The Ventricular System & Circulation of CSF Flashcards

1
Q

Ventricles:
- are
- derived from
- purpose

A
  • small cavity/chamber
  • derived from the expansion and
    folding of the neural plate
  • to produce and distribute CSF
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2
Q

Ventricles Embryology:

A
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3
Q

The neural tube is formed as it

A

detaches from the epiblast = neurulation

The neural crest cells seal the remaining space at the cranial and caudal ends are called the neuropores

If the pores do not seal causes congenital abnormalities

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4
Q

What cells develop into the PNS?
What cells develop into the CNS?

A
  • neural crest cells detach and create
    the PNS
  • the neural tube creates the CNS
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5
Q

Formation of Brain Vesicles:

A

neural tube starts to expand into three balloons at the top (prosencephalon, mesencephalon and rhombencephalon)

the three balloons then develop into 5 different components, which then fold in on themselves to create the brain

the rest of the tube forms the spinal cord

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6
Q

Brain Flexures:

A

the five different components fold in on themselves: in the brain we have the cerebral hemispheres on top, then the midbrain and then the cerebellum

forms different flexures: midbrain flexures, pontine flexure

(hollow cavity)

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7
Q

Lateral ventricles are next to which parts of the brain

A

telencephalon and prosencephalon

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8
Q

Aquaduct is

A

the ventricular system near midbrain

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9
Q

Central Canal:

A

hole in the middle of the spinal cord

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10
Q

Foramen of Monroe are

A

2 holes that divide the lateral ventricles

INTERVENTRICULAR

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11
Q

Foramen of Magendie and Foramen of Luschka

A

foramina connect the interventricular system so that CSF can leave the sealed structure

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12
Q

The Ventricular Pathway:

A
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13
Q

The Ventricular Pathway:

A
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14
Q

Dandy-Walker Malformation:

A
  • developmental problem with
    ventricular system resulting in an
    expanded fourth ventricle
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15
Q

Dandy-Walker Malformation:

A
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16
Q

What cells line ventricles?

A

Choroid cells = specialised ependymal cells
Ependymal cells = specialised glial cells

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17
Q

Choroid Cells:
- function

A

to produce cerebrospinal fluid (CSF)

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18
Q

Where does the majority of choroid cells lie?

A

The lateral ventricles

19
Q

What allows contact of CSF with brain cells?

A

leaky lining?

20
Q

***Choroid plexus:

A

network of choroid cells with capillaries

21
Q

Draw choroid plexus:

A
22
Q

Label diagram on addendum A

A

Choroid plexus

one confluent tube system

23
Q

Formation of CSF:

A

insert diagrams

First diagram blue = ventricles
green = ependymal cells

Second diagram shows fenestrated capillaries allowing substances to seep out into the extracellular space

in order for molecules to move from outside of capillaries and into CSf they have to pass through the choroid cells

they can not pass between the choroid cells because the choroid cells have tight junctions

Channels in choroid cells allow substances to pass into CSF.

Choroid cells also contain carbonic anhydrase which breaks down water into CO2 and H2

creates an acid, which can act as a buffer

24
Q

What is the composition of CSF determined by?

A

the channels the choroid cells possess

25
Q

Drugs that impact the kidneys can impact the brain

A

because channels found in cells lining kidney are same/similar to those found in choroidal cells

26
Q

CSF Production Cellular Level:

A

Water is broken down into bicarb which is pushed over by opposite flow of Na+ and K+

Creates fluid

27
Q

Drugs that inhibit carbonic anyhydrase results in

A

alteration of CSF production (slows down)

28
Q

CSF:
- is
- looks
- how much produced a day?
- means
- normal CSF pressure
- function

A
  • specialised version of blood
  • clear and colourless
  • 500ml per day, only need 150ml
  • rate of production = rate of
    reabsorption (high turnover results
    in efficient waste disposal)
  • 5-18cmH2O
  • offers mechanical and chemical
    protection
29
Q

CSF vs Plasma table

A
30
Q

The Blood Brain Barrier:
- function
- formed by
- areas that lack BBB
- hence

A
  • protects the brain from rapid shifts
    in electrolytes and metabolities
  • formed by tight junctions
  • choroid plexus and circumventricular
    organs (like pineal gland) lack a BBB
  • circumventricular organs are directly
    exposed to blood solutes ->
    neuroendocrine control
31
Q

Blood Brain Barrier:

A

capillaries inside the brain are unfenestrated

three different aspects:
- thick basement membrane
- tight junctions between cells
- astroctyes are a different glial cells
which seal off the capillary hence
offer a protective mechanism to the
brain and are involved in cell
signalling

32
Q

CSF Circulation:

A

CSF circulates in the ventricular system
three hollow tubes that allow CSF to travel into meningeal layers
between the pia mater and arachnoid mater hence in the sub-arachnoid space

fluid bathes brain in the sub-arachnoid space

***arachnoid granulations are outpouchings from the arachnoid layer into the dural layers, allowing waste products to travel into the venous system via the dural venous sinus

  • The CSF passes
    from the lateral
    ventricles to the
    third ventricle
    through the
    interventricular
    foramen (of Monro).
  • From the third
    ventricle, the CSF
    flows through the
    cerebral aqueduct
    (of Sylvius) to the
    fourth ventricle.
  • From the fourth
    ventricle, some CSF
    flows through a
    narrow passage
    called the obex and
    enters the central
    canal of the spinal
    cord. However, the
    majority of CSF
    passes through the
    apertures of the
    fourth ventricle; the
    median aperture (of
    Magendie) and two
    lateral apertures (of
    Luschka). Via these
    openings, the CSF
    enters the cisterna
    magna and
    cerebellopontine
    cisterns,
    respectively.
  • From there, the CSF
    flows through the
    subarachnoid space
    of the brain and
    spinal cord.
  • It is finally
    reabsorbed into the
    dural venous
    sinuses through
    arachnoid
    granulations.
33
Q

CSF Cisterns and the Venous System:

A
34
Q

CSF Cistern:

A
  • pools of CSF in larger spaces
  • eg pre-pontine cistern
35
Q

CSF Venous System: end-point:

A

All dural venous sinuses drain into the sigmoid sinuses which drain into the internal jugular vein, which combines with the subclavian veins to form the brachiocephalic veins which combine to form the superior vena cava at T4/5

36
Q

Glymphatic System

A

Arteries in the brain dive down into the brain, penetrating arteries creates a space between the tissue and and the vessels

move from periarterial to the perivenous space and then into venous sinuses

**occurs through channels called aquaporin 4 channels and through force/connective flow

37
Q

Problems with CSF Circulation:

A
  • higher pressure:
    - blockage of flow (stenosis,
    thrombosis)
    - overproduction (choroid plexus
    papilloma)
    - reduced reabsorption (neoplasm)
  • lower pressure:
    - leak (trauma/spina tap) causing
    brain sag
38
Q

Hydrocephalus:

insert diagram

A
  • fluid on the brain
  • two types:
    • communicating (no problem with
      the hydrocephalus)
    • non-communicating = blockage
39
Q

Hydrocephaly on CT:

A
  • fluid expands, squashes brain
    because brain is sealed
  • in child head is still moldable as it is
    growing, lateral ventricles will
    expand, makes the skull expand =
    make sure head circumference is
    correct
40
Q

Treatment of Hydrocephaly:

A
  • drugs that inhibit carbonic
    anhydrase (not very fast)
  • surgical intervention = put a tube in
    ventricles to remove some fluid, add
    tube down into peritoneum =
    ventriculo-peritoneal shunt
41
Q

Lumbar Puncture:

A
  • diagnostic tool
  • into cauda equina (around L3/4/5)
42
Q

CSF Analysis:

A
43
Q

Environment of the brain and spinal cord is protected by CSF both mechanically and chemically.

A

bouyancy
nutrients

44
Q
A