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2 - HNA > The Cranium, Meninges & Venous Sinuses > Flashcards

The Cranium, Meninges & Venous Sinuses Flashcards

1
Q

Bones of the skull vault

A

Unpaired:

  • Frontal
  • Ethmoid
  • Sphenoid
  • Occipital

Paired:

  • Temporal
  • Parietal
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2
Q

Features of the Frontal Bone

A
  1. Supra-orbital notches
  2. Superior cilliary ridges
  3. Air sinuses (initially 2 parts, fuse in early life)
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3
Q

Parts of the Sphenoid Bone

A
  1. Greater & lesser wings
  2. Medial & lateral pterygoid plates
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4
Q

Features of the sphenoid bone

A
  • Sella turcica (contains pituitary)
  • Foramina:
  1. Optical canals
  2. Superior orbital fissures
  3. Rotundum
  4. Ovale
  5. Spinosum
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5
Q

Parts of the Temporal Bone

A
  1. Squamous
  2. Petromastoid
  3. Tympanic
  4. Styloid process
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6
Q

Features of the petromastoid part of the temporal bone

A
  • Middle & inner ear
  • Internal auditory meatus
  • Facial canal
  • Air cells (in mastoid process)
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7
Q

Features of squamous part of the temporal bone

A
  • Zygomatic process
  • Mandibular fossa
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8
Q

Features of tympanic part of the temporal bone

A
  • External auditory meatus
  • Acts as attachment for tympanic membrane
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9
Q

Features of the styloid process

A
  • Attachment for ligaments and muscles

NB: CN VII emerges from the adjacent stylomastoid foramen

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10
Q

Features of the parietal bone

A
  • Foramina for emissary veins
    • Connect scalp veins → dural sinuses
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11
Q

Parts of the occipital bone

A
  1. Squamous
  2. Basal
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12
Q

Features of the occipital bone

A
  • Superior nuchal line
  • Occipital protuberance
  • Occipital condyles
  • Foramen magnum
  • Hypoglossal canals
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13
Q

Discuss fractures of the skull vault

A

Fractures heal with fibrous tissue which may not ossify, leaving fracture lines visible on x-ray

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14
Q

Discuss cranial suture size and the clincal relevance

A

Growth of cranial suture is the result of intracranial pressure i.e. NOT genetically controlled

Clinical relevance:

  • Low IC pressure = microencephaly
  • High IC pressure = hydrocephaly

NB: pterion = meeting of sutures of sphenoid (greater wing), temporal, parietal & frontal bones

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15
Q
A
  • A: Crista Galli
  • B: Hypoglossal Canal (CN XII)
  • C: Foramen Ovale (CN Vc)
  • D: Foramina for Olfactory Nerves (CN I)
  • E: Internal Auditory Meatus (CN VII & VIII)
  • F: Optic Canal (CN II)
  • G: Foramen Rotundum (Vb)
  • H: Jugular Foramen (CN IX, X, XI)
  • I: Superior Orbital Fissure (CN III, IV, Va & VI)
  • J: Foramen Lacerum
  • K: Foramen Spinosum:
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16
Q

Features of the anterior cranial fossa

A
  • Foramina for olfactory filaments (cribriform plate)
  • Crista galli (attachment for falx cerebri)

NB: houses frontal lobes

17
Q

Features of the middle cranial fossa

A
  • Pituitary fossa
  • Clinoid processes (form sella turcica w/ fossa)
  • Superior orbital fossa
  • Foramen ovale
  • Foramen rotundum
  • Foramen spinosum

NB: houses temporal lobes laterally

18
Q

Features of the posterior cranial fossa

A
  • Internal acoustic meatus
  • Jugular foramen
  • Hypoglossal canal
  • Foramen magnum

NB: houses occipital lobes

19
Q

Define the meninges

A

A tri-layered connective tissue membrane structure investing the brain and spinal cord:

  1. Dura mater (two layers)
  2. Arachnoid mater
  3. Pia mater
20
Q

Discuss the dura mater

A
  • Dense connective tissue layer
  • Two layers (single around spinal cord)
    • Endosteal layer - cont. with pericranium
    • Meningeal layer
  • United, separated to form the dural sinuses
  • Reflected to form folds
    1. Falx cerebri - sep. cerebral hemispheres
    2. Tentorium cerebelli - sep. cerebrum from cerebellum
    3. Falx cerebelli - sep. cerebellar hemispheres
    4. Diaphragma sellae covering pituitary fossa
21
Q

Discuss the arachnoid mater

A
  • Thin & non-vascular
    • In cranium, it is thicker, with strands connecting it to the pia
  • Subarachnoid space filled with CSF
    • Cisterns form where the arachnoid bridges across larger grooves
22
Q

Discuss the pia mater

A
  • Delicate, highly vascular layer
  • Invests grooves, sulci (brain) & ventral median fissure (cord)
23
Q

Discuss the meningeal spaces

A

Spinal:

  • Spinal epidural: between dura & periosteum
    • Loose connective tissue, venous plexuses and lymphatics

Cranial:

  • Extradural: between endosteal layer & skull
    • Potential space
  • Subdural: between dura & arachnoid
    • Potential space
  • Subarachnoid: between arachnoid & pia
    • Extends to lumbar cistern (S2) in adults
24
Q

Drainage of dural venous sinuses - Diagram

A
25
Q

Define the dural venous sinuses

A

Complex network of venous channels draining blood from the brain and cranium

NB: Lined with vascular endothelium but lack valves/musculature

26
Q

Path of the superior sagittal sinus

A
  • Begins at the crista galli, runs in the superior margin of falx cerebri
  • Forms median groove in cranial vault
  • Drains to right transverse sinus
27
Q

Path of the inferior sagi ttal sinus

A
  • Runs in posteroinferior border of falx cerebri
  • Joins great cerebral vein & basal vein to form straight sinus
  • Straight sinus runs in falx cerebri tentorium cerebelli junction
  • Continues as the left transverse sinus
28
Q

Path of the transverse sinus

A
  • Run in lateral margins of tentorium cerebelli
  • Receives superior petrosal → sigmoid sinus
29
Q

Path of the greater petrosal sinus

A
  • Runs in edge of tentorium cerebelli (where TC attaches to petrous bone)
  • Joins with cavernous sinus with transverse sinus
  • GPS + TS form sigmoid sinus
30
Q

Path of the sigmoid sinus

A
  • Deeply grooves petrous temporal bone
  • Curves forward onto occipital bone → jugular foramen
  • Lies medial to mastoid air cells
    • Consequences for mastoiditis
  • Joins with lesser petrosal sinus to form internal jugular vein
31
Q

Path of the inferior petrosal sinus

A
  • Lies in groove between occipital and petrous temporal bones
  • Joins with the sigmoid sinus
32
Q

Describe the cavernous sinus

A
  • Contains interlacing strands of connective tissue forming a cavern-like meshwork
  • Lies either side of body of sphenoid
  • Infections of face can spread to sinus
    • Facial → superior ophthalmic → sinus
    • Causes cavernous sinus thrombosis
33
Q

Limits of the spinal cord

A
  • Foramen magnum → Lower board of L1
    • Tapers at end as conus medullaris
  • Filum terminale attaches conus to dural sac (S2)
    • Stalk of pia
  • Cauda equina = roots of spinal nerves S2-Co
    • Pass caudal from conus
34
Q

Discuss lumbar punctures

A
  • Performed in L3/4 intervertebral space to collect CSF for:
    • Diagnosis
    • Therapeutics (spinal analgesia, chemo)
35
Q

Discuss the spinal nerve roots

A
  • Ventral aspect gives rise to motor fibres, dorsal aspect = sensory
    • Join, form mixed spinal nerves of intervertebral foramina
  • Covered by the meninges which fuse with epineurium as emerge from IV foramen

2 - HNA (11 decks)

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