week 2 components of intracranial vault Flashcards

1
Q

components of the intracranial vault

A
  • brain 80-85%
  • blood 5-10%
  • CSF 10-15%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

arteries that supply blood to the brain

A
  • B/L carotid arteries
  • B/L vertebral arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

left carotid artery arises from

A

aortic arch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

right carotid artery arises from

A

innominate artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

internal carotid artery enters where and supply what

A
  • enters base of the skull
  • supplies circle of Willis and eye via ophthalmic artery
  • ultimately bifurcates into the anterior and middle cerebral arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

external carotid artery where in the skull

A

remains superficial to the skull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

flow of blood through the brain (anterior and posterior)

A
  • posterior circulation – aorta > subclavian > vertebral > basilar > posterior structures and cervical spinal cord
  • anterior circulation – aorta > carotid > internal carotid > circle of willis > cerebral hemispheres
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

venous system drainage flow

A
  • venous blood drains into the venous sinuses which lie between the layers of the dura mater and drain into the internal jugular vein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

venous system

A
  • sinuses are valveless
  • blood can flow back and forth
  • pressure within them is negative (air embolism)
  • little influence by the autonomic nervous system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

meninges 3 layers

A
  • covers the brain and spinal cord
  • dura mater
  • arachnoid mater
  • pia mater
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

pia mater

A
  • anchored to the brain by astrocytes which form the BBB
  • allows for passage and transport of small molecules, lipophilic molecules, passive transport of glucose, active transport of amino acids
    -prevents large molecules (dopamine) and charged (ionized) molecules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

arachnoid mater

A
  • CSF circulates in the subarachnoid space (between arachnoid and pia mater)
  • contains the blood supply to the brain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

dura mater

A
  • consists of the outer ( endosteal layer) and inner (meningeal layer)
  • dural sinuses are between these layers
  • drains CSF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

epidural hematoma

A
  • bleeding between skull and dura mater
  • does not cross suture line
  • arterial blood (meningeal arteries)
  • fast onset of bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

subdural hematoma

A
  • bleeding between dura and arachnoid mater
  • venous blood
  • usually from tears in bridging veins
  • slower onset
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

subarachnoid hemorrhage

A
  • SAH is a neurological emergency
  • hemorrhage in the subarachnoid space (between arachnoid membrane and the pia mater)
  • less common but an important cause of stroke
  • usually from ruptured cerebral aneurysm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

lateral ventricles of the brain

A

2 lateral ventricles which are within the cerebral hemispheres and communicate with the 3rd ventricle through the foramen of monroe

18
Q

3rd ventricle of the brain

A
  • inside the substance of the thalamus (in diencephalon), dividing it to 2 lateral parts the floor of the ventricle is the optic chiasm
19
Q

4th ventricle of the brain

A
  • communicates with the 3rd ventricle via the aqueduct of sylvius
  • lies anterior to the cerebellum (between pons and cerebellum)
  • has a connection to the subarachnoid space through the median foramen of Magendie and 2 lateral foramen of luschka
20
Q

CSF

A
  • produced by the choroid plexus
  • surrounds brain and spinal cord
  • 500 cc produced / 24 hrs
  • total volume 150 cc
21
Q

CSF flow

A
  • L & R ventricles > foramen of monro > third ventricle > aqueduct of sylvius > fourth ventricle > foramen of luschka > subarachnoid space & spinal cord
  • each ventricle has a choroid plexus (site of production)
22
Q

cranial nerve 1

A
  • olfactory
  • sensory: nose
23
Q

cranial nerve 2

A
  • optic
  • sensory eye
24
Q

cranial nerve 3

A
  • oculomotor
  • motor: all eye muscles except those supplied by cranial nerve 4 and 6
25
Q

cranial nerve 4

A
  • trochlear
  • motor: superior oblique muscle of eye
26
Q

cranial nerve 5

A
  • trigeminal
  • sensory: face, sinuses, teeth
  • motor: muscles of mastication
  • the zygomatic branch can be damaged by mask straps
27
Q

cranial nerve 6

A
  • abducens
  • motor: external rectus muscle of the eye
28
Q

cranial nerve 7

A
  • facial
  • motor: muscles of the face
29
Q

cranial nerve 8

A
  • vestibulocochlear
  • sensory: inner ear
30
Q

cranial nerve 9

A
  • glossopharyngeal
  • motor: pharyngeal musculature
  • sensory: posterior part of tongue, tonsils and pharynx
31
Q

cranial nerve 10

A
  • vagus nerve
  • motor: heart, lungs, bronchi, GI tract
  • sensory: heart, lungs, bronchi, trachea, larynx, pharynx, GI tract, external ear
32
Q

cranial nerve 11

A
  • accessory nerve
  • motor: sternocleidomastoid and trapezius muscles
33
Q

cranial nerve 12

A
  • hypoglossal
  • motor: muscles of the tongue
34
Q

cranial nerve 7 (facial) specifics

A
  • innervates muscles of facial expression (motor)
  • innervates orbicularis oculi
  • provides sensory and parasympathetic innervation
  • frequently monitored during surgery around the face (parotidectomy, acoustic neuroma, cochlear implant)
35
Q

cranial nerve 9 (glossopharyngeal)

A
  • sensory innervation to the baroreceptors of the carotid sinus can cause bradycardia nd hypotension during CEA
  • sensory innervation to the chemoreceptors of carotid body
  • sensory innervation of the posterior oral mucosa (gag reflex)
  • motor innervation of the pharynx (swallowing)
  • provides parasympathetic innervation to the parotid gland
36
Q

vagus nerve branches

A

SLN
RLN

37
Q

SLN branches

A
  • internal branch (sensory)
  • external branch (motor) cricothyroid muscles
38
Q

injury to the SLN

A
  • external branch innervates the cricothyroid muscle which tenses the adducts the vocal cords
  • injury can change voice but is not generally dangerous
39
Q

RLN injury

A
  • innervates all the muscles of the larynx except the cricothyroid
  • unilateral injury produces abductor VC paralysis = hoarseness
  • bilateral VC paralysis = partial or complete airway obstruction (resp distress, stridor)
40
Q

vagus nerve and the heart

A
  • convey parasympathetic innervation to the SA and AV nodes of the heart
  • vagal stimulation reduces HR and is constantly active
41
Q

vagus nerve and the lungs

A
  • parasympathetic stimulation within pulmonary plexuses causes vasodilation and bronchoconstriction
42
Q

vagus nerve and the GI tract

A
  • parasympathetic innervation to majority of abdominal organs
  • stimulates smooth muscles contraction and glandular secretion in these organs
  • vagal stimulation during GI surgery and endoscopy = bradycardia and even asystole