Midterm 1 Flashcards
(177 cards)
Where is the pain sensitivity within the skull restricted to
Pain sensitivity in the skull is restricted tot he intracranial meninges
What are the three layers of the Meninges
Dura mater
Arachnoid mater
Pia Mater
Describe the dura mater
Thickest, outermost layer, protective, impermeable
Made of two layers: Periosteal layer, Meningeal layer
Describe the two layers of the Dura mater
Periosteal: attached to inner surface of skull, continuous with periosteum (outside) on outside of skull bones and cranial sutures
Meningeal layer: covering brain, penetrates spaces in cerebral hemispheres
Describe the arachnoid mater
Middle layer, impermeable, adjoins dura (not tightly bound- potential subdural space) separated from Pia by Subarachnoid space that is filled with CSF
Describe the Pia mater
Delicate, permeable, innermost, resting on the brain surface
vascular membrane that adheres closely to brain
What are the two important partitions that arise from the meningeal layer
Falx cerebri, tentorium cerebelli
Describe the Falx cerebri
Sickle-shaped fold separating the cerebral hemispheres. The superior convex border forms floor of superior sagittal sinus; inferior border houses inferior sagittal sinus
Restrict brain displacement
Tentorium cerebelli
Fits between the cerebellum and the occipital lobes; separates the posterior cranial fossa from the rest of the cranial vault. Arches upward along median line to become continuous with falx cerebri to form straight venous sinus
Restrict Brain displacement
What is the location, usual cause, and symptoms of an epidural hemorrhage
Location: tight potential space between the dura and the skull
Cause: rupture of the middle meningeal artery during head trauma
Symptoms: initially no symptoms (lucid interval), within hours the hematoma compresses the brain and increases ICP, which leads to herniation and death. (unless surgery)
What is the location, usual cause, and symptoms of an subdural hemorrhage
Location: potential space between the dura and the loosely adherent arachnoid
Cause: rupture of bridging veins that pass through en route to dural sinuses (vulnerable to shear injury)
Same symptoms has epidural
What are acute and chronic subdural hematomas/hemorrhages
Acute: can occur with high velocity impact
Chronic: seen in elderly where brain atrophy allows the brain to move freely (bridging veins susceptible to injury). Slow bleeding over weeks/ months allows brain to accommodate so symptoms often vague: headache, cognitive impairment, unsteady gait.
What is the time frame each blood is seen in the brain: hyperdense, isodense, hypodense
hyperdense: More dense than surrounding brain tissue, acute/ recent injury
Isodense: 1-2 weeks
Hypodense: 3-4 weeks
What separates the Pia from the Arachnoid mater
Subarachnoid space (CSF)
Where are all cerebral arteries and veins (aneurysm site, may hemorrhage)
subarachnoid space, sending off branches that penetrate into the brain
How is the Arachnoid connected to the Pia
Delicate threads called trabeculae
What are arachnoid granulations
site where CSF diffuses into the venous sinuses
What layer fuses with the ependyma to form the choroid plexus
Pia mater, arteries carry sheath of pia as they enter the parenchyma
Where does pain from headaches come from
No pain receptors in brain, so pain comes from trigeminal and first three cervical nerves innervating the meninges and vasculature
Dura above the tentorium by the trigeminal ganglion
Dura below the tentorium by cervical nerves
What innervates the dura above and below the tentorium
Above: trigeminal ganglion
below: cervical nerves (1-3)
What do migraines depend on
depend on the activation of the trigeminal afferents that densely innervate the meninges
Meningitis and meningiomas
Inflammation of the meninges and tumors in the meninges
Effects of space-occupying lesions
Increased ICP and stretching of dura
What is a cluster headache
Lancinating or boring periorbital pain. More sever than childbirth