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Flashcards in Bleeding in the Brain Deck (18)
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1
Q

what can cuase an epidural hematoma

A

tearing of the middle meningeal artery

2
Q
what is the main blood supply to the dura 
what is a branch of 
how does it enter the skull
what layer does it travel in 
what is the external landmark
A
  • middle meningeal artery
  • maxillary artery
  • formaen spinosum (middle cranial fossa)
  • travel in periosteal layer
  • pterion
3
Q

where are the anterior meningeal branches from?

wehre are the posterior meningeal branches from?

A

ant: ophthalmic artery
post: from occipital and vertebral artery

4
Q

what is the dura innervated mainly by
what is the supratentorial dura innvated by?
post fossa?

A

CN V
trigeminal nerve
vagal and upper spinal nerves

5
Q

where is the middle meningeal artery located in the dura?

A

supratentorial dura

6
Q

what is the most common cause of an epidural (extradural) hemotoma

A

skull fracture that results in a laceration (tear) of a major dural vessel, such as the MIDDLE MEN ARTERY

7
Q

in dorsal midbrain syndrome…

  • can’t look _____
  • pupils dont constrict to light, but constrict to ____
  • upper lids are above ______
  • eyes get sucked into sockets in attempted upgaze, what is this called
A
  • can’t look up (upgaze paralysis)
  • contrict to a near target (light-near dissociatoin; “tectal pupils”
  • upper lids are above sup limbus (lid retraction)
  • convergence-retraction “nystagmus”
8
Q

vertical gaze center is in the….

horizontal gaze center is in the..

A

midbrain

pons

9
Q

where do projections of the INC cross

A

in the posterior commisure

10
Q

lesions involving the projections of the INC in the PC are thought to produce…

A

vertical gaze abnormalities for all classes of eye movements
=particularly true for upgaze

11
Q

the riMLF projections do not cross in the PC but…

A

bifurcate lower down

12
Q

what are the levators bilaterally controlled by

A

the single midline central caudal nucleus (CCN) of the oculomotor nuclear complex
-in turn controlled by M-group neurons

13
Q

in the downward gaze, what inhibits M-group neurons

A

INC

-this is what ultimately allow the lids to relax as you look down

14
Q

if you have a lesion in the PC, why will yo lose the normal inhibition over the CCN and thus onto the levators
-both lids will be “retracted”

A

bc the INC projections cross in the PC

15
Q

what does RAPD tell you

A

if there is optic nerve disease

16
Q

what are the 5 causes of light-near dissociation

(no rxn to light but will constrict to near”

A
  1. blind (amaurotic or no light perception)
  2. tectal (DMS)
  3. argyll robertson
  4. aberrant regeneration of CN3
  5. tonic
17
Q

what is degeneration towards the cell body called

A

retrograde

18
Q

what is degeneration away from the body called

A

anterograde

-wallerian degeneration