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Path 404 > CNS Path > Flashcards

CNS Path Flashcards

1
Q

Type II fibers

A
  • white
  • fast glycolytic
  • quick actions
  • when high pH these are dark
  • more type II in muscles than type I
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2
Q

Type I fibers

A
  • red
  • slow oxidative (mitochondria)
  • when low pH these are dark
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3
Q

perimecium

A
  • connective tissue around vesicles of muscle fibers
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4
Q

group atrophy

A
  • when many skeletal fibers atrophy at once

- adipose and fibrous tissue replaces

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5
Q

Myopathies: Muscular Dystrophy

A
  • genetic loss or abnormality of the contractile proteins in the muscle
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6
Q

Progressive (Duchenne) Muscular Dystrophy

A
  • x-linked, recessive
  • affects boys
  • loss of dystrophin which anchors actin to the cell membrane
  • muscle weakness results
  • fatal around age 20
  • distinctive sign is small clusters of muscle fibers undergoing necrosis at the same time or are in same stage of regeneration
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7
Q

what are most disorders of peripheral nerves a cause of? (Besides trauma)

A
  • metabolic (acquired) & toxic 50%
  • inflammation/infection (10-20%)
  • idiopathic (10-20%)
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8
Q

epineurium

A
  • connective tissue that combines all the vesicles of nerve fibers together
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9
Q

perineurium

A
  • connective tissue that surrounds a vessicle
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10
Q

endoneurium

A
  • in between individ fibers
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11
Q

Axonal Degeneration cause

A
  • from mechanical insults (compression or transection)
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12
Q

Wallerian degeneration

A
  • axon distal to point of insult will undergo degeneration and fragmentation
  • myelin breaks down but schwann cells remain
  • macrophages clean up debris
  • proximal axon produces new sprouts which can reconnect with severed pathway
  • schwann cells often larger # but remyelinate the axon
  • slower transmission b/c more cells
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13
Q

traumatic neuroma

A
  • open injuries (penetrating wounds) result in aberrant regenerative sprouting
  • scar tissue buildup
  • painful whenever compressed
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14
Q

arterial circle (circle of wills)

A
  • composed of internal carotids, veterbral arteries and a circle that includes anterior, middle, and posterior cerebral arteries
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15
Q

anterior cerebral artery supplies blood to

A
  • medial surface of the brain
  • frontal and parietal lobes on medial surface
  • little of lateral surface also
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16
Q

posterior cerebral artery supplies blood to

A
  • temporal lobe, occipital lobe on medial surface

- little of lateral surface also

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17
Q

middle cerebral artery supplies

A

most of the lateral surfaces of the brain of all lobes

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18
Q

border zones (water shed)

A
  • region of brain on later surface receiving blood from two different vessels
  • still right amt of blood
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19
Q

Cerebrovascular Accident (CVA)

A
  • stroke
  • sudden onset of focal neurological deficit w/o etiology
  • 40-80 yrs with equal prevalence in each decade
  • more common in males
  • 3rd leading cause of death
  • 42% of stroke victims have reoccurrence
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20
Q

arteriosclerosis

A
  • generic hardening of arteries
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21
Q

atherosclerosis

A
  • large and medium arteries
  • hyperlipidemia
  • cause large infarcts
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22
Q

arteriolosclerosis

A
  • small arteries and arterioles
  • CAUSES hypertension
  • cause mostly hemorrhages in the brain
  • microaneursyms
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23
Q

pattern of injury of CVA

A
  • 73% infarcts (thromboembolism causing hypoxia/ischemia)
  • 19% intraparenchymal hemorrhages secondary to hypertension
  • 7% subarachnoid hemorrhages, most common cause rupture of berry aneurysms (that isn’t trauma)
24
Q

Hypoxia

A
  • decreased amount of oxygen in perfused tissue regardless of bp
  • can lead to ischemia
25
Q

Ischemia

A

decrease in blood supply

26
Q

Infarct

A
  • necrosis of tissue secondary to ischemia/hypoxia

- some strokes do not result in this b/c they are reversible

27
Q

Cerebral emboli

A
  • commonly result of carotid or cerebral vessel thrombi

- sudden and most common cause of cerebral infarction

28
Q

Thrombosis

A
  • occlusion of a vessel in situ (it’s original place)

- usually somewhere with atherosclerosis

29
Q

Hemorrhage

A
  • association with hypertension

- common sites cerebellum, pons, basal nuclei

30
Q

Blood Brain Barrier

A
  • has tight junctions

- protects brain from large particles that would bring in fluid and result in swelling

31
Q

Infarcts-

A
  • vascular occlusions (thrombosis, embolism), hypotension, or hypoxia
  • cerebral emboli most common cause of strokes
32
Q

transient ischemic attacks

A
  • loss of speech days or weeks before a stroke or hemiparesis (weakness of one side of body)
33
Q

Intraparenchymal hemorrhage

A
  • can be all sizes and caused by variety of things

- hemorrhage in the parenchymal parts of brain

34
Q

Hypertensive hemorrhage

A
  • most common cause of non-traumatic intraparenchymal hemorrhage
  • immediate threat to life
  • results in loss of smooth muscle, thinning of vessel wall, and rupture under pressure
  • if rupture into ventricles, death results rapidly
35
Q

Subarchanoid hemorrhage

A
  • most commonly due to rupture of saccular or berry aneurysm ( if not by trauma)
36
Q

Saccular or berry aneurysm

A
  • disease of adults though the aneurysm is thought to be genetic defect in the vesicle elastica
  • more common in women
  • 90% of all aneurysms found in anterior portion of the arterial circle
  • 30% of patients die
37
Q

Aneurysms present in 3 ways

A
  • subarachnoid hemorrhage (most common)
  • intracranial hemorrhage into brain parenchyma (associated with rapid death)
  • expanding intracranial masses that compress the hypo mimicking pituitary tumors
38
Q

Brain Herniation: parahippocampal/uncal

A
  • entire or part of parahippocampal gyrus herniates through the opening of the tentorum (incisura) causing compression of brain stem
39
Q

Brain herniation: cerebellar tonsilar herniation

A
  • cerebellar tonsils herniate though the foramen magnum causing compression of the medulla
  • can lead to cardiac and respiratory interference and death
40
Q

what else can happen with a brain herniation?

A
  • when brain is pulled down, arteries stretch and can tear
41
Q

Epidural Hemorrhage

A
  • one of the most acute medical emergencies
  • usually occurs with temporal bone fracture
  • laceration of middle meningeal artery
  • blood accumulates very rapidly, lethal within a few hours
  • lucid interval where brief loss of consciousness and then fine
  • rapidly deteriorates, losing consciousness, fixed pupil on ipsilateral side; hemiparesis
42
Q

Subdural Hemorrhage

A
  • hematoma
  • present in 50% of fatal cases of head injury
  • may be nontraumatic
  • very young and very old patients
  • ruture of cortical veins
  • frontal parietal
43
Q

Acute, subacute, and chronic subdural hemorrhage

A
  • acute: lethal within hours if sufficient blood accumulates
  • subacute: occur within a few days of injury
  • chronic: may be discovered years after in autopsy
44
Q

Meningitis

A
  • inflammation of the pia and arachnoid (leptomeningies)
45
Q

three types of meningitis

A
  • pyogenic - bacterial
  • granulomatous - fungal or TB
  • lymphocytic - viral
46
Q

Bacterial Meningitis

A
  • sudden onset with fever, headaches, stiff neck, coma
  • thick yellow, fibrino-purulent exudate over the convexity or base of brain
  • congestion of meningeal vessels and brain edema
  • exudate accumulates in compartments where CSF circulates
47
Q

Perinatal period meningitis

A
  • E. coli

- B streptococcus

48
Q

Infants and children meningitis

A
  • haemophilus influenzae
49
Q

adolescents and young adults meninigitis

A
  • neisseria meningitidis (meningococcus)
50
Q

adults meningitis

A
  • streptococcus pneumonia
51
Q

Granulomatous meningitis

A
  • from fungus (cryptococcus neoformans) or TB
  • subacute, slowly progressive with headaches and cranial nerve deficits
  • location at base of brain, whitish thickening of meningies
  • granulmatous tissue
  • hydocephalus due to partial outflow blockage of CSF
  • gets to brain by blood
52
Q

Viral Meningitis

A
    • ECHO and Cowsackie
  • via the bloodstream
  • do not require treatment
  • headaches, anorexia, apathy
  • PCR for diagnosis
53
Q

Viral encephalitis

A
  • no pus
  • can be RNA or DNA
  • target is nerve cells (polio; rabies) or nerve and glia cells (herpies, CMV)
  • glial nodules: microscopic accumulation of lymphocytes
54
Q

Poliomyelitis

A
  • enteric virus
  • attacks and kills motor neurons
  • respiratory paralysis is immediate cause of death
55
Q

Rabies-

A
  • transmitted through saliva of infected animal
  • reaches CNS through peripheral nerves
  • incubation 4-6 wks
  • confusion, hyperirritability, pharyngela spasms
  • hydrophobia, flaccid paralyses, coma
  • death 1-2 wks b/c of respiratory failure
  • negri bodies in cerebellum, brainstem, hippo neurons
56
Q

Arthropod-borne viruses

A
  • mosquito or tick vectors
  • california virus in midwest
  • attacks nerve cells of the cerebral cortex, basal nuclei, brainstem
  • irritability, confusion
57
Q

HIV

A
  • 30% develop subacute dementia
  • brain atrophy
  • perivasculated multinucleated giant macrophages

Path 404 (5 decks)

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