Flashcards in Week 2 Fetal and Neurologic Injury (everything) Deck (66)
** The depolarizing effect of GABA and it's affects play a major role in
activity-dependent synapse formation
fetal brain is encoded by genetic programming- such programs remain highly susceptible to what
environmentally induced epigenetic modifications and appear closely intertwined with maternal immune and endocrine systems
maternal infection and inflammation in early pregnancy can cause an array of neurodevelopment abnormalities- name two
schizophrenia and autism
among maternal infections _____ is best characterized and thoroughly investigated model of perinatal neuroinflammation
the exact mechanism by which maternal inflammation triggers a fetal immune response is likely
Review Box 10.4
10-4 Fetal Cerebral Responses to Asphyxia
FETAL CEREBRAL METABOLISM
• Increased oxygen extraction
• Use of alternative energy sources
• Decreased growth
• Altered behavioral state
FETAL CEREBRAL O2 TRANSPORT
• Redistribution of cerebral blood flow
*** the fetus can conserve additional energy by what two ways?
decreasing breathing and gross body movements***
** during chronic hypoxemia the fetus may also restrict the use of energy from oxidative metabolism to maintain essential cellular process- this leads to
decreased somatic growth and fetal growth restrictions ***
*** unlike the adult brain what can the fetal brain use as alternate energy sources
ketone bodies and lactate ****
the fetus takes advantage of several adaptive responses for survival and growth- what is this due to
the relatively hypoxemia intrauterine environment
what is a useful tool in the diagnosis of neonatal brain injury
MRI can assist the diagnosis of these 4 things
hypoxic- ischemic encephalopathy
determine volume of gray matter
extent of white matter myelination
estimates timing of the brain injury for cerebral palsy.
in VIVO MRI can be used to identify structural abnormalities - quantify brain growth beginning at what week gestation
18th week gestation
neuraxial techniques- used in labor focus on
and obstetric and short-term neonatal outcomes
True or false
epidrually administered local anesthetics cross the placenta and enter fetal circulation
True- whatever we give to the mother we give to the baby.
True or false
the long term effects of peripartum opioid exposure on the infants neurodevelopment shows a decrease in their development
false- the infant exposure to opioids remains unclear of any harm to their neurodevelopment
what systemic opioid used for labor analgesia is the most widely studied
What receptors in the fetal brain play a limited role during early brain development, they remain functionally silent because of magnesium ion- induced channel blockade? (they originate later than GABA receptors)
NMDA-subtype glutamate receptors. (bold in ppt)
what three NT systems develop concomitantly and appear fully functional by the 2nd trimester?
Dopaminergic, cholinergic, and serotonergic systems.
Pharmacologic interventions (e.g., ethanol, antiepileptic drugs) that act directly or indirectly on these powerful neuromodulator systems (dopaminergic, cholinergic, and seotenergic) induce what? (bold in ppt)
(basically saying if a system in the brain is developed and you use drugs that mess with it then what can happen long term to the fetus).
long-lasting impairment of fetal brain development, mainly owing to impaired neurogenesis and/or altered neuronal migration.
Alteration of this excitation-inhibition balance is purported to be responsible for an array of childhood neurodevelopmental disorders.
Experimental studies have revealed what about the fetal blood-brain barrier at term?
morphologically well developed and functionally competent at term.
Is Cerebral palsy a progressive or non progressive disorder of the CNS?
What is Cerebral Palsy?
Present since birth that include impairment of motor function or posture.
Intellectual disability may or may not be present.
****The only types of cerebral palsy associated with intrapartum hypoxia, what are they?
spastic quadriplegia and, less commonly, dyskinesia****
what three disorders should not be ascribed to birth asphyxia unless accompanied by spastic quadriplegia.
learning disorders, and
What age should a child be before statements about the severity of Cerebral Palsy be made?
3 to 4 years of age, , because mild cases may improve and dyskinesia may not be evident until then.
*** Intrapartum hypoxia sufficient to cause cerebral palsy is always accompanied by WHAT?
neonatal encephalopathy and seizures. ***
An association between cerebral palsy and chorioamnionitis has been demonstrated in preterm and term infants. But it is hard say which moms have chorioaminionitis. until which tests are confirmed?
placental culture or histologist examination
What is chorioamnionitis?
Chorioamnionitis also known as intra-amniotic infection (IAI) is an inflammation of the fetal membranes (amnion and chorion) due to a bacterial infection. It typically results from bacteria ascending from the vagina into the uterus and is most often associated with prolonged labor.