CNS-Congenital Disease & Stroke

Question 1

what supplement can women take to help prevent neural tube defects in their fetus’? (neuroectodermal invagination and closure occurs within the first 5 weeks post -fertilization - needs to be early!)

Answer 1

folic acid (B vitamin)

Question 2

dysraphism

Answer 2

neural tube defect

Question 3

what two substances can be found in the amniotic fluid to indicate dysraphism?

Answer 3

alpha-fetoprotein (AFP)

AChE

Question 4

absence of a large portion of the brain or the skull

Answer 4

anencephaly

Question 5

incidence for anencephaly?

Answer 5

1/10,000 births

Question 6

incomplete closure of the superior part of the neural tube. AKA cranium bifidum. most commonly an opening in the occipital area

Answer 6

encephalocele

Question 7

a condition where the whole spinal canal is open (many adjacent segments, at least)

Answer 7

rachischisis

Question 8

lissencephaly-agyria

Answer 8

absent gyri (in the cerebrum)

Question 9

what virus that has been in the news within the past couple of years causes microcephaly (small brain)?

Answer 9

zika virus

Question 10

where in the spine is a common place for syringomyelia to occur?

Answer 10

C5

Question 11

central cord sydrome, caused by syringomyelia, will cause what manifestation of the upper extremity?

Answer 11

like a “cape over the shoulders” - will be able to feel you touch, but not poke with sharp object (pain and temperature loss)

Question 12

cerebral palsy damage often occurs between the thalamus and caudate nucleus causing pyramidal and extrapyramidal defecits, meaning what exactly?

Answer 12

motor deficits

Question 13

a treatment for athetoid cerebral palsy?

Answer 13

baclofen: GABA agonist = decrease to movements

Question 14

most common type of CP?

Answer 14

spastic (tense, contracted muscles)

Question 15

constant, uncontrolled motion of limbs, head, and eyes is what type of CP?

Answer 15

athetoid

Question 16

list the 3 types of axonal injury in order of least amount of damage to most:

Answer 16

1. neurapraxia
2. axonotmesis
3. neurotmesis

Question 17

the two types of stroke?

Answer 17

1. ischemic

2. hemorrhagic

Question 18

which type of stroke is sudden and which is more gradual?

Answer 18

sudden = ischemic
gradual = hemorrhagic

Question 19

the process of breaking down the rER

Answer 19

chromatolysis

Question 20

microglia/macrophages that are FULL of lipid

Answer 20

foamy cells

Question 21

____ are the most important cells in response to injury and repair when referring to the blood-brain barrier

Answer 21

astrocytes

Question 22

two hallmarks of CNS damage and disease?

Answer 22

1. reactive gliosis

2. neurofibrillar tangles

Question 23

lyme disease of the brain is called?

Answer 23

neuroborreliosis

Question 24

hemorrhagic stroke accounts for

Answer 24

<20%

Question 25

usually caused by a middle meningeal artery tear due to temporal bone fracture

Answer 25

epidural (extradural) hemorrhage

Question 26

if a concussion occurs with an epidural hemorrhage, consciousness may be regained, called a ____, but will then be lost as the hematoma enlarges

Answer 26

lucid interval

Question 27

an epidural hematoma is ___ blood, while a subdural hematoma is ___ blood

Answer 27

arterial, venous (fragile or brittle “bridging” vein)

Question 28

____ hemorrhage most commonly occurs from spontaneous rupture of a small arterial aneurysm termed a saccular (berry) aneurysm. these occur over the base of the brain (circle of willis area)

Answer 28

subarachnoid

Question 29

between __-__% of patients with a spontaneous hemorrhage from a saccular aneurysm will die with the first episode. this hemorrhage will produce “the worst headache i’ve ever had”

Answer 29

25-50%

Question 30

when a piece of blood clot breaks off and travels to another part of the body (for instance - a clot in the left atrium breaks off and travels to smaller vessels in the brain). what is it called?

Answer 30

embolism/embolic (the most common type of ischemic stroke)

Question 31

“cellular chaos” is caused by ____ in the heart (another cause of clot formation)

Answer 31

atrial fibrillation (200-400bpm)

Question 32

in situ atherosclerotic plaquing ischemic strokes

Answer 32

thrombotic

Question 33

hypertension leads to damage to the endothelial cells of the vessels, which then de-differentiate into lipohyaline (dense irregular connective tissue), which leads to lipids being trapped and amyloid angiopathy (brittle/”scarring” tissue) and then breaks off

Answer 33

know this

Question 34

congenital disorder related to dysfunction of copper metabolism (defect in chromosome 13) leading to excess copper in three sites: brain, liver, margin (limbus) of the cornea (Kayser-Fleisher Ring)

Answer 34

Wilson’s disease

Question 35

Hallervorden-Spatz disease (HSD) is related to what heavy metal?

Answer 35

Iron