DPT 540 TEST 1 EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS GRADED A++
1400 grams
weight of the brain
15-20%
what percent does cerebral blood flow count towards cardian output
Glucose
main source of energy
Low pH
The increases blood flow
Alkalosis
Decreases blood flow
Autoregulation
Mechanism by which the brain can maintain relatively constant blood flow even with
large changes in systemic blood pressure.
Flucturations in BP in healthy young people is normal and is anywhere between 60-140
mmHG. In patients with hypertension, CBF is normal because this mechanisms helps to
set a higher level
Neurogenic factors
Minor factor in CBF. Sympathetic innervation to cerebral vessels. May become
important with heavy exercise as blood pressure increases, sympathetic innervaiton will
constrict large and intermediate sized vessels of brain to reduce pressure on smaller
artereis of brain
Blood viscosity
Inversely proportional to CBF. Polycythemia decreases, and anemia increases CBF
PET, SPECT, fMRI
Applications of brain metabolism and CBF to create maps of brain function
Cranium
,Protection of brain. Holes allow entry/exit of cranial nerves, blood vessels, and spinal
cord
Foramen Magnum
Where the spinal cord mets the medulla (cervicomedullary junction)
Middle meningeal artery
Runs through the epidural space
Bridging veins
Runs through the subdural space
CSF and major vessels
Runs through the subarachnoid space
Falx cerebri
Layer suspended from the roof of the cranium; separates right and left cerebral
hemispheres
Tentorium cerebelli
covers the upper surface of the cerebellum. Divides intracranial cavity into
supratentorial and infratentorial regions
Protection, buoyancy, remove waste, regulating ion concentrations to maintain
homeostasis
What is the job of cerebrospinal fluid
Choroid plexus in lateral ventricle, foramen of monro, third ventricle, cerebral
aqueduct, fourth ventricle, luschka or magendie, subarachnoid space, arachnoid
villa, superior sagittal sinus
CSF flow thru brain
150 cc
Normal CSF volume
Blood-Brain Barrier
Refers to the impermeability of CNS blood vessels to most substances in the serum.
Regulating exchange of substances between blood and nervous tissue, serves as a
protective mechanism from harmful substances that may be in the blood. Prevents
transission of blood chemistry fluctuations, certain meds, etc
Endothelial cells by tight junctions
, What forms the blood brain barrier
Circumventricular organs
Regions of the brain where the BBB is absent. Located close to the midline and
adjacent to ventricular cavities
Key clinical concepts
Headache, intracrainial mass, elevated intracranial pressure, herniation, hemorrhage,
hydrocephalus, tumors, lumbar puncture
Headache
No pain receptors in the brian parenchyma. Pain caused by mechanical traction,
inflammation, irritation of other structures that are innervated. Vascular vs. tension vs.
migrane
Intracranial mass
Pressure rises if there is an increased in this- usually caused by the presence of tumors,
hemorrhage, and hydrocephalus
Elevated intracranial pressure
Normal is 9 mmHg, more than 20 is bad. Doctors usually treat anything above 25.
Ususally need 70-80 mmHG of blood flow to prevent neuronal death.
Papilledma, diplopia, cushing's triad (hypertension, bradycardia, irregular
respirations)
What are the signs of increased ICP
Communicating hydrocephalus
Caused by impaired CSF reabsorption in the arachnoid granulations, obstruction of flow
in the subarachnoid space, or by excess CSF production
Noncommunicating hydrocephalus
Caused by obstruction of flow within ventricular system
Lumbar puncture
Low CSF after spinal tap --> terrible headache. Direct access to subarachnoid space of
lumbar cistern. Use to obtain samples of CSF, measure CSF pressure, remove CSF,
and introduce drugs or radiographic contrast
Craniotomy
COMPLETE SOLUTIONS GRADED A++
1400 grams
weight of the brain
15-20%
what percent does cerebral blood flow count towards cardian output
Glucose
main source of energy
Low pH
The increases blood flow
Alkalosis
Decreases blood flow
Autoregulation
Mechanism by which the brain can maintain relatively constant blood flow even with
large changes in systemic blood pressure.
Flucturations in BP in healthy young people is normal and is anywhere between 60-140
mmHG. In patients with hypertension, CBF is normal because this mechanisms helps to
set a higher level
Neurogenic factors
Minor factor in CBF. Sympathetic innervation to cerebral vessels. May become
important with heavy exercise as blood pressure increases, sympathetic innervaiton will
constrict large and intermediate sized vessels of brain to reduce pressure on smaller
artereis of brain
Blood viscosity
Inversely proportional to CBF. Polycythemia decreases, and anemia increases CBF
PET, SPECT, fMRI
Applications of brain metabolism and CBF to create maps of brain function
Cranium
,Protection of brain. Holes allow entry/exit of cranial nerves, blood vessels, and spinal
cord
Foramen Magnum
Where the spinal cord mets the medulla (cervicomedullary junction)
Middle meningeal artery
Runs through the epidural space
Bridging veins
Runs through the subdural space
CSF and major vessels
Runs through the subarachnoid space
Falx cerebri
Layer suspended from the roof of the cranium; separates right and left cerebral
hemispheres
Tentorium cerebelli
covers the upper surface of the cerebellum. Divides intracranial cavity into
supratentorial and infratentorial regions
Protection, buoyancy, remove waste, regulating ion concentrations to maintain
homeostasis
What is the job of cerebrospinal fluid
Choroid plexus in lateral ventricle, foramen of monro, third ventricle, cerebral
aqueduct, fourth ventricle, luschka or magendie, subarachnoid space, arachnoid
villa, superior sagittal sinus
CSF flow thru brain
150 cc
Normal CSF volume
Blood-Brain Barrier
Refers to the impermeability of CNS blood vessels to most substances in the serum.
Regulating exchange of substances between blood and nervous tissue, serves as a
protective mechanism from harmful substances that may be in the blood. Prevents
transission of blood chemistry fluctuations, certain meds, etc
Endothelial cells by tight junctions
, What forms the blood brain barrier
Circumventricular organs
Regions of the brain where the BBB is absent. Located close to the midline and
adjacent to ventricular cavities
Key clinical concepts
Headache, intracrainial mass, elevated intracranial pressure, herniation, hemorrhage,
hydrocephalus, tumors, lumbar puncture
Headache
No pain receptors in the brian parenchyma. Pain caused by mechanical traction,
inflammation, irritation of other structures that are innervated. Vascular vs. tension vs.
migrane
Intracranial mass
Pressure rises if there is an increased in this- usually caused by the presence of tumors,
hemorrhage, and hydrocephalus
Elevated intracranial pressure
Normal is 9 mmHg, more than 20 is bad. Doctors usually treat anything above 25.
Ususally need 70-80 mmHG of blood flow to prevent neuronal death.
Papilledma, diplopia, cushing's triad (hypertension, bradycardia, irregular
respirations)
What are the signs of increased ICP
Communicating hydrocephalus
Caused by impaired CSF reabsorption in the arachnoid granulations, obstruction of flow
in the subarachnoid space, or by excess CSF production
Noncommunicating hydrocephalus
Caused by obstruction of flow within ventricular system
Lumbar puncture
Low CSF after spinal tap --> terrible headache. Direct access to subarachnoid space of
lumbar cistern. Use to obtain samples of CSF, measure CSF pressure, remove CSF,
and introduce drugs or radiographic contrast
Craniotomy
