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Block 3 > Skull, Meninges, Ventricular System & CSF > Flashcards

Skull, Meninges, Ventricular System & CSF Flashcards

1
Q

How many bones make up the skull?

A

22

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2
Q

How is the skull split up?

A

Neurocranium (protecting brain)

Visceracranium (protecting face)

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3
Q

What are the different sutures of the brain?

A

Coronal
Sagittal
Lambdoid

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4
Q

What are the structures found in an infants skull that are no longer present in an adults?

A

Anterior fontanelle - closes at 18 mnths

Posterior fontanelle - closes at 3 months

Mastoid + sphenoidal fontanelle

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5
Q

What is the pterion and why is this clinically important?

A

Weak spot where the parietal bone, squamous part of temporal bone and sphenoid join - middle meningeal artery lines underneath it so if it become damaged, the artery is at risk

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6
Q

What bones make up the neurocranium?

A 
Ethmoid 
Frontal 
Occipital
2 x parietal
Sphenoid
2 x temporal
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7
Q

What bones make up the visceracranium?

A 
2 of each: 
Inferior nasal concha 
Lacrimal bones 
Mandible
Maxilla 
Nasal bones 
Palatine bones 
Vomer
Zygomatic bones
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8
Q

What is the difference in adult and neonatal skull appearances?

A

Neonatal skulls have a bigger calvarium and sutures are not fused in contrast to adult skulls

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9
Q

What can fontanelles be used for?

A

US’s

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10
Q

What is the ossification centre?

A

Where bones start to ossify so you can see radiations coming from these points e.g. in the skull

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11
Q

What are the features of the flat skull bone?

A

Bone between scalp/pericardium and dura

Bone has an external and internal table with diploe in between

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12
Q

What bone down the internal acoustic meatus sit in?

A

Petrous part of temporal bone

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13
Q

What are the 3 cranial fossa’s?

A
  1. Anterior
  2. Middle
  3. Posterior
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14
Q

What comes out of the inferior orbital fissure?

A

CNVb comes out of this hole in the inferior part of the orbit bone

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15
Q

What are the 3 meningeal layers (external to internal)?

A
  1. Dura (periosteal and meningeal layer)
  2. Arachnoid mater
  3. Pia mater
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16
Q

What are the cranial meninges continuous with?

A

Spinal meninges through the foramen magnum

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17
Q

Damage to what vessel would cause a extradural haematoma?

A

Middle meningeal artery

18
Q

What would a extradural haematoma look like?

A

Lens like shape due to sutures preventing further spread

19
Q

How do you deal with brain bleeds?

A

Relieve pressure by draining it out

20
Q

Damage to what vessel would cause a subdural haematoma?

A

Bridging veins

21
Q

What would a subdural haematoma look like?

A

It would span the whole hemisphere on one side

22
Q

Damage to what vessel would cause a subarachnoid haemorrhage?

A

Cerebral arteries for e.g. due to an aneurysm

23
Q

What way could you detect a subarachnoid haemorrhage without scanning the brain?

A

Blood cells would be seen in a lumbar puncture sample as the subarachnoid space is where CSF is present

24
Q

What are dural reflections?

A

The meningeal layer of the dura forms several double-layered folds which project inwards, separating parts of the brain that help to stabilise and support CNS structures

25
Q

What dural reflections are present in the brain?

A

Falx cerebri (separates hemispheres)
Tentorium cerebelli (over cerebellum)
Falx cerebelli
Diaphragm sellae

26
Q

What is the tentorial notch? Why is this clinically relevant?

A

Free edge of the tentorium cerebelli so this is a potential site of herniation of anything above the notch when there is raised ICP

27
Q

What are dural venous sinuses?

A

Valveless sinuses that are endothelial lined running between the 2 layers of dura mater that receive venous drainage from the cerebral cortex that goes through them ending up in the IJVs

28
Q

What are the venous sinuses?

A 
Superior sagittal
Inferior sagittal
Straight
Transverse
Sigmoid
Cavernous
29
Q

Where is the confluence of sinuses located?

A

connecting point of the superior sagittal, straight, and occipital sinus found deep to the occipital protuberance of the skull

30
Q

How can a boil on the forehead cause cavernous sinus thrombosis?

A

Infection can track back into the intracranial venous sinuses as the sinuses are valveless getting into the cavernous sinus and causing thrombosis as a blood clot forms to try and prevent infection spread - this can damage many CNs via compression and block important vessels

31
Q

Where is the cavernous sinus?

A

Lies laterally to the body of the sphenoid bone and sinus and pituitary fossa (pituitary gland and diaphragm sellae covering it) - also close to optic chiasm

32
Q

What is contained within the cavernous sinuses?

A

CNs III, IV, Va, Vb and VI

ICA

33
Q

Where is cerebrospinal fluid (CSF) produced? What does it then do?

A

Constantly produced in the ventricular system by choroid plexus (mostly lateral ventricles) and then circulates around the CNS to protect, nourish and cushion the brain giving it buoyancy

34
Q

What route does cerebrospinal fluid (CSF) take?

A
  1. From lateral ventricle through IV foramen to 3rd ventricle
  2. Goes through cerebral aqueduct to get into 4th ventricle
  3. Goes through lateral (x2) and median (most) apertures to get into subarachnoid space
  4. Can then circulate around brain or go down central canal of spinal cord
35
Q

Where is the cerebral aqueduct?

A

Between the cerebellum and brainstem to the 4th ventricle

36
Q

What will the choroid plexus look like?

A

Fluffy appearance

37
Q

4th ventricle is continuous with _______.

A

Central canal of spinal cord

38
Q

Where is cerebrospinal fluid (CSF) reabsorbed?

A

Into dural venous sinuses and then into venous blood through superior sagittal sinus arachnoid villi/granulations

39
Q

What problems can go wrong with the ventricular system?

A

Blockage can cause a CSF build-up resulting in enlargement of the ventricles causing hydrocephalus - raised ICP, squashing structures and potentially causing herniation

40
Q

What are the common places for the ventricular system to get blocked?

A

Cerebral aqueduct will disrupt flow

Arachnoid space will disrupt reabsorption

41
Q

What effect of hydrocephalus would you see in an infant but not in an adult?

A

Hydrocephaly where the head is enlarged as there bones and sutures are not fused together properly

42
Q

How do you fix a ventricular system blockage?

A

Drain the built up CSF by putting a shunt in

Block 3 (40 decks)

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