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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
how might a subarachnoid haemorrhage present in a patient? and the cause
ruputre of an aneurysm- cerbral artery- classic sudden severe- thunderclpa headhace.
26
is there an epidural space in the spinal meinges?
yes - superificial to the dura/
27
describe the relationship of the pai matter to the spinal cord and exceptions
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
what are dural sinuses?
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
what is this?
Dural venous sinus
30
Label this superiro sagital sinus inferiro sagital sinus strasight sinus confluence of sinuses sigmoid sinus tranver sinus internal jugualr
31
what is the cavenrous sinus?
paired plexus of veins conntected by the intercavernous sinuses drain into the sigmoid sinus or IJV via superiro petrosal sinus
32
Label this
33
label this
34
why is the cavernous sinuses area of veins an area that could potential cause problems?- Infection
the veins have no valves- infection can come form oral cavity nasopharynx orbiut paranasal sinus
35
what is subdrual empyema?
pus between the dura and arachnoid
36
what is the image showing?
Thrombus formation in the superiro sagital sinus.
37
Clinical relevance of the dural venous sinuses
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
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?
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
Label? and what is the ventricular system?
Ventricular system- cavities within the brian- repsonsible for the production and transport and removal of CSF
40
name the connections between the ventricles
interventricular formen- between 2 lateral lateral and 3rd Cerebal aqueduct between third and forth
41
Describe production of the CSF
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
describe the flow of CSF
* 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
Label the subarachnoid cisterns posteriro crebellomedullary cistern Ponto cerebellar cistern interpeduncualr cistern chiasmtic cistern quadriegminal cistern
44
Describe reabsoption of CSF
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
what is hydrocpehalus
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
* what are the 2 major types of hydrocephalus
* 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
describe the ventriuclar system of the spinal cord?
small , central canal (almost vistigial) however the subarachnoid space extednds into and around the spoinal cord and therefor bathes the spinal cord
48
Label this * Pia matter * subarachnoid space * Arachnoid matter * dura matter * epiural sapce
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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