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Flashcards in session 1 - lecture Deck (98)
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1
Q

* cranial fossa

A

parts of skull base where areas of brain are seated

2
Q

*skull foramina

A

exit and entry holes

3
Q

*dural sinuses

A

regions filled with blood from which blood drains back into systemic circulation

4
Q

*components of the skull

A

mandible cranium - made of neurocranium with brain in and viscerocranium- known as fascial cranium

5
Q

*components of the cranium

A

vault - bit that houses the brain

base of skull - where the brain sits

6
Q

*bones of the cranium

A

relate to lobes of brain frontal parietal one on either side occipital at back temporal on sides sphenoid - deep in centre of skull ethmoid - towards top of nose

7
Q

*describe the bones of the fascial skeleton

A

maxilla - paired - cheek, above upper teeth

zygoma - paired - 2 cheek bones

nasal - paired - nasal bones at top before cartilaginous parts

lacrimal bones - paired - in he orbit related to drainage apparatus of lacrimal glands

vomer - single bone in middle of skull - point up into nasal cavity

inferior conchae - paired - infolding bones from nasal cavity, increase SA - warm air

palatine bones - paired - top of mouth

mandible - jaw bone

8
Q

*describe the lacrimal glands

A

in the top corner of eyes, drain across into medial side and then into nasal cavity

9
Q

describe fibrous sutures in the skull in adult *

A

fibrous joints holding bones together, permitting little or no movement

10
Q

fibrous sutures in infant skull *

A

not completely fused fontanelles - soft spots on top of head, pulsates anterior close between 18-24months, posterior 2-3months present because skull needs to be able to move in childbirth difficult to break - strong fibrous [image]

11
Q

*what bone is the forehead

A

frontal bone

12
Q

*what can you feel in the occipital bone

A

a protrusion called the inion

13
Q

*which bones attach to the teeth

A

the maxilla and the mandible

14
Q

*what is the role of the inferior and medial nasal concha

A

they warm air and humidify it

15
Q

*what is the external acoustic meatus

A

where the sound gets directed in towards the tympanic membrane

16
Q

*describe the temporomandibular joint

A

allow movement in more than 1 direction for chewing

17
Q

*describe the location of the lacrimal bone

A

in the medial side of orbit

18
Q

*describe ethmoid bone, orbital plate

A

forms the orbit

19
Q

what does the saggital suture divide *

A

the parietal bones

20
Q

what is the suture dividing the occipital and the parietal lobes*

A

lambdoid suture

21
Q

what is the connection between the lambdoid and sagittal suture called *

A

lambda

22
Q

why are muscels attached to the occipital bone

A

to maintain head upright

23
Q

* where does the medulla exit the cranial cavity

A

foramen magnum

24
Q

* where are muscles attachedto to help with chewing

A

pterygoid plates of sphenoid

25
Q

* where are the condyles (joint/knuckle) placed

A

sit on C1 vertebrae - form joint between skull and vertebrae - yes joint - move head up and down

26
Q

what fossa does the frontal lobe sit in *

A

the anterior cranial fossa

27
Q

what fossa does the temporal lobe sit in *

A

the middle cranial fossa

28
Q

what fossa does the cerebellum sit in *

A

the posterior cranial fossa

29
Q

describe the anterior cranial fossa *

A

slightly raised because the orbit and eye is beneath it (frontal lobe has orbital gyri too)

30
Q

ventral side of brain is the ….

A

bottom side where you can see all the cranial nerves

31
Q

what foramina are in the ethmoid bone *

A

holes of the olfactory nerve coming from nasal cavity before synapsing in olfactory bulb and going back via olfactory tract

32
Q

describe the middle cranial fossa *

A

has lots of foramina and fissures which cranial nerves go through internal carotid artery goes into the cranial cavity via foramen lacerum,. exit is not directly opposite because carotid goes in, turns and then goes up

33
Q

foramens for CN to eye in middle cranial fossa *

A

superior orbital fissure foramen rotundum

34
Q

foramens to face in middle cranial fossa *

A

foramen ovale

35
Q

forman to mandible in middle cranial fossa *

A

foramen spinosum

36
Q

artery through the foramen spinosum *

A

middle meningeal artery high pressure artery - involved in damage to vulnerable part of skull - if damaged can cause fast filling epidural bleed

37
Q

*general order of the cranial nerves

A

1-12 from rostral to caudal end so exit in that general place in the head

38
Q

what does the name acoustic suggest

A

that it will have something to do with the vestibulocochlear nerve - nerve of balance and hearing

39
Q

what does the name jugular suggest

A

the place when the veins are draining out of cranial cavity into neck

40
Q

foramen ovale

A

oval hole

41
Q

what passes through cribiform plate of ethmoid *

A

olfactory nerve fibres

42
Q

what passes through optic canal *

A

optic nerve - including central artery of retina, ophthalmic artery

43
Q

what passes through superior orbital fissure *

A

oculomotor nerve, trochlear, ophthalmic division of trigeminal nerve V1, abducent CN, superior ophthalmic vein

44
Q

what passes through foramen rotundum *

A

maxillary division of trigeminal nerve V2

45
Q

what passes through foramen ovale *

A

mandibular division of trigeminal nerve V3

46
Q

what passes through the foramen lacerum, sphenopetrosal fissure *

A

internal carotid artery

47
Q

what passes through foramen spinosum *

A

middle meningeal artery and vein

48
Q

what passes through carotid canal, internal aperture *

A

internal carotid artery

49
Q

what passes through the internal acoustic meatus *

A

facial, vestibulochlear, labyrinthine artery and vein

50
Q

what passes through the jugular foramen *

A

glossopharyngeal, vagus, accessory nerve, sigmoid sinus into internal jugular vein

51
Q

what passes through the hypoglossal canal *

A

hypoglossal CN

52
Q

what passes through the foramen magnum *

A

vertebral arteries, medulla of brain, spinal roots of accessory nerve spinal cord

53
Q

describe the meninges *

A

3 layers dura - outermost, tough, durable, thick and inelastic - 2 layers: periosteal (close to skull) and meningeal (close to brain) (largely stuck together) arachnoid mater - elastic, spider like projections subarachnoid space - full of CSF - continuous over surface of the brain to the base of the spinal column

54
Q

*clinical relevance of difference between the meninges in vertebral column and in cranium

A

can inject and remove stuff form space in vertebral column to see what’s going on in the brain - lumbar puncture. or put in anaesthetic - spinal anaesthetic or spinal block

55
Q

*where are the layers of dura not together

A

at sinuses - filled with blood act as an anchor as well - prevent movement at dural folds

56
Q

*describe the change in the dura at the foramen magnum

A

the outer periosteal layer fuses with the skull and it is the meningeal layer that goes down the vertebral column - so largee space between dura and bone in vertebral column

57
Q

what is the main fold of the meningeal layer called *

A

falx cerebri - sickle shaped double layer

58
Q

where does the superior saggital sinus run *

A

from front to back

59
Q

what happens at the superior saggital sinus *

A

there is a penetration from the arachnoid mater so that CSF can be recirculated back into the venous system

60
Q

how can herniation occur *

A

if there is a raise in intracranial pressure the tough dural sheets can push the brain through and under tentorial notch, and push part of temporal lobe to brain stem - this is the clinical significance of the tentorial notch some cerebellum can herniate through the foramen magnum

61
Q

effect of subfalcine herniation

A

not clinically significant

62
Q

effect of uncal herniation

A

affects midbrain - unconsciousness

63
Q

tonsillar herniation

A

affects medulla, cardioresp failure

64
Q

where does blood supply to the meninges come from *

A

to the arteries that normally supply the face - middle meningeal artey - gets inside cranial cavity. runs past soft spot called pterion - if fractured a large epidural bleed can occur

65
Q

where is the inferior sagittal sinus *

A

at the bottom of the falx of the superior sagittal sinus

66
Q

why are emissary veins important *

A

they traverse from the outside of the skull to the inside of the cranial cavity - can transmit infection from outside would to inside world - scalp lacerations pose a threat

67
Q

*describe the cavernus sinus

A

lots of structures associated many CN travel through so thrombosis could affect any of the CN

68
Q

*what is the relationship between the carotid canal and the foramen lacerum?

A

the internal carotid artery goes through both

69
Q

layers of the scalp *

A

skin connective tissue aponeurosis loose areolar tissue periosteum

70
Q

where is the bone of the skull thickest

A

the occipital region

71
Q

what is the scalp proper *

A

the 1st three layers of the scalp that are attached tightly together - forming a single unit

72
Q

describe the skin layer of the scalp *

A

outer similar to other skin - and has hair

73
Q

describe the connective tissue layer of the scalp*

A

anchors the skin to the 3rd layer contains the arteries, veins and nerves supplying the scalp

74
Q

describe the aponeurotic layer of the scalp *

A

has the occipitofrontalis muscle - has a frontal belly anteriorly an occipital belly posteriorly and an aponeurotic tendon - the epicranial aponeurosis connecting the 2 frontal belly begins anteriorly - connects to eyebrows it passes up across forehead becoming continuous with the aponeurotic tendon posteriorly - each occipital belly arises from the lateral part of the superior nuchal line of the occipital bone and the mastoid process of temporal bone - attaches to tendon frontal belly innervated by temporal branches of the facial nerve, posterior belly innervated by the posterior auricular branch

75
Q

describe the loose connective tissue of the scalp *

A

separates the aponeurotic layer from pericranium - facilitates movement of scalp proper over calvaria

76
Q

describe the pericranium *

A

it is the periosteum on the outside of the calvaria attached to bones of the calvaria but is removable - except in area of the sutures

77
Q

what is the significance of the scalp blood supply in relation to laceration injuries *

A

there is a lot of blood supply from the external carotid arteries - so there would be heavy bleeding if there was a laceration also scalp bleeding is very arterial because venous pressure is v low in erect position also the vessels don’t contract when they are lacerated because the dense connective tissue holds them open

78
Q

what does the coronal suture divide *

A

the frontal and parietal lobes

79
Q

what is the point of connection between the coronal and sagittal suture called *

A

Bregma

80
Q

what are the boundaries of the cranial fossa *

A

anterior cranial fossa ends at the SPENOIDAL CREST, in the midline is the anterior edge of the chiastmatic sulcus

middle cranial fossa ends at the SUPERIOR BORDER OF THE PETROUS PART OF THE PETROMASTOID PART OF THE TEMPORAL BONE

81
Q

describe the floor of the anterior cranial fossa *

A

made of:

  • frontal bone
  • cribriform plate of the ethmoid bone
  • body and lesser wings of the sphenoid bone

the frontal bone projects anteriorly - frontal crest

posteriorly to this you have the foramen cecum

posterior - have the crista galli, a projection from the ethmoid

lateral to this is the cribiform plate of the ethmoid bone

the rest of the floor is formed by the body and lesser wings of the sphenoid - wings hang over the anterior part of the middle fossa, ending as a sharp point laterally, medially they curve posteriorly as the anterior clinoid process

82
Q

describe the floor of the middle cranial fossa *

A

made of sphenoid and temporal lobes

floor in the midline is elevated - body of the sphenoid bone

lateral are depressions made of greater wing of sphenoid and squamous part of the temporal lobe

posterior to body of sphenoid is the sella turcica containing the hypophyseal fossa

superior orbital fissure separates the the greater wing of the sphenoid from the lesser

medially in the temporal bone there is the trigeminal impression in the petrous part of the temporal bone marks the sensory ganglion for the trigeminal nerve

then there are 2 small grooves - the groove and hiatus for the greater and lesser petrosal nerve

the arcuate eminence is a rounded protusion of bone - produced by underlying circular canal of the inner ear

the tegmen tympani marks the thin bony roof of the middle ear cavity

83
Q

*what is the chiasmatic sulcus

A

a smooth groove stretching between the optic canals and the body of the sphenoid

84
Q

*describe the floor of the posterior cranial fossa

A

mainly temporal and occipital, small contributions from sphenoid and parietal bones

largest and deepest fossa contains brainstem anc cerebellum

anterior border is the clivus and dorsum sellae and the superior border of the petrous part of the temporal bone

clivus is slope of bone from foramen magnum made of occipital and sphenoid

lateral border- petrous part of the temporal bone posteriorly - squamous part of the occipital lobe to the groove for transverse sinus and small parts of the occipital and parietal bones

there is a groove for the inferior petrosal sinus

jugular foramen separates occipital from temporal lobe

running to this are the groove for the sigmoid sinus and the petrosal sinus jugular tubercle - large rounded mound of the occipital bone

condylar canal transmits an emissionary vein

squamous occipital bone has: internal occipital crest, either side of this the floor is concave for the cerebellum.

the crest ends posteriorly as teg internal occipital proturberance from this are the grooves for the transverse sinuses [image]

85
Q

*identify all of the cranial foramina on the diagram and the structures that they transmit *

A

image

86
Q

explain the entrance of cerebral veins into the superior sagittal sinus in relation to subdural haemorrhage *

A

the superior sagittal sinus receives blood from superior cerebral veins that come from in the subarachnoid space if these veins tear where they enter the sagittal sinus it causes a subdural haematoma

87
Q

describe the path of the venous sinuses *

A

blood drains from the superior sagittal, and straight sinuses into the confluence of sinuses at the posterior of the head, then into the transverse sinuses which lead into the sigmoid sinus and then into the internal jugular veins which leave the brain passing through the jugular vertebral foramen

88
Q

what is the anatomy of the dural sinuses *

A

there are endothelial lined areas where the periosteal and meningeal layers of the dura are separated by venous blood

89
Q

describe the dural reflections and list them*

A

the inner layer of the meninges goes in between sections of the brain and separates them, it supports the brain and forms sinuses for venous drainage - falx cerebri - tentorium cerebelli - flax cerebelli

90
Q

*what is in the cisternae magna in life

A

a large well of CSF

91
Q

*what do the internal carotid arteries supply

A

anterior part of the brain

92
Q

what do the 3 branches of the facial nerve supply *

A

stylomastodoid foramen - facial expression petro-tympanic fissure - tongue -taste, salivary gland pterygoid canal - eye, lacrimal gland

93
Q

when would you use US to examine the brain

A

babies - no radiation

also you need the fontenelles so that the US can reach the brain, it would be stopped by the skull in adults

94
Q

describe the superior sagittal sinus *

A

in the superior border of the flax cerebri

begins anteriorly at the foramen cecum and ends at the confluence of the sinuses

usually bends to the R to empty into the R transverse sinus

95
Q

describe the inferior sagittal and straight sinuses *

A

inferior - inferior margin of the flax cerebri, ends at the anterior ridge of the tentorium cerebelli where it is joined by the great cerebral vein - together they form the straight sinus

straight - continues posteriorly along junction of the flax cerebri and tentorium cerebelli and ends at the confluence of the sinuses - usually bending L to enter the L transverse sinus

96
Q

*describe the confluence of sinuses, transverse and sigmoid sinuses

A

superior, straight and occipital sinuses empty into confluence. It is a dilated space at the internal occipital proturbance. drained by the transverse sinuses

transverse drain horizontally

as the transverse sinuses lkeave the surface of the occipital bone they become sigmoid sinuses

sigmoid sinuses end at the beginning of the internal jugular veins

97
Q

*describe the cavernous sinuses

A

paired

either side of the sphenoid bone, on either side of the sella tucica

structures passing through the cavernous sinuses are internal carotid artery, abducent nerve

structures in the lateral wall of the cavernous sinuses are the oculomotor nerve, trochlear nerve, opthalmic nerve (V1), maxillary nerve (V2)

subject to damage from inflammation because the structures pass through

on the anterior and posterior sides of the pituitary stalk the intercavernous sinuses connect teh 2 cavernous sinsuses

98
Q

describe the superior and inferior petrousal sinuses *

A

superior drains the cavernous sinus into the transverse

inferior - end in the jugular vein. basilar sinus connects the inferior petrosal sinuses to each other and to teh vertebral plexus of veins