BIO 004 · Human Anatomy

CNS Meninges and CSF

Block 5 · Module 4: The Meninges and Cerebrospinal Fluid

A reference for the meninges and CSF video and lab. This page covers the cranial and spinal meninges, the dural reflections, the meningeal spaces, where the spinal cord ends and the lumbar puncture, the ventricles, cerebrospinal fluid and its circulation, and the blood-brain barrier.

How to use this sheet Toggle the toolbar above. Notes prints the full reference for review. Study prints as a fill-in-the-blank worksheet. Print it, then write each definition while you watch the video or read your book. Quiz me is on-screen typing practice: type the term, click Reveal to check yourself. The comparison grids respond to Study and Quiz too, with a Reveal button on each row.

Practice Spaced Recall

The Foundations video gives you a complete foundational understanding of this topic, enough on its own for a foundational course. Learn it first, then move on to the Deep dive, which adds the majors-level material: the dural reflections, the spinal meninges and the lumbar puncture, and the circulation of CSF.


By the end
  1. Name the cranial and spinal meninges and the spaces between them.
  2. Identify where the spinal cord ends and the layers a lumbar puncture passes.
  3. Describe cerebrospinal fluid, where it is found, and where it is made.
  4. Trace the circulation of CSF from production to reabsorption.

Your pre-work

Work through these the evening before class. None of it is turned in. It is how you learn the material and build your spaced recall.

This is more than a checklist. Ticking these boxes is the start, not the finish. Committing this material to memory and being able to apply it takes considerable time and repeated effort. You are not done when the boxes are checked. Put in the real hours, and keep coming back for frequent recall and review until the material is genuinely yours.

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The meninges

Add a labeled section showing the dura, arachnoid, and pia mater and the spaces between them.

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The ventricles

Add a labeled view of the lateral, third, and fourth ventricles and their connections.

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The circulation of CSF

Add a labeled diagram tracing CSF from the choroid plexus to the arachnoid granulations.


An Overview

The brain and spinal cord are soft and irreplaceable, so they are protected four ways: by bone, by the meninges, by a cushioning fluid, and by a barrier that screens the blood.


The Cranial Meninges

Three connective tissue membranes wrap the brain. Their Latin names run from tough mother on the outside to tender mother within. Compare them.

The three cranial meninges compared
LayerPositionDescription
Dura materthe outermost layera tough membrane with two layers: an outer periosteal layer against the skull and an inner meningeal layer; the two are fused except where they part to form the dural venous sinuses
Arachnoid materthe middle layera delicate, lace-like membrane
Pia materthe innermost layera thin membrane, rich in blood vessels, that clings directly to the surface of the brain

The Dural Reflections

In a few places the inner meningeal dura folds inward as a partition that anchors the brain and separates its parts. These folds are the dural reflections, also called the dural extensions.

Where the two dural layers part within these folds, they form the dural venous sinuses. The sinuses collect venous blood from the brain, along with the CSF returned by the arachnoid granulations, and drain it toward the heart. Follow the main drainage route.

  1. Superior sagittal sinusruns along the top edge of the falx cerebri; receives CSF from the arachnoid granulations
  2. Confluence of sinusesthe meeting point of the major sinuses, at the internal occipital protuberance
  3. Transverse sinusesthe paired sinuses running laterally from the confluence
  4. Sigmoid sinusesthe S-shaped sinuses that curve down toward the jugular foramen
  5. Internal jugular veinscarry the blood out of the skull and back toward the heart

The Spinal Meninges

The same three membranes continue down around the spinal cord, with one important difference: the vertebral canal has a true epidural space, and the cranium does not.


The Meningeal Spaces

The gaps around and between the meninges are named spaces. Each one matters in the clinic, whether for an injection, a bleed, or a spinal tap. Compare them.

The meningeal spaces compared
SpaceLocationContents
Epidural spacebetween the spinal dura and the vertebral bonefat and veins; present in the vertebral canal but not the cranium
Subdural spacebetween the dura mater and the arachnoid matera potential space only, with a thin film of fluid
Subarachnoid spacebetween the arachnoid mater and the pia matercerebrospinal fluid; this is where CSF is found around the brain and cord

Where the Spinal Cord Ends

The spinal cord is shorter than the vertebral column. It ends high in the lumbar region, and the subarachnoid space continues below it as a pool of CSF.


The Lumbar Puncture

A lumbar puncture, or spinal tap, draws CSF from the lumbar cistern. The needle enters in the midline between the L3 to L4 or L4 to L5 spines, safely below the end of the cord. Follow the structures it passes, superficial to deep.

  1. Skinthe epidermis and dermis of the lower back
  2. Subcutaneous fatthe superficial fascia beneath the skin
  3. Supraspinous ligamentthe ligament running along the tips of the spinous processes
  4. Interspinous ligamentthe ligament between adjacent spinous processes
  5. Ligamentum flavumthe tough elastic ligament joining the laminae of adjacent vertebrae
  6. Epidural spacethe fat-filled and vein-filled space inside the vertebral canal
  7. Dura materthe tough outer meningeal membrane
  8. Arachnoid materthe delicate middle meningeal membrane
  9. Subarachnoid spacethe needle reaches the lumbar cistern, where CSF is withdrawn

The Ventricles of the Brain

The ventricles are connected, fluid-filled chambers deep within the brain, lined by ependymal cells. Cerebrospinal fluid is made in them. Compare them.

The ventricles of the brain compared
VentricleLocationConnects to
Lateral ventriclesone in each cerebral hemispherethe third ventricle, through the interventricular foramina of Monro
Third ventriclein the diencephalonthe fourth ventricle, through the cerebral aqueduct of Sylvius
Fourth ventriclebetween the brainstem and the cerebellumthe central canal and the subarachnoid space, through three apertures
Central canalruns the length of the spinal cordcontinuous above with the fourth ventricle

Cerebrospinal Fluid

Cerebrospinal fluid is the clear liquid cushion of the central nervous system. It is made, circulated, and reabsorbed continuously, keeping a steady volume.


The Circulation of CSF

Cerebrospinal fluid follows a one-way loop, produced in the ventricles and reabsorbed into the blood. The ventricles below hold choroid plexus, where ependymal cells produce CSF. Follow it in order.

  1. Lateral ventricleshold choroid plexus, where ependymal cells produce CSF; one ventricle sits in each cerebral hemisphere
  2. Interventricular foramina of MonroCSF passes through these paired openings into the third ventricle
  3. Third ventriclein the diencephalon; also holds choroid plexus, adding more CSF
  4. Cerebral aqueduct of SylviusCSF flows down this channel through the midbrain
  5. Fourth ventriclebetween the pons and the cerebellum; also holds choroid plexus
  6. Apertures of the fourth ventricleCSF exits through the two lateral apertures of Luschka and the median aperture of Magendie
  7. Subarachnoid spaceCSF bathes the whole surface of the brain and spinal cord; some passes into the central canal
  8. Arachnoid granulationsCSF is reabsorbed here into the venous blood of the superior sagittal sinus, completing the loop

The Blood-Brain Barrier

The blood-brain barrier is the structural seal that keeps brain tissue separate from the changing chemistry of the blood. It is built from three components.


Disorders of the Meninges and CSF

Compare the common disorders by the structure each one affects.

Common disorders of the meninges and cerebrospinal fluid compared
DisorderStructure affectedWhat it is
Meningitisthe meningesinflammation of the meninges, usually from infection; diagnosed by testing CSF drawn at a lumbar puncture
Hydrocephalusthe ventriclesa buildup of CSF that enlarges the ventricles and raises intracranial pressure
Epidural hematomathe epidural spacebleeding between the dura mater and the skull
Subdural hematomathe subdural spacebleeding between the dura mater and the arachnoid mater
Subarachnoid hemorrhagethe subarachnoid spacebleeding into the CSF-filled space around the brain

See also: The Brain and The Spinal Cord for the structures these membranes protect, and The Peripheral Nervous System.

Study questions

Work on answering these in writing, in your own words. They are the questions to bring to class, and good practice for the reasoning the exams ask for.

  1. Name the three meningeal layers from superficial to deep and what sits between them.
  2. Trace the circulation of cerebrospinal fluid from where it is made to where it is reabsorbed.
  3. Name the four ventricles and describe how they connect.
  4. Explain why the spinal cord ends where it does, and how that makes a lumbar puncture safe.
Dr. Sharilyn Rennie BIO 004 · Block 5 · Module 4