On these “Gold Standard Step 1 Facts” pages you will find Free:
- USMLE Audio Review files from our “Gold Standard USMLE Reviews”
- Transcriptions of those files
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- Listening to the Audio
- Following along with the transcription
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Let’s start our USMLE Review with Anatomy from the Gold Standard USMLE Step 1 Audio Review program.
Play USMLE Audio MP3 25 09 CSF Clinical Correlations Below
Begin 25 09 CSF Clinical Correlations Transcription
Now we’re going to take a look at the clinical correlations of the anatomy that we’ve covered this far.
Student doctor, for an obstructive or noncommunicating hydrocephalus to occur, the CSF must be prevented, by whatever blockage, from entering what space?
- A noncommunicating or obstructive hydrocephalus results from any obstruction which blocks the movement of CSF from the fourth ventricle into the subarachnoid space. This of course would include any blockage above the fourth ventricle which keeps CSF from getting into the fourth ventricle in the first place.
So, for a noncommunicating or obstructive hydrocephalus, above what specific structure must the obstruction be?
- Above the three foramina by which the fourth ventricle communicates with the subarachnoid space. These three foramina are the two lateral foramina of Luschka and the medial foramen of Magendie.
Now, what is the structure or foramen that the CSF goes through before it reaches these foramina in the fourth ventricle?
- This would be the aqueduct of Sylvius.
What type of hydrocephalus would result if the aqueduct of Sylvius were blocked?
- This would be the noncommunicating or obstructive hydrocephalus.
What happens to the pressure of the intraventricular CSF in a noncommunicating or obstructive hydrocephalus?
- The intraventricular pressure increases.
Student doctor, please name a common symptom and a common sign indicating an increase in the intraventricular pressure. The symptom would be the headache, and the sign would be papilledema upon fundoscopic examination.
Now, if there were blockage or impaired reuptake distal to the fourth ventricle, what would be the resulting type of hydrocephalus?
- A communicating or nonobstructive hydrocephalus.
What is the other name for a communicating or nonobstructive hydrocephalus?
- This is a normal pressure hydrocephalus.
****END OF TRANSCRIPTION****
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