1.
Arachnoid Granulations (collections of arachnoid Villi): Effect the transfer of CSF to the venous system
2.
Arachnoid Mater and Pia Mater: (Leptomeninges) Contain the fluid filled space, Subarachnoid space, filled with CSF
3.
Arteries of Dura: Middle Meningeal Artery is a branch of maxillary artery and enters the Foramen Spinosum
4.
Attachments of Falx Cerebri: -Anteriorly to the frontal crest of the frontal bone and crista galli of the ethmoid bone.
-Posteriorly to the Internal Occipital Protuberance and continues with the Tentorium Cerebelli
5.
Attachments of Tentorium Cerebelli: 1. To the clinoid process of the sphenoid bone
2. Petrous part of the temporal bone
3. Internal surface of the occipital bone
6.
Basilar Plexus/Sinus: connects the Inferior Petrosal Sinuses and communicated with the Internal Vertebral Venous Plexus
7.
Bleeding Into the Subarachnoid Space Results in: 1. Meningeal Irritation
2. Severe Headache
3. Stiff Neck
4. Often loss of consciousness
8.
Blunt Trauma to Head: usually tears Dura and results in leakage of CSF
9.
Bulging of the Diaphragma Sella: 1. Pituitary Tumors may extend superiorly through the aperture in the diaphragma sella
2. Superior Extension may cause visual symptoms due to pressure on the Optic Chiasma
10.
Cavernous Sinuses Blood supply: From:
1. Superior and Inferior Opthalmic Veins
2. Superficial Middle Cerebral Vein
3. Sphenoparietal Sinus
11.
Cavernous Sinuses Components: - CN III, IV, V1, and V2 pass through it (in that order from superior to inferior) attached to the lateral wall, while CN VI is "free-floating" and not attached to the wall of the cavernous sinus
- Internal Carotid Artery, surrounded by the carotid plexus of sympathetic nerves
12.
Confluence of Sinuses: 1. Superior Sagittal sinus
2. Transverse sinus
3. Occipital sinus
4. Straight sinus
13.
Cranial meninges layers: 1. Dura mater=external fibrous layer
2. Arachnoid Mater=Thin, intermediate layer
3. Pia Mater=delicate, internal vasculated layer
14.
CSF: -Provides nutrients and cushions brain
-Formed by the choroid Plexuses of the 4th ventricle of the brain
15.
Diaphragma Sella: Covers the pituitary gland in this fossa and has an aperture for passage of the Infundibulum and the hypophyseal veins
16.
Dura Mater: -Thick, dense, bilaminar membrane aka Pachymeninx
-2 Layers: External Periosteal and Internal Meningeal
17.
Dura-Arachnoid Junction: -not a natural space b/w the dura and arachnoid mater
-a space may develop as a result of trauma, such as a blow to the head
18.
Dura-Cranial Interface: 1. Extradural or Epidural Space lies between the cranial bones and the External periosteal layer of the Dura Mater
It becomes a space only pathologically: for example, when the blood from torn meningeal vessels pushes the periosteum away from the cranium
19.
Dural Origin of headaches: Dura is sensitive to pain, distension of the scalp or meningeal vessels (or both) is believed to be a cause
- many headaches appear to be dural in Origin, such as the headache occurring after the Lumbar Puncture for removal of CSF
20.
Dural Venous Sinuses: All the blood from the brain ultimately drains through them into the Internal Jugular Vein
21.
Emissary Veins: Connect the Dural venous sinuses with the veins outside the cranium.
22.
Falx Cerebelli: Attached to the internal occipital crest
23.
Falx Cerebri: -Largest dural infolding, sickle shaped, lies in the longitudinal cerebral fissure
-Separates the Right and Left Cerebral hemispheres
24.
Foramina in the middle cranial fossa - all structures pass through the sphenoid bone: - Optic canal - CN II, Ophthalmic Artery
- Superior orbital fissure - CN III, IV, V1, VI, Ophthalmic vein
- Foramen rotundum - CN V2
- Foramen ovale - CN V3
- Foramen spinosum - Middle Meningeal A.
25.
Fracture of Pterion: Can be life threatening because it overlies the anterior branches of the middle meningeal vessels
-A hard blow can result in a hematoma which exerts pressure on the underlying cerebral cortex.
*left untreated middle meningeal artery hemorrhage may cause death in a few hours
26.
Inferior Petrosal Sinuses: Drains the Cavernous sinus directly into the transition of the sigmoid sinus to the Internal Jugular Vein
27.
Inferior Sagittal Sinus: Ends in the Straight Sinus
does not meet at the Confluence of Sinus
28.
Leptomeningitis: -Inflam. of Arachnoid and Pia resulting from Pathogenic Microorganisms (may enter space through blood/septicemia)
Acute purulent meningitis can result from infection with almost and pathogenic bacteria (meningococcal meningitis)
29.
Leptomeninx: Are the intermediate and internal (arachnoid and pia) continuous membranes
30.
Nerve Supply of Dura: Branches of Trigeminal Nerve
31.
Occipital Sinus: lies in the attached border of the Falx Cerebelli
32.
Optic Chiasma: The place where the Optic nerve fibers cross
33.
Pia Mater: Vascular Membrane of the brain
34.
Pterion: Junction between these bones:
1. the parietal bone
2. the squamous part of temporal bone
3. the greater wing of sphenoid bone
4. the frontal bone
35.
Sigmoid Sinuses: Continues as the INTERNAL JUGULAR VEIN after traversing the Jugular Foramen
36.
Straight Sinus: Formed by the union of the Inferior Sagittal Sinus and Great Cerebral Vein
37.
Subarachnoid (leptomeningeal) Space: Separates the arachnoid from the pia filled by the CSF
38.
Subarachnoid Space: Lies b/w arachnoid and pia mater, it is a REAL space that contains CSF, trabecular cells, arteries and veins
39.
Superior Petrosal Sinuses: Connects the Cavernous sinus to the Transverse Sinus
40.
Superior Sagittal Sinus: Begins at Crista galli and ends near the INternal Occipital Protuberance at the Confluence of Sinuses
41.
Tentorial Herniation: 1. Temporal lobe may be lacerated and herniate through tentorial notch
2. Oculomotor Nerve (CNIII) may be stretch, compressed or both.
- CNIII lesions may produce paralysis of the Extrinsic Muscles of the eye supplied by the nerve
42.
Tentorial Notch: gap in the concave free anteromedial border, through which the brain stem (pons and Medulla) extends from Posterior cranial to middle cranial fossa
43.
Tentorium Cerebelli: -separates the occipital lobes of the cerebrum from the cerebellum
44.
Thrombophlebitis of Facial Vein: Clinically Important vein, connections with Cavernous Sinus through Superior Opthalmic Vein and Pterygoid Venous Plexus through the Inferior Ophthalmic and Deep Facial Veins
-An infection of the face may spread to these areas
45.
Thrombophlebitis of Facial Vein Definition: Inflammation of the vein with secondary thrombus (clot) formation, the pieces of the clot may extend into the intracranial venous system and produce inflammation/clots of the Cavernous sinus
46.
Transverse Sinuses: Course along the attached margins of the Tentorium Cerebelli and becomes the sigmoid sinuses
47.
Veins of Dura: 1. Middle Meningeal Veins run with Middle Meningeal Artery leaving through Foramen Spinosum and drains into the Pterygoid Venous Plexus
