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SF2- Exam 2 > Cranium > Flashcards

Cranium Flashcards

1
Q

The meninges surrounds the spinal cord and brain, but there is a difference between the meningeal coverings of the brain and spinal cord. What is that difference?

A

In the cranium, the dura mater is fused to the periosteum

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2
Q

___________ is a dural fold that separates the cerebral hemispheres.

A

Falx cerebri

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3
Q

___________ is a dural fold that separates the right and left cerebellar hemispheres.

A

Falx cerebelli

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4
Q

The ___________ separates the cerebellum from the occipital lobe of the cerebral cortex.

A

Tentorium cerebelli

*Dura mater proper (not fused)

NOTE: The tentorium cerebelli covers the posterior cranial fossa

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5
Q

The pituitary gland is surrounded by the _____________.

A

Diaphragm sella

  • The diaphragm through which the pituatary stalk goes from the pituitary gland and attaches to the hypothalamus
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6
Q

What are the two parts of the pituitary gland and what are the embryonic origins of each?

A

Anterior pituitary: Develops as the diverticulum of the developing mouth (Rathke’s pouch)

Posterior Pituitary : Develops from the brain itself (extension of the hypothalamus)

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7
Q

Tumors can form from both parts of the pituitary. Which types of tumors can form from each?

A

Anterior pituitary: Craniopharyngioma (forms from embryonic tissue and common in children

Posterior pituitary: Pituitary ademoma (common in adults)

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8
Q

Pituitary adenoma begins as ______________

A

Bitemporal superior quadrantanopsia

* A loss of vision in a quarter section of the visual field

of both eyes.

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9
Q

Craniopharyngioma begins as ____________.

A

Bitemporal inferior quadrantanopsia

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10
Q

As the pituitary adenoma tumor grows through the diaphragm sella, it has no where to expand to except anteriorly. This expansion puts pressure on the ______________.

A

Optic chiasm

*The axons in the optic chiasm are collecting visual info about the periphery.

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11
Q

What are the results of pressure on the optic chiasm, caused by the growing pituitary adenoma?

A
  • Bitemporal tunnel vision
  • Loss of vision in upper lateral quandrants

NOTE: The central field of vision is in tact

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12
Q

What are symptoms of a craniopharyngioma?

A
  • Bitemporal vision loss in the lower lateral quandrants of the visual field
  • Headache
  • Vomiting
  • Difficulty sleeping
  • Extreme thirst
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13
Q

Does the brain have nerve endings?

A

No.

*The dura mater that covers the brain has sensory nerve endings

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14
Q

Which nerve primarily supplies the dura mater?

A

The trigeminal nerve

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15
Q

Which nerve supplies the dura over the anterior fossa?

A

The opthalamic nerve (V1)

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16
Q

Which nerve supplies the tentorium cerebrelli?

A

The opthalamic nerve (V1)

*A small part is also supplies by the mandibular nerve (Which nerve supplies the anterior fossa (V3)

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17
Q

Which nerve supplies the dura over the greater wing of the sphenoid (in the middle cranial fossa)?

A

Maxillary nerve (V2)

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18
Q

Which nerve supplies the dura of the back part of the middle cranial fossa?

A

Mandibular nerve (V3)

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19
Q

What innervates the dura mater of the posterior cranial fossa?

A

Sensory branches of C2 and C3

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20
Q

Pain from the dura is usually described as __________

A

Headache

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21
Q

What role do inflammed blood vessels play in headache?

A

Inflammation of the blood vessels supplying the dura irritates and stimulates the sensory fibers of the nerves innervating the dura mater causing headache

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22
Q

What artery supplies the dura?

A

The middle meningeal artery

*Runs between the skill and the periosteum

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23
Q

The middle meningeal artery is a branch of the ____________ artery in the infratemporal fossa

A

Maxillary

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24
Q

The middle meningeal artery is surrounded by the _____________ nerve.

A

Auricular temporal nerve

*The splitting of the auricular temporal nerve by the middle meningeal artery helps indentification of the different branches

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25
Q

The middle meningeal artery entes the skull through the ____________.

A

Foraman spinosum

26
Q

Skull fractures may tear meningeal artery producing an _____________

A

Epidural hematoma

*Bleeding outside of the dura mater

  • Will produce a severe headache, due to stripping
27
Q

An epidural hematoma can result in:

A
  • Compression of the brain
  • Herniation of uncus through tentorium
    • ​Compression of CN III
    • Dilation of pupil
  • Herniation of cerebellar tonsils through foramen magnum
    • Compression of the medulla
    • Cushing triad
    • Death
28
Q

Herniation of the uncus through the tentorium can result in compression of which nerve?

A

CN III

*This affects the parasympathetic fibers and results in dilated and fixed pupils

29
Q

What are the symptoms of Cushing’s triad?

A
  • Irregular breathing
  • Bradycardyia
  • Systolic hypertension (in which the stroke volume of the heart increases)
30
Q

In the case of a “talk and die” patient, when is the lucid interval longer?

A

The lucid interval is ;pnger if the source of the hemorrhage is venous (under lower pressure) rather than arterial

31
Q

Which sinuses are found in the edges of the falx cerebi?

A

Superior sagittal sinus

Inferior sagittal sinus

32
Q

The union of the falx cerebri and tentorium contains the __________ sinus

A

Straight

*Fromed by the union of the inferior sagittal sinus and the great vein of Gallen

33
Q

Which sinuses drain into the confluens of sinuses?

A

Straight

Superior sagittal

Occipital

*The superior cerebellar veins drain into the straight sinus

34
Q

_______________ sinus takes blood from the brain to the internal jugular vein.

A

Transverse

35
Q

The confluens of sinuses drains into the ____________ sinus.

A

Transverse sagittal sinus

REMEMBER: The confluens of sinuses is made up of the straight sinus, superior sagittal sinus, and the cerebellar sinus.

*Transverse sinus takes blood from the brain to the internal jugular vein

36
Q

The transverse sinus takes and “S” shaped turn and becomes the _________ sinus, which passes through the jugular foramen and empties into the internal jugular vein.

A

Sigmoid sinus

37
Q

At the jugular foramen, the sigmoid sinus becomes the internal jugular vein, whcih then continues to becomes the ___________ vein and then the _____________.

A

Subclavian

Superior vena cava

38
Q

Where do cerebral veins run?

A

On the surface of the brain, deep to the arachnoid mater

39
Q

Rupture of the cerebral brains produces…

A
  • Severe headache (due to effect on the nerve endings in the meninges)
  • Subarachnoid bleeding, resulting in a subaracnoid hematoma
40
Q

Causes of subarachnoid hematomas

A
  • Rupture of cerebral veins
  • Rupture of a berry aneurysm (most common)

NOTE: Aneuryms represent weakness in the arterial walls

41
Q

What are the common sites of a berry aneurysm?

A
  • Anterior cerebral and anterion communicating arteries
  • Where the middle cerenra; amd posterior communicating arteries meet

*Patients experience a “thunderclap” headache

42
Q

There is a close relationship between the posterior cerebral artery, the posterior communicating artery, and the ____________ nerve.

A

Oculomotor nerve

*Rupture of aneurysm cause irritation of the oculomotor nerve, which results in dilated, fixed pupils

43
Q

Subarachnoid hemorrhage can cause ___________ hydrocephalus.

A

Communicating

*CSF becomes mixed with blood. Clotting factors in blood cause clotting in the arachnoid villi and reduce the drainage (or reabsorption) of the CSF resulting in communicating hydrocephalus. CSF is being produces at the same rate but isn’t being reabsorbed and the ventricles become expanded.

NOTE: Communicating hydrocephalus can also be caused by meningitis

44
Q

The superior sagittal sinus is formed between the ________ and ____________.

A

Periosteum and dura mater

NOTE: The dura mater is made up of two fused layers. The superior sagittal sinus is the space between the two layers of the dura mater that have split.

45
Q

Cerebral veins drain into the ___________

A

Superior sagittal sinus

*Superficial veins on the surface of the cerebral cortex go through the arachnoid mater and drain into the supeior sagittal sinus. These are called bridging veins; veins that go across the subdural space

46
Q

Cerebral veins are also known as__________.

A

Bridging veins

47
Q

Cause of subdural hematomas

A

Tearing of bridging veins where they enter the superior sagittal sinus

  • This can result from shearing head truma akso known as shaken baby syndrome

NOTE: Subdural hematomas are crescent- shaped, not lens shaped

48
Q

CSF reabsorbs into the vascular system into the superior sagittal sinus via ____________

A

Arachnoid villi

*Villi often become calcified (arachnoid granulation) and form indentations in the skull

49
Q

What are symptoms of Hakim’s Triad?

A
  • Ataxia
  • Dementia
  • Urinary incontinence
  • Headache
  • Papilledema (swelling of the optic disc)
  • Nausea
  • Vomiting
  • Sleeplessness
  • Coma
50
Q

Where is the cavernous sinus found and where does it drain?

A

The cavernous sinus is found in the middle cranial fossa (lateral to the sella tursica) and it drains into the transverse sinus via the S. petrosal sinus

51
Q

What are the contents of the cavernous sinus?

A
  • Oculomotor nerve (CN III)- Runs lateral wall
  • Trochlear nerve (CN IV)- Runs in lateral wall
  • Opthalamic nerve (CN V1)- Runs in lateral wall
  • Maxillary nerve (CN V2)- Runs in lateral wall
  • Internal carotid artery- Runs in cavernous sinus itself
  • Abducens nerve (CN VI)- Runs in cavernous sinus itself
52
Q

Which nerve is most often affected if there is thrombosis in the cavernous sinus? What are results?

A

Abducens nerve

  • Results in lateral rectus palsy, which result in loss of lateral gaze

*As thrombosis gets more advanced you may lose more snesation and it could affect the oculomotor and trochlear nerves causing complete ocular palsy

53
Q

Are all parts of the trigeminal nerve contents of the cavernous sinus?

A

NO

*The mandibular nerve (V3) is not.

54
Q

The pterygoid plexus receives branches from the ________ vein, draining from the teeth and has communication with the __________ sinus.

A

Facial; cavernous

*Infections can be drained here from popped pimples, dental carries, etc.

NOTE: The communications are between the pterygoid plexus and the cavernous sinus are VALVELESS

55
Q

_________ veins conect the scalp with the venous sinuses.

A

Emissary

*Infections can spread via emissary veins to produce meningitis

NOTE: Emissary veins are valveless

56
Q

Premature closure of sagittal suture

A

Scaphocephaly

57
Q

Premature closure of the coronal and lambdoid suture

A

Acrocephaly (Oxycephaly-Tower head)

58
Q

Alpert’s syndrome is also known as________. What are symptoms? What is the cause?

A

Acrocephaly

  • Symptoms
    • Flat face
    • High forehead
    • Shallow and wide orbits
    • Narrow, high palate
  • Causes
    • Premature frusion of skull and facial bones similar to Crouzon’s
59
Q

Alpert’s syndrome is classified as a _____ branchial arch syndrome.

60
Q

What three “sinuses” come together to form the straight sinus?

A

Great cerebral vein of Galen

Inferior sagittal sinus

The superior cerebellar veins

SF2- Exam 2 (16 decks)

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