CNS pathology-Parks Flashcards
What is a contusion?
lesion in the brain
sometimes associated w/ hemorrhage & necrosis
What is a closed head injury?
when the brain moves around inside the skull.
can cause a contusion & even a concussion
cerebral edema
What is a coup?
when the frontal lobe smashes up against the front of the skull
What happens when cells get injured?
they swell up & take on water.
cerebral edema w/ tissue damage!
Which lobes of the brain are usu injured w/ a frontal coup closed head injury deal?
frontal & temporal lobes
What are 3 things that can cause vasogenic cerebral edema?
trauma
tumors
inflammation-encephalitis
**get edema b/c of trauma to BBB
What is cytotoxic edema?
following ischemia–neurons & glia get damaged
Once again, what are the 2 types of edema?
vasogenic & cytotoxic
How do you get from tissue injury to hydropic degeneration (damage from edema)?
hypoxia
ATP production decreases
sodium & water move into cell
potassium moves out of the cell
osmotic pressure increases, attracting more water in the cell
endoplasmic reticulum distend, rupture, form vacuoles
extensive vacuolization
Why do you sometimes get herniation of the brain?
b/c the falx & tentorium don’t move
What is subfalcine herniation?
herniation of the brain underneath the falx
What is transtentorial herniation? Another name? Danger level?
Very dangerous-affecting brainstem
brain goes under the tentorium
aka uncal herniation
What is tonsillar herniation?
when the brain goes underneath the skull
Which nerve does the uncal herniation affect?
CN 3 (ipsilateral) sympathetic goes first-->get pupillary dilation then if it really gets to the nerve--down & out. & severe ptosis
What is kernohan notching?
something sometimes seen on the cerebral peduncle.
happens with uncial herniation.
a consequence of cerebral edema
What can happen to a patient with severe cerebral edema?
the midbrain can become compressed & the patient can go into a coma
What type of hemorrhage can happen w/ uncal herniation?
duret hemorrhage in the midbrain & pons
Which artery is messed w/ to create duret hemorrhage?
paramedian branch of the basilar artery
What is the real problem with duret hemorrhage?
reticular activating system is also here…
the respiratory system can be damaged & they can die.
heart can also stop.
What’s the deal with spina bifida occulta?
neural tube defect, but still have a closed neural tube. minor problems.
What are the bad NTDs?
meningocele, meninges bulging out of spine
myelomeningocele, meninges & spinal cord outside of spine.
Why do you test alpha fetoprotein in pregnant women when you are looking for NTD?
if there is an open neural tube…alpha fetoprotein will leak into amniotic fluid. This will get into maternal bloodstream.
Test mom’s blood & see elevated AFP…think NTD.
T/F Ultrasounds are better than AFP to test for NTDs in pregnant women.
True.
What type of prenatal supplements should be given to pregnant women?
30-60 mg elemental iron
0.5-0.8 mg folate-to prevent NTD
