Exam 4 - Meninges and Spine

Question 1

Three layers of mengines?

Answer 1

Dura
Arachnoid
Pia

Question 2

How many Dura layers in brain and spine?

Answer 2

Brain=2

Spine=1

Question 3

Which Dura layer on bone, which on CNS?

Answer 3

Outer layer=bone

Inner layer=CNS

Question 4

Does Arachnoid layer adhere to Pia

Answer 4

No

Question 5

What is innermost meningeal layer?

Answer 5

Pia

Question 6

What areas where two dura layers separate?

Answer 6

Dura Sinuses

Question 7

Where do Dura Sinuses eventually drain into?

Answer 7

Internal Jugular Vein

Question 8

Where and is Epidural Space? What pathologies?

Answer 8

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

Question 9

Which artery responsible for Epidural Hemorrhage?

Answer 9

Middle Meningeal Artery

Question 10

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

Answer 10

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

Question 11

What causes Subdural Hemorrhage?

Answer 11

Rupture of cerebral veins passing from brain to venous sinus

Question 12

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

Answer 12

Arachnoid-Pia interface. Contains CSF! Subarachnoid Hemorrhage.

Question 13

Where is CSF contained?

Answer 13

Subarachnoid Space (Arachnoid-Pia interface)

Question 14

Where does Subarachnoid Hemorrhage occur? Due to what?

Answer 14

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

Question 15

What does CSF fill and where does t flow into?

Answer 15

Fills ventricles, flows into Subarachnoid Space

Question 16

Lateral Ventricles to Third Ventricle via?

Answer 16

Foramen of Monroe

Question 17

Third Ventricle to Fourth Ventricle via?

Answer 17

Cerebral Aqueduct

Question 18

Fourth Ventricle to Subarachnoid Space via?

Answer 18

Foramen of Mag and Luk

Question 19

CSF in SAS goes to which two places?

Answer 19

90% to Arachnoid Villi/Granulations

10% to Interstitial Space via perivascular spaces

Question 20

Role of CSF?

Answer 20

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

Question 21

CSF made by what two things?

Answer 21

70% in Choroid Plexus of Ventricles

20-30% by Ependymal Cells

Question 22

Total circulating CSF volume?

Answer 22

150ml

Question 23

Rate formed CSF hour and day?

Answer 23

Hour=20-25mL

Day=550mL

Question 24

CSF turns over how many times each day

Answer 24

3-4

Question 25

Does rate of CSF production change due to intracranial pressure?

Answer 25

No

Question 26

Arachnoid Villi open when?

Answer 26

When SAS pressure is 1mmhG more than venous sinus

Question 27

Open pressure of LP on left side?

Answer 27

8-15mmHg

Question 28

Open pressure of LP sitting?

Answer 28

14-22mmHg

Question 29

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

Answer 29

CSF

Question 30

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

Answer 30

Higher in CSF.

Question 31

Where is Interstitial Fluid (ISF)?

Answer 31

Within and surrounds CNS cells (neurons and glia)

Question 32

ISF drains out from where to where?

Answer 32

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

Question 33

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

Answer 33

2-3 weeks. Rarely permanent.

Question 34

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

Answer 34

Acute Phase

Question 35

Subacute Phase of SCI when?

Answer 35

2-3 weeks after injury

Question 36

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

Answer 36

Subacute Phase

Question 37

Extreme Hypertension and Bradycardia due to what?

Answer 37

Autonomic Dysreflexia

Question 38

SCI above T-5 can cause what?

Answer 38

ANS Hyperresponsiveness, sympathetics fireing extensively raising BP and lowering HR

Question 39

Autonomic Dysreflexia due to injury where?

Answer 39

SCI above T-5

Question 40

Autonomic Dysreflexia very often due to what? Treatment?

Answer 40

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

Question 41

All levels of SCI injury impacts what?

Answer 41

Bladder and bowel control

Question 42

T12 injury causes paraplegia to what?

Answer 42

LE

Question 43

T2-T4 injury causes paraplegia to what?

Answer 43

LE and Trunk. Stable sitting/posture hard

Question 44

C6-C7 injury causes quadriplegia. What is maintained?

Answer 44

Proximal UE maintained

Question 45

C1-C4 injury causes loss of what?

Answer 45

Everything, including respiratory loss

Question 46

Sacral/Lower Lumbar injury causes varying what?

Answer 46

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

Question 47

In Anterior Cord Syndrome remains intact?

Answer 47

Proprioception, discriminating touch, vibration sense

Question 48

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

Answer 48

UE loss more than LE. | "Cape-like" sensory disruption

Question 49

What is the most common loss in Central Cord Syndrome?

Answer 49

Pain and temp loss

Question 50

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

Answer 50

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

Question 51

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

Answer 51

Brown-Sequard Syndrome

Question 52

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

Answer 52

Anterior Spinal Artery. | From R/L vetebral arteries.

Question 53

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

Answer 53

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

Question 54

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

Answer 54

CNS, hyper, slow muscle atroply

Question 55

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

Answer 55

PNS, hypo, fast atrophy. Radiculopathy.

Question 56

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

Answer 56

Mixed.