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Trigger 1 - spina bifida Flashcards

1
Q

when does spina bifida occur

A

when the neural tube fails to close during the first month of embryonic development

spinal cord and meningeal membranes protrude

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2
Q

common symptoms of spina bifida

A

urinary/faecal incontinence

muscle weakness

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3
Q

how many spinal/somatic nerves

A

31 pairs

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4
Q

5 locations of spinal nerves

A 
cervical
thoracic
lumbar
sacral
coccygeal
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5
Q

2 types of spinal nerves

A

sensory

motor

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6
Q

sensory nerves/neurones

A

deliver information from muscles/joints to spinal cord about body position

transmit sensations such as temperature, pressure, pain and touch from skin’s surface

information enters spinal cord via grey posterior horn

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7
Q

dermatome chart

A

maps areas of skin that relate to particular spinal nerves

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8
Q

motor nerves/neurones

A

pass info from brain to skeletal muscles through spinal tracts
direct precise voluntary movements

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9
Q

spinal nerves are linked to specific…

A

muscles

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10
Q

cervical spinal nerves

A

supply muscles of the neck, shoulders, arms, hands and diaphragm
e.g. extending elbow/fingers

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11
Q

thoracic spinal nerves

A

supply truck muscles and muscles involved with breathing

intercostal and abdominal muscles

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12
Q

lumbar and sacral spinal nerves

A

supply hip, leg, foot muscles

sacral nerves supply anal/urethral sphincters

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13
Q

major breathing muscles

A

diaphragm and intercostal muscles

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14
Q

abdominal muscles

A

help you cough and expel matter from your air passages

important in balance and posture.

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15
Q

divisions of autonomic nervous system

A

parasympathetic

sympathetic

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16
Q

what is the ANS responsible for

A

bodily functions such as digestion, urination, changing the size of blood vessels in order to regulate blood pressure, regulating body temperature and keeping your heart beating.

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17
Q

parasympathetic nervous system is responsible for…

A

slowing your heart rate
bronchial or air passage constriction
increasing gastric secretions
bladder function (e.g. bladder muscle contraction, release of urine)
bowel function
sexual function (e.g. erectile function and lubrication)

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18
Q

sympathetic nervous system

A 
increasing your heart rate
increasing blood pressure
increasing respiratory or breathing rate
regulating your temperature
pupil dilation (enlargement)
bronchial or air passage dilation
decreasing gastric secretions
bladder function (e.g. bladder muscle relaxation, storage of urine)
sexual function
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19
Q

reflex activity

A

fast and automatic responses

occur via spinal nerves

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20
Q

overview of the study design pyramid

A

case-control makes up the base
as we progress upwards, studies becomes more evidence based and less numerous
meta-analysis is at the top

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21
Q

why is meta-analysis at the top of the study design pyramid

A

can only be written after much other research has been done on a topic
fewer of them but offer strong evidence

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22
Q

case reports

A

An article that describes and interprets an individual case, often written in the form of a detailed story

lowest level/first line of evidence

can help identification of a new drug/disease/trend

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23
Q

case-control

A

compares a group of patients who have the disease (cases) with a group of patients who don’t (controls)

purely observational - study carried out after disease has occurred
no intervention
retrospective

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24
Q

advantages and disadvantages of case-control studies

A

good for studying rare diseases
can look at multiple risk factors
take less time to complete- disease already occurred
useful to initially establish an association between a risk factor and a disease

problems with data quality - rely on memory/recall bias
difficult to find suitable control group

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25
cohort study
where one or more samples (cohort) are followed and evaluations with respect to the disease and conducted to determine which risk factors are associated with it outcome from participants in each cohort is measured and relationships with specific characteristics determined cohorts need to be chosen from separate but similar populations
26
risk factor
initial participants exposure characteristics
27
advantages of a cohort study
subjects in cohorts can be matched standardisation of outcome/criteria is possible easier/cheaper than RCT
28
disadvantages of a cohort study
cohorts difficult to identify due to confounding variables no randomisation - imbalances in patient characteristics could exist blinding is difficult outcome of interest could take time to occur
29
randomised control trial
randomly assigns participants into an experimental/control group the difference between the two groups should be the variable being studied should be a study of one population only
30
advantages of RCT
randomisation washes out population bias easier to blind well known stats tools easily used for analysis populations of participating individuals easily identified
31
disadvantages of RCT
time/money consuming volunteering population may not be representative does not reveal causation
32
practice guidlines
a statement outlining best practice to inform health care professionals and patients in making clinical decisions should be updated frequently created by panel of experts known as 'evidence-based' or 'clinical' guidlines
33
systematic review
document reviewing/summarising all relevant studies on a particular clinical or health-related topic/question
34
advantages of systematic review
evidence based reliable less time consuming than making a new study however may not be easy to combine studies into one
35
meta-analysis
subset of systematic reviews combines quantitative and qualitative study data develops single conclusion with great statistical power due to increased number/diversity of subjects studies for review should all be of a similar type e.g. all RCT so they are comparable
36
when would you use a meta-analysis study
To establish statistical significance with studies that have conflicting results To develop a more correct estimate of effect magnitude To provide a more complex analysis of harms, safety data, and benefits To examine subgroups with individual numbers that are not statistically significant
37
advantages of meta-analysis
Greater statistical power Confirmatory data analysis Greater ability to extrapolate to general population affected Considered an evidence-based resource
38
disadvantages of meta-analysis
Difficult and time consuming to identify appropriate studies Not all studies provide adequate data for inclusion and analysis Requires advanced statistical techniques Heterogeneity of study populations
39
when would you carry out csf analysis
to diagnose a condition involved with CNS e. g. bleeding within brain/skull, autoimmune disorder or cancer e. g. meningitis, encephalitis (determining if it fungal, viral or bacterial)
40
how do you collect a csf sample
lumbar puncture or spinal tap from lower back | multiple tubes may be used to improve quality of testing
41
where is csf formed continually
choroid plexus tisssue (has many blood vessels lining the ventricles of the brain) 500mL produced a day
42
what characteristics of csf are measured
pressure colour - should be clear turbidity - cloudy/turbid could mean presence of WBC/RBC viscosity- should be same as water
43
biomarker definition
"a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes or pharmacological responses to a therapeutic intervention
44
characteristics of a good biomarker
Safe and easy to measure Cost efficient to follow up Modifiable with treatment Consistent across gender and ethnic groups
45
anticholinergic medicines
used to treat urinary incontinence relax the overreactive detrusor muscle in the bladder wall bladder capacity increases and urinary urge decreases
46
features of sympathetic ganglionic neurons
short pre-ganglionic - releases ACh to nicotinic receptor long post-ganglionic - releases noradrenaline to muscarinic adrenoreceptor
47
which nerve regulates gastric acid secretion
vagus nerve
48
which autonomic nervous system has a long pre-ganglionic neuron
parasympathetic
49
where does reflex signal travel through
spinal cord | not brain
50
why does myelination increase speed of conduction
Na+ can only depolarise at nodes of ranvier saltatory conduction jump from node to node
51
myotomes
the group of muscles that a singler spinal nerve innervates
52
clinical significance of myotomes
can identify where spinal lesions might be
53
Na+ influx via ligand-gated channels on post-synaptic membrane
causes end-plate potential | propagates across muscle
54
calcium storage in SR
uptake via ATP exchange - SERCA pump calsequestrin important to reduce calcium conc to relax muscles
55
thin filaments in sarcomeres
actin tropomyosin troponin
56
thick filament
myosin
57
H band
just mysoin
58
I band
just actin
59
A band
length of myosin with some actin overlap
60
Z line
vertical line between adjacent sarcomeres
61
what makes up limbic system
thalamus | hypothalamus
62
normal CSF composition
``` no RBC few WBC water few small proteins some glucose ```
63
hydrocephalsu
build up of CSF in the brain | icnreases intracranial pressure
64
chairi malformation
cerebellum too larger blocks ventricles in brain CSF builds up intracranial pressure increases
65
if CSF is cloudy
WBC or RBC present | microorganisms or proteins present
66
proteins in CSF
disease
67
reciprocal innervation
when contraction of muscles is accompanied by simulatous inhibition of antagonistic muscles
68
when do stretch receptors in the bladder signal to sacral nerves (parasympathetic NS)
when it fills to 400ml
69
which sacral nerves are involved in micturition
S2-S4
70
receptor and signalling causing contraction of bladder detrusor muscle
M3 | Gaq
71
effect of cAMP on smooth muscle contraction
G alpha s increases cAMP which inhibits MLCK so inihbits smooth muscle contraction
72
opening of external sphincter
voluntary somatic allows you to wee
73
sympathetic control of bladder
filling B3 adrenoreceptor stimulated relaxation of bladder detrusor muscle
74
contraction of internal sphincter
closes sphincter | alpha 1 adrenoreceptor
75
most rigorous study design
meta-analysis
76
major regions found in temporal lobe
primary auditory cortex | wernickes area
77
lateral fissure
between temporal and frontal lobe
78
wernickes area
responsible for comprehension of speech | temporal loebe
79
middle cerebral artery (MCA)
largest branch on internal carotid artery common stroke site lenticulostriate arteries branch off
80
difference between cerebral arteries and systemic arteries
cerebral arteries have no external lamina | and fewer elastic fibres
81
anterior cerebral artery
supplies frontal lobes
82
posterior cerebral artery
supplies temporal/occipital lobes
83
common carotid arteries
external and internal
84
cause of haemorrhagic stroke
when a weakened blood vessel ruptures in the brain blood spills causing swelling and pressure tissue damage
85
why are strokes on left side of brain worse
effects seen on right side of body | e..g speech and language problms
86
2 types of haemorrhagic stroke
intracerebral - blood leaks to surrounding brain | subarachnoid - blood leaks into subarachnoid space
87
circle of willis
arterial loop at the base of the brain | carotid and vertebrobasilar arteries
88
collateral circulation
circle of willis ensures that if blood flow is obstructed to one vessel, blood can still be delivered to all regions of the rbain methods to avoid aschaemia
89
stents are used to treat
narrow or weak arteries
90
percutaneous coronary intervention (PCI)
stent implantation method - insertion of catheter with collapsed balloon inserted into bronchial artery - balloon inflated to compress plaque against artery wall and expand stent - balloon deflated, catheter removed - cells grow over to cover stent
91
drug-eluting stent
coated with medicine which releases slowly over time | often immunosuppressants
92
reason for drug-eluting stent
prevent re-stenosis
93
re-stenosis
too much tissue growth around stent can lead to more blockage

DDT (12 decks)

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