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Pathology IV > CNS Path Quiz 6 part 2 > Flashcards

CNS Path Quiz 6 part 2 Flashcards

1
Q

3 categories of cerebrovascular disease

A

thrombotic
embolic
hemorrhagic

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2
Q

two pathophysiologic processes taking place in cerebrovascular disease?

A
  • lack of blood supply and oxygen (ischemic)

- rupture of blood vessels (hemorrhagic)

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3
Q

two types of cerebral ischemia

A

focal (localized)- due to thrombi/emboli

global- due to cardiac arrest, hypotension

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4
Q

Microscopically, ischemic and infarcted cells will fail to

A

stain properly with vital stains such as a H. and E. stain

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5
Q

Macroscopically, in cerebrovascular disease the brain may appear

A

edematous with swollen gyri and narrowed sulci

poor demarcation between white and grey matter

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6
Q

global hypoxia results in

A

border zone infarcts

laminar necrosis

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7
Q

cerebral infarction aka

A

stroke

loss of circulation to an area of the brain

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8
Q

risk factors for stroke

A 
advanced age
HTN
DM
high cholesterol 
tobacco use
atrial fib
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9
Q

while it’s hard to distinguish hemorrhagic from ischemic stroke, what sx point towards hemorrhagic?

A

N/V
h/a
change consciousness

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10
Q

ischemic stroke due to

A

thrombosis
emboli
systemic hypoperfusion

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11
Q

hemorrhagic stroke due to

A

intracerebral hemorrhage
subarachnoid hemorrhage
subdural hemorrhage
epidural hemorrhage

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12
Q

80% of strokes are which category?

A

ischemic

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13
Q

which category of stroke is more severe and results in higher mortality rates?

A

hemorrhagic

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14
Q

Approximately 50% of all stroke deaths occur within

A

the first 48 hours

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15
Q

first 12-24 hours of a stroke, neurons undergo which changes?

A

red neurons

dead neurons as a result of hypoxia

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16
Q

what changes occur after 24 hrs in a stroke patient?

A

neutrophil infiltration at edges of lesion

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17
Q

1-14 days after what changes take place in a stroke patient?

A

incr. macrophages

gliosis (not scars dues to lack of fibrosis)

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18
Q

gliosis aka

A

reactive proliferation of astrocytes

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19
Q

first response in gliosis

A

microgliosis (migration of macrophages and local microglia to the injury site)

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20
Q

gliosis eventually leads to

A

a dense fibrous network of neuroglia

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21
Q

macroscopically one can see what after 12-24 hrs?

A

discoloration (appears red)
softening in the affected
arterial territory with edema

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22
Q

most common cause of thrombotic occlusion

A

atherosclerosis

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23
Q

which vessel has the greatest degree of compromise in ischemic stroke?

A

middle cerebral artery

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24
Q

infarction due to embolism may show

A

punctate hemorrhages

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25
Q

intracerebral hemorrhage (a type of hemorrhagic stroke) is caused by what?

A

HTN

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26
Q

which imaging should be done first in a hemorrhagic stroke? why?

A

CT because it’s much better at picking up blood

27
Q

how does hemorrhage look on CT

A 
radio-opaque 
midline shift (corpus collosum)
28
Q

dreaded complications of hemorrhagic stroke?

A
  • incr intracranial pressure
  • herniation
  • greater risk of stroke occurs further down (brainstem or cerebellum)
29
Q

cerebellar and brain stem strokes generally occur as a result of pathology where?

A

vertebral and basilar arteries

30
Q

whats the most common cause of a subarachnoid hemorrhage?

A

rupture of saccular aneurysm (berry aneurysm)

31
Q

what IS a berry aneurysm?

A

out-pouching from the circle of Willis

32
Q

where’s the most common spot for a berry aneurysm to occur?

A

anterior communicating artery

33
Q

what’s the most common type of vascular malformation?

A

Arteriovenous malformations

34
Q

an arteriovenous malformation hemorrhage differs from a hypertensive hemorrhagic how?

A

AVM hemorrhage has less blood

35
Q

In macroscopic appearance, they resemble a tangled network of wormlike vascular channels and have a prominent, pulsatile arteriovenous shunt with high blood flow through the malformation

A

arteriovenous malformation

36
Q

acute hypertensive encephalophathy is characterized by

A

diffuse cerebral dysfunction

bleeding does not remit spontaneously, so rapid intervention is necessary

37
Q

what 3 physical forces can coexist to produce head injury?

A

skull fractures
parenchymal injury
vascular injury

38
Q

The characteristic neurologic picture of concussion includes

A

loss of consciousness,

temporary respiratory arrest and loss of reflexes

39
Q

unequal pupil size can be a sign of brain injury (more serious than concussion)

A

Anisocoria

40
Q

contusion (brain bruise) and laceration (tearing of brain tissue) are associated with injury to what part of the brain?

A

parenchymal injury

41
Q

cerebral injury at the point of contact

A

coup

42
Q

brain damage opposite the point of contact

A

countercoup

43
Q

most common type of skull fracture?

A

linear skull fractures

44
Q

linear fracture that occurs along sutures lines in young children

A

diastatic skull fracture

45
Q

in skull fracture, what artery is at particular risk of injury?

A

middle meningeal artery

46
Q

if the meningeal artery should rupture in a skull fracture, what is this called?

A

Epidural hematoma

47
Q

rupture of veins between the brain and the superior sagittal sinus is called what?

A

Subdural hematoma

48
Q

accumulation of blood between the dura and the arachnoid in a skull fracture is called? occurs in what part of brain?

A

Subdural hematoma

fronto-parietal regions of the cerebral hemispheres

49
Q

accumulation of blood between the dura and skull is called?

A

Epidural hematoma

50
Q

irreversible cessation of ALL brain function

A

brain death

51
Q

in order to declare someone brain dead, what perimeters must be met?

A
  • pt not in hypotensive shock
  • body temp above 32 deg
  • no drug intoxication or neuromuscular blockage causing coma
52
Q

is an EEG showing the absence of any physiologic brain activity necessary to declare a patient brain dead?

A

NO

53
Q

cerebral injury at the point of contact

A

coup

54
Q

brain damage opposite the point of contact

A

countercoup

55
Q

most common type of skull fracture?

A

linear skull fractures

56
Q

linear fracture that occurs along sutures lines in young children

A

diastatic skull fracture

57
Q

in skull fracture, what artery is at particular risk of injury?

A

middle meningeal artery

58
Q

if the meningeal artery should rupture in a skull fracture, what is this called?

A

Epidural hematoma

59
Q

rupture of veins between the brain and the superior sagittal sinus is called what?

A

Subdural hematoma

60
Q

accumulation of blood between the dura and the arachnoid in a skull fracture is called? occurs in what part of brain?

A

Subdural hematoma

fronto-parietal regions of the cerebral hemispheres

61
Q

accumulation of blood between the dura and skull is called?

A

Epidural hematoma

62
Q

irreversible cessation of ALL brain function

A

brain death

63
Q

in order to declare someone brain dead, what perimeters must be met?

A
  • pt not in hypotensive shock
  • body temp above 32 deg
  • no drug intoxication or neuromuscular blockage causing coma
64
Q

is an EEG showing the absence of any physiologic brain activity necessary to declare a patient brain dead?

A

NO

Pathology IV (19 decks)

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