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Neurology > Clinically relevant anatomy of intracranial space occupying lesions & head trauma > Flashcards

Clinically relevant anatomy of intracranial space occupying lesions & head trauma Flashcards

1
Q

What are the layers of the scalp?

A

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

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2
Q

What is contained within the connective tissue layer of the scalp?

A

The named arteries of the scalp

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3
Q

Describe the blood supply to the scalp

A

The common carotid artery branches into the internal and external carotid artery. Internal carotid artery –> right ophthalmic artery. External carotid -> scalp branches

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4
Q

What is the protuberance of the skull?

A

External occipital protruberance

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5
Q

What are the processes of the skull

A

Mastoid and styloid processes

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6
Q

What is the pterion?

A

Thinnest part of the skull - H shaped Joins frontal, parietal, temporal and sphenoid bone

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7
Q

Which artery courses deep to the pterion?

A

Middle meningeal artery

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8
Q
A
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9
Q

What are meninges?

A

Protective converings for the brain and spinal cord

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10
Q

What are the three layers of the meninges?

A

Dura mater

Arachnoid mater

Pia mater

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11
Q

Describe dura mater

A

Tough/fibrous

Has a sensory nerve suppy from CN V

Encloses the dural venous sinuses

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12
Q

Describe the arachnoid mater

A

Spidery mother

Arachnoid granulations (reabsorb CSF)

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13
Q

What is contained in the subarachnoid space?

A

CSF

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14
Q

Describe pia mater

A

Adherent to the brain and the blood vessels and nerves entering or leaving brain

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15
Q

What is tentorium cerebelli

A

Sheet of dura mater ‘tenting’ over the cerebellum

Attaches to the ridges of the petrous temporal bones

Has a central gap to permit the brainstem to pass through

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16
Q

What is the diaphragm sellae

A

Tough sheet of dura mater forming a roof (diaphragm) over pituitary fossa

17
Q

What is the falx cerebri?

A

Midline structure

Made of dura mater

Attaches to deep aspect of skull

Separates right and left cerebral hemispheres

18
Q

What aspect of the skull does falx cerebri attach to anteriorly?

A

Crista galli of the ethmoid bone

19
Q

What aspect of the skull does the falx cerebri attach to medially?

A

Sagittal suture

20
Q

What aspect of the skull does the falx cerebri attach to posteriorly?

A

Occipital protruberance

21
Q

Describe the drainage of the brain

A
22
Q

Which arteries supply the brain?

A

vertebral artery

internal carotid

23
Q

Describe the arteries in the circle of willis and what they supply

A
24
Q

What is the volume of circulating CSF?

A

400-500mls

25
Q

Where is CSF produced?

A

Choroid plexus of the ventricles

26
Q

Where is CSF reabsorbed?

A

Dural venous sinuses via arachnoid granulations

27
Q

Where does the subarachnoid space end?

A

S2 part of spine

28
Q

where can CSF be accessed?

A

lumbar puncture at L3/L4 or L4/L5 IV disc levels to obtain a sample

29
Q

Describe the circulation of CSF?

A
  1. secreted by choroid plexus in lateral and third ventricle
  2. moves from left to right ventricles via foraminae of monroe
  3. moves to the 3rd ventricle (midline)
  4. then into the cerebral aqueduct
  5. then into the 4th ventricle
  6. then into the subarachnoid space or into the central canal
  7. reabsorbed from subarachnoid space via arachnoid granulations
  8. then into the dural venous sinuses
30
Q

What is hydrocephalus?

A

Excessive production, obstruction to flow or inadqeuate reabsorption of CSF leading to increased CSF volume

31
Q

Describe a ventricular peritoneal shunt

A

Shunt catheter is tunelled beneath the skino f the nect and chest then sited within peritoneal cavity

32
Q

Where does the circle of wilis lie?

A

Within the subarachnoid space

33
Q

What are the three kinds of bleeds within the cranial cavity?

A

Extradural haemorrhage

Subdural haemorrhage

Subarachnoid haemorrhage

34
Q

Describe an extradural haemorrhage

A
  • between the bone & the dura
  • ruptured middle meningeal artery
  • trauma to the pterion
35
Q

Describe a subdural haemorrhage

A
  • separates the dura from the arachnoid
  • torn cerebral veins
  • falls in the elderly
36
Q

Describe a subarachnoid haemorrhage?

A
  • into the CSFof the subarachnoid space
  • ruptured Circle of Willis (“berry”) aneurysm
  • congenital aneurysm
37
Q

What are the kinds of supratentorial herniations

A

cingulate (subfalcine)

Central (trans-tentorial)

Uncal

Transcalvarial

38
Q

What are the kinds of infratentorial herniations?

A

Upward cerebellar/transtentorial

Downward cerebellar (tonsilar

39
Q

Which type of herniation leads to a blown pupil?

A

Compression of the oculomotor enrve by an uncal herniation leads to an ipsilateral fixed dilated pupil

Neurology (41 decks)

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