Cabs Unit 5 Ventricles/meninges

Front 1

Layers of the scalp:

Back 1

Skin, connective tissue, aponeurosis, loose CT and periosteum

Front 2

Which veins can translocate bacteria into the cranial cavity from an infection in the scalp (from scalp laceration) to a brain abscess or meningitis?

Back 2

Emmisary veins

Front 3

What is the function of the arachnoid granulations?

Back 3

Projections on the scalp- where CSF is reabsorbed from subarachnoid space into the dural sinus (most likely the superior sagittal sinus)

Front 4

What are the two extensions of dura discussed in class?

Back 4

Falx cerebri and tentorium cerebelli

Front 5

What is the area where all of the sinuses meet?

Back 5

Confluence of sinus

Front 6

Where does the transverse sinus empty?

Back 6

Into the sigmoid sinus which empties into the internal jugular vein--> brachiocephalic vein --> SVC --> to return blood flow back to the heart

Front 7

Signs of uncal herniation:

Back 7

Ipsilateral blown pupil (fixed and dilated), can compress the PCA which leads to visual field deficit (optic radiations produce contralateral homonymous hemianopia), contralateral weakness and decreased LOC (stuporus to coma)

Front 8

What are the 3 main causes of increased ICP?

Back 8

Hemorrhage, tumors or increased CSF

Front 9

What is the affect of increased ICP on the brain?

Back 9

Decreased blood flow-can get ischemia, pressure in brain is greater than in arterioles and veins- impaired blood flow in brain without previous to a herniation

Front 10

What type of breathing is described as crescendo descrescendo then period of apnea?

Back 10

Cheyne-stokes

Front 11

Signs of tonsillar herniation:

Back 11

Cushing's triad: bradycardia, hypertension and irregular respirations (cheyne stokes)

Front 12

Common sxs of increased ICP:

Back 12

Headache (worse in morning), ALOC, nausea/vom, papilledema, diploia (due to oculomotor injury), cushing's triad (seen with tonsillar herniation)

Front 13

Arachnoid granulations drain CSF into where?

Back 13

Superior sagittal sinus

Front 14

A laceration to the bridging veins leads to:

Back 14

Subdural hematoma- the bridging veins cross the dura into the dural sinuses, these with trauma can be sheared or torn --> especially with atrophy

Front 15

Subdural hematomas are common in which population/age group?

Back 15

Elderly or alcoholics or alzheimer's

Front 16

What is the most common cause of a spontaneous SAH?

Back 16

Berry aneurysm rupture

Front 17

A chronic subdural hematoma appears how on CT?

Back 17

Crescent shaped- gray= old blood, white= fresh blood/acute

Front 18

A laceration of the middle meningeal artery leads to:

Back 18

Epidural hematoma- mostly caused by trauma; skull lacerates the middle meningeal artery

Front 19

Why is an epidural hematoma a faster bleed than subdural?

Back 19

Epidural is an ARTERY (middle meningeal) vs VEIN (bridging vein) seen with subdural…arterial bleed is a higher pressure bleed..bleed faster etc

Front 20

How will an epidural bleed be visualized on CT?

Back 20

Biconvex lens - white

Front 21

Which type of bleed may have "talk and die"?

Back 21

Epidural hematoma- lucid interval then stuporous and coma

Front 22

What is the structure called that drains fluid from the lateral ventricles to 3?

Back 22

Interventricular foramen of monro

Front 23

What is the structure that drains CSF from 3 to 4 ventricle?

Back 23

Cerebral aqueduct of sylvius- descends through the brainstem

Front 24

There are 3 openings from the 4th ventricle that drain CSF to the subarachnoid space- what are they?

Back 24

Foramen of magendie and two foramina of Luschka

Front 25

Accumulation of CSF can cause:

Back 25

Hydrocephalus

Front 26

What is normal CSF pressure in the ventricles?

Back 26

70-180mm H2O

Front 27

What type of hydrocephalus is caused from a blockage- such as cerebral aqueduct of sylvius?

Back 27

Non-communicating obstructive hydrocephalus; more obvious in children because their sutures are not well fused- skull expands

Front 28

What type of hydrocephalus is seen more in elderly?

Back 28

Communicating from either a blockage in the subarachnoid space (decreased reabsorption into the dural sinuses) or chronically dilated ventricles

Front 29

What is normal pressure hydrocephalus?

Back 29

A type of communicating hydrocephalus as a result of increased CSF/pressure that leads to dilated ventricles

Front 30

How does a patient presure who has normal pressure hydrocephalus?

Back 30

Wacky, wobbly and wet- wacky: demented, wobbly: unsteady gait and wet: urinary incontinence

Front 31

What is the flow of CSF from the 4 ventricle to the rt atrium?

Back 31

4 ventricle --> median foramina of magendie and two foramina of Lushcka to subarachnoid space --> arachnoid granulations --> superior sagittal sinus --> confluence of sinuses --> transverse sinus --> sigmoid sinus --> internal jugular vein --> brachiocephalic vein -->SVC --> right atrium