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69 Cards in this Set
- Front
- Back
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Which spina bifida type is restricted to vertebral arches and usually is asymptomatic with small tuft of hair or dimple
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Spina bifida occulta
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Which type of spina bifida is more extensive and involves bony and soft tissue defects and meninges protrude as fluid filled sac - lateral aspects covered by skin, apex is ulcerated
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Spina bifida with meningocele
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Which type of spina bifida is more extensive and involves spinal cord flattening
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Spina bifida with meningomyelocele
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Which type of spina bifida involves extreme defect with spinal column converted to gaping canal
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Spina bifida with raschishisis
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Malformations associated with spina bifida
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- Arnold- Chiari malformation
- Dandy- Walker malformation - Hydrocephalus - Hydromyelia - Polymicrogyria |
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Which disease is second in incidence to spina bifida
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Anencephaly
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Anencephaly is _
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Congenital absence of parts or all brain
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What are the common manifestations of Arnold- Chiari malformation
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- Beaking of quadrigeminal plate
- Herniation of cerebellar tonsils - Kinking of dorsal aspect of lower medulla/upper spinal cord - Hydromyelia- dilation of central portion of spinal cord |
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Tubular cavitation of spinal cord is called _
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Syringomyelia
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Dilation of central portion of spinal cord is called _
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Hydromyelia
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Arnold Chiari malformation involves _ which parts of brain?
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Medulla and cerebellum
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In Arnold Chiari malformation brainstem and cerebellum are compacted into _
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Bowl shaped posterior fossa
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What usually causes Arnold Chiari malformation?
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Myelomeningocele anchors down lower end of spinal cord, causes downward growth of spinal cord and puts traction on medulla
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In Arnold Chiari malformation caudal aspect of _ is herniated through _
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Cerebellar vermis through enlarged foramen magnum
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In Dandy Walker malformation _ is enlarged, and _ is absent or only in rudimentary form - in its place is a _
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Posterior fossa enlarged
Cerebellum Large midline cyst |
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What is the most common cause of congenital hydrocephalus?
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Congenital atresia of aqueduct of Sylvius
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What is the difference between communicating and non-communicating hydrocephalus?
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In non-communicating hydrocephalus only portion of ventricular system (3d ventricle for example) is enlarged while in communicating hydrocephalus there is enlargement of entire ventricular system
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In communicating hydrocephalus there is an impairment of _
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REABSORPTION
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If patient dies from hydrocephalus what is the actual cause of death ?
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Increased ICP --> Herniation
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Dilation of ventricular system with increased CSF secondary to loss of brain parenchyma is called _
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Ex vacuo hydrocephalus
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Disorders of cerebral gyri are associated with _
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Mental retardation
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Presence of small and excessive gyri is called _
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Polymicrogyria
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If there is decrease in number of gyri and gyri that are present are unusually broad this is called _
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Pachygyria
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Derangements in autosomes 1-12 are _
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Incompatible with life, usually spontaneously aborted
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Down syndrome patients develop _ by 4th decade
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Alzheimers
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In Holoprosencephaly - how does the brain look? Whats absent? Which chromosomes involved?
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Brain is microcephalic, there is no corpus callosum or interhemispheric fissure, not compatible with life
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In vasogenic edema there is _ disruption resulting in _ - may be focal or generalized
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Disruption of BBB resulting in increased permeability
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In cytotoxic edema there is increase in _ caused by _
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Increased intracellular volume caused by hypoxia/ischemia inhibiting active pumps (no ATP)
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With epidural hematoma there is usually fracture of _
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Temporal bone
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How does epidural hematoma look on x ray?
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Like olive
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If pupil is fixed and dilated, what does that tell you
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There is intracranial bleed on the same side
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In boxing trauma there is damage to _
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Reticular formation
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_ inhibits nerve conduction - used as defibrillator
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ADENOSINE
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_ Blocks adenosine receptors
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CAFFEINE
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Static subdural hematoma has 3 routes of resolution - name them
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- May be reabsorbed
- Remain static and undergo calcification - Enlarge and rebleed within 6 months |
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Does absence of blood in CSF negate presence of subdural hematoma
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NO - does NOT negate presence of subdural hematoma
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Stretching meninges causes _
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Headache
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Focal cortical irritation causes _
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Seizures
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Bilateral subdural hematoma causes _
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Cognitive dysfunction
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2/3 of cases of subarachnoid bleeding reflect _
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Rupture of pre- existing aneurysm
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How does patient with subarachnoid hemorrhage present?
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Severe headache + nuchal rigidity + photophobia
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In cerebral contusion if lesion is at the point of impact its called _
If lesion is on the opposite side its called _ |
COUP
COUNTER COUP |
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What type of necrosis occurs in brain
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Liquefactive
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High velocity contributes _ to the projectile launching in the brain
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BLAST EFFECT
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Spinal cord injuries often lead to _
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Paraplegia or quadriplegia
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If patient presents with signs of spinal cord injury what do you need to give patient right away
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Steroids - anti-inflammatorys
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In hyperextension injury (posterior displacement) which ligament tears
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Anterior spinal
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Spinal cord necrosis and edema caused by contusion is called _
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Myelomalacia
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Hematoma within spinal cord is called _
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Hematomyelia
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What is the most common congenital vascular malformation
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AVM
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AVM's are typically seen where
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Cerebral cortex
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Vascular malformation formed by large, irregular, thin walled vascular channels is called _
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Cavernous angioma
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How does cavernous angioma usually present?
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Asymptomatic - if bleeding can cause seizures or other neurological symptoms
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Focal aggregate of small vessels is called _
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Telangiectasia
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Focus of few enlarged veins is called _
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Venous angioma
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What causes rupture of aneurysms
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Increased vascular pressure and weakened arterial wall
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Saccular aneurysm that looks like balloon on top of vessel is called _
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Berry aneurysm
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Give example of atherosclerotic aneurysm
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AAA
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What kind of aneurysm is induced by hypertension
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Charcot- Bouchard
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Is berry aneurysm congenital or acquired
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CONGENITAL
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What is the most likely location of berry aneurysms
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At the branch point of the vessel
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Name 4 locations of berry aneurysms
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Internal carotid complex
Anterior communicating artery Trifurcation Basilar (5%) |
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Fusiform aneurysm is what kind of aneurysm
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ATHEROSCLEROTIC
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What causes mycotic aneurysm
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Invasion of vasa vasorum of ascending aorta by syphillis
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Name three most common places of cerebral hemorrhage
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Basal ganglia - thalamus
Pons Cerebellum |
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Lypohyalinosis (deposits of lipids and hyalin into arteries ) weakens arteria wall and causes _ aneurysm
Where does it commonly occur? |
Charcot - Bouchard
Along trunk of blood vessel rather than at bifurcation |
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What is more severe hypoxia or ischemia
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Ischemia
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Proximal and MCA arteries are occluded by _
Resultant infarct transects _ causing _ |
Atherosclerosis and thrombosis
Internal capsule - causing hemiparesis or hemiplegia |
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When small emboli occlude capillary bed petechiae are most common in _
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White matter
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