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NSB Biweekly 1 > Pavlick: Meninges and CSF flow > Flashcards

Pavlick: Meninges and CSF flow Flashcards

1
Q

layers of the head

A

SCALP over DAP
(skin, CT, aponeurosis, loose CT, pericranium)
(Dura, arachnoid, pia)

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2
Q

Pachymeninges

A

“thick” —-dura mater

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3
Q

Leptomeninges

A

“thin”—-arachnoid and pia mater

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4
Q

___space b/t dura and calvaria

A

epidural

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5
Q

____space b/t dura and arachnoid mater

A

subdural

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6
Q

skull cap

A

calvaria

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7
Q

bleed caused by damage to middle meningeal a.

A

Epidural

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8
Q
A

epidural bleed

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9
Q

Union of temporal, frontal, parietal and sphenoid bones

A

Pterion

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10
Q

due to fracture of ______ that causes damage to middle meningeal a.

A

Pterion

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11
Q

results from rupture bridging meningeal veins

A

subdural bleed

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12
Q

onset of symptoms can be much slower (e.g., several hours) due to lower pressure control

A

subdural bleed

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13
Q

____ mater is a double layer

A

dura mater

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14
Q

separates cerebral hemispheres

A

Falx cerebri

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15
Q

separates cerebellum hemispheres

A

Falx cerebelli

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16
Q

“tent” over cerebellum

A

Tentorium cerebelli

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17
Q

the dura outer layer creates ______ sinuses

A

venous

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18
Q

venous drainage starting at cavernous sinus

A
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19
Q

venous drainage starting at inferior sagittal sinus

A
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20
Q

venous drainage starting at superior sagittal sinus

A
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21
Q

Symptoms include:
Headache
Blurred vision
Seizures
Coma

A

central(cerebral) venous sinus thrombosis

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22
Q

most common site of cerebral venous sinus thrombosis

A

superior sagittal sinus

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23
Q

“spider mother”
Cobweb-like appearance between dura and pia mater

A

arachnoid mater

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24
Q

____ space lies above arachnoid

A

subdural

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25
Q

____ space lies below arachnoid

A

subarachnoid space

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26
Q

span entire space and attach to pia mater; act to suspend brain to reduce weight but still provide some stability; “bungee cords”

A

Arachnoid trabeculae

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27
Q

contains CSF and vasculature

A

subarachnoid space

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28
Q

site of CSF diffusion from subarachnoid space into dural sinus

A

Arachnoid granulations

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29
Q

“frozen chicken”
“5 star”
(basilar(subarachnoid)cisterns)

A

subarachnoid hemorrhage

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30
Q

Occupies potential space between arachnoid and pia mater

A

subarachnoid

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31
Q

second most common cause of rupture of arterial berry aneurysm

A

subarachnoid hemorrhage

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32
Q

Under arterial pressure—–higher pressure (quick and severe onset)

A

subarachnoid hemorrhage

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33
Q

“thunderclap headache”—-worst headache of your life

A

subarachnoid hemorrhage

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34
Q

Innermost meningeal layer which closely adheres to the brain and spinal cord

A

Pia mater

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35
Q

The spinal cords version of bungee cords so its not swinging around

A

pia mater

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36
Q
A

top: conus medullaris
middle: cauda equina
bottom: filum terminate interum

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37
Q

anchor spinal cord laterally (extension of pia mater)

A

denticulate ligaments

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38
Q

extension of pia mater that anchors spinal cord caudally

A

Filum terminale internum

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39
Q

tumor arising from meninges (meningothelial cells)

A

Meningioma

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40
Q

hollow spaces which contain and allow the flow of CSF (system looks like a halo spaceship)

A

ventricles

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41
Q

produces CSF

A

choroid plexus w/in ventricles

42
Q

Site for very selective exchange of ions and nutrients (similar to glomerular filtrate/kidney)

A

choroid plexus

43
Q

CSF flows from lateral ventricles through ______ to third ventricle

A

foramina of monro (interventricular formamina)

44
Q

CSF flows from third ventricle to the fourth ventricle through what

A

cerebral aqueduct

45
Q

through what 2 things does CSF flow through to get from brainstem to spinal cord (subarachnoid space)

A

Foramen of Magendie (medial)
Foramen of Luschka (lateral)

46
Q

will be reabsorbed through arachnoid granulations and cycle back through

A

CSF

47
Q

“water in the head”

A

hydrocephalus

48
Q

increased CSF within the ventricles can be due to ______ flow of CSF

A

blocked

49
Q

Can be resolved by placing a shunt to relocate CSF to abdominal cavity for reabsorption

A

hydrocephalus

50
Q

aqueductal stenosis is most common cause

A

hydrocephalus

51
Q

often observed with this is dilation of ventricles

A

hydrocephalus

52
Q

loss of brain ___ leads to increased ventricular size (Ex-vacuo type hydrocephalus)

A

parenchyma

53
Q

Non-communicating (“obstructive”)—-> impairment of CSF flow ___________ ventricular system

A

within

54
Q

Communicating (“non-obstructive”)—-> impairment of CSF flow ___________ of ventricular system

A

outside

55
Q

Normal Pressure (intracranial hypertension)—-> ____ CSF production

A

increased

56
Q

HA and elevated ICP but NO lesion present or ventricular dilation

A

Pseudotumor cerebri

57
Q

signs of hydrocephaly but imaging is normal

A

Pseudotumor cerebri

58
Q

Symptoms:
Vision changes
Dizziness, nausea/vomiting
Stiff neck
Tinnitus
Cognitive change

A

hydrocephalus

59
Q

can be acquired via lumbar puncture (L3-L5) and constituents analyzed for diseases

A

CSF

60
Q
A

normal CSF

61
Q

Xanthochromia

A

RBC degeneration in CSF (hemorrhage)

62
Q

custard like

A

meningitis (elevated WBCs)

63
Q
A

traumatic tap

64
Q

refers to inflammation of the soft meninges (pia and arachnoid) and can be classified into several types

A

Leptomeningitis

65
Q

fever
HA/stiff neck
altered mental status
Brudzinski’s sign/Kernig’s sign
neutrophils in staining

A

Meningitis

66
Q

flexion of both hips and knees when neck is passively flexed

A

Brudzinski sign

67
Q

resistance to full extension of leg at knee when hip is flexed

A

Kernig sign

68
Q

most common causes of neonatal meningitis

A

Group B strep
E. coli
Listeria

69
Q

2 most common causes of meningitis in kids and adults

A

S. Pneumoniae
N. Meningitidis

70
Q

Observe opisthotonos (looks like baby is possessed)

A

neonatal meningitis

71
Q

Community acquired
Newborns acquire through maternal genital flora (on the way out)
Opisthotonos

A

Group B strep meningitis

72
Q

gram + cocci
beta hemolytic
meningitis in new borns

A

group B strep

73
Q

Spread through respiratory secretions (aerosolized)
Risk factors include age <5 and >65 and immunocompromising conditions (e.g., HIV, Sickle-cell disease)

A

Strep pneumoniae

74
Q

gram + diplococci
alpha hemolytic
MOPS

A

Strep pneumoniae

75
Q

MOPS from infection with strep pneumoniae

A

meningitis
otitis media
pneumonia
sinusitis

76
Q

gram - bacilli
ferments lactose
capsular K antigen (neonatal ____ )
EHEC
ETEC

A

E. coli; neonatal meningitis

77
Q

gram + bacilli
“rocket tails” moves intracellularly
Acquired by ingesting improperly processed deli meats and unpasteurized dairy products
pregnant women

A

Listeria

78
Q

most common cause of bacterial meningitis before HIB vaccine
can cause cellulitis

A

Haemophillus influenza type b

79
Q

in children, causes adrenocortical hemorrhage leading to DIC and shock

A

Neisseria meningitis

80
Q

Adrenocortical hemorrhage leading to DIC and shock in children

A

Waterhouse-Friedrichsen syndrome

81
Q

Outbreaks associated with young adult army recruits and colleges

A

N. meningitis

82
Q

results from untreated syphilis infection

A

neurosyphilis

83
Q

Thickened meninges
Obliterative endarteritis
Ependymal granulations
(neurosyphilis)

A

meningitis from syphils

84
Q

spirochetes on darkfield microscopy
S shaped on HandE
treat infection with Penicillin G

A

Treponema pallidum

85
Q

aseptic (viral) meningitis is most commonly caused by _____

A

enteroviruses

86
Q

difference b/t viral and bacterial meningitis

A

treat bacterial w/ antibiotics

87
Q

Caused by slow-growing organisms which cause symptoms to appear weeks to months post-infection

A

chronic meningitis

88
Q

Caseating granulomas in respiratory

Overtime, can penetrate BBB and irritate meninges

A

Mycobacterium tuberculosis

89
Q

form necrotic, expanding colonies called Rich foci

A

Mycobacterium tuberculosis (tuberculosis meningitis)

90
Q

immunocompromised states
Encapsulated yeasts with narrow neck buds in subarachnoid space
causes chronic meningitis

A

cryptococcal spp.

91
Q

encapsulated yeast from subarachnoid space into basal ganglia; since this most commonly occurs in basal ganglia, will see movement disorders/tremors

A

chronic meningitis from cryptococcal spp.

92
Q

Symptoms brain tumors will include ____________________________ and typically a specific function deficit which can help localize it

A

increased ICP

93
Q

most common spinal cord tumor

A

Ependymoma

94
Q

common in posterior fossa of children

A

Ependymoma

95
Q

Ependymomas originate from ______ cells

A

radial glial cells (ependymal cells)

96
Q

Form “____________________” around blood vessels instead of a lumen

A

pseudorosettes

97
Q

Rare, neuroepithelial intraventricular tumor
Typically found in Foramen of Monro, fornix
Affects children and young adults

A

central neurocytoma

98
Q

rare neuroepithelial tumor that stains for synaptophysin, chromogranin, and NSE

A

central neurocytoma

99
Q

2 main age related changes that occur within brain

A

ventricular dilation
calcification of arachnoid granules

100
Q

More rapid progression of ______in neurodegenerative or atrophying conditions:
Alzheimer’s
Huntington’s disease

A

ventricular dilation

101
Q

Leads to decreased reabsorption of CSF and subsequent hydrocephalus

A

calcification of arachnoid granules

NSB Biweekly 1 (15 decks)

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