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BDS3 - Anatomy > week 4 > Flashcards

week 4 Flashcards

1
Q

with regards to the central sulcus, where would you find the motor cortex and somaesthetic cortex

A

Motor cortex in front

somaesthetic cortex behind

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2
Q

what is found on the left hemisphere beside the motor cortex

A

the motor speech area

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3
Q

what is the path of the anterior cerebral artery

A
  • goes forwards on the medial side near the frontal lobe

- and gives branches around the corner into the lateral side

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4
Q

what does the posterior cerebral artery supply?

A

posterior part of hemisphere and much of the lower part of the hemisphere

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5
Q

where does the middle cerebral artery come from

A

the main continuation from the internal carotid artery

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6
Q

what is the path of the middle cerebral artery

A

Comes off the internal carotid artery and moves laterally and runs into the deep part of the lateral fissure

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7
Q

if the patient has an embolus / blood clot which artery territory is most likely to be affected

A

If the patient had an embolus / blood clot it is quite likely to go into the territory of the middle cerebral artery

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8
Q

what is the effect on the patient if there is damage to the left cerebral artery

A

patient likely to be paralysed in the face on the opposite side (in this patient it would be the right side that is affected), lower face and upper limb on right hand side

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9
Q

what artery supplies the lower limn area of the hemisphere

A

anterior cerebral artery

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10
Q

what artery supplies the area of the motor speech area

A

left middle cerebral artery

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11
Q

how would a lesion in the left middle cerebral artery affect the motor speech area?

A

the patient cannot put a speech together and what comes out is unintelligible sounds

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12
Q

what other cortex might be affected by a lesion in the left middle cerebral artery

A

auditory cortex

but hopefully the other side would be able to maintain some of the hearing

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13
Q

where is the visual cortex found

A

posterior cerebral cortex

the visual cortex is in this territory on the medial side of the hemisphere

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14
Q

what. is the cranial cavity lined by

A

dura mater - the outer most layer of the meninges

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15
Q

what can be see around the outside of the floor of the cranial cavity

A

the cut edge of the vault

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16
Q

what can be seen at the front within the vault

A

the frontal air sinus

one on each side of the midline

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17
Q

where is bone marrow found

A

Bone marrow is found in between the inner and outer tables of the skull

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18
Q

what is diploe

A

Diploe is the spongy cancellous bone separating the inner and outer layers of the cortical bone of the skull.

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19
Q

what is the first cranial nerve

A

olfactory nerve

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20
Q

how / where does the olfactory nerve appear on the floor of the cranial cavity

A

Lots of little nerves come from the olfactory epithelium

these little nerves come through the cribriform plate of the ethmoid bone

Soon join the olfactory bulb which has a long tract which leads to the rest of the forebrain

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21
Q

what is the role of the olfactory nerve

A

Takes information about the sense of smell to the frontal lobe of the brain

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22
Q

what is the bony projection in the anterior cranial fossa called

A

anterior clinoid process

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23
Q

what is the anterior clinoid process a useful landmark for?

A

when looking for the optic nerve

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24
Q

what is the second cranial nerve

A

the optic nerve

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25
Q

what is the path of the optic nerve

A

The optic nerve is passing from the cranial cavity into the orbit through the optic canal (a little round bony opening)

the optic nerve disappears out of the cranial cavity next to the anterior clinoid process

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26
Q

what can be see a little behind the optic nerve

A

pituitary stalk

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27
Q

what is the name of the thin layer of dura mater that covers the pituitary gland

A

diaphragma sellae

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28
Q

what artery can be seen next to the optic chiasm and the pituitary stalk

A

internal carotid artery

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29
Q

abnormal swellings / aneurysms of the internal carotid can cause what problem

A

Abnormal swellings / aneurysm (pathological swelling) of the artery can press on the optic chiasm and cause visual disturbances

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30
Q

what is the superior orbital fissure

A

large comma shaped opening which leads into the orbit)

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31
Q

what is the 3rd cranial nerve

A

oculomotor nerve

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32
Q

what is the 4th cranial nerve

A

trochlear nerve

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33
Q

what is the 5th cranial nerve

A

trigeminal nerve

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34
Q

what does the oculmotor nerve pass through to leave the cranial cavity

A

superior orbital fissure

runs forward underneath the dura but on top of the bone

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35
Q

where is the trochlear nerve in relation to the oculomotor nerve

A

Immediately behind the oculomotor, and slightly to the side

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36
Q

what does the trochlear supply

A

Supplies the superior oblique muscle / muscles in the orbit

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37
Q

what does the trochlear nerve pass through

A

superior orbital fissure

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38
Q

where is the territory of the middle cranial fossa between

A

The middle cranial fossa is from the lesser wing of the sphenoid bone to the border of the petrous temporal bone

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39
Q

where is the trigeminal nerve found

A

Right at the back edge of the middle cranial fossa

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40
Q

where is the trigeminal nerve in relation to the 3rd and 4th cranial nerve

A

It is found a little bit lateral to where the 3rd and 4th cranial nerve is

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41
Q

what is the path of the trigeminal nerve

A

Comes from the pons, disappears into a tunnel / cave in the dura called the trigeminal cave

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42
Q

what are the divisions of the trigeminal nerve

A
  • opthalmic
  • maxillary
  • mandibular
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43
Q

what happens after the trigeminal nerve enters the trigeminal cave

A

We will find that very soon after going into the trigeminal cave, we would find the trigeminal ganglion and the 3 divisions of the trigeminal nerve

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44
Q

what is the trigeminal ganglino

A

Flat lacey structure is the trigeminal ganglion and from that the branches come off

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45
Q

what is the path of the opthalmic division

A

The ophthalmic division goes forwards from the ganglion and disappears out of the cranial cavity into the orbit through the superior orbital fissure, going to supply the skin of the forehead and the front of the skull

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46
Q

what is the path of the maxillary division

A

quite close to the opthalmic division and running forwards [but not quite so far] is the maxillary division which is going to the foramen rotundum

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47
Q

what is the path of the mandibular division

A

Out to the side is the mandibular division which is going to the foramen ovale

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48
Q

what is found within the trigeminal ganglion

A

Cell bodies of many of the sensory neurons of the trigeminal lie within the trigeminal ganglion

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49
Q

what is teh french word for trigeminal neuralgia

A

Tic Doloreux

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50
Q

what is trigeminal neuralgia

A

Terrible condition, common enough

Presents as an extremely sharp pain in one of the sensory areas of the trigeminal nerve, quite often the maxillary division

patient experiences this extremely sharp pain on one side of their face

Very difficult to manage

Dental treatment can act as a trigger for it - might come across it

Very often treated medically with a drug called carbamazepine - suppressor drug, anti-epileptic

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51
Q

what is the foramen magnum

A

large hole in the base of the skull

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52
Q

what is the 6th cranial nerve

A

abducens

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53
Q

what is the clivus

A

that long slope down to the foramen magnum n the posterior cranial fossa

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54
Q

what is the path of the abducens nerve

A

Has a very long course

its going to run under the dura over the edge of the petrous temporal bone then forwards to get to the superior orbital fissure where it will leave the cranial cavities

(has a long way deep to the dura before it actually goes out through the bone)

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55
Q

what is the 7th cranial nerve

A

facial nerve

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56
Q

what is the 8th cranial nerve

A

vestibulocochlear nerve

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57
Q

where is the 8th cranial nerve found

A

the 8th is lateral to the 7th and a little bigger than the 7th

Important clinically but not so much as a dental significance

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58
Q

what is the passage way of the 7th and 8th cranial nerves

A

The passage way these nerves are going into is called the internal auditory / acoustic meatus (bony opening) on their way to an area where the middle ear is (middle ear inside the petrous temporal bone)

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59
Q

where does the 8th nerve go to

A

the ear

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60
Q

where does the 7th nerve go to

A

The 7th nerve is going to carry on past CN8, run close to the middle ear then comes out from the base of the skull to supply the muscles of facial expression

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61
Q

what is the 9th cranial nerve

A

glossopharyngeal

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62
Q

what is the 10th cranial nerve

A

vagus nerve

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63
Q

what is the 11th cranial nerve

A

accessory nerve

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64
Q

what is the 12th cranial nerve

A

hypoglossal nerve

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65
Q

where is the 10th and 11th (cranial root) cranial nerves found

A

Immediately behind the 9th nerve and lateral to this is the 10th nerve (quite big) and a little 11th nerve (cranial root)

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66
Q

what does the cranial root of CN11 do

A

the cranial root helps the vagus supply the muscles of the pharynx and larynx

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67
Q

what nerve comes up from the upper cervical cord

A

the spinal root of the accessory nerve

Spinal root comes from the first 5 cervical segments of the spinal cord

it comes up from the foramen magnum and joins CN9, CN10 and the cranial root of CN11

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68
Q

what does the spinal root of CN11 do

A

supply the sternocleidomastoid muscle and the trapezius

69
Q

what do the vertebral arteries join to form

A

basilar artery

70
Q

where does the basilar artery run up

A

the pons

71
Q

where do the vertebral enter the cranial cavity

A

foramen magnum

72
Q

where do the vertebral arteries join together to form the basilar artery

A

The vertebral arteries are coming through the dura themselves into the view, comes up from below and into the spinal canal, makes its way up through the foramen magnum, up alongside the medulla then when it gets to the pons it joins together to form the basilar artery

73
Q

what is found in front of the foramen magnum

A

little rootlets of the hypoglossal nerve

74
Q

what does the hypoglossal nerve supply

A

muscles of the tongue

75
Q

what does the hypoglossal nerve pass into

A

hypoglossal canal

76
Q

where is the hypoglossal canal found

A

sits just in front of the foramen magnum, slightly to the side of the midline

Imagine it is disappearing under the dura

77
Q

what is found immediately inside the vault of the skull

A

dura mater

78
Q

is the dura mater attached to the vault

A

Slightly attached to the vault but its not firmly attached to the vault

we can take the vault off and push the dura away

79
Q

what is can be seen in the midline of a coronal section of the head

A

falx cerebri ~ a large sickle shaped fold

80
Q

what is inside the falx cerebri

A

superior sagittal sinus

81
Q

what is in the superior sagittal sinus

A

venous blood

82
Q

what are the 3 layers of meninges

A
  • Dura mater
  • Arachnoid mater
  • Pia mater
83
Q

where is the pia mater dound

A

On the surface of the brain

also found down around the spinal cord (covers the CNS)

84
Q

describe the pia mater layer

A

Quite a vascular area - many fine blood vessels in it

Very thin

Follows the surface of the brain everywhere - where there is a gyrus it follows it down into the depths of the sulci

85
Q

what is the arachnoid layer

A

middle layer of meninges

86
Q

where is the arachnoid layer found

A

Lies immediately deep to the dura

not really attached to the dura, just pushed up against the dura

87
Q

what is the difference between the meninges layers

A

Arachnoid and pia are quite soft, flimsy layers

whereas the dura is a very tough layer of collagen

88
Q

where is cerebral spinal fluid made

A

inside the ventricles

89
Q

what is the space between teh arachnoid and pia layer called

A

sub-arachnoid space

90
Q

where is the 4th ventricle found

A

Down at the hind brain, where there is the 4th ventricle, the space between the cerebellum on one side and the pons and the medulla on the othe

91
Q

how does the CSF escape the brain

A

escapes from the 4th ventricle at the hind brain

92
Q

where is CSF found outside the brain

A

in the sub-arachnoid space

also goes down around the spinal cord as well through the foramen magnum

93
Q

what is the function of CSF

A

CSF has biochemical functions

also helps to cushion the brain if someone was to fall and the brain was to move slightly

94
Q

what gives off the thin cob web like strands found within the sub-arachnoid space

A

little extensions from the arachnoid mater

95
Q

where else can these little projections of arachnoid be found

A

Up at the sinuses, the superior sagittal sinus for example, there are little projections of arachnoid through the wall of the sinus that absorb the CSF - these are arachnoid vili

96
Q

what are arachnoid villi

A

The arachnoid villi are little specialisations of the arachnoid that pass through the dura and into the lumen of the superior sagittal sinus

97
Q

what happens to the CSF around the brain

A

the CSF around the brain is gradually absorbed into the blood stream of the sinuses by the arachnoid villi

98
Q

what happens to the CSF around the spinal cord

A

it is taken away by local lymphatics down in the vertebral region

99
Q

what else drains the brain

A

Also get veins draining the brain and heading through the dura as well and opening into the sinus

cerebral vein coming over from the brain into the sinus

100
Q

what does the middle meningeal artery supply

A

the vault and to some extent the meninges

101
Q

where does the middle meningeal artery run

A

running up between the dura and the bone

the artery is running in a groove at this site of the pterion

102
Q

what happens if fracture occurs at the pterion

A

the middle meningeal artery is likely to burst and the blood starts to come out of the vessel between the dura and the bone

enlarges the blood clot / haematoma which then starts to press on the underlying brain

This build up of blood would probably happen over a few hours - patient’s conscious level would start to deteriorate and they might become confused

extra dural haemorrhage

103
Q

what are the 3 types of haemorrhages you get around the brain (extracerebral)

A
  • extradural haemorrhage
  • subdural haemorrhage
  • subarachnoid haemorrhage
104
Q

what is an extradural haemorrhage

A

○ Rupture of the middle meningeal artery
○ Between the dura and the bone
○ Occurs over a few hours with the patient’s conscious level deteriorating
○Happen to anyone at any age if they get a fracture to the skull

105
Q

what is a subdural haemorrhage

A

○ Involves the cerebral veins

○ Tends to happen in the elderly with a small blow to the head - tissues aren’t quite as resilient as they were before so even a little bump of the head could be enough to move the brain

○ Cerebral vein is going from the brain through the dura to the superior sagittal sinus
§ The soft vein is attached to the firm dura - movement is likely to damage this site, can actually pull the vein off just as it is going into the dura

○ Arachnoid is immediately internal to the dura so blood starts to build up between the arachnoid and the dura

○ Blood tends to ooze out slowly and you get an enlarging blood clot between the dura and the arachnoid
§ Because it is venous blood it is not coming out as quickly as arterial blood does in an extradural haemorrhage

○ Tends to occur over a few days / weeks

106
Q

what is a subarachnoid haemorrhage

A

○ Bleeding of the cerebral arteries still at base of brain
○ Around the area of the circle of Willis you might get a little aneurysm which is known as a Berry aneurysm

○ sometimes in middle life people get a little pathological swelling somewhere on the arteries in this area (often where there is a bifurcation of an artery)
Can burst and give a subarachnoid haemorrhage

○ Can either be caused by trauma or can occur spontaneously

○ Massive bleed into the subarachnoid space, only on the underside of the brain
§ Arterial blood

○ Patients often have a very severe headache in the moments before they go unconscious or sometimes people go unconscious immediately - well recognised cause of sudden death

○ Caused by the pathological process that causes a localised weakness of the artery (aneurysm)

107
Q

what part of the brain overlies the foramen magnum

A

cerebellum

108
Q

what is the layer of dura that covers the cerebellum called

A

tentorium cerebelli

has a gap in it for brainstem to pass down

109
Q

where does the superior sagittal sinus comes down

A

where the falks meets the tentorium cerebelli

check diagram lol cos i think ive taken this down wrong

but i think the superior sagittal sinus runs within the falks to the back of the skull?

110
Q

what happens to the blood in the superior sagittal sinus when it gets to the tentorium cerebelli

A

the blood in it swings to the right and the name of the sinus changes to the right transverse sinus

111
Q

where does the right transverse sinus run

A

Right transverse sinus runs from the place where the tentorium is meeting the side wall

makes a groove on the inside of the bone of the skull

112
Q

what happens to the right transverse sinus once it reaches the front of the postrerior cranial fossa

A

it changes direction again and forms an ‘S’ shaped bend

it is now called the sigmoid sinus

113
Q

where is the sigmoid sinus found

A

Deep to the dura of the floor of the posterior cranial fossa, down under the cerebellum

114
Q

where does the sigmoid sinus exit the skull

A

at the jugular foramen

115
Q

what else leaves the skull at the jugular foramen

A

CN9
CN10
CN11

116
Q

what does the blood run into runs it leaves the skull at the jugular foramen

A

once the blood leaves the skull at the right jugular foramen it becomes the right internal jugular vein

117
Q

where does the straight sinus run

A

the straight sinus which is running in the place where the falks is meeting the tentorium

118
Q

where does the straight sinus go

A

it comes round and swings to the left and becomes the left transverse sinus

119
Q

what happens to the left transverse sinus

A

The left transverse sinus then forms an ‘S’ shaped bend (sigmoid sinus) and goes down to the jugular foramen as well

120
Q

what is the little connection between the straight sinus and the superior sagittal sinus called

A

the confluence of sinuses

121
Q

where does the transverse sinus run

A

Transverse sinus runs fairly horizontally where the tentorium is meeting the side wall

122
Q

in the middle cranial fossa, what sinus is formed when 2 opthalmic veins join together

A

cavernous sinus

123
Q

how is the cavernous sinus drained

A

drained by little sinuses which run along the edge and down

these are called the superior and inferior petrosal sinuses

124
Q

where does the cavernous sinus receive blood from

A

Cavernous sinus is receiving lots and lots of blood from the orbit, has connections to the face through the orbit so there is lots of venous blood coming in the ophthalmic veins in the orbit which drains into the cavernous sinus

125
Q

is the cavernous sinus a single lumen

A

There are lots of spaces within the cavernous sinus,

it is not a single lumen, instead

there are lots of little lumens within

126
Q

how fast is the blood flow within the cavernous sinus

A

there is a very slow blood flow through the cavernous sinus

127
Q

what sinus travels to the sigmoid sinus from the middle cranial fossa

A

The petrosal sinuses go down to the sigmoid sinuses and so goes out into the internal jugular vein
(superior and inferior petrosal sinuses)

128
Q

what is the vein that comes out the side of the cavernous sinus

A

sphenoidal emissary vein

129
Q

where does the sphenoidal emissary vein go

A

goes through the base of the skull

often goes through the foramen ovale but sometimes it has its own hole

130
Q

what problems can patients get in the cavernous sinus

A

thrombosis of the cavernous sinus (the blood inside it clots)

131
Q

why can bacteria multiply from infection within the cavernous sinus

A

because the blood flow is slow

132
Q

what happens if there is bacteria multiplying within the cavernous sinus

A

blood cannot get back from the orbit

133
Q

what are features of cavernous sinus thrombosis

A

swollen eye and fever

134
Q

what is the name of the little plexus of veins from behind the upper jaw

A

pterygoid venous plexus

135
Q

can dental sepsis cause cavernous sinus thrombosis

A

yes

The bacteria from an abscess of a tooth might get into the blood of the pterygoid venous plexus

this plexus connects through the little sphenoidal emissary vein into the cavernous sinus

It is possible that bacteria from the upper jaw area to make their way through the veins into the cavernous sinus and allow bacteria to multiply and the blood to clot

Thrombosis stops the blood flowing back from the eye so the patient again has a fever and a swollen eye

136
Q

what colour do bones appear in an MRI scan

A

white

they are radiopaque

137
Q

what is periosteum

A

thin membrane immediately on surface of bone

138
Q

what would you expect to see in the cut surface of the vault

A
  • Part in middle = diploe (spongy bone, rich in bone marrow)
  • Outer zone = outer table of the skull (cortical bone)
  • Inner zone = inner table of the skull (cortical bone)
139
Q

what happens in paget’s disease

A

bone remodelling is out of control

skull can look more bulging in this disease
can affect any part of the skeleton

140
Q

what is the tentorium cerebelli

A

fold of dura mater between the cerebrum and the cerebellum

141
Q

what bony projection does the falx cerebri attach to

A

crista galli

142
Q

where does the great cerebral vein go into

A

straight sinus

143
Q

what is the middle crania fossae

A

depression formed by sphenoid and temporal bones

144
Q

what is the central part of the middle cranial fossae occupied by

A

pituitary gland

145
Q

what do the lateral parts of the middle cranial fossae contain

A

temporal lobes of the cerebral hemispheres of the brain

146
Q

where do the transverse sinuses begin

A

at the confluences of sinuses

147
Q

where do the transverse sinuses pass

A

passes laterally across occipital bone in the attached margin of the tentorium cerebelli

148
Q

where do the transverse sinuses drain into

A

sigmoid sinus

149
Q

where does the transverse sinuses receive from

A
  • inferior cerebellar veins
  • inferior cerebral veins
  • posterior temporal
  • occipital diploic veins
  • superior petrosal sinus (into sigmoid sinus)
150
Q

where is the straight sinus found

A

site of attachment between falx cerebri and tentorium cerebelli

151
Q

where does the straight sinus pass

A

passes down and back to enter confluence of sinuses then continues as left transverse sinus

152
Q

where does the straight sinus receive from

A

superior cerebellar veins

153
Q

where does the superior petrosal sinuses run

A

over the groove of the upper border of petrous parts of temporal bonea

passes back and out from cavernius sinus to transverse sinus at junction with sigmoid sinus

154
Q

where is the inferior petrosal sinuses found

A

at lower border of petrous bone, groove on petro-occipital suture

155
Q

where does the inferior petrosal sinuses pass

A

passes from postero-inferior side of cavernous sinus and terminates at sigmoid sinus / jugular foramen

156
Q

where does the tentorium cerebelli lie

A

between cerebellum and occipital lobes of cerebral hemispheres

157
Q

where does the lateral edges of the tentorium cerebelli attach

A

attach to occipital bone

encloses the transverse sinuses

158
Q

where are the anterior lateral edges of the tentorium cerebelli attached to

A

attached to the upper borders of the petrous parts of temporal bones and contain the superior petrosal sinuses

159
Q

where is the free margin of the tentorium cerebelli found

A

continues anteriorly to get attachment to anterior clinoid processes

160
Q

what is the falx cerebri

A

sickle shaped fold of dura that lies along the median sagittal plane in the longitudinal cerebral fissure between 2 cerebral hemispheres

161
Q

what does the falx cerebri separate

A

separates 2 lobes of cerebellum

162
Q

where does the falx cerebri attach anteriorly

A

the crista galli of the ethmoid bone

163
Q

where else does the falx cerebri attach to the skull

A

attachment to the skull continues supero-posteriorly along the margins of the superior sagittal sinus to the internal occipital protuberance

164
Q

what happens to the falx cerebri at the posterior and inferior limits

A

it is continuous with the tentorium cerebelli

165
Q

where does the inferior sagittal venous sinus run

A

in the free border of the falx cerebri

166
Q

where does the straight sinus run

A

runs along the falx cerebri’s junction with the tentorium cerebelli

167
Q

what is teh anterior cranial fossae

A

depression fromed by frontal, ethmoid and sphenoid bones

168
Q

what is the anterior cranial fossae occupied by

A

frontal lobes of the cerebral hemispheres of brain

BDS3 - Anatomy (10 decks)

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