Spinal Cord, Brain, Meninges

Question 1

Where is CSF located?

Answer 1

Subarachnoid space (superficial to pia mater and deep to arachnoid mater)

Question 2

Where is a caudal epidural performed?

Answer 2

sacral hiatus

Question 3

What is numbed by an epidural block in lumbar region?

Answer 3

dorsal and ventral roots in lumbar region

Question 4

Where does the dural sac (dura mater) terminate?

Answer 4

S2 vertebral level

Question 5

What is arachnoid mater deep to?

Answer 5

dura mater

Question 6

What is the name for the enlargement of subarachnoid space in the lower lumbar region of the vertebral column?

Answer 6

lumbar cistern

Question 7

Denticulate ligaments are lateral extentions of which spinal meningeal layer?

Answer 7

pia mater

Question 8

In adults how much of the vertebral canal does the spinal cord occupy?

Answer 8

2/3 since growth of the vertebral column exceeds that of the spinal cord during development

Question 9

Where are the two spinal cord enlargements?

Answer 9

1. Cervical enlargement
   - ventral rami give rise to the brachial plexus
2. Lumbosacral enlargement
   - ventral rami give rise to the lumbosacral plexus

Question 10

Where does the conus medularis terminate?

Answer 10

L1 or L2

-in children the conus medullaris may terminate as low as L3

Question 11

To performa lumbar puncture (spinal tap) where is the needle inserted?

Answer 11

L3-L4 interlaminar space

or

L4-L5 interlaminar space

Question 12

What makes up the cauda equina?

Answer 12

elongated lumbosacral (and coccygeal if present) dorsal and ventral roots

Question 13

Where does the filum terminale start and end?

Answer 13

Start: tip of the conus medullaris

End: passes through the sacral hiatus to attach to the coccyx

Question 14

Where are ventral and dorsal roots located in relation to the vertebral canal?

Answer 14

within the vertebral canal

Question 15

Where are dorsal root ganglia located?

Answer 15

dorsal root ganglia are located in intervertebral foramina

Question 16

What is the name for the roof of the skull?

Answer 16

calvaria

Question 17

What is the name for the floor of the skull?

Answer 17

basicranium

Question 18

Name the three principle sutures of the skull?

Answer 18

1. Sagittal (between parietal bones)
2. Coronal (between frontal and parietal bones)
3. Lambdoid (between occipital, temporal, and parietal bones)

Question 19

Pterion is the junction between which bones?

Answer 19

1. parietal
2. temporal
3. frontal
4. sphenoid

Question 20

Fractures at pterion can injure which vessel?

Answer 20

anterior branch of the middle meningeal artery

-causes an epidural hematoma

Question 21

Middle meningeal artery supplies what?

Answer 21

cranial dura mater

Question 22

How many layers does the spinal dura mater have? the cranial?

Answer 22

Spinal:
1 layer

Cranial dura mater:
2 layers (external periosteal layer, internal meningeal layer)

Question 23

Which cranial nerves innervate the cranial dura mater?

Answer 23

• Trigeminal (CN V)
• Vagus (CN X)

*clinically relevant or headache or migraine

Question 24

What type of hematoma can occur at the dura-arachnoid junction?

Answer 24

dural border (subdural) hematoma

Question 25

Arachnoid granulations function

Answer 25

transfer of CSF to the venous system

Question 26

Name the 4 dural reflections

Answer 26

1. Falx cerebri 2. Tentorium cerebelli 3. Falx cerebelli 4. Diaphragm sellae

Question 27

Where is the anterior attachement of the Falx cerebri

Answer 27

frontal crest and crista galli

Question 28

Where is the posterior attachment of the Falx cerebri?

Answer 28

occipital bone

Question 29

Which dural reflection is between the occipital lobes of the cerebrum and cerebellum (transverse)?

Answer 29

Tentorium cerebelli

Question 30

Where does the diaphragm sellae attach?

Answer 30

clinoid processes -forms a roof over pituitary gland but allows infundibulum (pituitary stalk) and veins to pass through

Question 31

Where do dural venous sinuses drain?

Answer 31

internal jugular veins

Question 32

What two structures combine to form the straight sinus?

Answer 32

1. Great cerebral vein 2. Inferior sagittal sinus *at the junction between falx cerebri and tentorium cerebelli

Question 33

What combine to form the confluence of sinuses?

Answer 33

1. superior sagittal sinus 2. straight sinus 3 occipital sinus

Question 34

What path does blood take from the confluence of sinuses to the internal jugular vein?

Answer 34

Confluence of sinuses > transverse sinuses > Sigmoid sinuses > internal jugular

Question 35

Which two sinuses drain directly into the internal jugular veins?

Answer 35

1. Inferior petrosal sinus | 2. Sigmoid sinus

Question 36

What are the three structures that the cavernous sinuses drain into?

Answer 36

1. Superior petrosal sinus (joins the transverse) 2. Inferior petrosal sinus (joints the internal jugular) 3. Pterygoid plexus

Question 37

Which two structures pass through the cavernous sinus?

Answer 37

1. Internal carotid artery * only structure in the body where an artery passes through vein 2. Abducent nerve (CN VI)

Question 38

Which 4 structures are in the lateral walls of the cavernous sinuses?

Answer 38

1. Oculomotor (CN III) 2. Trochlear (IV) 3. Opthalmic (V1) 4. Maxillary (V2)

Question 39

What are the folds in the surface of the brain called?

Answer 39

gyri

Question 40

What are the grooves in the brain surface?

Answer 40

sulci

Question 41

What are the 3 components of the brainstem?

Answer 41

1. Midbrain 2. Pons 3. Medulla oblongata *gives rise to most cranial nerves

Question 42

Vertebral arteries supply which part of the brain?

Answer 42

posterior circulation | travel within transverse foramina (C6-C1

Question 43

Where do the vertebral arteries enter the brain?

Answer 43

foramen magnum

Question 44

Vertebral arteries give rise to what artery?

Answer 44

basilar artery

Question 45

What are the three branches of the internal carotid?

Answer 45

1. Anterior cerebral 2. Middle cerebral 3. Opthlamic artery (doesn't supply brain) *connects via the posterior communicating artery to the posterior cerebral

Question 46

Where does the internal carotid artery enter the cranium?

Answer 46

carotid canal in temporal bone | then courses medially and horizontally- superior to cartilage covering foramen lacerum