General Neurophysiology Flashcards

1
Q

Describe the Formation of CSF.

A
  • Most of the CSF (50-70%) is made by the CHOROID PLEXUS
  • Remaining CSF is made by the tissue that lines the ventricles and blood vessels 2 step Process:
  • Passive filtration of the Serum
  • HCO3, Cl, and K concentrations controlled by channels on epithelial cells. Aquaporins also exist
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2
Q

How much CSF is flowing at any moment? How much do you make a day?

A

~150 mL

~ 550 mL/day because the CSF is NOT recirculated

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3
Q

Differentiate between the composition of the CSF and the Plasma.

A

** Na+: Higher or the same in CSF

Cl- & HCO3: SAME in the two

Higher in CSF: Mg2+; CO2

Lower in CSF: K+; Ca2+; Protein; Glucose

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4
Q

Describe the Flow of the CSF.

A
  • One way Flow and it is NOT re-circulated
  • Major Absorption point is at the Arachnoid Villi into the Venous sinus (Primary way of absorption); Endothelium of SINUS and the membrane on the VILLI have fused
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5
Q

Describe the relationship between Intracranial pressure and Absorption of CSF. What is the normal intracranial pressure?

A

Absorption of CSF is PROPORTIONAL to Intracranial Pressure

  • At pressure below 68 mm CSF, NO ABSORPTION

Normal Pressure: 112 mm CSF

  • Increased Pressure changes can damage neurons
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6
Q

List the two MAIN components of the Blood-Brain Barrier.

A
  1. Tight Junctions between endothelial cells
  2. Glial endfeet come in close contact with blood vessel
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7
Q

What can pass through the Blood-Brain Barrier through Passive diffusion?

A
  1. H2O
  2. CO2
  3. O2
  4. Free steroid hormones
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8
Q

What is the major energy source for neurons?

A

GLUCOSE

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9
Q

Which Glucose transporter is going to be in the brain? Describe some of its properties

A

GLUT1

  • Located on the Endothelial Cells (55K) and Astroglial End-Feet (45K)
  • NOT insulin-dependent!
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10
Q

Describe the purpose of the Na/K/2Cl Transporter in the Blood-Brain Barrier.

A

Moves all ions FROM CSF TO blood

  • Expression of the transporter is tied to Endothelin 1 and 3
  • May be related to the [K+] in the CSF
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11
Q

What is the function of P-Glycoprotein (Multi-Drug Resistance 1) in teh Blood-Brain Barrier?

A

It will pump substances back out into the blood that should not have entered into the CSF!

** Protects the composition of the CSF

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12
Q

Define what is meant by “Circumventricular Organs.” Where are the four regions found that fall into this category?

A

Regions in the brain that lack TIGHT JUNCTIONS between the endothelium.

  1. Posterior Pituitary (Neurohypophysis)
  2. Area Postrema (Right @ the opening of the 4th ventricle); Strongly associated with VOMITTING (manages toxins that enter the blood stream)

3 & 4. Organum vasculosum of the lamina terminalis (OVLT) and Subfornical organ (Both involved in control of body water/thirst/blood volume control)

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13
Q

How much of the Cardiac Output will go to the Brain?

A

15-20%

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14
Q

Describe the Cerebral Circulation of the Brain (Circle of Willis).

A

Mainly supplied by the Internal Carotid Arteries and the Basilar Artery (Fusion of the two Vertebral Arteries)

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15
Q

Describe the Blood Flow in the Circle of Willis and what happens if there is a disruption of blood from one of the arteries.

A
  • Little mixing of the blood from the different sources
  • Disruption of one of the inputs will produce LOCALIZED areas of ischemia
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16
Q

Describe the Sympathetic Innervation to Cerebral Circulation.

A
  • Neurotransmitters: Norepinephtine & NPY
  • Receptors: a-adrenergics
  • Leads to CONSTRICTION when systemic Cardiac Output/Blood Pressure increases (Protects capillaries in brain from high blood pressure)
17
Q

Describe the Parasympathetic Innervation to the Cerebral Circulation.

A
  • Neurotransmitters: Ach
  • Vasoactive Intestinal Polypeptide (VIP)
  • Causes VASODILATION
18
Q

List the neurotransmitters that will cause vasodilation in relation to the sensory fibers associated with Cerebral Circulation.

A
  1. Substance P
  2. Neurokinin A
  3. CGRP
19
Q

Explain the role of sensory innervation to the Cerebral Circulation.

A
  • In the presence of reduced CSF volume, the brain is effectively heavier and simple motion can cause pain because of the ‘torsion’ of the blood vessels.
20
Q

Explain the control of the blood flow in the Cerebral Circulation.

A
  • Under LOCAL control
  • OXYGEN Consumption will dictate where in brain the blood will flow
21
Q

Explain the relationship between Cerebral Blood Flow and Intracranial Pressure (Also relate it to Sympathetics and Mean Arterial Pressure).

A

As Intracranial pressure goes UP; Venous Outflow is Obstructed which will lead to a REDUCED arterial flow

  • You will be doing damage to the Blood-Brain Barrier if you increase Mean Arterial Blood Pressure above 140 mmHg
  • Sympathetics will INCREASE the range of blood pressure that the body can have before you do harm to the brain (They will VASOCONSTRICT the vasculature in the brain for protection)
22
Q

What will happen if brain perfusion decreases?

A

Activation of vasomotor centers will force the SYSTEMIC Blood Pressure to Increase Drastically (I.e 300/220 mmHg)

23
Q

What are some things that can increase Intracranial Pressure?

A
  • Hydrocephalus of any variety
  • Edema
  • Bleeding within the skull