Anatomy of Space Occupying Lesions

Question 1

define space occupying lesion

Answer 1

abnormal tissue in the brain that is taking up space

Question 2

2 types of space occupying lesion and an example of each

Answer 2

acute eg brain bleed

subacute eg brain tumour

Question 3

describe the monroe kellie hypothesis

Answer 3

small increase in ICP will increase intracranial volume massively

Question 4

name the 5 layers of the scalp

Answer 4

Skin
Connective tissue (contains blood supply to scalp)
Aponeurosis
Loose connective tissue
Pericranium

Question 5

which arteries anastamose to supply the scalp

Answer 5

external carotid and internal carotid arteries

Question 6

why does a scalp laceration bleed so much

Answer 6

anastamosis of muscle holds wound open

rich blood supply to the scalp

Question 7

thinnest layer of the scalp?

Answer 7

loose connective tissue

Question 8

what is a periosteum?

Answer 8

outer layer of bone responsible for bone formation

Question 9

how many bones are in the skull?

Answer 9

23

Question 10

why do sutures exist in the skull?

Answer 10

help prevent skull fractures from spreading

Question 11

what artery exists under the pterion?

Answer 11

middle meningeal artery

Question 12

start and end point of anterior cranial fossa?

Answer 12

frontal

lesser wings of sphenoid

Question 13

start and end point of middle cranial fossa?

Answer 13

lesser wings of sphenoid

petrous part of temporal bone

Question 14

start and end point of posterior cranial fossa

Answer 14

petrous part of temporal bone

occipital bone

Question 15

sensory nerve supply to dura mater?

Answer 15

CN V

Question 16

role of the arachnoid granulations in the arachnoid mater?

Answer 16

reabsorb CSF

Question 17

name the 2 layers of the dura mater and their anatomical relations

Answer 17

periosteal layer (closest to bone)
meningeal layer (under the dural venous sinus - closest to arachnoid mater)

Question 18

what action causes pain in meningitis?

Answer 18

stretching of the dura mater

Question 19

smallest fold of dura? where is it located?

Answer 19

diaphragm sellae

middle cranial fossa

Question 20

the diaphragm sellae is located immediately superior to…

Answer 20

the sella turcica

Question 21

what does the tentorium cerebelli attach to?

Answer 21

ridges of the petrous temporal bones

Question 22

why is there a gap in the tentorium cerebellae have a gap in it?

Answer 22

to allow the brainstem to pass through

Question 23

where is the falx cerebri located?

Answer 23

between the cerebral hemispheres in the midline

Question 24

anterior and posterior attachments of the falx cerebri?

Answer 24

crista galli of ethmoid anteriorly

internal occipital protuberance of the occipital bone posteriorly

Question 25

which veins are located in the falx cerebri?

Answer 25

superior and inferior sagittal sinus

Question 26

where do the dural venous sinuses (Esp the sagittal sinuses) join?

Answer 26

the confluence of sinuses

Question 27

what does the confluence of sinuses drain into?

Answer 27

the right/left sigmoid sinus

Question 28

what do the sigmoid sinuses become and at what anatomical location?

Answer 28

the internal jugular vein at the jugular foramen

Question 29

where is the danger triangle of the brain?

Answer 29

front of the face from the forehead down to the top lip

Question 30

why is the danger triangle called this?

Answer 30

possible route for infection as no valves so an infection can spread to the cavernous sinus eg by squeezing a spot

Question 31

cerebral veins are mini branches off of what sinuses?

Answer 31

the sagittal sinuses (superior and inferior)

Question 32

what do cerebral veins do?

Answer 32

drain venous blood into dural venous sinuses

Question 33

the right posterior cerebral artery supplies...

Answer 33

the posterior aspect of the right cerebral hemisphere

Question 34

middle cerebral arteries are a branch of...

Answer 34

the internal carotid arteries

Question 35

anterior cerebral arteries supply...

Answer 35

the medial aspect of the cerebral hemispheres

Question 36

he posterior cerebral arteries supply..

Answer 36

the posterior aspect of the cerebral hemispheres (1 for each side)

Question 37

what do the posterior communicating arteries communicate with?

Answer 37

internal carotid arteries

Question 38

middle cerebral arteries supply?

Answer 38

the lateral aspect of the cerebral hemispheres

Question 39

opthalmic artery is a branch of...

Answer 39

internal carotid artery

Question 40

the circle of willis is contained in what meningeal layer?

Answer 40

subarachnoid space

Question 41

subarachnoid space terminates at...

Answer 41

S2

Question 42

spinal cord ends at...

Answer 42

L2

Question 43

the anterior cerebral artery is a branch of..

Answer 43

internal carotid artery

Question 44

what branch comes off the anterior cerebral artery?

Answer 44

anterior communicating artery

Question 45

the central canal of the spinal cord is continuous with the __ ventricle

Answer 45

4th

Question 46

excessive production, obstruction or adequate reabsorption of flow leading to increased CSF volume is defined as...

Answer 46

hydrocephalus

Question 47

Tx of hydrocephalus

Answer 47

ventricular peroneal shunt

Question 48

the lateral ventricles are contained in which lobe?

Answer 48

parietal lobe on either side

Question 49

the middle meningeal artery is contained between what layers?

Answer 49

bone and dura

Question 50

cerebral veins transverse what layers? why?

Answer 50

arachnoid mater and dura to get to the dural venous sinuses

Question 51

3 types of haemorrhage

Answer 51

extradural subdural (below dura) subarachnoid (bleed into subarachnoid space)

Question 52

CSF with blood in it suggests a __ haemorrhage

Answer 52

subarachnoid

Question 53

a subdural haemorrhage will be a result of damage to what veins?

Answer 53

cerebral

Question 54

an extradural haemorrhage will be a result of damage to what vessel?

Answer 54

middle meningeal artery

Question 55

first ligaments reached by an epidural catheter from superficial to deep

Answer 55

supraspinous ligament interspinous ligament ligamentum flavum

Question 56

how can an epidural haematoma be caused by an epidural anaesthetic?

Answer 56

damaging the extradural venous plexus which will compress the spinal cord

Question 57

a lumbar puncture's final destination is...

Answer 57

subarachnoid space

Question 58

why is L3/4 used for anaesthesia/samples?

Answer 58

1. spinal cord has ended and cauda equina is less easily damaged 2. vertebrae haven't fused yet unlike in the sacral/coccygeal region

Question 59

R or L cerebral hemisphere herniates under the falx cerebri is an example of what kind of herniation?

Answer 59

cingulate herniation

Question 60

what happens in uncal herniation

Answer 60

the medial part (uncus) of the temporal lobe herniates inferior to the tentorium cerebelli

Question 61

which type of herniation involves a herniation through a defect eg fracture

Answer 61

transcalvarial

Question 62

a downward cerebellar herniation would herniate through...

Answer 62

the foramen magnum

Question 63

what type of herniation can cause a "blown" (ipsilateral fixed dilated pupil) and why?

Answer 63

uncal | compresses the oculomotor nerve