CSF
What does ICP Stand for?
What is Intercranial Pressure
What are the two largest ventricles called?
What is the lateral ventricles
Name the layers of the meninges from superficial to deep starting with the skull and ending with the brain.
What is
Skull -> Dura Mater -> Arachnoid -> Mater -> Subarachnoid Space -> Pia Mater -> Brain
A patient has increased intercranial pressure because CSF is accumulating. What is the general term for this condition?
What is hydrocephalus
Name at least 3 signs that would lead you to believe a patient that you are working with may be experiencing increased ICP
What is headache, vomiting, nausea, drowsiness, gait ataxia, vision problems, eye movement abnormalities.
Where is CSF ultimately returned to the venous circulation?
What is arachnoid granulations into the dural venous sinuses
What connects the third ventricle to the fourth ventricle?
What is the cerebral aqueduct
Which meningeal layer contains the dural venous sinuses that drain venous blood from the brain?
What is the dura mater.
Which type of hydrocephalus is due to poor absorption of CSF?
What is communicating hydrocephalus
*Remember*: poor absorption = communicating; blockage = non-communicating AKA obstructive
A patient presents with a severe headache and identifies that pain increases with head movements, what is the likely condition they are experiencing?
What is meningitis
What structure is primarily responsible for producing CSF?
What is the choroid plexus
Which ventricle is located between the thalamus and hypothalamus?
What is the third ventricle
What is the space called where the CSF circulates?
What is the subarachnoid space
What is the most common cause for hydrocephalus in infants?
What is blockage
A patient presents with a tumor that blocks the cerebral aqueduct. CSF cannot flow from the third ventricle to the fourth ventricle. What type of hydrocephalus would this cause?
Non-communicating (obstructive) hydrocephalus.
What are the two major functions of CSF?
What is:
- Nutrition to CNS
- Waste removal
- Protection/ cushioning
- Buoyancy
The fourth ventricle is located between the cerebellum and what major part of the brainstem?
What is the pons and medulla.
This meningeal layer follows the contours of the brain’s gyri and sulci.
What is Pia mater
An infant with hydrocephalus may develop an unusually large head circumference. Why is this more possible in infants than adults?
What is The infant’s cranial sutures have not fully fused, allowing the skull to expand.
A 72-year-old patient has gradually developed difficulty walking, urinary urgency/incontinence, and progressive cognitive changes. Brain imaging shows enlarged ventricles. There is no obvious obstruction preventing CSF from moving through the ventricular system. What condition is most consistent with this presentation?
What is Normal pressure hydrocephalus (NPH), a form of communicating hydrocephalus.
For symptoms, think “Wet, Wacky, Wobbly”
Name the flow of CSF fluid
What is
Lateral ventricles -> Interventricular foramen -> Third ventricle -> Cerebral aqueduct -> Fourth ventricle -> Central canal of spinal cord -> Subarachnoid space -> Arachnoid granulations -> Dural venous sinuses -> Venous blood stream
A patient has a blockage at the interventricular foramen. Which ventricle would have difficulty receiving CSF from the affected lateral ventricle?
What is the third ventricle
What are the two extensions of the dura mater called?
What is falx cerebri and tentorium cerebelli
What condition is due to inflammation of meninges due to viral or bacterial infection?
What is meningitis
A 6 month-old infant is brought to the pediatrician because their head circumference has rapidly increased over the past several months. The infant also demonstrates irritability, vomiting, poor feeding, and a downward deviation of the eyes ("sunsetting"). Imaging shows enlarged ventricles. What condition is most likely occurring, and why does the infant present with increased head size?
What is hydrocephalus. Increased accumulation of CSF causes enlargement of the ventricles and increased intercranial pressure. Because an infant's cranial sutures have not fully fused, the skull can expand in response to the increased pressure, resulting in rapidly increasing head circumference.