6.02 Spina bifida, hydrocephalus, epilepsy Flashcards

1
Q

What is the first important day in CNS development?

A

Day 18

Ectoderm thickens to form neural plate. It starts to invaginate to form the neural groove

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2
Q

What is the process of neural tube development called?

A

Neurulation

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3
Q

What are the 3 layers of the embryo?

A

Ectoderm, mesoderm, endoderm

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4
Q

When does the cranial neuropore close?

A

Day 24

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5
Q

Neuropore

A

The cranial and caudal openings before they fuse

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6
Q

Primary neurulation

A

Folding down to S2

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7
Q

Secondary neurulation

A

From S2 to coccyx. Neural tissue extends from the closed neural tube as a solid cord. The neural tube cavity grows into the structure.

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8
Q

Neural tube defects are caused by …

A

defective closure of the neural tube at the neuropores

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9
Q

Anencephaly

A

Failure of closure of the cranial neuropore. Skull fails to develop over the brain tissue. Exposed tissue degenerates and child born with most brain missing at birth

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10
Q

Once the neural tube closes, what happens to the cells?

A

Cell division, proliferation and migration. This happens in the cells closest to the lumen and they migrate “inside out”

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11
Q

When does cell division occur?

A

Weeks 7-16.

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12
Q

What happens during migration in the cortex?

A

The radial glia (scaffolding cells) form first and migrate out. Each new cell formed migrates past the existing cells via the radial glia. (“Inside out” formation)

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13
Q

Notochord

A

Made of mesoderm. Secretes SHH and initiates the formation of the neural plate

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14
Q

Types of spina bifida

A

Spina bifida occulta, spina bifida cystica meningocele, spina bifida cystica myelomeningocele

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15
Q

When is most brain neuronal proliferation complete?

A

By 16 weeks

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16
Q

When does cerebellar neuronal proliferation occur?

A

First postnatal year

17
Q

What are the 3 original subdivisions of the head region?

A

Prosencephalon, mesencephalon, rhombencephalon

18
Q

What are the 5 subdivisions of the head region?

A

Telencephalon, diencephalon, mesencephalon, metencephalon, myelencephalon

19
Q

The metencephalon becomes the …

A

pons and cerebellum

20
Q

The myelencephalon becomes the …

A

medulla

21
Q

Encephalocele

A

When brain tissue herniates through the cranium, similar to a meningocele

22
Q

What % of spina bifida cystica is myelomeningocele?

A

90%

23
Q

Which is caused by earlier defects, myelomeningocele or meningocele?

A

Myelomeningocele

24
Q

What are the consequences of myelomeningocele?

A

LMN paralysis - bowel and bladder problems. Gait disturbance/LMN paralysis re lower limbs, depending on level of injury.

Chiari type II malformation and possible hydrocephalus on closure

Latex allergies (from being handled with latex from birth)

Learning difficulties (reasons unknown)

25
Q

What can cause spina bifida?

A

Anticonvulsants, particularly valproate, carbamazepine.

Prepregnancy obesity

26
Q

Does giving excess folic acid protect against risks if a person is taking anticonvulsants during pregnancy?

A

No. Folic acid does not protect against spina bifida risks if a person is taking anticonvulsants

27
Q

What could a grand mal seizure to do a foetus?

A

Cause hypoxia (and foetus will die)

28
Q

Chiari Type II malformation

A

Where the cerebellum and medulla become wedged in the foramen magnum, blocking off the openings for the CSF to get out

29
Q

What type of hydrocephalus can Chiari II malformation cause?

A

Non-communicating/obstructive hydrocephalus

30
Q

Types of hydrocephalus

A

High pressure hydrocephalus
Normal pressure hydrocephalus
Low pressure hydrocephalus

31
Q

CSF contains

A

Similar osmolarity to plasma

Higher Mg and Cl
Lower glucose and Ca