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NS-1 > CSF and Hydrocephalus > Flashcards

CSF and Hydrocephalus Flashcards

1
Q

Where is CSF produced?

A

primarily by choroid plexus in lateral ventrical (65%)

also in 3rd and 4th ventricles

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2
Q

What makes up the BBB?

A

continuous tight jxns in endothelial cells

basement membrane

asctrocyte foot processes

transport carriers for glucose and AAs

sodium ion transporters

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3
Q

How does the Blood-CSF barrier compare to the BBB?

A

more permeable

fenestrations in the endothelium

basement membrain

*tight jxns btw choroid cells (not endo cells like in BBB)

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4
Q

What occurs if there is a problem in the blood-csf barrier?

A

will see an increase in protein concentration in the CSF

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5
Q

Where do you do a lumbar puncture and what are you looking for?

A

btw L4 and L5

looking for an increase in protein content in CSF

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6
Q

What are the 4 main functions of CSF?

A

protection: shock absorber
buoyancy: pressure at base of brain is reduced
metabolic: one-way flow of CSF to blood takes toxins away

endocrine medium

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7
Q

Where is the interventricular foramen of monroe?

A

in btw lateral and 3rd ventricles

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8
Q

Where is the cerebral aqueduct?

A

btw 3rd and 4th ventricles

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9
Q

How does CSF leave the 4th ventricle?

A

2 lateral foramina of Luschka

1 median aperture/foramen of magendie

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10
Q

What is the flow of CSF?

A

choroid plexus –> lateral ventricles –> interventricular foramen –> 3rd –> crebral aqueduct –> 4th –> median aperture and foramenia of luschka –> subarachnoid space –> villi –> bloodstream

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11
Q

What is hydrocephalus?

A

excessive amount of CSF accumulates w/in cerebral ventricles and/or subarachnoid spaces –> ventricular dilation –> increased ICP

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12
Q

What can cause hydrocephalus?

A

overproduction of CSF (rare)

under-absorption of CSF

obstruction of outflow of CSF from ventricles

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13
Q

What are the 2 types of hydrocephalus?

A

communicating = non-obstructive

non-communicating = obstructive

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14
Q

What are the hallmarks of communicating hydrocephalus?

A

flow of CSF is blocked AFTER it leaves the ventricles

due to abnormalities that inhibit the resorption of CSF - at level of arachnoid villi

typically assoc w/ increased ICP

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15
Q

What is normal pressure hydrocephalus?

A

chronic communicating hydrocephalus

intermittently elevated CSF pressure

most common in adults over 60

*triad of sx: dementia, apraxic gait, urinary incontinence

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16
Q

What can cause normal pressure hydrocephalus?

A

increased viscosity of CSF

altered elasticity of ventricular walls

impaired absorption due to prior menigitis or subarachnoid hemorrhage

17
Q

What is hydrocephalus ex-vacuo?

A

compensatory enlargement of ventricles and subarachnoid spaces due to brain atrophy, post-traumatic, in some psych disorders

18
Q

What is a non-communicating hydrocephalus?

A

excess accumulation of CSF due to structural blockage of CSF flow w/in ventricular sys

can be concenital or acquired

can figure out where block is based on which ventricles are enlarged

19
Q

What is aqueductal stenosis?

A

narrowing of cerebral aqueduct blocking flow of csf –> non-communicated hydrocephalus

caused by tumor compression, gliosis (hypertrophy of glial cells, w/ hx of infection)

20
Q

What are the signs/sx of aqueductal stenosis?

A

thunderclap headache

papilledema

enlarged head (in infants)

decreased level of consciousness

upward gaze palsy

21
Q

What is the Dandy-Walker Malformation?

A

congenital bran malformation

obstruction at outlet of 4th ventricle + cerebellar hypoplasia

complete or partial agenesis of crebellar vermis

dandy-walker cysts: enlarged fourth ventricles

22
Q

What are sx of dandy-walker malformation?

A

frequent vomiting

tense anterior fontanelle

hypotonia

rapid enlargement of head circumference

23
Q

what is Chiari II malformation?

A

downward displacement of inferior cerebellar vermis, tonsils, and medulla through foramen magnum

usually w/ myelomeningocele

hydrocephalus in 90% of cases

24
Q

What are sx of chiari II malformation?

A

swallowing and breathing problems

feeding problems

poor bladder control

difficulty moving lower extremities

25
Q

What can cause acquired hydrocephalus?

A

brain tumor or cyst

blocked CSF flow

bleeding

trauma

infection

NS-1 (50 decks)

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