Neuro Block 1

Front 1

What are the meninges

Back 1

They are protective layers around the brain and are called dura, arachnoid, and pia

Front 2

Which layer is the closest layer to the brain

Back 2

pia

Front 3

w/c layer is falx cereberi and tentorium cerbelli found

Back 3

They are found in dura, which is the hard layer

Front 4

What structure is responsible for dividing the hemispheres

Back 4

Falx cereberi, as opposed to the tentorium cerebella w/c is tent like structure

Front 5

What is the unique thing about arachnoid layer

Back 5

It is the spider spongy like layer where the CSF percolates over the brain surface

Front 6

Where does CSF percolate

Back 6

Arachnoid layer

Front 7

Where are all the blood vessels located

Back 7

They are in the layer just below the arachnoid layer called sub arachnoid layer

Front 8

What are bridging veins

Back 8

They run between subdural space and super sagiettal space and can cause subdural hematoma

Front 9

w/c layer is juxtaposed to the brain and sticks to it closely

Back 9

Pia

Front 10

Where is epidural space

Back 10

Between skull and the dura

Hint 10

None

Front 11

Where is subdural space

Back 11

Between arachnoid and dura

Front 12

Where Is the subarachnoid space

Back 12

It’s between arachnoid and pia

Front 13

What’s significant about this space

Back 13

CSF percolates here and all the major vessels run through here

Front 14

How are hematomas formed?

Back 14

Brain is encased, so any trauma to the head can lead to bleeding i.e. hematoma

Front 15

What happens if the meningeal artery is ligated

Back 15

It will usually lead to epidural hematoma b/c meningeal artery run along epidural space

Front 16

What happen if the bridging vein are ligated

Back 16

Subdural hematoma, b/s briding veins run between subdural hematoma and super sagiettal space

Front 17

What does epidural hematoma look like on CT scan

Back 17

It is a biconvex lens shaped, quick, bleeds a lot, and usually seems darker, it has tight flow b/s that’s where the dura attaches very strongly to the brain

Front 18

What does subdural hematoma look like

Back 18

It looks rather crescent shaped, this will bleed more freely b/c the bridging vein will dissect the area freely

Front 19

What are space occupying injuries of the brain

Back 19

Tumor, hemorrhage, edema, hematoma

Front 20

What do space occupying lesion cause

Back 20

They can increase the pressure in the cranial vault, they can push up on some of the surrounding neural structures, and they can push these structure to one side away fron their original location= hernia

Front 22

What is uncal herniation

Back 22

It happesn when the nedial temporal lobe herniates, this pushes on the uncus in the midbrain, w.c in turn pushes on the CN3, leading to symptoms of fixed pupil and papillary dilation

Front 23

What is another thing that uncal herniation can cause

Back 23

It can push on the reticular formation and that could lead to coma

Front 24

During developmental level, where to we see lateral ventricles

Back 24

At telencephalon

Front 25

During developmental level, where to we see 3rd ventricles

Back 25

At the diencephalon

Front 26

What ventricle do we see at the level of mesencephalon

Back 26

None, only cerebral aqueduct

Front 27

What level do we see fourth ventricles

Back 27

At rhombencephalon

Front 28

What are the most anterior and largest ventricles

Back 28

Lateral

Front 29

How do lateral ventricles join the inferior temporal horns

Back 29

By attaching to the atrium

Front 30

How does one go from lateral ventricles to the third ventricles

Back 30

Via foramen of Monroe

Front 31

How does the 3rd connect to the fourth

Back 31

Via cerebral aqueduct

Front 32

Whats another name for the aqueduct of sylvius

Back 32

It is called cerebral aqueduct

Front 33

What structures make up the wall of 3rd ventricle

Back 33

Thalamus and hypothalamus

Front 34

How does CSF exit the fourth ventricles

Back 34

It leaves by 2 lateral opening called foramen Lushka and 1 central opening called foramen of magendie

Front 35

What cells make and secrete CSF

Back 35

Choroid epithelial cells

Front 36

What cells line the ventricles

Back 36

Epindymal cells

Front 37

Where is choroid plexus found

Back 37

Tucked w/in the ventricles and is made up fucion of vascular epindymal cells that line the sides of the ventricles

Front 38

What is ionic make up of CSF

Back 38

↑ In Mg and Cl, ↓ in K

Front 39

Why is it necessary to know the make up of CSF

Back 39

b/c it can predict disease, for example meningitis is caused by bacteria and viruses, the bacterial is dangerous and treated differently, so in bacterial there is no glucose but in viral the glucose concentration of the CSF is normal

Front 40

What happens to CSF once it leaves the 4th ventricle

Back 40

It moves in to the cisterns, then it percolates over the hemispheres, and then finally exits via arachnoid villus and finally moves into the subarachnoid space in the spinal chord

Front 41

What are cisterns

Back 41

They are widened parts of the subarachnoid space, the CSF flows through them

Front 42

What is the significance of lumbar cistern

Back 42

That’s where we do a spinal tap and sample CSF

Front 43

What structure is responsible for draining the CSF

Back 43

Arachnoid villus

Front 44

What happens if CSF is not drained properly or if flow is obstructed

Back 44

hydrocephalus

Front 45

What are the reason for hydrocephalus

Back 45

Too nuch CSF (papillary tumor + the choroid plexus), or poor drainage or obstruction of CSF at a certain location causing it to pool

Front 46

What is the most common cause of hydrocephalus

Back 46

Obstruction of flow due to tumors blocking the passage through the ventricles or congenital defects where the opening to the ventricle doesn’t form

Front 47

What is a communicating hydrocephalus

Back 47

Ventricles can communicate but the obstruction is in subarachnoid space or arachnoid granulations not absorbing CSF

Front 48

What is a non-communicating hydrocephalus

Back 48

Something is blocking the foramina of the ventricles, this is seen with dandy-walker syndrome, where the exit foramina don’t develop properly or ventricular enlargement

Front 49

What is the blood brain barrier

Back 49

It formed by formation of the tight junction b/t endothelial cells of the brain capillary, exclusively, it is not present systemically anywhere else

Front 50

What id function of BBB

Back 50

It prevent the flow of substance into the brain, it helps minimize infection to the brain

Front 51

What causes the formation of the tight junction

Back 51

Pedicles of astrocytes

Front 52

Is their another barrier in the brain

Back 52

Yes, it exists between the choroid plexus and CSF, it (X) flow of materials into the CSF and help CSF stay with epindymal cells

Front 53

If access to brain is so tightly contolled then how does one get drugs to the brain

Back 53

Via circumventicluar organs, these are the area where BBB doesn’t exist

Front 54

Where are these circumventricles located and what are there functions

Back 54

1)Area pstrema=located at the caudal wall of the 4th ventricle, in the medulla, detects toxins that can cause vomiting
2)median eminence and neurohyphysis w/c regulates ands secretes pituitary hormone
3)pineal gland=release melatonin w/c regulates our circaidian rhythm