Csf production,circulation & absorption

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Csf production,circulation & absorption

  1. 1. CSF PRODUCTION, CIRCULATION &ABSORPTION LECTURE BY DR. ANSARI CHAIRPERSON & PROF. OF ANATOMY RAK COLLEGE OF MEDICAL SCIENCES & RAK COLLEGE OF DENTAL SCIENCES Tuesday, January 07, 2014 1
  2. 2. A 9 year old boy was brought to his GP by his parents who noted that he was having difficulty with his balance and was complaining of head aches. • He was referred to the neurosurgical unit and a CT scan was perform of his head region. This showed the presence of dilated lateral and III ventricles with a normal IV ventricle. There was effacement of the overlying cortical sulci in the brain and a diagnosis of Hydrocephalus was made. MRI showed the cerebral aqueduct was stenosed. • The boy subsequently had a III ventriculostomy performed, and his symptoms resolved rapidly. Tuesday, January 07, 2014 2
  3. 3. Tuesday, January 07, 2014 3
  4. 4. C.S.F Circulation involves • • • • • • Lateral ventricle. III ventricle. Cerebral aqueduct. IVventricle. Subarachnoid cisterns Subarachnoid spaces Tuesday, January 07, 2014 4
  5. 5. Sub arachnoid cisterns & spaces • • • • The major cisterns are:1) Cisterna interpeduncularis 2) Cisterna ambiens 3) Cisterna magna 4) Cistern of the lateral sulcus • 5) Cisterna pontis • 6) Subarachnoid spaces Tuesday, January 07, 2014 5
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  8. 8. The arachnoid villi & granulations • Are the structures that drain the excess amount of CSF into the circulatory system/Dural venous sinuses. • These are the safety valve that opens up and drain into the superior Sagittal sinus. • From the ventricles the CSF comes out into the subarachnoid sinuses through 3 apertures, • Foramen of Magendie & foramina of Lusaka Tuesday, January 07, 2014 8
  9. 9. The CSF is drained in to the superior sagittal sinus through the arachnoid villi and granulations Tuesday, January 07, 2014 9
  10. 10. Humans produce 500 ml of CSF daily The total CSF volume is only 1/3 of the daily production. • Most of the 500 ml of CSF is produced in the choroid plexuses in the four brain ventricles, and the remaining is produced across the blood-brain barrier. • The CSF passes from the lateral ventricles (I and II) through the foramen of Monroe into the third ventricle (III), through the aqueduct of Sylvius, the fourth ventricle (IV), and out into the subarachnoid space through the foramina Lushka & Magendie . Tuesday, January 07, 2014 10
  11. 11. (18) foramina of Lushka Tuesday, January 07, 2014 11
  12. 12. Foramen of Monro/interventricular foramen (12) Tuesday, January 07, 2014 12
  13. 13. Cast of the ventricles of brain 1. Anterior horn of lateral ventricle 2. Body of lateral ventricle 3. Posterior horn of lateral ventricle 4. Inferior horn of lateral ventricle 5. Third ventricle 6. Fourth ventricle 7. Interventricular foramen 8. Cerebral aqueduct Tuesday, January 07, 2014 13
  14. 14. The lateral ventricles • Situated in the cerebral hemispheres, it has a body, an anterior horn in the frontal pole, posterior horn in the occipital pole &inferior horn in the temporal pole. • The two lateral ventricles are interconnected by interventricular foramen and it also communicates with the III ventricle. • All ventricles are lined by ependyma. • The choroid plexus are formed by a dual layer of ependyma invaded by bunch of capillaries. Tuesday, January 07, 2014 14
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  16. 16. Tela choroidea (7) is a double fold of Pia mater entering into the choroid fissure and forming the organs for CSF formation along with the choroid plexus Tuesday, January 07, 2014 16
  17. 17. Tela choroidea Tuesday, January 07, 2014 17
  18. 18. The duct of Sylvius/Cerebral aqueduct forms the cavity of midbrain Tuesday, January 07, 2014 18
  19. 19. Tuesday, January 07, 2014 19
  20. 20. Roof of IV ventricle formed by cerebellum and superior cerebellar peduncles and superior medullary velum Tuesday, January 07, 2014 20
  21. 21. The fifth ventricle & terminal ventricle • The central canal expanding at the level of filum terminale, of conus medullaris, is the terminal ventricle. • The fifth ventricle is the median cleft between the two laminae of the brain's septum pellucidum (cavum septum pellucidum). • The CSF is getting emptied / drained into the dural venous sinuses through the arachnoid villi and granulations. Tuesday, January 07, 2014 21
  22. 22. Cavum Septum pellucidum Tuesday, January 07, 2014 22
  23. 23. A sagittal section of the brain showing the ventricles Tuesday, January 07, 2014 23
  24. 24. Tuesday, January 07, 2014 24
  25. 25. III Ventricle • It lies below the lateral ventricles. • It is a cavity of the diencephalon. In the roof there is choroid plexus, that produce CSF. • Superiorly it communicates with the two lateral ventricles through the interventricular foramen. • Inferiorly it communicates with the IV ventricle through the cerebral aqueduct. • The lateral wall is formed by thalamus and hypothalamus. The two thalami are annexed by interthalamic adhesion. Tuesday, January 07, 2014 25
  26. 26. Structures in the lateral wall of III ventricle Tuesday, January 07, 2014 1. Thalamus 2. Hypothalamus 3. Midbrain 4. Pons 5. Interthalamic adhesion 6. Anterior commissure 7. Optic chiasma 8. Mammillary body 9. Pineal body 10. Tectum of midbrain 11. Lamina terminalis 12. Interventricular foramen 26
  27. 27. IV Ventricle • It is a cavity of the rhombencephalon. • It has a roof and floor. • The floor is formed by two parts, medullary & pontine part. • Hypoglossal nucleus, vagal nucleus, trigeminal nucleus, glossopharyngeal nucleus, auditory nuclei and facial and abducent nuclei are located in the Tuesday, January floor. 07, 2014 27
  28. 28. Applied anatomy of ventricles of brain • • • • • Hydrocephalus Anencephaly Spina bifida Meningitis Encephalitis Tuesday, January 07, 2014 28
  29. 29. Imaging study showing enlarged cavities of brain due to hydocephalous Tuesday, January 07, 2014 29

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