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Block 8 Week 2 > CNS malformations- Parks > Flashcards

CNS malformations- Parks Flashcards

1
Q

What are the 6 types of nervous system pathology?

A
  • contusion, necrosis (traumatic closed head injury)
  • cerebral edema
  • herniation
  • malformations (NTDs and spina bifida)
  • Hydrocephalus
  • Developmental Problems (Arnold-Chiari malformation)
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2
Q

When the brain moves around, within the skull, it is called a (blank). It can lead to a contusion which can also lead to a (blank) clinically.

A

closed head injury

concussion

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3
Q

Whats the difference between a cotusion and concussion?

A

contusion-> is the lesion in the brain

Concussion->temporary unconsciousness caused by a blow to the head

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4
Q

When the brain hits the front of the skull it is called (blank). When the brain hits the back of the skull it is called (blank)

A

coup

contrecoup

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5
Q

When cells die in closed head injury you will get (blank) .

A

edema

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6
Q

Following trauma you will get (Blank) edema from a damaged BBB

A

vasogenic edema

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7
Q

What other kinds of edema is present in trauma but just to a lesser extend than vasogenic edema?

A

cytotoxic edema

cerebral edema

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8
Q

What besides trauma shows cerebral edema?

A

tumors, inflammation (encephalitis)

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9
Q

In vasogenic edema, fluid shifts from (Blank) into extracellular space.

A

vascular

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10
Q

Following stroke and hypoxic-ischemia insult (cardiac arrest) you will get (Blank) edema

A

cytotoxic edema

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11
Q

Cytoxic edema results because of (blank) and (Blank) being injured

A

neurons and glial cells

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12
Q

When you damage the BBB (Blank) will leak out between cells

A

fluid

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13
Q

How does injury lead to swelling?

A

injury-> hypoxia-> sodium moves into cell and potassium out-> water moves into cell-> extensive vaculation and swelling-> Hydropic degeneration

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14
Q

Whn you have cerebral edema what does the brain look like?

A

flattened gyri and shallow sulci

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15
Q

How do you get herniation?

A

when you have swelling in your brain and the brain has no place to escape so herniates

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16
Q

What are the three kinds of herniation?

A

falx herniation
uncal herniation
cerebellar herniation

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17
Q

What is the worst hernation? Why?

A

uncal herniation

cuz it will affect your brain stem and cause nerve impingement and artery occlusion

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18
Q

An uncal herniation will impinge what cranial nerve and what will this present as?

A

CN 3 and present as ipsilateral dilation of pupil

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19
Q

Why will you get vision problems with uncal herniation?

A

the uncus will impinge on the posterior cereral artery which supplies the visual cortex which will cause ischemia there and therefore vision problems

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20
Q

Uncal transtentorial herniation refers to impaction of the (blank) gyrus into the (blank) opening just anterior to and adjacent to the midbrain

A

anterior medial

tentorial opening

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21
Q

How do you get a coma when you have an uncal herniation?

A

due to compression of the midbrain against the OPPOSITE tentorial edge

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22
Q

Why can you sometimes get a babinskis sign and hemiparesis contralaterla to the original hemiparesis?

A

due to compression of the opposite cerebral peduncle

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23
Q

Uncal herniation may aso compress the anterior and posterior (blank) causing (Blank)

A

cerebral arteries

hydrocephalus

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24
Q

What is the Kernohan-Woltman sign?

A

when you get a babinskis sign and hemiparesis from compression of cerebral peduncle by an uncle herniation

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25
Q

(blank) are small areas of bleeding in the ventral and paramedian parts of the upper brainstem, (midbrain and pons).

A

Duret hemorrhages

26
Q

What will extreme displacement of the brainstem result in? Is it fatal?

A

duret hemorrhage

usually fatal

27
Q

Why does durets hemmorhage cause death?

A

because it will create a mass affect and apply too much pressure to the brain stem respiratory center and induce ischemia resulting in inability to breath and respiratory failure

28
Q

What are the brain stem respiratory center components?

A
  • pneumotaxic center
  • caudal pons
  • retrotrpezoid nucleus
29
Q

If you have impingement, compression or a messed up posterior cerebral artery what will result?

A

vision problems

30
Q

If you see a brown spot in the brain what is it?

A

ischemic necrosis-infarct

31
Q

A subdural hematoma can result in a (blank)

A

uncal herniation

32
Q

The neural tube closes around day (Blank)

A

28-30

33
Q

WHen are fetuses most susceptible to teratogens?

A

3-9 weeks

34
Q

What are the three neural tube defects that people can possibly live with?

A
  • spina bifida occulta
  • meningocele
  • myelomeningocele
35
Q

In a meningocele, what does the spinal cord look like?

A

it is intact, you just have a weird bubble protruding out your back

36
Q

IN myelomeningocele, what does the spinal cord look like?

A

the spinal cord and nerves go out into the sac protruding in your back

37
Q

Which is more sever, meningocele or myelomeningocele?

A

myelomeningocele

38
Q

What result if you have a myelomeningocele?

A

you get bladder and walking problems, nerve and artery impingments

39
Q

Is spina bifida occulta pretty bad?

A

No not at all, you just dont have completey formed vertebrae and but you dont get spinal or nerve protrusion through the gap.

40
Q

How can you tell if a women is pregnant with a fetus that has a neural tube defect?

A

LOok for elevatd AFP levels in her blood.

if you have open neural tube, a ton of AFP will leak out into the amniotic fuid which leak into the maternal blood

41
Q

What do moms need to eat when pregnant?

A

folate and iron

42
Q

How do babies get congenital hydrocephalus?

A

they get edema before suture fusion

43
Q

How do you treat congenital hydrocephalus?

A

you use a ventricuar catheter to drain the fluid

44
Q 
T or F 
congenital hydrocephalus (CHC) is one of the most frequent congenital malformation of CNS
A

T

45
Q

What are the risk factors for CHC?

A
  • -Lack of prenatal care
  • maternal diabetes
  • maternal HTN
  • -maternal consumption of alcohol
  • certain infections (parvovirus B19)
  • maternal antidepressants (SSRIs)
46
Q

How does CSF start and end?

A

gets produced by the choroid plexus and goes through the ventricles into the subarachnoid space where it is reabsorbed by the arachnoid villi

47
Q

What happen if you get inflammation in the arachnoid villi?

A

you get scarring which will cause them to be unable to reabsorb CSF and thus results in hydrocephaly

48
Q

WHat are the 2 types of hydrocephalus?

A
  • noncommunicating

- communicating

49
Q

What is a noncommunicating hydrocephalus?

A

localized obstruction within the ventricular system. (only that ocal ventricle enlarges while the other ventricles do NOT enlarge)

50
Q

What is a communicating hydrocephalus? WHen does this typically occur?

A

entire ventricular system enlarges.

-from reduced CSF reabsorption

51
Q

What do adult patients with hydrocephalus complain of?

A

urinary incontinence, headache, apraxia (cant move the way you want to), dementia

52
Q

What do dialated ventricles indicate?

A

hydrocephalus

53
Q

What is hydrocephalus caused by?

A
  • impaired reabsorption
  • obstruction
  • overproduction is rare
54
Q

What are all the place you can get hydrocephalus?

A

-Problems at the foramen of monroe, third ventricle, fourth ventricle, pineal regions, cerebral aqueduct

55
Q

What kinds of obstructions can cause hydrocephalus?

A
  • absorptive obstruction

- basilar obstruction

56
Q

What are the ways you can get absorptive obstruction?

A
  • arachnoditis (posthemorrhagic)
  • postmenigitic
  • venous thrombosis
57
Q

What can happen in the pineal region of the brain that can induce hydrocephaly?

A

tumor

58
Q

What can happen in the cerebral aqueduct that can induce hydrocephaly?

A
  • aqueductal stenosis
  • aqueductal forking
  • subependymal gliosis
  • periaqueductal gliomas
59
Q

What can happen in the foramen of monro that can cause hydrocephaly?

A
  • gliosis

- colloid cysts

60
Q

What can happen in the third ventricle that can cause hydrocephaly?

A
  • chiasmal gliomas
  • craniopharyngiomas
  • arachnoid cysts
61
Q

What can happen in the fourth ventricle that can cause hydrocephaly?

A
  • medulloblastomas
  • ependymomas
  • astrocytomas
  • Dandy-Walker cysts

Block 8 Week 2 (8 decks)

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