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Bioscience II > Neurological System V > Flashcards

Neurological System V Flashcards

1
Q

***In what areas is CSF located?

A
  • Cerebral ventricles
  • Cisterns
  • Subarachnoid space surrounding the brain and spinal cord
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2
Q

What are the major functions of CSF?

A
  • Provides support
  • Regulates ionic composition
  • Removes metabolites
  • Protects brain and spinal cord against trauma
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3
Q

The cranial vault is a rigid structure with a fixed total volume, what the percentages of volume contained in each component of the central nervous system?

A
  • Brain (80%)
  • Blood (12%)
  • CSF (8%)
  • An increase in one compartment must be offset by an equivalent decrease in another
  • Due to its’ rigid structure, the brain cannot tolerate an increase in pressure after age 2.
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4
Q

What are the characteristics of CSF and what can this tell us about the state of the brain?

A
  • Clear
  • Colorless
  • Odorless
  • Alterations in composition present in various disorders
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5
Q

What are the two parts in the system that comprises CSF?

A
  • Internal portion

- External portion

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6
Q

Communication of the internal and external portions occur through what 2 apertures?

A
  • Foramen of Luschka

- Foramen of Magendie

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7
Q

***What is the normal amount of CSF in adults?

A
  • About 150mL combined in all spaces
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8
Q

***How much CSF is produced and absorbed daily?

A
  • 400-500 mL

- 21 mL per hour

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9
Q

***What is the normal mean CSF pressure?

A
  • 70-180 mmH20

- Memorization tool: The numbers are just about 10 higher than the CPP range of autoregulation (60-160). Likely not

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10
Q

The pressure of the CSF rises if what factors occur?

A
  • Intracranial volume
  • Blood volume
  • CSF volume
  • All increases in the cranial vault
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11
Q

***CSF production is formed primarily where?

A
  • Choroid plexuses of the cerebral ventricles
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12
Q

Small amounts of CSF is also formed directly by what other neurological structures?

A
  • Ependymal cell lining

- And even smaller amounts from perivascular spaces surrounding cerebral vessels

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13
Q

How is CSF secreted?

A
  • Active transport of sodium ions through ependymal cells

- The resulting fluid is isotonic with plasma despite lower potassium, bicarbonate, and glucose concentrations

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14
Q

***What are the factors that decrease CSF production?

A
  • Carbonic anhydrase inhibitors (Glaucoma medication)
  • Corticosteroids
  • Spironolactone (diuretic)
  • Furosemide (diuretic)
  • Isoflurane
  • Vasoconstrictors
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15
Q

***What is the pathway of CSF circulation?

A
  • Lateral ventricles
  • Interventricular foramina (of Monro)
  • Third Ventricle- Cerebral aqueduct (of Sylvius)
  • Fourth ventricle
  • Median aperture (foramen of magendie) and lateral apertures (foramina of Luschka)
  • Cisterna magna
  • Subarachnoid space
  • Brain and spinal cord
  • Absorbed in arachnoid granulations over cerebral hemispheres
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16
Q

How does CSF absorption occur?

A
  • It involves translocation of fluid from arachnoid granulations into cerebral venous sinuses in the superior sagittal sinus.
  • Endothelial cellsof villi contain opening that permits the free flow of CSF, protein, and RBCs into venous circulation
17
Q

***What is the relationship between CSF absorption and ICP and cerebral venous pressure?

A
  • Directly proportionate to ICP (Increase in CSF, increase in absorption)
  • Inversely proportionate to cerebral venous pressure (Decrease in cerebral venous pressure, increase in CSF absorption)
  • **Entire CSF volume replaced every 3-4 hours
18
Q

***What are the factors that affect the absorption of CSF?

A
  • Blockage of villi by cell debris or fibrosis
  • Tumors or hemorrhage which increase ICP
  • Specific volatile anesthetic agents (Halothane)
19
Q

***What does restriction of the circulatory pathway of CSF lead to?

A
  • Dilation of the ventricles upstream (hydrocephalus)
  • CSF production continues despite obstruction
  • Ventricles expand
  • Gyri flatten
  • If skull is still pliable, the head may enlarge
20
Q

In communicating hydrocephalus, where is the obstruction?

A
  • In the subarachnoid space due to thickening of the arachnoid with a resultant block of return block of return-flow channels
  • This can be the result of prior bleeding or meningitis
  • If ICP increases as a result of excess CSF, the central canal of the spinal cord may dilate
21
Q

How do you treat noncommunicating hydrocephalus or improve absorption in general?

A
  • Various procedures have been developed to bypass the obstruction
  • V/P Shunt

Bioscience II (6 decks)

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