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Neurology > Meninges, Ventricles, CSF, Blood Supply > Flashcards

Meninges, Ventricles, CSF, Blood Supply Flashcards

1
Q

Which two arteries is the brain supplied by?

A

The internal carotid and the vertebral arteries

Anastamose at the circle of willis

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2
Q

In which space do the cerebral and cerebellar arteries given off by the circle of willis run?

A

The subarachnoid space

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3
Q

What is the course of the ICA?

A

Runs in the carotid canal of the petrous temporal bone, through the cavernous sinus, into the middle cranial fossa.

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4
Q

Describe the course of the vertebral arteries

A

Ascend through the transverse foramen in the upper six cervical vertebrae

Enter the posterior cranial fossa via the foramen magnum

Unite to form the basilar artery at the lower border of the pons which bifurcates to form the posterior cerebral artery

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5
Q

Where do the anterior cerebral arteries supply?

A

The medial surfaces of the frontal and parietal lobes

Continue to the parieto-occipital sulcus

The leg area of the somatosensory cortex

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6
Q

Where do the posterior cerebral arteries supply?

A

The inferior surface of the brain and the occipital lobes

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7
Q

Where do the middle cerebral arteries supply?

A

The lateral surface of the cerebral cortex

Most of the dorsilateral surface

The motor and sensory area of the central sulcus (except the leg area)

Speech and language areas

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8
Q

Blood supply to the cerebellum?

A

The superior cerebellar artery (terminal branch of the basilar artery)

Anterior inferior cerebellar artery (branch of the basilar artery)

Posterior inferior cerebrellar artery (branch of the vertebral arteries)

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9
Q

Where do the pontine arteries supply?

A

The pons and adjacent areas of the brain

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10
Q

What are the main routes of venous drainage of the brain?

A

Cerebral veins and venous sinuses, all draining into the internal jugular vein

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11
Q

Where are the cerebral veins found?

A

External (bridging) cerebral veins - subarachnoid space

Internal cerebral veins (drain deeper structures) emerge from the transverse fissure

Bridging veins cross the subdural space to drain into venous sinuses found within the dura mater layers

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12
Q

In which space are the arteries supplying the spinal cord?

A

In the pia mater

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13
Q

What is the blood supply to the spinal cord?

A

Posterior spinal arteries supply the dorsal columns

The rest is supplied by the anterior spinal artery

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14
Q

What is the artery that reinforces the anterior spinal artery in the thoracic region?

A

The artery of Adamkiewicz off the abdominal aorta

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15
Q

Attachments of the falx cerebri?

A

Crista galli anteriorly

Horizontal tentorium cerebelli posteriorly

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16
Q

What does the tentorium cerebelli separate?

A

Cerebellum and the occipital lobe

Divides the brain into supratentorial and infratentorial regions

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17
Q

Arterial supply and venous drainage of the dura mater?

A

Middle meningeal artery

Emissary veins connect the dural venous sinuses (found between the two dural layers) to the veins outside the cranium

18
Q

What forms the leptomeninges?

A

The arachnoid mater and pia mater

19
Q

What lies in the subarachnoid space?

A

CSF

Cerebral arteries and veins

Bridged by trabeculae

Arachnoid granulations

20
Q

How is CSF drained?

A

Arachnoid granulations branch through the meningeal layer of the dura mater into dural venous sinuses to allow CSF to drain into systemic circulation from the subarachnoid space

21
Q

What is the dural sac?

A

The long tubular sheath of of dura mater that runs within the vertebral canal

From the foramen magnum to below the conus medullaris

Anchored by the filum terminale

22
Q

What is the name of the dural sac caudal to the conus medullaris? What does it contain?

A

Lumbar cisterna

Contains the cauda equina and CSF

23
Q

Where is the epidural space in the vertebral column?

A

Between the dura mater and the periosteum and ligaments that form the vertebral canal

Terminates laterally at each IV foramen

24
Q

What can the subarachnoid space be used for?

What can the epidural space be used for?

A

Subarachnoid: lumbar punctures

Epidural: epidural anaesthetics

25
Q

Between which vertebrae is the needle inserted in an LP?

A

L3 and L4

26
Q

Which structures does the needle pass through in an LP?

A

Supraspinous ligament

Ligamentum flavum

Punctures the dura mater and arachnoid mater

Into the lumbar cistern

27
Q

When should LPs not be performed?

A

If there is any chance of raised ICP

28
Q

Why is an epidural anaesthetic injected into the epidural space?

A

So it can bathe the spinal roots

29
Q

Which cells secrete CSF and where are they found?

A

Chroroid plexus cells

Line the ventricles

30
Q

What is the movement of CSF?

A

Lateral ventricles to third ventricle via foramina of Monro (interventricular foramen)

Third ventricle to fourth via the cerebral aqueduct

Fourth ventricle to subarachnoid space via median aperture or paired lateral apertures

Over the cerebral hemispheres to enter arachnoid villi

Flow into the dural venous sinuses

31
Q

What stops CSF from flowing back into the subarachnoid space from the dural venous sinuses?

A

Pressure in the subarachnoid space is higher than in the dural venous sinuses

32
Q

What is the composition of CSF compared to blood?

A

Less protein

Less glucose, Ca, K

More Na, Cl, Mg

33
Q

How is CSF formed?

A

Initial filtration of blood through fenestrations of endothelial cells that line choroidal capillaries

Tight junctions prevent movement of peptides, proteins and other large molecules

Active transporters alter the CSF composition and osmotic movement of water maintains osmotic balance

34
Q

Functions of the CSF?

A

Cushions CNS, dampening effect of trauma

Removes metabolites from the CNS

Provides a stable ionic environment for the CNS

35
Q

Location of the third and fourth ventricles?

A

Third: Occupies the midline

Fourth: Posterior to the pons and upper half of the medulla, ventral to the cerebellum

36
Q

What is the shape of the lateral ventricle?

A

Anterior, posterior and inferior horn

Body

37
Q

What is hydrocephalus?

A

Increase in CSF volume within the ventricular system

38
Q

When is hydrocephalus formed?

A

When the circulation of CSF is blocked or absorption is impeded whilst CSF production continues at the normal rate

39
Q

What is non-communicating hydrocephalus?

Causes?

A

Where movement of the CSF out of the ventricular system is impeded so cannot enter the subarachnoid space

Tumour, Dandy-Walker syndrome

40
Q

What is communicating hydrocephalus?

Causes?

A

Where reabsorption of the CSF into the dural sinuses is impeded due to function impairment of the arachnoid villus/granulation

Subarachnoid haemorrhage

Meningitis - where there is fibrosis of the subarachnoid space

41
Q

How are the two types of hydrocephalus distinguished?

A

A tracer dye is injected into the lateral ventricle. If it appears in the spinal tract it is communicating, if it does not then it is non-communicating

Neurology (20 decks)

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