Malformation and Dev Neuro

Question 1

Function of Cerebral Cortex

Answer 1

Higher brain function, including thought. Receives and processes sensations; initiates movement

Question 2

Function of Thalamus

Answer 2

Sensory nerve impulses pass through here on their way to the cerebral cortex

Question 3

Function of Hypothalamus

Answer 3

Controls the endocrine system. Regulates sleep, sexual function, body temperature and water content.

Question 4

Function of Basal nuclei

Answer 4

Islands of gray matter; helps coordinate movement.

Question 5

Funcntion of cerebellum

Answer 5

Involved in balance and control of muscle movement

Question 6

Function of brainstem (general)

Answer 6

Relays nerve impulses between the spinal cord and the brain. Controls vital functions such as heart rate and breathing.

Question 7

3 parts of brain stem

Answer 7

Midbrain, PONS, Medulla

Question 8

Function of Midbrain

Answer 8

Vision, hearing, eye movement, body movement

Question 9

Function of PONS

Answer 9

Involved in motor control, sensory analysis. Important for level of consciousness, sleep.

Question 10

Function of Medulla

Answer 10

Maintains breathing.

Question 11

What happens in gray matter?

Answer 11

Nerve impulses originate?

Question 12

Two abnormalities of brain volume

Answer 12

• Megalencephaly

- Microencephaly

Question 13

Incomplete / inadequate separation of the cerebral hemispheres (right and left)

Answer 13

Holoproencephaly

Question 14

Network of fibers connecting two hemispheres have not developed. Fairly benign.

Answer 14

Agenesis of Corpus Colosum

Question 15

Four forebrain abnormalities:

Answer 15

• Microencephaly
• Megaoencephaly
• Holoproencephaly
• Agenesis of Corpus colosum

Question 16

What occurs with a forebrain abnormality? What’s the prognosis?

Answer 16

The development of the brain is affected. Often leads to stillbirth.

Question 17

What occurs with neural tube defects? What is the prognosis?

Answer 17

Source of the problem is in the early development of the nervous system in utero. Prognosis varies widely.

Question 18

Defect: When hte soft, bony components of the skull and brain are missing. Most severe form of neural defects. Tube fails to fuse at head region.

Answer 18

Ancephaly

Question 19

A herniation or protrusion of brain and meninges through a defect in the skull, resulting in a sac-like structure.

Answer 19

Encephalocele

Question 20

Where does encephalocele most commonly occur?

Answer 20

Most commonly in occipital portion (back of head). Also in temporal, frontal, nasopharyngeal

Question 21

Caudal variations of neural tube defects (3), Which is the worst?

Answer 21

• Spinal bifida occluda
• Meningocele
• Myelomeingocele (spina bifida cystica)*** WORST.

Question 22

Spina Bifida Occluda

• What is it?
• Clinical manifestations

Answer 22

• Failure of spinal cord to fuse
• “Hidden”
• Sometimes completely asymptomatic, sometimes there is a tuft of hair at the surface of the skin.

Question 23

Meningocele

• What is it?
• What does it look like?
• Treatment

Answer 23

• Herniation of meninges and spinal fluid with spinal cord intact and in appropriate location
• Sac-like cyst of meninges filled with spinal fluid forms when the neural tube fails to close completely.
• Fairly easily corrected with surgery

Question 24

Myelomeningocele (Spina Bifida Cystica)

• What occurs?
• Prognosis
• Clinical manifestations

Answer 24

• Spinal cord and nerve roots herneate into a sac comprising the meninges.
• Worst of the caudal spinal cord abnormalities.
• Clinical manifestations may impair ability to walk, bowel / bladder control.

Question 25

When does neural development occur?

Answer 25

3rd week of gestation

Question 26

What germ cells become neural tube

–> CNS?

Answer 26

Ectoderm

Question 27

What cells become the peripheral nervous system (Cranial nerves, spinal cord)

Answer 27

NEural crest cells

Question 28

Define “static encephalopathy”

Answer 28

A condition that happens as the result of a singular injury; is not progressive in nature.

Question 29

What is the most common cause of perinatally induced cerebral palsy?

Answer 29

Ischemia

Question 30

Cerebral Palsy Risk Factors – Prenatal Maternal (9)

Answer 30

• Metabolic diseases
• Nutritional deficencies (eg anemia)
• Twin or multiple births
• Bleeding
• Toxemia
• Blood incompatibilities
• Exposure to radiation
• Infection
• Premature labor

Question 31

Cerebral Palsy Risk Factor in Prematurity

Answer 31

Asphyxia leading to cerebral hemorrhage

Question 32

Cerebral Palsy Risk factors – Genetic

Answer 32

Absence of corpus callosum, aqueductal stenosis, cerebellar hypoplasia

Question 33

Cerebral Palsy Risk factors – Congenital abnormalities of the brain

Answer 33

Unknown causes not evident on clinical examination

Question 34

Cerebral Palsy Risk factors – Perinatal (5)

Answer 34

• Anesthesia or analgesia during labor and delivery
• Mechanical trauma during delivery
• Immaturity at bith
• Metabolic disorders
• Electrolyte disturbances

Question 35

Cerebral Palsy Risk factors – Postnatal

Answer 35

• Head Trauma
• Infections
• Cerebrovascular accidents
• Toxicosis
• Environmental toxins

Question 36

3 parts of the brain may be affected to cause cerebral palsy.

• Name them
• Which is the most common?

Answer 36

(1) The primary motor cortex **
(2) Basal ganglia
(3) The cerebellum

**Most common

Question 37

Three categories of clinical features of cerebral palsy (and prevalence)

Answer 37

(1) Spastic (70-80%)
(2) Dystenetic (10-15%)
(3) Ataxic (<5%)

Question 38

How can a patient adequately manage cerebral palsy against contractures (3)?

Answer 38

• Physical therapy
• Hand splinting
• Botox (limited benefit)

Question 39

Three manifestations of spastic cerebral palsy

Answer 39

• Diplegia (both legs affected)
• Hemiplegia (one side of body affected)
• Quadriplegia (all 4 limbs affected)