CNS Flashcards
What is the job of the oligodendrocytes
Myelination
What is the job of the microglial cells
Immune effector cells (CNS Macrophage)
What cells help in the movement of CSF
Ependymal cells
What disease is associated with loss of neuromelanin
Parkinsons
What makes CSF
Choroid Plexus
What is global cerebral ischemia
Brain dead after a heart attack
Ischemic stroke
Classic stroke, one vessel affected
Hemorrhagic stroke
Emboli vs thrombi multi-focal
2 types of cerebrovascular hemorrhage
Intracerebral
Berry Aneurysm
Which cerebral artery supplies 90% of blood to brain
MCA
What are a few potential causes of a Global CI
Shock
Cardiac Arrest
Hypotensive Episode
What does F.A.S.T. stand for
Face Arm Speech Time
What color are the dying neurons in the histology of Ischemic stroke pictures?
Dense purple/red….pyknotic and dense
What kind of infiltrate do you see in 24-48 hours
Neutrophil
What kind of infiltrate occurs after 2days-2weeks
Macrophages
What happens to the area of the infarct if the patient survives past three weeks
Cavitated lesion due to liquefactive necrosis
Hemorrhagic Stroke
Intraparanchymal Hemorrhage
What does an intraparenchymal hemorrhage look like
Cerebral blood clot
Occurs in the deep grey or white matter
What are the two causes of subarachnoid hemorrhage?
Trauma Berry Aneurysm
What hemorrhage has a lucid period before passing out
Epidural Hemorrhage
What ruptures before a subdural hemorrhage
Bridging veins
Where does the berry aneurysm happen?
Base of skull
What shape do you look for on a CT scan for a berry aneurysm?
Star pattern
What are the two major issues with HTN
Arteriosclerosis Charcot-Bouchard microaneurysms
What is the term for an infarction caused by atherosclerotic occlusion?
Lacunar Infarct
Insert Lacunar infarct picture
Lacunar Infarct
What can cause a “blown pupil”
Oncular herniation
What nutrient deficiency is linked to neural tube defects?
Folate
What is anencephaly
absense of cranial vault
no cerebral cortex, incompatible with life.
Only brainstem
Spina bifida occulta
asymptomatic some vertebrae aren’t completely closed
Meningocele
Protrusion of meninges (filled with CSF) Fixable
Myelomengocele
Exposed spinal cord. Intrauterine surgery required to save as much function as possible
Who is at risk for germinal matrix hemorrhage
Low birth weight and very early delivery.
Less then 34 weeks
Two intrauterine ischemic events
Periventricular leukomalacia (chalky white matter) Multicystic encephalopathy. Brain cysts and seizures
Arnold Chiari Type I
Asymptomatic cerebellar malformation and easily fixable
Arnold Chiari Type 2
Congenital Cerebellar malformation Small posterior fossa 4th Ventricular compression Hydrocephalus Lumbar Meningomyelocele
Dandy Walker Malformation
Two hemispheres of the cerebellum are not connected. Kids usually don’t live
Bacterial CSF
High Neutrophils Low Glucose
Viral
High Lymphocytes Normal Glucose
Neonates Bacterial Meningitis
E coli Group B
Infants
Strep. pneumo
H. influenza (Vaccine)
Young adults
Neisseria
Elderly
Strep. pnuemo
Listeria
HSV
Rabies Encephalitis
Negri bodies
Perkinji Cells
Measles Encephalitis
Subacute sclerosing panencephalitits (5-10 years after clearning virus)
PML
JC Virus
Immunocompromised Demyelination (Blue to white on slide)
Toxoplasmosis
Get it from cats
Cryptococcus Abcess
Fungal
AIDS Patients
What cromosome codes the CJD protein located on
20
Are most CJD cases infective?
No genetic
Clinical of CJD
Rapidly progressive dementia
Spongiform and atrophy
Amyloid plaques
Which CJD is from eating bad beef
vCJD
What are the 2 types of trauma to brain
Blunt force Sharp/Projectile
What are determinants of blunt force trauma
Shape of object (flat v. angled)
Amount of force applied
Brain movement relative to head (linear rotation, acceleration/deceleration)
Determinant of sharp/projectile
Projectile velocity is more important than size
Contusion Skin
blood exiting dermal vessels, skin surface not broken Pattern injury
Contusion Brain
Damage to surface of brain at crest of gyri, rarely you can get deep white matter bruises
two types of cerebral contusion
Coup = at site of impact
Contrecoup = secondary impact as brain sloshes to opposite of impact site. Usually larger than coup site
Hemorrhagic infarct vs contusion?
Contusion affects surface, infarct does not
Lacerations
tears to the skin from blunt force injury over a bony surface Skin bursts apart so it is not a clean cut like an incision Jagged edges and tissue bridging
Diffuse blunt force trauma traumatic axonal injury
Force shears the axons Petechiae caused by capillaries also getting sheared
Location of Traumatic axonal injuries (TAI)
Corpus callosum
Dorsolateral Brain Stem
Parasagittal cerebral white matter
Traumatic Axonal Injury
Multiple Sclerosis
Arnold Chiari Type 2
Posterior Small Fossa
Lumbar meningomylocele
What disease occurs because the two hemispheres of the cerebral cortex are not connected?
Dandy Walker
