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Scalp, Brain, Craniu
| Question | Answer |
|---|---|
| 5 tissue layers associated with the scalp (from outermost to innermost) | 1.Skin. 2.Connective tissue (primarily superficial fascia). 3.Epicranial Aponeurosis (connects the occipitalis and frontalis muscles on the superior aspect of the skull). 4.Areolar tissue (allows Epi Aponeuro. to slide freely). 5.Pericranium (perioste |
| Pericranium | periosteum over the outer table of bone. Innermost layer of the scalp. |
| Vertebral A | 1st branch of the 1st part of the subclavian A. Ascends up the cevical vertebrae (C1-6) through the transverse foramen. After perforating the dura & arachnoid and passing through the foramen magnum, they unite to form the basilar A at dorsal pons. |
| Basilar A | Closely associated with the cranial base, ascends the clivus, passes through the pontocerebellar cistern to the superior pons. Then divids into posterior cerebral A. Supplies the brainstem, cerebellum, and cerebrum. |
| Anterior Cerebral A | Anterior most part of Circle of Willis and an anterior division of the Internal Carotid A, supplies the medial & superior surfaces, and frontal pole of the brain. |
| Middle Cerebral A | a lateral extension directly off the Internal carotid A. Supplies the lateral surface and the temporal pole of the brain. |
| Posterior Cerebral A | Connected to the Internal Carotid A via the posterior communicating ateries. Supplies the inferior surface of the brain and the occipital pole |
| Posterior communicating A | Originates off the posterior cerebral A and connects it to the internal Carotid A. It supplies the inferior aspect of the cerebral hemisphere and occipital lobe. |
| Anterior communicating A | connects the two Anterior Cerebral Arteries. Is the most common site for a saccular aneurysm leading to a subarachnoid hemorrahge. Pt will have Head ache and vision loss. |
| Posterior Inferior Cerebellar A | First branch off the basilar A at the inferior pons. |
| Superior cerebellar A | Last branch off the basilar A before it bifricates into the posterior cerebral arteries. |
| Periosteal layer of the dura mater | External layer of dura. Adheres to the internal surface of the cranium (specifically along the suture line and cranial bse). Continuous w/ periosteum of skull via cranial foramina. |
| Meningeal layer of the dura mater | Internal layer of dura. Supporting layer that reflects away from external layer forming dural infoldings. It is continuous with the dura mater of the spinal cord at the foramen magnum |
| 4 Dural infoldings of meningeal dura | 1.Falx cerebri (largest, lies in longitudinal cerebral fissure seperating the hemispheres). 2.Tentorium cerebelli (seperates the occipital lobes and cerebellum). 3.Falx Cerebelli (vertical infold seperating cerebellum). 4.Diaphragma Sellae |
| Diaphragma Sallae | Smallest dural infold. Circular covering over the hypophysial fossa that runs between the anterior and posterior clinoid processes. **Covers Pituitary gland. |
| Tentorial Notch | Concavity in the anteromedial border of the tentorium cerebelli. Allows the brainstem to extend from the posterior to middle cranial fossa. |
| Contents of the brainstem | 1.Medulla. 2.Pons. 3.Midbrain |
| What makes up the different dural venous sinuses? | endothelium within the two dural layers. Form where the dural septa attach along the free edge of the falx cerebri as well as in relation to cranial floor |
| Superior sagittal Sinus | Lies in the convex attachment of the falx cerebri. Runs from Crista galli to internal occipital protuberance. here it drains into the confleunce of sinuses. |
| Confluence of Sinuses | Located at the internal occipital protuberance, is a meeting place for the superior saggital, straight, occipital sinuses. Drains into sigmoid sinuses via transverse sinuses |
| Inferior Sagittal Sinus | much smaller than superior. Runs in the inferior, free border of Falx cerebri and empties into the straight sinus close to tentorium cerebelli. |
| Straight sinus | Formed by the union of the Inferior sagittal sinus and the great cerebral vein. Runs inferoposteriorly along Falx cerebri's attachment to tentorium cerebelli. It empties into the confluence of sinuses. |
| Transverse Sinuses | Leave the confluence of sinsus laterally along the posterolateral attachments of the tentorium cerebelli. Empties into Sigmoid sinus at the petrous temporal bones. **Left is more dominant** |
| Sigmoid Sinuses | S-shaped course in the posterior cranial fossa coursing both occipital and temporal bones. Leaves the jugular foramen as the Internal Jugular V. |
| Cavernus Sinus | venous plexus, Superolateral to the sphenoid air sinus on either side of the sella turcica. Goes from the superior orbital fissure to the petrous part of temporal bone. Receives BL from: Sup & inf opthalmic veins. Drains into sup or inf petrosal sinuses |
| Superior Petrosal Sinuses | Runs from posterior cavernous sinuses to the sigmoid sinuses. Lies in the anterolateral attachment of the tentorium cerebelli. |
| Inferior Petrosal Sinuses | Run from the the posterior cavernous sinuses to the jugular foramen and empties into the IJV. |
| Middle Meningeal A | Superior branch off the maxillary A. Enters the floor of the middle cranial fossa via foramen spinosum. Runs laterally up the skull and divids into Ant and Post branches. Damage is Responsible for epidural hematoma/lateral shift/lucid interval |
| Arachnoid mater | Avascular. in close association but to attached to meningeal dura layer, only held against it by CSF pressure. Contains fibroblasts, collagen, and elastic fibers. |
| Pia mater | highly vascularized but can't see on a cadaver. Adheres to the surface of the brain and all its contours. Follows cerebral arteries when they penetrate the cerebral cortex (only for short distance). |
| Subarachnoid Space | between Arachnoid mater and the pia mater. contains CSF, trabecular cells, arteries, and veins |
| Central Sulcus | Seperates the frontal (Anterior) and parietal lobes of the brain |
| Lateral Sulcus | Seperates the temporal lobes (inferior) from both the parietal lobes and frontal lobe. |
| Parieto-occipital sulcus | Seperates the occipital lobe (posterior) from both parietal and temporal lobes. |
| Lateral Ventricles | 1st and 2nd ventricles, largest of all ventricles. Derived from the telencephalon. Occupy large areas b/w cerebral hemispheres. |
| Interventricular foramen | Allows CSF drainage from the lateral ventricles to the 3rd ventricle. |
| 3rd Ventricle | slit-like structure between the R and L Diencephalon. Drains CSF to the cerebral Aqueduct. |
| Cerebral Aqueduct | Narrow channel in the midbrain connecting the 3rd and 4th ventricles. Derived from the mesencephalon. |
| 4th ventricle | Pyramid shaped, between the Posterior Pons and Anterior Cerebellum. Derived from the Meten and Myelencephalon. Drains CSF to subarachnoid space via: Median Aperture or 2 lateral apertures. |
| Occipital Sinus | Lies in the attached border of falx cerebelli and empties into the confluence of sinuses. |
| Arachnoid granulations | Main site for CSF absorption into the dural venous system. |
| Spread of scalp infection | Purulent material can move freely within the loose areolar tissue. |
| Head Aches (dural innervation) | Dura is innervated by trigeminal N (all three branches). Pain is usually caused by vasodilation and distortion of the dura |
| Epidural Hematoma | B/c the squamous temporal bone is very thin, it can be fracture thus damaging the middle meningeal A. BL is contained within the dura and the inner skull table. Raises intracranial pressure, creates lateral shift and lucid interval. CN III affected 1st |
| Most common symptom seen with Cavernous sinus infections | Since CN VI travels through the middle, it will be affected first, leading to the lose of the Lateral Rectus M and an inability to ABDuct the eye past midline |
Created by:
WeeG
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