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202: Theme 1, Fundamental neuroscience and the brain > Skull and cranial cavity > Flashcards

Skull and cranial cavity Flashcards

- Describe the arrangement of the layers of the meninges - Explain the locations and flow of blood in the dural sinus - Describe the blood supply to the brain - Explain the clinical consequence of interruption or damage to the venous or arterial blood supply to the head and brain

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1
Q

Layers of the scalp

S C A L P

A

From superficial to deep:

S-Skin

C- Connective tissue, dense.

A- Aponeurotic layer.

  • When lacerated, loses the scalp anchoring properties.
  • Connects frontalis to occipitalis.

L- Loose connective tissue.
- Separates upper three layers from pericranium.

P- Pericranium

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2
Q

Innervation of the scalp

A

Innervated by the trigeminal nerve (CN V) and spinal cutaneous nerves.

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3
Q

Function of meninges

A

Protection of the brain.

Supports network of blood vessels.

Forms fluid filled cavity to cushion and nourish the brain.

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4
Q

Dura mater

A

Outermost layer of the meninges that surrounds brain and spinal cord

Divided into two layers:

  • Endosteal (outer), lines the skull.
  • Meningeal (inner)

Dural sinuses forms between both layers.

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5
Q

Nervous supply to the dura mater

A

CN V- trigeminal
CN X- vagus

C1-3, sympathetic supply

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6
Q

Blood supply of the dura mater

  • Source
  • Branches
A

Middle meningeal artery
- Branch of maxillary artery

Branches into anterior and posterior middle meningeal artery.

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7
Q

Meningeal layer of the dura

A

Innermost dura mater layer that folds to form septa.
- Folds helps to restrict movement of the brain

Folds:

  • Falx cerebri
  • Tentorium cerebelli
  • Falx cerebelli
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8
Q

Falx cerebri

A

A fold in the meningeal, dura mater that separates the cerebral hemispheres.

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9
Q

Tentorium cerebelli

A

A fold in the meningeal, dura mater that separates the cerebral hemispheres from the cerebellar hemispheres.

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10
Q

Falx cerebelli

A

A fold in the meningeal, dura matter that separates the cerebella hemispheres.

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11
Q

Dura anatomical basis of headaches

A

Caused by the dura’s sensitivity to stretching.

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12
Q

Extradural haematoma

A

A collection of blood between the inner skull surface and the endosteal layer of the dura mater.

Can be caused by damage to the middle meningeal artery.

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13
Q

Tentorial herniation

  • Mechanism
  • Causes
A

When a part of the brain is squeezed through the tentorium cerebelli due to an increase in intracranial pressure.
- Herniation in temporal lobe

Increase in ICP can be caused by a space occupying lesion like a brain tumour or intracranial haemorrhage.

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14
Q

Arachnoid mater

A

The middle layer of the meninges.

Avascular layer, contains projections (arachnoid granulations) to transfer CSF to venous sinuses.

Subarachnoid space contains CSF which protects brain from mechanical force.
- This is also the space where structures to and from the brain pass through.

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15
Q

Layers of the meninges

A

Dura (hard) mater- outermost

Arachnoid mater- middle

Pia (soft) mater- innermost

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16
Q

Cerebrospinal fluid (CSF)

A

Fluid produced by specialised ependymal cells in the choroid plexus in brain ventricles.

Found in the brain and spinal cord.
- Absorbed by arachnoid granulations in the meninges

Provides buoyancy in the subarachnoid space which protects agains mechanical force.

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17
Q

Pia mater

A

Innermost, soft, layer of the meninges.

Follows the brain gyri and sulci.

Very vascular structure that forms part of the cerebral arteries entering the brain.

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18
Q

Spinal cord meninges

A

3 layers that form part of the spinal nerve roots:

  • Dura mater (only the meningeal layer)
  • Arachnoid mater
  • Pia mater
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19
Q

Leptomeningitis

A

Infection and inflammation in the leptomeninges (arachnoid and pia mater).

Can cause septicaemia if infection enters subarachnoid space and consequently into the blood.

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20
Q

Dural sinuses

A

Venous channels between the layers of the dura.

  • Contains drained blood and CSF from the brain and cerebral veins.
  • Drains into the IJV.

Communicates with the veins of the skull and scalp.

Contains no valves or SM- just a thick endothelial wall.

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21
Q

Blood supply to the brain

A

Main branches:

  • Internal carotid, from common carotid artery
  • Vertebral artery, from subclavian.

Circle of Willis is formed from their anastomose.

Anterior and middle cerebral arteries- terminal branches

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22
Q

Vertebral artery

A

Supplies the brain, branches from the subclavian.

Passes within cervical vertebrae and enters through foramen magnum.

Unites to form basilar artery.

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23
Q

Circle of Willis

A

Anastomose of 2 internal carotid arteries with 2 vertebral arteries.

ICA connects to the posterior cerebral artery by the posterior communicating artery.

Anterior communicating artery connects anterior cerebral arteries together.

24
Q

Anterior cerebral artery

  • Source
  • Supply
A

Source- Internal carotid artery

Part of Circle of Willis

Supplies medial and superior surfaces of the brain + frontal pole

25
Q

Middle cerebral artery

  • Source
  • Supply
A

Source- internal carotid

Supplies- lateral surfaces and the temporal pole.

26
Q

Posterior cerebral artery

  • Source
  • Structure
  • Supplu
A

Source- Basilar artery

Part of Circle of Willis- connects to MCA and ICA via posterior communicating artery.

Supplies- inferior surfaces and occipital pole.

27
Q

Occlusion of vertebral/ ICA

A

Causes mixing of blood in posterior communicating artery.

- Blood passes back and forth to compensate lack of blood flow.

28
Q

Neurocranium

A

The cranium, composed of 8 bones:

  • Frontal
  • Parietal x2
  • Temporal x2
  • Occipital
  • Ethmoid
  • Sphenoid

Intra-sutural bones can appear- extra bones

29
Q

Viscerocranium

A

The facial bones: 14

  • Nasal 2x
  • Maxilla 2x
  • Zygomatic 2x
  • Nasal conchae x2
  • Palatine x2
  • Lacrimal x2
  • Mandible
  • Vomer
30
Q

Skull

A

Composed of the cranium (neurocranium) and the facial bones (viscerocranium).

22 bones in total.

Protects the brain and allows attachment for muscles of the face and head.

31
Q

Cribiform plate

A

Part of the ethmoid bone

Foramen in the skull that supports the olfactory bulb.

32
Q

Optic canal

A

Formed from the sphenoid bone.

Passageway for:

  • Optic nerve
  • Ophthalmic artery
33
Q

Superior orbital fissure

A

Opening of the skull, in the sphenoid bone.

Many structures pass through.

34
Q

Foramen rotundum

A

Opening of the skill of the sphenoid bone.

Maxillary nerve of the trigeminal nerve passes through.

35
Q

Foramen ovale

A

Opening of the skull in the sphenoid bone.

- Mandibular nerve of CN V passes through.

36
Q

Foramen spinosum

A

Opening of the skull in the sphenoid bone.
Passageway for:
- The middle meningeal artery
- Middle meningeal vein
- Meningeal branch of the mandibular nerve.

37
Q

Internal acoustic meatus

A

Foramen of the temporal bone.

Passageway fron CN VII and VIII (Facial and vestibulocochlear)

38
Q

Foramen magnum

A

Foramen of the occipital bone.

  • Passageway for CN XI (accessory)
  • Meninges
  • Medullar oblongata
39
Q

Hypoglossal canal

A

Foramen in the occipital bone

Passageway for CN XII (hypoglossal)

40
Q

Jugular foramen

A

Foramen in the temporal bone.

Passageway for nerves IX, X and XI (glossopharyngeal, vagus and accessory)

41
Q

Foramen lacerum

A

Foramen in the sphenoid bone

Opening for the internal carotid artery.

42
Q

Stylomastoid foramen

A

Opening in the temporal bone.

Passageway for facial nerve (CN VII)

43
Q

Middle meningeal artery

A

Supplies the dura mater

Source: Internal maxilla artery
Foramen: Foramen spinosum

44
Q

Superior sagital sinus

A

Dural sinus at the superior border of the flax cerebri

45
Q

Straight sinus

A

Dural sinus at the falx cerebri and tentorium cerebelli junction.

Drains into the right and left transverse sinus

Receives blood from:

  • Inferior sagittal sinus
  • Great cerebral vein
46
Q

Inferior sagittal sinus

A

Dural sinus at the inferior margin of the flax cerebri.

Drains into the straight sinus.

47
Q

Transverse sinus

A

Dural sinus at the posterior and lateral attachments of the tentorium cerebelli.

Drains

48
Q

Transverse sinus

A

Dural sinus at the posterior and lateral attachments of the tentorium cerebelli.

Drains from confluence of sinuses and superior posterior sinus.

Drains into sigmoid sinus.

49
Q

Sigmoid sinus

A

Dural sinus at the groove of the occipital, temporal and parietal bones.

Drains from the transverse sinus into the internal jugular vein.

50
Q

Fontanelles

A

Soft membraneous gaps between sutures in infants.

  • The brain expands faster than the skull can grow.
  • Provides space for the brain to expand.
51
Q

Posterior fontanel

A

Also called

  • Lambdoid
  • Occipital

Triangular shaped Fontanel formed at the junction between the sagittal and lambdoid suture

52
Q

Anterior fontanel

A

Also called:

  • Bregmatic
  • Frontal

Diamond shaped, between the coronal and sagittal sutures.

Persists until 18 months after birth.

Function:

  • Allows the deformation of the skull during childbirth.
  • Expansion of the brain after birth.
53
Q

Clinical significance of fontanelles

A

Sunken fontanelles= dehydration

Tense/ bulging anterior fontanelle= raised inter cranial pressure

54
Q

Sphenoidal fontanelle

A

Also called the anterolateral fontanelle

Located between these bones:

  • Frontal
  • Sphenoidal
  • Parietal
  • Temporal
55
Q

Mastoid fontanelle

A

Also called the posterolateral fontanelle

Located between these bones:

  • Temporal
  • Occipital
  • Parietal bone

202: Theme 1, Fundamental neuroscience and the brain (27 decks)

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