腦和脊髓的被膜和血管

1、The Meninges and Blood Vessels of Brain and Spinal Cord, and the Cerebrospinal Fluid,山東大學醫(yī)學院 解剖教研室李振華,The Meninges of Brain and Spinal Cord,The spinal cord and brain are surrounded by three membranes, the meninges.

2、 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脊髓蛛網(wǎng)膜 Spinal pia mater 軟脊膜,Spinal dura mater 硬脊膜,

3、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 between spinal dura mater and p

4、eriosteum 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 bl

5、ock anesthesiaSubdural space硬膜下隙,Spinal arachnoid mater 脊髓蛛網(wǎng)膜,CharactersA thin, delicate, tubular membran loosely investing spinal cordAbove, it is continuous with cerebral arachnoid mater,,Subarachnoid space

6、蛛網(wǎng)膜下隙Position: lies between pia and arachnoid maters containing cerebrospinal fluidTerminal cistern 終池: the largest part of subarachnoid space extending from termination of spinal cord to level of S2, where it is occup

7、ied by nerves of cauda equina, so it is the best site for a lumbar puncture,,Lumbar spinal puncture (spinal tap),Spinal pia mater 軟脊膜,A delicate vascular membrane that closely invests the spinal cordDenticulate ligament

8、齒狀韌帶: 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.Filu

9、m terminale: an extension of pia beyond conus medullaris,The Meninges of Brain,Cerebral dural mater 硬腦膜Cerebral arachnoid mater 腦蛛網(wǎng)膜Cerebral pia mater 軟腦膜,Cerebral dural mater 硬腦膜,CharactersA thick and dense inelastic

10、 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 septa Cerebral falx 大腦鐮Tentorium of cerebellum

11、小腦幕－in front there is a gap, the tentorial incisure 幕切跡, for passage of midbrainCerebellar falx 小腦鐮Diaphragma sellae 鞍隔,,Sinuses of duramater 硬腦膜竇Superior sagittal sinus 上矢狀竇 Inferior sagittal sinus

12、下矢狀竇 Straight sinus 直竇 Confluence of sinus 竇匯,,Transverse sinus 橫竇 Sigmoid sinus 乙狀竇Superior petrosal sinuses 巖上竇inferior petrosal sinuses 巖下竇,,Cavernous sinu

13、s 海綿竇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 maxillary divisions of

14、 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 sin

15、us,Inf. petrosal sinus,Internal jugular vein,Sigmoid sinus,,,,,,,,,,,,,,,Cerebral arachnoid mater 腦蛛網(wǎng)膜,Characters: a delicate membrane covering brain loosely, passing over sulci and entering only cerebral longitudinal an

16、d transverse fissures,,Arachnoid granulations 蛛網(wǎng)膜粒－ project into sinuses of dura mater, serve as sites where cerebrospinal fluid diffuses into bloodstream,,Subarachnoid cisternsCerebellomedullary cistern 小腦延髓池Interped

17、uncular cistern 腳間池Pontine cistern 橋池Superior cistern 上池,,Cerebellomedullary cistern,Cerebral pia mater 軟腦膜,Closely invests brain surface, in some areas the pia invaginates into ventricles to take part in the format

18、ion of choroids plexus,Circulation 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 f

19、or 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,interventricular

20、 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 spinal cord,Arter

21、ies 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 s

22、tem and cerebellum,Internal carotid artery 頸內動脈,Anterior cerebral artery 大腦前動脈 Middle cerebral artery 大腦中動脈 Anterior choroidal artery 脈絡叢前動脈Posterior communicating artery 后交通動脈,,Anterior cerebral artery大腦前動脈Joine

23、d 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 parietooccipital sulcus and superior border of the suprolatera

24、l surface of the cerebral hemisphere Central branches: supply caudate nucleus, anterior part of lentiform nucleus and anterior limb of internal capsule,,Middle cerebral artery大腦中動脈Cortical branches: supply most of supe

25、rolateral 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脈絡叢前動脈: pa

26、sses 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 pallidusPosterior com

27、municating artery后交通動脈: runs backward to join posterior cerebral artery,,Vertebral artery 椎動脈Cranial brancheAnterior and posterior spinal arteries 脊髓前、后動脈Posterior inferior cerebellar artery 小腦下后動脈Branches of basilar

28、 arteryAnterior inferior cerebral artery小腦下前動脈Labyrinthine artery 迷路動脈Pontine arteries 腦橋動脈Superior cerebellar artery 小腦上動脈Posterior cerebral artery 大腦后動脈,,Posterior cerebral arteryCortical branches: supply m

29、edial and inferior surfaces of temporal lobe and occipital lobeCentral branches: supply dorsal thalamus, medial and lateral geniculate bodies, hypothalamus and subthalamus,Cerebral arterial circle ( circle of Willis ),F

30、ormation: formed by anterior communicating artery, both anterior cerebral arteries, internal carotid arteries, posterior communicating arteries, and posterior cerebral arteriesPosition: lies on sella turcica around opti

31、c 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 c

32、erebral 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 s

33、pinal cordTwo sources Anterior and posterior spinal arteriesBranches of segmental arteries: radicular arteries of posterior intercostals arteries, lumbar arteries, and lateral sacral arteriesDamage area: T1~T4,ventra