Ch 1 Intro to peds Flashcards
What age is considered a pediatric pt?
Birth to 18 years
What age is considered premature?
<36 weeks gestation
What does NICU stand for?
Neonatal intensive care unit
Why is it so important we maintain hygiene in the NICU?
B/c premature babies are highly susceptible to infection
What 2 things create the CNS?
Brain + spinal cord
What covers the brain + spinal cord (CNS)?
The meninges (3 protective membranes)
What is the dura mater?
-Outermost layer of meninges (attaches to skull)
-Most durable + strongest
What is the arachnoid mater?
Middle layer of meninges b/w dura mater + pia mater
What is the pia mater?
-Inner layer of meninges
-Delicate
-Highly vascular
Purpose of CSF?
Surrounds brain + spinal cord as a cushion to prevent injury
Where does CSF exist?
In subarachnoid space (b/w pia + arachnoid mater) + in ventricular system
What is the only main bone in the pediatric skull that is not paired?
Occipital bone
Where is the frontal suture?
Divides the two halves of the frontal bone
Where is the coronal suture?
Separates frontal + parietal bones
Where is the sagittal suture?
B/w the 2 parietal bones
Where is the lambdoid suture?
Connects occipital bone with the parietal bones
Where is the squamous suture?
Connects the temporal and parietal bones
4 main bones of pediatric skull?
-Frontal (forehead)
-Parietal (mid head)
-Occipital (back head)
-Temporal (behind ears)
What is another name for the anterior fontanelle?
Bregma
What is the anterior fontanelle?
Junction of coronal, sagittal + frontal sutures (main scanning window)
When does the anterior fontanelle close?
9-15 months
What is the posterior fontanelle?
Junction of lambdoid + sagittal sutures
What is the mastoid fontanelle?
Junction of squamosal, lamboidal + occipital sutures
What is the sphenoid fontanelle?
Junction of sphenoid, parietal, temporal + frontal bones
(think directly behind eyes)
What is sulcus + gyri?
Sulcus: shallow grooves throughout brain that produce gyri
Gyri: ridges b/w sulci
What are fissures?
Long narrow deep grooves that separate larger portions of the brain into lobes
What does the longitudinal (interhemispheric) fissure divide?
RT + LT lobes
What does the lateral (sylvian) fissure divide?
Frontal/parietal from temporal
What does the parieto-occipital fissure divide?
Occipital from parietal
What does the TRV fissure divide?
Cerebrum from cerebellum
What does the central fissure divide?
Frontal + parietal
The MCA is located in which fissure?
The lateral sylvian fissure
Brain is divided into what 3 parts?
-Cerebrum
-Cerebellum
-Brain stem
What is the largest section of the brain?
Cerebrum
The cerebrum is divided into RT + LT cerebral hemispheres by the ___ fissure?
Longitudinal interhemispheric fissure (falx cerebri lies here)
___ is composed of gray matter?
Cerebral cortex, thalamus, caudate nucleus
___ is composed of white matter?
Deeper portion of cerebrum + corpus callosum
Where is the cerebellum located?
At posterior aspect of brain, beneath occipital lobes
Purpose of cerebellum?
Balance + posture
The cerebellum is separated from the cerebrum by the ___?
Tentorium
Cerebellum has 2 hemispheres connected via the ___?
Vermis
What does the brain stem connect?
Cerebral hemispheres to spinal cord
Brain stem is responsible for what functions?
Subconscious (breathing, HR, etc)
The brain stem contains what 3 structures?
-Midbrain (top)
-Pons (middle)
-Medulla oblongata (bottom near neck)
Which meninge layer contains venous sinuses + meningeal arteries?
Dura mater
What are the 4 areas where the dura extends deeper into the cranial cavity?
-Falx cerebri
-Tentorium cerebelli
-Falx cerebelli
-Diaphragma sellae
What is the largest fissure in the brain?
Longitudinal (interhemispheric) fissure
What is the falx cerebri?
Fold of dura mater b/w the cerebral hemispheres in the longitudinal interhemispheric fissure
The inferior + superior sagittal sinus travel within what dural fold?
Falx cerebri
What is the tentorium cerebelli?
Fold of dura mater that separates the cerebellar hemispheres from the cerebrum
(90 degrees to the falx cerebri)
The ___ sinus lies within the tentorium cerebelli?
TRV sinus
What is the falx cerebelli?
Small projection of dura mater that divides the 2 cerebellar hemispheres
The arachnoid mater has a ___ appearance?
Spider web
Where is the subarachnoid space?
B/w arachnoid mater + pia mater (filled with CSF)
Do vessels cross the arachnoid mater?
Yes
The pia mater is separated from the arachnoid mater by ___?
The subarachnoid space (filled with CSF)
___ provides a pathway for the circulation of CSF?
Ventricles
The ventricle system consists of what 4 ventricles?
-Lateral ventricles (paired)
-3rd (midline)
-4th (midline)
What is the narrowest point in the fetal brain?
Cerebral aqueduct of sylvius (allows CSF to flow b/w 3rd + 4th ventricle)
Another name for interventricular foramina?
Foramina of monro (paired)
CSF is produced by the ___?
Choroid plexus
Explain the flow of CSF?
-LVs drain into 3rd ventricle via foramina of monro
-3rd ventricle drains into 4th ventricle via cerebral aqueduct of sylvius
-4th ventricle drains into foramina of luschka + magendie
-CSF now flows upward around brain where it gets reabsorbed by the arachnoid granulations into the superior sinuses
Location of LVs?
Either side of cerebrum
What is the largest of the ventricles?
LVs
LVs are divided into what 4 segments?
-Frontal anterior horn
-Body
-Temporal horn
-Occipital posterior horn
___ is the region where the anterior, occipital + temporal horns join?
The trigone/atrium
What is choroid plexus?
Delicate vascular capillary beds that produce/regulate CSF
CP tapers at the ___ groove?
Caudothalamic groove
Where does CP exist?
-Roof of 3rd + 4th ventricles
-NOT in frontal or occipital horns
What is the largest white matter structure in the brain?
Corpus callosum
Purpose of CC?
Allows communication b/w RT + LT side of cerebrum
4 divisions of the CC?
-Rostrum
-Genu
-Body
-Splenium
What is the thalamus?
-Paired gray matter structures b/w cerebral cortex + midbrain, beside 3rd ventricle
-Relays nerve impulses for sensory info
What is the caudate nucleus?
-Paired elongated curved masses of gray matter
-Has head, body + tail
What structure has the caudothalmic groove?
Caudate nucleus
What is the cisterna magna?
-Fluid filled structure that communicates with 4th ventricle
-Lies b/w cerebellum + dorsal side of medulla
What is the CSP?
Space filled with CSF b/w the frontal horns of the lateral ventricles
What is it called in premies when a posterior extension of the CSP is seen?
Cavum vergae
When does the CSP close?
-Starts closing 6 months gestation + is fully closed 6-8 months after birth
-Closure progresses from posterior to anterior
___ is the largest part of the choroid plexus + lies within the LV at the trigone?
The glomus
Most amount of CSF is produced where?
The glomus