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Systems Path Exam 2 > Exam 2 Ch. 22 > Flashcards

Exam 2 Ch. 22 Flashcards

1
Q

What is a irreversible neuronal injury?

A

Acute neuronal injury
“Red neurons”
Frequently from acute hypoxia

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2
Q

What is it called when the soma becomes shrunken?

A

Red neurons

Irreversible injury

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3
Q

What do astrocytes do?

A

Perform gliosis

Activation from gemistocytic astrocyte

They become enlarged and eosinophilic

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4
Q

What do oligodendrocytes do

A

Produces myelin in the CNS, enlarge when activated

This is the site for viral inclusions

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5
Q

What are microglia

A

Are phagocytes of the CNS

Perform neuronophagia

Proliferate and enlarge after injury

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6
Q

what are ependymal cells

A

Line ventricles and spinal cord

May become infected from cytomegalovirus

May cause choroid plexus dysfunction

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7
Q

What produces Negri body

A

Rabies

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8
Q

What is CMV

A

Owl’s eye appearance

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9
Q

WHat disease produces levy bodies

A

Parkinson’s disease

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10
Q

What are symptoms of Alzheimer’s

A

Neurofibrillary tangles

B-amyloid plaques (tau) proteins

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11
Q

What is lipofuscin

A

Aging and lipid accumulation

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12
Q

What can increase intra cranial pressure

A

Blood, pus, tumor, edema

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13
Q

What is vasogenic edema

A

Blood-brain-barrier disruption

Results in extracellular edema

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14
Q

What can cause vasogenic edema

A

Severa trama

Can be localized due to tumors, infection, inflammation

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15
Q

What is cytotoxic edema

A

Nueronal/glial membrane injury

INTRACELLULAR EDEMA

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16
Q

What causes cytotoxic edema

A

Hypoxic-ischemic injury or toxic exposure

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17
Q

What are three symptoms of cerebral edema

A

Flattened gyri

Narrowed sulci

Ventricular compression

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18
Q

What causes an increase in CSF within the ventricles

A

Hydrocephalus

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19
Q

What is the most common cause of hydrocephalus

A

Choroid plexus tumor which increases production of CSF

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20
Q

What is the cutoff for hydrocephalus in age

A

< 2 years old= cranial enlargement

> 2 years old=increased ICP and enlarged ventricles

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21
Q

How is it caused and treated hydrocephalus

A

Unknown incidence 50% idiopathic

Treatment is shunting; aka ventriculoatrial shunt

If untreated results in respiratory arrest and death

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22
Q

What is a herniation in the CNS

A

Shifting/protrusion of CNS tissue following a increase in ICP

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23
Q

What is the process of herniation

A
  1. Vessels compress
  2. Displacement of CSF
  3. Cerebrum shifts(herniation)- across the dura or through foramen magnum

Results in ischemia then leads to infarction

IS A POSITIVE FEEDBACK LOOP

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24
Q

What is the most common herniation?

A

Subfalcine (cingulate)

Displaced cingulate gyrus, under falx cerebri

Abnormal posturing, coma

25
Q

Transtentorial herniation is

A

Aka uncinate, displaced temporal lobe under anterior tentorium

CN III- oculomotor, “blown pupil” / abnormal vision

Hemiparesis, brainstem compression

Duret hemorrhage

26
Q

What is a tonsillar herniation

A

Cerebellum tonsilis through Foramen Magnum

Results in cardiorespiratory arrest, hydrocephalus, and headache

27
Q

What are two types of abnormal posturing

A

Decorticate rigidity

Decerebrate rigidity

28
Q

Decorticate rigidity results in

A

Brachial flexion
Extension of legs along with internal rotation
Injury between the cortex and red nuclei

29
Q

Decerebrate rigidity results in

A

Extension of all 4 limbs

Pronation of arms, plantar flexion

Injury to brainstem- between red nuclei and vestibular nuclei

30
Q

What is a duret hemorrhage cause by

A

Transtentorial (uncinate) herniation

Disrupts the vessels in the pons

Aka “flame shaped”

31
Q

What is mydraisis

A

Dilation of a pupil

Indicates compression of CN III

32
Q

What causes mydriasis

A

A transtentorial herniation

33
Q

What is anisocoria

A

Unequal pupil size

34
Q

Which from of Arnold chiari malformations are worse?

A

Type II is the sever form

35
Q

What is the most common Arnold chiari malformations

A

Type I

Found mainly in ADULTS

Low lying cerebellar tonsils

36
Q

WHich type of chiari occurs in infants

A

In utero or infants

37
Q

What is the 5th most common cause of mortality in the USA

A

1 cause of neurological morbidity

Cerbrovascular disease

Ex. Stroke

38
Q

What is a stroke?

A

Acute dysfunction due to cerebral infarction

Thrombosis or emboli occlusion

Vascular rupture

39
Q

What is mini stroke

A

Transient ischemic attack

40
Q

What is the difference between a stroke and a transient ischemic attack

A

A Transient ischemic attack no infarction occurs

Neurological dysfunction lasts less than 24 hrs

41
Q

What are the signs of a stroke

A

Face drooping
Arm weakness
Speech difficulty
Time to call 911

42
Q

Bell’s palsy occurs ___________ and affects paralysis of what CN ____

A

Unilateral facial weakness

CN VII

43
Q

What causes Bell’s palsy

A

Viral association HSV-1

Inflammation of the facial nerve self limited within 2-8 weeks

44
Q

Stoke vs. Bell’s Palsy

A

Stroke-contralateral lower facial weakness. Weak smile (dysarthria). Preserves upper face motor function

Bell’s Palsy- asymmetrical forehead weakness

45
Q

What are the brain requirements

A

2% of body mass, 15% of cardiac output 20% of O2

46
Q

FUnctional hypoxia occurs from

A

Increase in altitude and anemia, cyanide, CO

47
Q

Different types of Ischemia

A

Hypotension, occculsion aka clot

Transient=TIA

Permanent=stroke

48
Q

What is global cerebral ischemia

A

Widespread ischemic hypoxia injury

Cardiac arrest, sever hemorrhage

Mild confusion its TIA, severe is a stroke

49
Q

WHen severe what causes neuronal death

A

Global cerebral ischemia

Cerebral edema, red neurons, gliosis

results in coma, impairment, death

Mechanic ventilation=aka autolysis

50
Q

What causes Focal Cerebral Ischemia

A

A localized arterial occlusion

51
Q

What protects against focal cerebral ischemia

A

Circle of wills will provide some collateral flow

52
Q

What is the most common Focal Cerebral Ischemia

A

MC Emboli-cardiac mural thrombi, valve disease, arrhythmia

Thrombi- atherosclerotic plaques (carotid arteries)

53
Q

What occurs during non hemorrhagic cerebral infarction aka stroke

A

Red neurons

Liquefaction necrosis

Thrombocytic meds

54
Q

What is the mc cause of intracranial hemorrhage

A

HTN

Injury to vessel walls
Tumors
Trauma

55
Q

What is a microbleed?

A

Spontaneous intraparenchymal bleed

HTN is the most common cause

Average age 60 years old

Clinically silent or lethal,

15% of deaths in chronic HTN patients

Bleed-Clot-Cavitation

56
Q

What causes a subarachnoid hemorrhage

A

1/3 from increased ICP, straining and orgasm

Often described as the “worst headache ive ever had” nausea and vomiting

25-50% lethal, commonly re occur

57
Q

What is the MC cause of subarachnoid hemorrhage

A

MC-Ruptured Saccular aneurysm

Malformed vessel or a tumor

58
Q

What is also known as a Berry aneurysm

A

Saccular Aneurysm

It is 80-90% of all intracranial aneurysms

59
Q

What is berry aneurysm is associated with

A

Polycystic Kidney Disease

Systems Path Exam 2 (6 decks)

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