Central Nervous System Flashcards
1
Q
[response to injury: determine the cell]
shrinkage of soma
Pynosis
Absence of nucleolus
Intense eosinophilia
A
acute res
2
Q
[response to injury: determine the cell]
hyperplasia
hypertrophy
accumulation of GFAP
A
astrocyte
3
Q
[response to injury: determine the cell]
proliferation
A
microglia
4
Q
the most important histopathologic finding that indicates CNS injury
A
gliosis
5
Q
[type of cerebral edema]
generalized hypoxic-ischemic injury
A
cytotoxic or vasogenic
6
Q
[type of cerebral edema]
localized: adjacent to inflammation and neoplasm
A
vasogenic
7
Q
[type of cerebral edema]
hydrocephalus
A
interstitial
8
Q
[type of hydrocephalus]
localized: limited to upstream obstruction
A
non-communicating
9
Q
[type of hydrocephalus]
ventricular system that communicates with subarachnoid space
A
communicating
10
Q
[type of hydrocephalus]
increased CSF as compensation to decreased parenchymal mass;
no ventricular dilation
A
hydrocephalus ex vacuo
11
Q
[type of herniation]
herniate through the falx cerebri
A
subfalcine
12
Q
[type of herniation]
herniate across tentorium cerebelli
A
transtentorial
13
Q
[type of herniation]
herniation of cingulate gyrus
A
subfalcine
14
Q
subfalcine herniation compresses this artery
A
anterior cerebral artery
15
Q
[type of herniation]
herniation of the medial aspect of the temporal lobe
A
transtentorial
16
Q
Transtentorial herniation can compress this part of the brain
A
CN III
contralateral cerebral peduncle
17
Q
[type of herniation]
pupillary dilation
hemiparesis ipsilateral to the lesion
A
transtentorial
18
Q
[type of herniation]
herniation through the foramen magnum
A
tonsillar
19
Q
[type of herniation]
herniation of cerebellar tonsils
A
tonsillar
20
Q
tonsillar herniation can lead to compression of this structure
A
brainstem
21
Q
[neural tube defect]
extension of the spinal cord and meninges through a defect in vertebral column
A
myelomeningocele
22
Q
[neural tube defect]
extension of the meninges through a defect in the vertebra
A
meningocele
23
Q
[neural tube defect]
diverticulum of a malformed brain tissue through a defect in the cranium
usually in the posterior fossa but can occur across the cribiform plate in anterior fossa
A
encephalocele
24
Q
[neural tube defect]
failure of the closure of the anterior neural tube
A
anencephaly
25
[neural tube defect]
skin dimpling, a patch, a hair patch over the defect
spina bifida occulta
26
[posterior fossa anomalies]
enlarged posterior fossa
hypoplasia of the cerebellar vermis
cystic dilation of the fourth ventricle
Dandy-walker malformation
27
[posterior fossa anomalies]
Small posterior fossa with mishapen cerebellar tonsils
Non-communicating hydrocephalus (due to aqueductal stenosis)
Lumbar myelomeningocele
Arnold-Chiari Malformation
Chiari II
28
[posterior fossa anomalies]
low-lying cerebellar tonsils
clincally silent or hydrocephalus
Lumbar myelomeningocele
Arnold-Chiari Malformation
Chiari II
29
[perinatal injury]
nonprogressive neurologic motor deficits (dystonia, spasticity, ataxia/athetosis, paresis) occurring during perinatal and prenatal periods
cerebral palsy
30
[perinatal injury]
increased risk in preterm infants, most often near developing thalamus and caudate; can lead to hyrdocephalus
intraprenchymal hemorrhage
31
[perinatal injury]
surpatentorial periventricular white matter infarcts
multicystic encephalopathy: cystic lesions throughout cerebral hemispheres in extensive ischemic damage
periventricular leukomalacia
32
[parenchymal injuries, trauma]
most common site of contusion
frontal lobes along orbital ridges and temporal lobes
33
[parenchymal injuries, trauma]
axonal swellings develop coma shortly post-trauma
diffuse axonal injury
34
[parenchymal injuries, trauma]
depressed, retracted, yellowish brown patches involving the crest of gyri (plaque jaune)
old traumatic lesion
35
[parenchymal injuries, trauma]
can become epileptic foci
old traumatic lesions
36
[traumatic vascular injury]
lucid intervals, rapidly evolving neurologic symptoms
epidural hematoma
37
[traumatic vascular injury]
lentiform density
epidural hematoma
38
[traumatic vascular injury]
fracture to pterion ruptures ___ artery
middle meningeal artery
39
[traumatic vascular injury]
rupture in middle meningeal artery is associated with ____
epidural hematoma
40
[traumatic vascular injury]
extremes of age, slowly evolving neurologic symptoms; delayed onset
subdural hematoma
41
[traumatic vascular injury]
bridging veins
subdural hematoma
42
[traumatic vascular injury]
crescent-shaped density
subdural hematoma
43
[traumatic vascular injury]
occurs with generalized reduction of cerebral perfusion
global cerebral ischemia
44
[traumatic vascular injury]
neurons most sensitive to ischemia
1. pyramidal layer of hippocampus
2. Cerebellar purkinje cells
3. pyramidal cells of cerebral cortex
45
[traumatic vascular injury]
neurons most sensitive to ischemia
1. pyramidal layer of hippocampus
2. Cerebellar purkinje cells
3. pyramidal cells of cerebral cortex
46
[traumatic vascular injury]
between areas of perfusion of major cerebral vessels susceptible to ischemia
watershed areas
47
[traumatic vascular injury, ischemic changes]
red neuron, cerebral edema, infiltration of neutrophils
acute
48
[traumatic vascular injury, ischemic changes]
liquefactive necrosis, influx of macrophages, reactive gliosis
subacute
49
[traumatic vascular injury, ischemic changes]
removal of necrotic tissue, gliosis
chronic
50
[traumatic vascular injury, ischemic changes]
edema, neuronal microvascularization, pyknosis + karyorrhexis, increased neutrophils
acute changes
51
[traumatic vascular injury, ischemic changes]
increased microglial cells, gliosis
chronic changes
52
[traumatic vascular injury, ischemic changes]
reduction or cessation of blood flow to a localized area of brain due to arterial occlusion of hypoperfusion
Focal Cerebral Ischemia
53
[hypertensive cerebrovascular disease]
small perforating vessels; involved: basal ganglia, pons, deep, white matter, thalamus
Histo: small cavitary infarcts
lacunar infarct
54
[hypertensive cerebrovascular disease]
small perforating vessels
rupture of small vessels due to hypertension
Histo: tissue destruction, pigment-laden macrophages and gliosis
slit hemorrhages
55
[diagnosis]
diffuse cerebral function
headaches, confusion, vomiting, convulsions, leading to coma
edematous brain without herniation; petechiae and fibrinoid necrosis of arterioles in gray and white matter
hypertensive encephalopathy
56
most common cause of deep parenchymal hemorrhages
hypertension
57
most common cause of lobar intraparenchymal hemorrhage
cerebral amyloid angiopathy
58
most common location of hypertensive intracranial hemorrhage
putamen (50-60%)
| Thalamus, pons, cerebellar hemispheres are rae
59
[intraparenchymal hemorrhage]
charcot-bouchard microaneurysm in basal ganglia
hypertensive ICH
60
most common cause of subarachnoid hemorrhage
ruptured saccular berry aneurysm
61
most common intracranial aneurysm
saccular aneurysm
62
most common location of intracranial saccular aneurysm
ACA-ACoA junction
63
[vascular malformation]
vessels of the subarachnoid space and brain
enlarge vessels with intervening brain tissue
AVM
64
[vascular malformation]
located in the cerebellum, pons and subcortical region
enlarged vessels without intervening brain tissue
Cavernous malformation
65
[vascular malformation]
located in pons
small, thin-walled vessels with intervening brain tissue
capillary telangiectasia
66
[vascular malformation]
ectatic venous channels, variable location, developmental venous anomalies
venous angiomas
67
[meningitis]
most common cause of meningitis in infants
E. coli and GBS
68
[meningitis]
most common cause of meningitis in adolescents
N. meningitidis
69
[meningitis]
most common cause of meningitis in elderly
S. pneumoniae
| L. monocytogenes
70
[meningitis]
Infiltrate: PMN
sugar: very low
protein: high
culture positive
bacterial
71
[encephalitis]
exudates on basal cisterns
obliterative endartrisits
hydrocephalus
TB
72
[meningitis]
infiltrate: lymphocytes
protein: high
sugar: very low
TB
73
[neurosyphilis]
frontal lobe affected
severe dementia, progressive impairment with mood alteration
paretic
74
[neurosyphilis]
dorsal columns
locomotor ataxia
charcot joints
lightning pains
agryll-robertson pupil
tabes dorsalis
75
[meningitis: type of virus]
hemorrhagic necrotizing temporal lobe encephalitis
HSV
76
[meningitis: type of virus]
subacute encephalitis involving paraventricular subependymal region
periventrucular necrosis and calcification
CMV
77
[meningitis: type of virus]
flaccid paralysis, muscle wasting, hyporeflexia
neuronophagia of the anterior horn motor neurons of the spinal cord
poliomyelitis
78
[meningitis: type of virus]
widespread neuronal degeneration most severe in brainstem
presence of negri bodies
Rabies
79
[meningitis]
brain abscesses near the gray-white junction (cerebral cortex)
CT: ring enhancing lesions,
Central foci of necrosis surronded by tachyzoites and bradyzoites
toxoplasma
80
[meningitis]
affects basal leptomeninges
soap bubble appearance
gelatinous material within the subarachnoid space and small cysts in basal ganglia
cryptococcus
81
[prion disease]
subtle memory change to progressive dementia
startle myoclonus
cerebellar ataxia
spongiform transformation
CJD
82
most common demyelinating disorder
multiple sclerosis
83
viral cause of progressive multifocal leukoencephalopathy
JC virus
84
[diagnosis]
unilateral optic neuritis
nystagmus
intention tumor
scanning speech
moderate pleocytosis, elevated protein, increased IgG
multiple sclerosis
85
__ triad of MS
nystagmus
intention tumor
scanning speech
charcot triad
86
[MS plaques]
evidence of partial and incomplete remyelination
shadow plaque
87
[neurodegenerative disease]
AB, Tau
alzheimer
88
[neurodegenerative disease]
alpha-synuclein, tau
parkinson
89
[neurodegenerative disease]
polyglutamine aggregates
huntington
90
[neurodegenerative disease]
TPD-43, FUS
ALS
91
[neurodegenerative disease]
lesion in the cortex
dementia
92
[neurodegenerative disease]
lesion in the basal ganglia and brainstem
parkinsonism
93
[neurodegenerative disease]
lesion in the spinal cord and cerebellum
ataxia
94
[neurodegenerative disease]
lesion in the motor neurons
muscle atrophy
95
[diagnosis]
insidious impairment of higher intellectual function, slow, unrelenting
presence of neuritic plaques, neurfibrillary tangles
alzheimer
96
[diagnosis]
tremor, rigidity, bradykinesia
pallor of substansia nigra
presence of lewy body
parkinson
97
[diagnosis]
loss of striatal neurons that dampen motor output,
excessive motor output, generalized jerky, hyperkinetic, dystonic
caudate atrophy, loss of striatal neurons, frontal lobe atrophy
dilation of lateral and third ventricle
huntington
98
[diagnosis]
progressive ataxia, spasticity, weakness, sensory neuropathy, cardiomyopathy
betz cells, involvement of CN VIII, X, XII
degeneration of cerebellum, and clarke column
friedrich ataxia
99
[diagnosis]
loss of UMN in cerebral cortex
loss of LMN in the spinal cord and brainstem
atrophic B4,6
bunina bodies
ALS
100
[diagnosis]
seen in remaining neurons, PAS (+), remnant of vacuoles
seen in ALS
bunina bodies
101
[diagnosis: type of enceph]
psychotic symptoms
ophthalmoplefia
ataxia, confusion, ophthalmoplegia
reversible with B1
Wernicke enceph
102
[diagnosis: type of enceph]
short term memory disturbances, confabulation
confabulation, hallucinations, amnesia
chronic
irreversible with B1
Korsakoff Syndrome
103
[metabolic diseases]
resemble ischemic brain injury
hypoglycemia
| carbon monoxide
104
[metabolic diseases]
may damage anterior vermis of the cerebellum
ethanol
105
most common primary tumor of the brain
gliomas
106
[diagnosis: brain tumor]
children: cerebellum
Adults: cerebral cortex
astrocytoma
107
[diagnosis: brain tumor]
4th-5th decade of life
cerebral cortex (white matter)
oligodendroglioma
108
[diagnosis: brain tumor]
1st to 2nd decade: near the 4th ventricle
Adults: spinal cord
ependymoma
109
[WHO Grading of astrocytoma]
Atypia + mitosis
Grade III, anaplastic
110
[WHO Grading of astrocytoma]
Atypia + mitosis + endovascular proliferation or necrosis
pseudopalisading pattern of cells around necrosis
Glioblastoma, IV
111
[diagnosis: brain tumor]
limited infliltration
bipolar cells with thin hair-like processes, rosenthal fibers
eosinophilic granular bodies
pilocytic astrocytoma
112
[diagnosis: brain tumor]
fried-egg appearance
aleration of 1p19q co-deletion
tumor cells arrayed around neurons
oligodendroglioma
113
ependymoma located here is almost imposible to remove
4th ventricle
114
[diagnosis]
children with hydrocephalus, cerebellum
can disseminated to CSF "drop metastasis"
radiosensitive, homer-wright rosettes, small, round blue cells
medulloblastoma
115
most common origin of primary CNS lymphoma
B cell lymphoma
116
most common subtype of primary CNS lymphoma
DLBCL
117
most common primary CNS lymphoma in ICC
EBV(+)
118
meningothelial cells of arachnoid
meningioma
119
[diagnosis: brain tumor]
located in parasagittal, dura over lateral brain convexity
psammoma bodies
meningioma
