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Themeningesandbloodvesselsofbrainandspinalcord,andthecerebrospinalfluid
Partone
Themeninges(orcoverings)ofbrainandspinalcordThreemeningesenvelopthebrainandspinalcord(fromoutertoinner):thedura,thearachnoidandthepiamaters.MeningesI.Theduramater1ThespinalduramaterTheepiduralspace:Aspacebetweenthespinalduraandtheperiosteumofthevertebralcanal,whichcontainsthelooseareolartissue,lymphaticvesselsandvenousplexuses.Thespinalnervespassthroughthespace.EpiduralblockSpinalduramaterepidural
space
2.Thecerebralduramater(1)Characteristics:loosecontactwiththecalvaria,closelyattachedatthebaseofskull;formdurasepta:thecerebralfalxandthecerebellartentoriumformduravenoussinuses(lacksmoothmuscle):Inferiorsagittalsinus→straightsinus→(superiorsagittalsinus→)confluenceofsinuses→(cavernoussinuses→)transversesinuses→sigmoidsinuses→internaljugularveinEpiduralhematomaCSFleak
(2)ThecavernoussinusesLocation:oneithersideofthesellaturcica.Communication:withthefacialveinviatheophthalmicvein,andwiththepterygoidplexusthroughtheforamenovale.Structurespassingthroughthesinuses:theinternalcarotidartery,theoculomotornerve(III),trochlearnerve(IV),theophthalmicandthemaxillarydivisionsofthetrigeminalnerve(V),andtheabducensnerve(VI).II.Thearachnoidmaterisaavascularmembrane.1.Thesubarachnoidspace:betweenthearachnoidandthepiamaters,filledwiththecerebrospinalfluid(CSF).2.Thesubarachnoidcisterns:thesewidenedthesubarachnoidspace.3.Thearachnoidgranulations:berry-likeclumpsofthearachnoidprotrudingintosuperiorsagittalsinusandothersinuses.III.Thepiamatercontainsrichbloodvessels.Andcombineswiththeependymaandchoroidsvesselstoformthechoroidplexusofthethird,fourthandlateralventricles.Betweenthedorsalandventralnerverootsofthespinalcordtoformthedenticulateligament.SpinalpiamaterParttwo
ThebloodvesselsofthebrainandspinalcordI.Thearteriesofbraincomefromtwopairsoflargevessels:theinternalcarotidarteriesandvertebralarteries.Theinternalcarotidarteriessupplytheanteriortwo-thirdsofthecerebralhemisphereandpartsofthediencephalon.Theposteriorone-thirdofthecerebralhemispheres,theremainderofthediencephalons,brainstemandcerebellumaresuppliedbythevertebralarteries.ArteriesofbrainTheinternalcarotidarteryCourseSegmentsCervicalPetrousCaverousCerebral(supraclinoid)Carotidsiphon:includescaverousandcerebralsegments.PresentUorVshape.Atherosclerosisoccureshere.(3)Mainbranches:AnteriorcerebralA.MiddlecerebralA.:runsinthelateralsulcusandsupplymostofthedorsolateralsurfaceofthecerebralhemisphereandthelentiformnucleus,caudatenucleus,theinternalcapsule.
PosteriorcommunicatingA.AnteriorchoroidalA.OphthalmicA.Ant.cerebralA.AnteriorcerebralA.MiddlecerebralA.MiddlecerebralA.PosteriorcommunicatingA.2Thevertebralartery
Twovertebralarteriesunittoformthebasilarartery.(1)MainbranchesofthevertebralA.AnteriorandposteriorspinalA.PosteriorinferiorcerebellarA.(2)MainbranchesofthebasilararteryAnteriorinferiorcerebellarA.PontineA.SuperiorcerebellarA.PosteriorcerebralA.Vertebralarteries3ThecircleofWillis(cerebralarterialcircle)formedbytheanteriorandposteriorcerebralarteries,theanteriorandposteriorcommunicatingarteries,andasegmentofinternalcarotidarteries.Thisisimportantforthefunctionallyadequateanastomosistooccur.II.Theveinsofthebraindonotruntogetherwiththearteries,andusuallyaredividedintosuperficialanddeepgroups.(III)ThebloodvesselsofspinalcordThebloodofthespinalcordcomesfromtheanteriorandposteriorspinalarteriesofthevertebralartery,andalsofromtheposteriorintercostalandthelumbararteries.SpinalarteriesSpinalarteries
Partthree
Cerebrospinalfluid(CSF)NormalCSFisclear,colorless,andodorless.Andfillswithventricles,thesubarachnoidspaceandthecentralcanalofthespinalcord.Andproducedbythechoroidsplexusesoftheventricles.1Function:playarolelikelymphinthecentralnervoussystem,hasfunctionofthesupport,protection,nutrition,andcarriesawaymetabolites.2Circulation:Lateralventricles(throughtheinterventricularforamens)→thesubarachnoidspacethethirdventricle(throughthecerebralaqueduct)→thefourthventricle(throughlateralandmedialapertures)→thesubarachnoidspace(throughthearachnoidgranulations)→durasinuses→veinsPartfourBarriersinthenervoussystem
1Blood-brainbarrier(BBB):consistsoftheendothelialcellandbasementmembraneofcapillarie
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