Cerebrospinal fluid - function, production and circulation - animation by Dr. Cal Shipley, M.D.

[@svgs14]

Sir, you summarised my one hour lecture into five minutes.Great.Respect.Thanks a ton !

[@TrialImageInc]

Glad it helped!

[@baseeratfatima4246]

same here bro

[@raginald7mars408]

I add 2 tons more

[@danielpa8644]

So far I watched 4 videos on CSF production, circulation, function and still I felt lost. This video gave me a "gut" understanding so I am sure I won't forget x years. Brilliant explanation.

[@TrialImageInc]

Thank you Daniel! You can access my entire library of medical videos at trialimage.com

[@jbaketkd]

The best video representation of this process I have seen yet. Perfect explanation!

[@TrialImageInc]

Thanks Jacob!. You can access my entire library at www.CalShipleyMD.com

[@amyburks858]

This was immensely informative. I thank you for making this video which was intended to be supplementary but ended up giving more information than was given in lecture. Thank you again.

[@TrialImageInc]

I'm glad it helped Amy. You can find much more at my website www.calshipleymd. com

[@ahmedayesh3728]

thanks a lot, you summarized the topic of CSF so perfectly and the video is so obvious

[@يوسفالنصراوي-ت1ع]

Simple,easy & representative Great job👏👏👏👏

[@joeamrine7450]

This was the video I was looking for... this is the one video on KZbin that shows a labeled csf moving throughout the anatomy... thank you for creating the one video on KZbin to do so

[@TrialImageInc]

You are very welcome Joe. You can access my entire medical library at www.CalShipleyMD.com

[@Leon-tq2dd]

Beautiful visualization. Thank you, Dr. Shipley.

[@TrialImageInc]

+Leon Orenstein thank you! Http://www.CalShipleyMD.com

[@TrialImageInc]

+Leon Orenstein thank you! Http://www.CalShipleyMD.com

[@helicart]

Brilliant and to the point. Thanks for your efforts. I am a clinician with an interest in hydrocephalus pathophysiology, and this is a brilliant educational tool for the more enthusiastic patient.

[@helicart]

p.s. would be good to include CSF flow through glymphatics,.

[@TrialImageInc]

Many thanks helicart! Where do you practice?

[@helicart]

@@TrialImageInc Brisbane, Australia

[@TrialImageInc]

Nice part of the world! We hope to visit someday. Https://www.CalShipleyMD.com

[@Muuip]

Excellent concise visual presentation! Very informative, much appreciated! 👍

[@TrialImageInc]

Thank you Muuip! You can access my entire library of medical videos at trialimage.com

[@mountainmolerat]

This was terrific. Question if you still happen to see comment: When the csf goes down the spine, does it return to the brain in a circular fashion of sorts, or does it return to the blood stream like it does in the brain? Thanks much.

[@TrialImageInc]

Hi Carol - Even after more than a century of scientific study, the precise manner production, circulation and absorption of CSF is still debated amongst top researchers in the field. To your question, one thing that is currently agreed on is that CSF is a one way flow (unlike blood, which of course leaves and then returns to the heart), and Imis absorbed back into the bloodstream at various points including the arachnoid granulations , and possibly through the lymph system in the neck, as well as other mechanisms as yet unconfirmed. Because of the one way flow, the body must precisely balance both production and absorption in order to maintain CSF pressure within physiological levels. If you're interested in delving into the topic in more detail, here's a link to a fairly recent scientific article on the state of the art thinking regarding CSF. www.ncbi.nlm.nih.gov/pmc/articles/PMC6057699/#:~:text=The%20CSF%20from%20the%20subarachnoid,through%20a%20pressure%2Ddependent%20gradient.

[@sphoorti190]

Amazing and to the point video. Thank you sir.

[@TrialImageInc]

Thank you Sphoorti! You can access all of my medically related videos at trialimage.com

[@heatherbaldwin8888]

This is great! My Med/Surg nursing class does not go this in depth (with the villi and such), but going "deeper" helps me understand the material better. Thank you!

[@TrialImageInc]

+Heather Baldwin - thanks Heather! Good luck with your studies... www.calshipleymd.com

[@oliveabroad4278]

This was a very clear, concise description of CSF and helped me to understand what I'm learning in class - thanks!

[@TrialImageInc]

Glad it helped Olive! You can access my entire library of Medical Videos at www.CalShipleyMD.com

[@joanvictoriacanete5817]

Best animation I've seen so far in here. Thank You!!

[@TrialImageInc]

Thanks Joan! Http://www.CalShipleyMD.com

[@Jessica-jq7lr]

Thank you for this video! If CSF comes from the filteration of the plasma, how do you explain how organoids that are not vascularised, still can produce CSF?

[@ggonsg]

LOVE your video. I'm studying to be a Craniosacral Therapist, so your video is sooooo helpful!!! Thank you!!!

[@TrialImageInc]

+Sharon Gonzales - that's great Sharon! You can access my entire video library at CalShipleyMD.com

[@ggonsg]

OOOOOOOOH; how very EXCITING. Thank you so much. I will check out your wonderful videos!!!! Yay!!!

[@sdas127]

Thanks for providing such an great informative video. Great illustration.

[@TrialImageInc]

+sdas127 - you re welcome! www.CalShipleyMD.com

[@javierchile88]

Incredible video. Now I can easily explain it to people. Your website is also easily accessible and very informative. I'll def suggest people there! Thanks.

[@TrialImageInc]

+Javier Palacios -thanks Javier! Access my entire library at CalShipleyMD.com

[@teclajeptui9288]

Very clear and understandable. Thank you so much.

[@saharafsheen6964]

best way to convey this topic

[@shasikasujay8886]

It was so easy to understand thank you sir so short and straight ❤

[@ashish143b]

it was great.....it made my most concepts clear...thanks Cal Shipley,MD

[@TrialImageInc]

Thanks Ashish! www.CalShipleyMD.com

[@goncalosilva9324]

Thank you for your video, it really helped me understanding this.

[@JayOrr-z2x]

I'm a 6th drop out so why do I find this stuff fascinating ? Excellent thankyou Dr.

[@rmt3589]

Sweet! This is just the insight I needed to make my friend a functional CSF system!

[@TrialImageInc]

Thanks rmt! You can access my entire library of medical videos at trialimage.com

[@HadeerSinawe]

Wonderful animation and explanation. Thanks!

[@TrialImageInc]

Glad it helped Hadeer. You can access my entire library of medical presentations at www.calshipleymd.com

[@vmz5811]

veryyy brilliantly explained...want to see more videos of human anatomy like this

[@TrialImageInc]

Thanks Anugya. You can access my entire video library at www.CalShipleyMD.com

[@dannichols6261]

Your animation of the circulation of the CSF is *very* helpful! Thank you for producing it! However I think the downward movement of the CSF in the spinal cord happens in the *central canal* of the spinal cord, not in the arachnoid membrane around it as you showed. I think there's a hole in the bottom of the central canal which allows the CSF to enter the arachnoid & then travel back up through it like you did show (I'm guessing by the beating of cilia 'pumping' it upward?).

[@dannichols6261]

Although maybe I'm confused & wrong, maybe CSF circulates like you say, as I find some things online which suggest that the central canal often occludes as we age, so maybe CSF doesn't circulate *down* it after all, still not yet sure.

[@TrialImageInc]

Hi Dan - excellent question! the precise sites of production and circulation of the CSF are (like many aspects of human anatomy and physiology) still debated by experts in the field and not completely understood. However, there are a few general statements regarding CSF circulation that I think most current researchers would agree on 1) CSF flows from the ventricular system of the brain into the subarachnoid space which surrounds both brain and spinal cord 2) the majority of CSF (75-90%) returns to the venous system via arachnoid villae (AV) which may be found in both the brain and spinal cord) 3) the remainder is absorbed directly into the lymphatic system, which interfaces with the subarachnoid space around cranial nerves (especially the olfactory nerve) and spinal nerve roots in the spinal cord. Regarding the central canal of the spinal cord, some research has found a small quantity of CSF movement from the subarachnoid space into the central canal, and vice versa, but this does not appear to represent a significant part of CSF circulation, which explains why closure of the central canal does not appear to have an impact on CSF dynamics. This is really a fascinating subject, and there is a great more detail one can get into. Of particular interest to me is research regarding WHY CSF (under normal circumstances) flows from the subarachnoid space across the AV into the venous system. For many years, this was thought to be due to an osmotic gradient (venous blood having a higher osmolality than CSF), but current thinking is that this is more likely due to a hydrostatic pressure gradient. If you’re interested in getting into the topic of CSF circulation in greater detail, here is an excellent review article from 2010 that delves into the history of research findings and conclusions on the subject fluidsbarrierscns.biomedcentral.com/articles/10.1186/1743-8454-7-9 You can access my entire library of medical videos at: www.CalShipleyMD.com

[@dannichols6261]

@@TrialImageInc Thank you Dr. Shipley, I appreciate your detailed answer to my misunderstanding! I've downloaded Pollay's paper, pretty heavy reading for a geezer with some college but no degree. :) Cursory reading suggests a kind of gating response with the villi to reverse pressure gradient? I do have what I hope is a simpler question: are there ventricle *wall* structures, similar to the composite walls of arteries, supporting the ependymal cells which line them? Or do the ependymal cells simply adhere to the adjacent nuclei etc structures & that's it? And perhaps more difficult, if there is Pia *inside* choroid plexus, as reading & pictures suggest, where does it *come* from! I've guessed that it adheres to & follows arteries in as arteries enter the brain through the pia of the meninges, but I've seen both yes&no about that. Thanks again for your answer and the article reference.

[@lawyerdoctor]

Thank you, that was very concise and intelligent.

[@TrialImageInc]

Thank you TK! You can view my entire medical video library at www.CalShipleyMD.com

[@anitag2944]

thank you so much for this video my lecturer did such a bad job at explaining the production and route of the csf

[@fiammettagrieco8010]

Hello! Sorry for bothering, I am doing some researches for my engineering thesis about brain-on-chip; firstly this is definitely the best video I've seen so far! thank you so much, everything is so much clearer. I was wondering whether all the contents of this video are still valid even after the discoveries about glymphatic system. Moreover, I was asking to myself if you could suggest me some reliable sources about parameters of the fluids in brain... such as perfusion flow rate, shear stress, clearance, permeability... and this kind of numerical parameters. Thank you so much, I hope you will answer!

[@TrialImageInc]

Sorry for the delayed response Fiammetta. If you are referring to the abosorption of CSF, most researchers still believe that the majority of absorption takes place into the Sagittal venous Sinus via the arachnoid granulations. However, there certainly does appear to be some absorption into the lymphatics, especially around the cranial and spinal nerves. Here are some articles that might help: www.ncbi.nlm.nih.gov/pmc/articles/PMC2842089/#:~:text=Systolic%20arterial%20expansion%20causes%20a,space%20and%20the%20spinal%20canal. www.ncbi.nlm.nih.gov/pmc/articles/PMC6057699/ www.ncbi.nlm.nih.gov/pmc/articles/PMC3042981/ Also, regarding the effects of shear stress, here is an article and an animation I prepared regarding diffuse axonal injury due to shear stress: trialimage.com/home-page/stock-medical-animation/neurology-animation-library/diffuse-axonal-injury-video/ trialimage.com/home-page/articles/diffuse-axonal-injury-review/

[@paulafrengul9761]

Very clear and well explained. Thank you.

[@TrialImageInc]

+Paula Frengul - thank you Paula! CalShipleyMD.com

[@noraabdualwahab2283]

Thank you for existing in life

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[@Kaguro1]

Thank you for this video and your website! The multimedia in there is very helpful for studying :D

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[@sakshis7277]

Thank you :)... best video

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[@successneedstime96]

Simply Marvelous !!!!

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Glad you liked it Zack! www.CalShipleyMD.com

[@zeeshankhan9307]

Thank you sir May you live long

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[@arielshikoba1857]

Finally!!! A clear explanation! 😊

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[@kashedaa.bonner-bey4295]

Great explanation! Thanks!

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[@Dgehjeo]

Amazing. Thank you for sharing.

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[@monish4501]

Sir you are really great.

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[@nomercyolan]

Thank you very much , very good video.

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Thank you petros

[@theGOAT-ml4lw]

wow that was so easy to understand

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[@manihaven6239]

i understand well., and now i teach other medical student

[@نور-ج9ف2ه]

Thank you again

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Thank you Sir... Excellent....

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[@reem4912]

Amazing. Thank you so much.

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Excellent !!

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Thank you❤

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Awesome video

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illustration was too good keep it up

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Thank you! Thank you! Thank you!

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Thanks! Your video is so helpful !!

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Great VDO,THANK YOU

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[@izzahfarhana7434]

Thank you this was very clear

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[@izzahfarhana7434]

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[@zaib1081]

Really useful ❤

[@TrialImageInc]

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[@TroyOi]

Very helpful, Dr. Shipley. I've been watching a video lecture series on anatomy by Dr. Anthony Goodman. In his lecture on the CNS, he indicates that CSF is produced by the arachnoid villi and secreted into the sinuses of the brain (as opposed to coming by way of the choroid plexus' villi into the cerebral ventricles, as this video asserts). Dr. Goodman's lecture series is 14 years old. Is his understanding outdated? Also, what is the distinction between a brain ventricle and a brain sinus? Thanks!

[@TrialImageInc]

Hello David - CSF is produced by the choroid plexuses, and absorbed (not produced) by the arachnoid villi, which facilitate transport into the venous sinuses, which are large channels of venous blood located around the perimeter of the brain, in essence, the sinuses act as large veins, collecting both CSF and venous blood to return it to the heart . (The sinuses are the large areas of blue you'll see in the CSF video.) The ventricles are a series of connected chambers deep within the brain (see the video) which are the sites of CSF production (via chorioid plexuses), and also participate in the flow of CSF. These concepts were taught the same way when I attended medical school some 40 years ago. Hope this helps... Cjs

[@skarpengland]

I have a question, i hope you are still answering questions :) Seeing how the Pia mater is the innermost layer connective tissue, going from Periosteum - dura mater, arachnoid, and pia mater covering the brain. Is it continous from say, the parietal lobe, and to the ventricles of the brain? Or are we talking about pia mater covering the external surface of brain, and another tissue called pia mater covering the ventricles of the brain? I am a bit confused about this.

[@chrismexican21]

i am no doctor, however, my understanding is the pia matter acts as a membranous covering that encases both the brain and spinal cord's exterior. I don't believe it penetrates the cerebral cortex, nor do i believe that pia matter covers the brain ventricles. Ventricles are hollow spaces left over from embryonic brain (neural tube) development, which form a network and contain specialized capillaries which filter blood plasma, thus creating csf.

[@aazoa43]

This is useful thanks 👍🏻

[@TrialImageInc]

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[@mahroof_8]

One of the textbooks ( Sembulingam Physiology) says that the csf is formed by secretion and active transport mechanism and not by ultrafiltration or dialysis... please clarify

[@TrialImageInc]

Hello Mohamed - excellent question! Despite much research in the past few decades, the precise mechanism of CSF production has not been proven, and there are many competing theories. Most researchers believe that ultrafiltration and active transport may both play a role. My video portrays one popular current theory. Active transport of ions across the cuboidal epithelium occurs as a result of polarizing charges on the epithelium. Once ions have been transported from the capillaries, across the epithelium, and into the brain ventricle, an osmotic gradient is produced, which draws water from the bloodstream into the ventricles as an ultrafiltrate. I hope this helps... www.CalShipleyMD.com

[@hjm4733]

I'm wondering how monocytes pass the BBB even though there's tight junctions between the endothelial cells.

[@TrialImageInc]

Hi HJM - the cell junctions are tight but not impermeable, allowing for the passage of specific ions and cells…

[@keerthireddy01]

Thanks a ton

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[@siwenstokes5930]

thank you!

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[@aishahnoor6742]

Great! Thanks!

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+Aishah Noor thanks! www.CalShipleyMD.com

[@dastanroy3784]

sir you didnt show where the csf merge in blood..

[@TrialImageInc]

+Dastan Roy - actually it does. At 4:12 you'll see the CSF moving from the arachnoid granulations into the bloodstream (venous blood)

[@rahul-db6fs]

Thank you

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[@roiebuxbaum1820]

bravo!

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[@hasna780]

Thanx a lot ..

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[@Muuip]

Question: Ependymal motile cilia make the spinal fluid flow?

[@TrialImageInc]

Great question Muuip! Like production of the CSF, there is controversy regarding just exactly what forces propel it throughout the brain and spinal cord. The ependymal cilia certainly seem to play at least a partial role in moving csf through the ventricles, but most authors seem to agree that some combination of pulsatile forces generated by the systolic expansion of arteries in the central nervous system, and respiration, are involved, but again, exactly how this works is as yet unknown. Here are a couple of links to some interesting scientific articles that touch on this question www.ncbi.nlm.nih.gov/pmc/articles/PMC2842089/#:~:text=Systolic%20arterial%20expansion%20causes%20a,space%20and%20the%20spinal%20canal. www.ncbi.nlm.nih.gov/pmc/articles/PMC6057699/ BTW, you can access my entire medical video library at: trialimage.com

[@Muuip]

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[@derarty4290]

This should be thought in schools... early

[@TrialImageInc]

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[@jessicaursua8092]

Perfect!!

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Thanks! sir make more video and help our like student

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[@c73media7]

Hi doctor, my uncle met with accident and his head bone near by ear was broken. After 1 week treatment light red with some liquid is came out through ear. So we asked our doctor he said the inside brain liquid is came due to bone broken. It will cured after 10 days slowly by taking regular tablets and injections. But we are very worried and scared. Plz tell me is it really a problem and is that liquid was regenerative. Please please i am looking for your replay.

[@TrialImageInc]

Sorry for the delayed response c73. How is your uncle doing?

[@منارباسلمرادعبدالأمير]

🤩 perfect

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[@louisecarbonneau6868]

Hello, could you please tell me what would be the cause and effect of scar tissue located in the L5-S1 lumbar? Once arachnoiditis is set in, the scar tissue starts expanding and impending the natural flow of CSF, thus obstructing the rich proteinated CSF to bath other nerves . Can you comment on this please? Is my deduction correct?

[@TrialImageInc]

+Louise Carbonneau - hello Louise. While I’m not aware of anything in the medical literature that pinpoints interruption of CSF flow to the spinal nerve roots as a cause of the pain and other nerve based symptoms in Arachnoiditis, it could be a factor. What is more certain is that the scar tissue and associated inflammation which forms around the nerve roots can cause severe pain, numbness and altered sensation in the areas of the body supplied by the nerve roots, as well as localized pain in the spine. I hope this helps...

[@claudiobiddau5516]

helped people number +1

[@kumarnarendra401]

Sir please say it is for which class,standard high school or above

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[@ananyamaheshwari6037]

Thank you! :))

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[@shamakuma1967]

Ultracentrifugate of plasma is csf

[@Quismo12]

Ramesh Kumaran not exactly

[@stelamajetic5365]

great, thanks :)

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[@SachinSachin-jx8tr]

Thank sir

[@ahmadtanveer1637]

Hii sir I am suffering with numbness in my head left arm and leg and so much pressure on my eyes and between nose and eyes bone lower back pain , I was in a hospital the took spinal liquid and it was normal doctor sent me to sycolojist,but I don’t have any problem like depressions , can you help me or guide me sir????

[@TraceLight]

Ahmad Tanveer you need to see an M.D. in person for that.

[@mansdoctooor]

Thanks

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