Meninges + ventricles + liquor Flashcards by LV D

Differentiate btw meninges.

pachymeninx = dura mater
leptomeninx = arachnoidea, pia mater

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1 - 5

2 terms for #2, #3, #5

Function of #5.

1) pia mater
2) dura mater - lamina ext. (periosteal layer)
3) dura mater - lamina int. (meningeal layer)
4) arachnoidea
5) granulationes arachnoideales (PACCHIONI) → secretion of liquor into blood

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6 - 10

What does #7 contain?

6) falx cerebri
7) spatium subarachnoideum → contains liquor
8) spatium epidurale
9) spatium subdurale
10) foveae granularis

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11 - 14

11) sulcus
12) gyrus
13) sinus durae matris
14) trabeculae arachnoideae

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Which structures are formed by dura mater lamina int.?

cavum trigeminale (MECKEL)
diaphragma sellae covers fossa hypophysialis
falx cerebri, cerebelli btw their resp. hemispheres
tentorium cerebelli covers cerebellum

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Where can falx cerebri be found?

Sites of attachment?

Content?

btw hemispheres of cerebrum in fissura longitudinalis cerebri

attaches to:

ant.: crista galli
post.: protuberantia occipitalis int.

__contents:

sinus sag. sup. + inf.
sinus rectus

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Where is the tentorium cerebelli located?

Site of attachment?

covers cerebellum + post. cranial fossa

attaches to procc. clinoidei post., ant.

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What are the functions of falx cerebri and tentorium cerebelli?

Why are they clinically relevant?

mechanical protection

→ prevent major displacement of brain, e.g. in case of cranial trauma

⇒ cerebellum can be pushed into foramen magnum, causes pressure on medulla oblongata (resp., circulatory centers) → life-threatening

= tonsillar herniation

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Which structures pass through incisura tentorii? (4)

Why is it clinically relevant?

brain stem
aa. cerebri post.
CN III + IV

⇒ swellings in case of cranial trauma (brain bleedings), brain tumors can push midbrain/temporal lobe into incisura tentorii → e.g. constriction of n. oculomotorius

= tentorial herniation

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Which pathological condition can be caused by Pacchioni granules?

meningeoma

→ almost always benign, can reach size of a fist

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What is special about the pia mater?

forms perivascular sheath around blood vessels when diving deep into brain, forms spatium perivasculosum

in case of large blood vessels: VIRCHOW-ROBIN space (VRS) can be seen on the MRI when dilated

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Which meninges are inflammed in case of a meningitis?

leptomeninx =

arachnoidea, pia mater

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Describe the blood supply, drainage of the meninges.

pia mater supplied by cerebral aa., arachnoidea no blood supply

dura mater: (EMP)

a. _e_thmoidalis ant. → r. meningeus ant.
a. _m_axillaris → a. meningea med.
a. _p_haryngea asc. → a. meningea post.
further rr. from a. vertebralis

drainage analog to supply

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Which vessels cause epidural, subdural, subarachnoidal bleedings?

Possible consequences?

esp. a. meningea med. → epidural → detachment of dura mater from calvaria (top left)
bridging veins of sinus durae matris → subdural → compression/displacement of brain parts (e.g. tentorial herniation) (top right)
a. of circle of Willis → subarachnoideal aneurism → head aches, meningitis, etc. (bottom)

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Which nn. innervate the meninges?

mainly n. V

n. ethmoidalis post. → ant. cranial fossa
n. V/1 → tentorium cerebelli
n. V/3 → med. cranial fossa
nn. IX + X → post. cranial fossa
C1 - 3 → clivus area

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How much liquor does each person have? Where?

What for?

How fast is it produced?

Contents?

volume: 110 - 160 ml (30 in ventricles, 80 in cran. subarach.space, 50 in spinal subarach. space)
function: cushion, regulation of breath centers (via CO₂ conc.), buoancy, transport
production rate: - 500 ml/d
content: low cell content (T-lymphocytes, monocytes), low protein content, electrolytes = plasma

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What is the choroid lamina epithelialis?

layer of modified ependymal cells persisting after thinning of the original wall of the brain vesicles

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What is tela choroidea?

choroid lamina epithelialis + pia mater

forms together w/ vascular network inside plexus choroideus

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Where can plexus choroideus be found?

each ventricle has its own plexus choroideus

BUT: exc. cornu frontale/occipitale
_{<em>(plexus choroideus of lat. ventr. reaches into cornu occ.)</em>}

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Where is the plexus choroideus attached?

taenia = line of attachment of tela choroidea

attachment sites lat./III. ventricle:

taenia thalami (red) lateral to stria medullaris thalami
taenia choroidea (green) in lat. ventricle
taenia fornicis (blue) medially, attached to fornix
taenia fimbriae (orange) medially, running along fornix (inferior part, originating from fimbria)
taenia terminalis (purple) laterally

attachment site IV. ventricle

taenia cinerea attached to velum medullare inf.

1 - 5

Another name for #5.

1) lat. ventricle - cornu frontale
2) lat. ventricle - pars centralis
3) lat. ventricle - cornu occipitale
4) lat. ventricle - cornu temporale
5) foramen interventriculare (MONROE)

6 - 10

6) adhesio interthalamica
7) III. ventricle - recessus supraopticus
8) III. ventricle - recessus triangularis (most anterior)
9) III. ventricle - recessus infundibularis
10) III. ventricle - recessus suprapinealis

11 - 15

11) III. ventricle - recessus pinealis
12) corpus pineale
13) chiasma opticum
14) aqueductus mesencephali
15) IV. ventricle - fastigium

16 - 19

Another name for #16, #17, #19.

16) IV. ventricle - apertura mediana (MAGENDIE)
17) IV. ventricle - apertura lateralis (LUSCHKA)
18) canalis centralis
19) granulationes arachnoidales (PACCHIONI)

What are the walls of cornu frontale of the lat. ventricle?

* *med.:* septum pellucidum * *lat.:* ncl. caudatus, caput * *floor:* corpus callosum, rostrum * *roof:* corpus callosum, truncus * *rostral:* corpus callosum, genu

What are the walls of pars centralis of the lat. ventricle?

* *med.:* choroid lamina epithelialis (attached to fornix + thalamus by teniae), resp. tela choroidea * *lat:* ncl. caudatus, corpus * *floor:* thalamus covered by lamina affixa * *roof:* corpus callosum, truncus

What are the walls of cornu occipitale of the lat. ventricle? BUT ... ?

* *med.:* corpus callosum, tapetum * *other walls:* medulla of occip. lobe _BUT:_ further structures can be found * *med.:* forceps major, calcar avis * *floor:* trigonum collaterale

What are the walls of cornu temporale of the lat. ventricle?

* *med.:* choroid lamina epithelialis + stria terminalis * *lat.:* medulla of temp. lobe * *floor:* hippocampus, eminentia collateralis * *roof:* ncl. caudatus, cauda * *rostr.:* corpus amygaloideum

What are the walls of the III. ventricle?

* *lat.:* thalamus, hypothalamus, sulcus hypothalamicus * *floor:* hypothalamus, chiasma opticum, infundibulum, corp. mamm., subthalamus * *roof:* choroid lamina epithelialis of III. ventricle * *rostr.:* lamina terminalis, commissura ant. * *caud.:* commissura habenularum, post.

What are the walls of the IV. ventricle?

* *floor:* fossa rhomboidea (7) * *roof:* velum medullare sup. (1), fastigium (2), nodulus of cerebellum (3), choroid lamina epithelialis (4) * *lat.:* pedunculi cerebellares

What are the rostral and caudal border of foramen interventriculare?

* *rostr.:* **columna fornicis, pars libera** * *caud.:* **thalamus, tuberculum anterius**

List the 7 circumventricular organs. Function?

**no blood-brain barrier** → sensory/secretory function

How do you call the structure formed by plexus choroideus of the IV. ventricle?

reaches through aperturae laterales out into subarachnoid space = **flower basket of BOCHDALEK**

What is a common cause of a hydrocephalus? Consequences?

e.g. stenosis of aqueduct → **incr. intracranial pressure due to accumulation of liquor** **in ventricles** ⇒ head aches, vomitting, visual disorders, damaged brain tissue, incr. skull size when during childhood

How do you call the thickened end of plexus choroideus in the lat. ventricle?

**glomus choroideum**

List unpaired cisterns.

* **cisterna cerebellomedularis = magna** * **cisterna pontis mediana** * **cisterna interpeduncularis** * chisterna chiasmatis * cisterna laminae terminalis * **cisterna corporis callosi** * **cisterna v. magnae cerebri**

Classify cisterna pontis mediana according to its location and content.

btw clivus and the ventr. surface of the pons

Classify cisterna magna according to its location and content. Another name. Why is it clinically relevant?

**cisterna cerebellomedullaris** btw medulla oblongata and the inf. surface of the cerebellum ⇒ site of cistern punction

Classify cisterna interpeduncularis according to its location and content.

outskirts on fossa interpeduncularis and corpus mammilare

Classify cisterna chiasmatis according to its location and content.

area of chiasma opticum, in front of cisterna interpeduncularis. A laminar connective tissue divide them from each other

Classify cisterna laminae terminalis according to its location and content. Which cisterns does it connect?

in front of lamina terminalis ⇒ interconnects the cisterna chiasmatis w/ corporis callosi

Classify cisterna corporis callosi according to its location and content. Why is it important?

above corpus callosum ⇒ leads the CSF on the medial surface of the hemispheres

Classify cisterna v. magnae cererbi according to its location and content. Which cisterns does it connect?

btw lamina tecti and the splenium of corpus callosum; posteriorly extends to velum medullare sup. ⇒ interconnects both cisternae ambientes w/ cisterna corporis callosi

List paired cisterns.

* **cisterna pontocerebellaris** * **cisterna ambiens** * cisterna cruris * **cisterna fossae lateralis cerebri** * cisterna carotica

Classify cisterna pontocerebellaris according to its location and content.

_paired_ extends from the cerebellopontine angles,  a) lateraly to the meatus acusticus int. b) forward to the cavum trigeminale

Classify cisterna ambiens according to its location and content. Which cisterns does it connect?

_paired_ lat. surface of midbrain ⇒ interconnects the cisterna interpeduncularis w/ cistern v. magnae cerebri

Classify cisterna cruris according to its location and content.

_paired_ lateraly from cisterna ambiens, between crus of midbrain and gyrus parahippocampalis

Classify cisterna lateralis according to its location and content. Why is it important?

_paired_ in sulcus lateralis (SYLVII) ⇒ leads the CSF from basal surface, to dorsal surface of the brain

Classify cisterna carotica according to its location and content. Why is it important?

_paired_ around a. carotis int. ⇒ covers the containg aa.