Skull Osteology and Cranial Structures

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Questions and Answers

What is the total number of bones in the human skull?

  • 28
  • 22 (correct)
  • 18
  • 24

Which of the following describes the arrangement of the meningeal layers?

  • Arachnoid mater, pia mater, dura mater
  • Pia mater, dura mater, arachnoid mater
  • Dura mater, arachnoid mater, pia mater (correct)
  • Dura mater, pia mater, arachnoid mater

Which cranial fossa is NOT one of the three main divisions?

  • Middle cranial fossa
  • Anterior cranial fossa
  • Superior cranial fossa (correct)
  • Posterior cranial fossa

Which bone is considered a single unpaired bone in the skull?

<p>Vomer (B)</p> Signup and view all the answers

What are the two main components that make up the skull?

<p>Cranium and mandible (D)</p> Signup and view all the answers

What is the role of the falx cerebri?

<p>It separates the two cerebral hemispheres. (D)</p> Signup and view all the answers

Where does the superior sagittal sinus typically drain?

<p>Right transverse sinus (B)</p> Signup and view all the answers

Which layer of the dura mater is attached to the inner surface of the skull bone?

<p>Periosteal layer (A)</p> Signup and view all the answers

What is the primary purpose of the dura mater's forming folds or septa?

<p>To reduce or prevent brain displacement during head movement. (C)</p> Signup and view all the answers

What type of space does the epidural space represent in the skull?

<p>Potential space (D)</p> Signup and view all the answers

What does the straight sinus connect to?

<p>Transverse sinus (D)</p> Signup and view all the answers

Which sine runs along the superior border of the petrous temporal bone?

<p>Superior petrosal sinus (A)</p> Signup and view all the answers

Which structure forms the roof of the pituitary gland's fossa?

<p>Diaphragma sellae (A)</p> Signup and view all the answers

What is the relationship of the cavernous sinus to the internal carotid artery?

<p>It surrounds the artery. (A)</p> Signup and view all the answers

Which sinus drains into the jugular bulb?

<p>Inferior petrosal sinus (C)</p> Signup and view all the answers

Which condition is described as life-threatening and can complicate due to facial, sinus, and orbital infections?

<p>Cavernous sinus thrombosis (B)</p> Signup and view all the answers

What important function does the subarachnoid space serve?

<p>Acts as a supportive cushion for the CNS. (B)</p> Signup and view all the answers

What anatomical feature separates the arachnoid mater from the pia mater?

<p>Subarachnoid space (C)</p> Signup and view all the answers

Where do the arachnoid villi drain cerebrospinal fluid?

<p>Into the dural sinuses (C)</p> Signup and view all the answers

What is the 'danger triangle' referring to in medical terms?

<p>Region connected to cavernous sinus thrombosis. (C)</p> Signup and view all the answers

Which sinus runs along the lesser wing of the sphenoid?

<p>Sphenoparietal sinus (A)</p> Signup and view all the answers

What condition is associated with the pushing of the uncus of the temporal lobe through the tentorial notch?

<p>Uncus herniation (A)</p> Signup and view all the answers

In a case of cerebellar tonsil herniation, which of the following is most likely to occur?

<p>Respiratory irregularities (C)</p> Signup and view all the answers

What is the primary cause of sub-arachnoid hemorrhage?

<p>Ruptured berry aneurysm (C)</p> Signup and view all the answers

What type of herniation occurs when the cerebellar tonsil is pushed into the foramen magnum?

<p>Cerebellar tonsil herniation (D)</p> Signup and view all the answers

What is a critical action to avoid when intracranial pressure is elevated?

<p>Conducting a lumbar puncture (B)</p> Signup and view all the answers

What condition may result from pressure on the medulla during cerebellar tonsil herniation?

<p>Increased blood pressure and decreased pulse rate (D)</p> Signup and view all the answers

Which type of hemorrhage requires minimal trauma to occur because of stretched cerebral veins?

<p>Chronic subdural hemorrhage (B)</p> Signup and view all the answers

Which of the following describes the symptoms that might develop over 2-3 days after an elderly patient experiences a stumble or fall?

<p>Gradual increase in confusion (B)</p> Signup and view all the answers

What structure is formed primarily by the parietal and occipital bones?

<p>Lambdoid suture (B)</p> Signup and view all the answers

Which cranial fossa is primarily formed by the sphenoid and temporal bones?

<p>Middle cranial fossa (A)</p> Signup and view all the answers

What is the characteristic shape of an extradural hematoma?

<p>Biconvex (Lentiform) (D)</p> Signup and view all the answers

At what age does the anterior fontanelle typically close?

<p>By 18 months (A)</p> Signup and view all the answers

Why do extradural hemorrhages not cross skull suture lines?

<p>Endosteum is attached to the suture membrane. (C)</p> Signup and view all the answers

Which symptom is associated with a subarachnoid hemorrhage?

<p>Sudden onset headache (B)</p> Signup and view all the answers

What condition is indicated by a bulging fontanelle in infants?

<p>Hydrocephalus (C)</p> Signup and view all the answers

What is a common clinical feature of extradural hemorrhage?

<p>Lucid interval followed by rapid deterioration (A)</p> Signup and view all the answers

What describes the area known as pterion?

<p>Intersection of the frontal, parietal, temporal, and sphenoid bones (A)</p> Signup and view all the answers

Which layer of the meninges is the thinnest and innermost?

<p>Pia mater (C)</p> Signup and view all the answers

What does a subdural hemorrhage typically resemble on imaging?

<p>Crescent or sickle shape (D)</p> Signup and view all the answers

What is the possible cause of subarachnoid hemorrhage related to vascular issues?

<p>Berry aneurysm (D)</p> Signup and view all the answers

What feature is characteristic of the fetal skull compared to an adult skull?

<p>Large cranium with small face (B)</p> Signup and view all the answers

Which sign may indicate cranial nerve compression in extradural hemorrhage?

<p>Hutchinson pupil or ‘blown pupil’ (C)</p> Signup and view all the answers

Which fontanelle closes first in infants?

<p>Posterior fontanelle (A)</p> Signup and view all the answers

What type of imaging is necessary to detect subdural hemorrhage changes over time?

<p>CT scans to observe increased density first, then hypodensity (C)</p> Signup and view all the answers

What does the 'calvaria' refer to?

<p>Upper part of the skull (C)</p> Signup and view all the answers

Which of the following is NOT a function of the meninges?

<p>Facilitate neural regeneration (D)</p> Signup and view all the answers

Which structure in the skull is primarily responsible for containing the middle meningeal artery?

<p>Pterion (C)</p> Signup and view all the answers

What is the composition of the outer layer of the cranial dura?

<p>Dense connective tissue (D)</p> Signup and view all the answers

What is the significance of the foramen ovale?

<p>It transmits the trigeminal nerve (B)</p> Signup and view all the answers

Which of the following best describes the surface of the arachnoid mater?

<p>Smooth with no blood vessels (A)</p> Signup and view all the answers

Which structure is NOT considered a single unpaired bone in the skull?

<p>Parietal (B)</p> Signup and view all the answers

Which of the following correctly identifies a location or component associated with the dural sinuses?

<p>Inferior sagittal sinus (B)</p> Signup and view all the answers

Which type of intracranial bleed is most likely to result from trauma that causes stretching of cerebral veins?

<p>Subdural hematoma (D)</p> Signup and view all the answers

Which cranial fossa is directly related to the passage of structures through the foramen magnum?

<p>Posterior cranial fossa (A)</p> Signup and view all the answers

Which of these bones is correctly classified as a paired bone in the human skull?

<p>Nasal (D)</p> Signup and view all the answers

Which sinus connects with the jugular bulb?

<p>Inferior petrosal sinus (D)</p> Signup and view all the answers

What is a potential consequence of cavernous sinus thrombosis?

<p>Brainstem infarction (D)</p> Signup and view all the answers

What structure acts as a protective layer around the brain and spinal cord?

<p>Subarachnoid space (A)</p> Signup and view all the answers

Which veins drain blood from the orbit into the cavernous sinus?

<p>Ophthalmic veins (D)</p> Signup and view all the answers

How does the subarachnoid space communicate with the fourth ventricle?

<p>Through the foramina of Luschka and Magendie (C)</p> Signup and view all the answers

Which condition can result from complications due to facial, sinus, and orbital infections?

<p>Cavernous sinus thrombosis (B)</p> Signup and view all the answers

What anatomical feature separates the arachnoid mater from the pia mater?

<p>Subarachnoid space (D)</p> Signup and view all the answers

Which sinus is primarily associated with the lesser wing of the sphenoid bone?

<p>Sphenoparietal sinus (A)</p> Signup and view all the answers

What is the primary role of the falx cerebri within the brain's meninges?

<p>To separate the two cerebral hemispheres (D)</p> Signup and view all the answers

Which sinus is responsible for draining blood from the inferior sagittal sinus?

<p>Straight sinus (A)</p> Signup and view all the answers

In the context of dural sinuses, what unique feature is characteristic of the confluence of sinuses?

<p>Its configuration can vary among individuals (B)</p> Signup and view all the answers

Which dural structure is located above the tentorium cerebelli?

<p>Superior sagittal sinus (A)</p> Signup and view all the answers

What anatomical relationship is observed between the superior petrosal sinus and the transverse sinus?

<p>The transverse sinus receives the superior petrosal sinus (D)</p> Signup and view all the answers

What characteristic distinguishes the epidural space in the vertebral column from that in the skull?

<p>It is a true anatomical space in the vertebral column (A)</p> Signup and view all the answers

Which structure does the tentorium cerebelli primarily separate within the brain?

<p>Occipital lobe from cerebellum (D)</p> Signup and view all the answers

Which layer of the dura mater forms a part of the periosteum on the inner surface of the skull?

<p>Periosteal layer (B)</p> Signup and view all the answers

What is a sign of uncus herniation due to increased intracranial pressure?

<p>Sluggish pupillary light reflex (B)</p> Signup and view all the answers

Which of the following symptoms is associated with cerebellar tonsil herniation?

<p>Elevated blood pressure (A)</p> Signup and view all the answers

What is the primary danger of performing a lumbar puncture in a patient with raised intracranial pressure?

<p>Herniation risk (A)</p> Signup and view all the answers

In elderly patients, what may cause gradual confusion following a fall?

<p>Subdural hematoma (D)</p> Signup and view all the answers

Which condition is linked to a sudden, severe headache that resembles a blow to the back of the head?

<p>Subarachnoid hemorrhage (C)</p> Signup and view all the answers

What kind of hemorrhage can occur with minimal trauma due to stretched cerebral veins?

<p>Subdural hemorrhage (D)</p> Signup and view all the answers

Which type of respiration may result from cerebellar tonsil herniation due to brainstem compression?

<p>Cheyne-Stokes respiration (D)</p> Signup and view all the answers

What is the likely cause of brain herniation in cases of space-occupying lesions?

<p>Tumors or bleeding (A)</p> Signup and view all the answers

What distinguishes the subarachnoid space around the brain from that around the spinal cord?

<p>It forms distinct cisterns around the brain. (A)</p> Signup and view all the answers

Which of the following is NOT a type of subarachnoid cistern mentioned?

<p>Interventricular cistern (D)</p> Signup and view all the answers

What is the primary function of arachnoid granulations?

<p>They allow for the absorption of cerebrospinal fluid into venous circulation. (D)</p> Signup and view all the answers

Which statement correctly describes pia mater?

<p>It closely adheres to the brain's surface and dips into gyri and sulci. (B)</p> Signup and view all the answers

What is the primary cause of extradural hemorrhage?

<p>Tearing of arterial vessels due to blunt force trauma. (D)</p> Signup and view all the answers

What is a common characteristic of subdural hemorrhage?

<p>Associated with the tearing of bridging veins. (C)</p> Signup and view all the answers

How can subarachnoid cisterns aid in medical imaging?

<p>They provide pathways for contrast agents in radiological procedures. (B)</p> Signup and view all the answers

Which type of intracranial bleeding occurs within the brain tissue itself?

<p>Intracerebral hemorrhage (A)</p> Signup and view all the answers

What is indicated by a sunken anterior fontanelle in infants?

<p>Dehydration (D)</p> Signup and view all the answers

Which of the following bones forms part of the anterior cranial fossa?

<p>Frontal (D)</p> Signup and view all the answers

At what age does the posterior fontanelle typically close?

<p>2 to 3 months (B)</p> Signup and view all the answers

What condition can lead to a bulging anterior fontanelle in infants?

<p>Intracranial hypertension (D)</p> Signup and view all the answers

Which of the following structures does NOT pass through the jugular foramen?

<p>Facial nerve (B)</p> Signup and view all the answers

Which type of ossification is responsible for the formation of the cranial vault?

<p>Intramembranous ossification (A)</p> Signup and view all the answers

What is the role of the cranial dural folds?

<p>Support the brain and contain venous blood (A)</p> Signup and view all the answers

Which cranial fossa is associated with the sella turcica?

<p>Middle cranial fossa (D)</p> Signup and view all the answers

What is unique about the fetal skull compared to the adult skull?

<p>It has unossified fontanelles (A)</p> Signup and view all the answers

Which layer of the meninges provides the innermost protection to the brain?

<p>Pia mater (B)</p> Signup and view all the answers

Where does the internal acoustic meatus lead to?

<p>From the inner ear to the brain (A)</p> Signup and view all the answers

What space is commonly associated with the presence of venous sinuses in the cranial cavity?

<p>Dural space (D)</p> Signup and view all the answers

What characteristic is true regarding the circumferential ossification of the skull during fetal development?

<p>It allows for flexibility during birth (A)</p> Signup and view all the answers

What significant relationship does the pterion have regarding cerebral concerns?

<p>It is a commonly fractured area associated with cranial bleed (B)</p> Signup and view all the answers

Flashcards

Skull structure

The skull comprises the cranium (calvarium, base/fossae, and facial bones) and mandible. Joined by sutures (fibrous joints).

Cranial Fossas

The base of the cranium has three depressions (anterior, middle, and posterior).

Skull Bones

The skull is composed of 22 bones, including 8 cranial and 14 facial bones. (excluding small ear bones).

Meninges

Protective membranes (layers) surrounding the brain and spinal cord.

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Intracranial Bleeds

Bleeding within the skull, affecting brain function.

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Cranial Dura

Inner layer of dura mater in the skull; smooth, avascular, and continuous with spinal dura.

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Dural Sinuses

Venous channels within the dura that drain blood from the brain.

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Superior Sagittal Sinus

Major dural sinus running in the falx cerebri, draining to transverse sinus.

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Transverse Sinus

Dural sinus that receives blood from superior sagittal sinus, becomes sigmoid sinus.

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Falx Cerebri

Dural fold separating the two cerebral hemispheres

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Tentorium Cerebelli

Dural fold separating the occipital lobe from the cerebellum

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Epidural Space

Potential space in skull & true space in spine.

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Sigmoid Sinus

Dural sinus that receives blood from the transverse sinus and drains into jugular vein.

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Cavernous Sinus

A venous sinus located on either side of the sphenoid bone, surrounding the pituitary gland.

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Sigmoid Sinus

A venous sinus that connects to the transverse sinus and drains into the internal jugular vein.

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Superior & Inferior Petrosal Sinuses

Venous sinus channels connecting cavernous and transverse/sigmoid sinuses.

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Cavernous Sinus Thrombosis

A rare and dangerous blood clot within the cavernous sinus.

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Arachnoid Mater

The middle meningeal layer lining the brain.

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Subarachnoid Space

The space between the arachnoid mater and pia mater, containing cerebrospinal fluid (CSF).

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Arachnoid Villi

Structures that drain CSF into dural sinuses to remove excess fluid.

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Danger Triangle of the Face

An area of the face where infections can spread to the cavernous sinus, possibly causing thrombosis.

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Pterion

A point on the skull where the frontal, parietal, temporal, and sphenoid bones meet, crucial for understanding potential intracranial bleeding.

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Sutures

Fibrous joints connecting skull bones, allowing for flexibility during birth and preventing movement in the adult.

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Anterior fontanelle

Unossified gap in the fetal skull, located at bregma, that closes around 18 months.

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Posterior fontanelle

Unossified gap in the fetal skull, located at lambda, that closes by 2-3 months.

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Fontanelles

Unossified spaces in a baby's skull that allow for its growth.

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Cranial Fossae

Indents on the skull's base, dividing the brain into anterior, middle, and posterior regions.

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Anterior Cranial Fossa

The skull's deepest bony cavity housing the frontal lobe of the brain. Formed by frontal, ethmoid, sphenoid bones.

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Middle Cranial Fossa

Middle bony cavity housing important structures like the pituitary gland. Formed by the sphenoid and temporal bones

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Posterior Cranial Fossa

The lowermost bony cavity, housing the cerebellum and brainstem. Formed By temporal and occipital bones.

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Meninges

Protective membranes (layers) surrounding the brain and spinal cord.

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Dura Mater

The outermost layer of meninges; a tough fibrous membrane.

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Arachnoid mater

Middle layer of meninges; a thin, webby structure.

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Pia mater

Innermost layer of meninges; directly adheres to the brain.

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Subdural space

The potential space between the Dura and Arachnoid membranes.

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Subarachnoid space

The space between the Arachnoid and Pia mater; contains cerebrospinal fluid.

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Calvaria

The skullcap (vault) covering the cranial cavity.

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Extradural Hemorrhage

Bleeding outside the dura mater, often from a meningeal artery.

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Middle Meningeal Artery

An artery that frequently causes extradural hemorrhages.

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Subdural Hemorrhage

Bleeding beneath the dura mater.

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Subarachnoid Hemorrhage

Bleeding into the subarachnoid space.

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Lucid Interval

A period of apparent recovery after head injury, followed by rapid deterioration.

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Biconvex Hematoma

A distinctive shape of an extradural hematoma, appearing lens-like (like a lentil).

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Loss of Consciousness (LOC)

Temporary or prolonged state of unconsciousness.

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Hutchinson Pupil/ "Blown Pupil"

A dilated pupil on the side affected by the brain injury, often associated with increased intracranial pressure and herniation.

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Sub-dural Hemorrhage

Bleeding between the dura mater and arachnoid mater, often caused by stretched cerebral veins and minimal trauma in elderly patients.

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Sub-arachnoid Hemorrhage

Bleeding in the subarachnoid space, often caused by ruptured aneurysm in the Circle of Willis, associated with sudden, severe headache.

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Brain Herniation

Displacement of brain tissue due to swelling, bleeding, or tumors, leading to compression of brain structures.

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Uncus Herniation

Displacement of the uncus (part of the temporal lobe) through the tentorial notch, pressing on cranial nerve III and causing a sluggish light reflex.

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Cerebellar Tonsil Herniation

Displacement of cerebellar tonsils into the foramen magnum, potentially impacting the cardiorespiratory center, potentially causing abnormalities in BP and pulse, and respiratory issues(Cheyne-Stokes).

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Intracranial Pressure

Pressure within the skull; Increased pressure causes herniation and can lead to neurological problems.

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Avoid During Increased ICP

Avoid lumbar puncture when intracranial pressure is elevated.

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Space Occupying Lesions

Structures (Tumors, hematomas) that expand within the skull affecting brain and CSF distribution and pressure by pushing on the brain.

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Skull Composition

The skull is composed of the cranium (calvarium, base/fossae, and facial bones) and the mandible, joined by sutures (fibrous joints).

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Cranial Fossae

The base of the skull has three depressions: anterior, middle, and posterior, which accommodate different brain regions.

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Skull Bones

The skull includes 22 bones, 8 cranial and about 14 facial bones. (excluding inner ear bones).

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Meninges

Protective membranes surrounding the brain and spinal cord: dura mater, arachnoid mater, pia mater.

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Intracranial Bleeds

Bleeding within the skull affecting brain function.

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Subarachnoid Cisterns

Enlargements of the subarachnoid space in the brain, including the cerebellomedullary and chiasmatic cisterns.

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Arachnoid Granulations

Structures that absorb CSF into venous sinuses.

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Pia Mater

The delicate innermost meningeal layer adhering to brain surface.

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Extradural Hemorrhage

Bleeding outside the dura mater, usually caused by a skull fracture.

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Subdural Hemorrhage

Bleeding between the dura and arachnoid mater in the potential subdural space

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Subarachnoid Hemorrhage

Bleeding into the subarachnoid space.

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Intracerebral Bleeding

Bleeding within the brain tissue itself.

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Regular vs. Irregular Subarachnoid Space

The width of the subarachnoid space around the spinal cord is more regular, while around the brain it's irregular and forms cisterns

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Cranial Dura

The inner layer of the dura mater in the skull; it's smooth, avascular, continuous with spinal dura, and forms folds to prevent brain displacement.

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Dural Sinuses

Venous channels within the dura that drain blood from the brain.

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Superior Sagittal Sinus

A major dural sinus running along the top of the falx cerebri, draining into the transverse sinus.

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Transverse Sinus

A dural sinus that receives blood from the superior sagittal sinus and continues as the sigmoid sinus.

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Falx Cerebri

A dural fold that separates the two cerebral hemispheres.

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Tentorium Cerebelli

A dural fold that separates the occipital lobe from the cerebellum.

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Epidural Space

A potential space (skull) / true space (spinal column) in vertebrates, between the dura mater and the skull/vertebra.

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Sigmoid Sinus

A dural sinus that continues from the transverse sinus and drains into the internal jugular vein.

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Pterion

Junction of frontal, parietal, temporal, and sphenoid bones; where middle meningeal artery runs; common site of intracranial bleeds.

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Anterior Fontanelle

Unossified gap in fetal skull at bregma; closes around 18 months.

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Posterior Fontanelle

Unossified gap in fetal skull at lambda; closes by 2-3 months.

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Fontanelles (general)

U-nossified spaces in newborn skull; allow for growth.

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Middle Meningeal Artery

Artery frequently involved in extradural bleeds.

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Cranial Fossae

Indentations on the skull base, housing different brain parts (anterior, middle, posterior).

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Anterior Cranial Fossa

Skull's deepest area, holding frontal lobe. Formed by frontal, ethmoid, and sphenoid bones.

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Middle Cranial Fossa

Skull's middle area, holding pituitary and other structures. Formed by sphenoid and temporal bones.

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Posterior Cranial Fossa

Skull's bottom area, holding cerebellum and brainstem. Formed by temporal and occipital bones.

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Dura Mater

Outermost meningeal layer, tough fibrous membrane adhering to the skull.

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Arachnoid Mater

Middle meningeal layer, web-like structure.

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Pia Mater

Innermost meningeal layer, directly covering the brain.

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Subdural Space

Potential space between dura and arachnoid.

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Subarachnoid Space

Space between arachnoid and pia mater; holds CSF.

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Cavernous Sinus

Venous sinus on either side of sphenoid bone, surrounding pituitary gland.

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Sigmoid Sinus

Dural sinus connecting transverse sinus and internal jugular vein.

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Cavernous Sinus Thrombosis

Rare, life-threatening blood clot in cavernous sinus, often from infections.

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Arachnoid Mater

Middle meningeal layer, separating dura and pia, with CSF-filled space.

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Subarachnoid Space

Space between arachnoid and pia mater, filled with CSF, protecting CNS.

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Superior/Inferior Petrosal Sinuses

Venous channels connecting cavernous and transverse/sigmoid sinuses.

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Danger Triangle of the Face

Area where infections can spread to cavernous sinus, risking thrombosis.

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Arachnoid Villi

Structures that drain cerebrospinal fluid (CSF) into dural sinuses.

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Subdural Hemorrhage

Bleeding between the dura and arachnoid mater, often from stretched cerebral veins in the elderly.

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Subarachnoid Hemorrhage

Bleeding into the subarachnoid space, usually caused by a ruptured aneurysm.

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Brain Herniation

Displacement of brain tissue due to swelling, bleeding, or tumors, leading to compression.

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Uncus Herniation

Displacement of the uncus (temporal lobe) through the tentorial notch, pressuring cranial nerve III.

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Cerebellar Tonsil Herniation

Displacement of cerebellar tonsils into the foramen magnum, potentially affecting cardiorespiratory function.

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Lucid Interval

Temporary recovery period after head injury, followed by deterioration.

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Avoid During Increased ICP

Do not perform lumbar puncture when intracranial pressure is elevated.

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Herniation (coning)

Structures pushed inward due from intracranial pressure, causing compression at various brain levels.

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Study Notes

Skull Osteology, Cranial Fossae, Meninges, Sinuses, and Intracranial Bleeds

  • Skull: Composed of cranium and mandible. Cranium includes calvarium, base, and facial bones. Bones are joined by fibrous joints called sutures.
  • Skull Bones: There are 22 bones (8 cranial and 14 facial). Cranial bones include occipital, frontal, sphenoid, ethmoid, parietal, and temporal. Facial bones include maxilla, mandible, palatine, zygomatic, vomer, nasal, lacrimal, and nasal conchae. The small bones of the ears are not included.
  • Cranial Fossae: The skull has three cranial fossae: anterior, middle, and posterior.
  • Anterior Cranial Fossa: Formed by frontal and ethmoid bones. Foramina present include foramen caecum and olfactory foramen.
  • Middle Cranial Fossa: Formed by sphenoid and temporal bones. Foramina include optic canal, superior orbital fissure, foramen rotundum, foramen ovale, and foramen spinosum.
  • Posterior Cranial Fossa: Formed by occipital and temporal bones. Foramina include internal acoustic meatus, foramen magnum, jugular foramen, and hypoglossal canal.
  • Learning Outcomes: Students will learn to describe skull osteology, identify foramina, define cranial fossae, list meningeal layers, identify blood vessel relations to meninges, describe dural sinuses, identify intracranial bleed types, and discuss herniation (coning).

Meninges

  • Meninges: Protective membranes surrounding the brain and spinal cord.
  • Layers of Meninges: Dura mater (outermost), arachnoid mater (middle), and pia mater (innermost, attached to brain surface).
  • Dura Mater: Two layers (periosteal and meningeal). They are intimately attached to the skull bone, except where dural folds (containing venous blood). It contains meningeal arteries. Important to note that epidural space is a "potential" space in the skull.
  • Arachnoid Mater: Separated from pia mater by subarachnoid space containing cerebrospinal fluid(CSF). Arachnoid villi and granulations drain CSF into dural sinuses.
  • Pia Mater: Delicate layer adhering to the brain surface.

Dural Sinuses

  • Dural Sinuses: Venous channels present between the two layers of the dura mater.
  • Superior Sagittal Sinus: Runs in the upper part of the falx cerebri.
  • Inferior Sagittal Sinus: Located on the free edge of the falx cerebri.
  • Straight Sinus: Formed by the confluence of the superior sagittal and inferior sagittal sinuses.
  • Transverse Sinus: Receives the superior and inferior sagittal sinuses. It runs in grooves, receives superior petrosal sinus, then becomes sigmoid sinus.
  • Sigmoid Sinus: Courses to the jugular foramen, becomes internal jugular vein.
  • Cavernous Sinus Located on either side of the body of the sphenoid, surrounding the pituitary gland. Crucial relations to the internal carotid artery and cranial nerves. The superior and inferior petrosal sinuses connect to it.
  • Important Clinical Considerations: Include cavernous sinus thrombosis, intracranial bleed presentations
  • Important Clinical Considerations: Related to intracranial bleeding, including subdural, epidural, subarachnoid, intracerebral, and intraventricular hemorrhage.

Intracranial Bleeding

  • Types of Intracranial Bleeding: Extradural, subdural, subarachnoid, intracerebral, and intraventricular hemorrhage.
  • Extradural Hemorrhage: Usually caused by a middle meningeal artery tear, often associated with a skull fracture affecting the temporal or temporo-parietal region; typically presented by a lucid interval, then deterioration
  • Subdural Hemorrhage: Occurs between the dura and arachnoid maters. Often associated with chronic subdural hematomas in elderly patients. Generally venous.
  • Subarachnoid Hemorrhage: Blood in the subarachnoid space, often due to an aneurysm.
  • Intracranial Herniation: Displacement of brain tissue due to space-occupying lesions. This can cause compression and damage to vital brain structures. Types like uncus and cerebellar tonsil herniation can occur resulting in specific presentations.

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