Chapter 2: Histology of the Nervous System Flashcards

1
Q

Neurofilaments

A

provide structural support for the neuron, and are most numerous in the axon and the proximal parts of dendrites

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2
Q

Microfilaments

A
  • form a matrix near the periphery of the neuron.
  • prominent in growth cones of neuronal processes and functions to aid in motility of growth cone
  • also prominent in dendrites and forms structural specializations at synaptic membranes
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3
Q

Where are microtubules found in the neuron?

A

all parts of the neuron, and are the cytoplasmic organelles used in axonal transport

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4
Q

What are Lewy bodies?

A

cytoplasmic inclusions of degenerating neurons of the substantia nigra, pars compacta, evident in Parkinson’s disease and in cortical and brain-stem neurons seen in certain forms of dementia

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5
Q

What are Negri bodies?

A

eosinophilic cytoplasmic inclusions seen in degenerating neurons in the hippocampus and cerebellar cortex in patients with rabies

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6
Q

Tau proteins becominng excessively phosphorylated prevents what action of the neuron?

A

prevents crosslinking of microtubules

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7
Q

Neurofibrillary tangles are prominent features of what conditions?

A

Alzheimer’s disease, amyotrophic lateral sclerosis, and Down syndrome

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8
Q

What are neurofibrillary tangles?

A

when tau proteins become excessively phosphorylated and prevent crosslinking of microtubules

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9
Q

What motor protein is important for fast anterograde transport in the neuron?

A

kinesin

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10
Q

Is slow anterograde transport dependent on microtubules or ATPase motor molecules?

A

neither

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11
Q

How does a person with diabetes manage to get polyneuropathies producing characteristic “glove and stocking” pattern?

A

hyperglycemia results in an alteration of proteins that form microtubules, which may disrupt axonal transport

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12
Q

Is retrograde transport faster or slower than anterograde transport?

A

slower than anterograde transport

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13
Q

What are the most numerous glial cells in the CNS?

A

astrocytes

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14
Q

Which glial cells have large numbers of radiating processes?

A

astrocytes

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15
Q

GFAP?

A

glial fibrillary acidic protein (GFAP). Large bundles of intermediate filaments that are contained within astrocytes

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16
Q

What are some viruses that are taken up into the neuron with retrograde axonal transport?

A

polio, herpes, and rabies viruses and tetanus toxins

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17
Q

What are radial glia?

A

precursors of astrocytes that guide neuroblast migration during CNS development

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18
Q

What are microglia cells?

A

smallest glial cells in the CNS

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19
Q

Are microglia cells derived from ecotoderm? Explain.

A

No, they are derived from bone marrow monocytes and enter the CNS after birth

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20
Q

What are oligodendrocytes?

A

form myelin for axons in the CNS

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21
Q

What are Schwann cells?

A

supporting cells of the peripheral nervous system

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22
Q

What is a collective name for groups of diseases that can affect myelin?

A

leukodystrophies

23
Q

What are some symptoms of MS?

A

Multiple Sclerosis

  • Symptoms separated in space and time
  • vision loss (optic neuritis)
  • internuclear ophthalmoplegia (MLF)
  • motor and sensory deficits
  • vertigo
  • neuropsychiatric
  • marked by hyperreflexia
24
Q

What are some symptoms of GBS?

A
  • acute symmetric ascending inflammatory neuropathy of PNS myelin
  • weakness begins in lower limbs and ascends; respiratory failure can occur in severe cases
  • autonomic dysfunction may be prominent
  • Cranial nerve involvement is common
  • sensory loss, pain, and parasthesias rarely occur
  • reflexes invariably decreased or absent
25
Q

Treatment for MS?

A

high dose steroids, interferon-beta, glatiramer

26
Q

What may be a sign 1-3 weeks prior to onset of GBS?

A

2/3 of patients have history of respiratory or GI illness 1-3 weeks prior to onset

27
Q

Describe important lab findings of those with GBS?

A

elevated CSF protein with normal cell count (albuminocytologic dissociation)

28
Q

What are ependymal cells?

A

cells that line the ventricles in the adult brain. Some ependymal cells differentiate into choroid epithelial cells, forming part of the choroid plexus which produces cerebrospinal fluid (CSF)

29
Q

What are tanycytes?

A

specialized ependymal cells that have basal cytoplasmic processes that contact with blood vessels; these processes may transport substances between a blood vessel and a ventricle

30
Q

What is the BBB comprised of? What is the most important part of it?

A
  • most important part is the cerebral capillary endothelial cells and their intercellular tight junctions
31
Q

What are examples of drugs that readily diffuse across the BBB?

A

heroin, ethanol, and nicotine are lipid soluble compounds that readily diffuse across

32
Q

What is Nissl substance?

A

ER of the neuron; none are found in the axon

33
Q

Schwannomas typically affect which cranial nerve fibers?

A

Vestibulocochlear nerve (CN VIII)

34
Q

Name the primary tumors of the brain.

A
  • glioblastoma multiforme ( grade IV astrocytoma)
  • astrocytoma (pilocytic)
  • oligodendroglioma
  • ependymoma
  • medulloblastoma
  • meningioma
  • Schwannoma
  • Retinoblastoma
  • craniopharyngioma
35
Q

What are some feature of glioblastoma multiforme ( grade IV astrocytoma)?

A
  • most common primary malignant brain tumor
  • usually lethal in 8-12 months
  • can cross the midline via the corpus callosum (“butterly glioma”)
36
Q

What are some features of astrocytoma (pilocytic)?

A
  • benign tumor of children and young adults
  • usually in posterior fossa in children
37
Q

What are some histological features of glioblastoma multiforme?

A

areas of necrosis surrounded by rows of neoplastic cells (pseudopalisading necrosis)

38
Q

Histopath and other lab features of astrocytoma (piloyctic)?

A
  • rosenthal fibers - eosinophilc corkscrew fibers
  • immunostaining with GFAP
39
Q

What are some features of oligodendrogliomas?

A
  • slow growing
  • long survival (avg 5-10 years)
  • typically seen in frontal lobe
40
Q

What are some histopathologic features of oligodendriomas?

A
  • “fried-egg” appearance - perinuclear halo
  • finely branched capillaries resembling chicken wire
41
Q

What are some featues of ependymoma?

A
  • ependymal origin
  • can arise in IV ventricle and lead to hydrocephalus
  • adult presentation in cauda equina
  • common presentation in neurofibromatosis Type II
42
Q

Histopathology of ependymoma?

A
  • rosettes and pseuduorosettes
  • rod shaped blephoroplasts (basal ciliary bodies)
43
Q

What mutation is related to medulloblastomas?

A

SHH mutation

44
Q

What are some features of medulloblastoma?

A
  • highly malignant cerebellar tumor
  • can compress the 4th ventricle or arise from 4th ventricle
  • A type of primitive neuroectodermal tumor (PNET)
  • locomotion difficulties, truncal ataxia, wide gait
  • common in children
  • highly radiosensitive
45
Q

What is the histopathology of medullblastoma?

A

blue, small, round cells with pseudorosettes

Homer Wright rosettes

lots of mitotic figures

46
Q

What are some features of meningiomas?

A
  • second most common primary brain tumor
  • most common non malignant-non glial primary tumor
  • can be benign or malignant
  • arises from arachnoid villi which are involved with reabsorption of CSF
  • increased bone density in surrounding area
  • seizures, hearing loss, unilateral vision loss, contralteral weakness depending on where brain compressing
  • dural convexities; parasagittal region
  • attaches to dura, (dural mass with calcifications compresses underlying brain without invasion
  • common in neurofibromatosis Type II
47
Q

Histo of meningiomas?

A

psammoma bodies

48
Q

What are the features of Schwannoma?

A
  • third most common primary brain tumor
  • other names: acoustic Schwannoma, vestibular Schwannoma, acoustic neuroma
  • most frequent location CN VIII at cerebellopontine angle hearing loss, tinnitus
  • CN V+ VII signs corneal reflex loss
  • Bilateral acoustic schwannomas - pathognomonic for neurofibromatosis type 2
  • good prognosis after surgical resection
49
Q

Schwannoma histology.

A
  • Antoni A (hypercellular) and B (hypocellular) areas
  • S100 +
50
Q

What are some features of retinoblastoma?

A
  • sporadic - unilateral
  • familial - bilateral; associated with osteosarcoma
  • Rb gene on chromosome 13
  • can present with leukocoria, strabismus, and vision loss

Dx: genetic testing

Rx: cryotherapy, photocoagulation, chemotherapy: carboplatin, vincristine, etoposide radiation

Surgery: (enucleation) surgical removal of the eye

51
Q

What is the histopathology of retinoblastoma?

A

small, round, blue cells; may have rosettes

52
Q

Craniopharyngioma features.

A
  • derived from oral epithelium (remnants of Rathke pouch)
  • forms in suprasellar region of brain and can cause hypopituitarism because of compression of pituuitary
  • usually children and young adults
  • often calcified
  • symptoms due to encroachment on pituitary stalk or oral cavity
  • benign but may recur
  • cyst surrounded by enamel like calcification (cyst filled with cholesterol crystals and yellow viscous fluid
53
Q

Histology of craniopharyngioma.

A
  • histology resembles adamantinoma (most common tumor of tooth)