Meninges Flashcards

1
Q

a fracture to the pterion can be life threatening because?

A

it overlies the frontal branches of middle meningeal vessels —> hematoma

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2
Q

how does an infection of the face travel to the cavernous sinus and pterygoid venous plexus?

A
  • the facial vein drains to superior opthalmic vein which drains into the cavernous sinus
  • the inferior opthalmic vein and deep facial veins all drain into the pterygoid venous plexus
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3
Q

why can blood drain from the facial vein to the cavernous sinus?

A

the facial vein doesn’t have valves

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4
Q

what is thromboplebitis of the facial vein?

A

inflammation of the facial vein with secondary thrombus formation —> thromboplebitis of the cavernous sinus

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5
Q

a blow to the cranial base can cause?

A

fracture –> tear of the dura and leakage of CSF

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6
Q

space occupying lesions or tumors can cause what in the supratentorial compartment?

A

increased intracranial pressure and temporal lobe herniation through the tentorial notch

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7
Q

what can tentorial herniation cause?

A

laceration of temporal lobe by tentorium cerebelli and stretching of CN III

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8
Q

lesions to CN III (occulomotor) can cause?

A

paralysis of the extrinsic eye

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9
Q

pituitary tumors can cause?

A

bulging of diaphragmatic sellae —> disturbances in endocrine function

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10
Q

superior extension of pituitary tumor can cause?

A

visual symptoms from pressure on optic chiasm

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11
Q

occlusions of the cerebral veins and dural venous sinuses can be caused by?

A

thrombi, thrombophlebitis, or tumors (meningiomas)

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12
Q

which dural venous sinuses are most frequently thrombosed?

A

transverse, cavernous, & superior sagittal

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13
Q

cavernous sinus thrombosis occurs from?

A

infections of the face in orbit, nasal sinuses, and superior part of face

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14
Q

thrombophlebitis of cavernous sinus can affect which nerve?

A

abducens nerve and nerves in lateral wall of sinus

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15
Q

septic thrombosis of cavernous sinus can cause?

A

acute meningitis

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16
Q

the basilar and occipital sinuses communicate with? through which structure?

A
  • internal vertebral plexuses

- foramen magnum

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17
Q

how can pus and tumor cells from basilar and occipital sinuses spread to the vertebrae and brain?

A

veins are valveless, so coughing can force venous blood into internal vertebral venous system to the dural venous sinuses

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18
Q

an arteriovenous fistula in the internal carotid can be caused by?

A

blow to base of cranium

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19
Q

what happens as a result of arteriorvenous fistula in the internal carotid?

A

arterial blood into cavernous sinus, which enlarges and forces blood retrogradely into the opthalmic vein —> exophthalmos (protruding eye) and chemosis (engorgement of conjunctiva)

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20
Q

what is pulsating exophthalmos?

A

protruding eye that pulses with the radial pulse

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21
Q

which nerves can be affected with the cavernous sinus is injured?

A

CN III, CN IV, CN V1, CN V2, and CN VI (in or close to lateral wall of sinus)

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22
Q

what is actually hurting during a headache?

A

dura, especially where it’s close to dural venous sinuses and meningeal arteries

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23
Q

distention of scalp or meningeal vessels causes?

24
Q

lumbar punctures for CSF removal and spinal nerve blocks can cause headaches because?

A

stimulation of sensory nerve endings of the dura AND/OR stretching of meninges and dura

25
what is leptomeningitis?
inflammation of leptomeninges (arachnoid and pia) from pathogenic microorganisms
26
how does leptomeningitis get into the subarachnoid space to the arachnoid and pia maters?
septicemia, cranial fracture, or fracture of nasal sinuses
27
epidural hemorrhage occurs from?
tear of middle meningeal that results in pool of blood between periosteal layer of dura and calvaria
28
epidural hematoma can cause?
- concussion - drowsiness and coma - compression of brain
29
how do you fix an epidural hematoma?
evacuation of blood and occlusion of bleeding vessels
30
what is a subdural hematoma?
extravasated blood from bridging veins that pools in between dura and arachnoid maters
31
blood pooling into subarachnoid space is called?
subarachnoid hemhorrage (arterial)
32
how do subarachnoid hemorrhages occur?
rupture of saccular aneurysm (sac on side of artery)
33
what is a cerebral concussion?
abrupt and brief loss of consciousness after a severe head injury
34
what is chronic traumatic encephalopathy?
- punchdrunk syndrome - brain injury causes weakness of lower limbs, unsteady gait, slowness of muscular movements, tremors of hands, hesitancy of speech, and slow cerebration
35
what is diffuse axonal injury?
acceleration or deceleration of brain that stretches or shears axons (cause of brain injury)
36
what is cerebral contusion?
- brain trauma that pulls the pia away from injured surface of brain - blood enters subarachnoid space
37
what is a cerebral laceration?
- associated with depressed cranial fractures - rupture of blood vessels and bleeding into brain - increased intracranial pressure and cerebral compression
38
what is a cisternal puncture?
- collection of CSF from posterior cerebellomedullary cistern - used in children (similar to lumbar puncture in adults)
39
where is a needle inserted for a cisternal puncture?
posterior atlanto-occipital membrane into cistern
40
what is obstructive hydrocephalus?
excess fluid in cerebral ventricles and enlargement of the head
41
what can cause obstructive hydrocephalus?
- overproduction of CSF | - obstruction of CSF flow
42
how does obstructive hydrocephalus occur?
excess CSF dilates ventricles and thins the cerebral cortex and separates bones of calvaria in infants
43
where is the most common blockage of CSF?
cerebral aqueduct or interventricular foramen
44
what can cause aqueductal stenosis?
tumor in midbrain or cellular debris from intraventricular hemorrhage or bacterial infection of CNS
45
what is communicating hydrocephalus?
flow of CSF through ventricles into subarachnoid space is not impaired, but flow of CSF from subarachnoid space into venous system is blocked
46
what is CSF otorrhea?
fractures in floor of middle cranial fossa can cause CSF leakage from external acoustic meatus if meninges superior to middle ear are torn and tympanic membrane is ruptured
47
CSF leakage through the nose (CSF rhinorrhea) is caused by?
fractures in floor of anterior cranial fossa involving the cribiform plate of ethmoid
48
CSF otorrhea and rhinorrhea increases the person's risk for?
meningitis
49
cerebral embolism can cause?
- cerebral ischemia and infarction to the area supplied by cerebral artery affected - anastomoses of cerebral arteries are NOT enough to compensate for occlusion of one of these arteries
50
what is an ischemic stroke?
sudden neurological deficits related to impaired cerebral blood flow
51
what is an ischemic stroke caused by?
embolism in major cerebral artery
52
what provides collateral circulation in case of a stroke?
cerebral arterial circle
53
what kind of saccular aneurysms are most common in the cerebral arterial circle?
berry aneurysms
54
what can cause rupture of an aneurysm in the brain?
hypertension causing weakness in arterial wall
55
rupture of an aneurysm causes what symptoms?
huge headache and stiff neck (gross bleeding into subarachnoid space)
56
what can an atheromatous plaque cause?
- progressive narrowing of artery which can cause neurological deficits - embolus can break off and occlude an artery in the brain
57
what is a transient ischemic attack?
- neurologic symptoms from ischemia | - dizziness, light-headedness, fainting, and parathesia