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Neurology > Embryology > Flashcards

Embryology Flashcards

0
Q

When do the 3 layers of embryonic tissue appear? When does Neural Plate give rise to Neural Tube? When is neural tube development complete?

A

Week 3

Day 18–> Neural Plate gives rise to Neural Tube.

Day 28–> Neural Tube development completed

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1
Q

When does the Nervous System develop?

A

3rd trimester

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2
Q

What does the Notochord form in the adult? What problems can it create?

A

Nucleus Pulposus, which lies within the vertebral column. It can herniate through the annulus fibrosus and impinge on spinal root–> PAIN.

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3
Q

Describe Neuralation (4 steps)

A

1) Notochord (which comes from Prenotochordal cells) induces overlying ectoderm to form Neural Plate. Notochord becomes nucleus Pulposus.
2) Nerual plate invaginates–> Neural Groove (Day 18)
3) Neural Groove–> forms Neural Tube and Neural Crest Cells
4) Neural Tube closes, starting in center and expanding rostrally and caudally.

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4
Q

What does the PNS develop from?

A

Neural Crest cells

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5
Q

What forms from the exterior and interior of the Neural Tube?

A

Exterior–> CNS

Interior–> ventricles and spinal canal

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6
Q

What is Anencephaly? What are the characteristic features?

A

Failure of the ROSTRAL neuropore to close

Features: absence of scalp, skull, and portions of cortex. FROG EYE appearance.

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7
Q

What is Spina Bifida?

A

Failure of caudal neuropore closure

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8
Q

What is the main cause of anencephaly and spina bifida?

A

Low folate levels

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9
Q

What clinical findings/tests can indicate fetal neural tube defects?

A

Elevated alpha-fetoprotein in maternal serum OR amniotic fluid. Can also be elevated with hepatocellular carcinoma and yolk sac tumors.

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10
Q

Describe the different forms of Spina Bifida

A

Spina Bifida Occulta: No herniation, but failure of vertebral archto clouse. Tuft of hair.
Meningiocele: Failure of vertebral arch to close with Herniation of meninges (subarachnoid space). Form lumbosacral cyst.
Meningomyocele: Failure of vertebral arch to close with Herniation of meninges AND spinal cord. Associate with Arnold-Chiari syndrome. Can result in loss of reflexes and sensation, paralysis.

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11
Q

What defines the severity of Spina Bifida?

A

-location and degree of closure

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12
Q

What is Meningoencephalocele?

A

Herniation of meninges and brain–> Mental Retardation

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13
Q

What is Meningohydrocephalocele?

A

Herniation of meninges, brain, and CSF-containing ventricles–> Mental Retardation

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14
Q

What are the Alar and Basal Plates? What is the Sulcus Limitans?

A

Alar Plate: gives rise to Sensory neurons
Basal Plate: gives rise to Motor neurons
Sulcus Limitans: separates two plates

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15
Q

What do the Neural Crest cells give rise to? (Possible defects)

A

MOST IMPORTANT: PNS and Schwann Cells

Aortic arch/ Aorticopulmonary Septum (Great vessel deformities)
Parafollicular Cells/ C-cells
Tissue of sclera. cornea, ciliary muscle
Connective/skeletal tissue of pharyngeal arches (DiGeorge–> pharyngeal pouches)
Enterochromaffin cells of intestines (Hirschprung Disease and achalasia
PNS
Schwann cells
Chromaffin cells of Adrenal Medulla
Odontoblasts
Melanocytes (Albinism)
Leptomeninges

16
Q

What is Arnold-Chiari? (Type I and II)

A

Congenital herniation of cerebellum through foramen magnum
Type I: Herniation of cerebellar tonsils ONLY.
Type II: Herniation of tonsils and vermis, breaking of tectal plate, aqueductal stenosis, stretching cranial nerves. May also have cervical syringomyelia and lumbar meningomyocele.

17
Q

What are the clinical presentations of Arnold-Chiari Types I and II? Prognosis?

A

Type I: Or cerebellar ataxia, hydrocephalus, etc. May have not symptoms or not until adolescence/adulthood.

Type II: diff swallowing, loss of sensation-with/out pain (back of neck, shoulders), mental retardation, hydrocephalus. Usually die (cranial nerve dysfcn or respiratory failure)

18
Q

What is Dandy-Walker Syndrome? Prognosis?

A

Occurs far less than Arnold-Chiari. Cerebellar vermis hypoplasia–> dilation of 4th ventricle due to failure of foramina of Luschka and Magendie to open. Posterior fossa cyst/ hydrocephalus.

Prognosis varies.

19
Q

What is the most common cause of hydrocephalus? Treatment

A

Aqueductal stenosis

Treatment: axtraventricular shunt, cauterize ependymal cells, endocscopic ventriculostomy

20
Q

Define: Microencephaly. Prognosis?

A

small brain size with decreased head circumference

50% mental retardation

21
Q

Define: Holoprosencephaly. Possible causes?

A

Failure of midline cleavage of forebrain. Forebrain may lack midline features.

Fetal Alcohol Syndrome or Trisomy 13 (Patau syndrome)

22
Q

What is the most common cause of mental retardation?

A

Fetal Alcohol Syndrome

23
Q

Which of the meninges is vascular?

A

Pia mater

24
Q

Where does the subarachnoid space terminate?

A

S2 vertebrae.

25
Q

What is contained in the Epidural Space?

A

Fatty areolar tissue, lymphatics, venous plexus, meningeal arteries

26
Q

Describe clinical features of Epidural Hematoma

A

Due to traumatic injury
Biconvex shape–> does not cross Dural Attachments
“Talk and die” syndrome (temporarily improve and then die)
Middle Meningeal artery most commonly ruptures

27
Q

Describe the clinical features of Subarachnoid Hemorrhage

A

Ruptured Berry Aneurysm
“Worst Headache of my life”
Sudden Onset headache
Increased Risk: HTN, smoking, increased age, polycystic kidney disease, Marfan, Ehlers-Danlos Type 4

29
Q

Describe Intracerebral/Parenchymal Hemorrhage

A

Trauma, infarct, angiopathy, diabetes, HTN (Charcot-Bouchard aneurysm)
Basal ganglia and thalamus common areas

30
Q

Describe clinical features of Subdural Hematoma

A

More common than epidural hematoma
Does NOT cross midline
Crescent-shaped
Elderly at risk due to atrophy of cortex–> increased tension on bridging veins
May be assoc. with contusion, subarachnoid, and other hemorrhages.

31
Q

What does Neuroectoderm give rise to?

A

CNS neurons, ependymal cells, oligodendrocytes, astrocytes

32
Q

What does Mesoderm five rise to in Nervous System?

A

Microglia

33
Q

Which drugs are strongly associated with neural tube defects?

A

Carbamazepine and Valporic Acid

34
Q

Which germ layer gives rise to Microglia?

A

Mesoderm

35
Q

Which nerve covering is re-ligated in surgery?

A

Perineurium

Neurology (11 decks)

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