Syllabus · Current · V5 (2025) · Nervous System including autonomic and pain
H2 · Nervous System Physiology
H2.ii · Cerebral & Spinal Blood Flow
Describe the regulation of the cerebral and spinal cord circulations.
Written examination
SAQ history
Cerebral Circulation — Blood Flow Control
7 exam appearances
(a) List the normal parameters for cerebral blood flow (5% of marks). (b) Describe the physiological factors that influence cerebral blood flow (95% of marks).
62%
Using a diagram, explain the effect of PaO2, PaCO2 and MAP (Mean Arterial Pressure) on cerebral blood flow (CBF). (60 % of marks) Outline the effects of propofol and ketamine on CBF and cerebral metabolic requirement for oxygen (CMRO2). (40% of marks)
74%
Using a diagram, explain the effect of PaO2, PaCO2 and MAP (mean arterial pressure) on cerebral blood flow (60% marks). Outline the effects of propofol and ketamine on cerebral blood flow (CBF), cerebral metabolic requirement for oxygen (CMRO2), and cerebral venous oxygen saturation (40% marks).
44%
Oral examination
VIVA history
-
2022B · Day 1 · VIVA 7
This viva will explore your understanding of cerebral blood flow. Describe the relationship between cerebral blood flow and 1: the arterial partial pressure of carbon dioxide 2: the arterial partial pressure of oxygen 3: the cerebral perfusion pressure (Image removed from report.)
-
2020B · Day 2 · VIVA 7
This viva will explore your knowledge of the central nervous system circulation and receptors. What is normal cerebral blood flow?
-
2019B · Day 1 · VIVA 3
This viva will test your knowledge of cerebral blood flow.
-
2018B · Day 2 · VIVA 4
This viva will assess your understanding of cerebral blood flow. What is normal cerebral blood flow (CBF) and how is it distributed?
-
2017B · Day 1 · VIVA 3
This viva will explore your knowledge of the following areas: Neurophysiology and neuropharmacology. What is normal cerebral blood flow? Is it the same for gray and white matter?
-
2017A · Day 1 · VIVA 6
This viva will examine your knowledge of cerebral perfusion, its control and measurement. What is a normal cerebral blood flow and how is this distributed?
-
2016B · Day 1 · VIVA 5
This viva covered cerebral physiology and related pharmacology including factors that influence cerebral blood flow and the related pharmacology of propofol and ketamine.
-
2016A · Day 1 · VIVA 5
This viva covered cerebral physiology and related pharmacology including factors that influence cerebral blood flow and the related pharmacology of propofol and ketamine.
-
2015B · VIVA 3
This Viva tested knowledge of cerebral physiology and related pharmacology. It explored the understanding of the cerebral blood flow and its determinants. It went on to discuss aspects of mannitol and ketamine pharmacology.
-
2014B · VIVA 1
This Viva tested knowledge of cerebral physiology and aspects of pharmacology. It explored topics such as cerebral blood flow, autoregulation and moved on to vasopressin pharmacology.
-
2012B · VIVA 6
This Viva will examine knowledge of Cerebral Blood Flow. What are the determinants of Cerebral Blood Flow? Subsequent discussion involved physiology of Cerebral Blood Flow, its regulation and the pharmacology of propofol.
-
2012A · VIVA 1
This Viva will explore your knowledge of the cerebral circulation and its measurement. What is normal cerebral blood flow? Subsequent questions explored knowledge of differences in grey and white matter blood flow, EEG activity in relation to blood flow, measurement and factors that affect CBF and changes at CBF in response to altitude induced changes in physiology.
-
2011A · VIVA 4
This Viva will test your knowledge about intracranial pressure and cerebral blood flow. Q 1. What are the determinants of intracranial pressure? This viva explored basic and highly relevant area of CNS physiology. Candidates are expected to draw, interpret and explain the relationship between intracranial pressure, cerebral blood flow and variety of chemical and physiologic control mechanisms as they may be illustrated within graphs. Basic pharmacologic pharmacologic principles of ICP control were also discussed. Lack of knowledge depth and conceptual understanding were areas that need further attention.
-
2010B · VIVA 5
This viva will explore your knowledge of Cerebral Blood Flow and the pharmacology of benzodiazepines. What is the normal Cerebral Blood Flow and what are its determinants? Candidates had a good knowledge of cerebral blood flow, although struggled to graphically represent the relationship of CBF with, for example changes in PaCO2. Questions relating to effects of benzodiazepines were also well answered.
-
2009B · VIVA 8
The initial information given to the candidates was – This station will explore your knowledge of the following areas: Neurophysiology and Opioid pharmacology Candidates were asked about cerebral blood flow, it’s measurement, regulation and opioids and their CNS effects
-
2008B · VIVA 2
The initial information given to the candidates was - What is normal cerebral blood flow? This viva explored the candidates’ knowledge in relation to the following points Cerebral Blood Flow, it’s measurement and factors that alter it Cerebral Blood Flow and acute changes in altitude Morphine, typical dose, CNS effects and metabolites Examination feedback: There was good understanding of cerebral blood flow, and most candidates used figures to good effect during the viva. Areas of weakness were an understanding of the methods of measuring CBF and differential flow to the white and gray matter. Candidates also were less confident with the different CNS effects of morphine. Adapting factual knowledge to define what would happen in states of altered physiology was also handled poorly.
Sources: objective text from the relevant CICM syllabus; historical SAQ and VIVA wording from CICM examiner reports.