1、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 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
2、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,CharactersAbove, attached to circumference of foramen magnumBelow, becomes thinner at level of S2, invests filum terminale to attach at back of coccyx,Epidural space 硬膜外隙Position: lies
3、 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 anesthesiaSubdural space硬膜下隙,Spinal arachnoid
4、 mater 脊髓蛛网膜,CharactersA thin, delicate, tubular membran loosely investing spinal cordAbove, it is continuous with cerebral arachnoid mater,Subarachnoid space 蛛网膜下隙Position: lies between pia and arachnoid maters containing cerebrospinal fluidTerminal cistern 终池: the largest part of subarachnoid spac
5、e 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,A delicate vascular membrane that closely invests the spinal cordDenticulate ligament齿状韧带:
6、 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
7、 dural mater 硬脑膜Cerebral arachnoid mater 脑蛛网膜Cerebral pia mater 软脑膜,Cerebral dural mater 硬脑膜,CharactersA thick and dense inelastic membrane that composed of two layers, an inner or meningeal and outer or endostealIt is in loose contact with calvaria, and most strongly adherent to base of skull,Four
8、septa 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 midbrainCerebellar falx 小脑镰Diaphragma sellae 鞍隔,Sinuses of duramater 硬脑膜窦Superior sagittal sinus 上矢状窦 Inferior sagittal sinus 下矢状窦 Straight sinus 直窦 Confluence of sinus 窦汇,Transverse
9、sinus 横窦 Sigmoid sinus 乙状窦Superior petrosal sinuses 岩上窦inferior petrosal sinuses 岩下窦,Cavernous sinus 海绵窦Position: lies on each side of sella turcicaRelations of cavernous sinus:Internal carotid artery and abducent nerve run through the sinus Oculomotor and trochlear nerves and ophthalmic and maxilla
10、ry 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,Cavernous sinus,Sup. petrosal sinus,Inf. petrosal sinus,Internal jugular vein,Sigmoid sinus,Cerebr
11、al 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,Subara
12、chnoid cisternsCerebellomedullary cistern 小脑延髓池Interpeduncular cistern 脚间池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,Circulat
13、ion of cerebrospinal fluid (CSF),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 fourt
14、h ventricles,Circulation of cerebrospinal fluid,CSF drains from lateral ventricle,interventricular foramina,third ventricle,mesencephalic aqueduct,fourth ventricle,median and two lateral apertures,subarachnoid space,arachnoid granulations,superior sagittal sinus,vein,Blood vessels of brain and spina
15、l cord,Arteries of brain,Two sourcesInternal carotid artery: supplies anterior 2/3 of cerebral hemisphere and parts of diencephalonVertebral artery: supplies postterior 1/3 of cerebral hemisphere and parts of diencephalon, brain stem and cerebellum,Internal carotid artery 颈内动脉,Anterior cerebral arte
16、ry 大脑前动脉 Middle cerebral artery 大脑中动脉 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Joined the fellow of the opposite side by the anterior communicating arteryCortical branches: supply all medial surface of the cerebral cortex as far back as the pa
17、rietooccipital 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Cortical branches: supply most of superolateral surface of ce
18、rebral 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
19、 geniculate body, posterior limb of internal capsule, middle 3/5 of crus cerebri,and globus pallidusPosterior communicating artery后交通动脉: runs backward to join posterior cerebral artery,Vertebral artery 椎动脉Cranial brancheAnterior and posterior spinal arteries 脊髓前、后动脉Posterior inferior cerebellar arte
20、ry 小脑下后动脉Branches of basilar arteryAnterior 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 arteryCortical branches: supply medial and inferior surfaces of temporal lobe and occipital lobeCe
21、ntral branches: supply dorsal thalamus, medial and lateral geniculate bodies, hypothalamus and subthalamus,Cerebral arterial circle ( circle of Willis ),Formation: formed by anterior communicating artery, both anterior cerebral arteries, internal carotid arteries, posterior communicating arteries, a
22、nd posterior cerebral arteriesPosition: lies on sella turcica around optic chiasma, tuber cinereum and mamillary bodies,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 vei
23、ns: 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 cordTwo sources Anterior and posterior spinal arteriesBranches of segmental arteries: radicular arteries of posterior intercostals arteries, lumbar arteries, and lateral sacral arteriesDamage area: T1T4,ventral part of L1vascular ring ( vasocorona ),Blood vessels of spinal cord,Spinal veins: drain into internal vertebral venous plexus,
