Meninges, Ventricles, CSF

Question 1

_______ are a specialization of the sub-arachnoid space that allow for circulation of the CSF.

Answer 1

arachnoid villi (arachnoid granulations)

Question 2

CSF circulates in the ______ space.

Answer 2

subarachnoid

Question 3

Severed middle meningeal artery leads to ___________.

Answer 3

epidural hematoma (potential space between scull and dura)

Question 4

Epidural hematoma is shaped like a _______ and the onset is ________.

Answer 4

lens shaped

rapid onset

Question 5

Arachnoid trabeculae attach to __________.

Answer 5

pia mater

Question 6

Arteries run in the _______ space.

Answer 6

subarachnoid space

Question 7

Bleeding between dura and arachnoid is called?

Answer 7

subdural hematoma

Question 8

Subdural hematoma occurs when ________ tears.

Answer 8

cerebral VEINS

lower pressure bleed than arterial

Question 9

Sickle cell shaped bleed is associated with ______ hematoma.

Answer 9

subdural hematoma

Question 10

Bleed of cerebral arteries causes ________ hemorrhage.

Answer 10

subarachnoid

Question 11

Which type of hemorrhage is most common?

Answer 11

subarachnoid

Question 12

With subarachnoid hemorrhage, the blood fills _______.

Answer 12

sulci

Question 13

Hunt&Hess (neuro exam) and Fisher Scale (CT) are severity indicators for which type of hemorrhage?

Answer 13

subarachnoid

Question 14

The middle of the brain begins to shift under the flax when what occurs?

Answer 14

Mid-line shift: a brain accommodation that occurs with slowly developing hemorrhages

Question 15

HIgh pressure bleeds are associated with

Answer 15

rapid onset arterial bleeds (epidural and subarachnoid hematomas)

Question 16

Infection of the meninges due to virus or bacteria usually affects which layers?

Answer 16

pia

arachnoid

Question 17

Meningitis signs:

Answer 17

fever, nuchal rigidity, headache, stupor, coma

Question 18

Mortality rate for meningitis?

Answer 18

10-20%

Question 19

Highest incidence for meningitis?

Answer 19

<15 YOA (related to immune system)

Question 20

What can meningitis cause?

Answer 20

venothrombosis

hydrocephalus

Question 21

What are the 5 parts of the lateral ventricle?

Answer 21

Frontal horn, body, posterior/occipital horn, inferior/temporal horn

Question 22

What lobes does the lateral ventricle run through? What shape is it?

Answer 22

all the lobes! C-shaped

Question 23

Where the body, posterior/occipital, and inferior/temporal horns meet is called the

Answer 23

trigone or atrium

Question 24

Which ventricle is in the midline of the diencephalon?

Answer 24

third ventricle

Question 25

Opening of the 3rd ventricle that connects with lateral ventricles is called?

Answer 25

interventricular foramen of monroe

Question 26

Describe the circulation of CFS starting from the lateral ventricle

Answer 26

``` lateral ventricle interventricular foramen 3rd ventricle cerebral aqueduct 4th ventricle lateral/median apertures subarachnoid space arachnoid villi superior sagittal sinus ```

Question 27

The "roof" of the 4th ventricle is made of?

Answer 27

superior medullary velum and inferior medullary velum (roof is peaked)

Question 28

The "floor" of the 4th ventricle is _______ shaped, called the _______.

Answer 28

diamond-shaped | rhomboid fossa

Question 29

The median aperture is a funnel-shaped hole in the inferior medullary velum that communicates with the

Answer 29

subarachnoid space

Question 30

There are 2 lateral apertures that are also known as? Located where?

Answer 30

foramina of Luschka | at the ends of each lateral recess

Question 31

4th ventricle ends in ______ which continues into the SC.

Answer 31

central canal

Question 32

The 4th ventricle is between which structures?

Answer 32

cerebellum and pons/medulla

Question 33

What cells absorb plasma then transform it to CSF and secrete it?

Answer 33

choroid cells

Question 34

What qualities of the choroid plexus make it effective?

Answer 34

highly convoluted (increased SA) fenestrated (leaky) capillaries choroid epithelium lines the ventricles

Question 35

Where is the choroid plexus located?

Answer 35

parts of lateral ventricles roof of the 3rd ventricle lower 4th ventricle to median aperture

Question 36

Compare and contract plasma and CSF

Answer 36

colorless liquid, low in cells and PRO CSF has > Mg and Cl than plasma CSF has < K and Ca than plasma

Question 37

Total volume of CSF turns over how many times/day? How much produced?

Answer 37

4 times per day | 600-700mL per day

Question 38

What is the primary fxn of CSF?

Answer 38

support and cushion the brain

Question 39

Total volume of CSF in adult? | Volume of ventricles?

Answer 39

140mL | 25mL

Question 40

What are the 3 possible mechanisms for hydrocephalus?

Answer 40

1. increased production 2. blocked circulation (most common area is cerebral aqueduct) 3. deficiency of resorption

Question 41

Rare tumors of the choroid plexus are called _______. What do they cause?

Answer 41

papillomas | cause increased production of CSF

Question 42

Tumors, congenital failure of lateral/median apertures to open, adhesions of meninges, and trauma can all cause

Answer 42

blockages of CSF circulation

Question 43

Deficiencies of resorptions are caused by

Answer 43

?congenital absence of arachnoid villi or increased pressure in superior sagittal sinus

Question 44

What structure acts as a barrier between CSF and venous blood?

Answer 44

arachnoid villi

Question 45

non-communicating hydrocephalus is due to

Answer 45

blockage in the ventricles (CSF cannot get to the subarachnoid space)

Question 46

communicating hydrocephalus is due to

Answer 46

CSF reaching subarachnoid space and getting blocked outside of the ventricles

Question 47

Shunts are places to

Answer 47

decrease pressure

Question 48

quasi-permanent shunts empty into

Answer 48

internal jugular vein or peritoneal cavity | for chronic conditions

Question 49

temporary shunts empty into

Answer 49

external ventricular drain (bag) | for trauma/brain bleeds

Question 50

What is the primary fxn of meninges?

Answer 50

stabilize and protect the brain and SC - literally suspends brain from scull - cushions brain with CSF

Question 51

Most superficial layer of dura mater is called the

Answer 51

periosteal layer

Question 52

Deeper layer of the dura mater is called the

Answer 52

meningeal layer

Question 53

What dural reflection occupies the longitudinal fissure and separates the 2 hemispheres?

Answer 53

falx cerebri

Question 54

What dural reflection separates the cerebellum from occipital bones?

Answer 54

tentorium cerebelli | supratentorial and infratentorial compartments

Question 55

falx cerebri attaches anteriorly to ______ and posteriorly to ________.

Answer 55

ant: crista galli post: tentorium cerebelli

Question 56

Tentorial notch: the space int he tentortium through which the _____ passes.

Answer 56

brainstem

Question 57

Tentorium cerebelli attaches post to_______ and contineus to the _________ of the temporal bone.

Answer 57

post: occipital bone | cont. to the petrous portion of temporal bone

Question 58

Brain tissue under pressure may herniate under/around which tissues?

Answer 58

falx cerebri and tentorium cerebelli (firm edges!)

Question 59

The separation of the 2 layers of dura form specific sinuses that act as _________.

Answer 59

venous channels: contain venous blood, no valves, cerebral veins empty into them

Question 60

Which sinus has CN III, IV, VI, V and internal carotid artery running through it?

Answer 60

cavernous sinus

Question 61

Which sinus empties into internal jugular vein?

Answer 61

sigmoid sinus

Question 62

What are the meningeal layers from superficial to deep?

Answer 62

1. epidural space 2. periosteal dura 3. meningeal dura 4. subdural space 5. arachnoid 6. subarachnoid space 7. pia