Meninges and sinuses

Question 1

Dural venous sinus=between these two layers

Answer 1

meningeal+internal periostium (on bone and blends w/ meningial membrane that sticks closely together)

Question 2

courses up into cranial vault

• supplies most of dura
• just deep to pterion (VERY THIN!)

Answer 2

Middle meningeal artery

Question 3

lateral blows to head at pterion cause:

Answer 3

= Epidural hemitoma

Question 4

CC: Epidural hematoma;

Answer 4

start to see dissection on meningeal layers away from bone, specifically periosteal layer (which wraps all way around cranial bone) Once hit suture line, ≠go further thus defiitive lensticular sizes)

Question 5

travels on inside of skull btwn meningeal and periostal layers = extra dural~ cause a groove in bone

Answer 5

Middle Meningeal Artery and Vein:

Question 6

Shearing of veins in subarachnoid space:

Answer 6

these guys don’t have specific shape = amorphous

Question 7

arachnoid + space of arachnoid + pia mater, is in contact w/ CSF or space where CSF circulates

Answer 7

Leptomeninges:

Question 8

Meninges and Superficial Cerebral Veins:

-beneath arachnoid layer; drain into?

Answer 8

into venous sinuses

Question 9

shearing of these guys during trauma d/t fixed dura mater and mobile brain~ brain moves and these shear off and can get subarachnoid hemorrhages

Answer 9

Superficial cerebral veins

Question 10

Tentorial Nerve does the posterior aspect of dura

Answer 10

V1

Question 11

does the middle aspect and lateral edge of the dura

Answer 11

V3:

Question 12

more anterior and internal part of dura

Answer 12

V2:Meningeal branch of Maxillary nerve

Question 13

innervates most of dura

Answer 13

V

Question 14

CC: responsible for dural headaches

Answer 14

V

Question 15

These guys embedded w/in dura matter~

Answer 15

Dural Venous Sinuses:

Question 16

w/in falx cerebri (double layer of dura) w/in outtermost layer→ drains into confluence of sinuses

Answer 16

Superior Sagittal sinus

Question 17

Where does the superior sagital sinus drain into?

Answer 17

Confluence of sinuses

Question 18

-Confluence of sinuses=

Answer 18

transvers (2) + Straight sinus (2)

Question 19

Sinus that on either side of celica tersica

*sits close to cranial nerves

Answer 19

Cavernous Sinus

Question 20

Cavernous Sinus drainage pattern

Answer 20

-blood drains from here →Superior Petrosal sinus

Question 21

This sinus lies along petrossal ridge

Answer 21

Superior Petrosal Sinus

Question 22

Drains →Internal Jugular Vein

Answer 22

Inferior Petrossal sinus

Question 23

made of Inferior petrosal sinus + Sidgmoid Sinus as they meet

Answer 23

Inferior jugular vein

Question 24

What passes through the Internal Jugular Foramen

Answer 24

IJV and CN 9, 10, 11

Question 25

General flow in standing person:

Answer 25

Start at vortex of head→Superior Sagittal Sinus→ Confluence sinus where Transverse Sinus and Straight sinus meet up→ goes down through Transverse→Sigmoid Sinus→ becomes Internal Jugular Vein

Question 26

Falx Cerebri superior edge =

Answer 26

superior sagittal sinus→ flows into confluence of sinuses

Question 27

Falx Cerebri inferior edge=

Answer 27

inferior edge= inferior sagittal sinus → Straight sagittal sinus into Confluence

Question 28

Orbital veins + pterigoid venous plexus contributions + deep facial vein dump into here

Answer 28

Cavernous sinus

Question 29

Internal Jugular Vein: meets up w/ subclavian =

Answer 29

brachiocephalic

Question 30

Which side is prefered for a Central line Cath: find SCM~ go btwn it’s 2 bellies

Answer 30

CC: Right side

Question 31

What do these guys have in common Facial Vein:Superior and inferior opthalmic veins Venous plexus + Pterygoid plexus

Answer 31

Drain into superior sagittal sinus

Question 32

Infection or thrombis in cavernous sinus is trouble bc what nerves are in this area?

Answer 32

CN III, IV, V1, V2, VI

Question 33

Which nerve is affected first if there is infection in cavernous sinus?

Answer 33

VI (Abducent or lateral eye muscle so can see on eye exam and or double vision)

Question 34

Symptoms of cavernous sinus infection

Answer 34

CC: Cavernous sinus or thrmobosis: issues w/ extraoccular eye muscle (VI and CN 3 and trochlear does one of them) Stabbing pain along distribution of V1(tip of nose to forehead) and V2( lower eyelid to upper lip) Infection from nasal cavities/sinus or directly from venous system

Question 35

pterion made of what 4 bones

Answer 35

(frontal + parietal + temporal + sphenoid)