Case 1

Question 1

What are the three layers of meninges (from outermost inwards)?

Answer 1

Dura, Arachnoid, Pia

Question 2

What are the four dural partitions?

Answer 2

1. Falx cerebri 2.Tantorium cerebelli 3.Falx cerebelli 4.Diaphragm sellae

Question 3

What are the attachments of the Flax Cerebri?

Answer 3

A: Crista Galli of ethmoid, frontal crest of frontal bone. P:Tentorium cerebelli. Projects downwards between cerebral hemispheres

Question 4

What are the attachments of the tantorium cereblli?

Answer 4

P: transverse sinuse grooves of occipital bone A+M are free and form an oval opening called the tentoria notch through which the midbrain passes. Horizontal projection seperating the cerebellum from the cerebral cortex

Question 5

What are the attachments of the Flax Cerebelli?

Answer 5

P: Internal occipital crest of occipital bone A: Free,

Question 6

Outline the Arachnoid mater

Answer 6

Thin avascular membrane, against but not adherent to dura mater, trabeculae extend through subarachnoid space and become continuous with pia mater, does not enter grooves of brain

Question 7

Outline Pia Mater

Answer 7

Thin delicate membrane, that adheres to the brains contours.

Question 8

What is the ventricular system in the brain?

Answer 8

4 - 2 lateral, a 3rd and 4th, interconnected by chennels and continuous with central canal.

Question 9

What is the shape and location of the lateral ventricles?

Answer 9

Located in cerebrum, C-shaped, large, roughly wrap around dorsal aspect of basal ganglia. 3 horns extend into different lobes, anteriorly into frontal, inferiorly into temporal, and posteriorly into occipital.

Question 10

Where is the third ventricle located and how does it communicate with the lateral ventricles?

Answer 10

Midline, below two lateral, appears as a thin slit on coronal sections. Communicates through interventricular foramen in diencephalon

Question 11

Where is the fourth ventricle located and how does it communicate with the third?

Answer 11

Hindbrain, communicates through cerebral aqueduct.

Question 12

What cells migrate to the head of the embryo to form the notochoral process and where to they come from?

Answer 12

Mesodermal cells from the primitve node

Question 13

What does the notochord stimulate?

Answer 13

Ectordermal cells to form the neural plate.

Question 14

What is the small intermediate horn?

Answer 14

accumulation of neurones between the two areas, contains sympathetic portion of autonomic nervous system and is only present at thoracic and upper lumbar levels

Question 15

What secretes sonic hedgehog (Shh), where does it travle to and what is its effect?

Answer 15

Secreted by the notochord, travles extracellularly to the ventral region of the neural tube and insturcts the cells to form the floor plate and diverse ventral cell types.

Question 16

What is the receptor for Shh

Answer 16

Patched (Ptc)

Question 17

What bone morphogenic proteins (BMP) are relevent in spinal cord formation and where are the secreted from?

Answer 17

4 + 7, from the overlying ectoderm

Question 18

What test of maternal blood can show a neural tube defect?

Answer 18

alpha-fetoprotein levels, main source of whic is the foetal liver, an open NTD can allow extra leakage into the mothers blood. An increase is best detected at 16-18 weeks of pregnancy. Can not be used to detect closed NTD and is less sensitive for women taking sodium valporate.

Question 19

Other than blood, how else can alpha-fetoprotein levels be measured?

Answer 19

Amniocentesis

Question 20

What percentage of children suffering spina bifida have mylomeningocele?

Answer 20

90%

Question 21

What are some common symptoms of spina bifida?

Answer 21

Varying degrees of paralysis, loss of bowel and urinary control, loss of skin sensation, hydroencephalus, tethered spinal cord (from scar tissue of initial surgery) can lead to lower body pain, leg weakness, incontinence and scoliosos.

Question 22

What are the risk factors leading to spina bifida?

Answer 22

Obestiy, folic acid deficiency, anticonvulsant medicine, possibly genetic basis (first child suffers spina bifida, 4-5% chance subsequent children will too) insulin dependent diabetes, female babies.

Question 23

Lifetime risk and onset of bipolar disorder?

Answer 23

1% life time risk, with onset usually during teeanage years.

Question 24

What are the different patterns of bipolar?

Answer 24

1. Rapid cycling - repeated swings from high to low, quickly with no normal period inbetween. 2.Mixed state - symptoms of depression and mania together 3.Cyclothymia - less severe but potentially longer mood swings, which can develop to full bipolar disorder.