4/09/2012

FACULTY OF SCIENCE
School of Biomedical Sciences (SBMS)

ANAT1005
CNS II
Meninges, CSF & Vessels

Lecturer: Tracey Langfield

Email: t.langfield@uq.edu.au
Phone: 07 3365 2700
Office: Otto Hirschfeld Building #81, Room 425A,

September 2012

Learning objectives: Meninges of the brain:

FUNCTIONS
•To learn the structure and function of the meninges of the CNS •Protective coverings
•Limit excessive displacement of the brain associated with rapid movements
•To understand the relationship of the meninges to the different forms of cerebral •Provide a space for cerebrospinal fluid and blood vessels
haemorrhage
SUPERFICIAL to DEEP:
•To relate the components of the ventricular system to the different regions of
the brain scalp
skull
•To learn the function of cerebrospinal fluid, its production, directional flow and 1. dura mater
reabsorption 2. arachnoid mater
3. pia mater
•To learn the arterial supply to and venous drainage of the brain

•To appreciate the relationship between the areas of vascular compromise and
functional consequences.

Rohen 2011

Meninges of the brain: Meninges of the brain:

dura mater:
•tough fibrous 2 layered connective tissue (periosteal layer + meningeal layer)
•sensory nerve supply (pain) alcohol
dura mater:
•meningeal arteries
•dural folds: meningeal layer folds inward falx cerebri (vertical sheet)
= falx cerebri (vertical sheet)
= tentorium cerebelli (horizontal)

Rohen 2011
Rohen 2011 Rohen 2011

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Meninges of the brain:

Meninges of the brain: dura mater
arachnoid mater: translucent spider web membrane
cerebral arteries and veins between arachnoid mater & pia mater
pia mater: very thin delicate membrane
*adheres to surface of brain (sulci / gyri)

Rohen 2011
Rohen 2011

Subarachnoid space:
•Cerebrospinal fluid
•Cerebral arteries & veins
SUPERFICIAL to DEEP:
Rohen 2011

skull & periosteal dura mater

scalp
*extradural “potential” space

skull
meningeal dura mater
Periosteal dura
*subdural “potential” space
Meningeal dura
arachnoid
arachnoid mater
Cerebral vessels:
*subarachnoid space (true space) – cerebral arteries & veins arteries & veins

pia
pia mater

Epidural haematoma: (abnormal epidural space)

Clinically: Blow to the anterior inferior portion of the parietal bone
*middle meningeal artery is torn
Epidural haematoma: Slow bleed
(abnormal epidural space) Meningeal layer is stripped off the periosteal layer
*middle meningeal artery Underlying motor cortex
slow

Subdural haematoma:
(abnormal subdural space)
bridging vein bleed
slow

Subarachnoid haemorrhage
= cerebral artery bleed in subarachnoid space
fast Schuenke et al 2010 Snell 2010

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Meninges of the spinal cord:

Human brain during development
Right lateral view:
Week 14 Week 24
Dura is not adhered to the yellow = periosteum of vertebra
vertebrae to allow for movement red = dura mater
•True epidural space green = arachnoid mater
•Filled with fat & venous plexus pink = pia mater
2
1
Denticulate ligaments: 3
lateral expansions of pia
mater 4

1 Occipital pole
2 Temporal pole
3 Frontal pole
4 Insula

Schuenke et al 2010

VENTRICULAR SYSTEM: Ventricles correspond to different parts of the brain:

•the neural tube distorted along with the development of the brain
•filled with cerebrospinal fluid Adult brain structure Associated ventricle

Greater development ... Larger ventricle

Martini , 2012

3rd ventricle
Lateral ventricles (2) •Midline between thalami

Rohen 2011

A
P

R lateral view with insula cortex removed to reveal left lateral ventricle
Rohen 2011 Schuenke et al 2010

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3rd & 4th ventricles Cerebral aqueduct & 4th ventricle

Remember mesencephalon didn’t differentiate ... Small cerebral aqueduct!

3rd
T T
Frontal lobe
midbrain

4th

Rohen 2011

Posterior view of diencephalon & brainstem with cerebellum removed Crossman & Neary 2010

Cerebrospinal fluid: Cerebrospinal fluid:

•produced continuously daily ~ 500ml

subarachnoid space
FUNCTIONS: •Combined volume in ventricles and subarachnoid space ~ 150ml
•Support & cushion the CNS
•Maintenance of constant external environment •Requires continuous drainage / reabsorption
•Distribution of hormones / neurotransmitters
•arachnoid granulations into the superior sagittal venous sinus

•Produced by choroid plexus in the lateral, 3rd and 4th ventricles

•Directional flow:
•Laterals – 3rd – cerebral aqueduct – 4th
•outflow to subarachnoid space or?
•up toward superior sagittal sinus

Crossman & Neary 2010

Directional flow of CSF:

•Lateral ventricles – 3rd – cerebral aqueduct – 4th
•outflow to subarachnoid space
•Reabsorbed into venous system via arachnoid granulations in the superior
sagittal sinus

Krebs 2012 Krebs 2012

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Arterial supply to the brain The circle of Willis

The brain receives approx 15% of the resting cardiac output •an arterial anastomosis system on the base of the brain
•not always complete

1. Anterior cerebral arteries

2. Middle cerebral arteries Carotid system
3. Posterior cerebral arteries

Internal carotid artery • Anterior communicating

• Posterior communicating

vertebral artery Vertebrobasilar

common carotid artery
system

subclavian artery

Krebs 2012
Schuenke et al 2010

Arterial supply to the brain

Cerebrovascular accidents (stroke)

Which artery was affected?

Brain areas supplied by different arteries - summary middle cerebral artery distribution: lateral view
Lateral: Medial:

Sits in lateral sulcus

Crossman & Neary 2010

Cortical branches:
• Anterior cerebral artery: medial surface of the frontal & parietal lobes & narrow strip superiorly
•Middle cerebral artery: lateral surface of all lobes

• Posterior cerebral artery: medial & basal surfaces of occipital & temporal lobes

Note that there are deep penetrating branches to the deeper subcortical structures

Schuenke et al 2010

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anterior and posterior cerebral arteries: Cerebrovascular accidents (stroke)

medial view
Which artery was affected?

Parietal lobe
Anterior cerebral artery

Parieto-occipital sulcus

Frontal
lobe

Occipital lobe

Posterior cerebral artery

And which cerebral functions will be affected?
Temporal lobe Which side of the body will be affected? Which parts?
Schuenke et al 2010

Different areas of the cortex are associated with

different functions The hemispheres are not the same

Parietal lobe = sensation

Frontal lobe
Motor & abstract Speech centre
intellect
Occipital lobe = vision
Insula cortex writing Analysis by touch

Spatial visualisation
Temporal lobe = auditory, memory Language and maths
and analysis
Martini , 2012

Martini , 2012

Sensory homunculus Motor homunculus

Primary somatosensory cortex Primary somatomotor cortex
Arterial supply to the brain – cerebellum & brainstem
post central gyrus parietal lobe Precentral gyrus frontal lobe
Receives somatic sensory input
Sends motor commands to
Touch, pressure, temperature, pain,
skeletal muscles
conscious proprioception Vertebrobasilar system

Martin 2012 Schuenke et al 2010

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Venous return
Superior sagittal sinus

Inferior sagittal sinus

Straight sinus
Cavernous sinus

Jugular foramen
Sigmoid sinus

Sigmoid sinus
Schuenke et al 2010 Transverse sinus
Internal jugular vein

Remember the CSF outflow into the superior sagittal sinus via arachnoid granulations
Straight sinus Confluence of sinuses Schuenke et al 2010

REFERENCES

•Crossman AR & Neary D (2010) Neuroanatomy. Churchill Livingstone Elsevier, UK.

•Krebs C, Weinberg J & Akesson E (2012) Neuroscience. Lippincott, Williams & Wilkins, USA.

•Martin JH (2012) Neuroanatomy Text and Atlas. McGraw Hill, USA.

•Martini FH, Nath JL & Bartholomew EF (2012) Fundamentals of Anatomy and Physiology.
9th Edition. Pearson Benjamin Cummings, USA.

•Rohen JW, Yokochi C & Lutjen-Drecoll E (2011) Colour atlas of anatomy. Lippincott,
Williams & Wilkins, USA.

•Schuenke M, Schulte E & Schumacher U (2010) Atlas of anatomy, Head and Neuroanatomy.
Thieme, Germany.

Snell RS (2010) Clinical Neuroanatomy. Lippincott, Williams & Wilkins, USA.