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Year 2 Medicine > Ventricular System > Flashcards

Ventricular System Flashcards

1
Q

What are the ventricles?

A
  • Series of CSF-filled interconnected spaces
    • Continuous with the subarachnoid space and central canal
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2
Q

Ventricular System

  • Series of …-filled interconnected spaces
  • Continuous with the … space and central canal
A
  • Series of CSF-filled interconnected spaces
  • Continuous with the subarachnoid space and central canal
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3
Q

Subarachnoid space - Between … and … layer of meninges

A

Subarachnoid space - Between pia and arachnoid layer of meninges

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4
Q

Development of the ventricles

  • … forms neural tube
  • … of neural tube becomes ventricles and central canal
  • Ependymal layer lines … and central canal
A
  • Neuroectoderm forms neural tube
  • Lumen of neural tube becomes ventricles and central canal
  • Ependymal layer lines ventricles and central canal
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5
Q

Development of the ventricles

  • Lumen expands at … end to form ventricles
  • There is a … associated with each part of the brain
A
  • Lumen expands at cranial end to form ventricles
  • There is a ventricle associated with each part of the brain
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6
Q

Lateral Ventricles

  • Two lateral ventricles (surrounded by ….)
  • Very large …-shape (one for each cerebral hemisphere)
  • Divided into:
    • Body - … lobe
    • Anterior horn - … lobe
    • Posterior horn - .. lobe
    • Inferior horn - … lobe
A
  • Two lateral ventricles (surrounded by telencephalon)
  • Very large C-shape ( one for each cerebral hemisphere)
  • Divided into:
    • Body - parietal lobe
    • Anterior horn - frontal lobe
    • Posterior horn - occipital lobe
    • Inferior horn - temporal lobe
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7
Q

Lateral Ventricles

  • … lateral ventricles (surrounded by telencephalon)
  • Very large C-shape ( one for each cerebral hemisphere)
  • Divided into:
    • … - parietal lobe
    • .. horn - frontal lobe
    • … horn - occipital lobe
    • … horn - temporal lobe
A
  • Two lateral ventricles (surrounded by telencephalon)
  • Very large C-shape ( one for each cerebral hemisphere)
  • Divided into:
    • Body - parietal lobe
    • Anterior horn - frontal lobe
    • Posterior horn - occipital lobe
    • Inferior horn - temporal lobe
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8
Q

What is the best imaging to view the lateral ventricles?

A

MRI

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9
Q

Lateral ventricles on MRI

  • CSF on T1 weighted appears …
A

black

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10
Q

Lateral ventricle borders

  • Septum … separates lateral ventricles - both white and grey matter
  • Corpus callosum sits in …
  • … nucleus sits in lateral wall
  • … (part of limbic system) sits in floor of inferior horn
A
  • Septum pellucidum separates lateral ventricles - both white and grey matter
  • Corpus callosum sits in roof
  • Caudate nucleus sits in lateral wall
  • Hippocampus (part of limbic system) sits in floor of inferior horn
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11
Q

Lateral ventricle borders

  • … … separates lateral ventricles - both white and grey matter
  • Corpus callosum sits in roof
  • Caudate nucleus sits in lateral wall
  • Hippocampus (part of limbic system) sits in floor of … horn
A
  • Septum pellucidum separates lateral ventricles - both white and grey matter
  • Corpus callosum sits in roof
  • Caudate nucleus sits in lateral wall
  • Hippocampus (part of limbic system) sits in floor of inferior horn
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12
Q

Interventricular foramen

  • Lateral ventricles communicate with the … ventricle through the Interventricular foramen
    • (also called Foramen of …)
A
  • Lateral ventricles communicate with the third ventricle through the Interventricular foramen
    • (also called Foramen of Monro)
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13
Q

Lateral ventricles communicate with the third ventricle through the ….

A

Interventricular foramen

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14
Q

Third ventricle

  • Third ventricle appears as a …-like cleft
  • Thalami sit in lateral walls
  • … forms the roof
A
  • Third ventricle appears as a slit-like cleft
  • Thalami sit in lateral walls
  • Fornix forms the roof
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15
Q

Summary of associated structure - Ventricles

A
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16
Q

Cerebral aqueduct

  • … ventricle communicates with … ventricle through the cerebral aqueduct
  • Also called Aqueduct of Sylvius
  • Surrounded by the …
A
  • Third ventricle communicates with fourth ventricle through the cerebral aqueduct
  • Also called Aqueduct of Sylvius
  • Surrounded by the midbrain
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17
Q

Third ventricle communicates with fourth ventricle through the … …

A

Third ventricle communicates with fourth ventricle through the cerebral aqueduct

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18
Q

Fourth ventricle

  • Surrounded by …:
    • … posterior
    • Pons and medulla anterior
    • Cerebellar peduncles lateral
    • superior and inferior medullary … form the roof
  • Continuous with the central canal of the spinal cord and … space
A
  • Surrounded by hindbrain:
    • Cerebellum posterior
    • Pons and medulla anterior
    • Cerebellar peduncles lateral
    • superior and inferior medullary velum form the roof
  • Continuous with the central canal of the spinal cord and subarachnoid space
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19
Q

Fourth ventricle

  • Surrounded by hindbrain:
    • Cerebellum posterior
    • … and … anterior
    • … peduncles lateral
    • superior and inferior … velum form the roof
  • Continuous with the … canal of the spinal cord and subarachnoid space
A
  • Surrounded by hindbrain:
    • Cerebellum posterior
    • Pons and medulla anterior
    • Cerebellar peduncles lateral
    • superior and inferior medullary velum form the roof
  • Continuous with the central canal of the spinal cord and subarachnoid space
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20
Q

How does the fourth ventricle communicate?

A
  • Three foramina exit into subarachnoid space:
    • 2 Foramen of Luschka (lateral)
    • 1 Foramen of Magendie (middle)
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21
Q

Fourth ventricle communication

  • Three foramina exit into subarachnoid space:
    • 2 Foramen of … (lateral)
    • 1 Foramen of … (middle)
A
  • Three foramina exit into subarachnoid space:
    • 2 Foramen of Luschka (lateral)
    • 1 Foramen of Magendie (middle)
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22
Q

In a coronal view of the fourth ventricles, what is the shape?

A

Rhomboid (diamond) shape of fourth ventricles

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23
Q

CSF produced by … …

A

CSF produced by choroid plexus

24
Q

Choroid Plexus

  • … produced by choroid plexus
  • Filters blood from branches of internal carotid and basilar arteries
  • Choroid plexus present throughout ventricles:
A
  • CSF produced by choroid plexus
  • Filters blood from branches of internal carotid and basilar arteries
  • Choroid plexus present throughout ventricles:
25
Q

Structure of the choroid plexus

  • Very simple structure
  • Capillary network surrounded by … epithelium
  • During CSF production
    • Blood filtered through … capillaries
    • Components transported through … epithelium into ventricles
A
  • Very simple structure
  • Capillary network surrounded by cuboidal epithelium
  • During CSF production
    • Blood filtered through fenestrated capillaries
    • Components transported through cuboidal epithelium into ventricles
26
Q

Structure of the choroid plexus

27
Q

Cuboidal epithelium

  • Specialized ependymal cells
  • … present to increase SA
  • Actively transport … components (or by facilitated diffusion)
  • …directional (uptake of metabolites into circulatory system)
  • Not all … produced by choroid plexus within ventricles
    • …% from other sites within brain parenchyma
A
  • Specialized ependymal cells
  • Villi present to increase SA
  • Actively transport CSF components (or by facilitated diffusion)
  • Bidirectional (uptake of metabolites into circulatory system)
  • Not all CSF produced by choroid plexus within ventricles
    • 40% from other sites within brain parenchyma
28
Q

CSF composition

  • CSF differs in composition compared to blood plasma - … protein in CSF compared to plasma
  • Differences maintained by … transport process
  • Very few cells (0-3 lymphocytes/cubic mm)
  • CSF composition ideal for physiological functioning of neurons
A
  • CSF differs in composition compared to blood plasma - lower protein in CSF compared to plasma
  • Differences maintained by active transport process
  • Very few cells (0-3 lymphocytes/cubic mm)
  • CSF composition ideal for physiological functioning of neurons
    *
29
Q

More protein in plasma or CSF?

A

More in plasma - lower in CSF

30
Q

CSF circulation within ventricles

31
Q

CSF passes out of ventricles into the … space

A

CSF passes out of ventricles into the subarachnoid space

32
Q

CSF circulation within subarachnoid space

33
Q

Not much CSF passes through central canal - why?

A

Central canal is usually blocked in adults

34
Q

Subarachnoid space

  • Lies between … and …
  • Subarachnoid space follows contours of brain
  • CSF in contact with brain … - IMPORTANT
    • Transfer of micronutrients into brain
    • Removal of …
A
  • Lies between pia and arachnoid
  • Subarachnoid space follows contours of brain
  • CSF in contact with brain parenchyma - IMPORTANT
    • Transfer of micronutrients into brain
    • Removal of metabolites
35
Q

T2 weighted MRI - CSF appears…

36
Q

Arachnoid granulations

  • … of arachnoid membrane (villi) through dura mater into venous sinuses
  • Mainly within the superior … and … venous sinuses
A
  • Herniations of arachnoid membrane (villi) through dura mater into venous sinuses
  • Mainly within the superior sagittal and transverse venous sinuses
    *
37
Q

Absorption of CSF

  • CSF pressure in subarachnoid space … pressure in venous sinuses - in order for CSF to … through
  • Prevents blood … in subarachnoid space
  • In disease:
    • If venous pressure … CSF pressure
    • Tips of arachnoid … close off - act as …-way …
A
  • CSF pressure in subarachnoid space exceeds pressure in venous sinuses - in order for CSF to move through
  • Prevents blood pooling in subarachnoid space
  • In disease:
    • If venous pressure exceeds CSF pressure
    • Tips of arachnoid granulations close off - act as one-way valves
38
Q

CSF volume

  • … CSF produced per day (0.35 ml/min)
  • Total volume in system = 90-140ml
    • Normally quoted …
      • 30 ml ventricles, 110 ml subarachnoid space
  • Continuously moving
  • Excess absorbed by arachnoid …
A
  • 500ml CSF produced per day (0.35 ml/min)
  • Total volume in system = 90-140ml
    • Normally quoted 140
      • 30 ml ventricles, 110 ml subarachnoid space
  • Continuously moving
  • Excess absorbed by arachnoid granulations
39
Q

Main functions of CSF

  • CSF is functionally important
  • Lots of functions:
    • Hydraulic buffer to cushion brain against …
    • Vehicle for removal of … from CNS
    • Stable … environment for neuronal function
    • Transport of … and chemicals
A
  • CSF is functionally important
  • Lots of functions:
    • Hydraulic buffer to cushion brain against trauma
    • Vehicle for removal of metabolites from CNS
    • Stable ionic environment for neuronal function
    • Transport of neurotransmitters and chemicals
40
Q

Colour of CSF in disease

  • CSF normally …, … fluid, but is discoloured in some pathological states:
    • …/…/… (Xanthocromia)
      • E.g. subarachnoid haemorrhage - Lysis of RBC, haemoglobin release
    • …/…
      • E.g. Bacterial meningitis - Leukocytes increased, Indicative of infection
A
  • CSF normally clear, sterile fluid, but is discoloured in some pathological states:
    • Yellow/Orange/Pink (Xanthocromia)
      • E.g. subarachnoid haemorrhage - Lysis of RBC, haemoglobin release
    • Cloudy/Turbid
      • E.g. Bacterial meningitis - Leukocytes increased, Indicative of infection
41
Q

CSF is normally what colour?

A

clear - but discoloured in some pathological states

42
Q

If CSF is cloudy/turbid…

A

indicates infection

43
Q

If CSF is yellow/orange/pink (xanthocromia) it means…

A

lysis of RBC, haemoglobin release - e.g. in subarachnoid haemorrhage

44
Q

CSF sampling - how?

A
  • Taken by lumbar puncture
    • At lumbar cistern - no spinal cord
45
Q

CSF sampling

  • Taken by … ..
    • At lumbar cistern - no .. ..
A
  • Taken by lumbar puncture
    • At lumbar cistern - no spinal cord
46
Q

CSF sampling between L.. and L.. in adults

A

lumbar puncture - L3 and L4

47
Q

Hydrocephalus

  • Dilation of brain …
  • Due to blocked … circulation, impaired absorption, or over secretion
  • Increased intracranial (…) pressure
  • … on surrounding tissues affects neurological function
    • Symptoms include: headaches, vomiting, visual disturbances, papilledema (Swelling of optic disc), seizures, altered cognition, balance and coordination problems
  • Can be congenital or …
A
  • Dilation of brain ventricles
  • Due to blocked CSF circulation, impaired absorption, or over secretion
  • Increased intracranial (CSF) pressure
  • Pressure on surrounding tissues affects neurological function
    • Symptoms include: headaches, vomiting, visual disturbances, papilledema (Swelling of optic disc), seizures, altered cognition, balance and coordination problems
  • Can be congenital or acquired
48
Q

Hydrocephalus

  • … of brain ventricles
  • Due to … CSF circulation, impaired …, or over …
  • Increased … (CSF) …
  • Pressure on surrounding tissues affects neurological function
    • Symptoms include: headaches, vomiting, visual disturbances, papilledema (Swelling of optic disc), seizures, altered cognition, balance and coordination problems
  • Can be … or acquired
A
  • Dilation of brain ventricles
  • Due to blocked CSF circulation, impaired absorption, or over secretion
  • Increased intracranial (CSF) pressure
  • Pressure on surrounding tissues affects neurological function
    • Symptoms include: headaches, vomiting, visual disturbances, papilledema (Swelling of optic disc), seizures, altered cognition, balance and coordination problems
  • Can be congenital or acquired
49
Q

Symptoms of hydrocephalus:

A

Symptoms include: headaches, vomiting, visual disturbances, papilledema (Swelling of optic disc), seizures, altered cognition, balance and coordination problems

50
Q

Non-communicating hydrocephalus

  • … within the ventricular system
    • Due to …, cyst, … (E.g. narrowing of cerebral aqueduct)
  • CSF does not … over surface of brain
A
  • Blockage within the ventricular system
    • Due to tumour, cyst, stenosis (E.g. narrowing of cerebral aqueduct)
  • CSF does not circulate over surface of brain
51
Q

Surgery for non-communicating hydrocephalus:

A

insert shunt to reduce intracranial pressure

52
Q

What is Dandy-Walker syndrome?

A
  • Type of non-communicating hydrocephaly - Congenital malformation of the cerebellum (1:30,000 births)
  • Obstruction within foramina of fourth ventricle
    • Symmetrical dilation of lateral, third and fourth ventricles
  • In infancy, child’s head may become enlarged
53
Q

Dandy-Walker syndrome

  • Type of non-communicating hydrocephaly - … malformation of the cerebellum (1:30,000 births)
  • Obstruction within foramina of … ventricle
    • Symmetrical … of …, … and … ventricles
  • In infancy, child’s head may become …
A
  • Type of non-communicating hydrocephaly - Congenital malformation of the cerebellum (1:30,000 births)
  • Obstruction within foramina of fourth ventricle
    • Symmetrical dilation of lateral, third and fourth ventricles
  • In infancy, child’s head may become enlarged
54
Q

Communicating hydrocephalus

  • Obstruction in the … villi
  • Movement of CSF into … sinuses is impeded
    • E.g. impaired absorption following subarachnoid …, trauma or bacterial …
A
  • Obstruction in the arachnoid villi
  • Movement of CSF into venous sinuses is impeded
    • E.g. impaired absorption following subarachnoid haemorrhage, trauma or bacterial meningitis
55
Q

What is communicating hydrocephalus?

A
  • Obstruction in the arachnoid villi
  • Movement of CSF into venous sinuses is impeded
  • E.g. impaired absorption following subarachnoid haemorrhage, trauma or bacterial meningitis

Year 2 Medicine (162 decks)

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