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xCase 16 SBA > Anatomy of the Meninges > Flashcards

Anatomy of the Meninges Flashcards

1
Q

what fissure divides the 2 cerbral hemispheres

A

great longitudinal fissure

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2
Q

where is the tranverse fissure located?

A

between occiptial lobe and cerebellum

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3
Q

what is the termination of the spinal cord called?

what are the extension the spinal nerves below this level referred to as?

A

spinal cord- brainstem ——> lumabr vertrbae L1

cons medullaris (L1)

Lumbar, scaral and occygeal spinal nerves extend downwards to leave the verebtral colum—–>cauda equina

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4
Q

what are the 3 layers of thje meninges and what is there function?

A

dura matter

arachnoid matter

pia matter

(DAP)

function- provide framework for cranila and cerebral vasculature

Protective- from mechanical dmaage help from too CSF

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5
Q

Label this diagram

A
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6
Q

Describe the Dura matter

A
  • tough, fiborous , vascularised
  • loos fititng
  • double emembrane in the cranium
    • outer periosteal layer (con tinuoius with the periostrum of the outer surfave of the skull
    • inner meningeal layer (exits skull to cover tehs pinal cord. SC only has one layer.
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7
Q

what is the extra-dural space?

A

Potential space between the cranium bone and the dura.

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8
Q

Name the Dural Reflections and what is there function

A
  1. Falx cereberi- dural extension within great longitudunal fissure
  2. Tenotrium cerebelli- tranvers fissure
  3. Falx cerebelli- btetween cerbellar lobes
  4. diagrahm sellae- hyposeal fossa
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9
Q

Label this

A
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10
Q

label this

A
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11
Q

Describe the arachnoid matter

A
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12
Q

Describe the pai mater

A

thin

translucent

tirghtly adherent to surfacve of the brain- follows fyri and sulci

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13
Q

Ppathophysiology of the Dura matter?

A

raised intracanial pressure- brain can herniate under the Falx cerebri

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14
Q

what are the subarachnoid spaces?

A

true spaces between the pia and arachnoid matter

filled with CSF and blood vessesl

as the pia is atightly adhered to the brain and the arachoid is loose- region sof subarahcnoid spaces - comparatively lareg called Cistern

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15
Q

what holds the arachnoid and pia matter together?

A

Trabeculae

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16
Q

Label the following…

superiro cistern

chiasmatic cistern

interpeduncular cistern

pontine cistern

cerebelliomedullary cistern

A
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17
Q

Describe blood supply the the dura

A

blood supply travels in the outer periosteal layer

4 major arteries

Anteriro meningeal

middle meningeal (main- branch of the maxillary artery from external carotid)

acessory meningeal artery

Posteriro meningeal artery

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18
Q

where does the middle meningeal artery branch from?

A

branhc of the Maxillary ateyr from external carotid

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19
Q

Where is the Middle meningeal artery?

A
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20
Q

Describe innervation of the dura?

A

tirgeminal nerve CNV

21
Q

what is the clinical relevance of the meninges?

pathohpysiology and treatment/diagnosios

A

Meningitis- inflaamtion fot the meninges, can be infective and noninfective

Lumbar punction- removal of CSF from the subarachnoid spaxces for analysis (below L1)

22
Q

form what space do we take CSF from in a lumbar punction

A

subarachnoid space

23
Q

why is the Pterion particular site of weaknes? what kind of intercranila haemohrage might we See?

A

epidural haemorrhage- pterion is particualr weeks site that converges of the skull bones (frontal patielta, occiptal, sphenoid bome)- overlies the middel meningeal artery

24
Q

in what groups might we see a subdural haemorrhage

A

occurs generally due to lower impact truama in indivudals with predisposing factors and is often a venous bleed

25
Q

how might a subarachnoid haemorrhage present in a patient? and the cause

A

ruputre of an aneurysm- cerbral artery- classic sudden severe- thunderclpa headhace.

26
Q

is there an epidural space in the spinal meinges?

A

yes - superificial to the dura/

27
Q

describe the relationship of the pai matter to the spinal cord and exceptions

A

tpai matter is tighly adhered to the spinal cord except

Denticulate ligament-–> lateral thickening of pai at the lateral edges of the cord- look for free lateral edge

AND

The filum terminal

thick exentsion of pai matter that arises from the conus medularis and attaches to the top of the coccyX

will apear hite/shiny cord in DR

28
Q

what are dural sinuses?

A

dformed between the 2 layers of the dura matter

recieved blood from superficial and deep cerebral veins

non valvues- venous blood can flow in both direction

recive b;ppd from braina nd drian into the interna;l jugual veins

29
Q

what is this?

A

Dural venous sinus

30
Q

Label this

superiro sagital sinus

inferiro sagital sinus

strasight sinus

confluence of sinuses

sigmoid sinus

tranver sinus

internal jugualr

A
31
Q

what is the cavenrous sinus?

A

paired plexus of veins conntected by the intercavernous sinuses

drain into the sigmoid sinus or IJV via superiro petrosal sinus

32
Q

Label this

A
33
Q

label this

A
34
Q

why is the cavernous sinuses area of veins an area that could potential cause problems?- Infection

A

the veins have no valves- infection can come form oral cavity

nasopharynx

orbiut paranasal sinus

35
Q

what is subdrual empyema?

A

pus between the dura and arachnoid

36
Q

what is the image showing?

A

Thrombus formation in the superiro sagital sinus.

37
Q

Clinical relevance of the dural venous sinuses

A

infecition risk- infections can trigger- compresion of structures within resulting in CN palsy (CNIII) blood vessels

lots of structures pass through (nerves)- O TOMCAT

Lateral

Oculomotor (CN III)

Superior

Trochlear (CNIV)

Ophthalmic division-trigeminal (CNV)

Maxillary division-trigeminal (CNV)

Inferior

Carotid artery (internal)

Abducent (CNVI)

(T)represents the level of the C&A e.g in line with the trochlear nerve

38
Q

dural venous sinuses

formed with — layers?

does it have valves?

can blood flow bidirectionally?

how does no valves and bllod flow create potential riks of?

A

formed between the 2 dural layers

the sinuses have no valves

blood flow can be bi-directional

Potential risk of intracrnail infection and thrombus

39
Q

Label? and what is the ventricular system?

A

Ventricular system- cavities within the brian- repsonsible for the production and transport and removal of CSF

40
Q

name the connections between the ventricles

A

interventricular formen- between 2 lateral lateral and 3rd

Cerebal aqueduct between third and forth

41
Q

Describe production of the CSF

A

Choriod plexus

vascular potion of the pia mater (tele choroidea)- folds into the vcavity of the ventricle then covered by ependymal cells.. extensive folding gives large surface area

choriod epithelial cells (modified epednymal cells) cuodi or simple columnar- secvete CDF

mostly in the lateral ventricles (alos in 3rd,4th)

42
Q

describe the flow of CSF

A
  • produced/secret choriod plexus lateral ventricle
  • fllow through interventriucalr foramina)- 3rd ventricle
  • CSF produced secreted by CP in thrid ventricle
  • CSf flows down cerebal aqueduct into fourth ventricle
  • 4th ventricle
    • CSF can flow out of
      • Median aperture (magendie)
      • right and left lateral (lushka)
      • central canal
  • into the subarachnoid spaces
43
Q

Label the subarachnoid cisterns

posteriro crebellomedullary cistern

Ponto cerebellar cistern

interpeduncualr cistern

chiasmtic cistern

quadriegminal cistern

A
44
Q

Describe reabsoption of CSF

A

once CSf has enter subarachnoid space

will need to be reabsorbe- continual supply of CSF

Arachnoid granulations

  • villi projections of arachnoid spaces into the dural venouss sinuses (primarily superior sagital sinus)
  • allows CSf to enter venous system

venous pressure within subarachnoif space is higher than that of lumen of sinus and greater colloid osmotic pressure of CSF compared to venous blood.

45
Q

what is hydrocpehalus

A

abnromal buildup in the ventricles deep within the brain

this excess fluid causes the ventricle to widne and put pressure on the brain tissues

can be congenital, acquired and norma pressure (older people)

46
Q
  • what are the 2 major types of hydrocephalus
A
  • communicating- occurs when flow of CSf blocked after it exist ventricles- reduced rebasoption
  • noncommunicating- CSf flownis blocked along one or more of the narro passages between the centricles
47
Q

describe the ventriuclar system of the spinal cord?

A

small , central canal (almost vistigial)

however the subarachnoid space extednds into and around the spoinal cord and therefor bathes the spinal cord

48
Q

Label this

  • Pia matter
  • subarachnoid space
  • Arachnoid matter
  • dura matter
  • epiural sapce
A

remeber- pia matter is tightly adhered to the spinal cord

subarachnodi space between pia and arachnoid

dural matter

then epidural space (above the dura)

xCase 16 SBA (18 decks)

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