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Neurology Flashcards

(54 cards)

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1
Q

When does development of the nervous system begin during gestation?

A

During week 3

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2
Q

What are the three germ layers?

A

Ectoderm, mesoderm, endoderm

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3
Q

Which part of the germ layer does neural tissue arise from?

A

Ectoderm

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4
Q

How does the neural tube form?

A

Neural folds become elevated and grow towards the midline to fuse and form the neural tube. Begins in the cervical regin and progresses in the cephalic and caudal region

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5
Q

When do you have full closure of the neural tube?

A

25-27 days

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6
Q

What is the neural crest?

A

A population of cells separates from the tips of the neural folds to form neural crest. These cells migrate throughout the body to form cell types such as schwann cells, meninges, adrenal medulla and parafollicular cells

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7
Q

What does the caudal end of the neural tube give rise to?

A

Composed of neuroepithelial cells which gives rise to neuroblasts which following maturation give rise to grey and white matter of the future spinal chord

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8
Q

What does the cephalic end of the neural tube give rise to?

A

Hindbrain, midbrain, forebrain

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9
Q

What does the neural tube and neural crest differentiate into?

A

Neural tube- central nervous system brain and spinal chord & neural crest- peripheral & autonomic nervous system

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10
Q

What does the forebrain form? (prosencephalon)

A

Cerebral hemisphere, thalami & lateral ventricles

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11
Q

What does the midbrain form? (mesencepahlon)

A

Midbrain & aqueduct

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12
Q

What does the hindbrain form?

A

Pons, cerebellum, medulla and fourth ventricle

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13
Q

What is anencephaly?

A

Failure of the neural tube to close at the cranial end. This is incompatible with life because you dont have brain development

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14
Q

What is spina bifida?

A

Failure of the neural tube to close at the caudal end

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15
Q

After having an affected child what is the risk for a second child or a third to have spina bifida?

A

Second child is 3-5% and third child is 5-10%

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16
Q

What can cause spina bifida?

A

Folate deficiency, folate antagonists such as sodium valproate and genetic polymorphisms in genes that are needed for folate metabolism such as methylenetetrahydrofolate reductase MHTFR

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17
Q

What are the spectrums for spina bifida?

A

Spina bifida occulta - developmental defect in the vertebral arch covered by intact skin and not involving the spinal chord. Lumbar spine is the most frequent location

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18
Q

What are the two types of spina bifida cystica?

A

Meningocele - fluid filled meninges but not the spinal chord protrude through the defect

Myelomeningocoele- neural tissue is also involved and protrudes

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19
Q

What is a chiari malformation?

A

Downward displacement of the cerebellar tonsils through the foramen magnum (into the spinal canal) squishing the outflow of CSF and causing hydrocephalus

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20
Q

What do pluripotent neural stem cells differentiate into?

A

Neurons, astrocytes and oligodendrocytes

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21
Q

What are neurons?

A

They have a cell body and dendrites and they are electrically excitable cells that rely on metabolically active ion channel pumps to maintain voltage gradients

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22
Q

What are astrocytes?

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A

Dominant cell line , star shaped and support the blood brain barrier. Can transform into neurons and provide nutrients to neural cells

23
Q

What is the function of oligodendrocytes?

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A

Support and insulate the axon and permit the conduction of nerve impulses along myelinated axons

24
Q

When does synaptogenesis (creation of a synapse) happen?

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A

Between 20 weeks gestation and continue to the first couple years after birth

25
What protein stabilizes the synapse
N cadherin
26
What is myelination and when does it happen?
Myelin is produced by glial cells and they insulate the axon so that it increases the speed and accuracy of transmission of info in the form of action potentials along a neuron. Between 36 weeks and term myelin increases from 1% to 5% total brain volume
27
Name 4 conditions affected by ion channel malfunction
Generalized epilepsy with febrile seizures plus, dravet syndrome, familiam hemiplegic migraine and some of the ataxias
28
Name three drugs that block sodium channels
Phenytoin, lidocaine and carbamazepine
29
At resting potential is the inside of the neuron more negatively or positively charged than the outside?
AT REST- More negative inside than outside, resting potential -70mV
30
What is depolarization?
Neurotransmitter molecules bind to receptors on the neurons dendrites and cause voltage gated ion channels to open and influx of positive ions to enter the target neuron.
31
What is the threshold potential and what happens?
At the threshold potential (-55mV), Na channels open and Na enters the cell and the neuron completely depolarizes to a positive membrane potential of about +40mV. The action potential now travels dowm the neuron
32
What happens when a action potential has been generated?
Na channels close and the cell is refractory to further stimulus. The voltage gated K+ channels open and K+ ions leave the cell making it negative again -70mv. The cells then rests itself by pumping out Na in exchange for K+
33
Name a neurotrophin that is thought to have a role in pyschiatric and neurodevelopmental disorders and possible a therapeutic agent for neurodegenerative conditions and MS
hormone nerve growth factor
34
What is the critical period of visual neuroplasticity in young children and up until when does the higher visual pathway continue to develop and differentiate?
3 months critical and continues to develop until 8 years
35
When do you have the most maximum number of synpatic connections?
Early childhood- most receptive to learning
36
How do neural cells migrate to their correct location?
Along specially created highway or glial cells
37
What are some molecules that can cross the blood brain barrier?
water, gases and lipid soluble substances
38
What is the pathophysiology of jaundice in the neonate?
unconjugated bilirubin is lipid soluble and able to pass reading through the BBB and into the brain which causes neurological damage
39
Why does light therapy help in neonatal jaundice?
The light of a certain frequency is able to convert the lipid soluble unconjugated bilirubin into a water soluble stat which means it cannot cross the BBB
40
What type of cell produces CSF ?
Ependymal cell mainly produced in the choroid plexus in the lateral ventricles of the brain
41
Describe the flow of CSF
Lateral ventricle -> third ventricle via intraventricular foramne of munro Third ventricle-> Fourth ventricle via aqueduct of sylvisu Reabsorbed into circulation via arachnoid vila
42
Name some causes of communicating hydrocephalus (no obstruction between the ventricles & subarachnoid space)
1) Excess CSF production - e.g. choroid plexus tumours 2) Impaired CSF re-absorption due to blockage of arachnoid granulations by debris after meningitis or haemorrhage
43
Name some causes of non communicating hydrocephalus (physical obstruction between ventricles and subarachnoid space)
1) Congenital malformations such as arnold chiari malformation or aqueduct stenosis 2) Acquired obstruction such as brain tumour
44
What are normal levels of glucose and protein in normal CSF?
The blood-brain barrier is effective against large molecules (e.g. protein) but allows the passage of smaller molecules (e.g. glucose). As such, normal CSF is generally a low-protein fluid with copious glucose.
45
What can you see via cranial USS?
Intraventricular haemorrhage, ischemic cysts of periventricular leukomalacia, ventricular dilatation, cerebral malformations such as agenesis of corpus callosum
46
What are oligoclonal bands?
Oligoclonal bands are visible as an increased concentration of restricted bands of IgG after isoelectric focusing and immunofixation of IgG. A serum sample is taken at the time of the lumbar puncture as oligoclonal bands may be present in CSF alone or CSF and blood. If present in both, they may represent systemic infection, autoimmune disease, sarcoidosis or neoplasia. Local CNS synthesis implies local CNS disease, especially multiple sclerosis
47
What does the CSF look like in T2 vs T1 weighted MRI sequence?
CSF is bright white in T2 vs dark in T1 and T2 is good for assessing tissue fluid content such as oedema vs T1 which is better for assessing tissue anomalies
48
When do you use Magnetic resonance angiography (MRA)?
Non-invasive assessment of the intracranial vascular system such as conditions like AVN malformations
49
What is magnetic resonance spectroscopy?
MRS- Can detect metabolites or other target molecules within brain tissue
50
What condition are infantile spasms associated with and what sign do you see on an EEG?
Tuberous scerlosis and EEG shoes hypsarrthymia
51
What are the 4 EEG wave patterns and after 3 years what is the predominant pattern?
alpha, beta, theta and delta and after 3 years the prominent is alpha
52
What is elcttomyography?
Needle electrode is directly inserted into the muscle. Can help detect myotonia and nerve injury
53
What does nerve conduction studies look for?
Peripheral neuropathy and the classification of axonal vs demyelinating conditions. Axonal- conduction velocity is preserved and the amplitude is reduced. In demyelination the conduction velocity is reduced
54
What doe the visual evoked potentials test help with?
Help detect lesions of the sensory visual pathways e.g. demyelination of the optic nerve in optic neuritis

TAS (10 decks)

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