6.01 &6.02 Amy, Chris, Gem, Cel: Things Regarding The Brain (Wk1&2)

Front 1

True or false: spinal shock is marked by absence of somatic AND autonomic reflexes above the level of cord injury?

Back 1

FALSE: BELOW the level of cord injury

Front 2

Loss of autonomic reflex activity in the viscera leads to what?

Back 2

bladder and bowel lose tone and become flaccid. Complete absence of bowel activity and bladder distension

Front 3

What does paralytic ileus mean?

Back 3

absence of bowel activity

Front 4

There is substantial loss of sympathetic vascular tone if the spinal cord injury is above which level?

Back 4

T6

Front 5

True or false: during spinal shock, heart rate increases to compensate for the reduced blood pressure?

Back 5

False. Heart rate decreases because of impaired sympathetic innervation and preserved vagally mediated parasympathetic function

Front 6

True or false: skin is warm and dry during spinal shock?

Back 6

true

Front 7

True or false: Hypotension associated with spinal shock should be treated with fluid replacement?

Back 7

False. This may lead to fluid overload

Front 8

If hypotension associated with spinal shock is severe, inotropic agents such as dopamine should be given which does what?

Back 8

increases pumping action of heart

Front 9

How long does a period of spinal shock last?

Back 9

several hours – 4 weeks

Front 10

How do somatic reflexes of affected limbs differ during spinal shock compared to after spinal shock?

Back 10

loss of reflexes during, hyperreflexia following

Front 11

What is a head contusion?

Back 11

bleeding from damaged small blood vessels that leak into brain tissue

Front 12

What are the different forms of haematoma?

Back 12

Intracerebral
Extradural
Subdural

Front 13

Extradural haematomas = bleeding between which two structures?

Back 13

skull and dura mater

Front 14

What is the recovery vs mortality of subdural haematomas?

Back 14

10% good recovery, 70% mortality

Front 15

What vessels rupture in subdural haematoma?

Back 15

dural bridging vessels

Front 16

Subdural haematoma occurs more readily in whom?

Back 16

elderly and alcoholics due to more brittle bridging vessels

Front 17

Most extradural haematomas are from the rupture of __________________ artery or vein after a __________________ bone fracture

Back 17

middle meningeal, temporal

Front 18

What type of haematoma has blood that is not in contact with the brain surface?

Back 18

intracerebral

Front 19

Which forces lead to diffuse (axonal) injuries?

Back 19

acceleration, deceleration, rotational

Front 20

What is the mortality vs good recovery of diffuse injuries?

Back 20

10% mortality, 70% good recovery

Front 21

What are the 3 grades of diffuse injury and what do they mean?

Back 21

Grade 1: nothing seen macroscopically
Grade 2: haemorrhages in corpus callosum
Grade 3: haemorrhages in lateral brain stem

Front 22

Diffuse injury causes axonal swelling. What happens next?

Back 22

calcium moves into axon -> microtubules damaged -> axonal transport affected -> build up of transported substances at site of axonal injury -> in severe cases, white matter shrinkage

Front 23

Excitotoxicity: Following trauma to the nervous system, what is released and what receptors does it act on?

Back 23

Glutamate, NMDA

Front 24

14. Over activity of the above receptors allows excess influx of what into the nerve cells, and what is the result of this and why does it cause nerve cell damage and death?

Back 24

Calcium, release of enzymes such as phospholipases, proteases, endonucleases which damage cell components

Front 25

What are the two most common causes of spinal cord injury?

Back 25

MVAs (50%) and sport (20%)

Front 26

Where does the spinal cord end?

Back 26

L1-2

Front 27

Prognosis of spinal cord injury depends on which 4 things?

Back 27

age of patient, degree of deficit, level of injury along spinal column, extent of lesion (transverse and longitudinal)

Front 28

What is Brown-Séquard Syndrome?

Back 28

lateral hemisection

Front 29

Anterior cord syndrome preserves what?

Back 29

Dorsal columns

Front 30

Therefore, which sensations are preserved in Anterior cord syndrome?

Back 30

fine touch and proprioception

Front 31

And, in anterior cord syndrome, motor function below level of injury is lost due to the interruption of which tract?

Back 31

CsT

Front 32

In anterior cord syndrome, pain and temp sensations below level of injury is lost due to the interruption of which tract?

Back 32

StT

Front 33

true/false :Spinal shock is more commonly associated with hemisection of the SC.

Back 33

False: it is more commonly associated with a complete transaction of the cord.

Front 34

true/false: Spinal cord injury about the level of T6 will result in loss of parasympathetic vascular tone resulting in hypotension.

Back 34

False: Spinal cord injury about the level of T6 will result in loss of sympathetic vascular tone resulting in hypotension

Front 35

true/false: A complete lesion in the upper sacral region will result in loss of bladder control.

Back 35

True: If lesion is above the lowest sacral segments will result in an impairment of autonomic function with loss of bladder and bowel control.

Front 36

true/false: An incomplete lesion will result in no sensory function preserved more than 3 segments below the site of lesion.

Back 36

False: incomplete lesions result in some preservation of voluntary and/or sensory function, including sacral sensory lesion.

Front 37

true/false: A high thoracic injury can result in an inability to cough?

Back 37

True: Whilst the diaphragm will be spared (by sparing of the phrenic nerve- C3,4,5), a high thoracic lesion can result in paralysis of intercostals and abdominal muscles. Thus forced inspiration is preserved, but forced expiration (e.g. cough) is severely impaired.

Front 38

true/false: Proton pump inhibitors are used to reduce the impact of paralysed ileus?

Back 38

False: proton pump inhibitors are used to counter potential stress ulcerations. Stress ulceration is associated with critical illness, and more specifically with mechanical ventilation for more than 48hrs.

Front 39

What are the aims of immediate management of SCI?

Back 39

To minimise secondary spinal cord damage & to prevent complications from altered physiological functioning following SCI.

Front 40

What actions can be undertaken to prevent thrombus formation in SCI patients?

Back 40

TED stockings and anticoagulants (heparin/ warfarin).

Front 41

What drug can be used to increase the BP in hypotensive (T6 lesion and above) patients?

Back 41

Dopamine

Front 42

What does the goals mnemonic ‘B BOUT SPINE’ stand for?

Back 42

B: increase BP
B: empty Bladder
O: Oxygen therapy
U: peptic Ulcer prevention
T: prevent Thrombus formation
S: stabilise Spine for transport
P: Pain relief
I: decrease Inflammation to limit extent of injury
N: Nasogastric (empty stomach contents)
E: Establish IV access

Front 43

How many layers of meninges are there, and what are they?

Back 43

3: Pia mater, arachnoid mater, dura mater.

Front 44

Where is the subarachnoid space?

Back 44

Between arachnoid and the pia matar.

Front 45

What layer are cisterns located in?

Back 45

Cisterns contain CSF, and it is the subarachnoid space which generally contains CSF.

Front 46

What layer contains the major branches of the cerebral blood vessels?

Back 46

subarachnoid space

Front 47

Where/where is a subdural space?

Back 47

A potential space between the dura and arachnoid mater.

Front 48

The dura forms folds, what are they called?

Back 48

Falx cerebri(b/w the hemispheres of the cerebri), tentorium cerebella (b/w cerebellum and cerebral cortex), falx cerebelli (b/w cerebella hemispheres)

Front 49

What is the epidural space:
a. In the head:
b. In the vertebra:

Back 49

a. A potential space filled with blood.
b. A real space, as the dura is not fused to the adjacent vertebra.

Front 50

What is more common, an arterial or venous hematoma?

Back 50

90% arterial

Front 51

(fill in the blank) is associated with blows to the head, that result in the rupture of the arteries.

Back 51

Epidural haematoma is associated with blows to the head, that result in the rupture of the middle meningeal arteries.

Front 52

Where in the head re the superficial veins and arteries of the brain located?

Back 52

Subarachoid space, on top of the pia mater.

Front 53

How can a subarachnoid haemorrhage lead to a stroke?

Back 53

Blood in the subarachnoid space mixes with CsF and covers the pia mater with a coat of RBC. As these RBS’s die, they releace haemoglobin, which comes into contact with arteries and stimulates contraction of their smooth muscles, decreasing arterial diameter.

Front 54

Where is CSF made?

Back 54

13. CSF is primarily made in the choroid plexus in the ventricles (80%) and by the ependyma cells of the brain, which line the ventricular walls.

Front 55

The ? ventricle forms a narrow slit between the thalami

Back 55

3rd

Front 56

15. Where is the choroid plexus found?

Back 56

15. In all areas of the ventricular system, except for the anterior and posterior hoens of the lateral ventricles.

Front 57

16. What cistern does the foramen of magendie and luschka drain into?

Back 57

16. Cerebellomedullary cistern

Front 58

17. Where is CsF reabsorbed?

Back 58

17. Dural venous sinuses

Front 59

What is the epidural space?
Choose the correct statement:

(A) in the cranium, it is a potential space between dura and bone
(B) in the cranium, it is a potential space between dura and arachnoid
(C) in the cranium, it is a potential space between pia and arachnoid
(D) in the vertebral canal, it is a potential space between dura and bone
(E) in the vertebral canal, it is a potential space between dura and arachnoid

Back 59

(A) in the cranium, is a potential space between dura and bone

Front 60

true or false: A myelomeningocele does not involve the spinal cord

Back 60

False

Front 61

true or false: A myelomeningocele is different to the term "spina bifida".

Back 61

False

Front 62

true or false: A meningocele does not involve the meninges

Back 62

False

Front 63

true or false: A myelomeningocele is nearly always associated with hydrocephalus

Back 63

True

Front 64

What is the clinical significance of the blood brain barrier (BBB)?
Choose the correct statement:

(A) A BBB is found at the level of the extracranial cerebral vessels
(B) The BBB has no control entry of particular substrates into the CNS
(C) The capillaries of the brain have many fenestrations
(D) The BBB at the choroid plexus is not absolute
(E) excludes toxins

Back 64

(D) The BBB at the choroid plexus is not absolute

Front 65

true or false: The mesencephalic aqueduct connects the lateral ventricles to the third ventricle

Back 65

False

Front 66

15. Where is the choroid plexus found?

Back 66

15. In all areas of the ventricular system, except for the anterior and posterior hoens of the lateral ventricles.

Front 67

16. What cistern does the foramen of magendie and luschka drain into?

Back 67

16. Cerebellomedullary cistern

Front 68

17. Where is CsF reabsorbed?

Back 68

17. Dural venous sinuses

Front 69

What is the epidural space?
Choose the correct statement:

(A) in the cranium, it is a potential space between dura and bone
(B) in the cranium, it is a potential space between dura and arachnoid
(C) in the cranium, it is a potential space between pia and arachnoid
(D) in the vertebral canal, it is a potential space between dura and bone
(E) in the vertebral canal, it is a potential space between dura and arachnoid

Back 69

(A) in the cranium, is a potential space between dura and bone

Front 70

true or false: A myelomeningocele does not involve the spinal cord

Back 70

False

Front 71

true or false: A myelomeningocele is different to the term "spina bifida".

Back 71

False

Front 72

true or false: A meningocele does not involve the meninges

Back 72

False

Front 73

true or false: A myelomeningocele is nearly always associated with hydrocephalus

Back 73

True

Front 74

What is the clinical significance of the blood brain barrier (BBB)?
Choose the correct statement:

(A) A BBB is found at the level of the extracranial cerebral vessels
(B) The BBB has no control entry of particular substrates into the CNS
(C) The capillaries of the brain have many fenestrations
(D) The BBB at the choroid plexus is not absolute
(E) excludes toxins

Back 74

(D) The BBB at the choroid plexus is not absolute

Front 75

true or false: The mesencephalic aqueduct connects the lateral ventricles to the third ventricle

Back 75

False

Front 76

The content of a paediatric history differs from that of an adult history. The acronym ADING is used to remember this. What does ADING stand for?

Back 76

Which statement is false?
A) Over 90% of spina bifida cystica are myelomeningoceles
B) Chiari malformations cause and obstruction of the cerebral aquaduct
C) Bladder and bowel involvement is almost always present with myelomeningocele
D) Orthopaedic deformities and renal complication can develop during infancy and childhood
E) A Chiari II malformation is frequently associated with the development of hydrocephalus

Front 77

The age has an impact on how you would obtain a history of a child. For the following ages would you ask the child their history directly? (Not simple yes/no answers):
3 months
3 years
6 years
13 years
17 years

Back 77

Generally, for children under the age of 4 the history will come from the parents. The older the child the more information will come from the child and as the child goes into adolescence it will become more important to ask them directly/confidentially.

Front 78

What are some issues with obtaining a history from a parent?

Back 78

Symptoms are the parents interpretation, parents can anxious, you may need to concentrate more on past history and family history, it allows you to observe the parent-child interaction

Front 79

Which of the following is not a mechanism of action of an anticonvulsant drug?
A) Activating GABA receptors
B) Limiting the firing frequency of neurons (via Na channels)
C) Activating GABA metabolism
D) Inhibiting GABA uptake
E) Activating adenosine receptors

Back 79

C. Activating GABA metabolism

Front 80

Barbiturates have been used as an anticonvulsant for a long time. Which of the following is incorrect?
A. Barbiturates work by inhibiting excitatory transmitter release
B. Barbiturates enhance GABA action
C. Barbiturates are displaced by benzodiazepines, which work by enhancing GABA action on a subset of GABA receptors
D. Barbiturates limit firing of neurons by inactivating Na channels

Back 80

D

Front 81

Which of the following is true?
A. Carbamazepine is safe to use in pregnancy
B. Carbamazepine is often used to treat absence seizures
C. Carbamazepine is used to treat complex partial seizures but often makes absence seizure worse
D. Tegratol has very few side effects
E. Pharmacologically, carbamazepine does not resemble phenytoin in its mechanism of action

Back 81

C

Front 82

Gemma, a 22 year old auburn haired girl with a history of generalised seizures over the last 9 years has come to see you because she wants to get pregnant and has heard her epilepsy medication can harm the baby. Gemma’s mother also reports that Gemma often stares into space in the middle of a conversation and has been known to drop things. Which statement is true?
A) She most likely has Juvenile myoclonic epilepsy
B) Gemma should stop taking her anticonvulsants during pregnancy because it is a Class D drug?
C) You should advise her never to have kids because she is a ranga (with epilepsy)
D) Her medication should not include valproate because it makes absence seizures worse
E) She has severe constipation

Back 82

A

Front 83

Which statement is false?
A) A number of mutation have been found in the genes that encode for GABAA receptors that cause an inheritable form of epilepsy
B) Lamotrigene is an agent that inhibits excitatory amino acid release but was withdrawn from the market in 1994 because it shuts down memory
C) GABA is an inhibitory neurotransmitter released by more than 40% of inhibitory neurons
D) Pregabalin and Gabapentin were first synthesized as GABA analogues
E) Lamotrigene is actually pretty good and is frequently used.

Back 83

B

Front 84

Spina bifida cystica is:
A) A general term used to describe defects that occur when the rostral neuropore fails to close
B) Associated with abnormalties of the spinal cord, nerve roots and their coverings that underlie a bony defect
C) A bony defect without herniation of the meninges
D) Due to a disturbance during the 4th month of pregnancy
E) Strongly associated with anecephaly

Back 84

E

Front 85

Which statement is false?
A) Over 90% of spina bifida cystica are myelomeningoceles
B) Chiari malformations cause and obstruction of the cerebral aquaduct
C) Bladder and bowel involvement is almost always present with myelomeningocele
D) Orthopaedic deformities and renal complication can develop during infancy and childhood
E) A Chiari II malformation is frequently associated with the development of hydrocephalus

Back 85

B

Front 86

Which of the following is not true in regard to hydrocephalus?
A) Hydrocephalus can be defined as an increase in CSF in association with dilation of the ventricular system
B) Following surgery to correct spina bifida head size should monitored
C) Hydrocephalus in an infant with spina bifida is classified as an overproduction of CSF
D) Hydrocephalus in association with a Chiari malformation is obstructive
E) Untreated hydrocephalus can cause brainstem dysfunction, bulbarparesis and vocal cord paralysis

Back 86

C

Front 87

1. Where is CSF found?

Back 87

a. Within ventricles and subarachnoid space

Front 88

Where is the majority (75%) of CSF found?

Back 88

Subarachnoid space in spine

Front 89

3. What colour is CSF (normally)?

Back 89

a. Crystal clear

Front 90

(true or false) Homeostasis: maintains constant enviro for neurons and glia

Back 90

true

Front 91

(true or false) Provides brain protection

Back 91

true

Front 92

(true or false) Provides nutrients

Back 92

false

Front 93

(true or false) CSF Reduces brain weight

Back 93

true

Front 94

(true or false) Provides metabolites

Back 94

false; it removes extracellular metabolites

Front 95

(true or false) Passage for adrenal hormones

Back 95

false; for some pituitary hormones

Front 96

(true or false) CSF regulates cerebral blood flow and pulmonary ventilation

Back 96

true

Front 97

True or false: the ventricular system is continuous with the central canal of the spinal cord

Back 97

true

Front 98

True or false: the four ventricles are not connected

Back 98

False. There are several small holes or foramina that connect them

Front 99

True or false: there is a potential space between the pia mater and the arachnoid mater

Back 99

False. It’s between the dura and arachnoid

Front 100

Where is CSF made?

Back 100

Choroid plexus and the ependyma

Front 101

What makes most (80%) of the CSF?

Back 101

Choroid plexus

Front 102

True or false: the choroid plexus is an avascular structure

Back 102

False. It is a very vascular structure

Front 103

Where is the choroid plexus located?

Back 103

In the ventricles

Front 104

What is the ependyma?

Back 104

A thin epithelial membrane lining the ventricular system of the brain and spinal cord

Front 105

True or false: we produce 500mL of CSF per day

Back 105

True

Front 106

True or false: CSF secretion (from epithelial cells of choroid plexus to ventricles of the brain) is an active process

Back 106

False. Its secretion relies on energy dependent mechanisms (Na-K ATPase and CO2 metabolism) AND passive (facilitated diffusion)

Front 107

How come H2O just diffuses across?

Back 107

Movement of Na+, Cl- and HCO3- from the blood to the ventricles creates an osmotic gradient which drives the secretion of water through aqueporins

Front 108

True or false: protein content in CSF is higher than that of serum

Back 108

False. In CSF, protein = 35mg/dL, serum = 7000mg/dL

Front 109

What does the majority of CSF absorption?

Back 109

Arachnoid villi

Front 110

What are the above?

Back 110

Extensions of the subarachnoid space

Front 111

They project through the inner layer of the dura and connect the ____________________ with the ________________ and therefore they connect CSF with _________________

Back 111

Subarachnoid space, dura, blood

Front 112

Absorption is a _______________ dependent process

Back 112

Pressure

Front 113

True or false: CSF pressure in the subarachnoid space has to be less than the venous pressure in order for CSF for be absorbed back into blood (in the venous system)

Back 113

False. CSF pressure needs to be greater than venous pressure in order to drive CSF out into the venous system

Front 114

Would CSF pressure be described as static or dynamic?

Back 114

Dynamic – it’s pulsatile – changes with heart beat and breath to breath

Front 115

Cerebral venous sinuses are venous channels which receive CSF from the SAS and empty into the internal jugular vein. They are found between the layers of which meninge?

Back 115

Dura mater

Front 116

What do we do a lumbar puncture for?

Back 116

Measure constituents of CSF

Front 117

Puncture site: midline of which vertebral level?

Back 117

L4-5

Front 118

If the CSF is not crystal clear, what three other colours could it be and what would that signify?

Back 118

1] Blood stained: put needle through vein during puncture? If doesn’t clear off, could be subarachnoid haemorrhage. 2] Turbid (cloudy): high protein content  infection. 3] Xanthochromic (yellow tinge): breakdown of haemoglobin and comes on a few days after a haemorrhage

Front 119

Why do CSF infusion studies?

Back 119

To see if the arachnoid villi can cope with an increased amount of fluid

Front 120

What is hydrocephalus?

Back 120

Increased CSF volume - - - a dynamic imbalance between the production and absorption of spinal fluid that results in an increase in the size of ventricles within the brain

Front 121

When hydrocephalus is due to an obstruction, where is the most likely location of this obstruction?

Back 121

Outlet foramina of the fourth ventricle

Front 122

True or false: Pseudotumor cerebri, like hydrocephalus, indicates an increase in CSF volumes

Back 122

False. Increased CSF pressure

Front 123

Acute hydrocephalus: symptoms?

Back 123

Headache, N&V, lethargy, drowsiness, stupor, coma

Front 124

Acute hydrocephalus: signs?

Back 124

Papilloedema, diplopia, setting sun sign, false localising signs (VI nerve palsies – NVI long and thin and runs along petrous temporal bone and is prone to having brain squished down on it)

Front 125

What is macrocephaly and what is a cause of it in infants?

Back 125

Big head. Infantile hydrocephalus – sutures of skull aren’t fused together => head can expand because sutures split

Front 126

The Munro-Kellie Doctrine in a nutshell: An ___________ in volume of the brain, CSF or blood of the introduction of a mass lesion must be accompanied by a ____________ in volume of the other components

Back 126

Increase, decrease

Front 127

Normal pressure hydrocephalus (NPH) has a characteristic triad:
a. _____________ disturbance
b. ________________
c. Urinary _______________

Back 127

gait (short, shuffling)
dementia
incontinence

Front 128

An example of CSF shunting as Rx for hydrocephalus?

Back 128

Ventriculo-peritoneal, ventriculo-pleural, ventriculo-atrial, lumbo-peritoneal

Front 129

True or false: intraventricular haemorrhage in infants is due to trauma

Back 129

False. It is due to bleeding into the subependymal germinal matrix

Front 130

In which infants is intraventricular haemorrhage most common
a. premature infants
b. overdue infants
c. very low birth weight infants (<1500g)
d. a and c

Back 130

d. a and c
The germinal matrix is the site of proliferation for neuronal and glial precursors in the developing brain. It contains a rich network of fragile thin-walled vessels thus this area is extremely sensitive to hypoxia and changes in perfusion pressure. In premature and VLBW babies, the ability for autoregulation of cerebral blood flow is missing and so increased arterial BP in these vessels leads to rupture and haemorrhage

Front 131

True or false: After the haemorrhage, ICP will be raised and the medulla or base of brain may herniate into the foramen magnum and cause death

Back 131

True

Front 132

True or false: anencephaly is the malformation of the posterior end of the neural tube

Back 132

False. Anterior end.

Front 133

What can be tested in a maternal blood sample for screening for spina bifida?

Back 133

Alpha fetoprotein

Front 134

What is holoprosencephaly?

Back 134

Incomplete separation of the cerebral hemispheres across the midline

Front 135

True or false: holoprosencephaly can lead to a single ventricle

Back 135

True

Front 136

Mutations in which gene is associated with holoprosencephaly?

Back 136

Shh

Front 137

True or false: holoprosencephaly is associated with trisomy 21

Back 137

False. Trisomy 13

Front 138

At 18 days the embryo how big and what shape is the embryo?

Back 138

At 18 days the embryo consists of an oval disc (1-2mm in length) which consists of 3 layers

Front 139

What are the 3 layers of the oval disc at this early stage?

Back 139

3 layers: upper ectoderm, middle mesoderm and lower endoderm

Front 140

Upper ectoderm eventually develops into:

Back 140

skin and CNS

Front 141

Middle mesoderm eventually develops into:

Back 141

muscle, skeletal structures, CT, BV’s & notochord

Front 142

Lower endoderm eventually develops into:

Back 142

lungs, respiratory, GIT

Front 143

At day 18, the that is overlying the midline becomes thickened into what cell type?

Back 143

At day 18, the ectoderm that is overlying the midline mesoderm becomes thickened into pseudostratified epithelium – this is the neural plate

Front 144

T/F: the cranial end of the plate is broad and will eventually develop into the spinal cord?

Back 144

False: The cranial part of the plate is broad, but the caudal part is narrow. The narrow caudal end will eventually develop into the spinal cord.

Front 145

Primary neurulation is what process?

Back 145

The elevation, folding and fusion process to convert the plate neural plate into a closed neural tube.

Front 146

Steps of primary neuralation?

Back 146

By day 24 only the cranial and caudal ends remain unzipped.

Front 147

What is secondary neurulation?

Back 147

The cavity of the neural tube then grows into this structure.

Front 148

What days does the cranial end (neuropore) close?

Back 148

Days 24-26

Front 149

What days does the caudal end (neuropore) close?

Back 149

Days 26-28

Front 150

What is the fate of the neural crest cells?

Back 150

They migrate from their margins to differentiate in a range of tissues, including:
i. Sensory neurons of dorsal root ganglia(the ones that stay close to the sc).
ii. Sympathetic and parasympathetic ganglia.

Front 151

What are the most common sites for defective closure of the neural cord?

Back 151

The neuropores.

Front 152

True/False: failure of closure of the posterior neuropore results in anencephaly?

Back 152

False: it is the anterior neuropore.

Front 153

What fails to develop in anencephaly?

Back 153

The brain, it is incompatable with life.

Front 154

Failure of the neural tube to close in any region of the spinal cord disrupts the formation of the vertebral column. What is this called?

Back 154

Spina bifida

Front 155

Where is the most site and name of the most common type of spina bifida?

Back 155

Posterior neuropore is the most common site, resulting in lumbro-sacral spina bifida called myelomeningocele.

Front 156

Where in the developing spinal cord is the proliferating layer?

Back 156

It is adjacent to the lumen of the tube, and cells migrate peripherally from here to differentiate into neurons.

Front 157

At week 5 of development how many columns run the length of the spinal cord, and what are they called?

Back 157

4

a. 2 dorsal (alar) columns- future sensory interneurons
b. 2 ventral (basal) columns- future motor neurons

Front 158

What is the groove between the two groups of columns called?

Back 158

Sulcus lumutans

Front 159

In the head region of the neural tube there 5 divisions or vesicles, what are they called?

Back 159

a. Telencephalon
b. Diencephalon
c. Mesencephalon
d. Metencephalon
e. Myelencephalon

Front 160

When is most of the brain neuronal proliferation completed?

Back 160

Week 16

Front 161

True/false: cerebella production of neurons in the internal granular layer doesn’t occur until the 2 years of postnatal life?

Back 161

False: this occurs in the first year of postnatal life.

Front 162

What is holopronsencephaly?

Back 162

A developmental anomaly of the human forebrain and midface. The cerebral hemispheres fail to separate into distinct left and right halves.

Front 163

In holopronsencephaly, which genes are commonly mutated?

Back 163

BMP (bone morphorgenic proteins) and SHH

Front 164

What is the difference between legal discrimination and enacted stigma that a patient may feel?

Back 164

1. Legal discrimination: where epilepsy patients are not allowed to be airline pilots, bus drivers, etc.  common sense

2. Enacted stigma: where a person with epilepsy is refused a job, based on their epilepsy, inappropriately. Eg. a bank teller