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HNN > Meningeal Layers, Dural Folds and Dural Venous Sinuses > Flashcards

Meningeal Layers, Dural Folds and Dural Venous Sinuses Flashcards

1
Q

What are the layers of the meninges?
From outermost to innermost

A

DAP
Dura mater
Arachnoid mater
Pia mater

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2
Q

What are the bumps in the brain called?

A

Gyri

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3
Q

What are the dips in the brain called?

A

Sulci

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4
Q

What are the fissures of the brain?

A

Longitudinal
Lateral x2

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5
Q

Describe the Pia mater

A

Microscopically thin
Delicate adherence to surface of brain
Follows every sulci + fissure

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6
Q

Describe the arachnoid mater

A

Soft fibrous translucent membrane
Doesn’t descend into sulci or lateral fissures
Does descent longitudinal fissure

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7
Q

What are the leptomeninges?

A

Pia and arachnoid mater

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8
Q

What does an infection in the leptomeninges cause?

A

Meningitis

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9
Q

Describe the dura mater

A
  • Tough fibrous membrane
  • Has two layers while in the skull: periosteal + meningeal
  • Separation of the layers forms: dural folds + dural venous sinuses
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10
Q

What is the subarachnoid space?

A

The space between the Pia + arachnoid mater

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11
Q

What does the subarachnoid space contain?

A

CSF
Cerebral arteries + veins

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12
Q

What are the two layers of the dura while in the skull?

A
  • periosteal: part against inner table of bone (periosteum)
  • meningeal: part adjacent to arachnoid
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13
Q

What forms when the two layers of the dura separate?

A

Dural folds
Dural venous sinuses

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14
Q

What is the dural fold in the longitudinal fissure called?

A

Falx cerebri

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15
Q

What is the dural fold in the lateral fissure called?

A

Tentorium cerebelli

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16
Q

Function of dural folds

A
  • Act as rigid dividers
  • Help to stabilise the brain: falx cerebri <> | tentorium cerebelli ^v
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17
Q

What can a rise in intracranial pressure cause?

A

Compression + displacement of parts of the brain against dural folds and/or through the foramen magnum

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18
Q

What are dural venous sinuses?

A

Venous blood filled spaces created by separation of meningeal + periosteal layer of dura

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19
Q

Where do dural venous sinuses drain into?

A

Internal jugular vein

20
Q

What dural venous sinuses are at the superior and inferior margins of falx cerebri?

A

Superior Sagittal sinus
Inferior Sagittal sinus

21
Q

What connects the cavernous sinus to the sigmoid sinus?

A

Superior + inferior petrosal sinuses

22
Q

What meets at the confluence of sinuses?

A
  • Superior sagittal sinus
  • Straight sinus (drains inferior sagittal sinus)
  • Occipital sinus
  • Transverse sinus x2
23
Q

Outline the route of venous blood from the confluence of sinuses to the cavernous sinus

A
  • confluence of sinuses
  • transverse sinus
  • sigmoid sinus
  • superior + inferior petrosal sinus
  • cavernous sinus
24
Q

What connects the inferior Sagittal sinus to the superior sagittal singus?

A

ISS > straight sinus which meets the SSS at the confluence of sinuses

25
Q

How do cerebral veins drain into dural sinuses?

A

Bridging veins

26
Q

How do scalp (extracranial) veins drain into the dural venous sinuses?

A

Emissary veins

27
Q

Link to test sinuses

A

https://sketchfab.com/3d-models/dural-venous-sinuses-deep-veins-c044a5d3e3374ce2b208ccf590ef3473

28
Q

What are the types of intracranial haemorrhage?

A

Extradural/epidural
Subdural
Subarachnoid

29
Q

What is an intracranial haemorrhage?

A

Head trauma can lead to bleeding in potential spaces between meningeal layers

30
Q

What is an intracerebral haemorrhage?

A

Bleeding occurs within the brain tissue itself

31
Q

What is a characteristic shape of an extra dural haemorrhage on a CT scan?

A

Biconvex shape with edges limited by bond to sutures

32
Q

Where does an extradural haemorrhage occur between?

A

Inner table of bone + periosteum

33
Q

How does fresh blood appear on a CT?

A

Bright white

34
Q

What is a characteristic history for a patient with an extradural haemorrhage?

A
  • trauma to side of head
  • loss of consciousness
  • normal after regaining consciousness
  • deterioration ~1 hours later
35
Q

Is the deterioration more rapid in a extradural or subdural haemorrhage and why?

A

Extradural haemorrhage
Bleed of arterial blood compared to venous blood

36
Q

What causes a subdural haemorrhage?

A

Venous bleed usually form bridging veins

37
Q

What is the weakest point in a bridging vein?

A

The point of connection with the dural venous sinus

38
Q

What is the characteristic shape of an subdural haemorrhage on a CT?

A

Crescent shape
Not defined edges

39
Q

Causes of a subarachnoid haemorrhage

A

Secondary to trauma
Spontaneous rupture of blood vessel
e.g. aneurysm

40
Q

Why is the circle of Willis a place where spontaneous rupture of blood vessels could occur?

A

Area of anastomoses
Aneurysms can occur

41
Q

How do you identify a subarachnoid haemorrhage?

A
  • patient complains of thunderclap headache
  • CT image
  • lumbar puncture if CT if inconclusive: sample CSF to identify presence of blood (haemoglobin degradation products)
42
Q

From the superior sagittal sinus, what is the route that venous blood takes as it leaves the cranial cavity?

A

Superior sagittal sinus
Confluence of sinuses
Transverse sinus
Sigmoid sinus
Internal jugular vein

43
Q

Connections of the falx cerebri

A
  • superior: top of skull
  • inferior: corpus collosum
  • anterior: anterior skull
  • posterior: posterior skull
44
Q

What is a characteristic history for a patient with an extradural haemorrhage?

A

Older patients
Alcoholics
On anticoagulants
Bump to head
Gradual decline

45
Q

A patient complains of the worst headache of their life, what is the most likely diagnosis?

A

Subarachnoid haemorrhage

46
Q

What layers is a subdural haemorrhage between?

A

Dura mater + Arachnoid mater

47
Q

What layers is a subarachnoid haemorrhage between?

A

Arachnoid mater + pia mater

HNN (24 decks)

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