Ventricles canalis centralis Ventriculus quartus (IV. ventricle) Fossa rhomboidea



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VENTRICLES
Canalis centralis
Ventriculus quartus (IV. ventricle)
Fossa rhomboidea (formed by dorsal part of medulla oblongata and pons Varoli)

Pars inferior (between pedunculi cerebellares inferiores)

Pars intermedia (between pedunculi cerebellares medii)

Pars superior (between pedunculi cerebellares superiores)

Sulcus medianus

Eminentia medialis

Sulci limitantes – finished by fovea superior (with locus coeruleus, V. cranial nerve) and fovea inferior (over sensory nerves of IX. and X. CN)

Trigonum nervi vagi

Trigonum nervi hypoglossi

Colliculus facialis (ncl.o.n VI., genu n.VII)

Striae medullares (tractus pontocerebellares)

Area vestibularis

Tuberculum acusticum (ncl. cochlearis dors.)


Tegmen (roof) of ventriculi quarti:

Velum medullare inferius (between nodulus vermis and pedunculi flocculi, with tela chorioidea ventriculi quarti; apertura mediana ventriculi quarti – foramen Magendi, aperturae laterales – Luschkae – CSF taken by them to subarachnoideal space)

Fastigium of cerebellum

Velum medullare superius (between pedunculi cerebellares superiores)
Aquaeductus mesencephali (Sylvii) connects the IV. ventricle with the III.
Ventriculus tertius

(through foramina interventricularia /Monroi/ is connected with lateral ventricles)

Ant. wall: partes liberae columnae fornicis, commissura anterior, lamina terminalis, recessus triangularis

Post. wall: commissura habenularum and posterior, recessus suprapinealis and pinealis

Inf. wall: hypothalamus, recessus opticus, chiasma opticum, recessus infundibuli

Sup. wall: tela choroidea ventriculi tertii (attached to stria medullaris thalami)

Lat. wall: med. surface of thalamus, sulcus hypothalamicus, adhesio interthalamica
Ventriculus lateralis

Cornu anterius: med.- septum pellucidum, upper wall – corpus callosum, lat. wall – caput

nuclei caudati



Pars centralis: upper wall - corpus callosum, caud. wall – corpus ncl. caudati, lamina affixa

thalami, tela choroidea ventriculi lateralis, fornix



Cornu inferius: upper wall – corpus callosum (tapetum), cauda ncl. caudati, stria terminalis,

caudal wall – hippocampus with pes hippocampi, fimbria hippocampi (a part of crus fornicis), alveus hippocampi, eminentia collateralis, glomus choroideum



Cornu posterius: upper wall: corpus callosum (tapetum), caudally trigonum collaterale,

medially – calcar avis


Ventricles are filled by CSF.
Dura mater encephali

Inner and external layer (periosteum) fuse together, no cavitas epiduralis!, sinuses

Inner layer forms:

Falx cerebri: to the fissura longitudinalis cerebri (sinus sagittalis sup. and inf., attached to crista galli, crista frontalis, sulcu sinus sagittalis superior, protuberantia occipitalis interna)

Falx cerebelli: in between hemisphers of cerebellum (attached to crista occipitalis interna)

Tentorium cerebelli: separates occipital lobi from cerebellum (attached to processus clinoidei os sphenoidalis, crista superior pyramidis, sulci transversi, protuberantia occipitalis interna)

Diaphragma sellae: closes fossa hypophysialis

Cavum trigeminale

Vagina nervi optici (fuses with sclera)
Vessels of dura mater encephali
Aa. meningeae

A. meningea anterior (from a. ethmoidalis anterior through lamina cribrosa ossis ethmoidalis)

A. meningea media (from a. maxillaris through foramen spinosum)

A. meningea posterior (from a. pharyngea ascendent through foramen jugulare)

R. meningeus (from a. carotis int.)
Veins: to the sinus durae matris

Nerves: rr. meningei from V. and X. cranial nerve
Dura mater spinalis

Endorhachis – external layer of dura mater spinalis

Saccus durae matris – S2-3, filum durae matris spinalis

Cavitas epiduralis (between endorhachis and internal layer of dura mater spinalis with plexus venosi vertebrales interni)
Vessels :

rr. meningei (rr. spinales of spinal arteries)

veins to plexus venosus vertebrales interni

nerves – rr. meningei of spinal nerves
Arachnoidea

is without vessels and nerves!

cavum subdurale, cavitas subarachnoidealis (with liquor cerebrospinalis)

Arachnoidea encephalion the surface of gyri, granulationes arachnoideales – processes of arachnoidea to sinus durae matris

(foveolae granulares – impressiones in bones)


Arachnoidea spinalistill S2 with broad subarachnoidal space
Pia mater encephali

with vessels, but no sensory innervation, covers gyri and runs into fissures between gyri, in ventricles forms a part of tela choroidea


Cisternae subarachnoideales:

Cerebellomedullaris – by apertura mediana and laterales flows liquor to subarachnoideal space

Cisterna interpeduncularis

Cisterna chiasmatis

Cisterna fossae lateralis cerebri
Pia mater spinalis no sensory innervation

20-25 ligg. denticulata – as suspensory apparatus



Cisterna lumbalis (L2-S2) (with cauda equina and filum terminale)

Lumbar punction – L4-5

Suboccipital punction (in children)

Pneumoencephalography (by lumbal punction), ventriculography (by trephination directly), lumbal anestesia (to subarachnoideal space)
Liquor cerebrospinalis – from blood plasma in plexus choroideus

About 150 cm3 (in ventricles 35 cm3, rest in subarachnoideal space)

– created in plexus choroideus of ventricles:

From lateral ventricles runs on the III. ventricle (through interventricular foramen), through aquaeductus mesencephali to IV. ventricle, through apertura mediana and laterales (in velum medullare inferius) to the subarachnoideal space – granulationes arachnoideales to sinus durae matris.


Vessels of the CNS

Spinal cord

Arteries

rr. spinales - from: a. cervicalis ascendens, a. vertebralis, a. cervicalis profunda

aa. intercostales, aa. lumbales, a. iliolumbalis, a. sacralis lateralis and mediana)

Form: rr. radiculares anteriores – form a. spinalis anterior

rr. radiculares posteriores – form aa. spinales posteriores

(aa. periphericae and rr. meningei for dura and pia mater – from all arteries)


Veins

vv. spinales (in epidural space), vv. basivertebrales (from vertebral bodies)to plexus venosus vertebrales interni – via vv. intervertebrales to plexus venosus vertebrales externi – to vv. lumbales and vv. intercostales posteriores
Vessels of the brain

1) Aa. vertebrales

2) Aa. carotis internae
A. vertebralis branch of a. subclavia, foramen magnum, clivus – right and left join into a. basilaris

  1. a. spinalis anterior and posterior – joins with arteries of spinal cord

  2. a. cerebelli inferior posterior – r. choroideus ventriculi IV., rr. medullares and rr. ad medullam oblongatam



A. basilaris – a. cerebelli inferior anterior

a. labyrintní - via porus acusticus internus

aa. pontis

a. cerebelli superior

aa. cerebri posteriores – aa. communicans posteriores, aa.centrales

posteriores, rr. choroidei, rr. corticales, r. calcarinus



A. carotis interna

through canalis caroticus and sinus cavernosus

(aa. hypophysiales, r. meningeus)

Aa. caroticotympanicae in canalis caroticus to tympanic cavity

A. ophtalmica (division of branches - see eye)

A. cerebri anterior (into fissura longitudinalis cerebri)

aa. centrales anteriores, a. communicans anterior, a. pericallosa, rr. corticales,

rr. orbitales et frontales, rr. parietales

A. choroidea anterior

A. cerebri media (into fossa cerebri lateralis)

aa. centrales anteriores, aa. thalamostriatae, a. haemorrhagica cerebri – often bleeding; rr. corticales, rr. insulares, rr. frontales, rr. parietales, rr. temporales
Circulus arteriosus cerebri (Willisi) - variable

Circle of arteries around chiasma opticum, lamina terminalis,

infundibulum and hypophysis and substantia perforata posterior

aa. cerebri posteriores – aa. communicantes posteriores – aa. cerebri mediae

aa. cerebri anteriores – a. communicans anterior


Veins – vv. cerebri – to sinus durae matris
Sinus durae matrisblood to the vena jugularis interna

Located in between periostal and internal layer of dura mater and in its folds,



no valves, no muscle layer – it is not possible regulation of blood drainage

Sinus sagittalis superior (into upper part of falx cerebri)

Sinus sagittalis inferior (into caudal part of falx cerebri)

Sinus rectus (junction of v. cerebri magna and sinus sagittalis inferior)

Sinus occipitalis (from foramen magnum and plexus basilaris to confluens sinuum)

Sinus transversus (from confluens sinuum continues to sinus sigmoideus)

Sinus sigmoideus (continuation of sinus transversus – its continuation is v. jugularis interna)

Sinus petrosus superior (in the attachment of tentorium cerebelli, joins with sinus

cavernosus and sinus sigmoideus)



Sinus petrosus inferior (joins to vena jugularis interna in foramen jugulare)

Sinus cavernosus (joined by sinus intercavernosus anterior and posterior, joins with

v. ophtalmica superior, course of n.III., n. IV., n. ophtalmicus, n. VI., a. carotis interna)



Sinus sphenoparietalis (along to lesser wing of sphenoid bone to sinus cavernosus)

Plexus basilaris - around foramen magnum (to sinus occipitalis, sinus cavernosus, sinus

petrosus inferior, through foramen magnum to plexus venosi vertebrales interni)


Tributaries to sinus durae matris

1) vv. meningeae (to sinus durae matris except for the biggest – v. meningea

media – to plexus pterygoideus)



2) vv. diploicae (to sinus durae matris or to superficial veins)

3) vv. emissariae (between sinus durae matris and superficial veinsv. emissaria mastoidea,

condylaris, parietalis)



4) vv. labyrinthi (from inner ear to sinus petrosus inferior)

5) v. ophtalmica superior (to sinus cavernosus)
Vv. cerebri – no valves, variable, superficial and deep
Superficial veins of the brain

vv. cerebri superiores (to sinus sagittalis superior)

v. cerebri media superficialis (from fossa cerebri lateralis to the sinus cavernosus)

vv. cerebri inferiores (blood from base of frontal, parietal and temporal lobe to the sinus cavernosus, sinus petrosus superior and transversus)
Deep veins of the brain

v. basalis (from genu corporis callosi to v. cerebri magna)

v. cerebri media profunda (from fossa cerebri lateralis to v. basalis)

vv. cerebri internae (on the ceiling of III. ventrikle, originate from: v. septi pellucidi,

v. choroidea superior and v. thalamostriata; below splenium corporis callosi both venae join into v. cerebri magna (Galeni). Together with vv. basalis and sinus sagittalis inferior is tributary to sinus rectus.
Veins of cerebellum

vv. cerebelli superiores and inferiores (to sinus transversus and sigmoideus)
Veins of brain stem

vv. mesencephalicae, vv. pontis, vv. medullae oblongatae (to veins of cerebellum and veins of spinal cord)


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