8: Anatomy - Space-occupying lesions

Question 1

The cranial vault has a ___ volume.

Answer 1

fixed volume

so as volume decreases e.g swelling, bleeding; pressure increases

Question 2

What is a space occupying lesion?

Answer 2

Some sort of abnormal tissue taking up space in the brain

Question 3

What may increase as a result of a space occupying lesion?

Answer 3

Intracranial pressure

Question 4

What may occur if intracranial pressure gets too high?

Answer 4

Herniation

Question 5

What is the pterion?

Answer 5

H shaped suture where frontal, parietal, temporal and sphenoid borders meet

Thinnest part of the skull

Question 6

What is notable about the pterion?

Answer 6

Thinnest part of the skull

Question 7

Which blood vessel is found posterior to the pterion?

Answer 7

Middle meningeal artery

Question 8

What is the middle meningeal artery immediately deep to?

Answer 8

Pterion

Question 9

What is meningitis?

Answer 9

Bacterial / viral inflammation of the meninges

Question 10

What are the three layers of meninges surrounding the brain and spinal cord, from superficial to deep?

Answer 10

Dura mater

Arachnoid mater

Pia mater

Question 11

In which layer of meninges are the dural venous sinuses found?

Answer 11

Dura mater

Question 12

What spaces are found in the dura mater?

Answer 12

Dural venous sinuses

Question 13

What space contains cerebrospinal fluid (CSF)?

Answer 13

Subarachnoid space

Question 14

Where in the meninges is CSF reabsorbed?

Answer 14

Arachnoid granulations

Question 15

Which layer of meninges is the thinnest and adheres to the brain’s sulci and gyri?

Answer 15

Pia mater

Question 16

Which sheets of dura mater are found on top of the

a) pituitary gland
b) cerebellum?

Answer 16

a) Diaphragm sellae

b) Tentorium cerebelli

Question 17

What structures are covered by the

a) diaphragm sellae
b) tentorium cerebelli?

Answer 17

a) Sella turcica and pituitary gland

b) Cerebellum

Question 18

What passes through the hole in the tentorium cerebelli?

Answer 18

Brainstem

Question 19

What type of meninges are the tentorium cerebelli and diaphragm sellae made of?

Answer 19

Dura mater

Question 20

What sheet of dura runs in the midline of the brain, along the plane of the longitudinal fissure, and separates the right and left cerebral hemispheres?

Answer 20

Falx cerebri

Question 21

Which aspect of the ethmoid bone is the falx cerebri attached to?

Answer 21

Crista galli

Question 22

What are the two dural venous sinuses running from the anterior to posterior of the brain?

Answer 22

Superior and inferior sagittal sinuses

Question 23

Which dural venous sinuses drains blood into the internal jugular vein?

Answer 23

Sigmoid sinuses

Question 24

Which blood vessels drain blood from the brain into the superior and inferior sagittal sinuses?

Answer 24

Cerebral veins

Question 25

At which structure do many of the brain's sinuses meet?

Answer 25

**Confluence of the sinuses**

Question 26

Which bony landmark acts as a) an attachment for the **falx cerebri** b) the site of the **confluence of the sinuses**?

Answer 26

**a) Crista galli of ethmoid bone** **b) Internal occipital protruberance**

Question 27

Why is part of the face known as the **danger triangle?**

Answer 27

**Facial vein anastomoses with ophthalmic vein, which drains into the cavernous sinuses** **So infection from the face can track back into the meninges and cause meningitis**

Question 28

What are the **first branches** coming off the **aorta**?

Answer 28

**Right and left coronary arteries**

Question 29

Which artery does the **vertebral artery** come from?

Answer 29

**Subclavian artery**

Question 30

Which structure, found only in cervical vertebrae, do the **vertebral arteries** pass through?

Answer 30

**Transverse foramen**

Question 31

How do the **vertebral arteries** reach the cranial cavity from the aorta?

Answer 31

**Subclavian artery** **Ascend through transverse foraminae of cervical vertebrae** **Ascend through foramen magnum**

Question 32

Which hole do vertebral arteries use to reach the cranial cavity?

Answer 32

**Foramen magnum**

Question 33

How does the **internal carotid artery** reach the brain?

Answer 33

**Carotid canal**

Question 34

Which carotid arteries supply the ## Footnote **a) neck, face and scalp** **b) brain?**

Answer 34

**a) External carotid artery** **b) Internal carotid artery**

Question 35

Which anastomosis of arteries supplies much of the brain?

Answer 35

**Circle of Willis**

Question 36

The **Circle of Willis** is an anastomosis of arteries from which root arteries?

Answer 36

**Left and right vertebral arteries** **Left and right internal carotid arteries**

Question 37

Which specific arteries supply the a) medial b) lateral c) posterior aspects of the cerebral hemispheres?

Answer 37

**a) Anterior cerebral artery** **b) Middle cerebral artery** **c) Posterior cerebral artery**

Question 38

In which space are the **cerebral arteries** found?

Answer 38

**Subarachnoid space**

Question 39

Where is **CSF produced**?

Answer 39

**Choroid plexuses** of each ventricle

Question 40

Where is CSF reabsorbed?

Answer 40

**Arachnoid granulations**

Question 41

At which vertebral levels can a **lumbar puncture** be carried out?

Answer 41

**L3/4** **L4/5**

Question 42

At which level does the spinal cord end?

Answer 42

**L2**

Question 43

The **Circle of Willis** is found **(superior / inferior)** to the **pituitary gland.**

Answer 43

**inferior**

Question 44

What path does CSF take from the lateral ventricles to the dural venous sinuses?

Answer 44

**1. Produced in choroid plexus** **2. Passes from lateral ventricles to 3rd ventricle** **3. Passes from 3rd ventricle to 4th ventricle** **4.** +/- **S****pinal cord** **5. Reabsorbed into dural venous sinuses by arachnoid granulations**

Question 45

How does CSF get from the **lateral ventricles** to the **3rd ventricle**?

Answer 45

**Foramen of Monro** | (on each side)

Question 46

Through which passages does CSF get from a) lateral to 3rd ventricle b) 3rd to 4th ventricle c) 4th ventricle to spinal cord?

Answer 46

**a) Foramen of Monro** **b) Cerebral aqueduct** **c) Central canal**

Question 47

What clinical condition is caused by an **increased volume of CSF** in the ventricles?

Answer 47

**Hydrocephalus**

Question 48

Where does blood go in an **extradural haemorrhage**?

Answer 48

Between the bone of the skull and the dura

Question 49

Which artery may be damaged by trauma to the **pterion**, causing an **extradural haemorrhage**?

Answer 49

**Middle meningeal artery**

Question 50

Where does blood go in a **subdural haemorrhage**?

Answer 50

**Between the dura and the arachnoid**

Question 51

Where does blood go in a **subarachnoid haemorrhage?**

Answer 51

**Into the subarachnoid space**

Question 52

What is a haemorrhage affecting the **Circle of Willis** called?

Answer 52

**Berry aneurysm**

Question 53

What is a **Berry aneurysm**?

Answer 53

**Haemorrhage into subarachnoid space caused by damage to Circle of Willis**

Question 54

What can happen to brain tissue if **ICP increases**?

Answer 54

Herniation