questions 5

CNS Development

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Topic updated on 12/28/16 3:40pm

 
 
 
Overview
  • CNS development (week 3)
    •  neuroectoderm (a subtype of ectoderm) → neural plate → brain and spinal cord 
  • Neural tube gives rise to
    • forebrain (prosencephalon) 
      • telencephalon 
        • cerebral cortex, lateral ventricles, caudate, putamen, hippocampus, olfactory bulbs
      • diencephalon
        • thalami, mammillary bodies, neurohypophysis, pineal gland, retina, optic nerve, chiasm, and tract
    • midbrain (mesencephalon)
    • hindbrain (rhombencephalon)
      • metencephalon
        • pons, cerebellum
      • mylencephalon
        • medulla
Neural tube defects
 
 
  • Failure of neuropores to fuse during week 4
    • vertebral arches do not fuse resulting in a connection between amnionic cavity and spinal canal
    • defect tends to occur in lumbosacral region
    • can be detected by testing maternal blood for ↑ α-fetoprotein (AFP)
      • if elevated and neural tube defect is present, then amniocentesis will show ↑ α-fetoprotein (AFP) and ↑ acetylcholinesterase 
    • associated with maternal folate deficiency commonly caused by: 
      • low folic acid intake during pregnancy 
      • medications that interfere with folate utilization 
        • Valproate, methotrexate, sulfasalazine, phenytoin
  • Spina bifida oculta
    • least severe variation with dura intact and no herniation
    • tuft of hair in lumbosacral region 
  • Spina bifida with meningocele
    • only meninges herniate through spinal defect forming a CSF filled sac, but spinal cord remains in spinal canal
  • Spina bifida with meningomyelocele
    • meninges and spinal cord herniate through defect


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Qbank (2 Questions)

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(M1.EB.6) A 24-year-old female with a history of recurrent infections, bipolar disorder, and no prenatal care gives birth to a male infant. On physical exam in the delivery room, you observe a tuft of hair over the infant's lumbosacral region. Which of the following drugs was this mother most likely taking during pregnancy? Topic Review Topic

1. Chloramphenicol
2. Gentamicin
3. Lithium
4. Valproate
5. Folic acid

PREFERRED RESPONSE ▶
TAG
(M1.EB.62) A 30-year-old female with a history of epilepsy becomes pregnant. Her epilepsy has been well controlled by taking a medication that increases sodium channel inactivation. Her obstetrician informs her that her epilepsy medication has been shown to have teratogenic effects. Of the following, which teratogenic effect is this woman's medication most likely to cause? Topic Review Topic

1. Discolored teeth
2. Renal damage
3. Limb defects
4. Ebstein's anomaly
5. Neural tube defect

PREFERRED RESPONSE ▶
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