CSF

Question 1

2 Linear Acceleration Lesions

Answer 1

Coup and often even bigger countrecoup

Question 2

Angular Acceleration

Answer 2

Brain doesn’t move w/ the skull, so fluid can actually make it compressed but tentatorium and cerebri and shit

Question 3

3 Driving Forces for CSF Flow

Answer 3

Pressure waves generated at production site
Respiration (inspiration CSF > cranium, expiration CSF > spinal column)
Ciliary Beat of Cells in Ependymal Lining

Question 4

CSF Production

Answer 4

Carbonic anhydrase produces H2O and HCO3- , latter which it actively pumps into CSF while bring K+ in and Na out

Question 5

2 Inhibitors of CSF Production

Answer 5

Oubain

Carbonic anhydrase inhibitors like diamox

Question 6

Ion Composition of Nascent CSF

Answer 6

Higher Na and HCO3-, and less K+

Question 7

CSF Absorption (4)

Answer 7

Follows pressure gradient so can reverse pathologically

Can’t be blocked by oubain and follows bulk flow

Question 8

CSF Pressure at Different Positions

Answer 8

Horizontal its constant, but upright actually neg pressure in head and high in spinal cord

Question 9

Pneumocephalus

Answer 9

Connection with outside area means upright neg head pressure causes air to rush in

Question 10

Monro-Kellie Principle

Answer 10

V(intracranial) is constant and is sum of V(blood/CSF/edema/whatever) so when one changes, the others respond

Question 11

Death by Pressure

Answer 11

Increased CSF pressure means blood can’t get to brain

Question 12

Jugular/Abdominal Compressions

Answer 12

Causes increase in pressure bc prevents blood or CSF lumbar drainage

Question 13

Sign of High CSF Pressure

Answer 13

Ocular structures coming out of macula densa not in same plane. Don’t draw CSF fluid from lumbar bc pressure difference could cause Chiari

Question 14

3 Symptoms of Increased Cranial Pressure

Answer 14

Headache
Vomiting
Blurred Vision

Question 15

Cushing’s Triad (& 3 symptoms)

Answer 15

Late stage increased cranial pressure: systolic hypertension, bradycardia, and depressed breathing

Question 16

3 Kinds of Hydrocephalus

Answer 16

e vacuo - from vacuum, like surgically removing hemisphere
Communicating - no impairment of flow. Either increased production or decreased absorption of CSF
Non-communicating - impairment of flow, often aqueduct from scarring or something

Question 17

Pseudotumor Cerebri (PTC)

Answer 17

Slight overproduction of CSF often in young females causes communicating hydrocephalus. Treat w/ diamox

Question 18

2 Shunts for Communicating Hydrocephalus and 1 Important Point

Answer 18

Either to jugular or peritoneal, but needs check valve to prevent backflow of blood

Question 19

2 Shunts for Noncommunicating Hydrocephalus

Answer 19

Ventriculo-cisternal or third ventriculostomy (create hole in 3rd ventricle to allow flow of CSF to basal cisternae

Question 20

2 Components of BBB

Answer 20

BBB proper and Blood-CSF barrier of choroid plexus

Question 21

2 Mechs of BBB Breakage and 3 Drugs

Answer 21

Osmotic: mannitol
Pharmacological: Bradykinin and zonulin (analogue to Vibrio cholerae zonula occludens toxin)