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Questions and Answers

What happens when intracranial pressure approaches arterial pressure?

  • Cerebral blood flow increases.
  • Unconsciousness is temporarily prevented.
  • Acidic conditions in the brain are normalized.
  • Cerebral circulation is arrested. (correct)

Which mechanism does not contribute to autoregulation of cerebral blood flow?

  • Hormonal control (correct)
  • Chemical (metabolic) mechanism
  • Myogenic mechanism
  • Reactive hyperemia

What is the primary chemical regulator of cerebral blood flow?

  • Carbon dioxide (correct)
  • Nitric oxide
  • Oxygen
  • H+ ions

Which response occurs when cerebral perfusion pressure (CPP) is increased?

<p>Vasoconstriction of cerebral vessels (A)</p> Signup and view all the answers

What is primarily responsible for increasing cerebral blood flow during oxygen deficiency?

<p>Formation of vasodilator substances (B)</p> Signup and view all the answers

How does increased cerebral activity affect cerebral blood flow?

<p>Increases blood flow to the active segment. (C)</p> Signup and view all the answers

What role does excess H+ concentration play in cerebral circulation?

<p>It promotes vasodilation of cerebral vessels. (A)</p> Signup and view all the answers

Which of the following is a hallmark of the Cushing reflex?

<p>Increased intracranial pressure. (C)</p> Signup and view all the answers

What can an impairment of the blood-CSF barrier lead to?

<p>An increase in protein concentration in CSF (B)</p> Signup and view all the answers

What is a consequence of a compromised blood-CSF barrier?

<p>Increased risk of CNS infections such as meningitis (C)</p> Signup and view all the answers

What is the average cerebral blood flow in a normal adult?

<p>750-900 ml/minute (C)</p> Signup and view all the answers

How does brain activity affect cerebral blood flow?

<p>Increased activity increases blood flow (C)</p> Signup and view all the answers

What primary function does cerebrospinal fluid serve?

<p>It cushions the brain and spinal cord (A)</p> Signup and view all the answers

Which of the following factors influences intracranial pressure?

<p>Volume of cerebrospinal fluid (B)</p> Signup and view all the answers

What type of transport mechanism is primarily used by the blood-brain barrier?

<p>Active transport for specific substances (D)</p> Signup and view all the answers

What is a key characteristic of the blood-brain barrier's permeability?

<p>It selectively allows lipid-soluble substances (C)</p> Signup and view all the answers

What is the primary function of the blood-brain barrier?

<p>To allow selective permeability of substances (C)</p> Signup and view all the answers

How does the composition of cerebrospinal fluid (CSF) differ from that of plasma?

<p>CSF contains lower protein concentration than plasma (D)</p> Signup and view all the answers

What happens to cerebral blood flow when arterial blood pressure falls below 60 mmHg?

<p>Cerebral blood flow severely decreases (B)</p> Signup and view all the answers

What causes a stroke in terms of blood supply to the brain?

<p>Death of brain tissue from either lack of blood supply or bleeding (D)</p> Signup and view all the answers

What is the normal range for cerebral blood flow autoregulation in terms of arterial blood pressure?

<p>60 to 140 mmHg (C)</p> Signup and view all the answers

What occurs if arterial blood pressure rises above 140 mmHg?

<p>Blood vessels may overstretch or rupture (B)</p> Signup and view all the answers

In a hypertensive individual, how is the autoregulatory range for cerebral blood flow affected?

<p>It shifts to higher pressure levels, up to 180 to 200 mmHg (C)</p> Signup and view all the answers

What is the relationship between intracranial pressure and cerebral blood flow?

<p>A slight rise in intracranial pressure has no effect on cerebral blood flow (B)</p> Signup and view all the answers

Flashcards

Brain Tissue Damage

Lack of oxygen for 10 seconds can lead to unconsciousness and irreversible brain damage within minutes.

Stroke Cause

Stroke results from a blocked or leaking blood vessel in the brain, either due to a blockage or a bleed.

Grey vs White Matter Blood Flow

In resting humans, grey matter receives more blood flow than white matter, and the cerebral hemispheres get more than the spinal cord.

Blood-Brain Barrier

The brain's tiny blood vessels (capillaries) control what enters the brain from the blood.

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CSF vs Plasma

Cerebrospinal fluid (CSF) has similar sodium to plasma, less glucose, protein, potassium, calcium, and bicarbonate, but more chloride.

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Cerebral Perfusion Pressure (CPP)

CPP is the difference between mean arterial blood pressure (MAP) and intracranial pressure (ICP).

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Autoregulation Range (CBF)

The brain's blood flow stays constant between 60 and 140 mmHg.

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Hypertension and CBF

In high blood pressure, the autoregulation range for CBF shifts to higher pressure values (180-200 mmHg).

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Cerebral Blood Flow (CBF)

The amount of blood delivered to the brain per minute, crucial for brain function.

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Blood-CSF Barrier

A selective barrier that controls what substances enter the cerebrospinal fluid from the blood.

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Cerebrospinal Fluid (CSF)

Fluid surrounding the brain and spinal cord, with crucial functions in protection and nourishment.

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Brain Metabolism

The chemical processes used by the cells of the brain to produce energy and other vital substances.

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Intracranial Pressure (ICP)

Pressure within the skull, affected by fluid volume and condition.

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Average CBF in Adults

Approximately 750-900 mL/minute, representing 15% of cardiac output.

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Blood Brain Barrier Transport

Substances can exchange between the blood and brain; the direction is not always one way

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Brain Oxygen Consumption

The brain consumes 3.5 mL of oxygen per 100g of brain tissue per minute.

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Cushing reflex

A compensatory increase in arterial blood pressure (ABP) in response to rising intracranial pressure (ICP).

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Autoregulation

The brain's ability to maintain a relatively constant blood flow despite changes in blood pressure.

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Myogenic mechanism

Cerebral blood vessel constriction/dilation in response to changes in blood pressure.

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Chemical (metabolic) mechanism (cerebral blood flow)

Cerebral blood flow regulation by carbon dioxide levels.

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Cerebral Blood Flow (CBF)

The amount of blood delivered to the brain tissues.

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Intracranial Pressure (ICP)

Pressure within the skull.

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Effect of CO2 on CBF

CO2 is a key chemical regulator of blood flow. High CO2 causes vasodilation; low CO2 causes vasoconstriction.

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Effect of O2 deficiency on CBF

Low oxygen causes vasodilation, increasing blood flow to bring more oxygen.

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Study Notes

Spinal Cord I (Anatomy)

  • The spinal cord is a long cord-like structure extending from the brainstem
  • It's approximately 45 cm long
  • Located within the vertebral canal for structural protection
  • Held in place by spinal nerve roots and denticulate ligaments
  • A segmental structure, giving rise to 31 bilaterally paired spinal nerves
  • Cervical nerves (C1-C8)
  • Thoracic nerves (T1-T12)
  • Lumbar nerves (L1-L5)
  • Sacral nerves (S1-S5)
  • Coccygeal nerve
  • Extends from the foramen magnum to the level of the disc between L1 and L2 vertebrae
  • At birth, it extends lower (to L3 vertebral level)
  • Different spinal cord segments can be related to specific vertebral levels

Anatomy of the Spinal Cord

  • Spinal nerves exit above the vertebra with the same number (e.g., C6 above C6 vertebrae) except for C8 which exits below C7.
  • Spinal cord levels can be linked to the vertebrae of the same level.
  • The spinal cord has different enlargements
  • Cervical enlargement (C5 through T1), supplying the upper limbs
  • Lumbar enlargement (L1 through S3), supplying the lower limbs

Spinal nerves

  • 31 pairs of spinal nerves
  • Formed by union of dorsal and ventral roots
  • Dorsal roots carry sensory info
  • Ventral roots carry motor info

The Meninges

  • Dura Mater: The outer layer
  • Arachnoid Mater: The middle layer
  • Pia Mater: The innermost layer

Spinal Cord Cross Section

  • The spinal cord is divided centrally and symmetrically.
  • Anterior median fissure and posterior median sulcus along its longitudinal length

Spinal Cord Blood Supply

  • Anterior spinal artery
  • Posterior spinal arteries
  • Segmental radiculospinal arteries

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