Physiology Flashcards
50-70% of CSF is made by the:
choroid plexus (within 3rd and 4th ventricles)
two-stage process of CSF formation:
- passive filtration of serum/plasma into ventricle
2. HCO3, Cl-, K+ concentrations controlled by channels on epithelial cells … aquaporins also exist
why would CSF production exacerbate increased intracranial pressure?
CSF is continually made, so it would increase intracranial pressure, making it worse
what ions are the same concentration between CSF and plasma? (3)
Na+
Cl-
HCO3
what ions/compounds are in greater concentration within CSF than in plasma? (2)
Mg2+
CO2
what ions/compounds are in lesser concentration within CSF than in plasma? (4)
K+
Ca2+
protein
glucose
Mg2+ blocks ___ channels?
Ca2+
pH in the brain can change drastically with changes in CO2 because:
we don’t have the protein to buffer it
at what level of CSF do we see no absorption by arachnoid villi? what is normal?
< 68 ml CSF
normal = 112 ml
what is the main role of CSF?
to protect the brain
capillaries in the brain have two fxns that limit exchange between the blood and the brain:
- tight jxns between endothelial cells
2. glial endfeet come in close contact with blood vessels
what compounds undergo passive diffusion through the BBB? how and which direction?
H2O - via gradient
CO2 - to blood
O2 - to neurons
free steroid hormones cross, but most are protein-bound (can’t cross)
how does glucose get across the BBB?
GLUT-1 transporter
is GLUT-1 dependent on insulin?
what forms exist?
GLUT-1 is not dependent on insulin
45 kD form - form on astroglia (capillaries to CSF)
55 kD form - form on capillary endothelial cells (blood to capillary)
if children do not possess either the 45kD or 55kD form, what happens?
seizures
-membrane depolarizes because glucose is not getting in (no E available to drive ATPase to maintain membrane potential)
role of Na/K/2Cl transporter:
move ions from CSF to blood
what ion is the Na/K/2Cl transporter most responsive to?
K+ (need it out)
Na/K/2Cl transporter expression is tied to:
endothelin (ET) 1 and 3
ET production is tied to signals from _________, which may be tied to [__] in CSF.
- astrocytes
- [K+]
incr [K+] CSF —> astrocytes/astroglia express endothelin 1 and 3 —> incr/decr expression of Na/K/2Cl transporter
incr [K+] CSF —> astrocytes/astroglia express endothelin 1 and 3 —> INCREASED expression of Na/K/2Cl transporter
P-glycoprotein is coded by what gene?
MDR-1
role of P-glycoprotein:
move drugs and compounds from the CSF (have crossed the BBB) back into blood
how does BBB protect chemical composition of CSF from blood-borne agents? (3)
- tight jxns
- end feet of glia
- P-glycoprotein
certain places in the brain are exposed to blood (exceptions of BBB). what is different about these places microscopically?
the capillaries in these areas do NOT have tight jxns between endothelial cells
brain organs exposed to blood are termed:
they include: (4)
circumventricular organs
1. posterior pituitary - release ADH/vasopressin & oxytocin
2. area postrema - at opening of 4th ventricle and spinal cord, vomiting center
3/4. OVLT and subfornical organ - BOTH involved in body water/thirst/blood volume control (angiotensin) … sense osmolarity
receptor for sympathetics (vasoconstriction)
alpha-adrenergics
distal blood vessels possess what type of innervation?
sensory innervation
what three NTs allows afferents to be sensitive to dilation?
Substance P
Neurokinin A
CGRP
sensory fibers render blood vessels of the brain extremely sensitive to torsion or manipulation. why is this important when there’s a decrease in CSF?
decreased CSF volume —> incr heaviness of brain —> incr brain motion —> torsion of blood vessels —> pain (sensory afferents)
cerebral blood flow is under _____ control
local
-O2 consumption dictates where in the brain blood goes
increase intracranial pressure —>
__ venous outflow —>
__ arterial flow
increase intracranial pressure —>
decrease venous outflow —>
decrease arterial flow
activation of alpha-adrenergics allows blood vessels to extend the range that blood flow in the brain is held constant. why is this a good thing? think capillaries and BBB…
high BP —> vasoconstrict brain vasculature to protect BBB (also protects capillaries in brain from damage)
where is ACh located? (3)
centrally
- pons
- midbrain
- striatum
pontine and midbrain group needs ACh to produce _________
consciousness
ACh is stored in vesicles and is moved in by _____
VAChT
what enzyme is bound to the post-synaptic cell membrane and breaks ACh down?
aceylcholinesterase
the neuronal ACh muscarinic receptor is which subtype? by what mechanism does it produce action?
M1 (neuronal type)
incr IP3/DAG —> incr Ca2+
where is GABA located? (3)
- cerebellum
- cortex
- retina
what is the functional role of GABA?
- major inhibitory NT in higher CNS
- critical for producing consciousness/awareness
- control of voluntary motion
from what compound is GABA derived?
what enzyme catalyzes the reaction to form GABA?
- glutamate
- glutamate decarboxylase
what is the effect when GABA binds to GABA(A) receptor?
- Cl- conductance –> hyperpolarization
- has a benzodiazepine site (potentiates the hyperpolarization from the Cl-)
what is the effect when GABA binds to GABA(B) receptor?
- effect on K+
- effect on adenylyl cyclase (AC)
- K+ efflux (hyperpolarization) (prevents Na+ channels from opening)
- decr AC –> decr IP3/DAG –> decr Ca2+ influx (hyperpolarization)
TQ: inhibitory NT in brain (cortex, cerebellum). think…
BUT if location is spinal cord or brainstem think…
- GABA
- glycine
where is glycine located?
spinal cord
brainstem
forebrain (less than GABA)
glycine receptors are blocked by:
strychnine
where do opioids act? (3)
basal ganglia
hypothalamus
parabrachial and raphe nuclei
functions of opioids (2)
modification of nociceptive (painful) inputs
modification of mood/affect (neuro 2)
TQ: opioids are base on four precursor molecules (just know these are opioids and they’ll act like opioids)
- proenkephalin
- pro-opiomelanocortinin (POMC)
- prodymorphin
- orphanin FQ (nociceptin)
effect of opioids binding to mu receptors: (5)
- analgesia
- respiratory depression
- EUphoria
- sedation
- constipation
effect of opioids binding to kappa receptors: (4)
- analgesia
- DYSphoria
- diuresis
- miosis
effect of opioids binding to delta receptors: (1)
analgesia
mu opioid receptors (increase/decrease) K+ efflux (hyperpolarization)
INCREASE K+ efflux
kappa & delta opioid receptors (increase/decrease) Ca2+ in the cell
DECREASE cellular Ca2+
where are endocannabinoids distributed within CNS? (3)
- hippocampus - memory formation
- basal ganglia - affect/motor
- spinal cord - nociception
- found in axons and pre-synaptic terminals of EAA and GABA synapses
- G(i) protein-coupled receptor (inhibits AC)
- decreases NT release
- binds either anandamide or 2-arachidonylglycerol well
CB-1 receptor
- found in brain (microglia, NOT neurons)
- immune system and gut
- anti-inflammatory
- in brain, causes macrophages to remove beta-amyloid
CB-2 receptor
- excitatory NT
- derived from a-ketoglutarate
- metabolic pool and NT pool are strictly separated
glutamate
- excitatory NT
- derived from oxaloacetate
- NT in visual cortex and pyramidal cells
- often found with glutamate
aspartate
activation of NMDA receptor causes: (1)
Ca2+ influx
name NMDA’s modulatory sites (3) and the function of each
- glycine binding site - serves as co-agonist to NT, but CANNOT open channel on its own
- Mg2+ binding site - block channel
- PCP binding site - block channel downstream from Mg2+
activation of NMDA receptor leads to a slow ____
EPSP
- long latency (time to remove Mg2+)
- longer duration (Ca2+ influx slower)
activation of non-NMDA receptor causes:
Na+ influx (very little amount of Ca2+, too)
2 subtypes of non-NMDA receptor:
- AMPA: Na+ entry, but has benzodiazepine binding site, which inhibits the response to NT (decreases Na+ entry)
- kainate: Na+ entry (with very small amount of Ca2+)
non-NMDA receptors are co-localized at the same synapse with NMDA receptors. why?
the entry of Na+ through non-NMDA leads to a depolarization of the cell membrane, which helps to remove PCP from blocking the NMDA channel and allow the influx of Ca2+
T/F: metabotropic receptors are located on BOTH pre- and post-synaptic neurons
TRUE
metabotropic receptors on the pre-synaptic membrane function to: (1)
control NT release
receptor that’s assoc with:
- primary afferents
- premotor (upper mn)
you think…
non-NMDA receptors
receptor that’s assoc with:
- long-term changes in synaptic strength
- learning
- memory
you think…
NMDA receptors
receptor that’s assoc with:
- learning
- memory
- motor systems
metabotropic receptors
how do neurons and glia get rid of EAA?
via high affinity uptake systems…
Na+ dependent 2ndary active transport
what is the specific role of glia in EAA uptake?
glia convert glutamate to glutamine and release into ECF
what is the specific role of neurons in EAA uptake?
neurons take up glutamine and convert it back to glutamate
activation of NMDA causes influx of Ca2+ —>
Ca2+ binds calcineurin —>
…what happens to NOS?
activation of nitric oxide synthase (NOS), which converts arginine to citrulline (NO is a by-product of the reaction)
what happens to a cell’s Na/K/ATPase if the cell is deprived of oxygen?
Na/K/ATPase stops
ATP within neurons = 0
–> membrane depolarization
during anoxia, high levels of EAA are released. since EAA re-uptake is Na+ dependent, EAA is not being taken up. how does this affect NMDA?
NMDA will be activated by high levels of EAA
–> Ca2+ influx
increased [Ca2+] in the neuron initiates: (4)
- activation of phospholipase A2
- activation of calcineurin (phosphatase)
- activation of mu-calpain (protease)
- activation of apoptotic pathway
activation of phospholipase A2 leads to:
release of arachidonate from membrane –>
physical damage to membrane
what intracellular receptor (in ER) does arachidonate also act on? what is the result?
ryanodine receptor
-more Ca2+ is then released inside cell (ER & mito)
release of Ca2+ from intracellular store in the ER leads to: (3)
- TQ: unfolded protein response - stops making protein
- activation of eIF2(alpha)-kinase
- impaired mito function