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Patho II > E3: pediatric neurological disorders > Flashcards

E3: pediatric neurological disorders Flashcards

1
Q

what are the three neural tube defects

A
  • anencephaly
  • encephalocele
  • spina bifida
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2
Q

at 20 days of gestation, what happen

A

a neural groove appears in the ectoderm of embryo

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3
Q

the nural groove does what after 20 days gestation

A

deepens and fuse together and the tube forms in both directions from center of embryo outward

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4
Q

when is the neural tube closed off

A

by the 4th week of gestation

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5
Q

why have CNS disorders decreased

A
  • early prenatal diagnosis
  • termination of pregnancies
  • maternal intake of folic acid before conception
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6
Q

cause of CNS disorders

A
  • maternal heat exposure
  • maternal age, obesity, zinc deficiency
  • drugs
  • familia; tendency
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7
Q

anencephaly

A

soft pony part of skull and part of brain is missing

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8
Q

characteristics of anencephaly

A

child has frog-like appearance from the front

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9
Q

prognosis of anencephaly

A
  • most die shortly after moth, have only premie reflexes

- candidate for organ donation

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10
Q

encephalocele

A

herniation and protrusion of the brain and meninges through the skull. usually the occipital area

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11
Q

spina bifida

A

the failure of the bony spine to close

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12
Q

the two types of spina bifida

A
  1. occulta

2. cystica

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13
Q

cause of spina bifida

A
  • maturnal heat exposure (sauna, hot tub)
  • drugs (anti-epileptic, valporic acid)
  • familial tendency has been reduce in families when mother takes a B vitamin folic acid supplement before conception
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14
Q

spina bifida occulta

A

no visible defect

  • most common in lumbosacral area
  • may appear as a dimple, nevi, dark tufts of hair or soft lipomas

10-30%

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15
Q

spina bifida cystica

A

-visible sack-like protrusion, covered with skin or thin membrane

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16
Q

meningocele

A

present in SBC

-contains meninges and spinal fluid

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17
Q

myelomeningocele

A

present in SBC

-contains the meninges, spinal fluid and NERVES

18
Q

clinical mani of spina bifida

A

depensds on location, may or may not involve sensory and motor impulses of bladder, rectum, lower extremities, may also have related joint deformities of hip back and feet as well as possible visual perceptual problems

19
Q

how to prevent spina bifida

A

folic acid-1 month before pregnancy and during first trimester

20
Q

hydrocephalus

A

increase in CSF volume secondary to blockages or decreased absorption.

this imbalance of secretion and absorption causes increased enlargement of the ventricles of the brain which compresses the brain against the cranium

in infants, the fontanels and sutures are not fused which causes enlargement of the skull as well as dilation of the ventricles

in older children, lines may re open

21
Q

hydrocephalus is often associated with

A

spina bifida

22
Q

how much CSF is produced daily in hydrocephalus

A

600cc produced in choroid plexus of lateral ventricles of the brain

23
Q

cause of hydrocephalus

A
  • congenital: usually related to developmental abnormalities in utero
  • acquired: result of hemorrhage, infections or neoplasms
24
Q

noncommunicating/obstructive hydrocephalus patho

A
  • obstruction to the flow of CSF through ventricular system

- causes dialation and increased pressure

25
Q

most common sites for hydrocephalus

A
  • aqueduct of sylvius-post hemorrhagic (seen in preturms and congenital stenosis or atresia)
  • forth ventricle and foramen magnum (50% of all hydrocephalus)
26
Q

communicating hydrocephalus

A

there is impaired absorption of the CSF by the arachnoid villa within the subarachnoid space

27
Q

infant clinical mani of hydrocephalus

A
  • bulging fontanels
  • abnormally large heads (non-c tend to be larger)
  • setting sun (sclera visible above the pupil
  • high pitched cry
  • irritability and lethargy
  • poor feeding with vomiting
  • opisthotonos (spasm which head and heals are bend back wards and body bowed)
28
Q

older children clinical mani of hydrocephalus

A
  • s/s related to increased intracranial pressure
  • headache on arising with improvement with emesis or upright position
  • papiledema
  • strabismus
  • lethargy
  • irritability
29
Q

meningitis

A

an acute infection of the meninges and CSF

30
Q

who is most affected by bacterial meningitis

A

children (1mo - 5 years)

31
Q

cause of meningitis

A
  • haemophilus influenzae (B)
  • streptococcus and E. Coli
  • meningococcus
32
Q

how is meningococcus seen and how is it transmitted

A

seen in epidemic form and is the only type readily transmitted by droplet incection

33
Q

what type of meningitis does streptococcus and e. coli cause

A

neonatal meningitis

34
Q

where does flu b meningitis start

A

in nasopharynx, ears or sinuses

35
Q

patho of meningitis

A
  • bac spread to CSF by blood
  • bac then invade subarachnoid space and inflammatory process starts
  • brain becomes hyperemic and edematous and is covered with purulent exudate

INCREASES ICP

36
Q

infants clinical mani of meningitis

A
  • bulging fontanel
  • fever
  • poor feeding
  • v
  • marked irritability
  • seizures accompanied by high pitched cry
  • nuchal rigidity
  • positive Kernig and brudzinski
37
Q

children clinical mani of meningitis

A
  • fever, chills
  • headache
  • v
  • extreme drowsiness, stupor agitation
  • nuchal rigidity and opisthotonos
  • positive kernig and brudzinski signs
38
Q

aseptic/viral meningitis

A
  • limited to meninges
  • caused by viruses
  • similar to B meningitis but mild
  • treatment is symptomatic
39
Q

cerebral pasly

A

nonprogressive disorders characterized by early onset of impaired movement and posture, abnormal muscle tone and coordination

40
Q

most common permanent physical diability of kids

A

cerebral palsy (motor and sensory deficits)

41
Q

causes of cerebral palsy

A
  • prenatal (tetrogens)
  • genitic syndromes
  • chromosome abnormalities
  • brain malformations
  • intrauterine infections
  • placental problems
  • labor and delivery (pre elcampsia
  • complications of labor
  • sepsis/CNS infection
  • asphyxia
  • prematurity
  • childhood meningitis
  • toxins
  • traumatic brain injury
  • not known 24%

Patho II (23 decks)

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