Anatomy

Question 1

What are Sharpey’s Fibers and what is their function?

Answer 1

Sharpey’s Fibers are collagenous fibers that bind cranial bones in a firm but movable manner.

From Avadhan: Sharpey’s fibers anchor intersutural material to cranial bone.

They are specialized ligaments that connect periosteum to bone.

Sharpey’s fibers are a matrix of connective tissue consisting of bundles of strong collagenous fibers that connect bone to periosteum. Also found in teeth and vertebral segments.

Question 2

What are denticulate or dentate ligaments and what is their function?

Answer 2

The denticulate ligaments, or dentate ligaments, are triangular shaped ligaments that anchor the spinal cord to the dura mater. The bases of the ligaments arise in the pia mater and they are firmly attached to the arachnoid mater and dura mater at the apex.

Question 3

Are all active lesions Energy Cysts?

Answer 3

No.

If the source of the trauma injury is from inside the body, such as an organ dysfunction, emotional issue, etc, the body tends to recognize the pattern as one of its own making, and may not encapsulate it.

Question 4

Where are the Dural membrane attachment sites?

see image in CST folder

Answer 4

The Dural membrane:
Lines and attaches to entire Cranial Vault
Attaches around entire Foramen Magnum
Posterior bodies of C2, C3
Anterior portion of Canal of S2
Blends with Periosteum of Coccyx

Question 5

What other names is the Dural Tube known as?

Answer 5

The Core Link and the Thecal Sac

Question 6

What are the movements of the paired bones of the skull with the CSR (extension and flexion)?

Answer 6

During flexion, the paired bones externally rotate and widen externally.

During extension, the paired bones of the skull internally rotate and narrow medially.

Question 7

What are the movements of the single bones of the skull and the sacrum with the CSR (extension and flexion)?

Answer 7

Extension – Single bones: Superior poles rock anterior.

The Sphenoid moves opposite to the other single structures.

During flexion, the single bones (midline structures) of the skull and the sacrum rotate around a transverse axis. Inferior poles rock anteriorly.

Question 8

How did Dr. Upledger at Michigan State University confirm that adult cranial sutures are not fixed/ossified, and instead are able to move?
(Name 5 structures found)

Answer 8

In the mid-1970’s the College of Osteopathic Medicine at Michigan State University with Dr. Upledger studied:

fresh cranial bone specimens (not preserved) and found with optical and electron microscopy:

blood vessels
nerve fibers
collagen
elastic fibers within cranial structures
AKA Sharpey's fibers

Question 9

How do you find the locations of the carotid arteries at base of jaw?

Answer 9

Carotid arteries are landmarked at the cornua of the hyoid, and inferior to the angle of the jaw.

Question 10

What attaches to the clinoid processes?

Answer 10

The 4 clinoid processes project around the sella turcica of the sphenoid body.

The 2 anterior clinoid processes of the sphenoid bone attach to the superior leaves of the anterior tentorium cerebelli.

The 2 posterior clinoid processes of the sphenoid are attached to the inferior leaves of the anterior tentorium cerebelli.

Question 11

Where is the Jugular Foramen located and what 2 bones form it?

Answer 11

The Jugular Foramen is situated between the basilar portion of the occiput and the mastoid portion of the temporal bone.

These are 2 foramina (left and right) anterior-lateral to the foramen magnum.

Question 12

Where are the

a) the coronal suture
b) the metopic suture

Answer 12

a) The coronal suture is the junction between frontal and both parietal bones
b) The metopic suture is a frontal bone suture that divides the 2 halves of frontal bones in infants. It fuses in first 3-9 months after birth

Question 13

Name the sutures and the bones where the Parietal bones articulate.

Answer 13

• frontal bone anteriorly (at coronal suture)
• occiput posteriorly (lambdoid suture)
• with 2 temporal bones inferiorly (squamosal suture)
• small articulations with tips of great wings of sphenoid (pterion)

Question 14

What type of joint is the TMJ?

How many planes does the joint move in?

Answer 14

Ellipsoid joint

The TMJ has 3 planes of articulation

Question 15

Which direction do maxilla bones go in flexion?

Answer 15

They are paired bones, so they rotate externally/laterally and widen/spread bilaterally

Question 16

Does CSF fill the central canal of the spinal cord?

Answer 16

Yes

Question 17

Where are the lateral ventricles of the cranium situated?

What is their numerical designation?

Answer 17

The lateral ventricles are the first and second ventricles.

These C-shaped structures are located on each side of your cerebral cortex, the wrinkly outer layer of your brain.

They have “horns” which project into the frontal, occipital and temporal lobes. Their volume increases with age.

Question 18

What is the function of the ventricles?

Answer 18

The 4 ventricles are structures that produce CSF (in their lining), store it and transport it around the cranial cavity.

They are lined with ependymal cells which form a structure called the choroid plexus. It is within the choroid plexus that CSF is produced.

Question 19

Name 6 functions of the Cerebral Spinal Fluid (CSF)?

Answer 19

Shock absorption: When you fall, get into a car accident, or otherwise knock your head, the CFS encasing your brain absorbs the shock so that your brain does not smack against your skull.

Nutrition: CSF supplies your central nervous system with essential nutrients, such as glucose, proteins, lipids, and electrolytes.

Intracranial pressure: A steady flow of CSF keeps the pressure around your brain stable. Too much CSF, possibly due to a traumatic brain injury or brain tumor, raises intracranial pressure.

Waste removal: CSF washes through your subarachnoid space, cleaning up toxins and waste products, which are then carried to your lymphatic ducts for filtration.

Temperature: CSF circulation keeps the temperature of your brain and spine stable.

Immune function: CSF contains numerous immune cells that monitor your central nervous system for foreign agents that could damage your vital organs.

Question 20

Generally describe the ventricle system of the cranium?

Answer 20

Your brain’s ventricular system is comprised of four ventricles as well as small structures that connect each ventricle called foramina.

Question 21

Name the foramina that join the lateral ventricles to the third ventricle.

Answer 21

CSF passes from the lateral ventricles, through two holes called the interventricular foramina, or the foramina of Monro, and into the third ventricle.

The foramina of Monro, or the interventricular foramina joins the lateral ventricles to the 3rd ventricle.

Question 22

Where is the third ventricle situated?

Answer 22

The third ventricle is a narrow, funnel-shaped structure situated between your right and left thalamus, just above your brain stem.

Question 23

Where is the fourth ventricle situated?

Answer 23

The fourth ventricle is a diamond-shaped structure that runs alongside your brain stem. It has four openings through which cerebrospinal fluid drains into an area surrounding your brain (subarachnoid space) and the central canal of your spinal cord.

Question 24

Name the channel that joins the 3rd and 4th ventricle

Answer 24

The cerebral aqueduct, or the aqueduct of Sylvius is the foramen that joins the 3rd and 4th ventricle

Question 25

What is the choroid plexus and where is it?

Answer 25

The walls of the lateral ventricles and the roofs of the third and fourth ventricles are lined with a layer of specialized tissue known as the choroid plexus.

It’s within the choroid plexus that CSF is produced.

Question 26

Through what structures does the CSF leave the ventricular system and enter the sub-arachnoid circulation?

Answer 26

CSF exits the fourth ventricle and drains into the subarachnoid space through the:

Median (or medial) and Lateral apertures of the 4th Ventricle. The Median aperture is also known as the foramen of Magendie. The Lateral apertures are called the foramina of Luschka.

The Median aperture drains the CSF into the cisterna magna.
The Lateral apertures (right and left) drain the CSF into the cerebellopontine angle cistern.

CSF also passes from the 4th ventricle through a structure called the obex before draining into the central canal of the spinal cord.

Question 27

Where does CSF come from and through what structures?

Answer 27

CSF is created by filtering the blood flow of the cranial vascular system through specialized structures of the choroid plexuses.
The choroid plexuses are located in the walls of the 1st and 2nd ventricles and the roofs of the 3rd and 4th ventricles.
These filters allow the clear fluid, or CSF, to pass into the ventricular system.

Question 28

How does the CSF re-enter the blood?

Answer 28

The arachnoid villi, located in the dural venous sinuses of the cranium, reabsorbs the CSF into the venous blood.

The arachnoid villi granulations extend from the arachnoid membrane through the outer membrane of the dura mater into the dural venous sinuses. The largest granulations are found along the superior sagittal sinus. The arachnoid granulations act as diffusion valves for drainage of cerebrospinal fluid from the subarachnoid space into the venous system.

Question 29

Name the layers of the meninges?

Answer 29

From superficial to deep, or outer layer to inner layer:

dural membrane/mater, arachnoid membrane, pia mater

Question 30

What bones do the palatines articulate with?

Answer 30

The palatines articulate with the

Vomer, maxillae, opposite palatine, inferior nasal concha, ethmoid.

Question 31

What is the primary direction of fascia in the body?

Answer 31

Longitudinal

Question 32

Name the cranial nerves are part of the parasympathetic nervous system?

Answer 32

FAiries OCcupy GListening VAlleys: Parasympathetic fibers leave the central nervous system through:
CN: III, VII, IX, X,
Facial, Oculomotor, Glossopharyngeal, Vagus

Question 33

What is the main component of the sphenobasilar junction?

Answer 33

Cartilage

Question 34

Are the dural sleeves watertight?

Answer 34

Yes

Question 35

Name the components of the horizontal membrane system

Answer 35

The tentorium cerebelli

Question 36

Name the components of the vertical membrane system

Answer 36

The falx cerebri, falx cerebelli

Question 37

What is the Bregma?

Answer 37

The point where the sagittal suture meets the coronal suture.

Question 38

What is the conus medullaris?

Answer 38

The tapered, lower end of the spinal cord, occurs at the vertebral level of L1-2. Corresponding spinal cord segments are S1-5

Question 39

Name the bones that articulate with the zygoma

Answer 39

Maxilla, temporal, frontal, sphenoid

Question 40

What is the difference between a synchondrosis and a symphysis type joint?

Answer 40

A synchondrosis is made of hyaline cartilage. It is less rigid with more flexible movement. Ex: sphenobasilar, first sternocostal joint, between the first rib and the manubrium.

A symphysis is made of fibrocartilage, many fibrous bundles of cartilage. It is stronger, more rigid and allows for less movement. Ex: pubic symphysis, manubrium to sternum.

Question 41

What are 4 names for the meninges?

Answer 41

1. Meningeal layers
2. intracranial membrane system
3. cranial membranes
4. Spinal membrane system
5. spinal meningeal layers, etc.

Question 42

How does the pia mater and arachnoid trebechulae assist CSF movement from the ventricles?

Answer 42

The intracranial pia mater forms a lining of the ventricles, creating the space for choroid plexuses that produce cerebrospinal fluid.

The pia mater filters CSF from the choroid plexuses into the subarachnoid space.

The arachnoid membrane and the pia mater are connected and stabilized via arachnoid trebechulae. The filamentous trebechulae regulate the movement of fluid and solutes into the subarachnoid space.