The present power spectrum is the original power spectrum at decoupling multiplied by the transfer function, which describes how the power in each mode k evolves over the course of time. The original power spectrum is purely representative of density and velocity perturbations just after the big bang. The transfer function T(k) from decoupling to now depends on what has happened to the universe over this time interval, and will involve an integration over two separate domains, the matter-dominated and the radiation dominated, as the perturbations evolve differently in different types of universe. The transfer function is also a function of k, because modes inside and outside the horizon will grow differently.
I don't remember the exact way they grow, though. We did a little maths on it but I could never follow the entire derivation... perturbation theory in general relativity is probably the nastiest set of formulas I've ever seen.
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To try to address your question a little more: The P(k) describes the power contained in different length scales, represented by k, so it contains information about structures over very large and very small scales if you want. But the key is the CMB power spectrum originated long before galaxies or stars formed, a snapshot of the universe as a hot plasma.