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Neurology > Anatomy of Space Occupying Lesions > Flashcards

Anatomy of Space Occupying Lesions Flashcards

1
Q

Any SOL can cause a rise in?

A

ICP

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2
Q

SOL can be acute or subacute. Define these.

A

Acute - happens quickly e.g blood leak

Subacute - happens slower e.g growing tumour

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3
Q

What can ICP result in?

A

Herniation

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4
Q

What is the name of the hypothesis?

A

Monroe-Kellie

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5
Q

What does thee hypothesis state?

A

As the skull is a closed box, any SOL or increase involute will increase pressure

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6
Q

Name the 5 layers of skin of the scalp from superficial to deep.

A 
S - skin
C - connective tissue
A - aponeurosis
L - loose connective tissue
P - pericranium
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7
Q

What layer contains the blood supply to the scalp?

A

Connective tissue

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8
Q

What is the pericranium?

A

Periosteum

Outer membrane of bone that is responsible for bone formation

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9
Q

What are the 2 main arteries of the scalp?

A

External carotid artery

Internal carotid artery

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10
Q

What do the main arteries of the skin of the scalp form?

A

Anastomosis

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11
Q

Describe the aponeurosis.

A

Tendinous layer

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12
Q

What muscles does the aponeurosis of the scalp join?

A

Frontalis muscle at the front with the occipitals muscle at the back

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13
Q

What is the function of sutures of the skull?

A

Help prevent skull fractures from spreading

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14
Q

What bones make up the pterion?

A

Frontal
Parietal
Occipital
Temporal

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15
Q

What is the thinnest part of the skull?

A

Pterion

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16
Q

What artery lies beneath the pterion? Why is this not good?

A

Middle meningeal artery

The pterion is very thin and easily fractured which may damage the artery and lead to haemorrhage

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17
Q

Look at slide 6

A

:(

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18
Q

What is meningitis?

A

Bacterial or viral infection of the meninges

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19
Q

What does the dura mater enclose?

A

Dural venous sinuses

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20
Q

What nerve supplies sensory innervation to the dura mater?

A

CN V

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21
Q

What is an important feature of the arachnoid mater. Describe this.

A

Arachnoid granulations

These are projections of the arachnoid mater up into the dural venous sinuses which reabsorb CSF

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22
Q

Where is CSF contained?

A

Subarachnoid space

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23
Q

What does dura mater adhere to?

A

Internal surface of the skull

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24
Q

What is the diaphragm sellae?

A

A tough sheet of dura mater which forms a roof over the pituitary fossa

25
Q

What is the name of the tough sheet of dura mater that covers the cerebellum?

A

Tentorium cerebelli

26
Q

The tentorium cerebelli has a gap to allow a structure to pass through. What is this structure?

27
Q

What does the tentorium cerebelli attach to?

A

Ridges of the petrous temporal bones

28
Q

Name the 3 layers of the dura mater.

A

Diaphragm sellae
Tentorium cerebelli
Falx cerebri

29
Q

What is the location of the falx cerebri?

A

Sits between the centre of both right and left cerebral hemispheres

30
Q

Describe the veins in the danger triangle of the face.

A

Thick

Valveless

31
Q

What isn’t a good thing to do in the danger triangle of the face? Why?

A

Squeeze a spot
It can introduce bacteria into the veins which will then travel into the cavernous sinus and allow bacteria to accumulate in the cranial cavity

32
Q

What is the function of the cerebral veins? Where do they drain into?

A

Drain venous blood from the brain into the dural venous sinus

33
Q

Describe the sigmoid sinus.

A

‘S’ shaped sinus drains into the internal jugular vein at the jugular foramen

34
Q

What is it known as when many dural venous sinuses come together?

A

Confluence

35
Q

Describe the confluence of sinuses.

A

In the midline at the internal occipital protuberance which is deep to the external occipital protuberance

36
Q

The vertebral arteries are a branch of what artery?

A

Subclavian arteries

37
Q

The internal carotid arteries are a branch of what artery?

A

Common carotid arteries

38
Q

The internal carotid artery becomes internal via the carotid canal and supplies what?

39
Q

The external carotid artery stays external and supplies what?

A

Neck
Face
Scalp

40
Q

Left/Right anterior cerebral artery supplies?

A

Medial cerebral hemisphere

41
Q

Left/Right middle cerebral artery supplies?

A

Lateral cerebral hemisphere

42
Q

Left/Right posterior cerebral artery supplies?

A

Posterior cerebral hemispheres

Visual cortex

43
Q

Right vertebral + Left vertebral artery =

A

Basilar artery

44
Q

At what level does the spinal cord end?

45
Q

At what level does the subarachnoid space end?

46
Q

Where is CSF produced?

A

In the choroid plexus of the ventricles

47
Q

Where is CSF reabsorbed?

A

In the arachnoid granulations of the dural venous sinuses

48
Q

What procedure is done to obtain a sample of CSF?

A

Lumbar puncture

49
Q

What level is safe to perform a lumbar puncture?

A

L2-L5

L3-L4 (most common)

50
Q

Outline the route of CSF.

A
  1. Secreted by choroid plexus
  2. Right and left lateral ventricles
  3. Foramen on Monroe
  4. 3rd ventricle
  5. Cerebral aquaduct
  6. 4th ventricle
  7. Subarachnoid space (or some to central canal)
  8. Arachnoid granulations to dural venous sinus
51
Q

What is hydrocephalus?

A

Excess production, obstruction to flow or inadequate reabsorption leads to increased CSF

52
Q

How is hydrocephalus treated? Explain this.

A

Ventricular peritoneal shunt
The shunt catheter is “tunnelled” beneath the skin of the neck and chest then sited within the peritoneal cavity

53
Q

Describe an extra-dural haemorrhage. What vessel is affected?

A

Bleeding between bone and dura
Trauma to pterion
Middle meningeal artery

54
Q

Describe a subdural haemorrhage. What vessel is affected?

A

Bleeding between dura and arachnoid
Falls in the elderly/those who drink
Cerebral veins

55
Q

Describe a subarachnoid haemorrhage. What vessel is affected?

A

Into CSF of subarachnoid space
Ruptured CIRCLE OF WILLIS’
‘BERRY ANEURYSM’
Congenital aneurysm

56
Q

Describe the stages of epidural anaesthesia.

A
  1. Catheter passed through supraspinous then infraspinous ligaments
  2. Then ligament flavum
  3. Then epidural space
57
Q

What is contained within the epidural space?

A

Fat and veins

58
Q

Describe the stages of a lumbar puncture.

A
  1. Catheter passed through supraspinous then infraspinous ligaments
  2. Then ligament flavum
  3. Then epidural space
  4. Dura mater
  5. Arachnoid mater
  6. Subarachnoid space
  7. CSF obtained
59
Q

What does damage to the epidural venous plexus result in?

A

Epidural haematoma compressing the spinal cord or caudal equina

Neurology (42 decks)

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