Blood Brain Barrier and CSF Flashcards

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1
Q

What are the 3 meningeal layers?

A

Dura mater, arachnoid, pia mater

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2
Q

Describe the dura mater

A

Adjacent to the skull (and attached to it in places). It has two layers, periosteal and meningeal, and these are fused together

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3
Q

Describe the arachnoid

A

Membrane has an outer compact layer of ‘barrier’ cells and an inner ‘trabecular’ meshwork

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4
Q

Describe the pia mater

A

Thin membrane which is tightly attached to the basement lamina of the brain

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5
Q

Where are veins found within the meninges?

A

Inner layers of the dura (meningeal layer) and crossing the dura-arachnoid interface

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6
Q

Where are blood vessels found within the meninges?

A

Within the dura and arachnoid

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7
Q

What is an epidural haemorrhage?

A

Involves bleeding outside of the dura, and it is usually arterial so there is a rapidly increasing size, usually caused by acute skull trauma

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8
Q

What is a subdural haemorrhage?

A

Where there is bleeding between the dura and arachnoid, and this usually occurs from damage to bridging veins, (from dura and arachnoid) so the onset of symptoms is slow as the blood spreads diffusely over the brain surface. Usually caused by rapid acceleration or deceleration of the head

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9
Q

What is a subarachnoid haemorrhage?

A

Where there is bleeding in the subarachnoid space and this is often due to a ruptured aneurysm, and therefore is a form of stroke

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10
Q

What is the falx cerebri?

A

Sheet of dura that extends down between the two hemispheres in order to divide them

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11
Q

What are the tentoria?

A

a pair of approximately transverse sheets of dura which extend laterally below the base of the occipital cerebrum, and they divide the cerebrum above from the cerebellum below

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12
Q

What is the tentorial notch?

A

Gap between the two tentoria where the brainstem passes

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13
Q

Outline how different compounds cross the BBB

A

Tight junctions prevent the passage of macromolecules, glucose is via GLUT transporters, amino acids via transporters (different depending on amino acid being basic, acidic or neutral) and lipid-soluble molecules can diffuse across BBB

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14
Q

Describe the structure of the blood-brain-barrier

A

Astrocyte end-feet and the tight junction system between the endothelial cells lining cerebral capillaries (prevent proteins leaving blood) make up the BBB

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15
Q

Describe how cerebrospinal fluid is formed

A

Formed by the choroid plexus; a network of capillaries that are covered by ependymal cells that protrude into the ventricles of the brain, the choroid capillaries are fenestrated and ultrafiltrate of the blood passes through these fenestrations into the subependymal layer

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16
Q

Where is most of the CSF formed?

A

Choroid plexus of the lateral ventricles

17
Q

Describe the composition of CSF

A

Very little protein, no cells and less glucose than plasma

18
Q

Outline the flow of the cerebrospinal fluid

A

Lateral ventricles –> third ventricle –> fourth ventricle  cisterna magna –> subarachnoid space  absorbed in arachnoid granulations (penetrate dura at top of brain and enable drainage into SSS) –> joins venous blood in superior sagittal sinus

19
Q

What type of vein runs in the skull?

A

Diploic

20
Q

What is hydrocephaly?

A

Accumulation of CSF in ventricular system resulting from obstruction of normal CSF circulation, usually treated by inserting a tube into the 3rd ventricle that leads to the subarachnoid space in order to allow shunting

21
Q

What type are most brain tumours?

A

Astrocytomas

22
Q

Explain the role of astrocytes in brain homeostasis

A

Maintain local pH and glucose in correct range, secrete GF , secrete cytokines to regulate immune cell function, form astrocytic scars in CNS injury repair