Week 23 - Brain

Question 1

What type of intracranial bleed is demonstrated in this image?

Answer 1

= Epidural hematoma

Question 2

Name the four bones that unite at the pterion.

Answer 2

Temporal, Parietal, Sphenoid, Frontal

The middle meningeal artery has a number of clinical implications. Rupture of the artery, which most commonly occurs at the pterion, typically leads to an epidural hematoma.

Question 3

Which of the following arteries is found within the cavernous sinus?

• a) External carotid artery
• b) Middle meningeal artery
• c) Internal carotid artery
• d) Middle cerebral artery
• e) Anterior cerebral artery

Answer 3

= Internal carotid artery

Question 4

List the layers pierced during an epidural anaesthetic.

What additional layers must be pierced in order to perform spinal anaesthesia or obtain a lumbar puncture?

Answer 4

Layers pierced for Epidural:

1. Skin
2. Subcutaneous layer
3. Supraspinous ligament
4. Interspinous ligament
5. Ligamentum Flavum
6. Epidural space
7. Dura mater
8. Arachnoid mater
9. Subarachnoid space containing CSF

= Spinal anaesthesia

• Epidural: anaesthetic released into epidural space = longer lasting
• Spinal: anaesthetic released into sub-arachnoid space/CSF = fast acting as anaesthesia acts directly on spinal nerves