Such clear liquid, colourless fluid is the cerebrospinal fluid, located within the ventricles of the brain and in the spinal canal. It provides important protection for the brain and spinal cord against mechanical shocks. The CSF also maintains homeostasis by nutrient transport, metabolic waste removal, and the regulation of the chemical environment in the brain.
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It will discuss details on the CSF production and circulation of the choroid plexus, multiple functions, blood-CSF barrier, and clinical relevance of abnormalities in CSF dynamics. The structure will be explained in diagrams and tables to expose the critical role played by CSF in maintaining central nervous system health.
The anatomy and physiology of cerebrospinal fluid is discussed-
The location and circulation of CSF is:
Mainly, CSF is produced inside the ventricles of the brain.
The ventricles include two lateral, one-third, and one-fourth.
CSF moves from the lateral ventricle to the third ventricle through the interventricular foramen and further to the fourth ventricle via the cerebral aqueduct.
CSF, on leaving the fourth ventricle, flows into the central canal of the spinal cord.
It is present along the entire length of the spinal cord, cushioning and protecting the tissues of the spinal cord.
The CSF also flows in the subarachnoid space, which envelopes the brain and the spinal cord.
This is a space between the arachnoid mater and pia mater, two of the meninges covering the brain and spinal cord.
In this space, CSF functions as a shock absorber and maintains constant conditions in the central nervous system.
Since there is no apparent effect of gravity, it causes both upward and downward flow of CSF hence mixing well.
The Choroid Plexus The ventricles of the brain are lined with a structure called the choroid plexus, which produces CSF.
The blood is filtered to produce CSF, which is secreted into the ventricles.
The composition and volume of CSF are regulated by the choroid plexus, and it contains the correct concentration of nutrients and ions.
It also clears waste products.
The main composition of CSF is water; it contains almost 99% water content.
This high water content could be the reason behind its ability to act like a cushion and shock-absorbing material for the brain and the spinal cord.
CSF contains numerous ions and molecules essential for the maintenance of the extracellular environment of the brain.
The most common ones are sodium, potassium, chloride, bicarbonate, glucose, and proteins.
In relation, the choroid plexus tightly controls the concentration of these ions and molecules to provide an optimal environment for neuronal activity.
The cerebrospinal fluid performs the following primary functions that play a significant role in maintaining health and stability within the central nervous system.
CSF serves to cushion the brain and spinal cord.
It protects these delicate structures from mechanical shocks and impacts through the mechanism of absorbing and dissipating external forces, which may cause injuries, especially those involving trauma.
The CSF cushions optimally reduce the effective weight of the brain.
The actual weight of the brain is about 1400 grams, but, because of buoyancy provided by the CSF, its net weight drops down to about 50 grams.
This reduced weight avoids pressing the brain onto the base of the skull and the spinal cord thus saving it from damage.
CSF is concerned with removing metabolic waste products from the brain.
In line with their mandate, neurons and other brain cells produce wastes in the course of performing their duties, which need to be flushed out of the system.
CSF facilitates the transportation of such waste products from the brain into the bloodstream for excretion.
CSF plays a very essential role in maintaining the intracranial pressure within a narrow optimal range.
Via its incessant circulation and subsequent reabsorption, CSF aids in the balancing of pressure inside the skull, ensuring that it stays stable despite alterations in the volume of the brain or blood flow.
CSF is concerned with removing metabolic waste products from the brain.
In line with their mandate, neurons and other brain cells produce wastes in the course of performing their duties, which need to be flushed out of the system.
CSF facilitates the transportation of such waste products from the brain into the bloodstream for excretion.
CSF serves as a medium for the delivery of essential nutrients like glucose, ions, and other molecules to the nervous tissue.
This delivery system thus presents substances to the brain cells, which will sustain energy production and metabolic processes.
The processes involved in CSF circulation and absorption are:
Cerebrospinal fluid is produced within the ventricles of the brain by the choroid plexus. CSF circulation follows this pathway:
Lateral Ventricles: The CSF is produced first in the lateral ventricles.
Interventricular Foramina (Foramina of Monro): These openings allow the CSF from the lateral ventricle to enter the third ventricle.
Third Ventricle: The CSF flows further in the third ventricle.
Cerebral Aqueduct (Aqueduct of Sylvius): From the third ventricle, the CSF passes through this narrow canal into the fourth ventricle.
Fourth Ventricle: The CSF accumulates within the fourth ventricle.
Foramina of Luschka and Magendie: The CSF leaves the fourth ventricle through these apertures into the subarachnoid space that encapsulates the brain and spinal cord.
Subarachnoid Space: In this space, the CSF flows around the brain and spinal cord, providing cushion and homeostasis.
Small projections of the arachnoid membrane—one of the meninges surrounding the brain—into the dural venous sinuses are called arachnoid villi.
These villi then congregate to form arachnoid granulations.
These structures are responsible for the absorption of CSF.
The CSF is absorbed via the arachnoid villi and granulations directly into the bloodstream.
These structures can be considered to provide one-way valves that permit the flow of CSF from the subarachnoid space into the dural venous sinuses but block backward flow.
The main site of absorption is the superior sagittal sinus, which is a big venous channel running along the top of the brain.
In the process, CSF is returned to the circulating venous system, whereby a constant volume and pressure are maintained within the central nervous system.
The proper circulation and resorption of CSF protect the brain and spinal cord and ensure metabolic waste removal and delivery of nutrients.
CSF flows from the ventricles through the subarachnoid space, draining into the bloodstream via arachnoid villi and granulations into the venous sinuses.
This constitutes an important function in maintaining equilibrium and activity of the central nervous system.
The cerebrospinal fluid is a limpid colorless transparent liquid that goes through the ventricles of the brain and in parts of the spinal canal. Its most important functions include protection against mechanical damage to the brain and spinal cord, maintenance of intracranial pressure, supplying nutrients, removing metabolic products, and buoying the brain inside the skull to reduce its effective weight.
The CSF originates mainly in the choroid plexus, a fringed mesh of blood vessels of the meninges that projects into the ventricles of the brain. Before passing through the ventricles, the central canal of the spinal cord, and the subarachnoid space surrounding the brain and spinal cord, the CSF is filtered from the blood by the choroid plexus.
Abnormalities in CSF have been related to hydrocephalus, and multiple sclerosis, an autoimmune disorder against the central nervous system. Resulting pathologies from this may perturb the normal production, circulation, and reabsorption of the CSF and give way to neurological symptoms of a wide range.
In the medical test of the lumbar puncture, also referred to as a spinal tap, a small amount of extracted cerebrospinal fluid is sent for diagnostic study. The procedure requires that a needle be introduced into the lower back, between the vertebrae, and into the subarachnoid space. The primary functions of the lumbar puncture are diagnosis of infections, especially meningitis, measurement of intracranial pressure, and detection of other neurological diseases.
The normal CSF is clear and colourless; the following are the usual measurements given:
Pressure: 10-20 cm H2O
Protein: 15-45 mg/dL
Glucose: 50-80 mg/dL (~ 60-70% of the amount in the blood)
White Blood Cells: 0-5 cells/µL
Red Blood Cells: None or very few (0-10 cells/µL)
Chloride: 110–125 mEq/L. The values may differ slightly depending on the laboratory and characteristics of the patient; however, gross deviation from these ranges may mean some underlying pathology.
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