PBL(1L) Anatomy
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Transcript of PBL(1L) Anatomy
Anatomy - Chapter 8 (Head and Neck) - Meninges
Brain and spinal cord protected surrounded by what?Meninges
How many layers in the meninges?3
Tough, outer layer?Dura
Delicate, middle layer?Arachnoid
Thin, inner layer?Pia
Cranial dura mater has how many layers?2
Spinal dura mater has how many layers?1
Outer layer of the cranial dura mater?Periosteal layer
What does this outer layer of cranial dura mater contain?Meningeal Arteries
Which layer of cranial dura mater extends through the FM and is continuous with the spinal dura?Meningeal Layer
What are dural partitions made of?Dura Mater
Crescent-shaped downward projection of meningeal dura mater that passes b/n two cerebral hemispheres?Falx Cerebri
Horizontal projection of meningeal dura mater that covers and seperates the cerebellum?Tentorium Cerebelli
Midbrain passes through what structure?Tentorial Notch (oval opening in the midline)
Small midline projection of meningeal dura mater in the posterior cranial fossa?Falx Cerebelli
Small, horizontal shelf of meningeal dura mater that covers the hypophyseal fossa in the sella tursica?Diaphragma Sella
Connects pituitary with the base of the brain, passes through the diaphragma sella?Infundibulum
Artery that supplies the greatest part of the dura?Middle Meningeal
Anterior meningeals are branches off of what artery?Ethmodial Arteries
Middle meningeal is a branch off of what artery?Maxillary
Where does the middle meningeal enter the skull?Foramen Spinosum
Which branch of the middle meningeal crosses the pterion?Anterior
Posteriro meningeal artery is the terminal branch of what artery?Ascending Pharyngeal A. (Jugular Foramen)
All the nerves that innervate the dura mater?First 3 Cervical N., V1, V2, V3, and Vagus
Innveration of the Falx?V1
Innervation of the middle cranial fossa?Medial: V2
Lateral: v3
Innervation of the Posterior Cranial Fossa?First 3 Cervical (enter through foramen magnum, hypoglossal canal and jugular foramen) + Vagus
Thin, avascular membrane that lines, but is NOT adherent to, the inner surface of the dura mater?Arachnoid Mater
Thin processes extend down, across the subarachnoid space and become continous with what?Pia Mater
Only fissure that the arachnoid mater enters?Longitudinal Fissure
Thin, delicate membrane that closely invests the surface of the brain?Pia Mater
Potential space is related with what?Dura Mater
Real space is associated with what?Between Arachnoid and Pia Mater
Potenital space between dura and bone?Extradural space
When can this potential space become fluid filled?Vascular Hemorrage (rupture of meningeal artery or a torn dural venous sinus) -> extradural hematoma
Bleeding due to a tearing of a vein as it enters a dural venous sinus can result in a ?Subdural hematoma
Arachnoid mater clings to the dura and does NOT follow what?The contour of the brain
Whereas, the pia mater does follow the contour of the brain, to create what?A real space between those layers
CSF is produced by what?Choroid Plexus
CSF returns to the venous system through what structures?Arachnoid Villi
These villi project as clumps into the sagittal sinus, known as what?Arachnoid granulations
The superior sagittal sinus is a dural venous sinus, and its lateral extensions are called what?Lateral lacunae
Dilatation of the cerebral ventricular system, due to obstruction or overproduction of CSF is called what?Hydrocephalus
CSF passes from the lateral ventricles to the 3rd ventricle via what?Intraventricular Foramina (foramina of Monro)
CSF passes from the third ventricle to the 4th ventricle through what?Cerebral Aquaduct
CSF passes from the 4th ventricle to the subarachnoid space via what?Midline foramen or the two lateral formina (foramen of Magendie or Foramina of Lushka)
Where is CSF absorbedArachnoid granulations in the walls of the dural sinuses
Most common cause of hydrocephalus in adults?Interuption of reabsorption through arachnoid granulations
Rare cause of hydrocephalus?Choroid plexus tumors that secrete excess CSF
Rare infection of the leptomeninges (combination of arachnoid mater and the pia mater)?Meningitis
Subcutaneous hemorrage (ecchymoses) is a feature of what type of meningitis?Meningococcal Meningitis
Mild headache, fever, drowsiness and nausea - then, photophobia, ecchymoses, + Kernigs and Neck pain.Symptoms of progressive meningitis
Lesion WITHIN the brain?Intra-axial
Lesion OUTSIDE the brain?Extra-axial
Meningiomas and Acoustic neuromas are typically which type of tumor?Extra-axial
Arise from the meninges and prefer Falx Cerebri, free edge of the tentorium cerebelli, and ant. Middle cranial fossa?Meningiomas
Typically found at the vestibulocochlear nerve (VIII) and in the cerebellopontine angle?Acoustic Neuromas
Most common type of intra-axial brain lesions?Secondary brain lesions from metastatic deposits
Metastatic tumor lesions are typically found in patients with either?Breast or Lung cancer
Gliomas, Oligodendrocytomas, and choroid plexus tumors can be classified as what?Primary brain lesions
During development, the cerebrum is called what?Telencephalon
Elevations in the brain?Gyri
Depressions in the brain?Sulci
During development, the part of the brain that contains the thalamus, hypothalamus, and other structures?Diencephalon
During development, the name for the midbrain?Mesencephalon
During development, the name for the part that gives rise to the cerebellum?Metencephalon
During development, the name for the medulla oblongota (CN VI - XII) are attached here?Myelencephalon
Two vertebral arteries enter the cranial cavity through what?Foramen Magnum
Two vertebral arteries fuse at the level of the pons to form what?Basilar artery
Where do the cartoids enter?Carotid canal
Before the two verebral arteries form into the basilar, each gives off how many branches?3
Connects pituitary with the base of the brain, passes through the diaphragma sella?Posterior Inferior Cerebral
Ends as a bifurcation and gives rise to two posterior cerebral arteries?Basilar artery
Each gives off the ophthalmic artery, post. Comm. Artery, middle and anterior cerebral arteries?Each Internal Carotid Artery
Formed at the base of the brain by interconnecting vertebrobasilar and internal carotid systems of vessels?Cerebral Arterial Circle
Connects the left and right anterior cerebral arteries to one another?Anterior communicating
Connects the internal carotid artery with the posterior cerebral artery?Posterior communicating
Acute development of focal neurological deficit as a result of localized or diffuse cerebral hypoperfusion?Stroke
Most common site for an athlerosclerotic plaque to form?Bifurcation of the common carotid
Less severe strokes that occur in the same manner, but usually resolve completely within 24 hours?TIA
Typically occur in anterior/posterior communicating arteries, branches of the MCA, and distal basilar artery?Cerebral Aneurysms
Patient complains of thunderclap headache, neck stiffness and vomitting?Ruptured Cerebral Aneurysm
Cannulation site for surgical treatment of cerebral aneurysm?Femoral -> Aorta -> Carotid -> Pack Aneurysm with Microcoil