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1H06A > 08 - Brain Protection & Vasculature > Flashcards

08 - Brain Protection & Vasculature Flashcards

1
Q

What is part of the central nervous system?

A

Brain
Spinal Cord

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2
Q

What is part of the peripheral nervous system?

A

Mixed spinal nerves carrying
1. Sensory info from the body to CNS
2. Motor info from CNS to the body

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3
Q

Are sensory info afferents or efferents?

A

AFFERENTS

  • Input to CNS
  • Body to CNS (entering the CNS)
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4
Q

Are motor info afferents or efferents?

A

EFFERENTS

  • Output from the CNS
  • CNS to body (exiting the CNS)
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5
Q

What are the 3 functional classes of neurons?

A

Afferent neurons
- cell body in the peripheral NS
- peripheral axon endings terminate in the peripheral organ
- central axon terminates in the CNS

Efferent neurons
- the cell body and dendrites are in the CNS
- enters the PNS as it travels to the effector organ

Interneurons
- 99% of all neurons in the body
- all are in the CNS or in the brain

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6
Q

Where do sensory info messages go?

A

Messages ENTER the CNS through the BACK of the spinal cord

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7
Q

Where do sensory info messages go?

A

Messages LEAVES the CNS through the FRONT of the spinal cord

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8
Q

Where do sensory info messages go?

A

Messages LEAVE the CNS through the FRONT of the spinal cord

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9
Q

Can neurons switch what they do?

A

No

Once the neurons are established & created the circuitry, they NEVER switches
- An afferent neuron will always be an afferent neuron (vice versa)

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10
Q

What do interneurons do?

A

Does the integration of signals that determine the appropriate output

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11
Q

What are PNS & CNS responsible for?

A

PNS brings info in & out of the CNS to the rest of the body

CNS is largely responsible for integration of that info

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12
Q

Why are spinal nerves “mixed”

A

B/c it’s a mixture of afferent & efferent neurons that are running through those spinal nerves
- Sensory neurons and motor neurons are wrapped together
- They’re glued together but info is either travelling in or out through them

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13
Q

What is the dorsal root ganglion?

A
  • Sensory neuron
  • A collection of nerve cell bodies out of the CNS
  • Most of its axon is out in the PNS and some is in the spinal cord (CNS)
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14
Q

Do afferent neurons send sensory messages from the back or front of the spinal cord?

A

Afferent neurons send sensory messages from the body to the spinal cord through the BACK

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15
Q

Do efferent neurons send motor messages from the back or front of the spinal cord?

A

Efferent neurons send motor messages out to the effectors in the body through the FRONT of the spinal cord

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16
Q

Where are the axons of motor neurons?

A

Axons go out into the PNS to interact with the effector

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17
Q

What are the cell types in the central nervous system?

A

Ependymal cells (CSF)
Astrocytes (blood-brain barrier)
Neurons (signals)
Microglia (immune)

Glial cells (support cells)

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18
Q

What are ependymal cells?

A
  • Lines all the ventricles (sites of CSF production) of your brain
  • Dialyzing/purifying the plasma of the blood to create CSF
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18
Q

What are astrocytes?

A
  • Foot-like processes go out and touch BVs where exchange of nutrients is going to occur
  • Signal to the cell of the BVs (the endothelium) to say which substance should be permitted to pass and which ones not
    • Creates the blood-brain barrier)
    • Many substances in the blood never enter the brain to protect the brain from potentially noxious stimuli
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19
Q

What are neurons?

A
  • Signalling cells
  • The smallest # of cells that we have in the CNS
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20
Q

What are microglia?

A
  • The immune cells in the brain
  • Has limited ability to do phagocytosis
    • All other immune cells that provide protection are stuck in the blood & can’t go to the brain due to the blood-brain barrier)
    • Those other immune cells can only get into the brain if there’s a problem with the blood-brain barrier

Microglia
- micro - small
- glia - glue

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21
Q

What are oligodendrocytes?

A
  • Has a few branches and arms hanging out
  • Those branches & arms are creating myelin sheaths around the axons of neurons in the CNS
    • Myelinate more than 1 axon

Oligodendrocytes
- oligo - few
- dendro - branches
- cytes - cells

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22
Q

What do glial cells do?

A

Glial cells hold everything together
- Includes all the types of cells

Glial - glue

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23
Q

What is the grey matter?

A

Area where the soma/cell bodies of neurons are found
- Nucleus
- Cellular machinery

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24
Q

What is the white matter?

A

Area where the axons of the neurons are the myelin that’s wrapped around it are found

  • Myelin is essentially plasma membrane (fat) wrapped around the axons
  • Fat –> light in colour
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25
Q

What are the glial cells involved in myelination?

A

Oligodendrocyte
Schwann cells

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26
Q

What are the differences between oligodendrocytes and Schwann cells?

A

Oligodendrocyte:
- Forms several myelin sheaths for the axons around it
- Myelinates sections of several axons
- Found in the CNS

Schwann cell:
- Forms one myelin sheath
- Myelinates one section of an axon
- Found in the PNS

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27
Q

Do both the Oligodendrocytes and Schwann cells have Node of Ranvier?

A

Yes both types of cells have it

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28
Q

How does node of Ranvier help conduction?

A

They speed up the neural conduction?

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29
Q

Can CNS regenerate? Why?

A

Very limited

  • regeneration is extremely limited
    • Once the neurons has formed and created their circuitry, they do not change
    • They do not divide or create new neurons
      • B/c we cannot have a lot of new, weird connections forming in the brain
  • neurons are postmitotic and glia inhibit axon growth
    • Largely due to the influences –> the inhibiting factors secreted by the glial cells
  • Only a few specific areas where there is the possiblility for neurons to regrow and make new connections
    • Largely in the memory centers
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30
Q

Can PNS regenerate? Why?

A

Yes - 1mm of regrowth of axon that was damaged per day

  • neurons can sprout collaterals & regenerate
  • There’s a 1:1 ratio b/w a Schwann cell and an axon making myelin sheath thus regeneration can happen
    • Schwann cells secrete growth factors and promote axonal growth
    • No inhibitory factors (b/c they’re not in the PNS)
  • glia produce growth factors
  • macrophages remove debris
    • from the blood out in our body which can remove debris and set the stage for healing & repair
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31
Q

What are the bony protections for the CNS?

A

Brain - Bony encasement (skull)

Spinal cord - Protection (vertebrate & veretbral column)

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32
Q

What are meninges?

A

Another layer of protection for the brain

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33
Q

What is the dura mater?

A

Part of the meninges

  • A leathery matter that is very durable
  • Firmly attached to skull (glued to the skull)
    • Keep the skull in place so there’s no space b/w the dura mater and the skull
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34
Q

What’s running through the meninges and the dura mater?

A

Meningeal veins, arteries & nerves

  • Plastered between the dura mater and the skull
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35
Q

What’s under the dura mater?

A

The arachnoid mater

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36
Q

What is the arachnoid mater?

A

Tiny spider-like projections coming down from the dura mater
- Lines inner surface of the dura mater

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37
Q

What does the arachnoid mater form?

A

Subarachnoid Space

Those spider-like webs span the gap b/w the dura mater and the surface of the brain
- There’s potential space there
- Where CSF are found

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38
Q

Where are cerebral BVs found?

A

Right under the pia mater
- The BVs that supplies blood to the brain

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39
Q

What is the pia mater?

A

Covers the surface of the brain and cerebral vessels

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40
Q

Do cerebrum BVs and Meningeal BVs have the same blood supply?

A

NO they have different blood supply

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41
Q

What are the meningeal layers of the brain?

A

Scalp
Skull
Periosteal dura mater (attached to the skull)
- peri- around
- osteal - bone
Meningeal dura mater
Arachnoid mater
Subarachnoid space
Pia mater
Cerebral cortex (brain)

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42
Q

How many layers does the dura mater have? What are they called?

A

2

Periosteal dura mater
- peri - around
- osteal - bone

Meningeal dura mater

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43
Q

What are the 2 dura mater layers?

A

Periosteal dura mater - attached to skull
- The layer intimately glued to the skull

Meningeal dura mater
- Dive away from the skull and create little invaginations/cavities that create compartments within the skull

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44
Q

What separates the left & right cerebral hemispheres?

A

Flax cerebri
- Sickle-shaped

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45
Q

What divides the cranium into compartments?

A

The inward extensions of the dura mater

  • Dura mater can create little flaps & folds (invaginations) in the skull to create compartments
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46
Q

What creates the SPACES for the hemispheres?

A

Dural extensions
- Separates the hemisphere above from the cerebellum below

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47
Q

What is the tentorium cerebelli

A

A flap (a dura) that sits on top of the cerebellum
- Forms a tent-like shape

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48
Q

What are the 2 types of damages to the brain or cranial by extreme movements of the CNS?

A

Herniation
Coning

  • Extreme movements of the CNS may be restricted by the dural extensions, resulting in damage to the brain or cranial nerves
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49
Q

What does a hematoma do in the brain?

A

Compresses the brain and move it around

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50
Q

What happens if you have a space-occupying lesion in your brain (eg. hematoma)?

A
  • Can lead to the brainstem to move out of the way, to exit the skull through the foramen magnum
  • Can move the brain from one compartment to another within the skull
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51
Q

What is it called if the brainstem moves out of the way due to a space-occupying lesion in the brain and exit the skull through the foramen magnum?

A

Coning

  • B/c the brainstem look like an ice cream cone
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52
Q

What happens to the brainstem in coning?

A
  • If you force it through that hole to exit the skull, you will shear off all the cranial nerves
  • Lead to an inability to do things like having any sensations, moving muscles, etc
  • The brainstem is where all the cranial nerves arise from
    • Cranial nerves: All the nerves that’s control all the muscles, the skin and everything attached to the skull
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53
Q

What is it called if the brain moves to another compartment within the skull due to a space-occupying lesion in the brain?

A

Herniation or Pouching

54
Q

What is the meningeal artery between?

A

The dura and skull

55
Q

What are cerebral vessels supplied by?

A

Internal carotid

56
Q

What are meningeal arteries supplied by?

A

External carotid artery

57
Q

What do cerebral veins do?

A

Drain blood away from the brain

58
Q

What are some of the trigeminal nerves?

A

Some of the trigeminal nerves are cranial nerves

59
Q

Does the brain itself have sensory receptors on its surface?

A

NO

60
Q

What is the trigeminal nerve?

A

Cranial nerve # 5

61
Q

What are the 3 branches of the trigeminal nerve?

A
  1. Mandibular branch
    - For the mandible
  2. Maxillary branch
    - For the maxilla
  3. Ophthalmic branch
    - For the eyes
62
Q

True or false?

Some headaches are referred pain

A

True

63
Q

What is the superior sagittal sinus?

A

The space between the dura mater where it created the flax cerbri

64
Q

What is the superior sagittal sinus?

A

The space between the dura mater where it created the flax cerbri

Superior sagittal sinus
- superior - the uppermost part of the skull
- sagittal - right on the midline

  • There’s only one superior sagittal sinus but there are other dural sinuses
65
Q

What drains the blood in the brain?

A

Cerebral veins
- Empty into sinuses
- BVs that are draining the surface of the brain across the CSF space, go into the dural sinus and dump their blood there

66
Q

What supplies the blood in the brain?

A

Cerebral arteries
- From internal carotid artery
- Supply the blood from the base of skull, through the brain tissue and get collected at the top of the surface with the cerebral veins

67
Q

Steps in blood draining from brain

A
  • Drains blood from the brain
  • Has to cross the subarachnoid space (CSF space)
  • Dumps the blood into the sinus
68
Q

There are a lot of _______ ____ and they are very thin-walled

Think in terms of the meninges

A

Bridging vein

69
Q

What is an Epidural hematoma?

A
  • Rupture of meningeal vessel
  • Blood between the skull and the dura mater

Epidural
- epi - upon or above
- upon or above the dura mater

70
Q

What is a Subdural hematoma?

A
  • Rupture of bridging vein
  • Blood in the arachnoid space (CSF space)
  • Blood gets mixed up with CSF

Subdural
- sub - below
- below dura mater
- arachnoid mater is below dura mater

71
Q

What is a Subarachnoid hematoma?

A
  • Rupture of cerebral artery
  • Blood in the subarachnoid space (CSF space)

Subarachnoid
- below the arachnoid mater
- pia mater is below the arachnoid mater

72
Q

What cause an epidural hematoma?

A
  • Caused by blunt force to skull
  • Peels the dura mater away from the bone
    • Blood gets captured there in the space between
73
Q

What cause a subdural hematoma?

A
  • Caused by sudden movement of the head which causes the brain to move inside the skull
    • Cause traction on those bridging veins which caused them to tear
74
Q

What cause a subarachnoid hematoma?

A
  • Caused by aneurism: the weakening of cerebral artery walls which led to them bursting
    • The bursting of cerebral artery will tear the pia mater on top of it
75
Q

Is the dura mater glued to the bones of the vertebrae? Why?

A

No

The dura mater is not glued to the bodies of the vertebrae to prevent tearing during movements

B/c all the bones in your skull are fused together & do not move

But your vertebral column are bones that are separate and have articulations b/w them which allows them to move

76
Q

What is the purpose of the epidural fat space?

A

Acts to cushion the dura mater from the bone as its moving around in the vertebral canal

77
Q

What are the 2 reasons why lumbar puncture are performed?

A
  1. To deliver an anesthetic to numb neurons
  2. To gain a sample of the CSF in the subarachnoid space in the spinal column
78
Q

Where to aim for in a lumbar puncture when doing an epidural?

A

The epidural fat space

79
Q

What is the epidural lumbar puncture?

A

A procedure that involves injecting a med (eg. anesthetic) into the epidural fat space

80
Q

What is it called when getting a sample of the CSF in the spinal column (lumbar puncture)?

A

Spinal tap

81
Q

What is the conus medullaris?

A

The terminus where the spinal cord end around the L1 vertebrae

  • Look like a cone shape
82
Q

Does spinal nerves end where the spinal cord end?

A

No

The spinal nerves continue down and exit through the openings at the side of the spinal cord in order to get out to the tissues
- Go all the way down to the sacral regions

Spinal cord ends at the conus medullaris

83
Q

What is cauda equina?

A

Spinal nerves running through the inter-vertebral canal

  • kind of look like a horse’s tail
  • cauda - tail
  • equina - horse
84
Q

What is the brain formed as during development?

A

A tube-like structure

  • Started as a flat sheet and the edges of the sheet curl up to form a tube-like structure
85
Q

How many ventricles do we have in the brain?

A

4

86
Q

What are the 4 ventricles in the brain?

A

2 lateral ventricles (one in each hemisphere in the brain)
third ventricle
fourth ventricle

87
Q

What are specialized tufts of BVs within the ventricles that produces CSF?

A

Choroid plexus

88
Q

What’s the cell that’s lining the ventricular system?

A

Ependymal cells

89
Q

What are the portions of a lateral ventricle?

A

A frontal portion
- associated with the frontal lobe

A body portion

An occipital portion
- a little tail that goes into the occipital lobe

A temporal portion
- come out to the temporal lobe

90
Q

What’s the largest ventricle(s) of the brain?

A

Lateral ventricles (a pair)

91
Q

How does the CSF drain from the lateral ventricles to ventricle #3?

A

Through tiny holes called interventricular foramina

92
Q

What is ventricle #3?

A

A single ventricle found on the midline b/w the 2 halves of the diencephalon

93
Q

Where does the CSF produced in ventricle 3 go?

A

To ventricle #4

94
Q

How does the CSF from ventricle #3 go to ventricle #4?

A
  • Have to pass through part of the brainstem called the mid brain
  • There’s a straw-like aperture (an opening) running b/w ventricle #3 and #4 called the cerebral aqueduct
95
Q

What is the straw-like aperture (an opening) running b/w ventricle #3 and #4 called?

A

Cerebral aqueduct

  • A structure to convey water from one region to another
  • It continues all the way down to the tip of the spinal cord as the central canal
96
Q

True or false

CSF is produced in the lateral, 3rd, and 4th ventricles by the ependymal cells of the CHOROID PLEXUS

A

True

97
Q

Why do we need CSF?

A
  • delivers nutrients to all the neurons and glial cells within the brain
  • a highly buoyant solution
    • Denser than water
    • Helps to float your CNS in the skull
98
Q

What are arachnoid granulations?

A

One way valves to let the CSF go back to the blood

99
Q

Issues when ppl don’t make enough CSF

A

Brain starts to droop in their skull
- Results in the brainstem being compressed
- Temporal lobes are compressed
- Thus deficiencies in functions

100
Q

How do CSF travel through the ventricles in the brain?

A

Ventricle 1&2 (lateral ventricles) - make CSF

CSF travel through the interventricular foramina

Ventricle 3 - make more CSF

CSF travel through the cerebral aqueduct through the midbrain

Ventricle 4 - more CSF made

Tiny little holes in the roof of ventricle 4 allows CSF to go into the subarachnoid space

101
Q

CSF composition

A

Filtered Plasma
+sodium
+chloride
potassium, calcium
proteins (no clotting factors)
glucose (2/3 as much as in the blood)

Very few white blood cells (lymphocytes & monocytes / macros)

No red blood cells

  • Similar to the plasma (liquid matrix of the blood)
102
Q

What will transfer CSF from the subarachnoid space to the superior sagittal sinus?

A

Arachnoid granulations (villi)

  • One way valves
103
Q

What does stenosis mean?

A

Narrowing

104
Q

True or false

Rate of CSF production and drainage are matched.
If rates unmatched, pathology ensues.

A

True

105
Q

What is the lumphatics system

A

The immun system

106
Q

Where is CSF drained through before returning to the blood near the heart?

A

Cervical lymph nodes

  • Help drain CSF
  • Swollen lymph nodes - indication of infection
107
Q

Blood supplies to the brain

A

2 paired internal carotid arteries and a set of vertebral arteries

108
Q

Where does blood go in the brain from?

A

The base of the brain

109
Q

What is the one that services all the structures on the outside of the skull including the muscles and the skin? Think of BVs

A

External carotid

110
Q

What is the anterior cerebral artery?

A
  • 2 of them (left & right hemispheres)
  • Go through the inferior surface of the frontal lobe and curl up to the top parts of the frontal lobe and the parietal lobe
111
Q

What comes off of the basilar artery and supplies blood to the occipital lobe?

A

Posterior cerebral

112
Q

What is basilar artery formed by?

A

The 2 vertebral arteries
- It’s on the base of the pons

113
Q

What does the posterior communicating artery do?

A

Allows blood to be shared b/w the basilar and the internal carotid

114
Q

Where is the anterior ocmmunication artery?

A

B/w the 2 anterior cerebral arteries

115
Q

What is a connection b/w arteries where there’s more than 1 route for blood flow called?

A

Anastomosis

  • The circle of Willis
116
Q

Where does most of the blood feeding the posterior cerebral arteries come from?

A

Basilar artery

117
Q

Where does most of the blood feeding the middle cerebral and the anterior cerebral come from?

A

The internal carotids

118
Q

What are the 4 vessels that feeds the Circle of Willis?

A

2 vertebral
2 internal carotids

119
Q

True or false?

85% of aneurysms occur in the Circle of Willis

A

True

120
Q

Why are congenital (presence from birth) weakening of the BVs more like to occur in the Circle of Willis?

A

B/c of all the branching points
- They tend to tbe the weakest parts of the vessels

121
Q

What are the 2 major types of cerebrovascular accidents (strokes)?

A

Hemorrhagic stroke
Ischemic stroke

122
Q

When do hemorrhagic stroke happen?

A

Occur when a cerebral BV tears & breaks
- Bleeding into the brain
- Intracerebral hemorrage

123
Q

What causes hemorrhagic strokes?

A

hemorrhage/blood leaks into brain tissue
(intracerebral hematoma)

124
Q

What causes ischemic strokes?

A

clot stops blood supply to an area of the brain

125
Q

What’s the problem in hemorrhagic strokes?

A

Where the BV is broken, distal (downstream) to it, those tissues are not receiving blood
- B/c the blood is bleeding into the brain, those tissues will die

126
Q

What’s the problem in ischemic strokes?

A

Blood clot prevents all the distal regions from receiving blood
- The anterior, middle & posterior cerebral arteries are the only ways to get blook to that region of the brain, thus, blood clot will stop blood flow to that region of the brain
- No anastomosis b/w those arteries
- If one of them is blocked, all the tissues it supplies will die

127
Q

What’s happening in ischemic strokes?

A

BVs are intact but there’s a blood clot that’s occluding/stopping blood flow

128
Q

True of false

Functional deficits due to strokes will depend on the area of brain supplied by the affected artery

A

True

129
Q

Functions of the right cerebral cortex

A

Movements on the left side of the body
Sensations from the left side of the body
Spatial orientation & object recognition
Damage = reduction of emotional component to speech

130
Q

Functions of the left cerebral cortex

A

Movements on the right side of the body
Sensations from the right side of the body
Spoken and written language
Damage = aphasia

131
Q

Which arteries are interconnected via the Circle of Willis?

A

middle, anterior and posterior cerebral arteries

132
Q

Do most people have a complete Circle of Willis?

A

No - most ppl have incomplete Circle of Willis, only minority have complete CoW

1H06A (8 decks)

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