neuroanatomy venous & spinal pwp Flashcards
for test 2
cerebral veins have no valves?
T/F
T
veins have what kind of tunica do they have
and what is a characteristic of it?
tunica media
& it is easily torn
& Tunica externa
the location of the cerebral veins
between the arachnoid and pia matter in the subarachnoid space
What vessels connect the dural sinuses to the veins of the scalp? (connection to veins outside the cranium)
emissary veins
tunica adaventitia is also known as
tunica externa
superfiscial veins drain what structures of the brain?
cerebral cortex & white matter
superior cerebral veins drain what portion of the brain’s hemispheres?
upper/lateral surface into superior sagittal sinus
inferior cerebral veins drain into the
transverse & superior petrosal sinus
inferior cerebral veins drain which portion of the brains hemisphere?
lower/lateral inferior surface of brain
subdural hematoma ruptures the
superior cerebral veins
superfiscial middle serebral veins drains what area of the brain?
the lateral surface of the brain
superfiscial middle cerebral veins dumps itno the
cavernous sinus
superficial middle cerebral veins creates anastamosis between
superior andinferior cerebral veinsq
deep veins drain
white matter & deep nuclei
internal cerebral veins begin at what level?
foramen of monro
internal cerebral veins are composed of 5 types of veins but which 3 are important
thalamostriate ( located on thalamus)
choroidal vein ( in Lateral ventricles)
septal vein
what two sturctures form the great vein of galen?
2 internal cerebral veins
great cerebral veins of galen joins what structure to form what?
inferior sagittal sinus –> to form the straight sinus
pathway of venous drainage
5veins –> internal cerebral vein –> great cerebral vein of galen –> staight sinus –> confluence of sinuses –> transverse sinus –> sigmoid sinus –> internal jugular veins
transverse sinus drains inferiorly into
sigmoid sinus
what week does the brain form?
3rd week
by week 3 how many primary vesicles are developed?
3
by week 5 how many secondary vesicles are formed?
5
what are the 3 flexure are known as during primary development
cephalic , pontine and cervicle flexures
formation of sulci and gyri are at what time point?
3rd month
when are ALL major gyri and sulci present
7th month
when is the lateral fissure developed?
4th month
do sensory areas develop first or does motor?
sensory develops first
characteristic of brain during development?
- gelatinous and cortex and white matter are poorly demarcated
critical period of CNS development?
week 3- 1.5 years
increase of B9 in the critical period of development of CNS will do what?
increase myelination
at what point of development is the gray cortex and subcortical white matter are clearly separated and similar to those of the adult brain ?
2+ years of development
characteristics of aging brain
number of neurons tends to decrease with age & the greates loss is in the cerebral cortex
where in the cerebral cortex is the greatest loss during aging
frontal lobe, precentral gyrus, and primary visual cortex
senescence is defined as
neurons not able to divide anymore = getting old
characteristics of a senescence cell
change in size, accumulation of age pigment in neuron cell bodies, decrease in amount of nissl substance
pathalogical changes in the aging brain?
Involvement of atrophy
cortical and hippocampal atrophy, and enlargement of ventricles.
grossly what happens to brain under aging?
decrease is weight and increase in size of ventricles and calcification of the meninges
hippocampus helps you with what
accessing memories
spinal cord is protected by the
vertebral bodies adn arches &
their are associated ligaments and muscles
spinal cord occupies what fraction of the vertebral canal?
2/3
begining and end of the spinal cord
foramen magnum and L2
in the embryo what is special about the spinal cord and vertebral canal
it occupies the full length
during growth what develops faster, the spinal cord or that vertebral column?
vertebral column
External features of the spinal cord posteriorly?
- The dorsal (posterior) surface of the spinal cord shows:
Midline dorsal median sulcus (aka posterior median sulcus).
Right and left dorsal intermediate sulci (T6-C1)
Right and left dorsal lateral sulci (attachment of dorsal rootlets of spinal nerves) aka posterior lateral sulcus
The ventral (anterior) surface of the spinal cord features
Midline ventral median fissure (aka anterior median fissure)
Right and left ventral lateral sulci (attachment of ventral rootlets of spinal nerves)
what makes a spinal segment?
outward attachment of paired dorsal rootlets and paired ventral rootles
spinal nerve is when
ventral and dorsal roots fuse
2 enlarged regions of the spinal cord
cervical and lumbar
cervical enlargement segements
c5-t1
Most of the ventral rami of its spinal nerves form the brachial plexus that innervate the brachial plexus
lumbar enlargement
segments L1-S3 (corresponds to vertebral levels T9-T12/L1), its ventral rami give lumbar and sacral plexuses that mainly innervate the lower limbs.
how many pairs of spinal nerves
31
how many cervical spinal nerves?
8
how many thoracic spinal nerves?
12
how many lumbar spinal nerves
5
how many sacral spinal nerves?
5
how many coccygeal spinal nerves
1
ventral is mainly motor or sensory?
motor
which communican comes first?
gray before white
dorsal roots of spinal nerves recieve what kind of fibers?
sensory fibers = afferent fibers
DRG contains what and where is it located?
cell bodies of axons making the dorsal roots and are outside the spinal cord in the IVFs
afferent fibers from the viscera travel in what
ramus?
white –> myelinated
GSE is
motor to muscles
- skeletal muscles from somites
GVE is
general visceral efferent it controls smooth muscles and glands
special visceral efferent
skeletal muscles from pharyngeal arches
GSA
general somatic afferent provides sensory info from the skin, skeletal muscles, joints, and arches
GVA
general visceral afferent - visceral organs
ventral roots of spinal nerves contain
efferent fibers; GVE and 14 contain preganglionic sympathetic autonomic givers; GVE
C1 is purely?
motor
why is C1 purely motor?
has no dorsal root
does everybody have a coccygeal nerve?
no
2 branches of the spinal cord
dorsal and ventral rami
dorsal rami supplies
skin and deep mm. of the back
ventral primary rami supplies
supply the limbs and the rest of the trunk through 5 plexuses (cervical, brachial, lumbar, sacral and coccygeal plexuses). The ventral primary rami of thoracic spinal nerves form 11 intercostal nerves and subcostal nerve: T12
2 other branches of the spinal cord?
. Recurrent meningeal nerves (sinuvertebral nerve): (GSA, GVE)
&
white rami communicans
Recurrent meningeal nerves (sinuvertebral nerve): (GSA, GVE) supplies most of what?
supply meninges and IVDs
white rami communicans fibers?
GVE and GVA
white rami communicans go to the
sympathetic ganglion
outermost covering of the spine
dura
what is contained in the epidural space?
a. Adipose tissue
b. Internal vertebral venous plexuses (anterior and posterior)
superior boundary of the epidural space?
Superiorly: foramen magnum
inferior boundary of the epidural space?
sacrococcygeal ligament covering sacral hiatus
anterior boundary of the epidural space?
: vertebral bodies, IVDs and Posterior Longitudinal Ligament
posterior boundary of the epidural space?
: laminae and ligamentum flavum
lateral boundary of the epidural space?
: Pedicles and IVFs
where does the dural sac end?
s2
what are dural root sleeves?
extend along the dorsal and ventral roots and spinal ganglia
dura mater is anchored by this structure?
filum terminale externum
does archnoid have boold supply?
no it is avascular
what does the subdural seperate?
dura and the arachnoid
subarachnoid space seperates?
pia and arachnoid matter
where is CSF & blood vessels located?
Subarachnoid space
innermost layer layer of meninges?
pia
does pia have blood supply?
yes
filum terminale internum is only
pia
filum terminale externa contains
all 3 layers pf meningies
filum terminale is within the
dural sac
job of the filum terminale?
anchors to the coccygeal
denticulate ligament?
A serrated ribbon of pia mater that attaches to the dura mater at about 21 points on each side between the dorsal and ventral roots of spinal nerves.
Subarachnoid space:
is it vascularaized?
yes
space of the meninges contains
cauda equina and filum terminale internum that float in CSF
the space of the meninges get large inferior to the conus medullaries forming the
lumbar cistern
lumbar cistern extends from
L2 - S2
where would you put a needle to test fluid?
lumbar cistern
CSF is drained through what and then into?
venous dural sinuses to the general circulation
job of the CSF
acts as a shock absorber as well as diffusion medium for dissolved gases, nutrients, chemical messengers (neurotransmitters, hormones, etc.) and waste products.
where is the lumbar puncture/spinal tap done?
L2
lumbar tap is done for what
diagnostic imaging &
bacterial testing for meningitis
spinal block
spinal anesthesia
The needle penetrates
skin, fascia, back muscles, supraspinous and interspinous ligaments and ligamentum flavum, epidural space, dura mater, subdural space and arachnoid mater.
epidural block
The anesthetic has a direct effect on the spinal nerve roots of the cauda equina as they exit the dural sac.
the lumbar puncture and epidural block both go through what initially?
sacral hiatus
how long does the epidural last?
10-20 minutes
how is an epidural commonly used?
prevent pain during childbirth.
birth canal is innervated by ____ & ____ meaning it wont effect what?
s2-s4
it will not effect the uterus
meningities is inflammation in
pia and arachnoid
a positive valsalvas maneuver means
be caused by increased intrathecal pressure. This may be due to a space-occupying lesion such as herniated disc, tumor or osteophytes.
central area of spinal cord is what shaped?
H
the peripheral area of the spinal is
white matter with myelin
what levels contain the lateral horn?
t1-L2
crossbar of H in spinal cord is made up of?
commissural neurons
commissural neurons surround what structures?
the central canal that contains CSF
lateral horn contains?
sympathetic nervous system innervating smooth muscles, cardiac muscle, sweat glands and adrenal medulla.
AHC are what? and what is their function?
anterior horn cells that are responsible for motor output too skeletal muscles
3 columns of white matter
ventral, lateral, dorsal
what is different about oligodendrocytes?
they have foot processes that can wrap around and affect other cells
each columns of white matter is contained of
tracts
ventral has what kind of tracts?
motor
lateral columns contain what kind of tracts?
mixed
dorsal column contains what kind of tracts?
ascending sensory
osteoarthritis can lead to what on the spine?
osteophytes/spurs
Cervical region important characteristics?
Large and oval-shaped.
ii) The amount of white matter is greater than any other region.
iii) The ventral horn of gray matter is large (large number of neurons to innervate upper limb muscles).
Thoracic region important characteristics?
i) Small amount of gray matter relative to white matter.
ii) Presence of a lateral horn.
- Lumbar region important characteristics?
i) Round appearance.
ii) Dorsal and ventral horns are very large.
iii) Relatively less white matter than cervical region.
which part of the spinal cord has a lateral horn?
thoracic
- Sacral region: important characteristics?
i) Predominance of gray matter over white matter.
ii) Smallest cross section of the spinal cord.
venous plexuses within the pia mater and drain into what veins?
cerebral veins
where are cerebral veins located?
on the surface of the brain
where do the cerebral veins eventually empty into too?
dural venous sinuses
where are dural venous sinuses located?
in between the meningeal and periosteal layer of the dura mater
some characteristics of dural venous sinuses
- low pressure channels
- no valves
- emissary veins connect the dural sinuses to the veins of the scalp
dural venous sinuses _______ valves and are located between?
no valves
located between the periosteal and meningeal layer
where does the superior sagittal sinus run along?
mid-sagittal plane
where does the superior sagittal sines receive it’s blood from?
superior cerebral veins
does the superior sagittal sinus receive CSF and if so how?
yes, through arachnoid granulations
where does the superior sagittal sinus empty into?
confluence of sinuses
where does the superior sagittal sinus drain inferiorly?
transverse sinus
inferior sagittal sinus receives veins from what portion of the brain’s hemispheres?
upper medial surface of the hemisphere
inferior sagittal sinus joins the great cerebral vein to form the
straight sinus
what structure drains into the confluence of sinuses most directly?
straight sinus
location of the straight sinus?
at the junction of the falx cerebri and tentorium cerebelli
straight sinus recieves blood from where?
great vein of galen and the inferior sagittal sinus
when does the straight sinus become the transverse sinus?
after in travels caudally to empty into the confluence of sinuses
location of transverse sinus?
posterior attached border of the tentorium cerebelli
each transverse sinus (2) receives blood froom where?
- inferior cerebellar veins
- cerebellar veins
- superior petrosal sinus
what sinus becomes the sigmoid sinus?
the transverse sinus
where does the sigmoid sinus exit out of?
jugular foramen as the IJV
when does the transverse sinus drop below the tentorium cerebelli?
as the sigmoid sinus becomes the IJV
sigmoid sinus runs along what structure?
the tentorium cerebelli to the jugular foramen
The IJV joins what structure to form what?
subclavian to form the brachiocephalic
what sinuses are responsible for the transport of the majority of the venous blood from the brain?
sigmoid sinus
where is the occipital sinus sinus located?
in the falx cerebelli
where does the occipital sinus receive blood from?
posterior occipital veins around the foramen magnum
the IVVP communicates with what sinus?
the occipital sinus
IVVP stands for?
internal vertebral venous plexus
where is the cavernous sinus located?
along the sides of the body of the sphenoid (sella turcica)
cavernous sinus extends between what two landmarks?
petrous ridge to the superior orbital fissure
what are the 3 structure3s that drain into the cavernous sinus?
- ophthalmic veins
- superficial middle cerebral veins
- sphenoparietal sinus
cavernous sinus empties into what structures?
- superior petrosal sinus
- inferior petrosal sinus
- pterygoid venous plexus
superior petrosal sinus drains into
the transverse sinus
inferior petrosal sinus drains into
the internal jugular vein
pterygoid vein drains into
deep facial vein
the intercavernous sinus creates a ring around
the pituitary gland
intercavernous has two divisions?
anterior and posterior
what connects the cavernous and transverse sinus?
superior petrosal sinus
where is the superior petrosal sinus located?
in the margin of the tentorium cerebelli
what does superior petrosal sinus drain?
cavernous sinus
where does the superior petrosal sinus empty too?
the transverse sinus just before the sigmoid sinus begins
what is the MAIN drain for the cavernous sinus?
inferior petrosal sinus
what other structures does the inferior petrosal sinus drain?
medulla, pons, cerebellum and the inner ear
the main pathway of drainage for the cavernous sinus
cavernous sinus –> inferior petrosal –> IJV
basilar sinus/ basilar venous plexusruns along where?
on the basilar part of the occipital bone (clivus) - ramp
what does the basilar sinus communicate with?
IVVP
what connects the 2 inferior petrosal sinuses?
basilar sinus/basilar venous plexus
Is the transverse sinus a single structure or paired structure?
paired
Where is the point where the sinus drops bellow the Tentorium Cerebelli?
Transverse Sinus
Is the sigmoid sinus a single structure or paired structure?
paired
What is the span of the sigmoid sinus?
from the Tentorium Cerebelli to the Jugular Foramen
How many cavernous sinuses are there?
2
How many Basilar sinuses are there?
1
What are the superficial veins pf the brain?
superior cerebral veins
inferior cerebral veins
superficial middle cerebral vein
What parts of the brain do the cerebral hemispheres grow over in development?
diencephalon
mesencephalon
What percentage of malformations and congenital deformations involves the CNS
50%
The spinal cord, meninges and related structures are located where?
vertebral canal
what is the major reflex center and conduction pathway between the body and the brain?
spinal cord
What is the tapering end of the spinal cord called?
conus medullaris
Because the vertebral column grows faster in fetal life, what is the orientation of the spinal nerve roots?
They present obliquity
What serves as the attachment of dorsal rootlets of spinal nerves?
right and left posterior lateral sulci
What is another name for recurrent meningeal nerves?
sinuvertebral nerve
What mater covers the spinal nerve roots and spinal ganglia?
arachnoid mater
What extends from the tip of the conus medullaris to the dorsum of the coccyx?
Hint*Slender filament of pia mater
filum terminale
What is the filum terminale externum also known as?
coccygeal ligament
How many times does CSF replace itself in a day?
4-5 times
What is the total amount of CSF in the body?
80-150 mL