The Meninges & Dural Venous Sinuses

Question 1

the brain & spinal cord are surrounded by three membranes or ___ (3)

Answer 1

meninges

• dura mater
• arachnoid
• pia mater

Question 2

the meninges:

protect the ___

provide a framework for ___ supply

enclose the ___ space containing ___ fluid which is vital for normal brain functioning

Answer 2

brain

vascular supply

subarachnoid space
cerebrospinal fluid

Question 3

dura mater:

pachymeninx - meaning ___ membrane

two layers (2)

Answer 3

thick

endosteal layer
meningeal layer (dura mater proper)

Question 4

dura mater:
endosteal layer:

ordinary ___ covering inner surface of the skull bones

does not extend through the ___ to become continuous w/ the dura mater of the ___

it is continuous w/ the ___ on the outside of the ___ around the margins of all the foramina of the ___

Answer 4

periosteum

foramen magnum
spinal cord

periosteum
skull
skull

Question 5

dura mater:
meningeal layer (dura mater proper):

dense, strong, fibrous layer covering the ___ & is continuous w/ the dura mater surrounding the ___

sends inward four ___ (___) which separate the regions of the brain from each other

which restrict rotatory ___ of the brain

Answer 5

brain
spinal cord

dural infoldings (septa)

displacement

Question 6

dura mater:
dural reflections (4)

Answer 6

falx cerebri
tentorium cerebelli
falx cerebelli
diaphragma sellae

Question 7

dura mater:
dural reflections:
falx cerebri:

___-shaped fold of dura mater that lies at the ___ separating the two ___

Answer 7

sickle-shaped
midline
cerebral hemispheres

Question 8

dura mater:
dural reflections:
falx cerebri:

attached in the median plane to the inner surface of the skull from the ___ crest & ___ anteriorly, to the ___ protuberance posteriorly

inferiorly, it blends at the midline w/ the ___

Answer 8

frontal crest
crista galli
internal occipital protuberance

tentorium cerebelli

Question 9

dura mater:
dural reflections:
tentorium cerebelli:

___-shaped fold which separates the ___ lobes of the brain from the ___

contains a gap anteriorly called the ___ for the passage of the midbrain

Answer 9

crescent-shaped
occipital lobes
cerebellum

tentorial notch

Question 10

dura mater:
dural reflections:
tentorium cerebelli:

attached to the ___ processes of the ___ bone, the superior borders of the ___ bones, & the margins of the grooves for the ___ sinuses on the ___ bones

the ___ is attached to the upper surface of the tentorium & holds it up

Answer 10

clinoid processes of the sphenoid bone
petrous temporal bones
transverse sinuses on the occipital bones

falx cerebri

Question 11

dura mater:
dural reflections:
falx cerebelli:

small, ___-shaped fold lying inferior to the ___

attached to the inferior surface of the ___ & the ___

partially separates the ___

Answer 11

sickle-shaped
tentorium cerebelli

tentorium
internal occipital crest

cerebellar hemispheres

Question 12

dura mater:
dural reflections:
diaphragma sellae:

small ___ fold of dura mater that forms the roof for the ___

a small opening in its center allows the passage of the ___ of the ___

Answer 12

circular fold
sella turcica

infundibular stalk of the hypophysis

Question 13

dural venous sinuses:

___ lined spaces b/n the ___ & ___ layers of the dura where the ___ attach

Answer 13

endothelium

periosteal & meningeal layers

dural septa

Question 14

dural venous sinuses:

receive blood from: (4)

all blood from the brain eventually drains through them to the ___ veins

Answer 14

brain
skull
orbit
internal ear

internal jugular veins

Question 15

dural venous sinuses:
major sinuses (6)

Answer 15

superior sagittal sinus
inferior sagittal sinus
straight sinus
transverse sinuses
sigmoid sinuses
cavernous sinuses

Question 16

dural venous sinuses:
superior sagittal sinus:

occupies the upper attached border of the ___

begins anteriorly at the ___ & ends at the ___ near the ___ protuberance

Answer 16

falx cerebri

foramen cecum
confluens of hte sinuses
internal occipital protuberance

Question 17

dural venous sinuses:
superior sagittal sinus:

the confluens of the sinuses is the meeting place of four sinuses (4)

Answer 17

superior sagittal
straight
occipital
transverse

Question 18

dural venous sinuses:
superior sagittal sinus:

communicates through small openings on each side w/ several irregularly-shaped ___

___ (collections of arachnoid villi) protrude through the ___ layer of the dura into the dural venous sinuses & especially the ___ & effect transfer of ___ fluid to the venous system

Answer 18

venous lacunae

arachnoid granulations
meningeal
lateral lacunae
cerebrospinal fluid

Question 19

dural venous sinuses:
inferior sagittal sinus:

occupies the free inferior margin of the ___

continues as the ___ sinus after union w/ the ___ vein of ___

Answer 19

falx cerebri

straight sinus
great cerebral vein of galen

Question 20

dural venous sinuses:
straight sinus:

occupies the line of junction b/n the ___ & the ___

joins the ___

Answer 20

falx cerebri
tentorium cerebelli

confluens of the sinuses

Question 21

dural venous sinuses:
transverse sinuses:

paired structures which begin at the ___ protuberance & course along the attached margins of the ___

the trasnverse sinuses drain the ___

Answer 21

internal occipital protuberance
tentorium cerebelli

confluens of the sinuses

Question 22

dural venous sinuses:
sigmoid sinuses:

direct continuations of the ___ sinuses forming s-shaped grooves in the ___ & ___ bones

continue in the ___ foramen as the ___ vein

Answer 22

transverse sinuses
temporal & occipital bones

jugular foramen
internal jugular vein

Question 23

dural venous sinuses:
cavernous sinuses:

situated on each side of the ___ of the ___ bone

the two sinuses communicate w/ each other via ___ sinuses

Answer 23

sella turcica
sphenoid bone

intercavernous

Question 24

dural venous sinuses:
cavernous sinuses:

receive blood from:

• ___ & ___ veins
• ___ sinuses
• ___ veins

Answer 24

superior & inferior opthalmic veins
sphenoparietal sinuses
cerebral veins

Question 25

dural venous sinuses:
cavernous sinuses:

drained by the:

• ___ & ___ sinuses
• ___ plexus

Answer 25

superior & infeiror petrosal sinuses

pterygoid venous plexus

Question 26

pia-arachnoid:

the ___ membrane & ___ mater develop from a single embryonic membrane, the ___

Answer 26

arachnoid membrane
pia mater
leptomeninx

Question 27

pia-arachnoid:
arachnoid membrane:

delicate, impermeable membrane separated from the dura by a potential space (the ___ space) & from the pia mater by the ___ space

the latter space is filled w/ ___ fluid which is produced by the ___ plexuses

Answer 27

subdural space
subarachnoid space

cerebrospinal fluid
choroid plexuses

Question 28

pia-arachnoid:
arachnoid membrane:

in certain areas, the arachnoid projects into the ___ sinuses to form ___

aggregations of these are called ___

Answer 28

venous sinuses
arachnoid villi

arachnoid granulations

Question 29

pia-arachnoid:
arachnoid membrane:

arachnoid villi & granulations are most numerous along the ___ sinus & ___ lacunae

arachnoid villi serve as sites where ___ fluid diffuses into the ___

Answer 29

supeiro sagittal sinus
lateral venous lacunae

cerebrospinal fluid
bloodstream

Question 30

pia-arachnoid:
pia mater:

delicate, ___ layer which closely invests the ___

Answer 30

vascular

brain

Question 31

brain supply of the dura mater:

the arteries supplying the dura mater are small w/ the exception of the ___ artery

the dense fibrous composition of the dura mater needs little blood supply & all of the ___ arteries serve to supply the ___ bones more than the underlying dura mater

Answer 31

middle meningeal artery

meningeal arteries
cranial bones

Question 32

innervation of the dura mater:
three fossas (3)

Answer 32

anterior cranial fossa
middle cranial fossa
posterior cranial fossa

Question 33

innervation of the dura mater:
anterior cranial fossa:

meningeal branches of the ___ nerve from the ophthalmic nerve (CN V1) supply the floor & anterior parts of the ___

additionally, another branch of the opthalmic nerve (___ branch) turns & runs posteriorly supplying the ___ & posteiror part of hte ___

Answer 33

anterior ethmoidal nerve
falx cerebri

tentorial branch
tentorium cerebelli
falx cerebri

Question 34

innervation of the dura mater:
middle cranial fossa:

supplied (medially/laterally) by meningeal branches of the ___ nerve

supplied (medially/laterally) by the meningeal branch of the ___ nerve which follows the distribution of the ___ artery

Answer 34

medially
maxillary nerve (CN V2)

laterally
mandibular nerve (nervous spinosus, CN V3)
middle meningeal artery

Question 35

innervation of the dura mater:
posterior cranial fossa:

supplied by meningeal branches of the ___ nerves, which enter the fossa through the ___, the ___, & the ___

the nerve fibers passing through the ___ & ___ pass along the ___ nerve & ___ nerves, respectively

Answer 35

firs tthree cervical nerves
foramen magnum
jugular foramen
hypoglossal canal

jugular foramen & hypoglossal canal
vagus nerve & hypoglossal nerves

Question 36

innervation of the dura mater:

all meningeal nerve branches carry (pre/postgang) (symp/parasymp) fibers originating in the ___ ganglion

Answer 36

postganglionic sympathetic fibers

superior cervical ganglion

Question 37

innervation of the dura mater:

the brain itself, the pia mater, & the arachnoid mater do not contain (sensory/motor) nerve endings

these endings are restricted to the dura mater & are especially abundant along the courses of the ___ sinuses & the ___ artery

stimulation along these nerve endings gives rise to pain that may be “referred” perceived as coming from the ___ or ___ region

Answer 37

sensory

dural venous sinuses
middle meningeal artery
face or neck region

Question 38

clinical correlations:
the cavernous sinuses:

the cavernous sinus is clinically important

the ___ artery & ___ nerve pass through the sinus

the ___ nerve, ___ nerve, & ___ & ___ divisions of the ___ nerve lie in its lateral wall

Answer 38

internal carotid artery
abducens nerve

oculomotor nerve
trochlear nerve
ophthalmic & maxillary divisions of the trigeminal nerve

Question 39

clinical correlations:
the cavernous sinuses:

the cavernous sinuses communicate anteriorly w/ the ___ vein via the ___ veins

they also communicate inferiorly w/ the ___ plexus (both directly & indirectly) & posteriorly w/ the ___ plexus which in turn communicates w/ the ___ plexus

Answer 39

facial vein
ophthalmic veins

pterygoid venous plexus
basilar plexus
internal vertebral plexus

Question 40

clinical correlations:
the cavernous sinuses:

there are no ___ in any of the communicating vessels

hence, any infection in any of the regions can spread into the cavernous sinuses & result in ___ & ___

Answer 40

valves

thrombosis
meningitis

Question 41

clinical correlations:
epidural hematoma:

this results form injuries to the ___ arteries

the most common artery to be damaged is the anterior division of the ___ artery

a comparatively minor blow to the side of the head in the region of the ___ may sever the artery

Answer 41

meningeal

middle meningeal artery

pterion

Question 42

clinical correlations:
epidural hematoma:

the pterion is the junction region of the ___ bone, ___ bone, ___ bone, & the greater wing of the ___ bone

Answer 42

frontal bone
parietal bone
temporal bone
sphenoid bone

Question 43

clinical correlations:
epidural hematoma:

blood collects b/n the ___ layer of the dura mater & the ___

intracranial pressure rises & the enlarging blood clot may exert pressure on the (sensory/motor) area of the cerebral cortex

Answer 43

periosteal layer
skull

motor

Question 44

clinical correlations:
subdural hematoma:

this results from tearing of the ___ veins at their point of entrance to the ___ sinus

the cause is usually a blow to the front of the back of the ___ causing excessive anterior-posterior displacement of the ___

blood form the torn veins begins to accumulate in the potential space b/n the ___ mater & the ___ membrane

Answer 44

superior cerebral veins
superior sagittal sinus

head
brain within the skull

dura mater
arachnoid membrane

Question 45

clinical correlations:
epidural hematoma:
subarachnoid hemorrhage:

this condition results from leakage of blood (usually arterial) into the ___ space

they often result from a leakage or rupture of a ___ aneurysm on the ___

Answer 45

subarachnoid space

congenital aneurysm
circle of willis