Cerebral Vasculature Flashcards

1
Q

What percentage of blood pumped from the heart every minute does the brain receive?

A

14%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Does blood mix in the circle of willis?

A

NO; very little mixing means that if one artery is occluded, only the part of the brain that it supplies will be affected! (localized ischemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the effect of parasympathetics on cerebral circulation?

A

Vasodilation!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some neurotransmitters that parasympathetics use on cerebral circulation?

A

Ach, Vasoactive intestinal polypeptide (VIP), PHM-27

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What do parasympathetics innervate for cerebral blood flow?

A

Larger blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the effect of sympathetics on cerebral circulation?

A

Vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When are sympathetics activated for cerebral circulation?

A

ONLY when blood pressure and cardiac output are high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What neurotransmitters does the sympathetic system use for cerebral circulation?

A

Norepinephrine and neuropeptide Y (NPY)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What receptors does the sympathetic system use for cerebral circulation?

A

Alpha 1 adrenergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the result of the sensory innervation of distal blood vessels?

A

Vasodilation and PAIN (sensitive to torsion/manipulation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some neurotransmitters used by sensory innervation of distal blood vessels?

A

Substance P, CGRP, NeurokininA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe what happens to the sensory innervation of distal blood vessels in the brain when the CSF is low

A

The brain moves more, so the sensory fibers sense more torsion = pain; AND they vasodilate to increase the intracranial volume closer to normal by passing more blood to brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What controls cerebral circulation?

A

Oxygen consumption dictates where the brain blood will go! (Using more oxygen = receiving more blood)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What organ controls cerebral circulation?

A

The BRAIN itself = AUTOREGULATION!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe autoregulation

A

When the cerebral blood flow is NOT controlled by mean arterial blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Without sympathetics, describe the range of autoregulation

A

When the mean arterial blood pressure is below 60 mm HG or its above 140 mm HG, the cerebral blood flow will be dependent on it the mean arterial blood pressure! (low flow below 60 and high flow above 140, constant in between)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

With sympathetics, describe the range of autoregulation

A

The range of autoregulation increases! After 60 mm HG is reached, autoregulation of blood flow is constant even for a time after 140 mmHG is reached!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why is autoregulation important?

A

It protects the capillaries in the brain from damage from dangerously high blood pressures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What happens as the intracranial pressure increases?

A

Venous outflow decreases = decreased blood flow and decreased O2 to the brain which = a DRASTIC increase in system BP (trying to get blood to brain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some causes of intracranial pressure increase?

A

Tumor, cerebral edema (swelling), intracranial bleeding, increased CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where does Cerebrospinal fluid flow?

A

Through ventricles, around brain and spinal cord (black area of MRI)

22
Q

Is CSF recirculated?

A

NO

23
Q

Describe the ventricular system

A

2 lateral ventricles, 3rd ventricle, 4th ventricle

24
Q

What connects the 2 lateral ventricles to the 3rd ventricle?

A

Intraventricular foramen

25
Q

What connects the 3rd and 4th ventricles?

A

Cerebral aquaduct

26
Q

What connects the 4th ventricle to the cisterna magna?

A

Median aperature

27
Q

What connects the 4th ventricle to the arachnoid space?

A

Lateral aperature

28
Q

Where is most of the CSF made?

A

Specialized tissue in choroid plexus in lateral ventricles

29
Q

What are the 2 steps to the formation of CSF?

A

Passive filtration of serum

Modification of ion composition

30
Q

What 2 pressures is the passive filtration of serum step dependent on?

A

Hydrostatic pressure and oncotic/osmotic pressure

31
Q

Describe hydrostatic pressure in the capillary

A

= BP; large force that pushes fluid out of capillary into surrounding tissues because the surrounding tissues opposing pressure is low

32
Q

Describe the oncotic/osmotic pressure

A

Pulls fluid into and out of capillary; forces are equal and opposite at choroid plexus

33
Q

Where does fluid flow during formation of CSF?

A

From capillaries to the ventricles

34
Q

What molecule controls the pH of CSF?

A

HCO3

35
Q

What ions have low concentrations in CSF, but high in plasma?

A

K, Ca, protein, glucose

36
Q

What ions have high concentrations in CSF, but low in plasma?

A

Mg, Cl, Co2

37
Q

What ion is slightly of lower concentrations but almost equal in CSF compared to plasma?

A

Na

38
Q

What is the role of CSF and how often is it produced?

A

Protects the brain (shock absorber); CONSTANT rate of production!

39
Q

What 2 components of a capillary limit exchange in the brain?

A

Tight junctions and glial endfeet

40
Q

What qualities of a molecule are needed in order to pass blood brain barrier?

A

Lipid soluble or have a channel

41
Q

What is the purpose of the blood brain barrier?

A

Protect composition of CSF

42
Q

How do the capillaries get glucose from there to the neurons?

A

Glut1 - 55K on capillaries and 45K on glia (2 forms)

Glut3 - used by neurons

43
Q

Na/K/2Cl transporter

A

Moves these ions from CSF to blood

44
Q

What controls the expression of the na/k/cl transporter?

A

Release of endothelin 1 and 3 from endothelial cells of blood vessels

45
Q

Many drugs can cross blood brain barrier, but what moves them back across?

A

P-glycoprotein

46
Q

Circumventricular organs

A

4 regions in brain that require exposure to blood-borne substances!

47
Q

What are the 4 circumventricular organs?

A

Posterior pituitary, area postrema, organum vasculosum of lamina terminalis (OVLT), subfornical organ

48
Q

Job of posterior pituitary

A

Release hormones into blood

49
Q

Job of area postrema

A

Protect composition of blood by eliciting vomiting

50
Q

Job of OVLT and subfornical organ

A

Control of body water/thirst/blood volume