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Child Health > Nervous System > Flashcards

Nervous System Flashcards

1
Q

When does human brain development begin?

A

In the 3rd week post conception

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2
Q

When is the embryonic period?

A

Conception to week 9

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3
Q

The 2 layers of the embryo

A

Epiblast and hypoblast

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4
Q

What determines the migration of cells through primitive streak and then rostral-caudal migration?

A

Nodal signalling

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5
Q

Which layer are skin, nails, hair and neural tissue from?

A

Ectoderm tissue

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6
Q

Which layer are muscle, bone and the vascular system from?

A

Mesoderm

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7
Q

Which layer are the gut and respiratory system from?

A

Endoderm

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8
Q

Which is the first well defined neural structure to form?

A

The neural tube

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9
Q

When does the neural tube form?

A

Days 20-27

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10
Q

Which cells form the neural plate

A

Neural progenitor cells

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11
Q

What is the ventricular zone?

A

the inside of the neural tubes lined with neural progenitors

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12
Q

What does the anterior/rostral tube become?

A

The anterior/rostral tube becomes the brain

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13
Q

What does the hollow centre of the neural tube become?

A

The hollow centre of the tube will become the ventricular system and central channel of the spinal cord

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14
Q

What does the caudal tube become?

A

The caudal tube will become the spinal cord

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15
Q

What does neural patterning in the embryonic period set the stage for?

A

Neural patterning in the embryonic period sets the stage for the latter development

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16
Q

Where is the highest concentration of Emx2 found?

A

More Emx2 found in the posterior/caudal

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17
Q

Where is higher concentration of Pax6 found?

A

Higher concentration of Pax6 at anterior/rostral

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18
Q

Emx2 and Pax6 signalling

A

High conc. Pax6 with low conc. of Emx2 induce progenitor to differentiate into motor neurons
Low conc. Pax6 and high conc. Emx2 induce visual cortical neurons

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19
Q

Where do progenitor cells stay and where to neurone migrate to?

A

Progenitor cells stay in the ventricular zone and continue to divide and produce more cells.
Neurons migrate to the developing neocortex

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20
Q

Neuronal migration

A

Somal translocation
Radial glial guides
Tangential migration and signalling pathways

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21
Q

Dendrites and arbors

A

Multiple dendrites form ‘arbors’ around the neuron

22
Q

Which cells develop processes which wrap around axons to form myelin sheaths?

A

Oligodendrocyte progenitor cells develop processes which wrap around axons to form progenitor cells

23
Q

Myelination occurs in what order? i.e. bottom to top etc

A

Bottom to top from back to front

24
Q

When does myelination mostly occur?

A

Myelination is mainly in the first two years of life but ongoing into the twenties

25
Q

Anencephaly

A

Anterior neural tube not closed

26
Q

Spina bifida

A

Posterior neural tube not closed

27
Q

Why are the gyri and sulci needed?

A

To accomodate the proliferating neurons

28
Q

Post-natal brain development

A

Post-natal proliferation

Myelination

29
Q

Holoprosencephaly

A

Failure of forebrain to develop normally

30
Q

What does PLP-1 gene encode?

A

PLP-1 encodes the main protein in myelin

transmembrane proteolipid protein

31
Q

On which chromosome is PLP-1 gene located?

A

Chromsome X

32
Q

What causes Pelizaeus merzbacher disease?

A

Mutations in the PLP-1 gene

33
Q

Mutations in the PLP-1 gene could cause what?

A

Pelizaeus merzbacher disease

Spastic paraparesis 2 manifests as spastic paraparesis with or without CNS involvement and usually normal life span.

34
Q

Mutations in the PLP-1 gene

A

Mutations in the PLP1 gene cause a spectrum of disorders
Pelizaeus –Merzbacher the most severe
Presents in infancy or early childhood with nystagmus, hypotonia, and cognitive impairment
Progresses to severe spasticity and ataxia.
Life span is shortened.
Spastic paraparesis 2 manifests as spastic paraparesis with or without CNS involvement and usually normal life span.

35
Q

Pelizaeus merzbacher disease

A

Mutations in the PLP1 gene cause a spectrum of disorders
Pelizaeus –Merzbacher the most severe
Presents in infancy or early childhood with nystagmus, hypotonia, and cognitive impairment
Progresses to severe spasticity and ataxia.
Life span is shortened.
Spastic paraparesis 2 manifests as spastic paraparesis with or without CNS involvement and usually normal life span.

36
Q

Spastic parapesis

A

Spastic paraparesis 2 manifests as spastic paraparesis with or without CNS involvement and usually normal life span.

37
Q

CSF has the same composition as what?

A

Brain extracellular fluid

38
Q

What does a turbid or cloudy CSF indicate?

A

may indicate inflammatory cells, the presence of micro-organisms or raised protein

39
Q

How much glucose should be in CSF (compare to blood glucose)

A

CSF should have at least 2/3rds of the glucose in blood. A ratio of CSF to blood glucose less than 0.5 is considered pathological

40
Q

What does raised protein in CSF suggest?

A

Inflammation/infection

41
Q

What is most commonly measured in CSF?

A

Protein and glucose

42
Q

What do oligoprotein bands indicate?

A

Oligoprotein bands indicate inflammation in the CNS

43
Q

Normal CSF fluid

A

Normal CSF should have no RBC cells, <5 WBC/ml and a CSF protein of less than 2g/dl

44
Q

What is the purpose of a lumbar puncture

A

Sampling the CSF

Measuring the CSF pressure

45
Q

Finding position to carry out lumbar puncture

A

Palpate the iliac crests laterally. The line connecting the iliac crests should correspond to approximately the L4 spinous process, one to two interspaces above the optimal space to access the subarachnoid space.

46
Q

Which position does the spinal cord usually end

A

L1

47
Q

Which structure anchors the spinal cord and dural sac distally?

A

The filum terminale

48
Q

The filum terminale?

A

Anchors the spinal cord and dural sac distally

49
Q

Indications for lumbar puncture

A
  1. Suspected CNS infection
  2. Suspected subarachnoid hemorrhage
  3. Therapeutic reduction of cerebrospinal fluid (CSF) pressure
  4. Sampling of CSF for any other reason
50
Q

Contraindictions for lumbar puncture

A
  1. Local skin infections over proposed puncture site
  2. Raised intracranial pressure (ICP)
  3. Suspected spinal cord mass or intracranial mass lesion (based on lateralizing neurological findings or papilledema)
  4. Uncontrolled bleeding diathesis
  5. Spinal column deformities (may require fluoroscopic assistance)
  6. Lack of patient cooperation (anaesthetic may be required in children)

Child Health (14 decks)

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