Diseases of the nervous system

Question 1

basics on Spina Bifida

Answer 1

a neuronal tube defect. occurring when vertebrae don’t form properly around the spinal cord leaving a ‘gap’ in the spinal cord

Question 2

severity of spina bifida depends on

Answer 2

where the ‘gap’ is located

Question 3

spina bifida causes problems with

Answer 3

movement, bladder and bowel

Question 4

spina bifida is associated with

Answer 4

Hydrocephalus- excess fluid in the brain

Question 5

the higher up the spine where the gap has occured

Answer 5

the more neuronal function the patient will have

Question 6

when does the spine fail to close propely

Answer 6

during the first month of pregnancy

Question 7

function fo CSF

Answer 7

produces a constant, controlled environment for the brain cells and protects from toxins. Prevents escape of NT

Question 8

what may cause the BBB to become more permeable allowing substances normally excluded from he blood brain barrier

Answer 8

inflammation irradiation and tumours

Question 9

which solutes have the same inc ocnentration in the CSF as the blood
CSF=blood

Answer 9

Na+
Cl-
HCO3-
Osmolarity

Question 10

[CSF}< blood

Answer 10

K+
Cas2+
Glucose
Amino acids
pH
cholesterol
protein

Question 11

solutes CSF> blood

Answer 11

Mg2+

Creatinine

Question 12

which substances are usually negligible in CSF

Answer 12

cholesterol and protein

Question 13

urinary incontinence

Answer 13

a condition when a individual suffer from involuntaryy leakage of urnine

Question 14

causes of urinary incontinence

Answer 14

1`- ads release reduction

• diuretcis which inhibit Na+ reabsorption
• anticholinergics- inhibit muscuarinic ACh receptors- less detrusor muscle contraction
• dpamine antagonist- less NT available so less detgusor regulation

Question 15

antimuscarinics help urinary inconitence by

Answer 15

cholinergic antagonists block activate of muscarinic ACh receptors therefore inhibiting detrusor muscle contraction and keeping internal sphincter closed - treats urge to wee

Question 16

what is used to treat overflow UI

Answer 16

cholinergic antagonist- increases detrusor muscle contraction

Question 17

what would be targeted for an antagonist drug for urinary incontinence

Answer 17

muscarinic ACh receptor

Question 18

what would be prescribed to someone who constantly needs to wee?

Answer 18

drug which binds to muscarinic receptor to inhibit contract or detrusor

Question 19

stroke basics

Answer 19

occurs when the blood supply to part of the brain are cut off. Blood carrying oxygen and nutrients can no longer reach certain cells, so they can n longer aerobically respire

Question 20

two types of stroke

Answer 20

ischaemic- block (80%)

Haemorrahgic - bleed (20%)

Question 21

deficits will depend on

Answer 21

how large the are of the brain being supplied is, s well as how long the occlusions have occurred

Question 22

death of neurones during stroke is due to

Answer 22

excitotoxicity

Question 23

excitotoxicity

Answer 23

• Lack of oxygen and sugar means ATP cannot be generated
• ATP reliant transporters like Na+/Ca2+ fail
• Depolarization too much calcium flows in
• Calcium triggers release of Glutamate (NT) into synaptic cleft
• NMDA receptor stimulated by Glu, when certain level of depolarization calcium block in AMPA channel allows the post synaptic neurone to be depolarized further
• Over excitation
• Calcium causes and increase in:
• ->Free radicals and
• ->ROS
• ->Calpain
• -> Endonucleases
• ->ATPases
• -> Phospholipases
• Membrane becomes more permeable harmful chemicals get into cell
• Mitochondria break down- releasing apoptotic factors
• Necrosis- releases more Glu
• VICIOUS CYCLE.

Question 24

what may also occur after stroke

Answer 24

reperfusion injury

Question 25

reperfusion injury

Answer 25

the tissue damaged caused when the blood supply return to the tissue after a period of schema or hypo

Question 26

why does reperfusion cause damage to tissue

Answer 26

The absence of oxygen and nutrients from the blood during the ischemic period creates a condition in which the restoration of circulation results in inflammation and oxidative damage- oxidative stress-

Question 27

when blood flow is restored and oxygen reintorduced

Answer 27

there are not enough antioxidants (not produced during hypoxia)= oxidative stress - oxygen free radicals destroy cell membrane and leads to necrosis

Question 28

which TF react to hypoxia

Answer 28

HIF -mediates the effects of hypoxia- e.g. helping the cells adapt to low oxygen conditions - growth of blood vessels

Question 29

stroke and the brainstem

Answer 29

- can affect both sides of the body nd leave someone in 'locked in' state- unable to speak or achieve any movement below the neck - usually causes death since the damage can prevent vital functions e.g. breathing

Question 30

medulla

Answer 30

breathing, swallowing, bp, hr, vomiting, sneezing, coughing

Question 31

midbrain

Answer 31

vision adhering, digestion, hr, br

Question 32

pons

Answer 32

breathing and regulation of deep sleep

Question 33

which is the arty most often occluded in stroke

Answer 33

Middle cereal artery- which supplies frontal lobe and lateral surge of the temporal and parietal lob

Question 34

cerebellum and stroke

Answer 34

may result in lack of coordination, clumsiness, shaking or the muscular difficulties

Question 35

if a stroke occurs in the right side of the brain

Answer 35

the right side of the body will be affected - paralysis of the left side of the body - vision problems - memory loss - quick, inquisitive behavioural style

Question 36

stroke on the left side of the brain

Answer 36

- affects right side of the body - paralysis - speech and language problems - slow, cautious behavioural style - memory loss

Question 37

parietal

Answer 37

unable to understand spoken or written language

Question 38

temporal

Answer 38

decreased visual and verbal memory and decreased understanding of words

Question 39

occipital

Answer 39

disability involving vision

Question 40

frontal lobe

Answer 40

- personality change - changing emotions - decreased voluntary movement - hard to convert thoughts into words

Question 41

biomarkers of stroke

Answer 41

correct diagnosis of ischaemic stroke is essential to treat and prevent further stroke. -BNP CRP -lipoptein associated phosplipase A2

Question 42

what is the treatment for sichaemic stroke

Answer 42

T-PA

Question 43

T-PA

Answer 43

tissue-plasminogen actiavtor | - dissolves blood clot by bidding to plasminogen and activating plasmin which dissolves fibrin

Question 44

what synthesises CSF

Answer 44

ependymal cells in the choroid plexuses of the ventricles of the brain