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Systems Pathology Exam Two > Chapter 22 - CNS Part 2 > Flashcards

Chapter 22 - CNS Part 2 Flashcards

1
Q

What location of the cerebrum are more susceptible to a brain contusion?

A

Gyri of the frontal and temporal lobes

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2
Q

What is the term for when the location of injury occurs at the impact site of a cerebral contusion?

A

Coup injury

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3
Q

What is the term for when the location of injury occurs at the opposite side of the site of a cerebral contusion?

A

Contrecoup injury

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4
Q

What condition is a tearing of cerebral parenchyma that disrupted vasculature that leads to hemorrhage?

A

Laceration

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5
Q

What is the condition of movement of one brain region relative to another region?

A

Diffuse axonal injury (DAI)

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6
Q

What kinds of movements can cause diffuse axonal injury?

A

Angular acceleration or shaking

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7
Q

What is the most common location for diffuse axonal injury?

A

Lateral ventricles and brain stem

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8
Q

What condition is responsible for 50% of post traumatic comas?

A

Diffuse axonal injury

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9
Q

What is a reversible alteration of consciousness from head injury in the absence of contusion?

A

Concussion

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10
Q

What is disrupted and what is unaffected with concussions?

A

Disrupted function, unimpaired structure

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11
Q

What constitutes post-concussion syndrome?

A

Decreased cognition, loss of consciousness, amnesia, nausea, depression, anxiety, irritability, headache, dizziness, photophobia

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12
Q

What is usually the recovery time period for a concussion?

A

7-10 days without treatment (80% recovery rate)

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13
Q

CT scans are done after concussions to rule out what serious issue?

A

Hemorrhage

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14
Q

What present as risks for concussions?

A

History of concussions, females, football, soccer, equestrian sports, bicycle riding

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15
Q

Epidural hematoma affect what blood vessels?

A

Dural arteries

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16
Q

Subdural hematomas affect what blood vessels?

A

Veins

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17
Q

What are the prime demographics for subdural hematomas?

A

Infants due to thin vessels, geriatrics due to cerebral atrophy

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18
Q

Which occur more rapidly: epidural or subdural hematomas?

A

Epidural hematomas

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19
Q

Which is more common: epidural or subdural hematomas?

A

Subdural hematomas (epidural hematomas make up 2% of severe head traumas)

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20
Q

What artery is most likely affected by epidural hematomas?

A

Middle meningeal artery

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21
Q

Which is more of a medical emergency: epidural or subdural hematomas?

A

Epidural

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22
Q

What is the frequency of a subdural hematoma occurring with head trauma?

A

5-25%

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23
Q

What is the most common neural tube defect?

A

CNS malformation

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24
Q

What is the frequency of CNS malformation?

A

1:1,000 live births

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25
Q

What are risks for CNS malformations?

A

Folate deficiency or previous child with CNS a malformation (5% recurrence)

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26
Q

What occurs with a neural tube defect?

A

It fails to close

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27
Q

What is a myelomeningocele?

A

Extension of CNS through vertebral defect leading to lower extremity motor/sensory defects

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28
Q

What is the most common location of the spine for myomeningoceles?

A

Lumbosacral region

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29
Q

What is the most common neural tube defect condition?

A

Asymptomatic spina bifida occult

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30
Q

What is anencephaly?

A

Absence of brain

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31
Q

What is an encephalocele?

A

CNS diverticulum through cranium

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32
Q

What condition develops following trauma to the cerebrum that injures and disrupts vessels leading to hemorrhage?

A

Contusion

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33
Q

Type 1 Arnold-Chiari malformation is associated with what condition?

A

Syringomyelia

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34
Q

What is syringomyelia (syrinx)?

A

Cyst within spinal cord

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35
Q

What condition involves the extension of the fourth ventricle?

A

Hydromyelia

36
Q

1/3 of those with cerebral palsy have what signs and symptoms?

A

Decreased cognition or seizures

37
Q

What is a movement disorder involving non-progressive defects in motor neurons as a result of damage during cerebral development?

A

Cerebral palsy

38
Q

What are risk factors for cerebral palsy?

A

Prematurity, hypoxia, infection

39
Q

Does cognitive decline occur in all cerebral palsy cases?

A

No, about 1/3 of them

40
Q

What is the most common way that infections of the nervous system are spread?

A

Hematogenously (other ways = direct implant by trauma, local extension, PNS)

41
Q

What is the serious issue with epidural abscesses?

A

Can compress the spinal cord (neurosurgical emergency)

42
Q

What is a subdural empyema?

A

Infection of skull or sinus in the subdural space

43
Q

What do epidural abscesses and subdural empyemas have in common?

A

Both are collections of pus

44
Q

What is meningitis?

A

Subarachnoid inflammation of leptomeninges

45
Q

What makes up the leptomeninges?

A

Arachnoid and pia mate

46
Q

What three signs/symptoms are extremely indicative of acute pyogenic (bacterial) meningitis?

A

Headache, nuchal rigidity, and photophobia

47
Q

What is seen in the cerebrospinal fluid with acute pyogenic (bacterial) meningitis?

A

Bacterial culture, increased pressure, increased neutrophils, increased proteins (exudate), decreased glucose

48
Q

What are the two neurological exams for meningitis? (Not on test, but we will see in future classes)

A

Kernig sign, Bruszinski sign

49
Q

What bacteria are likely to cause meningitis in neonates?

A

E. Coli and group B strep (strep agalactiae)

50
Q

What type of bacteria is likely to cause meningitis in young children?

A

Haemophilus influenzae

51
Q

What bacteria is likely to cause meningitis in adolescents and young adults?

A

Neisseria meningitidis

52
Q

What bacteria is likely to cause meningitis among older adults?

A

Strep. pneumoniae, listeria monocytogenes

53
Q

Which type of meningitis is self-limiting and which is generally fatal when left untreated?

A 
Aseptic = self-limiting
Bacterial = fatal if left untreated
54
Q

What kind of necrosis can be produced from a bacterial abscess?

A

Liquefaction necrosis

55
Q

Tertiary syphilis or Lyme disease are associated with what kind of meningitis?

A

Spirochetal (chonric)

56
Q

What kind of white blood cells are seen with viral encephalitis?

A

Mononuclear (monocytes, macrophages)

57
Q

What viruses can spread to the CNS and cause viral encephalitis?

A

Rabies, polio, rubella virus, West Nile, HSV-1, HSV-2, VZR, CMV, HIV

58
Q

Fungal infections are most commonly seen among what population?

A

Immunocompromised

59
Q

Candida albicans and Aspergillus fumigatus can cause what kind of parenchymal infections?

A

Fungal

60
Q

What does poliovirus attack?

A

Gray matter of the spinal cord/brainstem

61
Q

Where does the VZV remain dormant in chickenpox?

A

DRG

62
Q

What are the signs and symptoms of polio?

A

Gastritis, motor neuron damage leading to wasting and flaccidity

63
Q

What is the most common disorder of myelin?

A

Multiple sclerosis (MS)

64
Q

What is affected with MS?

A

White matter (demyelination)

65
Q

Which disorder of myelin is known to be “relapsing-remitting”?

A

MS

66
Q

What is the frequency of MS?

A

1:1,000

67
Q

What is the cause of the myelin deterioration in MS?

A

Autoimmune inflammatory attack from lymphocytes and macrophages resulting in white matter lesions (plaques)

68
Q

What are some risks for MS?

A

Family history (15X), young adults, females (2X)

69
Q

If a monozygotic twin has MS, what is the likelihood that the other will too?

A

25%

70
Q

What gene plays a part in family history being a large predictor for development of MS?

A

HLA-DR2

71
Q

What is the location for the white plaques associated with MS?

A

Anywhere in the CNS (cerebrum, near ventricles, optic nerve/chiasm, brainstem, spinal cord, cerebellum

72
Q

What is the activity of an active plaque in MS?

A

Ongoing myelin breakdown

73
Q

What is the activity of inactive plaques in MS?

A

Little myelin and minimal inflammation with permanent damage

74
Q

What vision ailment is commonly seen with MS?

A

Diplopia (unilateral vision impairments leading to double vision)

75
Q

What are some signs and symptoms of MS?

A

Cranial nerve dysfunction, ataxia, motor/sensory impairments, bowel/bladder dysfunction, sexual dysfunction, seizures, decreased cognition, depression

76
Q

What is the treatment for MS?

A

IV corticosteroids for immunosuppression to reduce relapses

77
Q

Deficiency in what substance associated with CNS issues like Wernicke-Korsakoff syndrome, confusion, memory, ataxia, chronic alcoholics, chronic gastritis?

A

Thiamine (B1)

78
Q

Necrosis and macrophages in the thalamus can be seen with what kind of deficiency?

A

Thiamine (B1)

79
Q

What is Beriberi?

A

Lower extremity paresthesia, paralysis, nystagmus

80
Q

Beriberi is seen with what deficiency?

A

Thiamine (B1)

81
Q

What are the effects of cobalamin (B12) deficiency?

A

Demyelination, subacute combined degeneration of the spinal cord, ataxia, paraplegia

82
Q

What are the effects of hypoglycemia?

A

Mimics global hypoxia (edema)

83
Q

What is the main source of hypoglycemia in the US?

A

Type I diabetes (insulin injections)

84
Q

What part of the brain is susceptible to injury with hypoglycemia?

A

Hippocampus

85
Q

What are the effects of hyperglycemia?

A

Hyperosmolar state, confusion, stupor, coma, glycosuria, decreased water

86
Q

Hyperglycemia is associated with what medical condition?

A

Type II diabetes

Systems Pathology Exam Two (6 decks)

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