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Ophthalmology > Cerebrospinal fluid, aqueous humour and intercranial pressure > Flashcards

Cerebrospinal fluid, aqueous humour and intercranial pressure Flashcards

1
Q

Describe CSF

A

Clear colourless fluid slightly more viscous than water

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2
Q

Where is CSF synthesised?

A

Choroid plexus in brain ventricles

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3
Q

Describe the circulation of the CSF

A

Produced in lateral and 3rd ventricles and circulates to the 4th ventricle and central canal then into the subarachnoid space before being absorbed into the venous circulation

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4
Q

What is the purpose of CSF?

A

Provide protection to the brain
Supply it with nutrients and remove waste
Homeostatic control- sense pH therefore alter ventilation

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5
Q

What is contained in the CSF?

A

Little protein (15-45mg/dl)
Little immunoglobulin
1-5 cells/ml

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6
Q

What is the choroid plexus found?

A

3rd and 4th and lateral ventricles.

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7
Q

What is CSF derived from?

A

Blood that passes close to the choroid plexus

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8
Q

What ions are transported from the blood to create CSF?

A

Na
Cl
HCO3 (Bicarb)
H2O

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9
Q

Where can CSF be accessed to measure?

A

Lumbar puncture

Cervical (somewhere)

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10
Q

How many ventricles are there in the brain?

A

4

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11
Q

What are the 4 ventricles in the brain?

A

Two lateral ventricles
3rd ventricle
4th ventricle

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12
Q

What links the lateral ventricles with the 3rd ventricle?

A

Interventricular foramina

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13
Q

What links the 3rd ventricle to the 4th ventricle?

A

Cerebral Aqueduct

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14
Q

What does the interventricular foramina do?

A

Link the lateral ventricles to the 3rd ventricle

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15
Q

What does the Cerebral Aqueduct do?

A

Link the 3rd ventricle to the 4th ventricle

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16
Q

What do the foramen Magendie and Luschka do?

A

Link the 4th ventricle to subarachnoid space

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17
Q

What links the 4th foramen to the subarachnoid space?

A

Foramen Magendie and Luschka

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18
Q

What extends inferiorly our of the 4th ventricle?

A

Central canal

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19
Q

What does the central canal do?

A

Carry CSF to the spinal cord

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20
Q

Where does CSF return to the venous circulation?

A

Arachnoid granulations/dura arachnoid vili

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21
Q

What separates the blood from the CSF?

A

Blood CSF barrier

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22
Q

What kind of pathologies can affect the ventricles or CSF?

A

Tumours
Hemorrhage
Hydrocephalus
Idiopathic intracranial hypertension

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23
Q

What can brain hemorrhages lead to?

A

Blood accumulation in the ventricles

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24
Q

What is the lay term for hydrocephalus?

A

Water on the brain

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25
Q

What is hydrocephalus?

A

Accumulation of CSF leading to enlargement of ventricles

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26
Q

What is papilloedema?

A

Swelling of the optic disk due to increased intracranial pressure

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27
Q

What are some symptoms of papilloedema?

A

Enlarged blind spot
Blurred vision
Loss of vision

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28
Q

What is aqueous humour?

A

Fluid that fills the anterior chamber of the eye

29
Q

What does aqueous humour do?

A

Supplies oxygen, metabolites and bicarb to the cornea and iris etc

30
Q

What is the importance of the bicarb in aqueous humour?

A

To buffer the H+ produced by anaerobic met in the cornea

31
Q

What is ascorbate?

A

A strong antioxidant

32
Q

Why is ascorbate found in the aqueous humour?

A

To help protect the eye from anaerobic met

33
Q

What ions are found in aqueous humour?

A

Na

Cl

34
Q

What is an overproduction of aqueous humour called?

A

Glaucoma

35
Q

What is glaucoma?

A

Overproduction of aqueous humour

36
Q

What medication types can be used to prevent glaucoma?

A

Carbonic Anhydrase Inhibitors

37
Q

Why do CA Inhibitors help prevent glaucoma?

A

Block CA which in turn prevents Na uptake

38
Q

Give some examples of CA Inhibitors used in glaucoma

A

Dorzolamide

Acetazolomide

39
Q

How is dorzolamide administered?

A

Eye drops

40
Q

How is acetazolomide administered?

A

Oral- kidney problems

41
Q

What can cause raised intracranial pressure?

A

Tumours, abscess, hemorrhage
Hydrocephalus
Meningitis

42
Q

What are the three layers of the meninges?

A

Dura mater- Durable mother
Arachnoid mater- Spider like
Pia mater- Soft mother

43
Q

What flows in the subarachnoid space?

A

CSF

44
Q

What is the dura mater a continuation of?

A

Periosteum of cranial cavity

45
Q

Are the meninges restricted to the contours of the skull or can they dive down into the sulci?

A

Dive down into the sulci

46
Q

What does the dura mater form in the sulci of the brain?

A

Falx cerebri

Cerebellar tentorium

47
Q

What is the falx cerebri?

A

Invagination of dura mater in the longitudinal fissure

48
Q

What does falx mean?

A

SIckle

49
Q

What are the cerebellar tentorium?

A

Invagination of dura mater between the cerebellum and occipital lobes of cerebrum

50
Q

What runs along the edge of the cerebellar tentorium?

A

Several nerves associated with the eye

51
Q

What passes through the hole in the cerebellar tentorium?

A

Brainstem

52
Q

What can be found between layers of the dura mater?

A

Dural venous sinuses

53
Q

What are dural venous sinuses?

A

SInuses of venous blood without vein walls

54
Q

What happens in the Arachnoid granulations/dura arachnoid vili?

A

CSF returned to venous blood

55
Q

Where are Arachnoid granulations/dura arachnoid vili found?

A

Dura venous sinuses

56
Q

Why can raised intracranial pressure lead to visual disturbances?

A

Because meninges and subarachnoid space extend along the optic nerve to the eye

57
Q

What extends along the optic nerve to the eye?

A

Meninges and subarachnoid space

58
Q

Why can raised intracranial pressure lead to visual disturbances?

A

Because meninges and subarachnoid space extend along the optic nerve to the eye

59
Q

What extends along the optic nerve to the eye?

A

Meninges and subarachnoid space

60
Q

What visual disturbances can raised intracranial pressure cause?

A 
Transient blurred vision
Double vision- Diplopia
Loss of vision
Papilloedema- Swelling of optic disk
Pupillary changes
61
Q

What is diplopia?

A

Doube vision

62
Q

What is the correct term for a swelling of the optic disk due to raised intracranial pressure?

A

Papilloedema

63
Q

How many eyes can raised ICP affect

A

One or both

64
Q

What is the correct term for a swelling of the optic disk due to raised intracranial pressure?

A

Papilloedema

65
Q

How many eyes can raised ICP affect

A

One or both

66
Q

What are some of the symptoms of trochlear nerve damage?

A

Eye cannot move inferomedially

Diplopia when looking down

67
Q

What are some symptoms of oculomotor nerve damage?

A

No/slow pupillary light reflex
Dilated pupil
Ptosis
Position of eye: looking ‘down and out’

68
Q

What are some of the symptoms of trochlear nerve damage?

A

Eye cannot move inferomedially

Diplopia when looking down

69
Q

What is the symptom of abducens nerve damage?

A

Medial deviation of the eye

Ophthalmology (10 decks)

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