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What is most responsible for forming compartments in the cranial cavity?
A.
Meningeal sinuses
B.
Pia mater
C.
Meningeal septa
D.
Arachnoid mater
Correct Answer
C. Meningeal septa
Explanation Meningeal septa are thin partitions that divide the cranial cavity into compartments. These septa help to provide structural support and organization within the cranial cavity. They separate different regions of the brain and help to prevent the spread of infection or injury from one area to another. Therefore, meningeal septa are most responsible for forming compartments in the cranial cavity.
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2.
The meninges start to form during the ____ month and by the end of the ___ trimester they have an adult pattern (3 layers)
A.
1st, 2nd
B.
1st, 1st
C.
2nd, 1st
D.
2nd, 2nd
Correct Answer
B. 1st, 1st
Explanation During the first month of development, the meninges begin to form. By the end of the first trimester, which is also the end of the first month, they have already developed into three layers, which is the adult pattern. Therefore, the correct answer is 1st, 1st.
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3.
A congenital dermal sinus
A.
Predisposes the patient to infection, because bacteria can easily get inside
B.
Is a developmental defect associated with spina bifida
C.
Is where the mesoderm fails to dissociated from neuroectoderm, leaving an epithelium lined channel to the surface of the skin
D.
Results in recurrent meningitis
Correct Answer(s)
A. Predisposes the patient to infection, because bacteria can easily get inside B. Is a developmental defect associated with spina bifida D. Results in recurrent meningitis
Explanation Is where the ectoderm fails to completely dissociate from neuroectoderm, leaving an epithelium lined channel to the surface of the skin
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4.
Regarding the ectomeninx...
A.
It forms the dura mater
B.
Around the brain it stays attaches to the periosteal connective tissue layer
C.
It eventually becomes continuous with the vertebral periosteum in adulthood
Correct Answer(s)
A. It forms the dura mater B. Around the brain it stays attaches to the periosteal connective tissue layer
Explanation The ectomeninx around the brain stays attached to the periosteal connective tissue layer. But in the spinal cord, it is initially continuous with the vertebral periosteum during development but later separates forming epidural space
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5.
Another word for dura mater is leptomeninx
A.
True
B.
False
Correct Answer
B. False
Explanation Dura mater is also called the pachymeninx. The arachnoid and pia mater are collectively called the leptomeninges
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6.
List the order from outside in
A.
Skull, periosteal dura, dural border cells, meningeal dura, arachnoid barrier cells, subarachnoid space, pia mater
Skull, periosteal dura, meningeal dura, dural border cells, arachnoid barrier cells, subarachnoid space, pia mater
D.
Skull, periosteal dura, meningeal dura, dural border cells, subarachnoid space, arachnoid barrier cells, pia mater
Correct Answer
C. Skull, periosteal dura, meningeal dura, dural border cells, arachnoid barrier cells, subarachnoid space, pia mater
Explanation The correct answer lists the layers of the meninges in the correct order from outside to inside. The meninges are the protective membranes that surround the brain and spinal cord. Starting from the outside, the order is as follows: Skull, periosteal dura, meningeal dura, dural border cells, arachnoid barrier cells, subarachnoid space, and pia mater. This order represents the layers of the meninges, with the pia mater being the innermost layer that directly covers the brain and spinal cord.
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7.
Dura mater is divided into what portions?
A.
Periosteal
B.
Meningeal
C.
Arachnoid
D.
Border cell
Correct Answer(s)
A. Periosteal B. Meningeal D. Border cell
Explanation The dura mater is divided into periosteal, meningeal, and border cell portions. The most distinct boundary is between dural border cells and meningeal dura.
The periosteal and meningeal layers contain a large amount of collagen and are very strong.
*Meanwhile, the border cell layer lacks dense CT, forming weakness between the arachnoid and dura...this can allow for blood to flow into these layers creating a subdural hematoma.
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8.
A subdural hematoma is between the skull and the dura mater
A.
True
B.
False
Correct Answer
B. False
Explanation A subdural hematoma is between the dura and arachnoid planes. More specifically, it is in the dural border layer.
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9.
Dural infoldings...
A.
Are also called septa or reflections
B.
Consist of areas in which the periosteal portion of the dura folds inward to separate the cranial cavity into compartments
C.
Form compartments which determine how displacements can occur with injury as an expanding lesion forces areas of the brain between compartments
D.
Include the falx cerebri and tentorium cerebelli which are considered the primary folds
E.
Includes the diaphragma sella, which is the largest septum
Correct Answer(s)
A. Are also called septa or reflections C. Form compartments which determine how displacements can occur with injury as an expanding lesion forces areas of the brain between compartments D. Include the falx cerebri and tentorium cerebelli which are considered the primary folds
Explanation consist of areas in which the meningeal portion of the dura folds inward to separate the cranial cavity into compartments.
Although the diaphragma sella is a dural septa, it is the smallest septum forming the roof of the hypophyseal fossa encircling the infundibulum.
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10.
Dural sinuses...
A.
Are formed primarily by the separation of the meningeal and periosteal dura
B.
Are arterial structures
C.
The blood filling the dural sinuses collect from connecting veins from the cortical surgace and internal structures
Correct Answer(s)
A. Are formed primarily by the separation of the meningeal and periosteal dura C. The blood filling the dural sinuses collect from connecting veins from the cortical surgace and internal structures
Explanation they are venous structures
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11.
The arterial supply for the dura runs between the periosteum and the periosteal dura
A.
True
B.
False
Correct Answer
A. True
Explanation These arteries typically run in the grooves on the skull. The middle meningeal artery is a primary example.
If the skull is fractured, it could disrupt these arteries producing a hematoma between these layers (epidural).
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12.
The brain is sensitive to pain
A.
True
B.
False
Correct Answer
A. True
Explanation The brain is insensitive to pain, but the dural coverings are sensitive.
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13.
The anterior and middle cranial fossa are innervated by branches of which nerve?
Correct Answer Trigeminal trigeminal CNV CN V cranial nerve V
Explanation The irritation of nerves in the dura can produce referred pain (usually a headache) that appears to originate in the area of the afferent nerve innervation.
In this case, where dura above the tentorium cerebelli is innervated by the trigeminal nerve, a headache in this region will be referred to the face.
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14.
The dura of the posterior fossa recieves sensory branches from C2 and C3
A.
True
B.
False
Correct Answer
A. True
Explanation It may also have some sensation through the vagus nerve.
*Irritation of the dura here will have referred pain to the back of the head.
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15.
If a patient is complaining of a headache that affects the back of their head, irritation of what part of the dura is likely to be involved?
A.
Periosteal
B.
The dura above the tentorium
C.
Infratentorial dura
Correct Answer
C. Infratentorial dura
Explanation The infratentorial dura is innervated by cervical spinal nerves 2 and 3. As such, irritation of this dura will refer pain to the back of the neck.
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16.
With regards to the arachnoid mater....
A.
It is more collagenous than dura mater
B.
It has two primary parts, the arachnoid barrier layer and the arachnoid trabeculae
C.
The arachnoid trabeculae help suspend the brain in the subarachnoid space
D.
The trabeculae help reduce the weight of the brain by about 97%
Correct Answer(s)
B. It has two primary parts, the arachnoid barrier layer and the arachnoid trabeculae C. The arachnoid trabeculae help suspend the brain in the subarachnoid space D. The trabeculae help reduce the weight of the brain by about 97%
Explanation The arachnoid mater has two primary parts, the arachnoid barrier layer and the arachnoid trabeculae. The arachnoid trabeculae play a crucial role in suspending the brain in the subarachnoid space. Additionally, the trabeculae help to reduce the weight of the brain by about 97%.
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17.
Collections of arachnoid villi are called....
Correct Answer(s) arachnoid granulations
Explanation The arachnoid villi are specializations of the dura arachnoid interface in dural sinuses that allow the drainage of CSF into the venous system. It is essential in order to maintain intracranial pressure.
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18.
Explain how leukemic cells can enter the brain
19.
Kernig and Brudzinski signs test for what?
Correct Answer(s) meningitis
Explanation Kernig sign is where the thigh is lifted at a 90 degree angle, an attempt is made to straighten the leg. Inability to straighten, due to tight hamstrings is an indication of meningitis.
Brudzinksi sign is where the head it pulled upward and the knees bend in reaction to stretching the dura.
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20.
The pia mater forms specialized attachments in the spinal cord called the denticulate ligament as well as the filium terminale externum which connects the end of the dura to the coccyx.
A.
True
B.
False
Correct Answer
B. False
Explanation The pia mater forms the filum terminale internum, while the dura has a specialized projection called the filum terminale externum
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21.
What is the primary enlargement of the subarachnoid space associated with the spinal cord meninges?
A.
Cervical cistern
B.
Thoracic cistern
C.
Lumbar cistern
D.
Sacral cistern
Correct Answer
C. Lumbar cistern
Explanation It is the extension of the spinal meninges after the end of the spinal cord, usually around L1-L2. It contains the cauda equina and it is the space commonly accessed in spinal taps
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22.
With regards to meningiomas...
A.
They are mosr likely to arise from clusters of arachnoid cells in the villi (arachnoid cap cells)
B.
Most likely to form at points where cranial nerves or blood vessels transverse the dura, along the base of the skull, and at the cribiform plate
C.
They are typically benign, and rarely (atypical) malignant.
D.
They frequently invade the brain tissue due to close proximity
E.
The tumors typically become quite large before detected because they usually occur in the anterior fossa.
Correct Answer(s)
A. They are mosr likely to arise from clusters of arachnoid cells in the villi (arachnoid cap cells) B. Most likely to form at points where cranial nerves or blood vessels transverse the dura, along the base of the skull, and at the cribiform plate C. They are typically benign, and rarely (atypical) malignant. E. The tumors typically become quite large before detected because they usually occur in the anterior fossa.
Explanation They may invade the adjacent skull but rarely penetrate brain tissue. Neurological signs are generally due to compression or edema.
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23.
Bacterial meningitis spreads through the subarachnoid space because it's an ideal place for bacteria to live.
A.
True
B.
False
Correct Answer
A. True
Explanation As a result, CSF is usually cloudy with many white blood cells, increased protein, and bacteria.
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24.
Viral meningitis is almost always fatal, usually causing death in 1-2 days
A.
True
B.
False
Correct Answer
B. False
Explanation Viral meningitis can be caused by a variety of viral agents and is usually seen in younger patients. Few antiviral agents are effective in treatment, therefore treatment in mild cases is generally only supportive, with conditions improving in 1-2 weeks.
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25.
The ____ are connective tissue membranes surrounding the central nervous system
Correct Answer meninges
Explanation The correct answer is meninges. The meninges are connective tissue membranes that surround and protect the central nervous system, which includes the brain and spinal cord. These membranes consist of three layers: the dura mater, arachnoid mater, and pia mater. The meninges provide a barrier against infection and physical damage, as well as help to regulate the circulation of cerebrospinal fluid.
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26.
The periosteal layer of dura attaches to both the vertebral column and the skull
A.
True
B.
False
Correct Answer
B. False
Explanation The periosteal layer of dura is attached to the skull, but not to the vertebral column.
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27.
The falx cerebri lies in the transverse fissure and separates the anterior portion of the brain from the posterior half.
A.
True
B.
False
Correct Answer
B. False
Explanation The falx cerebri lies in the longitudinal fissure and separates the hemispheres.
It is the tentorium cerebelli that lies in the transverse fissure but it separates the cerebrum from the cerebellum.
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