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Head and Neck - brain, meninges, blood supply
Anatomy of the head and neck
111
Health Care
Professional
10/08/2010

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Term
What does the brain develop from? Where, in relation to somites, does it develop?
Definition
The neural tube, rostral to the 4th pair of somites
Term
What are the three primary vesicles of the brain?
Definition
Proencephalon, mesencephalon, rhombencephalon
Term
Proencephalon gives rise to what secondary vesicle(s)?
Definition
Telencephalon, diencephalon
Term
Mesencephalon gives rise to what secondary vesicle(s)?
Definition
It remains and develops into the midbrain
Term
What secondary vesicles does the rhombencephalon give rise to?
Definition
Metencephalon, myelencephalon
Term
The telencephalon develops into...
Definition
the cerebral hemispheres
Term
The diencephalon develops into...
Definition
thalami, etc
Term
The mesencephalon develops into...
Definition
the midbrain
Term
The metencephalon develops into...
Definition
pons, cerebellum
Term
The myencephalon develops into...
Definition
the medulla
Term
The cerebral aqueduct is a remnant of which secondary brain vesicle?
Definition
Mesencephalon
Term
The 4th ventricle of the brain is a remnant of which secondary brain vesicle?
Definition
The metencephalon
Term
What is the function of the precentral gyrus?
Definition
Primary motor cortex
Term
The primary sensory cortex can be found where?
Definition
The postcentral gyrus
Term
The area of the brain responsible for audition is...
Definition
the superior gyrus of the temporal lobe
Term
The vision center of the cortex is on the ________ lobe, on banks of the __________ fissure.
Definition
occipital, calcarine
Term
The primary motor cortex is Brodmann's area ____.
Definition
4
Term
Describe the path of upper motor neuron axons. Where do they cross, and what proportion of them cross?
Definition
Leave the cortex, descend in the internal capsule, through the cerebral peduncle, into the pons/medulla. 90% cross in the medullary pyramids.
Term
How in the anterior (medial) corticospinal tract different from the lateral corticospinal tract?
Definition
The axons do not cross, and they innervate the trunk muscles (vs. extremities)
Term
The primary sensory cortex is Brodmann's area(s)...
Definition
3,1,2
Term
The dorsal columns (sensory pathway) carry what types of information?
Definition
Discriminatory touch, propioception, vibratory sense
Term
The anterolateral columns carry what type of information?
Definition
pain, crude touch, temp
Term
Where do axons in the dorsal columns cross?
Definition
Brainstem
Term
Where do axons in the anterolateral columns cross?
Definition
In the spinal cord
Term
Where do anterolateral and dorsal column systems RELAY through (on the way to the cortex)?
Definition
thalamus
Term
Injury of the corticospinal system above the pyramidal decussation causes...
Definition
Contralateral paralysis
Term
Injury of the corticospinal system anywhere below the decussation causes...
Definition
ipsilateral paralysis below the lesion
Term
Injury to the spinal cord will cause loss of pain and temperature sense below the lesion on the ________ side.
Definition
Contralateral
Term
Injury to the spinal cord will cause ipsilateral loss of what sensations below the lesion?
Definition
Discriminative touch, propioception, vibration
Term
What two arterial systems contribute to blood supply of the brain?
Definition
Internal carotid and vertebral
Term
Internal carotid artery comes off __________,
enters cranial cavity via the ____________, supplies primarily the ______, _______ and _______.
Definition
common carotid, carotid canal, orbit, eye and brain.
Term
_________ artery is the 1st branch of subclavian artery, travels through the ________ foramina of ______, enters the _______ ________, joins artery of opposite side to form __________ artery.W
Definition
Vertebral, transverse, C6-C1, foramen magnum, basilar
Term
What are the important branches from the internal carotid artery?
Definition
Ophthalmic, posterior communicating, middle cerebral, anterior cerebral
Term
What are the 3 branches of the VERTEBRAL artery (not basilar)?
Definition
Anterior spinal, posterior spinal, posterior inferior cerebellar
Term
The basilar artery surface is formed on the ______ surface of the ________.
Definition
inferior, pons
Term
What are the paired branches of the basilar artery, from caudal to rostral?
Definition
Anterior inferior cerebellar arteries
Pontine arteries (about 3)
Superior cerebellar arteries
Term
What is the termination of the basilar artery?
Definition
It bifurcates into two posterior cerebral arteries.
Term
The internal carotid artery passes through what important venous structure?
Definition
The cavernous sinus
Term
The Circle of Willis is an anastamosis between which arterial systems?
Definition
Vertebrobasilar and internal carotid
Term
Posterior communicating arteries connect...
Definition
Posterior cerebral to the internal carotid
Term
There is a watershed region between what two cerebral arteries?
Definition
Anterior and middle
Term
Occlusion of which cerebral artery could lead to vision disturbances? Can you name the specific branch?
Definition
Posterior cerebral artery, calcarine artery
Term
Abducens nerve could be affected by an aneurysm of which artery (think of the inferior surface of the brain)?
Definition
Anterior inferior cerebellar artery
Term
What are the layers of the cranial dura? What are they continuous with (at the foramen mangnum)?
Definition
Periosteal layer - periosteum of outer skull, meningeal layer - spinal dura
Term
Where is the superior sagittal sinus in relation to the layers of cranial dura?
Definition
Between the two layers of dura
Term
Dural venous sinuses are lined with...
Definition
endothelium
Term
What is the anterior attachment of the falx cerebri?
Definition
crista galli of the ethmoid, frontal crest of the frontal bone
Term
What is the posterior attachment of the falx cerebri?
Definition
It attaches and blends with tentorium cerebelli
Term
Falx cerebri contains what two venous structures?
Definition
Superior and inferior sagittal sinuses, straight sinus
Term
Tentorium of cerebelli is a horizontal shelf of...
Definition
meningeal dura
Term
What is the posterior attachment of the tentorium?
Definition
Occipital bone
Term
What is the lateral attachment of the tentorium?
Definition
The superior border of the petrous part of the temporal bone
Term
What is the anterior and medial attachment of the tentorium?
Definition
Those borders are free, forming the tentorial notch
Term
What passes through the tentorial notch?
Definition
The midbrain, basilar artery
Term
What structures pass through the tentorial notch during a transtentorial herniation?
Definition
The medial temporal lobe and uncus
Term
What are the classic signs of an uncal herniation?
Definition
Blown pupil, hemiplegia, coma
Term
A subfalcine herniation occurs where? In which direction is the force directed?
Definition
Inferior to the falx cerebri, horizontally (toward the midline)
Term
With a central herniation, where is the force directed?
Definition
Inferiorly
Term
What is the posterior attachment of the falx cerebelli?
Definition
The internal occipital crest of the occipital bone
Term
What is the superior attachment of the falx cerebelli?
Definition
The tentorium cerebelli
Term
What "separates" the two hemispheres of the cerebellum?
Definition
The falx cerebelli
Term
What is the small horizontal shelf of meningeal dura that covers the hypophyseal fossa? What passes through it?
Definition
Diaphagma sellae, the infundibulum
Term
What supplies blood to the dura in the anterior cranial fossa?
Definition
Anterior meningeal arteries (branches of ethmoidal artery)
Term
What arteries supply the dura in the middle cranial fossa? What are they branches of? Where do they enter the skull?
Definition
Middle (foramen spinosum) and accessory meningeal (foramen rotundum) arteries - branches of maxillary.
Term
What supplies blood to the dura in the posterior cranial fossa? What is it a branch of?
Definition
Posterior meningeal artery, from ascending pharygneal
Term
An epidural bleed is usually caused by damage to which artery?
Definition
Middle meningeal, particularly the anterior branch (from trauma to the pterion)
Term
In an epidural bleed, where exactly does blood collect? Between which layers?
Definition
Between the calvaria bone and the periosteal layer of dura, slowly separating it from the bone
Term
An epidural hemorrhage causes blood to accumulate in what shape (on a CT)?
Definition
Lens-shaped
Term
What innervates the brain for pain and touch sensation?
Definition
Nothing, it is insensate
Term
One cause of headache is from stretching of...
Definition
the dura mater
Term
Except for the posterior fossa, dura is mostly innervated by what nerve?
Definition
Trigeminal
Term
What innervates the dura in the posterior fossa below the tentorium?
Definition
Cervical nerves 2 and 3
Term
Where do fibers from C2 and C3 enter the skull to innervate the posterior portion of the dura?
Definition
Foramen magnum, hypoglassal canal and jugular foramen
Term
What are the properties of the arachnoid mater? Thick or thin? Vascular or avascular? What is its relationship to the dura?
Definition
Thin, avascular, against but not adherent to the dura
Term
What is the potential space associated with the dura and the arachnoid?
Definition
The subdural space
Term
The subarachnoid space is between which layers?
Definition
Arachnoid and pia mater
Term
What attaches the arachnoid to the pia mater?
Definition
Fine trabeculae
Term
Blood vessels travel in which meningeal space?
Definition
The subarachnoid space
Term
What type of brain bleed typically occurs in older individuals, and can have a seemingly trivial history?
Definition
Subdural bleed
Term
During a subdural bleed, where does blood collect? Where is the blood from?
Definition
Blood from torn veins fills the potential space between the dura and arachnoid mater
Term
Which type of bleed produces a crescent-shaped hemorrhage?
Definition
A subdural bleed
Term
SIGNIFICANT head trauma or bursting of a cerebral aneurysm can cause what type of bleed?
Definition
Subarachnoid bleed
Term
During a subarachnoid bleed, where does blood flow?
Definition
Down between the gyri of the brain, down into the sulci
Term
The abducens nerve could be affected by an aneurysm of which artery on the base of the brain?
Definition
Anterior inferior cerebellar artery
Term
A subarachnoid hemorrhage produces what shape on a CT?
Definition
It fills the subarachnoid space around the entire brain
Term
During an uncal herniation, what is moving where?
Definition
The median temporal lobe and uncus through the tentorial notch
Term
During a tonsillar herniation, what is moving where?
Definition
herniation of the cerebellar tonsil through the foramen magnum
Term
Dural venous sinuses empty into which vein, via which foramen?
Definition
The internal jugular, via the jugular foramen
Term
Name the dural sinuses.
Definition
Superior sagittal, inferior sagittal, straight, confluence of sinuses, superior petrosal, inferior petrosal, transverse, cavernous, basilar, sphenoparietal
Term
The superior petrosal sinus lies within what structure?
Definition
The tentorium cerebelli
Term
The confluence of sinuses unites which sinuses?
Definition
Superior sagittal, straight and transverse
Term
What sinuses lies beneath the cavernous sinus?
Definition
Sphenoidal sinus
Term
What artery runs through the cavernous sinus?
Definition
The internal carotid artery
Term
What nerve(s) lie WITHIN the cavernous sinus?
Definition
The abducens nerve
Term
What nerves lie within the wall of the cavernous sinus?
Definition
III, IV, V1 and V2
Term
What specialization of dura makes the roof of the cavernous sinus?
Definition
Diaphragma sellae
Term
What gland (sitting in a bony structure) almost divides the cavernous sinus into left and right halves?
Definition
The pituitary in the sella turcica.
Term
What does the cavernous sinus have to do with cancer?
Definition
It can be the site of metastasis from breast, lung and prostate cancer
Term
A cavernous aneurysm of the internal carotid could cause what syndrome?
Definition
cavernous sinus syndrome
Term
Cavernous sinus syndrome can cause what symptoms?
Definition
diplopia, painful ophthalmoplegia
Term
With cavernous sinus syndrome, there can be sensory loss of what nerve?
Definition
trigeminal
Term
What are the CSF-filled spaces in the brain called?
Definition
ventricles
Term
How many lateral ventricles are there? Where?
Definition
One in each hemisphere
Term
Where is the 3rd ventricle?
Definition
between diencephalons
Term
Where is the 4th ventricle?
Definition
in the region of the pons, beneath (deep to) the cerebellum
Term
How much CSF is made per day?
Definition
about 500cc
Term
How does CSF get into the third ventricle?
Definition
via the foramen of Monro
Term
How does CSF get from the 3rd to 4th ventricle?
Definition
Via the cerebral aqueduct, aka the aqueduct of Sylvius
Term
How does CSF leave the 4th ventricle?
Definition
Median foramen of Magendie and lateral foramen of Lushka
Term
Where is CSF reabsorbed?
Definition
In the arachnoid villi in the superior sagittal sinus
Term
Hydrocephalus can be caused by what two major methods?
Definition
Congenital obstruction of the aqueduct of Sylvius, or tumors can block it
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