audrone r. biknevicius, ph.d. dept. biomedical sciences ohio university- college of osteopathic...
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Audrone R. Biknevicius, Ph.D.Audrone R. Biknevicius, Ph.D.Dept. Biomedical SciencesDept. Biomedical Sciences
Ohio University-Ohio University-College of Osteopathic MedicineCollege of Osteopathic Medicine
Intracranial ContentsIntracranial Contents
Periosteum
EndosteumOsteosacroma of femur in 10 yo malewww.mds.qmw.ac.uk/.../kb/pathology/ funmedpics/pathtes2.htm
Cancellous bone
Cortical bone
Cortical bone
Postcranial Skeleton
New England Journal of Medicinewww.boston.com/news/daily/ 02/carpenter.htm
What is the equivalent “interior” of the skull?
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outer lamina (table)
inner lamina (table)
diploe
Skull
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periosteum
periosteum
endosteum
General Connective
Tissue
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epicranium
endocranium
endosteum
CranialConnective
Tissue
Vertebral column Cranium
Firmly attached Pericraniumto vertebrae - firmly attached to outer
lamina
Endocranium - loosely attached to
inner lamina- continuous with
pericranium at sutures
Periosteum
Spinal Meninges
Pia materArachnoid mater
Dura mater
Brain
Spinalcord
Meninges
Cranial
Spinal
Cranial Meninges
Coronal section through superior sagittal sinus
Spinal meninges Cranial meningesDura* - single-layer - periosteal layer
(=endosteal layer)
- meningeal layer
Arachnoid - trabeculae - trabeculae
Pia - attached to spinal cord - attached to brain
- denticulate ligaments - filum terminale
Meninges
*Note: only dura is pain-sensitive; somatic sensory innervation primarily via trigeminal n.
Vertebral column SkullPeriosteum “Epidural space”Epidural space Dura-periosteal layerDura Dura-meningeal layer
Subdural spaceArachnoid Arachnoid
Subarachnoid spacePia PiaSpinal cord Brain
Superficial
Deep
Meningeal Spaces
Dural Folds
www.yoursurgery.com/ ProcedureDetails.cfm?BR=4&Proc=19
Dural Folds
Tentorium cerebelli
Falx cerebri
Tentorial incisure
Falx cerebri
Falx cerebelli
Tentorium cerebelli
Dural Folds
Falx cerebri
Tentorium cerebelli
Cerebralhemispheres
Cerebellum
Tentorial incisure
Coronal section
www.brain-tumour.net
Dural Venous Sinuses
Stern Essentials of Gross Anatomy
(meningeal layer)(periosteal layer)
Coronal section through falx cerebri & hypophyseal fossa
Dural Venous Sinsuses
Superior sagittal
sinus
Confluence of sinuses
Inferior sagittal
sinus
Straight sinus
Transverse sinus
Sigmoid sinus
Cavernous sinus
Superior & inferior petrosal sinus
Occipital sinus Internal jugular v.
(meningeal layer)
Stern Essentials of Gross Anatomy
Cavernous Sinus•Adjacent to sella turcica (sphenoid bone)
•Envelops: internal carotid a.; oculomotor, trochlear, ophthalmic & maxillary nn.
•Internal drainage: superior & inferior petrosal sinuses
•External drainage (connection with facial v.): pterygoid plexus & inferior ophthalmic v.
Cerebral Veins
Netter Atlas of Human Anatomy
Netter Atlas of Human Anatomy
Subdural (Dural Border) Hematoma
•Accumulation of venous blood between meningeal layer of dura & arachnoid
www.nlm.nih.gov
Commonly due to rupture of cerebral vein
Meningeal Arteries
Netter Atlas of Human Anatomy
anatome.ncl.ac.uk/tutorials/ skulleasy/text/page3.html
Pterion
Sutural intersection formed by:
1. Frontal 2. Parietal3. Squamous temporal4. Greater wing of
sphenoid
• Overlies anterior brs. of middle meningeal a.
Epidural (Extradural) Hematoma
•Accumulation of arterial blood between periosteal layer of dura & calvarium•Most commonly due to rupture of middle meningeal a.
dura
Ventricular System
Leonardo Da Vinci The Anatomy of Man
1489-1490
Cerebrospinal fluid (CSF):
•Clear, odorless fluid
•Resembles plasma butlow protein (<50mg/dL),low cell content (<5/mL)
Ventricles & Choroid Plexus
Netter Atlas of Human Anatomy
Intraventicular Flow of CSF:•Lateral ventricles
•Interventricular foramen(of Monro)
•Third ventricle
•Cerebral aqueduct(of Sylvius)
•Fourth ventricle
Total CSF volume in ventricles: ~25 ml
Netter Atlas of Human Anatomy
CSF exits ventricular system (4th ventricle) via:•Median aperature (foramen of Magendie)
•Lateral aperatures (foramina of Luschka)
Cisterna magna(cerebellomedullary cistern)
Pontine cistern
Total CSF volume in subarachnoid space:~100 ml
Netter Atlas of Human Anatomy
CSF resorption into venous system via arachnoid villi
www.vh.org/.../BrainAnatomy/ Ch2Text/Section02.html
middle meningeal a.
superior sagittal sinus
lacuna lateralis with arachnoid granulations
•Arachnoid granulations = macroscopic collections of arachnoid villi
Netter Atlas of Human Anatomy
NORMAL CONDITION•CSF production=resorption
•Normal CSF pressure (at lumbar cistern; recumbent patient)< 200 mmH2O -or-About 9 mmHg ((higher than normal venous pressure)
Non-Communicating Hydrocephalus
Aqueductal stenosis•CSF obstruction at cerebral aqueduct•Lateral and 3rd ventricles dilates
•Causes: congenital, neoplasm, inflammation, hemorrhage
Animated Ventricular Anatomy
www.csuchico.edu/~pmccaff/syllabi/ SPPA362/362unit11.htmlwww.thirdage.com/health/adam/ imagepage/18009.htm
Arterial supply to CNS
SKULL CHECKOUT - Today @ 5pm (G139)GROSS ANATOMY LAB - Monday afternoon•Slide overview first 10 minutes (begins @ 1:10 & 3:10)•Come prepared to dissect (dissecting tools, including new scalpel blades, & gloves)•No sandals or other open-toe shoes•Bring your skull to lab
Audrone R. Biknevicius, Ph.D.Audrone R. Biknevicius, Ph.D.Dept. Biomedical SciencesDept. Biomedical Sciences
Life Science Building 125 Life Science Building 125 Drop by or office hours by app’tDrop by or office hours by app’t
Vertebral ArterySpinal brs.: posterior & anterior spinal aa.Cranial brs.:
1) Posterior inferior cerebellar aa. 2) Basilar a.
Basilar ArteryCerebellar brs.:
1) Anterior inferior cerebellar a. 2) Superior cerebellar a.3) Labyrinthine a.
Cerebral brs.: Posterior cerebral a.
Internal Carotid Artery1) Ophthalmic a.2) Posterior communicating a.3) Middle cerebral a.4) Anterior cerebral a.
Cerebral Arterial Circle (of Willis)
Anterior Cerebral ArterySuperficial brs.: medial surface of cerebral
hemisphere (except occipital & inferior temporal lobes)
Deep brs.:1) Medial striate a. (recurrent artery of Heubner)
– head of caudate & parts of interior capsule & putamen
2) Other brs: anterior hypothalmus (preoptic and supraoptic regions)
*
Middle Cerebral ArterySuperficial brs.: lateral surface of cerebral
hemisphereDeep brs.:
1) Anterior chroidal a.: choroid plexus of lateral ventricle, globus pallidus, hippocampus, posterior limb of internal capsule
2) Other brs: putamen, caudate, most of anterior limb of internal capsule
*
Posterior Cerebral ArterySuperficial brs.: medial surface of occipital &
inferior temporal lobes
*
Posterior Cerebral ArteryDeep brs.:
1) Posterior choroidal a.: tectum, medial regions of thalamus, choroid plexus of third ventricle
2) Posterior medial group: pituitary, tuber cinereum, hypothalamus, mammillary bodies, anterior and medial parts of thalamus
3) Posterolateral group: lateral and medial genicular nuclei, caudal thalamus, pulvinar, lateral nuclear groups of thalamus