alzheimer’s

Infratentorial external - w/communicating hydrocephalus

Question 16

What is a lemniscus?

What are the 4 clinically important ones?

Answer 16

Bundle of crossed, secondary nerve fibers in a conscious sensory fiber

Spinal
Lateral
Trigeminal
Medial

Question 17

What is internal hydrocephalus called?
Why?

Obstruction of what?

Results in what?

Answer 17

Noncommunicating bc it does not drain into the subarachnoid space

Obstruction in ventricle system

Dilation of ventricles proximal to the obstruction

Question 18

What causes communicating hydrocephalus?

What is the result?

Answer 18

Obstruction of subarachnoid space at the level of the Tentorial membrane

Infratentorial external (CSF in the infratentorial subarachnoid space) and internal (ventricle hypertrophy) hydrocephalus

Question 19

What is the ischemic penumbra in regional CBF?

Answer 19

Watershed region -> too ischemic to function, yet critically viable

Tx: directed at rescuing ischemic penumbra by improving tissue acidosis and oxygen delivery

Question 20

Branches of the ACA supply what region?

Occlusions of these branches result in what?

Answer 20

Paracentral lobule region

Paresis and/or paraesthesia of the leg and foot

Question 21

The Recurrent artery of Heubner is considered what?

Located where?

Supplies what?

Answer 21

Medial striate artery

Proximal to ACA

Internal capsule and corpus striatum (globus pallidus, putamen, and caudate)

Question 22

What defines the dominant hemisphere?

Answer 22

Presence of Broca’s speech area

Question 23

Wernicke’s area is responsible for what?

Answer 23

Language comprehension

Question 24

MCA occlusions may result in what?

Answer 24

Sensor and/or motor deficits in the contralateral upper limb and head

Question 25

Thrombosis results in expressive or Broca's aphasia. What is it characterized by?

Answer 25

Motor language disorder characterized by cryptic, telegraphic speech w/frustrating problem in invitation of speech motor patterns

Question 26

Obstruction of an artery in the dominant hemisphere may result in Wernicke's aphasia. What is it? Characterized by what?

Answer 26

Receptive language disorder Fluent and talkative, lack content or meaning in their spoken and written comprehension

Question 27

What is the chief arterial supply to the supra marginal and angular regions? Obstruction of this artery in the dominant hemisphere may result in what?

Answer 27

Angular artery Wernicke's aphasia

Question 28

Disruption of blood flow to the anterior spinal artery results in what? Specifically what? Characterized by what?

Answer 28

Central cord syndrome Ischemia of the central region of the spinal cord Central necrosis and cavitation of the spinal cord and the development of the syrinx

Question 29

What do the posterior spinal arteries branch off? Supply what?

Answer 29

Vertebral a or posterior inferior cerebellar a (PICA) Dorsal roots and 3/4 of posterior columns

Question 30

What do the anterior and posterior radicular arteries course with?

Answer 30

Ant - ventral rootlets Post - dorsal rootlets

Question 31

Displacement of the PICA on angiograms of the posterior cranial fossa indicates what?

Answer 31

Space occupying mass such as a tumor

Question 32

Thrombosis of PICA results in what?

Answer 32

Lateral Medullary (Wallenberg) Syndrome

Question 33

What does the superior cerebellar artery supply? Branches off what?

Answer 33

Superior lateral portion of the cerebellum, deep cerebellar nuclei, pons and midbrain Basilar artery

Question 34

What is the last branch off the basilar artery? Supplies what?

Answer 34

Posterior Cereberal A (PCA) Primary visual cortex

Question 35

The posterior spinal artery has penetrating branches to where?

Answer 35

Posterior 1/3 of spinal cord

Question 36

What drains into the Great vein of Galen? Where does the Great vein of Galen empty into?

Answer 36

Internal cerebral vein Basal vein of Rosenthal Straight sinus

Question 37

What drains into the Basal vein of Rosenthal?

Answer 37

middle deep cerebral v | Anterior cerebral v

Question 38

What drains into the internal cerebral vein?

Answer 38

Terminal v | Anterior septal v

Question 39

What cortical areas does the MCA supply?

Answer 39

``` Primary motor cortex Premotor cortex Primary somesthetic cortex Primary auditory cortex Broca's area Wernicke's area ```

Question 40

What may be compromised during surgical repair of AAA or a Thoracolumbar fracture? What does it supply?

Answer 40

Greater Artery of Adamkiewicz Inferior 2/3 of the spinal cord

Question 41

Lesion to the labyrinth artery causes what?

Answer 41

Hearing and equlibrium problems

Question 42

Occlusion to the anterior inferior cerebellar artery causes what?

Answer 42

Facial droop

Question 43

Uncal Herniations may compress what CN? What 2 structures is this CN located between?

Answer 43

Posterior Cerebral Artery Superior Cerebellar Artery