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Neuroanatomy - 4 Shift Practical Guide

Circle of Willis - when one blood vessel is blocked, another blood vessel can augment the
circulation.

Artery
Anterior Communicating
Anterior Cerebral (ACA)
Middle Cerebral (MCA)
Internal Carotid Artery
Posterior Cerebral (PCA)
Basilar
Pontine Arteries
Vertebral
Notes
Connects left/right Anterior Cerebral arteries
Supplies: Medial brain, 1 inch of superior surface;
Blockage: Paralysis of legs
Supplies: Dorsolateral brain; Blockage: motor, spastic
paralysis in upper extremities; Left Blockage: aphasia
2 Terminal Branches: Middle Cerebral (larger), Anterior
Cerebral (smaller)
Supplies: Area posterior to parieto-occipital sulcus; infero-
lateral surface of temporal lobe
Blockage: loss of vision
Union of 2 Vertebral Arteries @ Ponto-medullary junction
Terminal Branch: Posterior Cerebral Artery
Small
Branch of Subclavian

Artery Notes
Superior Cerebellar (SCA) Supplies: Superior lobe of Cerebellum
Anterior Inferior Cerebellar (AICA) Supplies: Anterior Inferior Cerebellum
Posterior Inferior Cerebellar (PICA) Largest branch of vertebral
 Dural Reflections/Sinuses

Dural Reflection Notes Dural Sinus Notes

Midline, vertical, sickle-shaped reflection; occupies longitudinal fissure corpus callosum; Receives tributaries from the nasal veins, terminates at confluence; region where CSF is drained
Superior Sagittal
divides supratentorial compartment into right/left cerebral hemispheres to join general circulation
Falx Cerebri
Superior Margin: Superior Sagittal Sinus Inferior Sagittal Opens into the straight sinus
Inferior Margin: Inferior Sagittal Sinus Junction of tentorium and falx; Formed by the union of the Inferior Sagittal sinus + Great vein of
Straight
Horizontal; between the cerebellum and occipital lobe; divides cranial cavity into Galen
Tentorium Cerebelli
supratentorial/infratentorial; Open end free due to attachment of brainstem; Posterior portion of tentorium cerebelli; receives blood from the confluence; continues as
Transverse
Falx Cerebelli Small dural reflection, between the postero-superior portions of the cerebellar hemispheres sigmoid sinus.
Covers sella turcica of the sphenoid bone; separates pituitary gland from the hypothalamus and Sigmoid Terminate at the jugular foramen; continues as the internal jugular veins
Diaphragma Sellae
optic chiasm; cavernous sinus is the space found here. Occipital Roof of the falx cerebella; empties into the confluence of the sinuses.
Antero-lateral portion of tentorium cerebelli; Terminates at internal juglar vein; in petrous
Superior Petrosal
portion of temporal bone
Dural Sinuses - Separations of the 2 layers of the dura mater. Venous sinuses receive blood from the veins draining the brain and Inferior Petrosal Drains into internal jugular vein; in petrous portion of temporal bone
flows from venous sinuses internal jugular vein Confluence of Sinuses Meeting point of superior sagittal sinus, transverse sinus, occipital sinus, straight sinus
 Ventricular System

Ventricle Roof Floor Wall Notes

Terminates at Foramen of Monroe;
Lateral drains into 3rd ventricle
CSF produced by choroid plexus
Tela Choroidea Midbrain Tegmentum Front – Lamina Terminalis Tela Choroidea = Pia mater + ependyma
3rd Ventricle
Lateral – Hypothalamus/thalamus Choroid Plexus = Tela Choridea + BV
Iter / Sylvian Aqueduct Located in midbrain
Sup/Inf medullar velum Rhomboid Fossa Cerebellar Peduncles Forms posterior surface of pons and
4th Ventricle
medulla
Foramen of Magendie (Medial)
Foramen Luschka (Lateral)
Corpora Quadrigemina
Path of CSF: Lateral Ventricle through Forman of Monroe 3rd Ventricle Iter / Sylvian Aqueduct 4th Ventricle through Foramen of Magendie & Luschka
Subarachnoid Space (Cisterna Magna) Arachnoid Villi (Superior Sagittal Sinus) Confluence Transverse Sigmoid Internal Jugular Vein
Communicating Hydrocephalus – free communication between the ventricles and subarachnoid space. Obstruction to flow of CSF.
Non-communicating Hydrocephalus – CSF in ventricular system cannot reach subarachnoid space; obstruction in flow of CSF in the foramen of Monroe, Iter, Foramen of
Magendie and Foramen of Luschka