Zill - Clinical Problems of CNS Blood Supply/Glossopharyngeal N.

Question 1

Major blood sources for brain?

Major blood sources for spinal cord?

Answer 1

Brain: Internl Carotid (80 %), Vertebral (20%)

Spinal Cord: Vertebral, Segmental

Question 2

What is the organization of most of the blood supply of the spinal cord?

Answer 2

Below cervical, most blood is anastomoses with minor radicular (segmental) arteries and Anterior/Posterior Spinal arteries

Question 3

Clinical: Obstruction of Radicular Artery (of Adamkewicz)

Answer 3

Can occur by clamping for heart surgery or by dissecting Aortic Aneurysm

Similar to Anterior Spinal Artery Syndrome

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Symptoms:

1) Paraplegia of lower body
2) Bilateral loss of pain and temperature (Spinothalamic)
3) Loss of sphincter control
4) Sparing of vibration and position sense (Dorsal column, sensory)

Question 4

Clinical: Metastasis to Vertebral Column

Answer 4

Veins of spinal cord have No Valves

Disease can spread to spinal cord and vertebra by Interbertebral Veins (in pelvis) can meetastasize to vertebral column and spinal cord

Question 5

What is a physical consequence of bifurications?

Clinical consequence?

Answer 5

Create turbulence which can contribute to formation of arterial plaque

Plaque can give rise to Emboli in Internal Carotid Artery and cause cerebrovascular occlusion (Stroke)

Question 6

Clinical: Damage to CN IX (Glossopharngeal) and impact on cardiac system?

Answer 6

Visceral sensory endings monitor blood pressure, chemoreception

Damage can lead to Cardiac-Pulmonary Dysfunction

Question 7

Inner ear Visceral Sensory CN?

Answer 7

CN IX (Glossopharngeal)

“My head hurts”

Question 8

Clinical: Damage to CN IX and salivation?

Answer 8

Lesser Petrosal Nerve (br. of CN IX) joins V3 and provides parasympathetics to Otic ganglion

Damage to IX can produce decreased salivation

Question 9

Clinical: Damage to CN IX (Glossopharyngeal) and reflexes?

Answer 9

Produce decreased or absent gag reflex

Question 10

Clinical: What nerve can be damaged during a tonsillectomy?

Answer 10

Glossopharyngeal

Question 11

Clinical: Damage to CN IX and taste?

Answer 11

Lose Taste/Sensation to Posterior 1/3 of tongue