Pbd Bbb, Brain, Meninges, Ventricles Dr Ellis

Front 1

What's responsible for the BBB?

Back 1

The tight jxns of overlapping capillary endothelial cells are responsible for the blood brain barrier

Front 2

What maintains the endothelial cells of the BBB?

Back 2

Structures labled in this pictures

Front 3

why are there many mitochondria surrounding the brain capillary

Back 3

There are many mitochondria b/c there are a lot transport mechanisms occurring and therefore need lots of energy

Front 4

Because the CNS vascular endothelium have little transcytotic activity, what 2 things do they lack?

Back 4

lack both fluid-phase and receptor-mediated endocytosis.

Front 5

what is found in the CNS- Vascular Endothelial?
a. specific transporters
b. catabolic enzymes
c. R mediated endocytosis
d. only a & b
e. all of th above

Back 5

D only A & B

Front 6

the specific transporters in the CNS vascular endothelium are to carry what?

Back 6

1. glucose
2. amino acids
3.vitamins
4. metals
5. nucleosides

Front 7

what Catabolic enzymes are found in the CNS vascular endothelium

Back 7

neurotransmitters and peptidases

Front 8

What transporter is used for glucose in the brain?

Back 8

Glucose - Glut1 –glucose transporter isotype-1
Glucose transported down its concentration gradient

Front 9

what transporters are used for amino acids in the brain?

Back 9

Amino acids -3 carrier systems
A System
ASC System
L System

Front 10

which aa are carried by A system?

Back 10

A system
Glycine and neutral AA with short linear side chains
Alanine or serine

Front 11

the A system for aa transport is dependent on what?

Back 11

Energy dependent, Na+dependent

Front 12

Which 2 aa transporters of the brain are Na dependent & energy dependent?

Back 12

A system
ASC system

Front 13

ASC system transports which aa?

Back 13

Transports alanine, serine and cysteine

Front 14

This aa transporter is located at the abluminal endothelial cell surface

Back 14

ASC system

Front 15

which aa system of the brain is Na independent

Back 15

L system is Na+-independent

Front 16

which aa are transported by the L system? their [ ] gradient?

Back 16

large neutral AA with branched or ringed side chains (leucine and valine)
AA are transported down their concentration gradient

Front 17

This a precursor for dopamine

Back 17

L-DOPA

Front 18

How is L-DOPA administered? given for Tx of what?

Back 18

systemically for treatment of Parkinson's

Front 19

2 fxns of the Na-K ATPase in the brain?

Back 19

1. Na,K-ATPase provides the energy and Na+ exchange.
2.Removal of K+ that accumulate in brain in response to intense neuronal activity

Front 20

Fxn of Multiple Drug Resistant - MDR

downside of this fxn?

Back 20

Protects brain from circulating neurotoxins

any chemotherapy drug is kicked out b/c the body thinks it's a toxin

Front 21

what are some experimental inhibitors of
a. L system

b. A system

Back 21

a. 2-aminobicycloheptane-2-carboxylic acid (BCH)

b. a-methylaminoisobutyric acid (MeAIB)

Front 22

4 things that disrupt the BBB?

Back 22

1. Tumors – lack BBB
2. Hypertension – opens BBB
3. Ischemic events (stroke)
4. Head injury

Front 23

what 5 things may circumvent the BBB?

Back 23

1. Direct injection – emergent needs
2. Injection of hypertonic solutions (glucose, mannose, sucrose, urea, etc) – shrink cells
3. Bradykinin analogues – pulls cells apart
4. Enhanced lipid solubility – pro drug approach
5. Chemical delivery systems

Front 24

areas within the CNS that lack BBB? (5) what is ech of their fxns and how are they regulated

Back 24

1. Median eminence – hormone/ANS regulation
2. Organum vasculosum of the lamina terminalis – BP
3. Subfornical organ –water balance/BP
4. Subcommissural organ – BP
5. Area postrema : vomiting

regulated by angiotensin II

Front 25

The lining of the ventricles and central canal of the spinal cord is called the _________.

Back 25

ependyma

Front 26

T/F: The ependyma lining have special cells called panycytes that form tight junction.

Back 26

FALSE: they're called tanycytes

Front 27

What is the fxn of the tanycytes?

Back 27

These tight junctions prevent the entry of molecules from the blood supply of the circumventricular organs from entering the CSF.

Front 28

Tight barriers are in _______ _______ which is the area that produces CSF.

Back 28

choroid plexus

Front 29

In the choroid plexus, there are _______ _______that also form tight jxns & preventing substances from entering the __________ .

Back 29

epithelial cells
ventricles

Front 30

Fxn of the dura venous? why can it have this fxn?

Back 30

Dura venous sinuses allow for exit of toxins from the brain since they connect with venous system

Front 31

the 4 barriers in the brain?

Back 31

1. BBB
Blood /CSF barrier
2. Choroid plexus
3. Circumventricular organs
4.Arachnoid villi

Front 32

Which of the statements is FALSE?
a. The BBB is formed primarily from tight jxns of overlapping capillary endothelial cells
b. L-DOPA is broken down by AADC and monamine oxidase in the capillary endothelial cells; therefore treatment for Parkinson’s dz includes L-DOPA and an inhibitor for AADC.
c. Substances that are not lipid soluble utilize specialized transporters to cross the BBB
d. None of the above
e. All of the above

Back 32

D: none of the above

Front 33

T/F: Special cells on arachnoid villi to protect the CSF from blood in the dura venous sinuses

Back 33

TRUE

Front 34

Connective tissue sheaths in the brain

Back 34

meninges

Front 35

Composition of the meninges

Back 35

Comprised of three membranous layers from the inner surface of the skull and vertebral column

Front 36

what are the 3 layers of the meninges?

Back 36

1. dura mater
2. arachonoid mater
3. pia mater

Front 37

Dense firm layer consisting of collagenous connective tissue

Back 37

dura mater

Front 38

The internal surfaces of the bones enclosing the cranial cavity are clothed by ________

Back 38

periosteum

Front 39

blood for the dura mater comes from where?

Back 39

periosteum

Front 40

Waste material from brain would enter the _______ ________ _______that’s imbedded in the dura mater.

Back 40

superior sagittal sinus

Front 41

The veins draining the brain empty into the ________ ________of the dura mater and then into the ________ ________ veins.

Back 41

venous sinuses
internal jugular

Front 42

3 features of the arachnoid mater

Back 42

1. collagenous and elastic fibers
2. both sides covered in squamous epithelial cells
3. avascular

Front 43

4 features of the pia mater?

Back 43

1. connective tissue- collagenous and elastic fibers
2. external surface covered in squamous epithelial cells
3. contains fine blood vessels
4. covers all surfaces of the brain and spinal cord

Front 44

This liquid flows through subarachnoid space

Back 44

CSF

Front 45

These are "fluid-filled" spaces in the brain where the cerebrospinal fluid (CSF) is produced and circulates

Back 45

ventricles

Front 46

This Interventrucilar foramen helps the lateral and third ventricles to communicate with each other.

Back 46

foramen of Monroe

Front 47

3rd & 4th ventricle communicate with each other via ________ _________

Back 47

cerebral aqueduct

Front 48

CSF leaves 4th ventricle to enter the subarachnoid spaces through these foramens

Back 48

foramens of Magende & Luschka

Front 49

Fxns of the CSF?

Back 49

1. Cushioning of CNS structures.
2. Dispersion of nutrients/mode of communication between various brain regions.
3. Removal of CNS metabolic wastes.

Front 50

specialized highly vascularized epithelial structures found on the inner lining of all brain cerebral ventricles.

Back 50

Choroid Plexus

Front 51

CSF is enriched with

Back 51

Enriched with Na,K-ATPase and other transporters

Front 52

CSF is filtrate of ________

Back 52

Plasma

Front 53

Choose the correct answer. CSF is produced in the ventricles at a rate of 400-500 ml/day. However, the amount of CSF in the ventricles and arachnoid is only 100-150ml. What accounts for the differences in the amount produced on a given day and the amounts localized in the spaces?
a.The production rate
b. The components of CSF vs Plasma
c. The osmolarity
d. All of the above
e. None of the above

Back 53

E. none of the above b/c it’s d/t turn over and absorption of arachnoid villi

Front 54

compare the protein and glucose in CSF vs plasma?

Back 54

both protein and glucose are more abundant in plasma

Front 55

Inflammation of the meningeal layers -

Back 55

meningitis

Front 56

which layers are most affected by meninigitis

Back 56

Pial and arachnoid layers most often affected

Front 57

Route of entry for meningitis

Back 57

ears or nasal sinuses or vascular system

Front 58

symptoms of meningitis

Back 58

headache
neck stiffness
fever
nausea/vomiting
photophobia
lethargy

Front 59

what is seen in the CSF of viral meningitis?

Back 59

1. Lymphocytes increase
2. increase in protein (moderate)
3. sugar content (normal)

Front 60

viral meningitis presents after what viral disorders?

Back 60

presents following other viral disorders (mumps, West Nile, Epstein-Barr etc).

Front 61

which meningitis has a worse prognosis? which has a higher incidence?

Back 61

bacterial
viral

Front 62

mortality rate of bacterial meningitis?

Back 62

20%

Front 63

Tx for bacterial meningitis?

Back 63

immediate antiobotic therapy of Penicillins and cephalosporins are current therapeutic choices

Front 64

three manin causes of bacterial meningitis?

Back 64

--Neisseria meningitidis – (meningococcal meningitis)
--Haemophilus influenzae – (type b)
--Streptococcus pneumoniae – (pneumococcal meningitis)

Front 65

which is the most common cause of bacterial meningitis

Back 65

Neisseria meningitidis – (meningococcal meningitis)

Front 66

increase in ventricular volume of CSF is d/t what 3 reasons?

Back 66

1. decreased absorption
2. overproduction
3. obstruction

Front 67

what may cause over secretion of CSF?

Back 67

Choroid Plexus tumor

Front 68

4 features of normal pressure hydrocephalus?

Back 68

1. increase in ventricular volume, normal ICP
2. unknown etiology
3. difficult to diagnose – dementia, incontinence, motor errors
4. treat with ventricular shunts (atrial or peritoneal)

Front 69

3 causes of communicationg hydrochephalus?

Back 69

1. any increase in venous pressure
2. subarachnoid hemorrhage
3. post-meningitis state

Front 70

2 causes of communicationg hydrochephalus

Back 70

1. Impaired Absorption of CSF – “clogged” arachnoid villi 2. Normal Pressure Hydrocephalus

Front 71

cause of noncommunicationg hydrocephalus

Back 71

Obstruction of CSF Flow

Front 72

cause of obstruction of CSF flow in noncommunicationg hydrocephalus

Back 72

1. obstruction in ventricular system
2. Brain tumors, congenital malformations

Front 73

Most likely location of tumor leading to noncommunicationg hydrocephalus is where?

Back 73

clogging is in Aqueduct of Silvius/cerebral aqueduct

Front 74

which group of people are likely to be affected in noncommunicating hydrocephalus?

Back 74

children

Front 75

this syndrome has narrowing of ventricular/subarachnoid interface which leads to obstruction flow and a noncommunicationg hydrocephalus

Back 75

Dandy-Walker Syndrome