Transcript The Meninges and Blood Vessels of Brain and Spinal Cord, and the

The Meninges and Blood Vessels of
Brain and Spinal Cord,
and the Cerebrospinal Fluid
脑膜，脑血管与脑脊液循环
The Meninges of Brain and Spinal Cord

The spinal cord and brain are
surrounded by three membranes,
the meninges. Named from the
outside inward they are the dura
mater, arachnoid, and pia mater.
The meninges of spinal cord

Spinal dura mater
硬脊膜

Spinal arachnoid mater
脊髓蛛网膜

Spinal pia mater
软脊膜
Spinal dura mater 硬脊膜
Characters

Above, attached to
circumference of foramen
magnum

Below, becomes thinner at
level of S2, invests filum
terminale to attach at back
of coccyx
Epidural space 硬膜外隙
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
Position: lies between spinal dura mater and periosteum of vertebral canal
Contents: a quantity of loose connective tissue, fat, lymphatic vessels and
vertebral venous plexus, the spinal nerves on each side pass through the
epidural space which is applicable for block anesthesia
Subdural space硬膜下隙
Spinal arachnoid mater 脊髓蛛网膜
Characters


A thin, delicate, tubular
membran loosely investing
spinal cord
Above, it is continuous with
cerebral arachnoid mater
Subarachnoid space
蛛网膜下隙


Position: lies between pia
and arachnoid maters
containing cerebrospinal
fluid
Terminal cistern 终池: the
largest part of subarachnoid
space extending from
termination of spinal cord to
level of S2, where it is
occupied by nerves of
cauda equina, so it is the
best site for a lumbar
puncture
Lumbar spinal puncture (spinal tap)
Spinal pia mater 软脊膜

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
A delicate vascular membrane
that closely invests the spinal
cord
Denticulate ligament齿状韧带:
consist of 21 pairs triangular
ligaments extending from
spinal cord on each side
between anterior and posterior
roots of spinal nerves to
spinal dura mate; these
ligaments help to fix position
of spinal cord.
Filum terminale: an extension
of pia beyond conus
medullaris
The Meninges of Brain

Cerebral dural mater 硬脑膜

Cerebral arachnoid mater 脑蛛网膜

Cerebral pia mater 软脑膜
Cerebral dural mater 硬脑膜
Characters


A thick and dense
inelastic membrane that
composed of two layers,
an inner or meningeal
and outer or endosteal
It is in loose contact with
calvaria, and most
strongly adherent to
base of skull
Four septa
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
Cerebral falx 大脑镰
Tentorium of cerebellum小脑幕－in front there is a gap, the
tentorial incisure 幕切迹, for passage of midbrain
Cerebellar falx 小脑镰
Diaphragma sellae 鞍隔
Sinuses of duramater
硬脑膜窦
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Superior sagittal sinus
上矢状窦

Inferior sagittal sinus
下矢状窦

Straight sinus
直窦

Confluence of sinus
窦汇

Transverse sinus 横窦
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Sigmoid sinus 乙状窦
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Superior petrosal
sinuses 岩上窦

inferior petrosal
sinuses 岩下窦
Cavernous sinus 海绵窦
 Position: lies on each side of sella turcica
 Relations of cavernous sinus:
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
Internal carotid artery and abducent nerve run through the sinus
Oculomotor and trochlear nerves and ophthalmic and maxillary
divisions of trigeminal nerve lie in the lateral wall of the sinus
The flowing of the blood in dural sinus
Sup. sagittal sinus
Inf. sagittal sinus
Straight sinus
Confluence of sinus
Transverse sinus
Sup. petrosal sinus
Sigmoid sinus
Cavernous sinus
Inf. petrosal sinus
Internal jugular vein
Cerebral arachnoid mater 脑蛛网膜

Characters: a delicate
membrane covering
brain loosely, passing
over sulci and entering
only cerebral
longitudinal and
transverse fissures

Arachnoid granulations 蛛网膜粒－ project into sinuses of dura
mater, serve as sites where cerebrospinal fluid diffuses into
bloodstream
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Subarachnoid cisterns
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
Cerebellomedullary
cistern 小脑延髓池
Interpeduncular cistern
脚间池
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Pontine cistern 桥池
Superior cistern 上池
Cerebellomedullary cistern
Cerebral pia mater 软脑膜

Closely invests brain
surface, in some areas the
pia invaginates into
ventricles to take part in
the formation of choroids
plexus
Circulation of cerebrospinal fluid (CSF)
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
Cerebrospinal fluid is a
clear colorless fluid, which
acts as a transport medium
for nutrients and vaster
products and provides a
protective fluid cushion for
the central nervous system.
Production: produced by the
choroids plexuses within the
lateral, third and fourth
ventricles
Circulation of cerebrospinal fluid
CSF drains from lateral ventricle
mesencephalic aqueduct
interventricular foramina
fourth ventricle
third ventricle
median and two lateral apertures
subarachnoid space arachnoid granulations superior sagittal sinus
vein
Blood vessels of brain and spinal cord
Arteries of brain
Two sources
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Internal carotid
artery: supplies
anterior 2/3 of cerebral
hemisphere and parts
of diencephalon
Vertebral artery:
supplies postterior 1/3
of cerebral
hemisphere and parts
of diencephalon, brain
stem and cerebellum
Internal carotid artery 颈内动脉
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Anterior cerebral artery
大脑前动脉
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Middle cerebral artery
大脑中动脉
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Anterior choroidal artery
脉络丛前动脉

Posterior communicating
artery 后交通动脉
Anterior cerebral artery
大脑前动脉
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Joined the fellow of the
opposite side by the
anterior communicating
artery
Cortical branches: supply
all medial surface of the
cerebral cortex as far back
as the parietooccipital sulcus
and superior border of the
suprolateral surface of the
cerebral hemisphere
Central branches: supply
caudate nucleus, anterior
part of lentiform nucleus and
anterior limb of internal
capsule
Middle cerebral artery
大脑中动脉
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Cortical branches:
supply most of
superolateral surface of
cerebral hemisphere and
insular lobe
Central branches:
supply lentiform and
caudate nuclei, genu and
posterior limb of internal
capsule (lenticulostriate
artery)

Anterior choroidal artery脉络丛
前动脉: passes backward,
enters inferior horn of lateral
ventricle, and ends in choroid
plexus. It supplies lateral
geniculate body, posterior limb
of internal capsule, middle 3/5
of crus cerebri,and globus
pallidus

Posterior communicating artery
后交通动脉: runs backward to
join posterior cerebral artery
Vertebral artery 椎动脉
Cranial branche
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Anterior and posterior spinal
arteries 脊髓前、后动脉
Posterior inferior cerebellar
artery 小脑下后动脉
Branches of basilar artery
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Anterior inferior cerebral artery
小脑下前动脉
Labyrinthine artery 迷路动脉
Pontine arteries 脑桥动脉
Superior cerebellar artery
小脑上动脉
Posterior cerebral artery
大脑后动脉
Posterior cerebral artery

Cortical branches:
supply medial and
inferior surfaces of
temporal lobe and
occipital lobe

Central branches:
supply dorsal thalamus,
medial and lateral
geniculate bodies,
hypothalamus and
subthalamus
Cerebral arterial circle ( circle of Willis )
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Formation: formed by
anterior communicating
artery, both anterior cerebral
arteries, internal carotid
arteries, posterior
communicating arteries,
and posterior cerebral
arteries
Position: lies on sella
turcica around optic
chiasma, tuber cinereum
and mamillary bodies
Area of oxygendeprives brain
Blockage
Thrombus
Plaque
Microaneurysm
Lenticulostriate arteries
Subarachnoid hemorrhage
Intracerebral
hemorhage
Arteriovenous
malformation
Veins of brain
Superficial cerebral veins
 Drain blood from cortex
and subcortical
medullary substance and
empty into adjacent
sinuses of dura mater
Veins of brain

Deep cerebral veins:
drain deeper parts of
hemispheres, basal
nuclei, internal capsule,
diencephalon and
choroid plexus,
ultimately form great
cerebral vein which
enter straight sinus
Blood vessels of spinal cord
Arteries of spinal cord

Two sources


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Anterior and posterior spinal
arteries
Branches of segmental
arteries: radicular arteries
of posterior intercostals
arteries, lumbar arteries,
and lateral sacral arteries
Damage area:
T1~T4,ventral part of L1
vascular ring
( vasocorona )
Blood vessels of spinal cord
Spinal veins: drain into internal vertebral venous plexus