The Meninges and Blood Vessels of Brain and Spinal Cord, and the Cerebrospinal Fluid山东大学医学院 解剖教研室 李振华The Meninges of Brain and Spinal CordnThe 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 nSpinal dura mater 硬脊膜nSpinal arachnoid mater 脊髓蛛网膜 nSpinal pia mater 软脊膜Spinal dura mater 硬脊膜CharactersnAbove, attached to circumference of foramen magnumnBelow, becomes thinner at level of S2, invests filum terminale to attach at back of coccyxEpidural space 硬膜外隙nPosition: lies between spinal dura mater and periosteum of vertebral canal nContents: 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 CharactersnA thin, delicate, tubular membran loosely investing spinal cordnAbove, it is continuous with cerebral arachnoid materSubarachnoid space 蛛网膜下隙nPosition: lies between pia and arachnoid maters containing cerebrospinal fluidnTerminal 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nA delicate vascular membrane that closely invests the spinal cordnDenticulate 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.nFilum terminale: an extension of pia beyond conus medullarisThe Meninges of BrainnCerebral dural mater 硬脑膜nCerebral arachnoid mater 脑蛛网膜nCerebral pia mater 软脑膜Cerebral dural mater 硬脑膜CharactersnA thick and dense inelastic membrane that composed of two layers, an inner or meningeal and outer or endostealnIt is in loose contact with calvaria, and most strongly adherent to base of skullFour septa nCerebral falx 大脑镰nTentorium of cerebellum小脑幕in front there is a gap, the tentorial incisure 幕切迹, for passage of midbrainnCerebellar falx 小脑镰nDiaphragma sellae 鞍隔Sinuses of duramater 硬脑膜窦nSuperior sagittal sinus 上矢状窦 nInferior sagittal sinus 下矢状窦 nStraight sinus 直窦 nConfluence of sinus 窦汇 nTransverse sinus 横窦 nSigmoid sinus 乙状窦nSuperior petrosal sinuses 岩上窦ninferior petrosal sinuses 岩下窦Cavernous sinus 海绵窦nPosition: lies on each side of sella turcicanRelations of cavernous sinus:qInternal carotid artery and abducent nerve run through the sinus qOculomotor and trochlear nerves and ophthalmic and maxillary divisions of trigeminal nerve lie in the lateral wall of the sinusThe flowing of the blood in dural sinus Sup. sagittal sinus Inf. sagittal sinus Straight sinus Confluence of sinus Transverse sinus Cavernous sinus Sup. petrosal sinus Inf. petrosal sinus Internal jugular vein Sigmoid sinusCerebral arachnoid mater 脑蛛网膜nCharacters: a delicate membrane covering brain loosely, passing over sulci and entering only cerebral longitudinal and transverse fissuresnArachnoid granulations 蛛网膜粒 project into sinuses of dura mater, serve as sites where cerebrospinal fluid diffuses into bloodstreamnSubarachnoid cisternsqCerebellomedullary cistern 小脑延髓池qInterpeduncular cistern 脚间池qPontine cistern 桥池qSuperior cistern 上池Cerebellomedullary cisternCerebral pia mater 软脑膜nClosely 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) nCerebrospinal 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.nProduction: produced by the choroids plexuses within the lateral, third and fourth ventriclesCirculation of cerebrospinal fluidCSF drains from lateral ventricleinterventricular foraminathird ventriclemesencephalic aqueductfourth ventriclemedian and two lateral aperturessubarachnoid spacearachnoid granulationssuperior sagittal sinusveinBlood vessels of brain and spinal cordArteries of brainTwo sourcesnInternal carotid artery: supplies anterior 2/3 of cerebral hemisphere and parts of diencephalonnVertebral artery: supplies postterior 1/3 of cerebral hemisphere and parts of diencephalon, brain stem and cerebellumInternal carotid artery 颈内动脉nAnterior cerebral artery 大脑前动脉 nMiddle cerebral artery 大脑中动脉 nAnterior choroidal artery 脉络丛前动脉nPosterior communicating artery 后交通动脉Anterior cerebral artery 大脑前动脉nJoined the fellow of the opposite side by the anterior communicating arterynCortical branches: supply all medial surface of the cerebra