Mechanisms of neuroprotection

The skull

Viscerocramium = protecting the face

neurocranium = protecting the brain

Bones of the neurocranium

• frontal bone

• pareital bone

• temporal bone

• occipital bone

• sephnoid bone

Viscerocranium bones

• Zygomatic (cheekbone)

• Maxilla (top teeth)

• Mandible (bottom teeth)

Brain sutures 

Lambdoid suture: 

• looks like lambda, in-between pareital and occipital bone.

Occipitomastoid suture: 

• between occipital and temporal bone. 

Squameous suture: 

• beterrn temporal and pareital lobs. 

Pterion - where all bones meet. 

Coronal Suture

Saggital suture. 

Fontanelles to sutures

• Anterior = coronal

• Posterios = lambdoid

• posteriolateral = occipitomastoid

• anterolateral = pterion

intro to the spine

• 24 vertebrae

  • 7 cervical

  • 12 thoracis

  • 5 lumbar

  • 1 saccrum (5 fused vertebrae)

  • 1 coccys

General vertebral anatomy

form your hands into a diamond

• hands = spine

• forearms = lamina

• elbows = transverse process

• bedicle = arm

• body = body!

additional vertebral anatomy

perpendicular to the tranverse proicess, there is the superior and articulate process.

Through the middle of spine = vertebral foramen.

Notches of the spine

• Superior vertebral notch

• Superior articular process

• inferior vertabral notch

• inferior articular facet

Brain & spinal chord meninges

• Dura matter (skull)

• Arachnoid matter (white & whispy)

• pia mater (adhered to brain surface).

Spaces

Epidural space (dural artery)

Subdural space (sinuses)

sub arachnoid space - (CSF +CAC)

Dural sinuses 

• seperation between endosteal and meningial layers. 

• Dural folds / septa = 

  • falx cerebri and falx cerebelli.

  • Tenrorium cerebelli

  • Diaphrama sellae

carotid + vertebral arteries 

• Common cartoited splits into internal and external at the caroited sinused 

  • external = Superficial (face + meninges)

  • Internal = deep (brain)

  • Subclavian - vertebral

    • Travels in transverse foramen of cervical vertebrae.

Cerebral arterial circle

• Prevents consequences of a stroke

  • anastomosis

  • only works before the circle

Name the arteries (in order of the circle of willis)

• Vertebral arteries

• Basilar artery

• Posterior cerebral artery

• Posterior communication

• Internal caroid artery

• middle cerebral artery

• anterior communicating artery

• Anterior cerebral artery

Distribution of blood supply

Middle cerebral artery: Temporal lobe

Anterior cerebral artery: Mohawk bart of the brain

posterior = bottom of brain

Stroke 

ischemic stroke = blockage 

hemmoragic stroke = bleed 

symptoms occur on opposite side

Sinus blood flow - top to bottom

Superior saggital sinus, inferior saggital sinus, straight sinus, cofluence of sinuses, L/R transverse sinus, L/R sigmoid sinus, internal jugular vein.

sinus function

• drain deox. blood from the brain.

• formed by split between endosteal and menengial layer of the brain.

Middle menengial artery

• between skull and dura mater.

• supplies dura and skull

• branch of external carotid

• deep to pterion

Where are the things 

Menengial artery = Epidural 

Venous sinus = Subdural 

Carebral A = Subarachnoid 

Cerebrospinal fluid

Roles:

• Protection (buoyancy of CNS)

• Homeostasis of interstitial fluid of the brain.

• waste removal

• Produced in the choroid plexus.

• SUBARACHNOID SPACE

name parts of the ventricles in order

• lateral ventricle

• interventricular foramen

• third ventricle

• cerebral aqueduct

• 4th ventricle

• central canal.

Circulation of CSF

CSF made by choroid plexus - ventricles (lat, 3rd, 4th), med/lat fenestations + central canal, sub-arachnoid space - goes into subarachnoid space, arachnoid granulations, venous sinus.

Middle cerebral artery

• supplies the lateral surface of the front parietal and temporal lobes

• Internal capsule

• Contra lateral weakness and sensory loss more in face and arm

• Aphasia

Anterior cerebral artery

supplies: médial surface of pariétal lobed (leg area of motor / sensory cortex)

Stroke = weakness In legs and urinary incontinence

Posterior cerebral artery

• occipital lobe (visual)

• Inferior temporal lobe

• Thalamus

• Visual field loss (contalateral)

• Can read but can write and thalamus syndrome

Basilar safety

• Cranial nerve defective (diplopie, facial weakness, dysarthria, dysphasia)

• Contralateral motor and sensory loss.

Vertebral artery

• medulla and inferior cerebellum

• Ipsalateral face sensory loss (pan/temp)

• Contralateral body sensory loss (pain/temp)

The type of circular blood supply to the brain is called

Anastomosis

Motor functions in the basal ganglia vs cerebellum

Cerebellum integrates vision and vestibular info while the basal ganglia was not

What is CSF produced from?

Arterial blood in cerebral circulation