Blood supply, Hemorrhage, Hydrocephalus Flashcards Preview

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Flashcards in Blood supply, Hemorrhage, Hydrocephalus Deck (55)
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1
Q

Where are the lateral ventricles located?

A

Cerebral hemispheres

2
Q

What connects the lateral ventricles to the 3rd ventricle?

A

Intraventricular foramen

3
Q

Where is the 3rd ventricle located?

A

Between thalami

4
Q

What connects the 3rd ventricle to the 4th ventricle?

A

Cerebral Aqueduct

5
Q

Where is the 4th ventricle located?

A

Between cerebellum and pons

6
Q

What drains the 4th ventricle?

A

Median and lateral apertures/foramina

7
Q

What space does the CSF drain into?

A

Subarachnoid space

8
Q

Arachnoid vili help to drain the CSF into what for reabsorption?

A

Dural venus sinus (superior sagittal sinus)

9
Q

How much CSF is in the ventricles at a time?

A

20-25 mL

10
Q

How much CSF is in the entire ventricular system at a time?

A

140 mL

11
Q

Hydrocephaly

A

Excessive amount of CSF

12
Q

In infants, the increased intracranial pressure caused by an increased amount of CSF causes what?

A

Enlargement of the head at the cranial sutures

13
Q

In adults, the increased intracranial pressure caused by an increased amount of CSF causes what?

A

The sutures are fused thus the head cannot expand; Thus this will result in destruction of cortical matter or papilledema

14
Q

External hydrocephalus

A

Excessive CSF in the subarachnoid space, compresses the brain to make more room

15
Q

What are the 2 types of external hydrocephalus?

A

Supratentorial or intratentorial – or both

16
Q

What is another name for Internal hydrocephalus?

A

Non-Communicating hydrocephalus

17
Q

Internal hydrocephalus/non-communicating hydrocephalus

A

The CSF is NOT draining out of the ventricular system possibly due to an obstruction and so the ventricles enlarge!

18
Q

Where do the ventricles enlarge due to internal hydrocephalus?

A

Proximal to the obstruction

19
Q

Communicating hydrocephalus

A

CSF is getting out of the ventricular system but it not getting all the way back to the venous system for reabsorption

20
Q

What is communicating hydrocephalus a mixture of?

A

Internal hydrocephalus and infratentorial external hydrocephalus

21
Q

Where is the obstruction with communicating hydrocephalus?

A

In the subarachnoid space at the level of the tentorial notch prevents CSF from flowing from the infratentorial region up over the cerebral hemispheres in the supratentorial regions

22
Q

What is the supratentorial external hydrocephalus most commonly associated with?

A

Atrophy of the cortex in a disease like Alzhemier’s

23
Q

Where is the likely obstruction with internal hydrocephalus?

A

Intraventricular foramen (if lateral ventricles enlarged), cerebral aqueduct or median and lateral apertures

24
Q

What makes CSF and how many of them are there?

A

Choroid plexus - each ventricle has one

25
Q

What 2 arteries supply the majority of the blood to the brain?

A

Internal carotid and vertebral arteries

26
Q

Occlusion of a large nutrient vessel to the brain

A

Focal ischemia - affects the area of the brain that artery supplies

27
Q

What are the 2 mechanisms for a stroke and what does a stroke result in?

A

Ischemic and hemorrhagic

Stroke refers to acute focal neurological deficits from loss of blood supply to that area

28
Q

With severe ischemia injuries what areas of the brain are most vulnerable?

A

Watershed regions

29
Q

What are watershed regions in the brain?

A

Areas only supplied by the most distal branches of the cerebral arteries and are the first to be compromised

30
Q

What area does the ACA supply?

A

2/3 of medial side and superolateral side of hemisphere

31
Q

What can an occlusion in the ACA result in?

A

Contralateral sensation loss of LE

- ACA supplies posterior paracentral gyrus in the somatosensory cortex that correlates to the contralateral LE

32
Q

What are the MCA branches?

A

Medial and lateral striate, central, frontal branches and angular arteries

33
Q

What do the medial and lateral striate arteries supply?

A

Internal capsule, thalamus and corpus striatum

34
Q

Where is the Central artery located?

A

In the central sulcus

35
Q

What does the Central artery supply?

A

Primary motor and somatosensory cortices

postcentral gyrus

36
Q

What does occlusion of the central artery result in?

A

Contralateral paralysis and paresthesia of the contralateral upper body, face, UE

37
Q

What do the frontal branches supply?

A

Broca’s area

38
Q

Occlusion of the frontal branches will result in?

A

Broca’s aphasia = Difficulty producing speech (motor)

39
Q

What does the angular artery supply?

A

Wernicke’s area

40
Q

Occlusion of the angular artery will result in?

A

Wernicke’s aphasia = Patients are talkative, but do not have much language comprehension - words lack content, meaning and choose inappropriate word choices

41
Q

What supplies the central portion of the spinal cord?

A

Anterior spinal A.

42
Q

What supplies the lateral medulla?

A

PICA - posterior inferior cereballar a.

43
Q

What supplies the primary visual cortex?

A

Posterior cerebral A.

44
Q

What can compress the posterior cerebral A. and result in vision changes?

A

Uncal herniation

45
Q

What is the main superficial venous drainage of the cerebral hemispheres?

A

Superficial middle cerebral vein

46
Q

What are the 2 veins that drain into the great vein of Galen?

A

Internal cerebral and Basal vein

47
Q

Where does the Great vein of Galen drain into?

A

Straight sinus

48
Q

A fracture of the pterion could rupture what and result in what?

A

Middle meningeal artery rupture could result in an epidural hematoma

49
Q

As the epidural hematoma grows it compresses the nearby cerebral hemisphere. What can result?

A

Midline shift of the cerebral hemispheres = falx herniation (across falx cerebri)

50
Q

Decreased venous drainage from retina from increased intracranial pressure

A

Papilledema

51
Q

What swells with papilledema?

A

Optic disc

52
Q

Bridging (cerebral) veins rupture

A

Subdural hematoma

53
Q

What is likely ruptured with a subarachnoid hemorrhage?

A

Major blood vessels, as they all run through the subarachnoid space

54
Q

Trauma to the midbrain may result in

A

Coma or state of consciousness

55
Q

With a subarachnoid bleed, what are the symptoms?

A

ABRUPT and BURSTING headache, vomiting, neck rigidity, positive kernig’s sign