Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Class grades 3 Quizzes 9/27: Ventricular System 11/20: Brainstem and Basal Ganglia 12/6: Cranial Nerves 2 Exams Clinical Notebooks Due: 11/13----no late submissions accepted 11/1: Somatosensory System, Visual System, Central Auditory System, and Vestibular System 11/27: Motor System: Cortical Level, Cerebellum, Brainstem, Basal Ganglia and Spinal Cord The Meninges and the Ventricular System Learning Objectives 1. Describe the meninges, their locations, and their functions. 2. Identify parts of the ventricular cavities. 3. Discuss functions of cerebrospinal fluid. 4. Describe the mechanism of cerebrospinal fluid production. 5. Describe the circulation of cerebrospinal fluid. 6. Explain the diagnostic significance of the cerebrospinal fluid. Protection of the CNS Function: CNS is fairly soft and gelatinous in nature Basic protection Meninges of the Brain Meninges of the Brain Three Meninges: The Meninges Bhatnagar & Andy, 1995, Figure 2.45A Meningeal Layers: Dura Mater Location: Function: Meningeal Layers: Dura Mater Structure: Two spaces Two fibrous layers of the dura The Meninges Bhatnagar & Andy, 1995, Figure 2.45A The Meninges Love & Webb, 1996, Figure 3-3 Dural Extensions Falx Cerebri Location: Cavity Formations: Dural Extensions on Midsagittal Section Bhatnagar & Andy, 1995, Figure 2.43 Dural Extensions on Coronal View Bhatnagar & Andy, 1995, Figure 2.44A Dural Extensions Tentorium Cerebelli Location: Tentorial Notch Dural Extensions on Midsagittal Section Bhatnagar & Andy, 1995, Figure 2.43 Dural Extensions on Coronal View Bhatnagar & Andy, 1995, Figure 2.44A Dural Extensions Falx Cerebelli Location: Dural Extensions on Midsagittal Section Bhatnagar & Andy, 1995, Figure 2.43 Dural Extensions on Coronal View Bhatnagar & Andy, 1995, Figure 2.44A Meningeal Layers: Arachnoid Membrane Structure: Location: Meningeal Layers: Arachnoid Membrane Spaces: 1. Subarachnoid space 2. Subdural space: The Meninges Bhatnagar & Andy, 1995, Figure 2.45A Arachnoid Villi or Granulations Bhatnagar & Andy, 1995, Figure 2.41 Meningeal Layers: Pia Mater Location: Structure: The Meninges and the Spinal Cord Similar Structures The Spinal Cord and Its Meninges Bhatnagar & Andy, 1995, Figure 2.46 The Ventricles The Ventricular System Three Parts: Function: Ventricular System in Relation to Brain: Lateral View Bhatnagar & Andy, 1995, Figure 2.37 Ventricular System: Lateral View Bhatnagar & Andy, 1995, Figure 2.35A Ventricular System: Dorsal View Bhatnagar & Andy, 1995, Figure 2.35B The Lateral Ventricles Structure and Shape: Location: Connection: Choroid Plexus: Ventricular System in Relation to Brain: Lateral View Bhatnagar & Andy, 1995, Figure 2.37 The Third Ventricle Location and Shape: Connection: Choroid Plexus: Ventricular System in Relation to Brain: Lateral View Bhatnagar & Andy, 1995, Figure 2.37 The Fourth Ventricle Location: Shape: Structure: Function: Ventricular System in Relation to Brain: Lateral View Bhatnagar & Andy, 1995, Figure 2.37 Subarachnoid Space Location: Arachnoid Trabeculae The Meninges Bhatnagar & Andy, 1995, Figure 2.45A Ventricles Inner Walls Cerebrospinal Fluid Structure: Circulation Function: Choroid Plexus Function: Location: Path of CSF Circulation Pathway: Flows from the lateral ventricles into the third ventricle Via Monro’s foramen Then flows from the third ventricle to the fourth ventricle through the cerebral aqueduct Then flows from the fourth ventricle into the subarachnoid space through three apertures Two lateral Foramina of Luschka One mediodorsal Magendie’s foramen Then travels to reach the inferior surface of the cerebrum and moves superiorly over the lateral aspect of each hemisphere Some of it moves into the subarachnoid space around the spinal cord The Ventricular System: Midsagittal View Bhatnagar & Andy, 1995, Figure 18.2 Circulation of the CSF Love & Webb, 1996, Figure 3-6 Clinical Considerations Drainage of the CSF Inadequate Drainage of the CSF Clinical Considerations Rate of CSF Production Disassociation between Production and Absorption Rate of the CSF Clinical Considerations Hydrocephalus Increased Pressure in the Brain Sustained Pressure MRI of Enlarged Lateral Ventricles Secondary to Hydrocephalus Bhatnagar & Andy, 1995, Figure 18.3 Medical Diagnostic Procedures Measurement of the pressure of the fluid If abnormally high, may suspect: Intracranial tumor Intracranial hemorrhage Hydrocephalus Meningitis Encephalitis Treatment Hydrocephalus No longer a fatal condition If diagnosed early Can be surgically treated Treatment Involves diverting the blocked ventricular CSF To another cavity for absorption Procedure Tube is surgically inserted in the ventricular cavity And use to divert CSF flow to the peritoneal cavity in the abdomen Medical Diagnostic Procedures Lumbar Puncture or Spinal Tap Needle inserted into the lumbar subarachnoid space Between the fourth and fifth lumbar vertebrae Because spinal penetration at this point does not cause any injury to nerve fibers Attach needle hub to a manometer or other pressure sensitive device A pressure level higher than normal suggests that a pathologic process exists Medical Diagnostic Procedures Catheter Insertion into the Lateral Ventricles Measure Ventricular pressure Increased intracranial pressure occurs in response to: 1. Increased amounts of CSF 2. Brain swelling 3. And brain tumors Medical Diagnostic Procedures Additional Procedures Associated with Spinal Puncture Procedure also used to draw out CSF for chemical or cell studies Diseases of the CNS change the constituent composition of the CSF An alteration serves as a diagnostic tool for identifying pathologic changes that occur in the brain and spinal cord May suggest acute bacterial meningitis Route used to inject drugs to combat infection or to induce anesthesia Anesthesia prevents nerve impulses from being conducted through the spinal nerves From the lower body up to the level of the spinal injection Define the Following Technical Terms: Arachnoid granulations Arachnoid trabecula Cerebrospinal fluid Choroid plexus Ependymal cells Intracranial pressure Lumbar Puncture Meninges Meningitis Septum Subarachnoid space Subdural space Ventricles Review Questions 1. Discuss the function of the meningeal membranes of the brain and spinal cord. 2. Describe the location of epidural, subdural, and arachnoid spaces. 3. Name the dural extensions of the brain and describe their relationship to the brain. 4. With a labeled diagram, identify major parts of the ventricular system. 5. Discuss the functions of the cerebrospinal fluid. 6. Discuss the production, circulation, and absorption of the cerebrospinal fluid. 7. Describe the mechanism, clinical implications, and treatment of hydrocephalus. The Meninges and the Ventricular System Graphics THINGS TO DO BEFORE LECTURE