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Anatomy > Neuroanatomy > Flashcards

Neuroanatomy Flashcards

0
Q

Clinical: Scalp

A

Scalp infection
Loose CT layer: blood and pus build up in this layer, passing into cranial cavity via emissary veins.
Infection or fluid can enter the eyelid from the scalp- frontalis m insertions into skin and subcutaneous tissue not bone.

Scalp lacerations
Bleed profusely due to numerous anastomoses between carotid aa
Black eyes: injury to scalp and forehead

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1
Q

Layers of the Scalp

A

Skin: good arterial supply and venous and lymphatic drainage
Connective Tissue layer : cutaneous nerve supply, highly vascular used
Aponeurosis (Epicranial Aponeurosis) : formed by the frontal is and occipitalis muscle.
Loose CT: has potential spaces I.e infection, allows for free movement of the first three layers
Pericranium: is continuous with the fibres of the cranial sutures and this can’t be removed easily from there. Forms external periosteum of the cavaria

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2
Q

Name the parts of the brain that are directly related to the floor of each of the cranial Fossae

A

Ant Cranial Fossa: frontal lobes
Middle cranial fossa: hypophysis, temporal lobes
Post Cranial fossa: brainstem, cerebellum

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3
Q

Meningeal arrangement

A
  1. Dura mater: external layer, fused with endosteum of the skull
  2. Arachnoid mater: middle layer, in direct contact with dura, numerous arachnoid trabeculae cross the space to reach the pia mater
  3. Pia mater: innermost layer, invests brain closely
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4
Q

Meningeal spaces

A

Epidural space: between skull and dura mater, potential space

Subdural space: dura and archanoid, potential space

Subarachnoid space: between arachnoid and pia mater, actual space- contains CSF, trabecular cells, arteries and veins

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5
Q

Dural venous sinuses: Location

A

Sup Sagittal: in attached border of flax cerebri
Inf Sagittal: free border of falx cerebri
Straight sinus: along line of falx cerebri to tentorium cerebelli
Transverse sinus: occipital and parietal(bone) attachment of tentorium cerebelli
Sup petrosal sinus: attachment of tentorium cerebelli to sup border of petrous temporal bone
Inf petrosal sinus: junction of petrous temporal bone and the clivus
Sigmoid sinus: descends along occipital bone to bulb of IJV
Sphenoparietal sinus: along lesser wing of sphenoid bone
Cavernous sinus: lat to body of sphenoid bone
Marginal sinus: surrounds foramen magnum
Occipital sinus: attachment of falx cerebelli to occipital bone

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6
Q

Blood flow through venous sinuses

A

Diploic vv, sup cerebral vv, deep cerebral vv drain into the dural venous sinuses.
Sup Saggital sinus -> right transverse sinus ➡️
Inf saggital sinus + great cerebral v➡️ straight sinus ➡️ tranverse sinus ➡️ sigmoid sinus ➡️ IJV
Sup petrosal sinus joins post cavernous sinus with transverse and sigmoid sinus
Inf petrosal connects cavernous sinus with IJV
Sphenoparietal sinus ➡️ ant cavernous sinus
Intercavernous sinus connects the two cavernous sinus
Occipital sinus ➡️ confluence of sinuses

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7
Q

Cerebral hemisphere

A

Superficial layer of grey matter : cerebral cortex
Sulci and gyri
Two hemispheres are joined by the corpus collosum
Axons from cells form white matter
Nuclear masses buried within white matter

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8
Q

Insula

A 
In depths of lateral sulcus
Opercula: parts of frontal, temporal and parietal lobes overlying the insula
Short gyri (3) - ant
Long gyri (2) - post
Central sulcus between them
Circular sulcus surrounds them
Gyri come together as the limen insulae
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9
Q

Lat Surface of cerebrum

A

Lat sulcus:

  • Ant(horizontal), asc & post rami
  • lie between the portions of the inf frontal gyrus

Inf frontal gyrus:
Opercular: post
Triangular: middle
Orbital: ant

Intraparietal sulcus: separates the sup and inf lobules (supmarginal gyrus:upturned end of lat sulcus and angular gyrus: upturned end of sup temporal sulcus)

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10
Q

Med surface of cerebrum

A 
Cingulate gyrus (fibers= cingulum)
-directly sup to corpus collosum

Paracentral lobule:

  • surrounds extension of central sulcus to the med surface
  • lies post to paracentral sulcus and ant to marginal sulcus
  • extension of pre & post central gyri onto the med surface
Med frontal gyrus
Cingulate sulcus
Callosal sulcus/ sulcus of corpus callosum
Parieto-occipital sulcus
Calcarine sulcus
Cuneus
Precuneus
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11
Q

Inf surface of cerebrum

A

Olfactory tract lies in sulcus rectus/olfactory sulcus

Gyrus rectus/Straight gyrus lies med to it

Lat occipito-temporal gyrus continues with the inf temporal gyrus

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12
Q

Primary motor cortex

A

Location: precentral gyrus
Contralat 1/2 of body represented in somatotopic fashion
Motor homunculus
Head controlled by the most inf part of primary motor cortex on lat surface
Lower limb controlled by med surface of primary motor cortex gyrus
//Area of cortex devoted to body part proportional to degree of precise movement possible

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13
Q

Premotor cortex

A

Brodmann 6
Ant to precentral gyrus
Medial surface -> supplementary motor cortex
Programming of movement and control of posture

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14
Q

Frontal eyefield

A

Brodmann 8
In middle frontal gyrus
Controls voluntary conjugate deviation of the eyes

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15
Q

Primary somatosensory cortex

A

Brodmann 1, 2, 3
Parietal association cortex post to it
Interpretation and understanding

16
Q

Primary auditory cortex

A 
Brodmann 41 & 42
Sup surface of sup temporal gyrus
Transverse temporal gyri = Heschl's gyri
Mostly hidden in lateral sulcus
Auditory association cortex
Auditory info is interpreted 
In dominant hemisphere the auditory association cortex is known as Wernicke's Area
17
Q

Primary visual cortex

A

Brodmann 17
Med surface occipital lobe
Gyri immediately sup and inf to calcarine sulcus
Rest of occipital lobe : visual association cotrex
Interpretation of visual images

18
Q

Primary olfactory cortex

A

Uncus and subjacent amygdala
Extends into limen insulae
Olfactory association cortex: ant part of the parahippocampal gyrus
Primary and association cortexes = pyriform cortex
Olfactory projection not via the thalamus

19
Q

Taste (gustatory area)

A

Adjacent to general sensory area of tongue (inf end of postcentral gyrus)
Extends to insula
Insula may be a site of integration of smell and taste

20
Q

Language Areas

A

Receptive language area: auditory assoc cortex (Wernicke’s area) and inf parts of supramarginal and angular gyri

Broca’s area (expressive speech area): opercular and triangular parts of inf frontal gyrus (brodmann 44 & 45)

Two areas are in communication with each through arcuate fasiculus

21
Q

White matter cerebrum

A

Association fibres: connect cortical areas within ONE hemisphere e.g. Arcuate fasciculus, cingulum

Commissural fibres: connect FUNCTIONALLY related structures between TWO hemispheres e.g corpus collosum, ant commisure

Projection fibres: between cerebral cortex and subcortical structures e.g internal capsule

22
Q

Cisterns

A

Cisterns: exist between regions of the pia mater and arachnoid mater, on regions where the brain does not conform exactly to the shape inside of the cranium

-pools of CSF in subarachnoid space.
Main cisterns:
- cistern of lat fossa
⭕️ Formed where arachnoid mater bridges the lat fissure and
contains middle meningeal a
- pre and post chiasmatic cisterns
⭕️ related to the optic chiasm
- interpeduncular cistern: formed where arachnoid mater bridges the cerebral peduncles, contains arterial circle of Willis
- cisterna ambiens, found on either side of midbrain,
‼️contains CNIV, post cerebral a, ant choroidal a, optic tract, basal vein of Rosenthal
- sup cistern: located between the splenium of corpus collosum and sup cerebellar surface, contains great cerebral v and pineal body

Cisterna ambiens + sup cistern = cisterna of great cerebral v

  • pontine cistern: located ant to pons, contains vertebral a and basilar a and its branches
  • cisterna magna/ cerebellomedullary cistern: extensive cistern where arachnoid mater spans between inf cerebellar surface and medulla,
23
Q

Lateral ventricle comprises of

A

Frontal horn: frontal lobe anterior to inter ventricular foramen

Central part: parietal lobe posterior to interventricular foramen stretching to the entrance of the temporal horn

Occipital horn: in occipital lobe surrounded by white matter

Temporal(inferior) horn: temporal lobe

24
Q

Describe the boundaries of the frontal horn

A

Lateral wall: head of the caudate nucleus

Roof: corpus callosum

Anterior wall: genuine of the corpus callosum limits the frontal horn anteriorly

Medial wall: septum pellucidum

*Floor: doesn’t exist because the medial and lateral walls meet

25
Q

Boundaries of Central part (body)

A

Floor:

  • dorsal surface of the thalamus
  • with the tail of the caudate nucleus forming a ridge along the lateral border of the floor.
  • stria terminalis (originating in the amygdaloid body and going to the the septal area) and the thalamostriate vein lies medial to the tail of the caudate nucleus
  • Medially it is completed by the body of the fornix
  • choroid plexus is attached to the margins of the choroid fissure, which intervenes bettween the fornix and the thalamus

Roof: corpus callosum

26
Q

Boundaries of Occipital horn

A

Medial wall:

  • There are two elevations on the medial wall
  • The upper one is the bulb of the occipital horn (produced by the fibers of forceps majour)
  • The lower one is calcar avis ( caused by calcarine sulcus )
27
Q

Boundaries of the temporal horn

A

Floor :

  • includes the hippocampus(inside), which is an extension of the parahippocampal gyrus (outside) “rolled into the floor”
  • pes hippocampi
  • fimbria of the fornix/fimbria of hippocampus is found along the medial border of the hippocampus
  • dentate gyrus is located medial to the hippocampus, hidden by the fimbria of the fornix
  • lateral to the hippocampus is a triangular area called the collateral triangle ( were the temporal and occipital horns diverge )
  • in this area there is a bulge called the collateral eminence, caused by the collateral sulcus on the exterior

Roof:

  • tail of the caudate nucleus with stria terminalis and thalamostriate vein medial to it
  • tail of the caudate nucleus extends to the amygdaloid body, which is also in the roof (just superior to the pes hippocampi)
28
Q

What is the pes hippocampi

A

The anterior expanded end of the hippocampus

29
Q

Third ventricle

A
  • interventricular foramina connect it to the lateral ventricals
  • boundaries of the interventricular foramina are the columns of the fornix anteriorly and the anterior end of the thalamus posteriorly
  • the third ventrical is narrow slit bettween the two thalami and the two hypothalami
30
Q

Boundaries of the the third ventricle

A

Anterior wall: is the lamina terminalis and anterior commissure

Lateral walls: thalamus and hypo thalamus with the hypothalamic sulcus separating them
- thalamus has a bundle of fibers running across it named the stria medullaris thalami

Floor: optic chiasma anteriorly, median eminence posteriorly, optic recess is found anterior to the optic chiasma, and posterior to that is the infundibular recess, that extends into the median eminence and proximal part of the pituitary stalk, posterior to that the floor slips upward to the cerebral aqueduct

Roof: membranous and is attached along the stria medullares thalami

  • in the roof is a small choroid plexus is suspended from the roof
  • posteriorly in the roof habenular commissure, pineal recess, posterior commissure (which is just above the entrance to the cerebral aqueduct)
31
Q

Roof of the fourth ventricle

A

Filled with CSF
Tent shaped
Covered by the cerebellum
The rostral part formed by sup cerebellar peduncles with the sup medullary velum stretching between them
The caudal part of the roof is formed by the thin inf medullary vellum (often adheres to the cerebellum)
Opening of the inf medullar velum is the median aperture (foramen Magendi)
Median aperture opens into Cisterna Magna
The choroid plexus is suspended from the inf medullary velum and extends into the lat recess

The lateral walls Include the inf cerebellar peduncles
Lat recesses extend around the medullar and open ventrally in the subarachnoid space as the lat apertures (foramina of Luschka) of the fourth ventricles
The lat apertures are located at the junction of the pons, medulla and cerebellum (cerebellopontine angles)
A small piece of choroid plexus usually extends through each lat aperture

32
Q

Production of CSF

A

Produced by choroid plexus of the ventricles
Most CSF produced in lat ventricles
Choroid plexus is formed by invaginations of vascular pia mater into the ventricles, taking along a layer of ependyma (lines ventricles on the inside)

33
Q

Circulation of CSF

A

Lateral ventricle -> third ventricle via interventricular formina -> fourth ventricle via cerebral aqueduct -> median aperture of the fourth ventricle -> cerebellomedullary cistern (cisterna manga, keep in mind that cisterns are part of subarachnoid space) -> lateral apertures of fourth ventricles -> subarachnoid space

The CSF circulates around the brain and spinal cord
A small amount of CSF enters the central canal of the spinal cord (the central canal and fourth ventricle are continuous)

34
Q

Absorption of CSF

A

Absorbed into venous system by passing into the dural venous sinuses
The sup sagittal sinus is the main site of absorption
The arachnoid mater invaginate into dural venous sinuses as arachnoid villi
With age arachnoid villi become hypotrophic and is then called arachnoid granulations

35
Q

Why does absorption occur?

A

Hydrostatic pressure is higher in subarachnoid space than in the lumen of sinuses
Colloid osmotic pressure of venous blood is greater than that of CSF

36
Q

Clinical Applications of CSF: hydrocephalus

A

Accumulation of CsF in the ventricular system
Overproduction is rare
Is usually the result of obstruction of normal CSF circulation
The result is: dilation of ventricles
Cause in the majority of cases in obstruction of the apertures of the fourth ventricle (Luschka and Magendi)

37
Q

Clinical Applications of CSF: menigitis

A

Can cause hydrocephalus
Leptomenigeal adhesions may compromise CSF circulation at the level of ventricular outlets and/or arachnoid granulations.

38
Q

Clinical Applications of CSF: Brain Tumours

A

Can cause hydrocephalus
An e.g a tumour that obstructs one of the interventricular foramina will result in a dilated lat ventrical on that side
The obstruction can be bypassed by inserting a shunt that connects the ventricles to the IJV or abdominal cavity

Anatomy (12 decks)

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