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physio > cortical deficits, cerebral blood flow, and CSF > Flashcards

cortical deficits, cerebral blood flow, and CSF Flashcards

1
Q

What is motor apraxia?

A

uncoordinated and on-purposeful movements after lesions to specific regions fo premotor cortex

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2
Q

dyslexia

A

visual receptive aphasia (word blindness)- unable to appreciate meaning of written word; angular gyrus

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3
Q

auditory receptive aphasia

A

unable to appreciate meaning of sounds; medial temporal lobe

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4
Q

somatosensory agnosia

A

unable to perceive stimuli related to touch; parietal cortex

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5
Q

anomia

A

unable to name object; lateral occipital/temporal lobe

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6
Q

prosopagnosia

A

unable to recognize faces; ventral temporal lobe

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7
Q

How much of the resting cardiac output goes to the cerebral blood flow?

A

15%

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8
Q

nutrients require transporters into pervascular space; what is is?

A

astrocytes end feet supply neurons

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9
Q

Glucose uptake in the brian independent of insulin via….

A

GLUT 1 or GLUT 2

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10
Q

What occurs when there is no glucose to the brain?

A

glycogen in neurons is sufficient for about 2 minutes

-after 2 minutes may result in coma or death

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11
Q

What controls CBF directly?

A

chemoreceptors in periphery and brainstem

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12
Q

What regulates CBF?

A

glutamates

astrocytes calcium wave dilates vessels

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13
Q

What are the 4 large arteries invovled in cerebral blood supply?

A

2 internal carotid arteries (anteriror circulation), 2 vertebral arteries (posterior circulation)

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14
Q

Merging of arteries forms the Circle of Willis. What is the anterior supply made of?

A 
Middle cerebral (2)
Anterior cerebral (2)
Anterior Communication
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15
Q

Merging of arteries forms the Circle of Willis. What is the posterior supply composed of?

A 
Posterior Communicating (2)
Posterior Cerebral (2)
Superior Cerebellar (2) Basilar
Anterior Inferior Cerebellar Vertebral (2)
Posterior Inferior Cerebellar(2)
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16
Q

What is the watershed area of the anteriror cerebral artery supply?

A

adjacent arterial branches supply the same cortical region

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17
Q

What does the anterior cerebral artery supply blood to?

A

medial cortex

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18
Q

What does the posterior cerebral artery supply blood to?

A

occiptal and medial temporal cortex

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19
Q

lesions in the posteriror cerebral artery supply would cause what?

A

deficits in vision and apsects fo memory

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20
Q

What does the middle cerebral artery (MCA) supply?

A

almost entire lateral surface fo the brain

21
Q

What are the components of the superior division of the middle cerebral artery supply?

A

Frontal, parietal
Deep vessels supply key internal structures
Broca’s area

22
Q

What are the components fo theinferior division of the middle cerebral artery supply?

A

Temporal lobe and small portion of occipital lobe

Wernicke’s area

23
Q

What do the lenticulostriate arteries do?

A

supply basal ganglia and interal capsule

24
Q

What does a rupture of lenticulostriate arteries do?

A

cerebrovascular accident (CVA) and extreme functional deficits

25
Q

in local autoregulation of the CBF; what does increase in H+ do?

A

causes vasodilation to increase CBF, depresses neuronal activity

26
Q

in local autoregulation of CBF; what does an oxygen deficiency do?

A

angiogenesis increases vascularity and oxygen supply

27
Q

Increased [H+] in the brain causes….

A

increase CBF, decreased neuronal activity

28
Q

What effect do alkaline conditions have on CBF?

A

increase neuronal activity, increase CO2, and increase H+

29
Q

What is the CNS ischemic respone?

A

activates by severe cerebral ischemia ‘emergency response’

  • CO2 activates chemorecptors directly in vasomotor center (medulla)
  • extreme increase in BP increase CBF dfor ten minutes
  • increased flow at expense of other orgams (kidney, heart)
30
Q

What is vasovagal syncope in ANS regulation of vasomotor center?

A

intense empotion (limbic circuits) activate anterior hypothalamus to increase vasodilation and cause fainting

31
Q

What is the mechanism of the astrocytes in CBF?

A

high neuronal activity cause increas in glutamate release
astrocytes take up glutamate which tirggers calcium waves
calcium waves cause release of vasoactive metabolites whcih cause artery dilation and increase in CBF

32
Q

Functions of CSF

A

cushions th ebrina
nmaintians nutrients
detoxification by microglia
signaling-circumventricular organs, pineal and area postrema monitor and regulate CSF

33
Q

What is the CSF flow sequence?

A

lateral ventricles–> third ventricle–> aqueduct of sylvius–> fourth ventricle–> foramen of magendie–> cisterna magna–> subarachnoid space–> arachnoidal villi

34
Q

What produces CSF?

A

choroid plexus- mostly from lateral ventricle

35
Q

How much CSF is produced a day?

A

500 mL

36
Q

What is the mechanism of CSF production?

A

sodium actively transported by epithelial cells into ventricle, chloride follows, water then follows (osmosis)

37
Q

CSF composition is similar to blood; what are the components?

A

[Na+ ] ~ equal to blood
[Cl – ] ~ 15% > than blood
[K + ] ~ 40% < than blood
[Glucose ] ~ 30% < than blood

38
Q

What is the BBB composed of?

A

tight junctions on capillary endothelial cells, tight junction on arachnoid cells and by specialized ‘leaky’ junctions on cells in choroid plexus

39
Q

What are circumventricular organs?

A 
blood brain barrier 'leaky' in certain areas
Median eminence
Endocrine releasing
factors
Pineal- melatonin and serotonin release modulates circadian rhythm
Subfornical organ-
Osmoreceptors and thermoceptors
Organum vasculosum- Osmoreceptors
40
Q

CSF drainage perivascular space

A

continuous with subarachnoid space- route for discharge of toxins, debris, and waste

41
Q

Two types of CVA (stroke)

A

ischemic and hemorrhagic

42
Q

causes of ischemic stroke

A

thrombosis (local blood clot) embolism (fragment of blood clot), systemic hypotension (severe shock), venous thrombosis (dural venous sinuses)

43
Q

4 types of hemorrhage which causes blood accumulation

A
  1. extradural- between skull and dura mater
  2. subdural- between dura and arachnoid
  3. subarachnoid- between arachnoiid and pia
  4. intracerebral- within brain parenchyma (intraparenchymal)
44
Q

characteristics of extradural hemorrhage

A

lens shape
rupture of feeder arteries
onset 3-4 hrs

45
Q

characteristics of subdural hemorrhage

A

crescent shape

rupture of bridging veins (dural drianage)

46
Q

characteristics of subarachnoid hemorrhage

A

along gyri/sulci
sudden rupture of cerebral vessel or aneurysm
“thunderclap” headache

47
Q

characteristics of intracerebral hemorrhage

A

deep penetrating vessels

~10% of cerebral hemorrhage

48
Q

Lesions increase intracranial pressure (ICP); what can this cause?

A

compression of vasculature causing ischemia (coma/death)
increases capillary pressure causing additional edema
vicious cycle causes herniation of vital neurological sturctures and cranial nerves resulting in coma/death

physio (14 decks)

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