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Neurology > CNS, Blood Brain Barrier And Neurovascular Unit > Flashcards

CNS, Blood Brain Barrier And Neurovascular Unit Flashcards

0
Q

What other anatomical sites have a barrier similar to the blood brain barrier?

A

Eye, inner ear and possibly testes

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1
Q

What is a physical anatomic barrier to protect the brain from circulating toxins found in blood?

A

Blood brain barrier

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2
Q

What structure mediates selective transport in and out of brain, maintains proper CSF and brain environmental concentration of glucose, ions, amino acids, neurotransmitters, hormones and vitamins and regulates interface for metabolism or modification of blood or brain borne substances?

A

Blood brain barrier

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3
Q

What structure expresses enzymes that degrade many peptides preventing entry to CSF?

A

Choroid plexus

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4
Q

The neurovascular unit is surrounded by what?

A

Astrocyte foot pads

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5
Q

What structure in the neurovascular unit has contractile function, participates in vascular development, contributes to the BBB properties, are multipotent cells, have roles in hemostasis and have immune and phagocytic functions?

A

Pericyte

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6
Q

What is the junction that occurs in epithelial cells that prevents entry of blood born substances?

A

Tight junction

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7
Q

The neurovascular unit has a high number of what organelle that is needed for energy to move particles back and fourth

A

Mitochondria

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8
Q

What structures mediate water transport into brain across blood vessels and choroid plexus and remove excess water, electrolytes, and amino acids into ventricles, brain and subarachnoid space?

A

Aquaporins

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9
Q

What maintain optimal water and it’s contents via astrocytes and are pores that allow water to be transported in and out?

A

Aquaporin

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10
Q

4 aquaporin is found where?

A

Astrocytes

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11
Q

1 aquaporin is found where?

A

Choroid plexus

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12
Q

What types of molecules are able to by pass the BBB?

A

High lipid soluble, small molecular weight, less molecular ionic charge, specific for transport receptors in choroid plexus or endothelium

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13
Q

Transporting molecules across the blood brain barrier is known as what?

A

Transcytosis

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14
Q

What are the three mechanisms of transcytosis?

A

Facilitated transport, active transport and efflux transport

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15
Q

What type of transport requires specific receptor, transports molecules from high concentration to low concentration, found in endothelium or choroid plexus but does not require energy? Ex: D-glucose transporter, large neutral amino acid transporter, actinic amino acid transporter

A

Facilitated transport

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16
Q

What type of transport requires energy, requires a specific receptor, transports molecules from low concentration to high concentration and is found within the capillary lumen, brain or CSF? Ex: insulin receptor, transferrin receptor

A

Active transport

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17
Q

What type of transport pumps out unwanted substances out of brain tissues and cells, requires specific receptors and requires energy? Ex: potassium, neurotransmitters, glutamate acid, glycine,

A

Efflux transporter

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18
Q

In what form is glucose found in the brain?

A

Glucose-6 phosphate

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19
Q

What areas of the brain lack the blood brain barrier?

A

Pituitary and pineal glands, area postrema, paraventricular nuclei, capillary endothelium in choroid plexus

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20
Q

What allows release of hormones into blood and CSF?

A

Pituitary and pineal glands

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21
Q

What detects circulating toxins to trigger vomiting?

A

Area postrema

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22
Q

What is located inside the 3rd ventricle and releases neurotransmitters and hormones into the CSF?

A

Paraventricular nuclei

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23
Q

What allows circulating molecules to reach choroid plexus epithelium? Tight junctions are now at the ependyma cells

A

Capillary endothelium in choroid plexus

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24
Q

What processes open the blood brain barrier?

A

Ischemia - stroke, vessel exposure to inflammatory cytokines or factors produced by tumors, marked hypertension, hyperosmolar solution arterial injections

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25
Q

What are a few consequences of opening the blood brain barrier?

A

Vasogenic cerebral edema - plasma leaving capillaries and veins into brain interstitial space, WBC entering brain or CSF, toxic molecules entering the brain - neuronal deaths, seizures, infectious organisms entering brain/CSF

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26
Q

What is a clear colorless fluid that fills the ventricular system and subarachnoid space and is primarily made by the choroid plexuses?

A

Cerebral Spinal Fluid

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27
Q

What are 3 CSF functions?

A

Mechanical support for the brain, removes brain metabolic and synaptic products, carries neurotransmitters between brain areas

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28
Q

Reduction of brain weight from 1500 to 50 gm and protection of brain via a water jacket from trauma describes what?

A

CNS mechanical support for brain

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29
Q

Active transport by efflux moving molecules from CSF across blood brain barrier to choroid plexus veins and CSF exiting into superior Sagittal sinus describes what?

A

CSF removal of brain metabolic and synaptic products

30
Q

Molecules being carried from 3rd ventricle to periaquaductal gray matter ( important for sleep) and molecules being carried from choroid plexus to hypothalamus (important for energy balance) describes what?

A

CSF carrying neurotransmitters between brain areas

31
Q

What arises from adipose tissue and regulates energy balance via the hypothalamus via specific receptors in the choroid plexus and walls of the 3rd ventricles?

A

Leptin

32
Q

What molecule is synthesized in the liver and is transmitted to the blood, then choroid plexus, then CSF and regulates hibernation?

A

Hibernation protein complex

33
Q

What are bipolar ependymal cells that line the sides of the 3rd ventricle and are possibly responsible for the secretion of molecules into the CSF?

A

Tanycytes

34
Q

What substance produced by the choroid plexus is critical for brain T4 by binding T4 and preventing removal from the CSF?

A

Transthyretin

35
Q

What molecule produced by the choroid plexus produces prostaglandin D2, most potent sleep inducer?

A

Lipocalin-type prostaglandin D synthase ( L-PGDS)

36
Q

What substance transmitted by the brain to other brain areas via CSF regulates sexual receptivity around time of ovulation?

A

Gonadotropin-releasing hormone

37
Q

What substance transmitted from pineal glands to CSF regulates seasonal control of LH release?

A

Melatonin

38
Q

What is the amount of CSF found in the ventricles?

A

25ml

39
Q

What is the amount of CSF found in the brain subarachnoid space?

A

85ml

40
Q

What is the amount of CSF found in the spinal chord subarachnoid space?

A

30ml

41
Q

What is the total amount of CSF in the CNS?

A

140ml

42
Q

What comes from blood, enters ventricles via choroid plexus, and returns to blood via superior Sagittal sinus

A

CSF

43
Q

What begins as plasma ultrafiltrate across permeable choroidal capillaries, picks up water and ions by transporters at the basolateral side of the choroid epithelium, convected through cytoplasm and actively released or secreted into ventricle CSF on apical side?

A

CSF

44
Q

In the choroid plexus what type of junction produces the ultrafiltration?

A

Gap junction

45
Q

What are the 2 mechanisms of CSF production by the choroid plexus?

A

Bulk flow and secretion

46
Q

Active transport of sodium via Na+-K+ ATPase which pulls water from blood to CSF thru an aquaporin 1 channel describes what?

A

Bulk flow

47
Q

Active transport of Na+, amino acids, vitamin C and B6, facilitated transport of glucose and vesicular transport of most macromolecules describes what?

A

Secretion

48
Q

Special receptors and energy are required to absorb what type of molecules into the CSF?

A

Organic bases, amino acids and K+

49
Q

How much CSF is produced per hour?

A

23ml

50
Q

How much CSF is produced per day?

A

600ml

51
Q

The choroid plexus produces what percentage of CSF?

A

2/3

52
Q

Extrachoroidal produces what percentage of CSF via Virchow Robins spaces and ependyma lining ventricles?

A

1/3

53
Q

How many times a day does the total CSF volume turn over?

A

5 times

54
Q

What is the space between the Cerebri cortex and pia mater covered blood vessels called?

A

Virchow-Robin spaces

55
Q

What areas do brain metabolic products leak into?

A

Virchow-Robin spaces

56
Q

CSF flow is mediated by what?

A

Pulsatile cerebral blood flow

57
Q

CSF outflow is proportional to what?

A

CSF pressure

58
Q

CSF formation is almost independent of what?

A

CSF pressure (at very high pressures it varies)

59
Q

CSF absorption is dependent upon what?

A

CSF pressure

60
Q

CSF is absorbed from what structure that is supplied by arachnoid villi and granulations which are extensions of the subarachnoid space?

A

Superior Sagittal sinus

61
Q

What are the 2 leading theories for CSF flow into the superior Sagittal sinus?

A

Vacuolar transport across arachnoid villus

One way channel bulk flow through arachnoid villus (leading theory)

62
Q

What percentage of CSF drains into the superior Sagittal sinus?

A

80%

63
Q

What percentage of the CSF drains into lymphatic drainage via cranial nerves and spinal cord roots?

A

10-25%

64
Q

A lumbar puncture is important in diagnosing what pathologies?

A

Infectious meningitis, neoplastic meningitis, small subarachnoid bleed

65
Q

A lumbar puncture is useful in what pathologies?

A

MS, acute motor polyneuropathy, benign intracranial hypertension, Guillain-Barré syndrome, narcolepsy with cataplexy

66
Q

A lumbar puncture is performed at what spinal cord level?

A

Between L3 and L4

67
Q

In a LB opening pressure is indicative of what?

A

Increased cranial pressure

68
Q

In an LB a cell count (WBC or RBC) is indicative of what?

A

Infection or hemorrhage

69
Q

In a LB decreased glucose is indicative of what?

A

Infection

70
Q

In a LB bacterial culture and gram stain is indicative of what?

A

Infection

71
Q

What are a few contraindications for doing a LB?

A

Mass in CNS with increased intracranial pressure
Obstructive hydrocephalus
Overlying lumbar skin infection
Bleeding disorder or thrombocytopenia

72
Q

The BBB is maintained by what?

A

Tight junctions between endothelial cells

Neurology (16 decks)

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