3.2 Meninges

Question 1

leptomeninges and their importance

Answer 1

pia and arachnoid mater
meningitis affects

Question 2

what’s contained in subarachnoid space?

Answer 2

-CSF (pressure keeps arachnoid and Pia separate)
-cerebral vessels (supply and drain brain)

Question 3

cerebral vessels

Answer 3

-arteries from vertebral and internal carotid arteries
-veins drain into dural venous sinuses

Question 4

can you pull the pia mater away from brain surface?

Answer 4

no

Question 5

arteries supplying menInges

Answer 5

meningeal arteries, between periosteal dura mater and inner table of skull

Question 6

what is a dural fold?

Answer 6

meningeal layer of dura mater comes away from periosteal layer and extends

Question 7

tentorial notch

Answer 7

tentorium cerebelli opens at top for brainstem

Question 8

which brain movement does fall cerebri stabilise?

Answer 8

left to right and vice versa

Question 9

which brain movement does tentorium cerebella stabilise?

Answer 9

up and down

Question 10

where are the cavernous sinuses?

Answer 10

in middle cranial fossa, either side of sphenoid bone

Question 11

how does inferior sagittal sinus meet superior one?

Answer 11

via straight sinus, meet at confluence of sinuses

Question 12

2 types of venous connection between DVS and other structures

Answer 12

1. cerebral veins in subarachnoid space via bridging veins to DVS (intracranial)
2. scalp veins via emissary veins to DVS (extra cranial)

Question 13

path of bridging veins to DVS

Answer 13

through subdural space

Question 14

path of emissary veins to DVS

Answer 14

through skull- especially holes in parietal bone

Question 15

symptom progression of extradural haemorrhage

Answer 15

head injury, headache and alert, 1 HOUR LATER = deterioration of neurological function

Question 16

lucid interval

Answer 16

time between head injury causing extradural haemorrhage and loss of neurological function where patient seems ‘normal’

Question 17

explain the appearance of an extradural haemorrhage

Answer 17

-lentiform
-rupture of middle meningeal artery strips periosteal dura away from inner table of bone
-blood fills space
-strong adherence of periosteal dura at sutures prevents further lateral expansion

Question 18

symptoms of subdural haemorrhage

Answer 18

-headache
-less rapid deterioration
-pressure and blood increase over time

Question 19

where is a subdural haemorrhage?

Answer 19

between meningeal dura and arachnoid mater, can fill all way round that hemisphere of brain = crescent shape on CT

Question 20

likely rupture location to cause subdural haemorrhage

Answer 20

where bridging vein joins wall of DVS

Question 21

explain how subdural haemorrhage could occur in a minor head injury

Answer 21

elderly people have cortical shrinkage, puts tension on connection of cerebral vein to DVS so snaps more likely

Question 22

typical feeling of subarachnoid haemorrhage

Answer 22

hit on head by bat

Question 23

why headache sudden in subarachnoid haemorrhage?

Answer 23

blood irritates meninges