NB2 8+9+DLAs

Question 1

Meroencephaly /Anencephaly

Answer 1

The cranial neuropore fails to fuse in week 4

skull is not formed

Brain tissue (if present) is disorganized and exposed to
the amniotic fluid which causes necrosis /degeneration

Rudimentary brain stem is usually present

Elevated alpha fetoprotein; polyhydramnios

Question 2

Holoprosencephaly

Answer 2

no cleavage of prosencephalon

small undivided forebrain and a large single fused ventricle

can have craniofacial anomalies

can be due to environmental or genetic (SHH) factors

Question 3

microcephaly

Answer 3

Abnormally small calvaria and brain but normal sized face

reduction in brain growth

neurological deficits

can be due to genetic or environmental factors
(virus, ionizing radiation, FAS)

Question 4

development of the skull

Answer 4

the skull develops from mesenchyme and the brain

Question 5

Craniosynostosis

Answer 5

One or more of the fibrous sutures in an infant skull fuses prematurely thereby changing the growth pattern of the skull

Question 6

Trigonocephaly

Answer 6

early closure of the frontal (metopic) suture

the forehead has a triangular shape

can have developmental delay, behavioral issues, vision defects

Question 7

Scaphocephaly

Answer 7

Most frequent type of craniosynostosis

caused by the premature closure of the sagittal suture
Enlargement of the cranium in the anterior/ posterior dimensions

CT scan shows long narrow shape of the head with bossing of the frontal and occipital regions

Question 8

Brachycephaly

Answer 8

Craniosynostosis due to the premature closure of the coronal sutures

On physical exam there might be flattening of the frontal and occipital regions

Question 9

Plagiocephaly

Answer 9

Missing, full, or bulging “soft spot” (fontanel) on the newborn’s skull

Facial abnormalities including bulging forehead and brow on one side, uneven cheekbones, eye sockets, or lower jaw

Prominent blood vessels in the scalp
Poor feeding or projectile vomiting and Seizures

Question 10

Cranium Bifidum

Answer 10

Defect in the formation of cranial vault usually in the midline

often in the occipital bone (foramen magnum)

Leads to encephalocele - herniation of intracranial contents

Question 11

Cranium Bifidum with Meningocoele

Answer 11

defect in the formation of the cranial vault
usually foramen magnum

swelling will contain meninges and CSF

Question 12

Cranium Bifida with Meningoencephalocoele

Answer 12

defect in the formation of the cranial vault usually at foramen magnum

Swelling contains meninges, CSF & brain

Question 13

Cranium Bifidum with Meningohydroencephalocoele

Answer 13

defect at the posterior fontanelle of cranium

Swelling contains extensions of meninges, CSF, brain and ventricle

Question 14

Arnold -Chiari Malformation

Answer 14

Most common anomaly of the cerebellum

Inferior displacement of the vermis of the cerebellum and medulla through the foramen magnum into the vertebral canal

can be associated with obstructive hydrocephalus

CN’s IX, X, and XII might be stretched causing difficulty in speech, swallowing and absent or diminished gag reflex

Question 15

Arnold-Chiari Malformation symptoms and imaging

Answer 15

symptoms: 
Headaches, nausea and vomiting due to raised intracranial pressure
Muscle weakness in the head and face
Difficulty swallowing
Impaired coordination
In severe cases paralysis

imaging:
Downward displacement of cerebellar tonsils through
foramen magnum in imaging

Compression of the brain stem

Dilation of the ventricular system due to non communicating hydrocephalus

Question 16

Orexigenic vs anorexigenic neuron

Answer 16

orexigenic:
increases hunger
stimulates ghrelin and inhibits insulin

Anorexigenic:
decrease hunger
stimulate insulin

found in the arcuate nucleus then goes to the paraventricular nuclei

NTS - found in brainstem.. goes to these two nuclei

Question 17

lateral vs ventromedial nuclei (feeding)

Answer 17

lateral = increase in feeding

ventromedial = decrease in feeding

Question 18

Ventromedial Hypothalamic Syndrome (Fröhlich syndrome)

Answer 18

a disorder of caloric balance characterized by obesity
(besides other symptoms). The obesity results from damage to the ventromedial nucleus of the hypothalamus

major want to eat

Question 19

anterior vs posterior hypothalamus (body temp)

Answer 19

anterior: temp decrease

dilation of skin vessels
sweating
remove clothes
cooler environment

posterior: temp increase

constriction of skin vessels
shivering
warmer environment
add clothes

Question 20

hypothermia

Answer 20

the body cant increase body temp

Question 21

hyperthermia

Answer 21

body cant decrease body temp

Question 22

Automatic Bladder

Answer 22

lesion above S2-S4 will lead to a spastic or autonomic bladder.

The patient will have reflexive emptying of the bladder once it fills and once there is threshold volume

Question 23

Atonic Bladder

Answer 23

A lesion at S2-S4

the spinal cord cannot process the incoming filling signals of the urinary bladder and would not be able to direct a reflex voiding response via the parasympathetic fibers. So, here the bladder will just fill to the brim and the urine will overflow

Question 24

pontine micturition center

Answer 24

facilitation of urinary discharge through activation of the parasympathetic and inhibition of the sympathetic innervation, with additional information reaching higher centers, contributing to urinary urges