CNS:PROTECTION Dura Mater: Toughest connective tissue Right under cranium
CNS:PROTECTION Arachnoid: Spider-web covering under dura mater.
CNS:PROTECTION Subarachnoid: Pockets of the arachnoid that contain cerebral spinal fluid (CSF)
CNS:PROTECTION Pia Mater: Delicate, contains many blood vessels.
CNS:PROTECTION CSF: Circulates subarachnoid space Cushions, and nourishes. Surrounds entire CNS
Ohio State University: Neurology: College of Medicine. CSF from the lumbar region contains 15 to 45 mg/dl protein (lower in childen) and mg/dl glucose (two-thirds of blood glucose). Protein concentration in cisternal and ventricular CSF is lower. Normal CSF contains 0-5 mononuclear cells. The CSF pressure, measured at lumbar puncture (LP), is mm of H2O (8-15 mm Hg) with the patient lying on the side and mm with the patient sitting up.
Problems Increased protein: In bacterial meningitis, CSF protein may rise to 500 mg/dl. A more moderate increase ( mg/dl) occurs in inflammatory diseases of meninges (meningitis, encephalitis), intracranial tumors, subarachnoid hemorrhage, and cerebral infarction. A more severe increase occurs in the Guillain-Barré syndrome and acoustic and spinal schwannoma.
Problem Xanthochromia (blonde color) of the CSF following subarachnoid hemorrhage is due to oxyhemoglobin which appears in 4 to 6 hours and bilirubin which appears in two days. Xanthochromia may also be seen with hemorrhagic infarcts, brain tumors, and jaundice.
Normal Clear as water Abnormal findings Faint yellow, orange or pink (Xanthochromia) CSF Protein >100 mg/dl CSF Protein CSF Protein Red Blood Cell lysis Red Blood Cell Red Blood Cell Red Blood Cell >100,000/mm3 (Subarachnoid Hemorrhage) Red Blood CellSubarachnoid Hemorrhage Red Blood CellSubarachnoid Hemorrhage Cloudy or turbid CSF Leukocytes > 200 wbc/mm3 CSF Leukocyte CSF Leukocyte Red Blood Cells > 400 per mm3 Red Blood Cell Red Blood Cell Brown or Dark CSF Metastatic Melanoma (meningeal Melanomatosis) Melanoma Jaundice (Hyperbilirubinemia) JaundiceHyperbilirubinemia JaundiceHyperbilirubinemia Green CSF Hyperbilirubinemia Hyperbilirubinemia Purulent cerebrospinal fluid
(1) intervertebral discs, (2) vertebral bodies, (3) dura, (4) epidural space, (5) spinal cord, and (6) subdural space
BRAIN Folded to increase surface area 35 billion neurons (98%) Adult = 3 lbs
Brain Brain (3 lbs) at rest needs as much oxygen as 61 lbs of skeletal muscle.
Brain Turn to page 224
BRAIN Gyrus: Peaks of the folds, ridges. Sulcus: furrow or groove between gyrus
Brain Ventricles: CSF circulate in four major canals. (Travels through brain and into spine) Continuous. Blue on page 228
BRAINSTEM Lower brain Unconscious part
BRAINSTEM COLOR CODE: Med. Oblongata = k Pons = f Midbrain = a Reticular formation = g