DOCSLIB.ORG

Spinal Meninges Neuroscience Fundamentals > Regional Neuroscience > Regional Neuroscience

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Spinal Meninges Neuroscience Fundamentals > Regional Neuroscience > Regional Neuroscience Spinal Meninges Neuroscience Fundamentals > Regional Neuroscience > Regional Neuroscience SPINAL MENINGES GENERAL ANATOMY Meningeal Layers From outside to inside • Dura mater • Arachnoid mater • Pia mater Meningeal spaces From outside to inside • Epidural (above the dura) - See: epidural hematoma and spinal cord compression from epidural abscess • Subdural (below the dura) - See: subdural hematoma • Subarachnoid (below the arachnoid mater) - See: subarachnoid hemorrhage Spinal canal Key Anatomy • Vertebral body (anteriorly) • Vertebral arch (posteriorly). • Vertebral foramen within the vertebral arch. MENINGEAL LAYERS 1 / 4 • Dura mater forms a thick ring within the spinal canal. • The dural root sheath (aka dural root sleeve) is the dural investment that follows nerve roots into the intervertebral foramen. • The arachnoid mater runs underneath the dura (we lose sight of it under the dural root sheath). • The pia mater directly adheres to the spinal cord and nerve roots, and so it takes the shape of those structures. MENINGEAL SPACES • The epidural space forms external to the dura mater, internal to the vertebral foramen. • The subdural space lies between the dura and arachnoid mater layers. • The subarachnoid space lies between the arachnoid and pia mater layers. CRANIAL VS SPINAL MENINGES  Cranial Meninges • Epidural is a potential space, so it's not a typical disease site unless in the setting of high pressure middle meningeal artery rupture or from traumatic defect. • Subdural is a potential space but bridging veins (those that pass from the subarachnoid space into the dural venous sinuses) can tear, so it is a common site of hematoma. • Subarachnoid space is an actual space and is a site of hemorrhage and infection, for example. Spinal Meninges • Epidural is an actual space, so it's a typical site of hematoma, infection, and neoplasia (cancer). • Subdural is a potential space (and since no dural sinuses are here, no bridging veins are here), so it is NOT a common site of disease). • Subarachnoid space is an actual space and is continuous with the cranium, so localized spinal disease can occur there or there can be spread of disease from the cranium. NERVE ROOTS & SPINAL NERVE  General Anatomy • Ventral nerve root. • Dorsal nerve root. - Nerve rootlets. - Dorsal root ganglion. • Mixed spinal nerve. 2 / 4 • Pia mater covers: the rootlets, roots, and dorsal root ganglion. • Vasculature runs along the pia mater (within the subarachnoid space). Arachnoid mater • The arachnoid mater lies external to the pia mater: notice that it does not directly wrap around the nerve roots, which leaves space between it and the pia mater for the subarachnoid space. Dura mater • Dura mater envelops the arachnoid mater. - Subdural space. - Dural root sheath. Epidural space • Epidural space lies between the vertebral arch and the dura mater. Dural root sheath • The dural root sheath is superficial and the dura mater transitions into the epineurium of the peripheral nerve. Perineurium • The arachnoid and pia mater, together, transition into perineurium; although intertextual variation exists regarding this point, and it often goes unmentioned in textbooks. LUMBAR PUNCTURE • CSF is withdrawn from the subarachnoid space within the spinal canal, at the L3/L4 level of the spinal canal (typically). Key physiology • 150 milliliters of cerebrospinal fluid in the nervous system. • Cerebrospinal fluid (CSF) is produced at a rate of roughly 0.35 milliliters per minute (about 20 milliliters per hour). • 10 to 20 milliliters of CSF are typically withdrawn in an LP. • This fluid is replaced within an hour: within 30-60 minutes. General landmarks for LP 3 / 4 • Palpate the highest points of the iliac crests; they may intersect the spine anywhere from L1/L2 to L4/L5. • Generally, the LP needle can be inserted at the L3/L4 or L4/L5 interspace, which should be well below the termination of the spinal cord. See: UpToDate's Review on the Lumbar Puncture Technique Powered by TCPDF (www.tcpdf.org) 4 / 4.
Load more

Recommended publications
  • Why Do Bridging Veins Rupture Into the Virtual Subdural Space?
    J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.47.2.121 on 1 February 1984. Downloaded from Journal of Neurology, Neurosurgery, and Psychiatry 1984;47:121-127 Why do bridging veins rupture into the virtual subdural space? T YAMASHIMA, RL FRIEDE From the Department ofNeuropathology, University of Gottingen, Gottingen, Federal Republic of Germany SUMMARY Electron microscopic data on human bridging veins show thin walls of variable thick- ness, circumferential arrangement of collagen fibres and a lack of outer reinforcement by arach- noid trabecules, all contributory to the subdural portion of the vein being more fragile than its subarachnoid portion. These features explain the laceration of veins and the subdural location of resultant haematomas. Most subdural haematomas due to venous bleeding walls are delicate, lacking muscle fibres, with only a have been attributed to lacerations in bridging veins. thin fibrous wall and a thin elastic lamina adjacent to These veins form short trunks passing directly from the endothelial layer. The conclusions of these two the brain to the dura mater, almost at right angles to authors, have gained wide acceptance, although guest. Protected by copyright. both. Between these two points, bridging veins take there was little evidence concerning the fragility of a straight course with no tortuosity to allow for the the vein walls. possible displacement of brain.' Trotter2 speculated The purpose of the present communication is to that subdural haematomas are invariably due to provide electron microscopic data on tissue fixed in trauma tearing large veins, an interpretation situ, which might throw some light on to the lacera- elaborated by Krauland.3 According to Leary,4 the tion mechanism of bridging veins and its relationship common sources of subdural haematomas are rup- to the development of subdural haematoma.
    [Show full text]
  • Distance Learning Program Anatomy of the Human Brain/Sheep Brain Dissection
    Distance Learning Program Anatomy of the Human Brain/Sheep Brain Dissection This guide is for middle and high school students participating in AIMS Anatomy of the Human Brain and Sheep Brain Dissections. Programs will be presented by an AIMS Anatomy Specialist. In this activity students will become more familiar with the anatomical structures of the human brain by observing, studying, and examining human specimens. The primary focus is on the anatomy, function, and pathology. Those students participating in Sheep Brain Dissections will have the opportunity to dissect and compare anatomical structures. At the end of this document, you will find anatomical diagrams, vocabulary review, and pre/post tests for your students. The following topics will be covered: 1. The neurons and supporting cells of the nervous system 2. Organization of the nervous system (the central and peripheral nervous systems) 4. Protective coverings of the brain 5. Brain Anatomy, including cerebral hemispheres, cerebellum and brain stem 6. Spinal Cord Anatomy 7. Cranial and spinal nerves Objectives: The student will be able to: 1. Define the selected terms associated with the human brain and spinal cord; 2. Identify the protective structures of the brain; 3. Identify the four lobes of the brain; 4. Explain the correlation between brain surface area, structure and brain function. 5. Discuss common neurological disorders and treatments. 6. Describe the effects of drug and alcohol on the brain. 7. Correctly label a diagram of the human brain National Science Education
    [Show full text]
  • The Strain Rates in the Brain, Brainstem, Dura, and Skull Under Dynamic Loadings
    Mathematical and Computational Applications Article The Strain Rates in the Brain, Brainstem, Dura, and Skull under Dynamic Loadings Mohammad Hosseini-Farid 1,2,* , MaryamSadat Amiri-Tehrani-Zadeh 3, Mohammadreza Ramzanpour 1, Mariusz Ziejewski 1 and Ghodrat Karami 1 1 Department of Mechanical Engineering, North Dakota State University, Fargo, ND 58104, USA; [email protected] (M.R.); [email protected] (M.Z.); [email protected] (G.K.) 2 Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA 3 Department of Computer Science, North Dakota State University, Fargo, ND 58104, USA; [email protected] * Correspondence: [email protected]; Tel.: +1-7012315859 Received: 7 March 2020; Accepted: 5 April 2020; Published: 7 April 2020 Abstract: Knowing the precise material properties of intracranial head organs is crucial for studying the biomechanics of head injury. It has been shown that these biological tissues are significantly rate-dependent; hence, their material properties should be determined with respect to the range of deformation rate they experience. In this paper, a validated finite element human head model is used to investigate the biomechanics of the head in impact and blast, leading to traumatic brain injuries (TBI). We simulate the head under various directions and velocities of impacts, as well as helmeted and unhelmeted head under blast shock waves. It is demonstrated that the strain rates for the brain 1 are in the range of 36 to 241 s− , approximately 1.9 and 0.86 times the resulting head acceleration under impacts and blast scenarios, respectively. The skull was found to experience a rate in the range 1 of 14 to 182 s− , approximately 0.7 and 0.43 times the head acceleration corresponding to impact and blast cases.
    [Show full text]
  • The Development of the Epidural Space in Human Embryos
    Folia Morphol. Vol. 63, No. 3, pp. 273–279 Copyright © 2004 Via Medica O R I G I N A L A R T I C L E ISSN 0015–5659 www.fm.viamedica.pl The development of the epidural space in human embryos Magdalena Patelska-Banaszewska, Witold Woźniak Department of Anatomy, University School of Medical Sciences, Poznań, Poland [Received 25 April 2004; Accepted 25 June 2004] The epidural space is seen in embryos at stage 17 (41 days) on the periphery of the primary meninx. During stage 18 (44 days) the dura mater proper appears and the epidural space is located between this meninx and the perichondrium and contains blood vessels. During the last week of the embryonic period (stages 20–23) the epidural space is evident around the circumference of the spinal cord. On the posterior surface it is found between the dura mater and the me- soderm of the dorsal body wall. Key words: human neuroembryology, primary meninx, epidural space INTRODUCTION horizontal, frontal, and sagittal planes and stained The epidural space lies between the spinal dura according to various methods (chiefly Mallory, hae- mater and the periosteum of the vertebral canal. This matoxylin and eosin and with silver salts). In some periosteum is formed by the outer endosteal layer embryos graphic reconstructions were prepared at of the dura mater. The epidural space contains loose each of the stages investigated. connective tissue, venous plexuses and adipose tis- sue, which is particularly evident in the lumbar re- RESULTS gion [8]. There is some evidence that it is only a po- The primordium of the epidural space appears in tential space [2].
    [Show full text]
  • What to Expect After Having a Subarachnoid Hemorrhage (SAH) Information for Patients and Families Table of Contents
    What to expect after having a subarachnoid hemorrhage (SAH) Information for patients and families Table of contents What is a subarachnoid hemorrhage (SAH)? .......................................... 3 What are the signs that I may have had an SAH? .................................. 4 How did I get this aneurysm? ..................................................................... 4 Why do aneurysms need to be treated?.................................................... 4 What is an angiogram? .................................................................................. 5 How are aneurysms repaired? ..................................................................... 6 What are common complications after having an SAH? ..................... 8 What is vasospasm? ...................................................................................... 8 What is hydrocephalus? ............................................................................... 10 What is hyponatremia? ................................................................................ 12 What happens as I begin to get better? .................................................... 13 What can I expect after I leave the hospital? .......................................... 13 How will the SAH change my health? ........................................................ 14 Will the SAH cause any long-term effects? ............................................. 14 How will my emotions be affected? .......................................................... 15 When should
    [Show full text]
  • A Cellular Atlas of the Developing Meninges Reveals Meningeal Fibroblast Diversity and Function
    bioRxiv preprint doi: https://doi.org/10.1101/648642; this version posted May 24, 2019. The copyright holder for this preprint (which was not certified by peer review) is the author/funder. All rights reserved. No reuse allowed without permission. 1 2 3 4 Title: A cellular atlas of the developing meninges reveals meningeal fibroblast diversity and function 5 6 Authors: John DeSisto1,2,3,, Rebecca O’Rourke2, Stephanie Bonney1,3, Hannah E. Jones1,3, Fabien 7 Guimiot4, Kenneth L. Jones2 and Julie A. Siegenthaler1,3,5 8 9 1Department of Pediatrics Section of Developmental Biology, 2Department of Pediatrics Section of 10 Section of Hematology, Oncology, Bone Marrow Transplant, 3Cell Biology, Stem Cells and Development 11 Graduate Program, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045 USA, 12 4INSERM UMR 1141, Hôpital Robert Debré, 75019 Paris, France. 13 14 5Corresponding Author: 15 Julie A. Siegenthaler, PhD 16 University of Colorado, School of Medicine 17 Department of Pediatrics 18 12800 East 19th Ave MS-8313 19 Aurora, CO 80045 USA 20 Telephone #: 303-724-3123 21 E-mail: [email protected] 22 23 Key words (3-6 words): brain development, meninges, pial basement membrane, retinoic acid, human 24 meninges bioRxiv preprint doi: https://doi.org/10.1101/648642; this version posted May 24, 2019. The copyright holder for this preprint (which was not certified by peer review) is the author/funder. All rights reserved. No reuse allowed without permission. 25 Abstract 26 The meninges, a multilayered structure that encases the CNS, is composed mostly of fibroblasts, 27 along with vascular and immune cells.
    [Show full text]
  • CHAPTER 8 Face, Scalp, Skull, Cranial Cavity, and Orbit
    228 CHAPTER 8 Face, Scalp, Skull, Cranial Cavity, and Orbit MUSCLES OF FACIAL EXPRESSION Dural Venous Sinuses Not in the Subendocranial Occipitofrontalis Space More About the Epicranial Aponeurosis and the Cerebral Veins Subcutaneous Layer of the Scalp Emissary Veins Orbicularis Oculi CLINICAL SIGNIFICANCE OF EMISSARY VEINS Zygomaticus Major CAVERNOUS SINUS THROMBOSIS Orbicularis Oris Cranial Arachnoid and Pia Mentalis Vertebral Artery Within the Cranial Cavity Buccinator Internal Carotid Artery Within the Cranial Cavity Platysma Circle of Willis The Absence of Veins Accompanying the PAROTID GLAND Intracranial Parts of the Vertebral and Internal Carotid Arteries FACIAL ARTERY THE INTRACRANIAL PORTION OF THE TRANSVERSE FACIAL ARTERY TRIGEMINAL NERVE ( C.N. V) AND FACIAL VEIN MECKEL’S CAVE (CAVUM TRIGEMINALE) FACIAL NERVE ORBITAL CAVITY AND EYE EYELIDS Bony Orbit Conjunctival Sac Extraocular Fat and Fascia Eyelashes Anulus Tendineus and Compartmentalization of The Fibrous "Skeleton" of an Eyelid -- Composed the Superior Orbital Fissure of a Tarsus and an Orbital Septum Periorbita THE SKULL Muscles of the Oculomotor, Trochlear, and Development of the Neurocranium Abducens Somitomeres Cartilaginous Portion of the Neurocranium--the The Lateral, Superior, Inferior, and Medial Recti Cranial Base of the Eye Membranous Portion of the Neurocranium--Sides Superior Oblique and Top of the Braincase Levator Palpebrae Superioris SUTURAL FUSION, BOTH NORMAL AND OTHERWISE Inferior Oblique Development of the Face Actions and Functions of Extraocular Muscles Growth of Two Special Skull Structures--the Levator Palpebrae Superioris Mastoid Process and the Tympanic Bone Movements of the Eyeball Functions of the Recti and Obliques TEETH Ophthalmic Artery Ophthalmic Veins CRANIAL CAVITY Oculomotor Nerve – C.N. III Posterior Cranial Fossa CLINICAL CONSIDERATIONS Middle Cranial Fossa Trochlear Nerve – C.N.
    [Show full text]
  • Why Woodpecker Can Resist the Impact
    Why woodpecker can resist the impact A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy Zhe Zhang Master of Civil Engineering, RMIT University, Melbourne, Australia School of Engineering College of Science, Engineering and Health RMIT University November 2019 II Declaration I certify that except where due acknowledgement has been made, the work is that of the author alone; the work has not been submitted previously, in whole or in part, to qualify for any other academic award; the content of the thesis is the result of work which has been carried out since the official commencement date of the approved research program; any editorial work, paid or unpaid, carried out by a third party is acknowledged; and ethics procedures and guidelines have been followed. Zhe Zhang 30 November 2019 III Acknowledgments The research in this thesis could not have been completed without significant support from many individuals and organisations. I would like to take this opportunity to express my deep gratitude to all of them. Firstly, I would like to express my sincere gratitude to my senior supervisor, Dr. Shiwei Zhou, for his wisdom in choosing this fascinating research topic for me and his constant encouragement and guidance. After the guidance of my Master graduation project, Dr. Zhou accepted me as one of the Ph.D. students and offered financial support for my first-year study at RMIT University. He has always been patient in providing guidance and offering supportive suggestions to me during my PhD candidature period. It is not an exaggeration to say that he has changed my life and his good characteristics have had a significant and positive impact on me which would be beneficial for the rest of my life.
    [Show full text]
  • Anatomy of the Spine
    12 Anatomy of the Spine Overview The spine is made of 33 individual bones stacked one on top of the other. Ligaments and muscles connect the bones together and keep them aligned. The spinal column provides the main support for your body, allowing you to stand upright, bend, and twist. Protected deep inside the bones, the spinal cord connects your body to the brain, allowing movement of your arms and legs. Strong muscles and bones, flexible tendons and ligaments, and sensitive nerves contribute to a healthy spine. Keeping your spine healthy is vital if you want to live an active life without back pain. Spinal curves When viewed from the side, an adult spine has a natural S-shaped curve. The neck (cervical) and low back (lumbar) regions have a slight concave curve, and the thoracic and sacral regions have a gentle convex curve (Fig. 1). The curves work like a coiled spring to absorb shock, maintain balance, and allow range of motion throughout the spinal column. The muscles and correct posture maintain the natural spinal curves. Good posture involves training your body to stand, walk, sit, and lie so that the least amount of strain is placed on the spine during movement or weight-bearing activities. Excess body weight, weak muscles, and other forces can pull at the spine’s alignment: • An abnormal curve of the lumbar spine is lordosis, also called sway back. • An abnormal curve of the thoracic spine is Figure 1. (left) The spine has three natural curves that form kyphosis, also called hunchback. an S-shape; strong muscles keep our spine in alignment.
    [Show full text]
  • Meninges Ventricles And
    Meninges ,ventricles & CSF Dr.Sanaa Al-Shaarawy Dr. Essam Eldin Salama OBJECTIVES • By the end of the lecture the student should be able to: • Describe the cerebral meninges & list the main dural folds. • Describe the spinal meninges & locate the level of the termination of each of them. • Describe the importance of the subarachnoid space. • List the Ventricular system of the CNS and locate the site of each of them. • Describe the formation, circulation, drainage, and functions of the CSF. • Know some clinical point about the CSF MENINGES • The brain and spinal cord are invested by three concentric membranes ; • The outermost layer is the dura matter. • The middle layer is the arachnoid matter. • The innermost layer is the pia matter. DURA MATER ▪The cranial dura is a two layered tough, fibrous thick membrane that surrounds the brain. ▪It is formed of two layers; periosteal and meningeal. ▪The periosteal layer is attached to the skull. ▪The meningeal layer is folded forming the dural folds : falx cerebri, and tentorium cerebelli. ▪Sensory innervation of the dura is mostly from : meningeal branches of the trigeminal and vagus nerves & C1 to C3(upper cervical Ns.). DURA MATER Folds Two large reflection of dura extend into the cranial cavity : 1.The falx cerebri, In the midline, ▪It is a vertical sickle-shaped sheet of dura, extends from the cranial roof into the great longitudinal fissure between the two cerebral hemispheres. ▪It has an attached border adherent to the skull. ▪And a free border lies above the corpus callosum. DURA MATER Folds 2. A horizontal shelf of dura, The tentorium cerebelli, ▪ It lies between the posterior part of the cerebral hemispheres and the cerebellum.
    [Show full text]
  • Structure and Junctional Complexes of Endothelial, Epithelial and Glial Brain Barriers
    International Journal of Molecular Sciences Review Structure and Junctional Complexes of Endothelial, Epithelial and Glial Brain Barriers Mariana Castro Dias *, Josephine A. Mapunda, Mykhailo Vladymyrov and Britta Engelhardt * Theodor Kocher Institute, University of Bern, 3012 Bern, Switzerland; [email protected] (J.A.M.); [email protected] (M.V.) * Correspondence: [email protected] (M.C.D.); [email protected] (B.E.) Received: 14 October 2019; Accepted: 26 October 2019; Published: 29 October 2019 Abstract: The homeostasis of the central nervous system (CNS) is ensured by the endothelial, epithelial, mesothelial and glial brain barriers, which strictly control the passage of molecules, solutes and immune cells. While the endothelial blood-brain barrier (BBB) and the epithelial blood-cerebrospinal fluid barrier (BCSFB) have been extensively investigated, less is known about the epithelial and mesothelial arachnoid barrier and the glia limitans. Here, we summarize current knowledge of the cellular composition of the brain barriers with a specific focus on describing the molecular constituents of their junctional complexes. We propose that the brain barriers maintain CNS immune privilege by dividing the CNS into compartments that differ with regard to their role in immune surveillance of the CNS. We close by providing a brief overview on experimental tools allowing for reliable in vivo visualization of the brain barriers and their junctional complexes and thus the respective CNS compartments. Keywords: brain barriers; blood-brain barrier; neurovascular unit; blood-cerebrospinal fluid barrier; arachnoid barrier; glia limitans; tight junctions; adherens junctions 1. Introduction The brain barriers established by the endothelial blood-brain barrier (BBB), the epithelial blood-cerebrospinal fluid barrier (BCSFB), the meningeal brain barriers and the blood spinal cord barrier are essential for maintaining central nervous system (CNS) homeostasis [1].
    [Show full text]
  • Lecture 4: the Meninges And
    1/1/2016 Introduction • Protection of the brain – Bone (skull) The Nervous System – Membranes (meninges) – Watery cushion (cerebrospinal fluid) – Blood-brain barrier (astrocytes) Meninges CSF The Meninges The Meninges • Series of membranes • Three layers • Cover and protect the CNS – Dura mater • Anchor and cushion the brain – Arachnoid mater – • Contain cerebrospinal fluid (CSF) Pia mater The Meninges • Dura mater – “Tough mother” Skin of scalp Periosteum – Strongest meninx Bone of skull Periosteal Dura – Fibrous connective tissue Meningeal mater Superior Arachnoid mater – sagittal sinus Pia mater Limit excessive movement of the brain Subdural Arachnoid villus – space Blood vessel Forms partitions in the skull Subarachnoid Falx cerebri space (in longitudinal fissure only) Figure 12.24 1 1/1/2016 Superior The Meninges sagittal sinus Falx cerebri • Arachnoid mater – “Spider mother” Straight sinus – Middle layer with weblike extensions Crista galli – Separated from the dura mater by the subdural space of the Tentorium ethmoid cerebelli – Subarachnoid space contains CSF and blood vessels bone Falx Pituitary cerebelli gland (a) Dural septa Figure 12.25a The Meninges • Pia mater – “Gentle mother” – Connected to the dura mater by projections from the arachnoid mater – Layer of delicate vascularized connective tissue – Clings tightly to the brain T Meningitis TT121212 Ligamentum flavumflavumflavum L • LL555 Lumbar puncture Inflammation of meninges needle entering subarachnoid • May be bacterial or viral spacespacespace LLL444 • Diagnosed by
    [Show full text]