Exam 4 - Meninges and Spine Flashcards

1
Q

Three layers of mengines?

A

Dura
Arachnoid
Pia

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2
Q

How many Dura layers in brain and spine?

A

Brain=2

Spine=1

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3
Q

Which Dura layer on bone, which on CNS?

A

Outer layer=bone

Inner layer=CNS

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4
Q

Does Arachnoid layer adhere to Pia

A

No

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5
Q

What is innermost meningeal layer?

A

Pia

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6
Q

What areas where two dura layers separate?

A

Dura Sinuses

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7
Q

Where do Dura Sinuses eventually drain into?

A

Internal Jugular Vein

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8
Q

Where and is Epidural Space? What pathologies?

A

Dura-Skull interface. Epidural hemorrhage from Middle and Epidural Abscess

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9
Q

Which artery responsible for Epidural Hemorrhage?

A

Middle Meningeal Artery

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10
Q

Where is Sub-Doral Space? What contains? What pathology?

A

Dura-Arachnoid Interface. Contains blood vessels supply brain. Subdural Hemorrhage.

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11
Q

What causes Subdural Hemorrhage?

A

Rupture of cerebral veins passing from brain to venous sinus

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12
Q

Where is Sub-arachnoid Space? What does it contain? Pathology?

A

Arachnoid-Pia interface. Contains CSF! Subarachnoid Hemorrhage.

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13
Q

Where is CSF contained?

A

Subarachnoid Space (Arachnoid-Pia interface)

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14
Q

Where does Subarachnoid Hemorrhage occur? Due to what?

A

Subarachnoid Space (Arachnoid-Pia interface). D/T “Berry Anuerysms”. “Worst HA ever!”

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15
Q

What does CSF fill and where does t flow into?

A

Fills ventricles, flows into Subarachnoid Space

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16
Q

Lateral Ventricles to Third Ventricle via?

A

Foramen of Monroe

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17
Q

Third Ventricle to Fourth Ventricle via?

A

Cerebral Aqueduct

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18
Q

Fourth Ventricle to Subarachnoid Space via?

A

Foramen of Mag and Luk

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19
Q

CSF in SAS goes to which two places?

A

90% to Arachnoid Villi/Granulations

10% to Interstitial Space via perivascular spaces

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20
Q

Role of CSF?

A

Provides stable environment for CNS. Cushions and insulated brain from internal forces. Removes metabolic waste, gas exchange.

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21
Q

CSF made by what two things?

A

70% in Choroid Plexus of Ventricles

20-30% by Ependymal Cells

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22
Q

Total circulating CSF volume?

A

150ml

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23
Q

Rate formed CSF hour and day?

A

Hour=20-25mL

Day=550mL

24
Q

CSF turns over how many times each day

A

3-4

25
Q

Does rate of CSF production change due to intracranial pressure?

A

No

26
Q

Arachnoid Villi open when?

A

When SAS pressure is 1mmhG more than venous sinus

27
Q

Open pressure of LP on left side?

A

8-15mmHg

28
Q

Open pressure of LP sitting?

A

14-22mmHg

29
Q

Ph, Potassium, glucose, protein, and cholesterol lower in CSF or Blood Plasma?

A

CSF

30
Q

PCO2, Cl, and Na higher in CSF or Blood Plasma?

A

Higher in CSF.

31
Q

Where is Interstitial Fluid (ISF)?

A

Within and surrounds CNS cells (neurons and glia)

32
Q

ISF drains out from where to where?

A

From Perivascular spaces to SAS -or- out of ependymal walls into ventriclular system pathways

33
Q

Acute Phase of spinal shock lasts how long? Is it permanent?

A

2-3 weeks. Rarely permanent.

34
Q

Flaccid paralysis, areflexia, bowel/bladder dysfunction, hypotension, and Horner’s Syndrome are from which spinal cord injury phase?

A

Acute Phase

35
Q

Subacute Phase of SCI when?

A

2-3 weeks after injury

36
Q

Hyperreflexia, hypertonicity, spastic paralysis, and orthostatic hypotension from which phase of SCI?

A

Subacute Phase

37
Q

Extreme Hypertension and Bradycardia due to what?

A

Autonomic Dysreflexia

38
Q

SCI above T-5 can cause what?

A

ANS Hyperresponsiveness, sympathetics fireing extensively raising BP and lowering HR

39
Q

Autonomic Dysreflexia due to injury where?

A

SCI above T-5

40
Q

Autonomic Dysreflexia very often due to what? Treatment?

A

Full bladder or bowels. Sit up, drain bladder/bowels.

41
Q

All levels of SCI injury impacts what?

A

Bladder and bowel control

42
Q

T12 injury causes paraplegia to what?

A

LE

43
Q

T2-T4 injury causes paraplegia to what?

A

LE and Trunk. Stable sitting/posture hard

44
Q

C6-C7 injury causes quadriplegia. What is maintained?

A

Proximal UE maintained

45
Q

C1-C4 injury causes loss of what?

A

Everything, including respiratory loss

46
Q

Sacral/Lower Lumbar injury causes varying what?

A

Varying paraplegia. Trunk, UE intact. Walk with devices.

47
Q

In Anterior Cord Syndrome remains intact?

A

Proprioception, discriminating touch, vibration sense

48
Q

In Central Cord Syndrome UE or LE which is affected more? What is the sensory disruption described like?

A

UE loss more than LE.

“Cape-like” sensory disruption

49
Q

What is the most common loss in Central Cord Syndrome?

A

Pain and temp loss

50
Q

In Brown-Sequard Syndome what is the damage? What sides for motor and sensory loss?

A

Hemisection.
Ipsilateral loss of proprioception, discrimination touch, and vibration.
Contralateral loss of pain and temp

51
Q

Which SCI hasIpsilateral loss of proprioception, discrimination touch, and vibration but Contralateral loss of pain and temp?

A

Brown-Sequard Syndrome

52
Q

Which artery supplies the anterior 2/3 of the spinal cord? From where?

A

Anterior Spinal Artery.

From R/L vetebral arteries.

53
Q

R/L Posterior Spinal Arteries from where? What to segmental branches supply?

A

From R/L PICA. Segmental branches supply anterior spinal artery at each level.

54
Q

Upper Motor Neuron Lesion affects where, hyper/hypo, and muscle?

A

CNS, hyper, slow muscle atroply

55
Q

Lower Motor Neuron Lesion where, hypo/hyper, muscle?

A

PNS, hypo, fast atrophy. Radiculopathy.

56
Q

MS and ALS due to upper motor neuron, lower motor neuron, or mixed?

A

Mixed.