A COURSE WORK PRESENTATION FOR PARTIAL

FULFILMENT OF GENERAL NEUROPHYSIOLOGY A

COURSE UNIT OF M.SC. ANATOMY.
Course unit : GENERAL NEUROPHYSIOLOGY ( MAS 1201 ).
Tittle: CSF DYNAMICS (PRODUCTION, CIRCULATION, FUNCTION
AND BLOOD BRAIN BARRIER.

Presentor: Ndyamuhakyi Elisa ( RN, MSc student)

Reg No: 2022-01-09278

By Elisa MSc Anatomy student KIU (2022) 1

Outline/Objectives
• Development of the ventricles

• Anatomy of the Ventricles

• Sub arachnoid spaces and Cisterns

• CSF composition

• CSF Flow in the ventricles (Secretion, circulation and Absorption)

• CSF-Brain Barrier

• Function

• Clinical correlations
Neural tube formation
Formation of Brain Vesicles
Secondary Brain Vesicle

Primary Vesicle
 Vesicles at different dev’t stages

Prof. Saeed makarem

5
ANATOMY OF THE Anterior and Lateral Views of Ventricles
VENTRICLES
• Adult Ventricular system
• Consists of ventricles
• 2 Lateral ventricles
• 3rd Ventricle
• 4th Ventricle
• Foramina:
• Foramen magendi
• F. Monro
• Cerebral Aqueduct
• CSF
 Lateral and Superior View
Lateral Ventricles.

• 2 cavities of telencephalon each in one

cerebral hemisphere.
• C-shaped consisting of 4 parts.
1. Anterior Horn
2. Central part/Body
3. Posterior Horn
4. Inferior Horn
5. Trigone
Anterior horn of lateral ventricle

Borders

• Anterior:

• Posterior:

• Roof:

• Base:

• Medial:

• Lateral:
• Communications:
• With 3rd ventricle: Foramen of Monro.

• Lateral ventricle Choroid plexus: Formed by,

• For Body of lateral ventricle: By Medial & lateral
posterior choroidal arteries.
• In Inferior Horn: By Anterior choroidal
artery.
• In Trigone: By anastomosis of anterior &
posterior choroidal arteries.
3rd ventricle.
• In the diencephalon cavity between RT & Lt
Thalami.
• Triangular in cross section.
• Boundaries:
• Anterior: Lamina terminalis, anterior
commissure and column of fornix
• Posterior: Epithalamus (pineal body,
habenular commissure
• Floor: Optic chiasma, infundibulum,
tegmentum of midbrain, mammillary body.
• Roof: Ependymal cells between 2 thalami
& tela choroidea
• Lateral wall: Hypothalamic sulcus
 3rd ventricle cont’n
• Communications:

• Laterally with lateral ventricle: Via intervevtricular

foramen/F. Monro

• Posteriorly with 4th ventricle: Via Cerebral aqueduct

• Choroid Plexus.

• Formed by

• Medial posterior choroidal artery

• Lateral posterior choroidal artery

Recesses of 3rd Ventricle:
Cerebral Aqueduct/ aqueduct of Sylvfus
• A narrow channel about 3/4 of an inch (1.8
cm) long

• Connects 3rd ventricle with the 4th ventricle.

• Lined with ependymal and surrounded by a

layer of gray matter (central gray).

• The cerebral aqueduct does not have a choroid

plexus.

• Direction of CSF flow is from the third to the

fourth ventricle.
4th Ventricle
• A tent-shaped cavity filled with CSF.

• Located anterior to the cerebellum & posterior to (pons & superior half of medulla oblongata).

• Continues above with cerebral aqueduct and inferiorly with central canal .

• Lined with ependymal.

• Triangular shaped on cross section

4th Ventricle borders Posterior Wall (Roof): Tent-shaped roof leading into the
• Has boundaries, a roof, and a rhomboid-shaped
cerebellum.
floor. Superior part : superior medullary velum.
• Lateral Boundaries Inferior part: Inferior medullary velum.
• Cranial part: by the superior cerebellar peduncle
• Caudal part: by inferior cerebellar peduncle.
 Choroid Plexus
• T shaped; Its vertical part is double .

• It Is suspended from Inferior half of the ventricle roof

• Formed from the highly vascular tela choroidea.

• Blood supply to the plexus: Postero-inferior cerebellar arteries.

Recesses of 4th ventricle
Sub arachnoid
Cisterns
• Brain areas where arachnoid & pia are widely separated by vesicular dilatation
(subarachnoid cisterns).

• Contain CSF, and soft tissue

structures
• These anchor the brain, such as
the arachnoid trabeculae,
vasculature, and in some cases,
cranial nerve roots.
 Cerebrospinal fluid (CSF):
• A clear, colorless plasma-like fluid that bathes CNS.

• Circulates in ventricles, subarachnoid space of the brain and spinal cord &
central canal of the spinal cord.

• Secretion: by choroid plexus found in the lateral, 3rd and 4th ventricles.

• Normally, CSF secretion = absorption thus about 150-270 milliliters of

cerebrospinal fluid within the CNS at all times. 

• Role: Cushions the brains and provides nutrients to the CNS.

CSF Normal Composition
• Cerebrospinal fluid (CSF):

• Glucose: 50-75 mg/dL in cerebrospinal fluid (CSF) or 60-70% of blood glucose concentration     

• Lactic Acid

• Plasma proteins: small amount of albumin and globulin.

• Urea and creatine

• Na+, K+, Mg2+ and Ca2+

• Cl- and HCO3-

• Lymphocytes

• Water
CSF Secretion
• By choroid epithelial/ependymal cells of choroid

plexuses in lateral, 3rd & 4th ventricles.

• Secreted (at the rate of 600–700 mL/day) or 0.2-

0.7ml/min in normal adult.

• Total CSF O 150-270ml in an adult. Thus CSF is

replaced about 4 times @ day.

• Choroid plexuses: Fringes of vascular pia mater (tela choroidea) covered by cuboidal epithelial cells.
• Invaginate into 3rd and 4th ventricles roofs and on the floors of the bodies and inferior horns of the
lateral ventricles.
CSF FLOW
Lateral ventricles

Intervevtricular foramen/
Foramina of Monro

3rd Ventricle

Cerebral aqueduct/aqueduct of sylvius

4th Ventricle
Median aperture

Cerebellomedullary cistern
Central canal of spinal cord

spinal cord central canal

Lateral apertures/Foramen of magendie

Pontomedullary cistern
CSF Absorption.
• CSF is absorbed from subarachnoid space into the venous system.
1. Arachnoid granulations: Their surface has arachnoid villi that increase absorption surface.
2. Minute channels in the cribriform plate:
• Small channel through cribriform plate openings of the ethmoid bone.
• Drain into the lymphatic channels of the nasal mucosa. 

3. Glymphatic system
• Formed by the astroglial cells around the pial arteries.
• Provides entrance route for CSF in exchange for interstitial fluid of
the brain and spinal cord.
• Small amounts of CSF enter the nervous tissue as same amount of
interstitial fluid exits into subarachnoid space in order to be
eliminated through the dural venous sinuses.
 CSF Absorption
cont’n.
• By diffusing via walls of arachnoid granulations.
• Provide a valvular mechanism for the inflow of CSF
into bloodstream but prevents backflow of blood
into the CSF.

• Normally the pressure of the CSF in SAS/Cisterns is higher than that of the venous system, so
CSF flows through the villi and granulations into the venous blood. 

• Most of the CSF is absorbed: In superior sagittal (arachnoid granulations of Pacchioni) and 
transverse sinuses due to high number of arachnoid granulations.
 Spinal CSF
• Via the median aperture (of Magendie) and lateral apertures
(of Luschka) to enter the interpeduncular and quadrigeminal
subarachnoid cisterns where it continues down via  spinal
cord subarachnoid space. 

• Spinal SAS is large, accommodates about half of total volume

of CNS CSF.

• Extends from foramen magnum and ends at S2 vertebra level.

• Below conus medullaris (L1-L2), enlarges into lumbar cistern.

• it contains the dorsal and ventral rootlets of L2-Co spinal

nerves (cauda equina).
 Blood-CSF Barrier (BCB)
• Choroid plexus layers form a selectively permeable barrier (blood-CSF Barrier (BCB).
• Controls the movement of water and solutes into CSF and from CSF into the neural tissue. 

• Components:
• Capillary endothelium
• Basement membrane of capillary endothelium
• Basement membrane of ependymal cells
• Ependymal cells.

• Functions:

• Prevents large molecules from freely entering brain vessels from CSF.

• Controls/Regulates electrolytes & biochemical equilibrium of blood &

CSF.
Functions of CSF
• Cushions against blows to the head/ acts as a shock absorber.

• Provides buoyancy: Prevents weight of the brain from compressing the cranial nerve roots
and blood vessels against the internal surface of the cranium.

• Regulation of intracranial pressure (Monro kelli-Doctrine).

• Regulation of exchange of nutrients in the brain( metabolic functions)

• Protection against infections (Lymphocytes)

• Provides suitable chemical environment for neuronal signaling. (ion balance facilitates
action potential).
Hydrocephalus: Clinical
correlations
• Overproduction of CSF, Obstruction of CSF flow, or interference with CSF absorption.
• Results in excess fluid in the cerebral ventricles and enlargement of the head.

• Obstructive hydrocephalus: Blockage

occurs in cerebral aqueduct or
interventricular foramen.

• Resulting in dilation of ventricles superior to obstruction and increased pressure.

• In infants, expansion of the brain & calvaria causing sutures & fontanelles are still open.
Clinical correlations
• In communicating hydrocephalus:

• Movement of CSF from SAS into venous system is partly or completely blocked.

• May be due to congenital absence of arachnoid granulations, or granulations blocked by

red blood cells due to subarachnoid hemorrhage.

• Leakage of Cerebrospinal Fluid.

• (CSF otorrhea): Fractures in middle cranial fossa floor may result in CSF leakage from
external acoustic meatus. If meninges superior to the middle ear and tympanic
membrane are ruptured.

• (CSF rhinorrhea): Fractures involving cribriform plate of ethmoid resulting in CSF leakage.
 Cisternal and Lumbar Puncture
• Cistern puncture: From posterior cerebellomedullary

cistern via posterior atlanto-occipital membrane into the

cistern.

• Most site of choice in infants and young children.

• Lumbar puncture (LP, spinal tap): Withdrawal of CSF

from the lumbar cistern.

• For ICP monitoring,

• CNS infection diagnosis.

• Treatment/ Anesthesia.
CSF ANALYSIS: Characteristics of normal spinal fluid
Acid-base balance:      
• Total volume: 150 mL                                     PH: 7.28-7.32                                                

• Color: Colorless, clear, like water Pco2: 47.9 mm Hg                                          

HCO3-: 22.9 mEq/L                                         

• Pressure: < 20 cm H 2O                 
Sodium: 135-150 mmol/L                                                
• Osmolality at 37°C: 281 mOsm/L Potassium: 2.7-3.9 mmol/L                                                       

Chloride: 700-750 mg/dL                                                      

• Specific gravity: 1.006 to 1.008
Calcium: 2.0-2.5 mEq/L (4.0 to 5.0 mg/dL)                                  
• Proteins: 20-40 mg/Dl Magnesium: 2.0-2.5 mEq/L (2.4 to 3.1 mg/dL)                              

• At different levels of spinal tap:      Lactic acid: 10-25 mg/dL                                                    

• Lumbar: 20-40 mg/dL                 Lactate dehydrogenase: 40 U/L or less (adults); 70 U/L or less

(neonates)                                      
• Cisternal: 15-25 mg/dL
Glucose: 50-75 mg/dL in cerebrospinal fluid (CSF) or 60-70% of blood
• Ventricular: 15-45 mg/dL  
Ventricular system
 Sources
• Grays atlas of anatomy

• K Moore cliniclal oriented anatomy

• Students grays anatomy 6th edition

• Snell's anatomy 7th edition

• Anatomy SD by sameh doss page 16

• Anatomy Head, Neck , Neuro by Vishram singhVOL3 6th edition

• Ken hub.com

• Netters atlas of anatomy

By Elisa MSc Anatomy student KIU (2022) 34