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82 Cards in this Set

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5 Scalp layers:
Skin
Connective Tissue
Aponeurosis
Loose areolar tissue
Pericranium
What is the skin of the scalp like?
Thin (except in occipit)
Sweat/sebacious glands
Hair
Good vascular supply/drainage
What is the scalp connective tissue like?
Thick, dense, rich vasculature
Innervated by cutaneous nn.
another name for the scalp aponeurosis:
epicranial apon.
what is the epicranial aponeurosis?
Broad/strong tendon sheet covering calvaria; attachment for muscles.
what muscles are attached to the aponeurosis?
-Occipitofrontalis
-Temporoparietalis
-Superior auricular
What is the collective name for the muscles and aponeurosis connecting them?
Epicranius
What is the epicranius innervated by?
The facial nerve - CN VII
What is the Scalp Proper?
-Skin
-Connective tissue
-Aponeurosis
The first three layers
What is the function of the Loose areolar layer?
Allows free movement of the scalp proper over the calvaria
What is the Loose areolar layer?
Spongey layer with potential space for infection/injury fluid
What is the pericranium?
Dense connective tissue - forms ext. neurocranium periosteum.
What holds superficial scalp wounds together?
Aponeurosis
How do deep and superficial scalp wounds caused by coronal lacerations differ?
Superfic: don't gape
Deep: gape - b/c the aponeurosis is cut and the occipitofrontalis muscle pulls apart.
Which layer of the scalp is the "Danger Area"?
Layer 4 - Loose Areolar
Why is the loose areolar layer dangerous?
Because pus/blood spread easily within it; can spread infection both within, and into cranium via emissary veins.
What forms when hair follicles get obstructed?
sebacious cysts
What is a Cephalhematoma?
Benign area of blood trapped btwn the pericranium/calvaria in a newborn; caused by traumatic birth.
What are cranial meninges and where are they?
Brain coverings immediately internal to the cranium (bone).
What are the 3 functions of the meninges?
1. Protection of brain
2. Framework for vasculature
3. Allow for subarachnoid space
What are the 3 layers of the meninges?
1. Dura mater
2. Arachnoid mater
3. Pia mater
What is each layer like in general?
Dura = tough/thick
Arachnoid = thin
Pia = delicate
What is the relationship between the arachnoid/pia maters?
-Continuous; together they are the leptomeninx.
-Separated by subarachnoid space
What lies within the subarachnoid space?
CSF!!
What is the purpose of the subarachnoid space?
to maintain the balance of CSF in the brain.
Where is CSF produced?
From choroid plexuses in the ventricles within the brain.
What is the dura mater structure like in general?
Bilayered - aka pachymeninx
What are the dura mater's 2 layers?
1. External periosteal layer
2. Internal meningeal layer
Where is the external periosteal layer of the dura mater?
just inside the cranium surface; it is continuous with external periostium at cranial foramina.
Which dura mater layers are continuous with that of the spinal cord?
Only the internal meningeal layer.
What is the internal meningeal layer of the dura like?
Strong and fibrous; continus w/ spinal dura at foramen magnum.
Which layer of dura mater forms dural infoldings, and what are the four infolding names?
-Meningeal layer of dura - forms
1. Falx cerebri
2. Tentorium cerebelli
3. Falx cerebelli
4. Diaphragma sellae
What brain compartments are separated by falx cerebri?
In what plane does it lie?
Lies in vertical longitudinal cerebral fissure; separates R/L cerebral hemispheres.
What are the cranial attachments of falx cerebri?
Anterior: Frontal crest
Posterior: Internal occipital protuberance
How does the falx cerebri end?
B/c contin w diphragm sellae
What brain regions does tentorium cerebelli separate?
In what plane does it lie?
Lies somewhat horizontally; separates occipital cerebral lobes from the cerebellum.
What are the cranial attachments of tentorium cerebelli?
-Front/rostral: clinoid processs
-Side/rostral: Petrous temporal
-Side/posterior: occipital and parietal bones.
Into what compartments does tentorium cerebelli segment the brain?
-Supratentorial
-Infratentorial
What is the medial/anterior side of tentorium cerebelli like?
Concave and open - free to provide a gap that lets the brainstem continue into middle cranial fossa.
What is the gap created by tent. cerebelli called (for continuance of brainstem)?
Tentorial notch
What does falx cerebellum separate, and what is its cranial attachment?
Vertically oriented to separate R/L cerebellar hemispheres; attached to internal occipital crest
What is diaphragma sellae? What are its attachment points?
The bedcovers for the pituitary gland; circular sheet of dura; suspends from clinoid processes.
What is a tentorial herniation?
Slippage of a tempora lobe through the tentorial notch
What can cause tentorial herniation? (2 contributors)
1 Supratentorial brain tumors increase intracranial pressure; 2 Tentorial notch is a little bigger than it needs to be.
What can result from tentorial herniation?
-Temporal lobe laceration by the tentorium itself
-Occulomotor lesions from stretching/compression.
Pituitary tumors making diaphragma sellae bulge may result in what 2 symptoms?
1. Hormone disturbances (disturbance of pituitary gland)
2. Visual - from pressure on the optic chiasm.
What important circulatory structures lie between the periosteal/meningeal layers of dura mater?
Dural venous sinuses
What is the function of the dural venous sinuses?
To recieve blood from surface veins and the brain in general; return it to IJV.
What is the highest sinus? Where does it end?
Superior sagittal sinus; ends at the confluence of sinuses.
What meets at the confluence of sinuses?
-Superior sagittal sinus
-Straight sinus
-Occipital sinus
-Transverse sinuses
What are lateral venous lacunae?
Lateral expansions of the superior sinus
What are arachnoid granulations?
Tufts of arachnoid extending into the sinuses - esp lateral venous lacunae.
What is the purpose of arachnoid granulations?
To allow transfer of CSF from the arachnoid space to the venous system.
Where is the inferior sagittal sinus located, & how does it end?
-Inferior border of falx cerebri
-Ends into straight sinus
What 2 structures form the straight sinus?
-Inferior sagittal
-Great cerebral vein
Where does the straight sinus run?
-From the union point of inf sagittal/great cerebral vein;
-To confluence of sinuses
What happens to blood circulation at the confluence of sinuses?
It is drained into transverse sinuses
Where does blood flow from the transverse sinuses?
Into sigmoid sinuses
Where does blood flow from sigmoid sinuses?
Into IJV after the sigmoids course through the jugular foramen.
What does the occipital sinus allow to communicate w/ the sinus system?
Internal vertebral venous plexuses.
Where is the cavernous sinous located?
On either side of sella turcica on the sphenoid bone
Where does blood flow into the cavernous sinus from?
-Superior/inferior opthalmic v.
-Superfic. middle cerebral vein
-Sphenoparietal sinus
What do the cavernous sinuses communicate with?
Intercavernous sinuses around the pituitary gland stalk.
Where do the cavernous sinuses drain into?
Down/backward into superior adn inferior petrosal sinuses.
Where do the superior petrosal sinuses run?
From cavernous sinus to transverse sinuses (where they become sigmoid)
Where do the inferior petrosal sinuses run?
In a groove between petrous temporal & basilar occiput. Empty into IJV directly.
Finish up neurovasculature of dura
ok
What structures make up the ventricular system of the brain?
-2 lateral ventricles
-3rd ventricle
-4th ventricle
-Cerebral aqueduct
What fills the ventricules?
CSF - produced from choroid plexuses.
How do the lateral ventricles communicate with the 3rd?
Through interventricular foramen
What does the 3rd ventricle flow into?
The cerebral aqueduct
What does the cerebral aqueduct connect?
The 4th aqueduct w/ the 3rd.
What does the 4th ventricle drain into?
-Spinal cord
-Median aperture
-2 Lateral Apertures
What do the median/lateral apertures flow into?
Subarachnoid space
What is special about these apertures?
It is the only site where ventricular CSF can get into the subarachnoid space!
How much CSF is secreted daily?
400-500 mL
What secretes CSF?
Choroid plexuses within the ventricles.
What happens to CSF after it circulates thru subarachnoid space and into cisterns?
Absortn via subarachnoid granulations extending into venous system.
What venous structures recieve CSF from subarachn. granules?
-Superior sagittal sinus
-Lateral lacunae
What cranial site is used for CSF puncture? In whom is this the preferable site?
Cerebellomedullary cistern - site of choice in infants and young kids.
What is obstructive hydrocephalus?
Enlargement of the head due to overproduction of CSF, obstruction of CSF flow, or interference w/ CSF absorption.
Finish vasculature of brain
ok