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Neuro Part I > CSF > Flashcards

CSF Flashcards

1
Q

CSF Pathway

A

choroid plexus -> lateral ventricles -> interventricular foramina -> III ventricle -> cerebral aqueduct -> IV ventricle

  • IV ventricle -> formen of Megendie -> cisterna magna -> superior cistern -> SAS
  • IV ventricle -> 2 foramina of luschka -> pontine, interpeduncular, and chiasmatic cisterns -> SAS

SAS -> arachnoid villi -> superior sagittal sinus -> right transverse sinus -> sigmoid sinus -> internal jugular vein

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2
Q

CSF Production

A

70-75% secreted by choroid epithelia in

  • lateral ventricles
  • roof of III and IV ventricles
  • two interventricular foramina
  • two formania of Luschka

rest from extrachoroidal sources

  • cerebral capillary walls
  • H20 production via metabolism
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3
Q

Choroid Plexus

A

70-75% of CSF production

choroid plexus capillary, fenestrated

choroid plexus epithelium, tight junctions -> BBB

    1. ciliated - CSF circulation
    1. many mitochondria - active secretion
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4
Q

CSF Volume Distribution

A

140 mL total

  • 30 mL in ventricles
  • 80 mL in brain SAS
  • 30 mL in spinal SAS

500 mL produced per day

replaced 3-4 times per day in order to

  • remove harmful metabolites
  • homeostasis of environment
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5
Q

CSF Functions

A
  1. remove harmful metabolites
  2. maintain constant environment for neurons, glia
  3. protection of CNS from trauma
  4. distribute neuroactive hormones
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6
Q

CSF Composition

A

CSF has

  • less protein
  • less K+, Ca2+, pH
  • more Mg2+, Cl–, lactate, H2O
  • equal Na+
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7
Q

CSF Appearance - Clear, Colorless

A

normal

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8
Q

CSF Appearance - Yellow, Bloody

A

hemorrhage

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9
Q

CSF Appearance - Protein > 150 mg/dl

A

bilirubin from plasma

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10
Q

CSF Appearance - Protein > 500 mg/dl

A

block in SAS by tumore, meningeal cancer, or other compressing lesion

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11
Q

CSF Appearance - WBCs

A

neuts = bacterial meningitis

lymphocytes = fungal

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12
Q

CSF Appearance - Decrease in Glucose

A

acute bacterial infection

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13
Q

CSF Appearance - Gamma Globulin

A

MS, inflammatory disorders

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14
Q

Hydrocephalus

A

“water in the brain” leading to increased intracranial pressure, enlargement of the ventricles at the expense of the surrounding brain

due to…

a) oversecretion of CSF = communicating hydrocephalus
b) impaired reabsorption of CSF = communicating hydrocephalus
c) obstruction in CSF circulation = noncommunicating hydrocephalus

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15
Q

Fluid Compartments and Barriers

A

(1) vascular, (2) CSF, (3) extracellular/interstitial

Blood-CSF Barrier

CSF-Brain Barrier

Blood-Brain Barrier

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16
Q

Blood-CSF Barrier

A
  • formed by tight junctions of choroid epithelia
  • important in the transport of nutrients that are needed in small amounts over long periords of time (VitC, Vit6, folates)
17
Q

Blood-Brain Barrier

A

formed by

  • tight junctions and continuous basement membrane of endothelial cells of brain capillaries
  • perivascular foot processes of astrocytes

regulates diffusion of metabolites and metabolic products that the brain consumes rapidly (gluose, lactate, amino acids, ribonucleases)

  • transport occurs via diffusion (lipid-soluble, hydrophobic), passive/active carriers, ion channels/exchangers
18
Q

CSF-Brain Barrier

A

ependymal cells lining ventricles and intercellular space, no tight junctions, free bidirectional exchange

19
Q

Failure of the BBB can occur with…

A
  • primary tymors or metastasis (-> vasogenic edema)
  • stroke or bacterial meningitis
  • MS (T lymp enter and atttack myelin, brain, spinal cord)
  • imflammation -> seizures, epilepsy

can exaccerbate neurological consequences of traumatic brain injury, HIV demementia, HTN, brain hemorrhage, and exposure to radiation or nerve gas

20
Q

Types of Brain Edema

A

vasogenic

  • increased permeability of BBB and capillaries -> increased brain ISF -> increased intracranial pressure -> smaller ventricles
  • caused by stroke, ischemia, head trauma, meningitis, tumor

cytotoxic

  • increased intracellular fluid volume (cell swelling) due to a failure of energy dependent mechanisms leading to accumulation of water inside cells -> decrease in brain ISF, increased intracranial pressure, reduction of ventricle size
  • caused by drug poisoning, hyponatremia, water intoxication, hypoxia/ischemia

Neuro Part I (8 decks)

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