Supporting systems of the brain and spinal cord Flashcards
(78 cards)
1
Q
what do the meninges consist of? what do they cover?
A
three layers of connective tissue covering the brain and spinal cord
2
Q
what do the meninges provide the CNS protection from?
A
contusion and infection
3
Q
within the meninges there are __ __ and __ __
A
blood vessels; CSF
4
Q
what are the three connective tissue layers of the meninges?
A
dura mater
arachnoid mater
pia mater
5
Q
dura mater
A
outermost meninx (layer of meninges)
6
Q
how many folds does the dura mater have?
A
4
7
Q
the dura mater lines the __ of the skull and protects the __
A
periosteum; brain
8
Q
what separates the dura mater from the arachnoid mater?
A
subdural space
9
Q
the subdural space separates the __ __ form the __ __
A
dura mater; subarachnoid mater
10
Q
arachnoid mater
A
middle meninx (layer of meninges)
11
Q
the __ mater is impermeable
A
arachnoid
12
Q
what meninx is impermeable?
A
arachnoid mater
13
Q
the arachnoid mater surrounds the __ in a __ manner
A
brain; loose
14
Q
what separates the arachnoid mater from the pia mater?
A
subarachnoid space
15
Q
the subarachnoid space separates the __ __ from the __ __
A
arachnoid mater; pia mater
16
Q
pia mater
A
innermost meninx (layer of meninges)
17
Q
the pia mater covers the __ of the brain
A
contours
18
Q
what does the pia mater form?
A
choroid plexus in the ventricular system
19
Q
what meninx lines the periosteum of the skull and protects the brain?
A
dura mater
20
Q
what meninx surrounds the brain in a loose manner and is impermeable?
A
arachnoid mater
21
Q
what meninx covers the contours of the brain?
A
pia mater
22
Q
what meninx forms the choroid plexus in the ventricular system?
A
pia mater
23
Q
meningitis
A
inflammation of the meninges of the brain and spinal cord
24
Q
there are a __ of forms of meningitis
A
variety
25
what type of meningitis is potentially fatal within hours of onset?
bacterial meningitis
26
bacterial meningitis is potentially __ within hours of onset
fatal
27
__ meningitis is considered a medical emergency
acute
28
what are the signs and symptoms (6) of meningitis?
fever, headache, vomiting
complaints of stiff and painful neck, nuchal rigidity
pain in lumbar area and posterior thigh
Brudznitski's sign
Kernig's sign
light sensitivity
29
nuchal rigidity
inability to flex the neck forward due to stiffness or resistance in the neck muscles
30
positive Brudznitski's sign
passive flexion of the neck facilitates flexion of the hips and knees
involuntary flexion is considered compensatory to reduce stretch on meninges
31
what special test is considered positive when flexion of the neck facilitates flexion of the hips and knees and is indicative of meningitis?
Brudznitski's sign
32
positive Kernig's sign
pain with combined, passive hip flexion and knee extension after having hip and knee flexed to 90 deg
33
what special test is considered positive when pain is ilicited with passive hip flexion and knee extension, beginning with the hip and knee flexed to 90 deg and is indicative of meningitis?
Kernig's sign
34
what is the gold standard for diagnosis of meningitis?
lumbar puncture
35
what types of interventions are included in treatment of meningitis?
antibiotic, antimicrobial and steroid pharmacological intervention
36
early diagnosis of meningitis is essential to avoid...
permanent neurological damage
37
what are the three dural spaces?
epidural space
subdural space
subarachnoid space
38
epidural space
area between the skull and outer dura mater that can be abnormally occupied
also the area between the dura mater and periosteum of the vertebrae
39
what dural space is the area between the skull and outer dura mater as well as the area between the dura mater and periosteum of the vertebrae?
epidural space
40
what does the subarachnoid space contain?
CSF and circulatory system for the cerebral cortex
41
what dural space contains CSF and the circulatory system of the cerebral cortex?
subarachnoid space
42
the ventricular system is designed to __ and __ the brain
protect and nourish
43
what is the ventricular system comprised of?
4 ventricles and multiple foramina
44
ventricle
fluid filled cavities
45
what do the 4 ventricles and multiple foramina of the ventricular system allow the passage of?
CSF
46
what does each ventricle contain?
specialized tissue (choroid plexus) that makes CSF
47
choroid plexus
specialized tissue within ventricles that makes CSF
48
what does the choroid plexus arise from?
the pia mater
49
cerebrospinal fluid
clear, fluid-like substance that cushions the brain and spinal cord from injury and provides mechanical boyancy and support
50
main functions of CSF?
cushions the brain and spinal cord from injury
provides mechanical boyancy and support
provides nutrition to the CNS
serves as a conduit for metabolite removal
51
how often is CSF produced?
constantly
52
CSF is produced constantly with a yield of __-__ ml/day
500-700 ml/day
53
CSF is constantly being __ and __ within the brain and spinal cord
absorbed and replenished
54
an excess of CSF in the brain can cause enlargement in the ventricles causing what condition?
hydrocephalus
55
hydrocephalus
enlargement in the ventricles caused by an excess of CSF in the brain
56
excess fluid within the spinal cord is known as __
syringomyelia
57
syringomyelia
excess fluid within the spinal cord `
58
what does the blood-brain barrier consist of (3)?
meninges
protective glial cells
capillary beds of the brain
59
what are the primary functions of the blood brain barrier (2)?
exchange of nutrients between CNS and vascular system
protection for the CNS by restricting certain molecules from crossing the barrier while others are able to do so freely
60
what supporting system of the brain is responsible for exchange of nutrients between the CNS and vascular system?
blood brain barrier
61
what supporting system of the brain provides protection for the CNS by restricting certain molecules from crossing the barrier while others are able to do so freely?
blood brain barrier
62
what impairments (3) is hydrocephalus (increase of CSF in ventricles) typically a result of?
poor resorption of CSF
obstruction of flow of CSF
excessive production of CSF
63
what are the 4 classifications of hydrocephalus?
congenital
idiopathic
communicating
noncommunicating
64
communicating hydrocephalus
occurs when the flow of CSF is blocked/due to absorption impairment after it exits the ventrucles, but it can still flow between the ventricles, which remain open
65
non-communicating hydrocephalus
blockage occurs within the ventricle system, preventing CSF flow between ventricles
66
what classification of hydrocephalus occurs when blockage or impaired absorption of CSF occurs after it exits the ventricles, but still allows CSF to flow between ventricles, which remain open
communicating
67
what classification of hydrocephalus occurs due to blockage of CSF within the ventricular system, preventing CSF flow between ventricles?
non-communicating
68
associated conditions and causative factors vary, but may include (6)...
spina bifida
CP
choroid plexus neoplasm
tumor
meningitis
encephalocele
69
choroid plexus neoplasm
benign or malignant tumor arising from the choroid plexus
70
encephalocele
congenital neural tube defect where a portion of the brain and meninges protrudes through a defect of the skull, typically appearing as a sac-like structure covered in skin/a thin membrane
can occur along the midline of the skull, from nose to the back of the neck
71
what does successful treatment of hydrocephalus include?
surgical placement of a shunt
or
performing endoscopic third ventriculostomy (ETV)
72
often, __ neurosurgical procedures are necessary to treat hydrocephalus
repeated
73
long-term health outcomes for patients with hydrocephalus remain __
unpredictable
74
endoscopic third ventriculostomy (ETV)
neurosurgical procedure used to treat hydrocephalus that involves creating a small opening in the floor of the third ventricle to allow excess CSF to flow into the subarachnoid space, where it can be reabsorbed
75
signs (9) of hydrocephalus or blocked shunt?
enlarged head or bulging fontanelles in infants
headache
changes in vision
large veins noted on scalp
behavioral changes
seizures
alteration in appetite, vomiting
sun setting sign or downward deviation of the eyes
incontinence
76
sun setting sign
clinical sign of elevated intracranial pressure, often associated by hydrocephalus and characterized by downward displacement of the eyes, with the upper eyelid retracted and the lower eyelid partially covering the pupil (as if the sun is setting over the horizon)
77
there must be __ medical intervention to alleviate elevated CSF in the brain and subsequent elevated intracranial pressure
immediate
78
failure to treat hydrocephalus within a timely manner can result in __ and/or __
coma and/or death
