3: Dural Sinuses and Meninges

Question 1

Two layers of dura mater

Answer 1

1. Periosteal layer: attaches to periosteum

2. Meningeal layer

Question 2

Dural venous sinuses

Answer 2

Gaps between periosteal and meningeal layer of dura mater, are filled with blood

Question 3

Arachnoid trabeculae

Answer 3

Web of collagen and elastin in arachnoid mater

Question 4

Space between arachnoid and dura mater

Answer 4

Subdural space

Question 5

Space between arachnoid and pia mater

Answer 5

Subarachnoid space

Question 6

Artery that supplies bulk of meninges

Answer 6

Middle meningeal A

Question 7

Innervation of the meninges (5 parts)

Answer 7

V1, V2, V3, C2, C3

Question 8

Cranial dural septa

Answer 8

Dura mater extensions deep into cranial cavity for support and stability

Question 9

Four dural septa

Answer 9

Falx cerebri, falx cerebelli, tentorium cerebelli, diaphragm sellae

Question 10

Nine dural venous sinuses

Answer 10

1. Inferior petrosal
2. Superior petrosal
3. Confluence of sinuses
4. Straight sinus
5. Transverse sinus
6. Sigmoid sinus
7. Inferior sagittal sinus
8. Superior sagittal sinus
9. Cavernous sinus

Question 11

Structures in the cavernous sinus

Answer 11

1. Pituitary gland
2. Internal carotid A
3. Nerves: CN 3, 4, 5, 6

Question 12

Which nerve is freely located in cavernous sinus while other nerves are embedded in CT?

Answer 12

Abducens (CN 6)

Question 13

Cavernous sinus thrombosis cause

Answer 13

Pt has trauma to face -> thrombus forms, moves through sinuses to the cavernous sinus

Question 14

Clinical signs of cavernous sinus thrombosis

Answer 14

Edema and erythema around eye, high fever, periorbital edema, cranial nerve palsy of abducens N, decreased visual acuity

Question 15

Possible tx options for cavernous sinus thrombus

Answer 15

IV Abx, heparin, surgical consult

Question 16

What forms CSF?

Answer 16

Ependymal cells in choroid plexus in each ventricle

Question 17

How is CSF similar to blood plasma?

Answer 17

Similar but…
Greater: Na, H, Ca
Less: K

Question 18

How does CSF drain into dural venous sinuses?

Answer 18

Through arachnoid granulations (villi)

Question 19

What can cause hydrocephalus

Answer 19

Obstruction in CSF flow that restricts reabsorption into venous bloodstream

Question 20

Two treatment options for hydrocephalus

Answer 20

1. Ventriculoperitoneal shunt -> drain to abdominal cavity

2. Ventriculostomy: hole in floor of 3rd ventricle -> drains to subarachnoid space

Question 21

Three major veins that drain craniofacial structures

Answer 21

IJV, EJV, facial V

Question 22

What two veins join to form the retromandibular V?**

Answer 22

Superficial temporal V + maxillary V

Question 23

What gland does the retromandibular vein run deep with?

Answer 23

Parotid gland

Question 24

What two veins join to form the EJV?

Answer 24

Retromandibular V + posterior auricular V

Question 25

What does the facial V create a confluence with?

Answer 25

Retromandibular V

Question 26

What does the facial V drain into?

Answer 26

IJV

Question 27

Which four superficial veins form anastomoses with intracranial veins?

Answer 27

Supratrochlear V, supraorbital V, angular V, facial V

Question 28

What is the importance of superficial veins anastomosing with intracranial veins?

Answer 28

Potential spread of infection into cranium

Question 29

Two veins that drain the orbit and eyeball

Answer 29

Superior and inferior ophthalmic veins

Question 30

Main vein that drains the anterior neck

Answer 30

Anterior jugular V