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?

A

headaches

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
Q

what is leptomeningitis?

A

inflammation of leptomeninges (arachnoid and pia) from pathogenic microorganisms

26
Q

how does leptomeningitis get into the subarachnoid space to the arachnoid and pia maters?

A

septicemia, cranial fracture, or fracture of nasal sinuses

27
Q

epidural hemorrhage occurs from?

A

tear of middle meningeal that results in pool of blood between periosteal layer of dura and calvaria

28
Q

epidural hematoma can cause?

A
  • concussion
  • drowsiness and coma
  • compression of brain
29
Q

how do you fix an epidural hematoma?

A

evacuation of blood and occlusion of bleeding vessels

30
Q

what is a subdural hematoma?

A

extravasated blood from bridging veins that pools in between dura and arachnoid maters

31
Q

blood pooling into subarachnoid space is called?

A

subarachnoid hemhorrage (arterial)

32
Q

how do subarachnoid hemorrhages occur?

A

rupture of saccular aneurysm (sac on side of artery)

33
Q

what is a cerebral concussion?

A

abrupt and brief loss of consciousness after a severe head injury

34
Q

what is chronic traumatic encephalopathy?

A
  • 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
Q

what is diffuse axonal injury?

A

acceleration or deceleration of brain that stretches or shears axons (cause of brain injury)

36
Q

what is cerebral contusion?

A
  • brain trauma that pulls the pia away from injured surface of brain
  • blood enters subarachnoid space
37
Q

what is a cerebral laceration?

A
  • associated with depressed cranial fractures
  • rupture of blood vessels and bleeding into brain
  • increased intracranial pressure and cerebral compression
38
Q

what is a cisternal puncture?

A
  • collection of CSF from posterior cerebellomedullary cistern
  • used in children (similar to lumbar puncture in adults)
39
Q

where is a needle inserted for a cisternal puncture?

A

posterior atlanto-occipital membrane into cistern

40
Q

what is obstructive hydrocephalus?

A

excess fluid in cerebral ventricles and enlargement of the head

41
Q

what can cause obstructive hydrocephalus?

A
  • overproduction of CSF

- obstruction of CSF flow

42
Q

how does obstructive hydrocephalus occur?

A

excess CSF dilates ventricles and thins the cerebral cortex and separates bones of calvaria in infants

43
Q

where is the most common blockage of CSF?

A

cerebral aqueduct or interventricular foramen

44
Q

what can cause aqueductal stenosis?

A

tumor in midbrain or cellular debris from intraventricular hemorrhage or bacterial infection of CNS

45
Q

what is communicating hydrocephalus?

A

flow of CSF through ventricles into subarachnoid space is not impaired, but flow of CSF from subarachnoid space into venous system is blocked

46
Q

what is CSF otorrhea?

A

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
Q

CSF leakage through the nose (CSF rhinorrhea) is caused by?

A

fractures in floor of anterior cranial fossa involving the cribiform plate of ethmoid

48
Q

CSF otorrhea and rhinorrhea increases the person’s risk for?

A

meningitis

49
Q

cerebral embolism can cause?

A
  • 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
Q

what is an ischemic stroke?

A

sudden neurological deficits related to impaired cerebral blood flow

51
Q

what is an ischemic stroke caused by?

A

embolism in major cerebral artery

52
Q

what provides collateral circulation in case of a stroke?

A

cerebral arterial circle

53
Q

what kind of saccular aneurysms are most common in the cerebral arterial circle?

A

berry aneurysms

54
Q

what can cause rupture of an aneurysm in the brain?

A

hypertension causing weakness in arterial wall

55
Q

rupture of an aneurysm causes what symptoms?

A

huge headache and stiff neck (gross bleeding into subarachnoid space)

56
Q

what can an atheromatous plaque cause?

A
  • progressive narrowing of artery which can cause neurological deficits
  • embolus can break off and occlude an artery in the brain
57
Q

what is a transient ischemic attack?

A
  • neurologic symptoms from ischemia

- dizziness, light-headedness, fainting, and parathesia