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Y3 Neurology Anatomy > Anatomy 5: Anatomy of SOLs > Flashcards

Anatomy 5: Anatomy of SOLs Flashcards

1
Q

What is a space-occupying lesion, and what are the two main types?

A

Abnormal tissue taking up space

Acute or subacute

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2
Q

What are the layers of the scalp?

A 
SCALP
Skin
CT (artery-rich)
Aponeurosis (tendon)
Loose CT (thinnest)
Pericranium (periostum - outer membrane of bone)
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3
Q

Why do scalp lacerations and incisions bleed excessively?

A

Scalp arteries form a rich anastomotic network just deep to skin

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4
Q

What two arteries do scalp arteries branch from?

A

Internal and external carotid

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5
Q

What is the thinnest part of the skull? What type of joint is it? What artery courses just deep to it? Which bones form it?

A

Pterion
Fibrous joint - suture (H shape)
Middle meningeal artery
Frontal, parietal, temporal, sphenoid bones

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6
Q

List the borders of each of the cranial fossa; anterior, middle and posterior?

A

Frontal bone - wings of sphenoid
WIngs of sphenoid - petrous temporal bone
Petrous temporal bone - occipital bone

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7
Q

What is the name for the protective coverings of the brain and spinal cord?

A

Meninges

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8
Q

List the 3 layers of membrane covering the brain and spinal cord, from superficial to deep.

A

Dura matter ‘hard matter’ (ADHERENT TO SKULL)
Arachnoid matter ‘spidery mother’
(Subarachnoid space)
Pia matter ‘faithful matter’ (ADHERENT TO BRAIN)

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9
Q

What CN is the sensory supply to the dura?

A

CNV

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10
Q

Which layer of the meninges encloses the dural venous sinuses? What are the main three types of dura?

A

Dura matter

DIaphragm sellae, tentorium cerebelli, falx cerebri

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11
Q

What is the diaphragm sellae? What does it sit upon?

A

Tough sheet of dura matter forming a roof over pituitary fossa (on sella turcica)

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12
Q

What is the tentorium cerebelli?

A

Tough sheet of dura matter tenting over cerebellum, which attaches to ridges of petrous temporal bone

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13
Q

What is the falx cerebri? What are the attachments to the deep aspect of skull?

A

Midline structure of dura matter that seperates the cerebral hemispheres
Crista galli of ethmoid bone, internal sagittal suture, internal occipital protuberance

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14
Q

Where do the cerebral veins drain into?

A

Dural venous sinuses

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15
Q

List the main dural venous sinuses that drain blood from the brain, and give their location

A 
Straight sinus (inferior sagittal to confluence of sinus)
Superior sagittal sinus (return blood from front brain)
Inferior sagittal sinus (return blood from front brain)
Transverse sinus (confluence of sinus - sigmoid sinus)
Sigmoid 'S' sinus (transverse sinus - IJV)
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16
Q

Where does the sigmoid sinus drain and to what foramen?

A

IJV at jugular foramen

17
Q

Where is the confluence of sinuses?

A

In midline at internal occipital protuberance

18
Q

What is the danger triangle of the face?

A

Venous spread of infection from superficial to deep - ophthalmic vein has no valves and can leak backwards = CAVERNOUS SINUS THROMBOSIS

19
Q

Outline the arterial supply to the brain

A
  1. ICA (branch of CCA)
  2. ECA (branch of CCA)
  3. VA (branch of SCA)
20
Q

What route does the vertebral artery take to reach the cranial cavity?

A

Through transverse foraminae in cervical vertebrae

Through foramen magnum

21
Q

Outline the branches of the Circle of Willis from bottom to top

A

Vertebral arteries (connected by anterior spinal)
Basilar artery (anastomosis of two VAs)
(Pontine arteries)
Posterior cerebral arteries (division of basillar artery)

ICAs (connected to PCAs by posterior communicating arteries)
1. Ophthalmic arteries
2. Branch of ICAs = Anterior cerebral arteries (connected by anterior communicating artery)
MCAs (continuation of ICAs)

22
Q

Which arteries supply the medial, lateral and posterior aspects of the cerebral hemispheres respectively?

A

ACAs
MCAs
PCAs

23
Q

Where can the Circle of Willis be found?

A

Inferior to midbrain, close to the pituitary stalk and optic chiasm in subarachnoid space

24
Q

What circulates within the subarachnoid space?

A

CSF

25
Q

Where does the subarachnoid space terminate?

A

S2 part of the sacrum

26
Q

Outline the route taken by CSF from production to reabsorption

A
  1. Secreted by choroid plexus
  2. From right and left lateral ventricles
    (via Foraminae of Munro - ONE FOR EACH)
  3. Into midline 3rd ventricle
    (Cerebral aqueduct)
  4. Into 4th ventricle
  5. Into subarachnoid space of brain and cord (and some into central canal)
  6. Reabsorbed into dural venous sinuses
27
Q

Where are the lateral ventricles, 3rd ventricle and 4th ventricle located, respectivelly?

A

Cerebral hemispheres
Diencephalon
Between cerebellum and pons

28
Q

What reabsorbs CSF back into the dural venous sinuses?

A

Arachnoid granulations

29
Q

What is hydrocephalus? How is it managed?

A

Excess production, obstruction to flow or inadequate reabsorption leading to increased CSF volume
Ventricular peritoneal shunt (connects ventricles to peritoneal cavity)

30
Q

List the types of bleeding that can occur within the cranial cavity and what causes each of them

A

EXTRADURAL HAEMORRHAGE (between bone and dura) due to ruptured middle meningeal artery (damage to pterior)

SUBDURAL HAEMORRHAGE (seperates dura from arachnoid) due to torn cerebral veins

SUBARACHNOID HAEMORRHAGE (into CSF of subarachnoid space) due to ruptured CIrcle of WIllis ‘Berry aneurysm’

31
Q

What can happen if you sustain damage to the extradural venous plexuses?

A

Epidural haematoma compressing spinal cord or cauda equina

32
Q

Where is the needle inserted in epidural anaesthesia? Why?

A

Subarachnoid space where it surrounds cauda equina (spinal nerves not as easily damaged as conus medullaris and vertebrae not fused)
Typically L3/4

33
Q

What are the four common types of supratentorial herniation?

A

Cingulate (under falx cerebri)
Central (through tentorium cerebelli)
Uncal (uncus = medial temporal lobe, inferior to tentorium cerebelli)
Transcalvarial (fracture of cranial cavity)

34
Q

What nerve can be compressed in uncal supratentorial herniation? What is the effect?

A

Oculomotor nerve

Fixed dilated pupil (ipsilateral)

35
Q

What are the two common types of infratentorial herniation?

A

Upward (over tentorium cerebelli)

Downward/ tonsillar herniation (of cerebral tonsils into foramen magnum)

36
Q

Where is the cerebral aqueduct located anatomically?

A

In the midbrain

37
Q

Which cranial nerve is located in the anterior midline of the midbrain?

A

Oculomotor nerve

38
Q

Which layer of the meninges is avascular?

A

Arachnoid matter

Y3 Neurology Anatomy (12 decks)

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