Anatomy JV Exam 3: Blood Supply to Brain, Dual Sinuses, CSF Flow
What is 1?
mesencephalon (midbrain)
What is 2?
metencephalon
What is 3?
medulla
What is 4?
inferior olive
What is 5?
pons
What is 6?
inferior colliculus
What is 7?
superior colliculus
What is 1?
mesencephalon
What is 2?
pons
What is 3?
metencephalon
What is 4?
medulla
What is 5?
pyramidal decussation
What is 6?
pyramids
What is 7?
inferior olives
What is 9?
cerebral peduncles
The brain is derived from the ______ ______ located ______ (cranial) to the ______ pair of somites.
neural tube, rostral, fourth
The three primary brain vesicles are the ______, the ______, and the ______.
prosencephalon, mesencephalon, rhombencephalon
The prosencephalon, or ______, gives rise to the ______ and the ______.
forebrain, telencephalon, diencephalon
The mesencephalon, or ______, remains as the ______ in the secondary vesicle stage.
midbrain, mesencephalon
The rhombencephalon, or ______, gives rise to the ______ and the ______.
hindbrain, metencephalon, myelencephalon
The telencephalon gives rise to the ______ ______ and the ______ ______.
cerebral cortex, basal ganglia
The ______ ______ are the remnant of the telencephalon ______.
lateral ventricles, vesicle
The diencephalon gives rise to the ______, the ______, and the ______ gland.
thalamus, hypothalamus, pineal
The ______ ______ is the remnant of the diencephalon ______.
third ventricle, vesicle
The metencephalon gives rise to the ______ and the ______.
pons, cerebellum
The ______ ______ is the remnant of the metencephalon ______.
fourth ventricle, vesicle
what does the myelencephalon give rise to?
______ ______
medulla oblongata
The aqueduct of ______, also known as the ______ ______, is a remnant of the ______ vesicle.
Sylvius, cerebral aqueduct, mesencephalon
What is 1?
frontal lobe
What is 2?
temporal lobe
What is 3?
anterior fossa
What is 4?
lesser wing of sphenoid bone
What is 5?
middle fossa
What is 6?
petrous ridge of temporal bone
What is 7?
foramen magnum
What is 8?
posterior fossa
What is 9?
cerebellum and brainstem
The ______ ______ contains the ______ ______ cortex responsible for voluntary movement.
precentral gyrus, primary motor
The ______ ______ contains the ______ cortex responsible for processing somatic sensations.
postcentral gyrus, sensory
The ______ gyrus of the ______ lobe is involved in ______ and aspects of memory.
superior, temporal, audition
The ______ lobe, specifically on the banks of the ______ ______, processes ______ information.
occipital, calcarine fissure, visual
What is 1?
primary motor cortex
What is 2?
central sulcus
What is 3?
primary somatosenosry cortex
What is 4?
parietal lobe
What is 5?
occipital lobe
What is 6?
primary visual cortex
What is 7?
primary auditory cortex
What is 8?
temporal lobe
What is 9?
sylvian fissure
What is 10?
frontal lobe
The primary motor cortex is located in the ______ ______ and corresponds to Brodmann's area ______.
precentral gyrus, 4
The precentral gyrus, where the primary motor cortex resides, is organized ______, meaning specific regions control specific ______ parts.
somatotopically, body
Axons from ______ ______ neurons leave the ______ and descend through the ______ ______.
upper motor, cortex, internal capsule
After descending through the internal capsule, upper motor neuron axons travel through the ______ ______, enter the ______, and reach the ______ where they form the pyramids.
cerebral peduncle, pons, medulla
In the medulla, about ______ percent of fibers cross in the ______ ______ before descending.
ninety, pyramidal decussation
After decussation, fibers descend in the ______ ______ tract and synapse on ______ ______ neurons in the ______ horn.
lateral corticospinal, alpha motor, ventral
from medial to lateral, describe the motor cortex humunculus:
______ , ______ , ______
______ ,______
______ , ______ , ______ , ______ , ______ , ______
______
______ , ______ , ______ , ______ , ______ , ______ , ______ , ______
toes, knee, hip
trunk,shoulder
arm, elbow, wrist, hand, fingers, thumb
neck
brow, eye, face, lips, jaw, tongue, pharynx, larynx
The primary sensory cortex is located in the ______ ______ and corresponds to Brodmann's areas ______, ______, and ______.
postcentral gyrus, 3, 1, 2
Like the primary motor cortex, the postcentral gyrus is organized ______, with distinct regions processing input from specific ______ parts.
somatotopically, body
The dorsal column pathway carries ______ ______, ______, and ______ sensations, and it crosses in the ______.
discriminative touch, proprioception, vibration, brainstem
The anterolateral system, also known as the ______ tract, carries ______ ______, ______, and ______ sensations, and it crosses in the ______ ______.
spinothalamic, crude touch, pain, temperature, spinal cord
Both major sensory pathways relay through the ______ before reaching the ______ cortex.
thalamus, sensory
from medial to lateral, describe the sensory cortex humunculus:
______ , ______ , ______ , ______ , ______ , ______
______ , ______ , ______ , ______ , ______ , ______
______ , ______ , ______ , ______ , ______ , ______
______ , ______ , ______
______
genitals, leg, hip, trunk, neck, head
arm, elbow, forearm, hand, fingers, thumb
eye, nose, face, lips, teeth, gums
jaw, tongue, pharynx
abdomen
An injury to the corticospinal system (pyramidal tract) ______ the pyramidal decussation results in ______ paralysis.
above, contralateral
An injury to the corticospinal system ______ the pyramidal decussation results in ______ paralysis ______ the lesion.
below, ipsilateral, below
A spinal cord lesion causes loss of ______ crude touch, ______, and ______ below the lesion due to damage to the ______ system.
contralateral, pain, temperature, anterolateral
A spinal cord lesion also results in loss of ______ discriminative touch, ______, and ______ below the lesion due to damage to the ______ columns.
ipsilateral, proprioception, vibration, dorsal
The internal carotid artery is a branch of the ______ ______ artery, enters the cranial cavity through the ______ ______, passes through the ______ ______, and primarily supplies the ______, ______, and ______.
common carotid, carotid canal, cavernous sinus, orbit, eye, brain
The vertebral artery is the first branch of the ______ artery, travels through the transverse foramina of ______ to ______, enters the ______ ______, and joins the opposite vertebral artery to form the ______ artery.
subclavian, C6, C1, foramen magnum, basilar
what is the main blood supply of the brain?
______ ______ a.
______ a.
internal carotid a.
vertebral a.
What is 1?
intracranial parts
What is 2?
basilar artery
What is 3?
posterior cerebral arteries
What is 4?
anterior communicating artery
What is 5?
anterior cerebral arteries
What is 6?
middle cerebral artery
What is 7?
origin of opthalmic artery
What is 8?
carotid canal
What is 9?
internal carotid artery
What is 10?
vertebral artery
What is 11?
common carotid artery
What is 12?
cervical part
What is 13?
atlantic part
What is 14?
foramen magnum
What is 1?
anterior communicating
What is 2?
posterior communicating
What is 3?
basilar
What is 4?
left internal carotid
What is 5?
left vertebral
What is 6?
left subclavian
What is 7?
left common carotid
What is 8?
aortic arch
What is 9?
brachiocephalic
What is 10?
right subclavian
What is 11?
right vertebral
What is 12?
right common carotid
What is 13?
right internal carotid
What is 14?
posterior cerebral
What is 15?
opthalmic
What is 16?
middle cerebral
What is 17?
anterior cerebral
what is the first branch of the internal carotid a.?
____ ____
ophthalmic a.
what branches arise from the vertebral artery?
-____ ____ a.
-____ ____ a.
-____ ____ ____ a.
-anterior spinal a.
-posterior spinal a.
-posterior inferior cerebellar a. "PICA"
The basilar artery is formed by the fusion of two ______ arteries and travels rostrally on the anterior aspect of the ______.
vertebral, pons
Branches of the basilar artery, from caudal to rostral, include the ______ ______ cerebellar arteries, about ______ pontine arteries, and the ______ cerebellar arteries.
anterior inferior, three, superior
The basilar artery bifurcates into two ______ ______ arteries.
posterior cerebral
The internal carotid artery enters the cranial cavity via the ______ ______ and passes through the ______ ______.
carotid canal, cavernous sinus
The terminal branches of the internal carotid artery are the ______ ______ artery, the ______ ______ artery, and the ______ ______ artery.
posterior communicating, middle cerebral, anterior cerebral
arteriogram
1= A = anterior cerebral a
2= M = middle cerebral a.
3= I = internal carotid a.
The circle of Willis is an anastomosis between the ______ and ______ ______ systems formed at the base of the ______.
vertebrobasilar, internal carotid, brain
The circle of Willis is formed by the ______ ______ artery connecting the left and right ______ ______ arteries.
anterior communicating, anterior cerebral
The ______ ______ arteries, one on each side, connect the internal carotid artery to the ______ ______ artery.
posterior communicating, posterior cerebral
What is 1?
anterior cerebral
What is 2?
opthalmic
What is 3?
middle cerebral
What is 4?
internal carotid
What is 5?
posterior communicating
What is 6?
posterior cerebral
What is 7?
superior cerebellar
What is 8?
basilar
What is 9?
anterior inferior cerebellar
What is 10?
posterior inferior cerebellar
What is 11?
vertebral
What is 12?
anterior spinal
What is 13?
labyrinthine artery
What is 14?
anteiror communicating
What is 1?
frontal lobe
What is 2?
anterior cerebral artery
What is 3?
anterior communicating artery
What is 4?
anterior cerebral artery
What is 5?
middle cerebral artery
What is 6?
posterior communicating artery
What is 7?
oculomotor nerve (CN 3)
What is 8?
trochlear nerve (CN IV)
What is 9?
trigeminal nerve (CN 5)
What is 10?
basilar artery
What is 11?
labyrinthine artery
What is 12?
anterior inferior
posterior inferior
(these are the cerebellar arteries)
What is 13?
vertebral artery
What is 14?
anterior spinal artery
What is 15?
hypoglossal nerve (CN 12)
What is 16?
spinal accessory nerve (CN 11)
What is 17?
vagus nerve (CN 10)
What is 18?
glossopharyngeal nerve (cn 9)
What is 19?
vestibulocochlear nerve (CN 8)
What is 20?
facial nerve (CN 7)
What is 21?
abducent nerve (CN 6)
What is 22?
superior cerebellar artery
What is 23?
posterior cerebral artery
What is 24?
temporal lobe
What is 25
internal carotid artery
What is 26?
optic nerve (CN 2)
What is 27?
corpus callosum
What is 28?
olfactory bulb and tract
What is 1?
middle cerebral artery
What is 2?
internal carotid arteries
What is 3?
basilar artery
What is 4?
vertebral arteries
What is 1?
anterior cerebral arteries
What is 2?
internal carotid artery
What is 3?
posterior cerebral artery
What is 4?
superior cerebellar artery
What is 5?
basilar and pontine arteries
What is 6?
vertebral artery
What is 7?
posteior inferior cerebrellar artery
What is 8?
anteior spinal artery
What is 9?
posterior spinal artery
What is 10?
anterior inferior cerebellar artery
What is 11?
posterior communicating artery
What is 12?
anterior communicating artery
What is 13?
middle cerebral artery and branches
an aneurysm to which artery might cause compression/damage to abducens n. (CN VI)?
______ ______ ______ artery
anterior inferior cerebellar artery
aneurysm to which artery might cause compression/damage to oculomotor n (CN III)?
______ ______ or ______ ______ arteries
posterior cerebral or superior cerebellar arteries
What is 1?
subarachnoid space
What is 2?
dura mater
arachnoid mater
pia mater
What is 3?
skull
What is 4?
intracranial venous structure (superior sagittal sinus)
What is 5?
inner meningeal layer of dura mater
What is 6?
outer periosteal layer of dura mater
What is 7?
dura partition (falx cerebri)
The falx cerebri is a crescent-shaped ______ specialization that projects downward between the ______ ______.
dural, cerebral hemispheres
Anteriorly, the falx cerebri attaches to the ______ ______ of the ethmoid bone and the ______ ______ of the frontal bone.
crista galli, frontal crest
Posteriorly, the falx cerebri attaches to and blends with the ______ ______.
tentorium cerebelli
what sinuses traverse the falx cerebri?
______ & ______ ______ sinuses
superior & inferior sagittal sinuses
What is 1?
tentorium cerebelli
What is 2?
falx cerebri
What is 3?
infundibulum
What is 4?
diaphragma sellae
What is 5?
tentorium cerebelli
What is 6?
falx cerebelli
What is 7?
tentorial notch
what structure separates the cerebellum from the overlying posterior lobes of the cerebral hemispheres?
______ cerebelli - ______ shelf of ______ dura
tentorium cerebelli - horizontal shelf of meningeal dura
The tentorium cerebelli is a horizontal shelf of ______ ______ that separates the ______ from the overlying posterior lobes of the ______ ______.
meningeal dura, cerebellum, cerebral hemispheres
The tentorium cerebelli attaches posteriorly to the ______ bone, laterally to the superior border of the ______ part of the ______ bone, and anteriorly and medially forms the ______ ______ where the ______ passes through.
occipital, petrous, temporal, tentorial notch, midbrain
what structures pass through the tentorial notch?
______
______ ______
midbrain
basilar artery
Transtentorial herniation is the herniation of the ______ ______ lobe and ______ through the ______ ______.
medial temporal, uncus, tentorial notch
A common type of transtentorial herniation is ______ herniation.
uncal
Uncal herniation is a common type of ______ herniation involving the ______ ______ lobe and ______ passing through the ______ ______.
transtentorial, medial temporal, uncus, tentorial notch
The clinical triad of uncal herniation includes a ______ pupil due to compression of the ______ complex, ______ from compression of the cerebral ______, and ______ due to distortion of the midbrain ______ system.
blown, oculomotor nuclear, hemiplegia, peduncles, coma, reticular
What is 1?
tentorial notch
What is 2?
tentorium cerebelli
The diaphragma sellae is a small, horizontal shelf of ______ ______ that covers the ______ ______ of the ______ ______.
meningeal dura, hypophyseal fossa, sella turcica
The ______ passes through a small opening in the diaphragma sellae within the ______ ______.
infundibulum, sella turcica
What is 1?
cut anterior falx cerebri
What is 2?
infundibular stalk projecting through the sella turcica
What is 3?
tentorium cerebelli has been cut to allow the removal of the cerebellum
An epidural hemorrhage, also called an ______ hemorrhage, is a ______-shaped accumulation of blood between the ______ of the calvarium and the ______ layer of the dura.
extradural, lens, bone, periosteal
Epidural hemorrhage is usually caused by tearing of the ______ ______ artery, particularly its ______ branch, due to trauma to the ______.
middle meningeal, anterior, pterion
In an epidural hemorrhage, blood slowly separates the ______ ______ from the underlying ______.
periosteal dura, bone
what has happened to this patient?
epidural/extradural hemorrhage
The dura is mostly innervated by the ______ nerve (CN ______), except for the ______ ______.
trigeminal, V, posterior fossa
The posterior fossa of the dura, below the ______, is innervated by cervical nerves ______ and ______, which enter through the ______ ______, ______ canal, and ______ foramen.
tentorium, C2, C3, foramen magnum, hypoglossal, jugular
The brain itself has no ______ or ______ receptors and is therefore ______.
touch, pain, insensate
What is 1?
anterior ethmoidal nerve
What is 2?
posterior ethmoidal nerve
What is 3?
C2,C3 fibers
What is 4?
C2,C3 fibers distributed by CN XII
What is 5?
C2 fibers distributed by CN X
What is 6?
tentorial nerve (recurrent meningeal branch of opthalmic nerve-CN v3)
What is 7?
meningeal branches of mandibular nerve (CN V3) (including nervus spinosus)
What is 8?
meningeal branch of maxillary nerve (CN V2)
What is 9?
anterior meningeal branches of ethmoidal nerve (CN V1)
what attaches the arachnoid to pia?
___ ___ - "look like spider webs"
fine trabeculae - "look like spider webs"
within what layer of mater do BVs travel?
_____ space - between _____ & _____ _____
subarachnoid space - between arachnoid & pia mater
A subdural bleed is a crescent-shaped hemorrhage caused by torn ______ veins, filling the potential ______ space between the ______ and ______ mater.
emissary, subdural, dura, arachnoid
Subdural hemorrhage typically occurs in ______ individuals due to brain ______, which increases the space between the brain and ______, straining veins that connect to the ______ ______ sinuses.
older, atrophy, arachnoid, dural venous
The history of a subdural bleed may involve a ______ injury, with or without ______ of ______.
trivial, loss, consciousness
what happened to this patient?
subdural bleed/hemorrhage
subdural vs epidural bleed (shape of pooled blood)
subdural - ______ shaped
epidural/extradural - ______ shaped
cresent
lens
A subarachnoid bleed is a hemorrhage of ______ blood in the ______ space that flows between ______ of the brain into the ______ and accumulates ______.
arterial, subarachnoid, gyri, sulci, rapidly
Subarachnoid hemorrhage is frequently caused by the bursting of a ______ ______ and may also result from ______ head trauma.
cerebral aneurysm, significant
what has happened to this patient? what most likely caused this injury?
subarachnoid bleed/hemorrhage
significant head trauma
The four typical sites of brain herniation are: ______ (under the falx cerebri), ______ (downward herniation of the brainstem), ______ (medial temporal lobe and uncus through the tentorial notch), and ______ (cerebellar tonsil through the foramen magnum).
subfalcine, central, uncal, tonsillar
Cushing’s triad is a classic sign of elevated ______ ______ and includes ______, ______, and ______.
intracranial pressure, hypertension, bradycardia, irregular respiration
In Cushing’s triad, hypertension is a reflex to maintain ______ ______, bradycardia is a reflex response to ______, and irregular respiration indicates impaired ______ function.
cerebral perfusion, hypertension, brainstem
Dural venous sinuses are ______-lined spaces located between layers of the ______ that drain blood into the ______ ______ veins via the ______ foramen.
endothelial, dura, internal jugular, jugular
What is 1?
beginning of superior sagittal sinus
What is 2?
supra-orbital vein
What is 3?
superior opthalmic vein
What is 4?
cavernous sinus
What is 5?
inferior opthalmic vein
What is 6?
pterygoid venous plexus
What is 7?
maxillary vein
What is 8?
deep facial veins
What is 9?
facial vein
What is 10?
sigmoid sinus
What is 11?
occipital sinus
What is 12?
superior and inferior petrosal sinuses
What is 13?
transverse sinus
What is 14?
straight sinus
What is 15?
tentorium cerebelli (inferior surface)
What is 16?
great cerebral vein
What is 17?
inferior sagittal sinus
What is 18?
falx cerebri (cerebral falx)
What is 19?
superior sagittal sinus
The straight sinus is formed by the junction of the ______ ______ vein (of Galen) and the ______ ______ sinus.
great cerebral, inferior sagittal
The straight sinus drains into the ______ of sinuses.
confluence
what drains the confluence of sinuses?
______ ______
transverse sinuses
The sigmoid sinus receives blood from the ______ sinus and the ______ and ______ petrosal sinuses.
transverse, superior, inferior
The sigmoid sinus empties its blood into the ______ ______ vein.
internal jugular
The structures that pass through the cavernous sinus are the ______ ______ artery and the ______ nerve (CN ______).
internal carotid, abducens, VI
The structures that pass along the wall of the cavernous sinus are the ______ nerve (CN ______), the ______ nerve (CN ______), the ______ division (CN ______₁), and the ______ division (CN ______₂) of the trigeminal nerve.
oculomotor, III, trochlear, IV, ophthalmic, V1, maxillary, V2
what structure lies lateral to the body of the sphenoid bone on either side of the sella turcica?
______ ______
cavernous sinus
Cavernous sinus syndrome can occur due to metastases from ______, ______, and ______ cancers or from a ______ artery aneurysm in the cavernous sinus.
breast, prostate, lung, carotid
Symptoms of cavernous sinus syndrome include ______ (double vision), painful ______, and possible ______ sensory loss.
diplopia, ophthalmoplegia, trigeminal
what cancers can metastasize to the cavernous sinus?
______ , ______ , & ______ ______
breast, prostate, & lung cancer
The four ventricles of the brain are CSF-filled spaces including two ______ ventricles, one ______ ventricle, and one ______ ventricle.
lateral, third, fourth
The two lateral ventricles are located in each ______ ______, the third ventricle is between the ______, and the fourth ventricle is in the region of the ______ beneath the ______.
cerebral hemisphere, diencephalons, pons, cerebellum
What is 1?
frontal lobe cortex
What is 2?
frontal lobe (white matter)
What is 3?
anterior horn of lateral ventricle
What is 4?
head of caudate nucleus
What is 5?
septum pellucidum
What is 6?
column of fornix
What is 7?
thalamus
What is 8?
3rd ventricle
What is 9?
choroid plexus
What is 10?
posterior horn of lateral ventricle
CSF is produced in the ______ ventricles (~500 cc per day) and flows to the ______ ventricle via the foramina of ______.
lateral, third, Monro
CSF flows from the third ventricle to the fourth ventricle through the aqueduct of ______.
Sylvius
CSF leaves the fourth ventricle via the median foramen of ______ and the two lateral foramina of ______.
Magendie, Luschka
CSF is reabsorbed by the ______ ______ in the ______ ______ sinus.
arachnoid villi, superior sagittal
What is 1?
superior sagittal sinus
What is 2?
fourth ventricle
What is 3?
foramen of magendie (medial foramen)
What is 4?
aqueduct of sylvius (cerebral aqueduct)
What is 5?
foramen of monro (interventricular foramen)
What is 6?
third ventricle
What is 7?
laterla ventricle
What is 8?
subarachnoid space
CSF is reabsorbed in the ______ ______ (also called ______) located in the ______ ______ sinus.
arachnoid villi, granulations, superior sagittal
Hydrocephalus is the buildup of ______ in the brain caused by congenital obstruction of the aqueduct of ______ or by ______.
CSF, Sylvius, tumors
In young children, before the skull sutures fuse, hydrocephalus causes ______ swelling and can severely damage ______ tissue.
head, brain
what has happened to this patient?
hydrocephalus
The anterior cranial fossa is supplied by the ______ meningeal arteries, which are branches of the ______ arteries.
anterior, ethmoidal
The middle cranial fossa is supplied by the ______ and ______ meningeal arteries, branches of the ______ artery.
middle, accessory, maxillary
The middle meningeal artery enters the skull through the ______ ______, while the accessory meningeal artery enters through the ______ ______.
foramen spinosum, foramen ovale
The posterior meningeal artery is a branch of the ______ ______ artery.
ascending pharyngeal
The corticobulbar tract is an upper motor neuron tract for the ______ with predominantly ______ projections and some ______ projections.
head, crossed, bilateral
The corticobulbar tract does not synapse in the ______, ______, or ______ nuclei.
oculomotor, trochlear, abducens
The lower part of the ______ nucleus and the ______ nucleus receive crossed corticobulbar tract input.
facial, hypoglossal
The ______ ______, motor nucleus for the pharynx and larynx, receives ______ projections via the corticobulbar tract.
nucleus ambiguus, bilateral
The trigeminothalamic tract is the head equivalent of the ______ tract. Its primary afferent neurons have cell bodies in the ______ ______ and other sensory ganglia.
anterolateral, trigeminal ganglion
In the trigeminothalamic tract, second-order neuron axons ascend and synapse on the ______ ______ nucleus of the ______.
posteromedial, thalamus
Third-order neurons of the trigeminothalamic tract project to the ______ ______.
sensory cortex
The trigeminal lemniscus is the head equivalent of the ______ ______ pathway.
dorsal column
Primary afferent axons for fine touch and vibratory sense synapse in the ______ sensory nucleus of CN V.
chief
Primary afferent axons for proprioception have cell bodies in the ______ nucleus of CN V.
mesencephalic
Second-order neurons of the trigeminal lemniscus synapse in the ______ nucleus of the thalamus. Third-order neurons of the trigeminal lemniscus project to the ______ ______.
VPM
sensory cortex