Anatomy - Hydrocephalus Flashcards

1
Q

where is choroid plexus found in the brain

A

lateral ventricle (majority)

third ventricle

fourth ventricle

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2
Q

describe the structure of the BBB

A

endothelial cells connected with tight junctions

then a basement membrane

then astrocyte foot processes

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3
Q

what transporters are in the BBB

A

transport carriers for glucose and essential amino acids

sodium ion transporters

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4
Q

what controls entry of NT in the BBB

A

metabolic processes within endothelial cells

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5
Q

describe the structure of the blood-CSF barrier

A

fenestrated epithelial (no tight junctions)

then a basement membrane

choroid cells connected by tight junctions

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6
Q

impairment of the blood-CSF barrier leads to what

A

increased protein concentration in the CSF

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7
Q

compare CSF and plasma content

A

CSF: low glucose, low protein

plasma: higher glucose, higher protein, amount the same Na+

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8
Q

how does CSF protect the brain from harmful toxins

A

it has a one-way flow wihch takes harmful metabolites, drugs, and other substances away from the brain

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9
Q

how does CSF work with the endocrine system

A

it serves to transport hormones to other areas of the brain

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10
Q

where is the interventricular foramen of monroe

A

between the lateral and 3rd ventricle

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11
Q

how does CSF leave the fourth ventricle

A

through either 2 of the lateral foramina (Luschka) or the 1 medial foramen (Magendie)

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12
Q

describe the pathway of flow of CSF

A

lateral ventricle –> interventricular foramen –> third ventricle –> cerebral aqueduct –> fourth ventricle –> lateral aperature, median aperature, or central canal –> subarachnoid space –> arachnoid villi of dural venous sinuses –> heart and lungs –> arterial blood –> back to brain

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13
Q

if CSF pressure is greater than venous pressure, how does CSF flow

if venous pressure is greater than CSF pressure, how does CSF flow

A

CSF > venous: flows into venous sagittal sinus

venous > CSF: one way valve; will not flow backwards

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14
Q

describe communicating/non-obstructive hydrocephalus

  • where is the problem normally located
A

flow of CSF is blocked after it has exited the ventricles

  • inhibition of resorption of CSF at the level of the arachnoid villi
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15
Q

what does this image show

A

communicating hydrocephalus

(enlarged lateral ventricle)

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16
Q

what is normal pressure hydrocephalus

  • what can cause it
A

a type of chronic communicating hydrocephalus

  • increased viscosity of CSF
  • altered elasticity of ventricular walls
  • impaired absorption due to prior meningitis or subarachnoid hemorrhage
17
Q

normal pressure hydrocephalus normally presents in what types of patients

A

adults over 60

  • dementia
  • apraxis gait
  • urinary incontinence
18
Q

what is this

A

hydrocephalus ex-vacuo

19
Q

what is hydrocephalus ex-vacuo and what causes it

A

a type of communicating hydrocephalus where there is compensatory enlargement of cerebral ventricles and subarachnoid spaces (making up for atrophy)

  • brain atrophy
  • post-traumatic brain injuries
  • schizophrenia
20
Q

compare LP results between normal pressure hydrocephalus and hydrocephalus ex vacuo (two types of communicating hydrocephalus)

A

normal pressure: intermittent elevated ICP pressure

ex vacuo: no increased ICP

21
Q

what is non-communicating/obstructive hydrocephalus

A

excess accumulation of CSF due to structural blockage of CSF flow within the ventricular system

22
Q

what dis

A

aqueductal stenosis

(non-communicating hydrocephalus)

23
Q

signs and sx of aqueductal stenosis

A

“thunderclap” headache

papilledema

enlarged head (infants)

cognitive/developmental delays

upward gaze palsy

decrease level of consciousness

tremors

24
Q

what is this

A

Dandy-Walker Malformation

25
what is this
Dandy-Walker Malformation
26
what is Dandy-Walker malformation
obstruction at outlet of 4th venticle + cerebellar hypoplasia - enlargement at the base of the skull in infants
27
complete or partial agenesis of the cerebellar vermis is associated with what disease process
Dandy-Walker
28
what is this
Chiari type II
29
what is a chiari II malformation
downward displacement of **inferior cerebellar vermis, cerebellar tonsils, and medulla** through foramen magnum
30
causes of Chiari type II
structural defects in the brain and SC genetics lack of vertain vitamins in maternal diet
31
what two sx are often associated with chiari type II
myelomeningocele hydrocephalus
32
what is this
aquired hydrocephalus from tumor
33
what is aquired hydrocephalus and what causes it
development of hydrocephalus from something preventing CSF drainage in the brain - brain tumor/cyst - blocked CSF flow - subarachnoid hemorrhage - head trauma - infection (meningitis)