Head And Neck Anatomy

Front 1

Anencephaly

Back 1

- the most severe form of neural tube defect;
-1 in 500 births
-More common in female fetuses
-Risk increase with with folate (folic acid) deficiency
-babies dead at birth

Front 2

Spina Bifida

Back 2

-Absence or hypoplasia of one or more of the dorsal arches of the vertebrae;
-meningeal and spinal defects possible
-Spina bifida cystica may cause gait disturbance, urinary incontinence, male impotence
-Spina bifida occulta:
unfused vertebral arch
(intact meninges and spinal cord) is common; 20% of general population and is usually symptomatic

Front 3

plagiocephaly
scaphocephaly
trigonocephly

Back 3

-fused coronal suture
-fused saggital suture
- fused metopic suture

Front 4

Cerebral Edema

Back 4

Increased water content of the brain parenchyma

Front 5

Vasogenic Edema

Back 5

Disruption in blood-brain barrier that allows escape of fluid from the vasculature into the interstitial space of the brain

Front 6

Cytotoxic Edema

Back 6

An increase in intracellular fluid secondary to cellular injury

Front 7

Brain Herniation

Back 7

The displacement of a part of the brain from one dural compartment to another

Front 8

Transtentorial Herniation

Back 8

a medial displacement of temporal lobe against the tentorium cerebelli; causes pupillary dilation,
impaired eye movements, and compression of posterior cerebral artery with ischemia to visual cortex

Front 9

Subfalcine Herniation

Back 9

a displacement of c. gyrus under falx cerebri caused by expansion of cerebral hemisphere; results in compression of anterior cerebral artery with ischemia to cortex and weakness/sensory abnormality of leg.

Front 10

types of hernia's

Back 10

locations

Front 11

ID the sutures of the crown of head

Back 11

MCSP

Hint 11

MCSP

Front 12

Tonsillar Herniation

Back 12

displacement of the cerebellar tonsils through the foramen magnum that compresses the respiratory centers of the medulla oblongata

Front 13

Hydrocephalus

Back 13

accumulation of excess cerebrospinal fluid in the ventricular system of the brain

Front 14

Causes of Hydrocephalus

Back 14

-Decreased resorption of CSF (most common)
-Overproduction of CSF
-Obstruction (within ventricles, foramina of Lushka & Magendie or subarachnoid space)

Front 15

Communicating hydrocephalus

Back 15

when full communication exists between the ventricles and subarachnoid space

Front 16

Noncommunicating hydrocephalus

Back 16

when CSF flow is obstructed within the ventricular system or in its outlets to the arachnoid space

Front 17

Obstructive hydrocephalus

Back 17

obstruction of the flow of CSF (intraventricular or extraventricular). Most hydrocephalus is obstructive

Front 18

Vascular Diseases of the Brain

Back 18

Generalized reduction in blood flow (hypoxic-ischemic encephalopathy)
Infarction
Hemorrhage (parenchymal or subarachnoid)

Front 19

Causes of Hypoxic-ischemic Encephalopathy

Back 19

Cardiac dysrhythmias
Shock
Increased intracranial pressure

Front 20

Modifiers of Hypoxic-ischemic Encephalopathy

Back 20

Age (younger more tolerant)
Duration (short duration “recoverable”)
Temperature (hypothermia slows rate of injury)

Front 21

Brain Infarction

Back 21

Most common form (70-80%) of strokes (CVA)
Of brain infarctions, about ¾ are ABI (atherothrombotic brain infarction)
7th decade; males>females
Thrombosis of atherosclerotic vessel predisposes to infarction (hypertension, diabetes & smoking)
Emboli (from heart or elsewhere can be a cause)

Front 22

Features of Brain Infarction

Back 22

-Transient ischemic attacks precede infarct in 1/3; TIA predictive of impending infarct
-Infarcts occur most often in areas supplied by middle cerebral artery
-Deficits can include visual field abnormalities, aphasia, apraxia, agnosia, contralateral hemiparesis & hemidysesthesia
-Paradoxical infarct related to collateral circulation

Front 23

Primary Brain Parenchymal Hemorrhage

Back 23

-Hypertension most common underlying cause (50%); other causes are coagulation disorders, amyloid, neoplasms, aneurysms, AVM (arteriovenous malformation)
-Mid-late adult life; peak at age 60
-Sudden headache, vomiting, loss of consciousness, coma, pupillary fixation, herniation, apena & death

Front 24

distribution of hypertensive hemorrhages

Back 24

-65% basal ganglia thalmus
-15% Pons
-10% cerebellum

Front 25

Types of Aneurysm

Back 25

-medial defect (berry or saccular)
-atheroscelrotic
-charcot (hypertension)

Front 26

Saccular (berry) Aneurysm

Back 26

-Present at bifurcations in 1%; risk of rupture when 6-10 mm in size; women > men, <50; incidence higher in polycystic kidneys, coarctation of aorta, AVM
-If ruptured, produces subarachnoid and/or brain hemorrhage
-Abrupt headache, vomiting, loss of consciousness with 50% death within days; infarction, hydrocephalus, herniation

Front 27

Common sites of saccular (berry) aneurysms in the circle of Willis

Back 27

.

Front 28

Arteriovenous Malformation

Back 28

-Most common congenital vascular anomaly of the brain; usually located in the cerebral hemispheres
-Hemorrhage and seizure most likely in 1st decade
-10% also have saccular aneurysm

Front 29

CNS Trauma

Back 29

Epidural hematoma
Subdural hematoma
Traumatic parenchymal injury

Front 30

Epidural Hematoma

Back 30

-Most frequently associated with skull fracture & ruptured middle meningeal artery; blood between skull and dura
-Concussion, “ lucid interval” followed by progressive loss of consciousness
-Can produce transtentorial and tonsillar herniation if not promptly treated

Front 31

Subdural Hematoma

Back 31

-Most acute cases caused by disruption of bridging veins between dura & arachnoid mater; “velocity change injuries”; chronic with atrophy of brain
-Symptoms slower onset than epidural; compression of brain with possible herniation if not resorbed or treated; may be chronic (neomembrane)

Front 32

Traumatic Parenchymal Injury

Back 32

Concussion
Contusion
Laceration
Diffuse axonal injury
Traumatic intracerebral hemorrhage
Generalized brain swelling

Front 33

contusion pattern
hit in front of head
hit in back of head
hit in back side of head

Back 33

-in the front
-in the front
-on the opposite side of head and front

Front 34

Neurocutaneous Syndromes (gene associations)

Back 34

Neurofibromatosis I (17)
Neurofibromatosis II (22)
Tuberous sclerosis (9 or 16)
von-Hippel-Lindau disease (3)
Sturge-Weber disease (unknown)

Front 35

Neurofibromatosis (type I)

Back 35

cafe au lait spots
Lisch nodules (tan or brwon spots on the iris

Front 36

Infection of the CNS

Back 36

Leptomeningitis (meningitis)
Brain abscess
Tuberculosis and toxoplasmosis
Encephalitis (mostly viral)
Spongiform encephalopathies

Front 37

Leptomeningitis (Meningitis)

Back 37

-Acute (purulent); bacterial
-Acute lymphocytic; viral
-Chronic; fungal, TB & neurosyphilis

Front 38

Evaluation of CSF

Back 38

Protein
Cell type
Glucose

Front 39

Brain Abscess

Back 39

Most often bacterial
Hematogenous spread
Contiguous spread
Direct implantation (trauma)

Front 40

Viral Encephalitis

Back 40

-Most common type of encephalitis
-Most often generalized,localized (HSV) to temporal lobe
-Arbovirus, HSV, CMV, HIV, JC

Front 41

Prions as Agents of Disease

Back 41

-Only known infectious agents devoid of RNA and DNA
-Manifest as infectious, sporadic or genetic diseases
-Accumulation of abnormal folded form of normal prion protein
-Prion conformation associated with specific disease

Front 42

Spongiform Encephalopathies

Back 42

Creutzfeldt-Jacob (CJD); classic and new-variant
Kuru
Gerstmann-Straussler syndrome
Fatal familial insomnia

Front 43

CNS Neoplasms

Back 43

-Astrocytoma
-Oligodendroglioma
-Ependymoma
-Primitive neuroepithelial neoplasm (medulloblastoma)

Front 44

CNS Neoplasms II

Back 44

-Neuronal neoplasms (ganglioglioma, gangliocytoma, dysembryoplastic neuroepithelial tumor)
-Primary CNS lymphoma
-Meningioma
-Metastatic neoplasms

Front 45

Astrocytoma

Back 45

-Most common of primary brain tumors; TP53 mutation thought to play a role
-Pilocytic type are slow growing; mostly in children
-Fibrillary types are diffuse and can grow rapidly; “grade” determines behavior; any age; astrocytoma, anaplastic astrocytoma, glioblastoma multiforme

Front 46

Metastatic Neoplasms to the Brain

Back 46

-The brain is a common site of metastasis
-Approximately 33% of all intracranial neoplasms are metastatic
-Excluding leukemia and lymphoma, frequent primaries are carcinomas of lung and breast and melanoma