Chapter 18 neuro peds

Question 1

structural malformations

Answer 1

• Responsible for 75% of fetal deaths and 40% of deaths in the first year
• Most central nervous system (CNS) malformations are defects of neural tube closure

Question 2

defects of neural tube closing

Answer 2

an arrest of the normal development of the brain and spinal cord during the first month of embryonic development.

Question 3

cause of neural tube closing

Answer 3

• gene
• environment
• maternal folic acid deficiency

Question 4

Chari II malformation

Answer 4

Extremely complex malformation of the brainstem and cerebellum
- associated with myelomeningoceles

results
- hydrocephalus
- cognitive and motor defesits

Question 5

Tethered Cord Syndrome

Answer 5

-spinal cord becomes abnormally attached or “tethered” as it grows in the vertebral canal

• May develop after surgical correction for myelomeningocele

Question 6

Spinal Bifida

Answer 6

when the vertebra fails to fail
- most common neural tube defect

Question 7

types of spinal bifida

Answer 7

1, spinal Bifida occulta: vertebral defect is not visible
2. anencephaly: part of the skull and brain are missing
3. encephalocele: herniation or protrusion of the brain
4. Meningocele: saclike cyst of meninges filled with spinal fluid
5. Myelomeningocele: protrusion of saclike cyst (containing a portion of spinal cord &nerves) through the posterior lumbar vertebra.

Question 8

Microcephaly

Answer 8

reduced proliferation of accelerated apoptosis of brain cells.

Cranial size is significantly below average

Small skull=small brain

Primary microcephaly-caused by a chromosomal defect

Secondary microcephaly-external causes (i.e., Zika virus)

Question 9

Hydrocephalus

Answer 9

Present at birth

Characterized by:

Increased CSF production

Enlargement of ventricles

Decreased resorption of CSF

Question 10

cerebral Palsy

Answer 10

• disorder of movement, muscle tone or posture
• Caused by: Injury or abnormal development (before, during, or up to 1 year after birth)
• Most common crippling disorder of childhood

Risk factors
- prenatal cerebral hypoxia
- hemorrhage
infection
- genetic abnormalities
-low birth weight

Question 11

epilepsy

Answer 11

More than one unprovoked seizure within 24 hours.
- cause is unknown

Question 12

seizures

Answer 12

abnormal discharge of electrical activity in the brain

cause
Structural abnormalities of the brain

Hypoxia

Intracranial hemorrhage

CNS infection (Meningitis)

Traumatic Brain Injury (TBI)

Electrolyte imbalances

Question 13

convulsion

Answer 13

Tonic-clonic (jerky, contract-relax) movements associated with some seizures

Question 14

status epilepticus

Answer 14

state of continuous seizures

Question 15

seizures are classified by

Answer 15

1. clinical manifestation
2. site of origin
3. EEG correlates
4. response to therapy

Question 16

seizures are classified by

Answer 16

1. clinical manifestation
2. site of origin
3. EEG correlates
4. response to therapy

Question 17

neuroanatomy of pain

Answer 17

1, Nociception
2. Nociceptors

Question 18

Nociception

Answer 18

processing harmful stimuli through a normally functioning nervous system

Question 19

nociceptors

Answer 19

• free nerve endings in skin, muscle, joints, arteriesthat respond to chemical, mechanical and thermal stimuli
• can detect mylenated and unmylenated fibers

Question 20

4 phases of nociception

Answer 20

1. transduction: activation of nociceptors
2. transmission: conduction to dorsal and up the spinal cord
3. perception: conscious awareness of pain

• Sensory-discriminative system
• Affective-motivational system: emotional
• Cognitive-evaluative system

Pain threshold, perceptual dominance, pain tolerance
4. modulation: increase or decrease in transmission before, during, or after perception