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COM II- Neuro Robbins > Chap 28 Key Concepts > Flashcards

Chap 28 Key Concepts Flashcards

1
Q

What is a feature of injury in the nervous system?

A

There is a distinct set of patterns of response to the injur

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2
Q

What are the characteristics of neuronal injury?

A
  • Cell death by apoptosis or necrosis

- Loss of neurons (difficult to detect)

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3
Q

What is the morphology of an injured astrocyte?

A
  • Hypertrophy of the cytoplasm
  • Accumulation of intermediate filament protein (GFAP)
  • Hyperplasia
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4
Q

What are microglia?

A

Resident monocyte-lineage population of the CNS

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5
Q

How does microglia react in response to injury?

A

Proliferate and accumulate

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6
Q

What is cerebral edema?

A

Accumulation of excess fluid within the brain parenchyma

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7
Q

What is hydrocephalus?

A

Increase in CSF volume within all or part of the ventricular system

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8
Q

What can raise the pressure inside the fixed capacity of the skull?

A 
Increases in volume of the intracranial contents
Ex. increase of CSF volume
Ex. edema
Ex. hemorrhage
Ex. tumor
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9
Q

How does increase in pressure relate to perfusion?

A

increased pressure can cause decreased perfusion which leads to ischemia

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10
Q

How do herniations occur?

A

increased pressure displaces tissue past the edges of dural partitions inside the skull or through openings in the skull

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11
Q

What can cause malformations in the CNS?

A

Single gene mutations, larger scale genetic alterations, exogenous factors

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12
Q

What stage of development is a malformation likely to be most severe?

A

The earlier in development of a malformation, the more severe

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13
Q

How does a neural tube defect occur?

A

Failure to close or inappropriate reopening of the developing neural tube

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14
Q

How does cortical development occur?

A

Proper progenitor cell proliferation in germinal matrix and migration of progenitors upward into developing cortex

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15
Q

What is the result of disruption of cortical development?

A

Alters size, shape and organization of the brain

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16
Q

Why is time so critical in a perinatal brain injury?

A

The earlier events cause greater damage and deficits

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17
Q

What is cerebral palsy?

A

Non-progressive deficits with injury during the prenatal and perinatal periods

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18
Q

How does physical injury to the brain occur?

A

When inside the skill comes into forceful contact with the brain

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19
Q

When and how do coup and countrecoup injures occur?

A
  • Occurs with blunt trauma
  • If the head is mobile, there is injury at the original point of contact (coup) and on the opposite side of the brain (countrecoup)
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20
Q

How do parenchymal injuries occur?

A

In the form of a contusion with hemorrhage extending into the subarachnoid space

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21
Q

How does diffuse axonal injury occur?

A

Rapid displacement of the head and brain that tears the axons

22
Q

What can traumatic tearing of blood vessels cause?

A

Epidural and subdural hematomas

23
Q

What is a stroke?

A

Clinical term for acute-onset neurologic deficits resulting from hemorrhagic or obstructive vascular lesions

24
Q

When does cerebral infarction occur?

A
  • Following the loss of blood supply

- Can be widespread or local or affect regions with the least robust vascular supply

25
Q

How does a focal cerebral infarct usually occur?

A

Following dissolution of an embolism and reperfusion

26
Q

What can cause a primary intraparenchymal hemorrhage?

A
  • Hypertension (in white matter, deep gray, posterior fossa contents)
  • Cerebral Amyloid Angiopathy
27
Q

What is the usual cause of a spontaneous subarachnoid hemorrhage?

A

A structural vascular abnormality

Ex. Aneurysm or arteriovenous malformation

28
Q

What are the various routes used by an organism to get access to the brain?

A
  • Hematogenous spread- abscess formation
  • Direct extension- after trauma or from sinuses
  • Retrograde transport along nerves
29
Q

What route by the organism is used in Rabies

A

Retrograde transport along nerves

30
Q

What infections are caused by bacteria involving the CNS?

A

Meningitis, cerebral abscesses, chronic meningoencephalitis

31
Q

What infections are caused by viruses involving the CNS?

A

Meningitis or meningoencephalitis

32
Q

What is the characteristic pattern of HSV-1 infection in the CNS?

A

Pattern in the temporal lobes

33
Q

What is the characteristic pattern of Polio in the CNS?

A

Pattern in anterior horn

34
Q

How does HIV directly and indirectly affect the brain?

A

Directly- cause meningoencephalitis

Indirectly- increasing risk of opportunistic infection (toxoplasmosis, CMV)

35
Q

How do prion diseases occur?

A

Conversion of normal protein PrPc into abnormal conformation PrPsc

36
Q

What is specific about the familial form of prion diseases?

A

Linked to mutations in PrPc gene (PRNP) which determine the phenotype

37
Q

What is the disease phenotypes for CJD?

A

Rapidly progressive dementia

38
Q

What is the disease phenotype for Gerstmann-Staussler-Scheinker syndrome?

A

Progressive cerebellar ataxia

39
Q

What does loss of myelin in demyelinating diseases cause?

A

Widespread and severe neurologic deficits

40
Q

What occurs in a demyelinating disease?

A

Breakdown and destruction of normal myelin

41
Q

What is Multiple Sclerosis?

A

Autoimmune demyelinating disease that affects young adults

42
Q

What is the pattern of clinical presentation of MS?

A

Relapsing-remitting course with progressive accumulation of neurologic deficits

43
Q

How are neurodegenerative diseases characterized?

A

By progressive neuronal loss involving specific neuronal circuits and brain regions
- Mostly associated with abnormal protein aggregates

44
Q

What reflects the pattern of the brain in neurodegenerative diseases?

A

Clinical phenotype

45
Q

What are groups of neurodegenerative diseases?

A
  • Grouped by clinical presentation: Dementias, hypokinetic movement disorders, hyperkinetic movement disorders, cerebellar ataxias, and motor neuron diseases
46
Q

What is the most common type of dementia and what occurs?

A

AD- with plaques of Ab and tangles of tau

47
Q

What do the lesions of Dementia with Lewy bodies contain?

A

alpha-synuclein

48
Q

What is the most common hypokinetic disorder?

A

Parkinson disease

- Contains alpha-synuclein inclusions

49
Q

What diseases have parkinsonism as a symptom?

A

PSP and CBD which are both have tauopathy

50
Q

What is the most common form of motor neuron disease?

A

Amyotrophic lateral sclerosis (ALS) which has genetic forms and sporadic forms

COM II- Neuro Robbins (8 decks)

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