CNS blood flow CSF and spinal cord

Question 1

galea aponeurotica

Answer 1

protective layer: aponeurosis of the fascia of the occipitalis and frontalis muscles

Question 2

subgaleal space

Answer 2

below SCALP: space has small connections to dural sinuses

Question 3

what if the pressure in the dural sinuses increases?

Answer 3

blood can shift from the sinus out to the subgaleal space - decreasing the intracranial sinus pressure

Question 4

connection between dural and subgaleal space via the __ veins

Answer 4

emissary

Question 5

2 functions of emissary veins

Answer 5

1. they can move blood that has cooled by the cranium into the dural sinus - helping to cool the brain
2. if ICP is elevated - blood can be transferred the other way out to the scalp which can help decrease ICP

Question 6

___ amount of CSF at one time in ventricles

__ produced in one day

Answer 6

125-500ml CSF

600mL in one day

Question 7

arachnoid vill grow through ___

Answer 7

dura mater - forming tufts in the SSS

Question 8

arachnoid villi have___

Answer 8

one way valve function: venous blood cannot go backwards back into the ventricular space

Question 9

what should not be in CSF

Answer 9

red blood cells, bacteria, white cells ( or numbers should be pretty low)

Question 10

elevated PRO in CSF think..

Answer 10

• Cells that shouldn’t be there (RBC, WBC, bacteria)
• presence of cell breakdown (myelin dz, cancer, brain dz)
  Lots of disease that include inflammation

Question 11

low CSF glucose?

Answer 11

bacteria, cancer cells or lots WBC

Question 12

low ICP?

Answer 12

dehydration, shock, CSF leak (whole in meninges)

Question 13

high ICP

Answer 13

blockage of CSF
things that take up space in CSF containing regions
other CSF liquid space

Question 14

___ is primary regulator of CNS blood flow

Answer 14

CO2 carbon dioxide

Question 15

circle of willis is the connection of …

Answer 15

carotid and vertebral

Question 16

nucleus pulpous

Answer 16

gel inner middle of the disc

Question 17

conus medullaris is the __ around __

Answer 17

end of spinal cord around L1/ L2

Question 18

cauda equine is __

Answer 18

a nerve bundle at the end of the spinal cord that extends to S 5

Question 19

location of cell bodies for upper and lower motor neurons

Answer 19

upper: in brain, axons travel down cord to appropriate level and synapse with lower motor neuron there in spinal cord
lower: in gray matter of spinal cord, axons extend into PNS

Question 20

NT of lower motor neuron

Answer 20

acetylcholine

Question 21

upper motor neuron

Answer 21

glutamate

Question 22

posterior dorsal columns

Answer 22

afferent : basic perception of touch, priopioception, vibration
Fibers cross at medulla to contralateral side

Question 23

spinothalamic tract

Answer 23

afferent

vague sense of touch
pain sensations (nociception)
temperature sense

these fibers cross at site of entry
*2 synapses: at level of entry and at other levels nearby

Question 24

corticospinal tract

Answer 24

motor to areas below the hand
crosses at the medulla but 10% remain ipsilateral in anterior region

ipsilateral fibers innervate proximal muscles in extremities

Question 25

most common cause of central cord syndrome

Answer 25

hyperextension of the spinal cord

Question 26

arms are more effected with central cord syndrome

Answer 26

because sacral and lumbar fibers are more lateral in the corticospinal tract and rarely injuried

Question 27

sacral sparing

Answer 27

someone with central cord syndrome will have better rectal tone than anterior leg function

Question 28

anterior cord syndrome

Answer 28

usually from hyperflexion .. loss of motor function with preservation of position, vibration and touch sense

Question 29

brown sequard syndrome

Answer 29

penetrated injury damages one side of cord

motor loss and dorsal column sensory loss on the same side and spinothalamic sensory loss on opposite side

Question 30

cause of subacute degeneration

Answer 30

caused by B12 deficiency

leads to demyelinization of posterior and corticospinal tracts… can be perminant if not treated

Question 31

tabes dorsalis

Answer 31

loss of myelin within the posterior columns of spinal cord

cause: untreated syphilis
sx: decreased ability to sense proprioception, light touch and vibration below site of lesion

KEY: advanced syphilis, abnormal sensory, dorsal columns