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Phase 1: weeks 6-12 > Brain structure, meningitis and disability > Flashcards

Brain structure, meningitis and disability Flashcards

1
Q

what are the main parts of the brain?

A

Cerebrum
Cerebellum
Brainstem
Diencephalon

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2
Q

What is the cerebrum and how it is divided?

A

Cerebrum is the largest part of the brain. It is divided into the left and right hemisphere and connected at the midline by the corpus callosum.

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3
Q

Describe the outer layer of the cerebrum, how is it arranged?

A

Made of grey matter and is called the cerebral cortex. It is folded in a way to increase the surface area.
There are grooves (sulci) and ridges (gyri)

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4
Q

List the lobes of the cerebrum

A

Frontal
Parietal
Temporal
Occipital

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5
Q

list the functions of the frontal lobe

A

Cognitive functions - concentration, problem solving, judgement
Motor control
Broca’s area (speech)
personality

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6
Q

list the functions of the parietal lobe

A

Visual perception
Spatial perception
sense of taste, smell and touch
Reading and writing

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7
Q

list the functions of the temporal lobe

A 
memory
learning 
emotions 
hearing
understanding language
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8
Q

list the function of the occipital lobe

A

vision

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9
Q

what is the function of the cerebellum?

A

balance/posture, coordination of voluntary movement

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10
Q

what is the function of the brainstem?

A

control heart rate, consciousness and breathing

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11
Q

List the function of the thalamus

A

Sensory relay centre between the spinal cord and the cerebral cortex

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12
Q

what is the function of the hypothalamus?

A

Regulates homeostasis

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13
Q

what are the basal ganglia, where are they found and what is their function?

A

Basal ganglia: 3 masses of grey matter embedded in white matter, surrounding the thalamus.

Function: control of movement (and posture)

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14
Q

what is the brain surrounded by?

A

Layers of fascia called Meninges

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15
Q

what is the limbic system and what are its main components ?

A

Limbic system is the part of the brain involved in emotional and behavioural responses.

Made up of:
Hippocampus
Amygdala
Hypothalamus

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16
Q

what’s the function of the hippocampus?

A

Formation of new memories (long term memory)

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17
Q

what’s the function of the amygdala?

A

Emotions and emotional responses/behaviour

18
Q

what are ventricles? what is their function? what are the ventricles in the brain?

A

Ventricles are a set of four interconnected cavities where cerebrospinal fluid is produced.
2 paired lateral ventricles
3rd single ventricle
4th single ventricle

19
Q

where are the meninges and what is their function?

A

meninges consist of 3 membranes which surround the brain and spinal cord.
Their function is to protect and support the brain, prevent the spread of infection, and hold the CSF

20
Q

what are the 3 layers of the meninges? describe them

A

dura mater (outer layer): dense connective tissue layer
arachnoid mater: thin membrane made of fibrous tissue, contains arachnoid trabeculae and subarachnoid space which holds CSF
pia mater: inner layer, thin, tight membrane

21
Q

what are the functions of the brain?

A

Interpreting touch, vision, hearing as well as emotions, reasoning, learning, and fine control of movement.
Coordinates muscle movements, maintain posture and balance
control of automatic functions: breathing, digestions, coughing, swallowing, vomiting, heart rate, body temperature, sleep/wake cycles.

22
Q

List the composition of the CSF

A 
Mainly water
Glucose
Proteins
Lactic acid + urea = waste substances
Cations: Na, K, Mg, Ca
Anions: Cl and HCO3 (bicarbonate) 
few WBCs
23
Q

Describe the functions fo the CSF

A

Mechanical protection + lubrication: serves as a shock absorbing medium that protects the delicate tissues of the brain tissue and spinal cord
Buoyancy: allows flotation of the brain without pressure
Circulation: provides nutrients and removes waste products
Transport medium for nutrients, metabolites, endocrine substances and neurotransmitters
Homeostasis: serves as a chemical buffer to maintain ionic stability

24
Q

How is CSF produced?

A

CSF is produced at the choroids plexuses - which are networks of blood capillaries in the walls of the ventricles. The choroid plexus capillaries are covered by ependymal cells which are tightly adhered to them. The ependymal cells are joined by tight junctions and form a blood-CSF barrier which controls filtration of substances in the blood plasma.

25
Q

Describe the circulation of CSF in the brain

A

CSF produced in the choroid plexus of the lateral ventricles flows into the 3rd ventricle through 2 interventricular foramina. More CSF is added by the choroid plexus in the 3rd ventricles.

The fluid then flows through the cerebral aqueduct (aqueduct of the midbrain), which passes through the midbrain to the 4th ventricle. Choroid plexus of the 4th ventricle contributes more CSF fluid.

The fluid then flows through 1 median and 2 lateral apertures. It circulates in the subarachnoid space around the brain and spinal cord, and in the central canal of the spinal cord.

26
Q

Describe the reabsorption of CSF

A

CSF is reabsorbed back into the blood stream through arachnoid villi - fingerlike extensions of the arachnoid that project into the dural venous sinuses. (Arachnoid granulations are clusters of arachnoid villi)

27
Q

What are venous sinuses?

A

venous sinuses are drainage channels between the 2 layers of the dura mater that drain into the internal jugular vein

28
Q

how does rate of reabsorption of CSF compare with rate of production?

A

they are the same

29
Q

define meningitis and describe the causes

A

Meningitis: inflammation of the protective membranes surrounding the brain and spinal cord (meninges)

Causes: an infectious agent, most commonly = viral, but bacteria, fungi and parasites can also be causes

30
Q

Briefly describe the pathophysiology of meningitis

A

Usually, the brain is protected by the meninges which create a barrier between the bloodstream and brain. This protects the immune system from attacking the brain.

In meningitis, the blood brain barrier is disrupted and when infectious agents reach the brain, they are isolated from the immune system.

When the body responds to fight the infection, the blood vessels become permeable and WBCs, fluid and other infection-fighting molecules enter. These cause inflammation which results in swelling of the brain and decreased blood flow to it, worsening the symptoms.

31
Q

Describe the clinical features of meningitis

A 
Fever
Severe Headache
Neck stiffness
Nausea/vomiting
Photophobia (sensitivity to light)
Sleepiness
Confusion 
no appetite or thirst
32
Q

Describe some possible complications of meningitis

A

Increased intracranial pressure - can lead to herniation
Cognitive defects: memory problems, learning difficulties
Hearing loss
Vision loss
Loss of limbs
Kidney problems
Brain damage
Coordination, movement and balance problems
Seizures
Bone and joints problems e.g. arthritis
Death

33
Q

Define disability

A

a physical or mental impairment that has a substantial and long-term negative/adverse effect on a person’s ability to do normal daily activities.

34
Q

Describe the impact of a disability on the individual and family/carer

A 
Individual:
Effect on mental health e.g. anxiety and depression
Loss of freedom/independance 
Frustration and anger 
Can lead to isolation
Unemployment = financial instability  
Loss of self esteem and confidence 
Family/carer:
Increase closeness of a family
Financial burden
Stress
Psychological and emotional strain
Exhaustion
35
Q

where is the subarachnoid space and what is its role?

A

Between the arachnoid and Pia mater.

filled with CSF, has arteries and veins
contain arachnoid trabeculae

36
Q

what is the difference in the meninges in the brain and in the spinal cord?

A

In spinal cord:
Dura mater has 1 layer
There is an epidural space which contains fat

37
Q

what are the epidural and subdural spaces in meninges?

A

Epidural: POTENTIAL space between the skull and dura mater
Subdural: POTENTIAL space between the dura mater and arachnoid

38
Q

how many millilitres of CSF is there in the brain usually?

A

150 ml

39
Q

Where is CSF found?

A

In the subarachnoid space of meninges and final cord and fills ventricles of brain

40
Q

what is the blood brain barrier?

A

semipermeable membrane separating the brain tissue from the blood circulation

41
Q

what is the blood brain barrier made of?

A

Not just one structure, but several features that act as a barrier.

tight junctions between endothelial cells in capillaries (no fenestrations)
thick continuous basal membrane
Astrocyte’s processes cover the vessel

42
Q

why is the blood brain barrier important?

A

It allows the selective entry of substances into the brain and spinal cord from blood.
It provides protection from harmful substances/toxins
It prevents the fluctuation in levels of ions and metabolites in CNS

Phase 1: weeks 6-12 (21 decks)

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