Meninges and CSF* Flashcards

1
Q

What are the meninges?

A

They are three layers of connective tissue that cover the brain and spinal cord and carry blood vessels to/from the brain.

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2
Q

What is cerebrospinal fluid?

A

It is formed within cavities in to the brain and circulates around the brain and spinal cord. It is involved in the nutrition of the brain and is also protective.

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3
Q

What are the 3 meningeal layers from outside inwards?

A

Dura, Arachnoid, Pia.

(DAP)

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4
Q

What is the dura mater?

A

It is a very thick fibrous layer lining the skull bones forming the cranial cavity. It has two layers which are closely adherent to each other.

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5
Q

How is the likelohood of teared vessels or nerves minimised in the brain?

A

Because the falx cerebri stabilizes the brain when the head is moved left or right. The tentorium cereblli stabilises the brain when the head is moved forwards or backwards.

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6
Q

What is the falx cerebri?

A

A vertical sheet of dura between the 2 cerebral hemispheres.

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7
Q

What is the tentorium cerebelli?

A

It is a horizontal sheet of dura forming a roof over the cerebellum separating it from the occipital lobes of the cerebral hemispheres.

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8
Q

Where are the venous sinuses formed?

A

They are formed where the dura is reflected off the skull and the two layers separate temporarily.

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9
Q

Explain the role of the venous sinuses?

A

They are held open under any circumstances because of the thickness of their walls, ensuring emptying of venous blood and perfusion of the brain.

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10
Q

What is the pia mater?

A

It is a thin layer of connective tissue adherent to the surface of the brain and spinal cord and extending into the sulci of the brain.

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11
Q

What does the arachnoid mater form?

A

It forms a thin layer on the inner surface of the dura and extends thin filaments to contact the pia. This created a slight gap between the dura and pia.

CSF circulates between the arachnoid and pia.

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12
Q

Where does the dura and overlying bones recieve their blood supply from? and is there a gap?

A

From meningeal arteries between the bone and dura. The dura is tightly adherent to the skull bones so there is no gap here. It is a potential space known as extradural space.

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13
Q

What is cerebrospinal fluid?

A

It is a filtrate of blood. Produced in specialized tissue called the choroid plexus located in the ventricles.

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14
Q

Explain how the four ventricles communicate.

A

2 Lateral ventricles communicate with the third ventricle which is a slit like cavity in the midline between the 2 halves of thalamus.

The third ventricle communicates with the fourth located between the brainstem and cerebellum.

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15
Q

Explain where the CSF goes?

A

It is produced in all 4 ventricles. It enters the subarachnoid space and 4th ventricle, circulates around the brain and spinal cord. It is reabsorbed into the cardiovascular system in the venous sinuses.

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16
Q

What are the functions of CSF?

A
  • It cushions and protects the brain and spinal cord, making sudden movements minimal.
  • It also helps in the diffusion of nutrients to and removal of waste products from the brain.
  • The levels of CO2 in CSF are important regulators of respiratory drive. High CO2 will increase respiratory rate to clear CO2.
17
Q

What causes hydrocephalus?

A

It occurs if the CSF circulation is impaired by space-occupying lesions such as tumours or because the ventricular system fails to develop fully.

18
Q

How is hydrocephalus treated?

A
  • inserting a subcutaneous shunt to remove CSF from the ventricles and carry it to the venous system usually the external jugular vein.
19
Q

Why is CSF sometimes withdrawn? and how is it achieved?

A

Sometimes it is withdrawn to detect the presence of blood or identify infection.

It is achieved by lumbar puncture by inserting a needle between third and fourth lumbar vertebrae. The same route is used for epidural anesthetics