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A&P Test 2 > 09/18 > Flashcards

09/18 Flashcards

1
Q

CNS is surrounded by 3 layers of connective tissue called the

A

Pia- thin layer
arachnoid mater-thin layer
dura mater- thick and leathery

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2
Q

subarachnoid hemorrhage happen in the

A

subarachnoid space

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3
Q

What is the dividing point between the cns and pns?

A

spinal nerves

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4
Q

the Pia, arachnoid, and dura mater cover the nerve until the point of

A

where the rootlets join together and form that spinal nerve

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5
Q

Spinal meninges are the

A

pia mater
arachnoid mater
dural mater

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6
Q

The meninges are covering up the

A

central nervous system

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7
Q

What is immediately outside of the dura layer?

A

epidural space

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8
Q

epidural space is filled with

A

fat and venous blood vessels

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9
Q

Because the epidural space is fatty, many of our lipophilic drugs are going to be

A

sucked into the adipose tissue making onset longer and wearing off longer after the drugs are stopped

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10
Q

What is a spinal?

A

when drugs are injected into the subarachnoid space. Onset is faster, but more dangerous

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11
Q

Where is the safest place to do a spinal? why?

A

In the lower back below L1
The spinal cord splits up into the cauda equina

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12
Q

What is the tip of the spinal cord called?

A

Conus medullaris

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13
Q

Where is the conus medullaris found?

A

L1

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14
Q

The enlargement at the top of the spine is called the

A

cervical enlargement

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15
Q

Where is the cervical enlargement found?

A

C3-C6

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16
Q

The enlargement at the bottom of the spine is called the

A

lumbar enlargement

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17
Q

Where is the lumbar enlargement found?

A

T11-L1

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18
Q

The cervical enlargement nerves exit the spinal cord and form the

A

brachial plexus

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19
Q

The lumbar enlargement nerves exit the spinal cord and form the

A

lumbar plexus and sciatic nerve

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20
Q

The dura mater are continuous with the nerves all the way down until the

A

bottom of the sacrum

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21
Q

What is the cuada equina made of?

A

posterior and anterior spinal roots

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22
Q

What is the extension of the pia matter that comes off the conus medullaris and ends in the dural sac, that anchors the cord and all of those structures to the spine?

A

the Filum terminale

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23
Q

What is the dural sac filled with?

A

CSF

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24
Q

What is the dural sac?

A

a continuation of the dura and arachnoid maters

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25
Q

What is another name for the lumbar sac?

A

Lumbar cycstern

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26
Q

the dural sac extends to the level of

A

S2

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27
Q

What is the upper portion of the ligament called at the end of the spinal cord?

A

Filum Terminale Internum

from end of cord to end of sac

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28
Q

What is the ligament that starts at s2 and anchors the bottom portion of the dural sac in place?

A

Filum Terminale Externum

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29
Q

Where does the conus medullaris end in a newborn?

A

L3

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30
Q

Why does the conus medullaris shift upwards as we mature?

A

Because the bones grow faster than the cord lengthens.

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31
Q

What is the downside to having the lumbar cystern at the bottom of the spine?

A

The CSF in the Lumbar cystern is “stale”

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32
Q

Where is a good place to sample CSF?

A

in the lower back; in the subarachnoid layer

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33
Q

Which vertebral space do we use to pull CSF or infuse meds into the spine?

A

L3-L4 interspace
L4-L5 interspace

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34
Q

Take CSF results from the lumbar cystern with a grain of salt because

A

the CSF is “stale” here

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35
Q

Besides the L3-L4 and L4-L5 interspaces to inject meds, what is another access point in the spine?

A

Sacral hiatus

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36
Q

What is one benefit to using the epidural space instead of giving a spinal?

A

You don’t puncture the CSF holding space so CSF doesn’t leak out when you pull the needle out

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37
Q

What is a place to inject meds in the sacral spine?

A

posterior sacral foramina

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38
Q

What angle should you shift the needle while giving an epidural or spinal?

A

15 degree angle

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39
Q

What is a arachnoid trabeculae?

A

pillar like structures the help hold open the arachnoid space and makes sure there is enough room for our blood vessels and CSF to provide a cushion for the brain

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40
Q

our bones are not solid structures and are innervated by

A

arteries and veins

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41
Q

When we crack the skull, we create an

A

epidural hematoma

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42
Q

majority of the epidural hematomas are

A

arterial

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43
Q

Subdural hemorrhages are mostly

A

venous, because the dura layer is basically continuous with some of the venous sinuses

44
Q

subarachnoid hemorrhages are typically

A

arterial

45
Q

CSF pH is_____
why?

A

7.31
there is less HCO3-
CO2 is constantly made through cellular metabolism making it more acidic

46
Q

Na+ levels in the CSF are

A

140mOsm, about the same as plasma

47
Q

Cl- levels in the CSF are

A

close to the Na+ levels, about 140mOsm which is more than the plasma

48
Q

K+ in the CSF is about ____ than in the plasma

A

40% less

49
Q

Mg+ in CSF are _____ than plasma

A

higher

50
Q

What electrolyte concentrations are going to limit our neurological activity?

A

Na+
Cl-
K+
Mg+

51
Q

CSF glucose is about

A

60mg/dL

52
Q

Plasma glucose is about

A

90mg/dL

53
Q

What color should CSF be?

A

clear

54
Q

What is the volume of CSF?

A

150mL

55
Q

How fast is CSF made in a day?

A

500mL/day

56
Q

What separates the CSF from the cardiovascular system?

A

Ependymal cells

57
Q

Ependymal cells are leaky to which electrolytes?

A

Na+
Cl-
Water

58
Q

How does an ependymal cell get electrolytes into the CSF?

A

Through a Na+ ATP pump
Sodium leaves the cell
Cl- follows Na+
Water follows both Cl- and Na+

59
Q

How can anesthetics increase or decrease CSF production?

A

by slowing down or speeding up the Na+ ATP pump

60
Q

Which cell manages K+ levels in the CSF?

A

astrocytes

61
Q

what is a group of ependymal cells called?

A

choroid plexus. found in a bunch of the parts of the brain’s CSF circulatory system.

62
Q

What are the containers of the CSF circulatory system called?

A

Ventricles

63
Q

The third ventricle is located where the

A

diencephalon and hypothalamus is

64
Q

The fourth ventricle is located where?

A

middle of the brainstem next to the cerebellum

65
Q

what are the two ventricles called at the top of the brain?

A

the left and right lateral ventricles

66
Q

where is CSF made?

A

in choroid plexuses in the ventrucles

67
Q

Name the CSF flow through the brain

A
  1. Left and right lateral ventricles
  2. interventricular foramen (foramen of monroe)
  3. 3rd ventricle
  4. cerebral aqueduct (aqueduct of Sylvius)
  5. 4th ventricle
    * central canal
    * lateral apertures (foramen of Luschka)
    * median aperature (foramen of Magendi)
    - cerebellomedullary cistern (cisterna magna)
68
Q

The foramen of monroe is also called

A

the interventricular foramen

69
Q

The aqueduct of Sylvius is also called

A

the cerebral aqueduct

70
Q

The foramen of Magendi is also called

A

the median aperture

71
Q

If we occlude one of the exit points in the CFS pathway, we would expect

A

the ventricles to swell and cause a problem

72
Q

Where is the most common block in the CSF pathway?

A

in the cerebral aqueduct (aqueduct of sylvius)

73
Q

What is non-communicating hydrocephalus?

A

A block in the pathway of the production and emptying system

74
Q

What is communicating hydrocephalus?

A

ventricular system is intact but for whatever reason the CSF isn’t being absorbed like it should be so we have pressure building up surrounding the brain

75
Q

Hydrocephalus gives us

A

high ICP and problems with brain profusion

76
Q

normally CSF is absorbed at the same clip that it is

A

being made

77
Q

Where are CSF reabsorbed in the CSF circulation?

A

at arachnoid granulations

78
Q

What are arachnoid granulations?

A

infoldings found at the longitudinal fissure. They are the CSF blow-off valves that open for a ICP > 10mmHg to mediate CSF reabsorption

79
Q

What is a normal ICP?

A

10mmHg

80
Q

The majority of the CSF is reabsorbed at the arachnoid granulations but some is reabsorbed in the

A

spinal cord

81
Q

If we have a stroke and clots form over the arachnoid granulation, you would expect to see

A

communicating hydrocephalus and increased pressures throughout the system

82
Q

What is the cerebellum?

A

part of the brain that is responsible for coordinating complex tasks

83
Q

What is the compartment located at the base of the skull that can be accessed to pull fresh CSF?

A

Cerebellomedullary cistern (cisterna magna)

84
Q

What is another name for the Cisterna magna?

A

cerebellomedullary cistern

85
Q

What feeds the Cerebellomedullary cistern (cisterna magna) with CSF?

A

the median aperture

86
Q

Sinus in the cardiovascular system is a

A

big vein

87
Q

What is the sinus that runs midline in the sagittal plane of the skull is called the

A

superior sagittal sinus

88
Q

Parallel and Below the Sagittal sinus is the

A

Inferior sagittal sinus

89
Q

What is the fan of connective tissue that separates the left brain from the right cerebral hemispheres?

A

Falx Cerebri

90
Q

The Falx cerebri continues down to the back of the brain and provides a floor for the occipital lobe to sit on called the

A

Tentorium cerebelli

91
Q

Below the Tentorium cerebelli is the

A

cerebellum

92
Q

The small stretch of vessel that connects the superior and inferior sinus is called the

A

straight sinus

93
Q

From the straight sinus, blood follows a lateral path to the left and right of the skull to provide an exit point for the blood returning from the superior and inferior sagittal sinuses called the

A

transverse sinus

94
Q

The sinus confluence is where

A

the superior sagittal, inferior sagittal and straight sinus all connect

95
Q

The blood comes from the transverse sinuses and makes a hairpin turn at the

A

sigmoid sinus

96
Q

The venous collection pool that is located in the front middle part of the brain that feeds the face and front of the brain is called the

A

cavernous sinus

97
Q

Where is all of the cranial blood emptied into?

A

The internal jugular

98
Q

The exertnal jugular takes care of the more

A

superficial structures on the side of the head

99
Q

We have vertebral arteries that supplies blood to the

A

back of the brain

100
Q

we have two internal carotid arteries that supplies blood to the

A

internal structures of the brain

101
Q

The external carotid arteries are in charge of supplying blood to the more

A

superficial parts of the brain

102
Q

Arterial blood flow is about ______mL/min
and _____ of our CO

A

750
15%

103
Q

Cardiac output is

A

5L/min

104
Q

the brain makes up what percent of the body weight?

A

2-3%
lopsided blood flow

105
Q

How much blood is supplied per minute per grams of tissue?

A

50mL/min/100g of tissue

106
Q

how much of blood flow to the brain goes to grey matter?

A

80%

107
Q

The main metabolic requirement of the CSN is to get blood to the

A

grey matter

A&P Test 2 (7 decks)

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