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71 Cards in this Set
- Front
- Back
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The posterior communicating artery runs close to which cranial nerve?
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CN III
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What is the most common aneurysm to cause pupil involving third nerve palsy?
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Aneurysm of posterior communicating artery at junction of internal carotid artery
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What are the four segments of the internal carotid artery?
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Cavernous
Petrous Cerebral Cervical |
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The posterior inferior cerebellar arteries (PICA) arise from what artery?
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Vertebral artery (before it joins to form basilar artery)
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The posterior cerebral artery is a branch of what artery?
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Basilar artery
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The posterior cerebellar artery anastamoses with what artery?
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Posterior communicating artery
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What does the posterior communicating artery supply?
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Areas around the hypothalamus (inferior and medial surfaces of temporal and occipital lobe)
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What is the largest branch off the internal carotid artery?
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Middle cerebral artery
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What are the four groups of branches that come off the circle of Willis?
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Anteromedial
Anterolateral Posterolateral Posteromedial |
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What arteries are in the circle of Willis?
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Anterior cerebral
Anterior communicating Internal carotid Posterior communicating Posterior cerebral Basilar |
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How much oxygen and cardiac output goes to the brain?
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20% of oxygen
15% of cardiac output |
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What is the cerebral artery most often occluded?
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Middle cerebral artery
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Individuals with long standing hypertension are at risk for what?
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Spontaneous hypertensive hemorrhage
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What is the most common site for spontaneous hypertensive hemorrhage?
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Lenticulostriate arteries
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Where do lenticulostriate arteries originate?
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From M1 segment of the middle cerebral artery
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What parts of the brain are most affected in acute hypoxia?
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Hippocampus
Cerebral cortex Cerebellar cortex |
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What is the average CBF?
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55 ml/100g/min
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What CBF causes ischemia?
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30-35 ml/100g/min
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What CBF causes infarction?
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<20 ml/100g/min
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What CBF causes massive infarction?
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<15 ml/100g/min
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In what situation would you want to cause hyperventilation in a patient?
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Increased intracranial pressure
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How does hyperventilation decrease ICP?
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Increase in oxygen and decrease in carbon dioxide causes vasoconstriction and decreased CBF. This will cause secondary lowering of ICP
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What happens when a penetrating artery is blocked?
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Ischemia
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What are some causes of saccular aneurysm?
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Infections (ie. peridontal disease)
Congenital Atherosclerosis |
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What artery is important collateral when the ICA is occluded?
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Anterior communicating artery
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What artery is a frequent site of saccular aneurysm?
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Anterior communicating artery
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Stroke in anterior communicating artery will result in what kind of defects?
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Contralateral sensorimotor defects in lower limb
Urinary incontinence and contralateral frontal lobe signs may be observed |
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What artery is most often a cause of subarachnoid hemorrhage?
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Posterior communicating artery
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What symptoms would occur with stroke in middle cerebral artery?
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Severe sensorimotor deficits in contralateral face and upper limb
Homonymous hemianopsia Global aphasia if dominant hemisphere involved Neglect syndrome if non-dominant hemisphere involved |
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What are the normal intracranial pressure, and intracranial hypertension numbers?
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Normal ICP<15mmHg
Intracranial hypertension >20mmHg |
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What are the respective percentages of the structures making up the skull?
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80% brain
10% CSF 10% blood |
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What factors affect CPP?
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MAP, ICP
Venous pressure Arterial obstruction |
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What factors affect CVR?
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Oxygen and carbon dioxide pressure
Drugs Viscosity |
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What is the Monro-Kellie doctrine?
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Physiological compartments of brain must remain constant. Increase in one compartment will result in decrease/compensatory change in one or more compartments
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What are the factors that affect CBF?
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CPP, MAP
Oxygen and carbon dioxide pressure Viscosity Neural activity |
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Why is the hypothalamus not a common region to be affected by stroke?
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The Circle of Willis provides collateral circulation
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What is inside the carotid sheath?
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Internal carotid and common carotid
Internal jugular Vagus nerve Carotid sinus and body Sympathetic plexus Deep cervical lymph nodes |
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How does CSF enter the subarachnoid space?
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Through the median and lateral aperature
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In what structure is CSF mainly absorbed?
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Arachnoid granulations
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What is the artery most often associated with epidural hemorrhages?
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Middle meningeal artery
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Subarachnoid hemorrhages are often seen with what?
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Subdural hemorrhages
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What are the risk factors for fusiform aneurysms?
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Tobacco use
Longstanding HTN |
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What types of skull fractures are most commonly seen in children?
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Diastatic fractures (extends to suture line and separates suture)
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What is a contusion?
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Wedge shaped bruise with petechial or larger sized hemorrhages
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What types of patients have clotting or bleeding tendencies?
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Alcoholics
Hypertensive patients |
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What is a coup contusion?
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Contusion that is directly underneath impact site
Object deforms skull and damages cortex |
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What is a contrecoup contusion?
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Contusions that occur on opposite side of impact
Bigger contusions than coup contusions |
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Where are herniation contusions usually seen?
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Ventral aspects of occipitotemporal lobe, hippocampus, parahippocampus gyri
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What types of contusions are usually seen in crushing head injury or falls from great height?
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Fracture contusion or lacerations
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Diffuse axonal injury also results in what types of hemorhages?
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Subarachnoid
Subdural |
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Severe hyperextension of the neck are immediately fatal due to complete alvusion of what?
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Pontomedullary junction OR
Cervicomedullary junction |
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What is the shape of an epidural hematoma?
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Lens-shaped
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What is the shape of a subdural hematoma?
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Crescent shaped
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The majority of epidural hemorrhages occur due to what?
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Skull fractures
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Bridging veins are more likely to tear under what circumstances?
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Rapid acceleration (falls or assaults like shaken baby syndrome)
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What type of patients are susceptible to tearing of bridging veins?
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Elderly and alcoholics (brain atrophy leading to increase distance between dura and brain)
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Traumatic basilar subarachnoid hemorrhage is caused due to tears of what artery?
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Vertebral artery
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What is the blood supply of the pituitary gland?
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Superior and inferior hypophyseal arteries (from I.C.)
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What is the venous drainage of the hypothalamus?
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Basilar vein --> Great cerebral vein --> straight sinus --> transverse sinus --> internal jugular
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What is the venous drainage of the pituitary gland?
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Intercavernous sinus --> transverse sinus --> internal jugular
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What is inside the cavernous sinus?
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CN III
CN IV V1 and V2 of CN V Abducens and internal carotid (and sympathetic plexus) |
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Where is CSF found?
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Ventricles
Subarachnoid space |
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What are the five different parts of the lateral ventricles?
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Anterior/frontal horn
Body Trigone Posterior/occipital horn Inferior/temporal horn |
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What is the foramina of Magendie?
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Median aperature
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What is the foramina of Luschka?
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Lateral aperature
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What kind of hydrocephalus is usually caused by tumors or congenital malformations?
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Obstructive
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What kind of hydrocephalus is usually caused by infections or hemorrhage?
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Communicating
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Who is considered a "young" stroke patient?
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Anyone younger than 55 years old
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What is the ischemic penumbra?
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Area where metabolic and blood flow border between adverse and favoring conditions for tissue viability
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Where are contrecoup contusions usually seen?
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Frontal and temporal lobes
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In the medial aspect of the brain, what does the MCA supply?
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Temporal poles
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