5 Neuropath 1 Concepts Flashcards
What are the 4 major types of glia cells?
Astrocytes
Oligodendroglia (or schwann)
Ependyma (choroid)
Microglia
What do red neurons represent?
Acute neuronal injury
What disease has lewy bodies? what disease has neurofibrillary tangles?
- parkinson’s
2. Alzheimer’s
What is lipofuscin due to?
aging
What does the idea of selective vulnerability mean in regards to CNS?
- neurons are in themselves vulnerable mores than other cells
- Neurons in specific regions can be singled out for injury (watershed ischemia, alzheimer’s and the hippocampus)
What CNS cell interacts with the neuron, capillary, pia mater, axons?
Astrocytes
have a lot of house keeping functions like storing sugar for emergencies
How many axons can oligodendrocytes myelin ate?
multiple- I’ve read like 30 somewhere
What are astrocytes reaction to injury?
- gliosis (glial scar)
2. Rosenthal fibers (corkscrew eosinophilic bundle)
What is oligodendrocytes reaction to injury?
demyelination and remyelination
What is the microglia reaction to injury? 3
- proliferate to form rod cells
- Neuronophagia-congregate around dying neurons
- Perform phagocytic functions
What 2 things make up the blood brain barrier?
- cerebral endothelium
2. astrocytes
What two things play a major role in the blood cerebrospinal fluid barrier?
- Choroid plexus
2. leptomeninges (pia mater, arachnoid)
What is vasogenic edema?
Leakage of BBB
What is cytotoxic edema from?
Intracellular fluid
Review things that can cause nonspecific cerebral edema?
- trauma
- hypoxia and ischemia
- infection and inflammation
- Neoplasms
What produces CSF? What reabsorbs CSF?
- Choroid plexus
2. Arachnoid Granulation
What is the enlargement of ventricular system?
Hydrocephalus
What type of hydrocephalus is defined as obstruction within ventricular system and results in focal enlargement?
Noncommunicating hydrocephalus
What type of hydrocephalus is defined by obstruction of outside ventricular system and results in enlargement of entire system?
Communicating
What is hydrocephalus ex vacuo?
Dilation of ventricular system due to atrophy of brain parenchyma
What are the 3 types of expanding lesions?
- hydrocephalus
- cerebral edema
- Mass lesions (hemorrhages, neoplasms, infections)
What are the 3 consequences of raised intracranial pressure?
- papilledema
- brain herniation
- decreased blood flow
Uncal herniation does what to the pupils and what to the brain stem?
- dilated pupils due to 3rd nerve compression
2. Duret hemorrhages (lineal areas of bleeding)
What is the difference between a diastatic fracture and a monostatic fracture?
diastatic fractures cross sutures
Review the following basilar skull fracture problems that secondary complications.
- orbital hemorrhages
- mastoid hemorrhages
- cranial nerve injury
- CSF leakage through nose or ears
- Meningitis
What are defined as displacement of the fracture edges by a distance greater than the thickness of the bone?
depressed skull fractures
When do basal fractures typically occur?
follow impact to the occiput or sides of head rather than vertex
(hard to detect on postmortem exam)
Panda bear or raccoon sign is a manifestation of what?
Orbital hemorrhages associated with basilar fractures involving orbital roof.
What is Battle’s sign evidence of?
Mastoid hemorrhage secondary to a basilar fracture
Rhinorrhea and otorrhea are signs of what?
CSF leakage following basilar fractures
CSF COMES OUT AND BACTERIA COMES IN
Is a epidural or subdural hematoma due to an arterial source? Slowly accumulating? medical emergency?
- epidural
- Subdural
- epidural
What are subarachnoid hemorrhages due to?
associated with contusions
Is a epidural or subdural hematoma due to an arterial source? Slowly accumulating? medical emergency?
- epidural (middle meningeal artery)
- Subdural
- epidural
What are subarachnoid hemorrhages due to?
associated with contusions
Review the 4 types of parenchymal injury
- Concussion
- contusion and laceration
- coup and countercoup injury
- Diffuse axonal injury
Ring and ball hemorrhages from blood tracking occur where?
perivascular spaces (Virchow-Robin Spaces)
The spaces are formed when large vessels take the pia mater with them when they dive deep into the brain
What are diffuse axonal injuries due from?
rotational acceleration/deceleration that creates shearing
(MORE INFO-When acceleration or deceleration causes the brain to move within the skull, axons, the parts of the nerve cells that allow neurons to send messages between them, are disrupted. As tissue slides over tissue, a shearing injury occurs. This causes the lesions that are responsible for unconsciousness, as well as the vegetative state that occurs after a severe head injury.
A diffuse axonal injury also causes brain cells to die, which cause swelling in the brain. This increased pressure in the brain can cause decreased blood flow to the brain, as well as additional injury. The shearing can also release chemicals which can contribute to additional brain injury. The main symptom of diffuse axonal injury is lack of consciousness, which can last up to six hours or more. A person with a mild or moderate diffuse axonal injury who is conscious may also show other signs of brain damage, depending upon which area of the brain is most affected.)
T-F– neurological dysfunction in spinal cord trauma is more due local damage as opposed to long white matter tracts?
False- due more to injury of long white matter tracts.
Review the factors that determine the degree of damage in craniocerebral trauma?
- nature or type of injury
- force of injury- length of fall, speed of automobile, bullet caliber and muzzle velocity
- situation/direction of the blow or impact.
What does the idea of selective vulnerability mean in regards to CNS?
- neurons are in themselves vulnerable mores than other cells
- Neurons in specific regions can be singled out for injury (watershed ischemia, alzheimer’s and the hippocampus)
What are astrocytes reaction to injury?
- gliosis (glial scar)
2. Rosenthal fibers (corkscrew eosinophilic bundle)
What is cytotoxic edema from?
Intracellular fluid
Review things that can cause nonspecific cerebral edema?
- trauma
- hypoxia and ischemia
- infection and inflammation
- Neoplasms
What is the enlargement of ventricular system?
Hydrocephalus
What is hydrocephalus ex vacuo?
Dilation of ventricular system due to atrophy of brain parenchyma
Uncal herniation does what to the pupils and what to the brain stem?
- dilated pupils due to 3rd nerve compression
2. Duret hemorrhages (lineal areas of bleeding)
What is the difference between a diastatic fracture and a monostatic fracture?
diastatic fractures cross sutures
When do basal fractures typically occur?
follow impact to the occiput or sides of head rather than vertex
(hard to detect on postmortem exam)
Review the 4 types of parenchymal injury
- Concussion
- contusion and laceration
- coup and countercoup injury
- Diffuse axonal injury
Ring and ball hemorrhages from blood tracking occur where?
perivascular spaces (Virchow-Robin Spaces)
What are diffuse axonal injuries due from?
rotational acceleration/deceleration that creates shearing
(MORE INFO-When acceleration or deceleration causes the brain to move within the skull, axons, the parts of the nerve cells that allow neurons to send messages between them, are disrupted. As tissue slides over tissue, a shearing injury occurs. This causes the lesions that are responsible for unconsciousness, as well as the vegetative state that occurs after a severe head injury.
A diffuse axonal injury also causes brain cells to die, which cause swelling in the brain. This increased pressure in the brain can cause decreased blood flow to the brain, as well as additional injury. The shearing can also release chemicals which can contribute to additional brain injury. The main symptom of diffuse axonal injury is lack of consciousness, which can last up to six hours or more. A person with a mild or moderate diffuse axonal injury who is conscious may also show other signs of brain damage, depending upon which area of the brain is most affected
T-F– neurological dysfunction in spinal cord trauma is more due local damage as opposed to long white matter tracts?
False- due more to injury of long white matter tracts.
