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Systems Path 1 > Exam 2: CNS > Flashcards

Exam 2: CNS Flashcards

1
Q

Reversible neuronal injury examples

A

Swelling of soma and axons

Aka spheroid

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2
Q

Spheroids can displace

A

Nissl bodies

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3
Q

Irreversible neuronal injury

A

Some shrinks
Pyknosis - nucleus necrosis
Eosinophilia

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4
Q

___ freq from acute hypoxia

A

Irreversible neuronal injury

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5
Q

Red neurons characteristic of

A

Irreversible neuronal injury

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6
Q

Astrocytes Function in

A

Gliosis

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7
Q

Activated astrocytes

A

Gemistrocytic astrocyte

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8
Q

Oligodendrocytes

A

Produce myelin in CNS

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9
Q

Oligodendrocytes can also be site for

A

Viral inclusions

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10
Q

Microglia

A

Phagocytes of CNS

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11
Q

Ependymal cells line

A

Ventricles and spinal cord

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12
Q

___ likes to infect ependymal cells

A

CMV

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13
Q

Viral infections: disease and inclusion

A

Rabies = negri body

CMV = owl’s eye appearance

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14
Q

Neurodegenerative diseases: name and inclusion

A

Parkinson’s = Lewy bodies

Alzheimer’s = beta amyloid plaques (tau protein); neurofibrillary tangles

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15
Q

Lipofuscin

A

Lipid accumulations

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16
Q

Increase in ICP can be due to

A

Blood
Pus
Tumor
Edema

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17
Q

Vasogenic edema

A

Disrupted BBB

Extracellular edema

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18
Q

Cytotoxic edema

A

Disrupted neuronal/glial membranes

Intracellular edema

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19
Q

Cerebral edema cause gyri to ___, sulci to ___, ventricles ___

A

Flatten

Narrow

Compressed

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20
Q

Hydrocephalus

A

Increase CSF volume in ventricles

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21
Q

Hydrocephalus can be due to

A

Disturbed CSF flow or resorption

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22
Q

Types of edema

A

Vasogenic

Cytotoxic

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23
Q

Hydrocephalus MC from

A

Choroid plexus tumor

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24
Q

Communicating hydrocephalus

A

Bilateral

Even

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25
Q

Noncommunicating hydrocephalus

A

Localized

Uneven

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26
Q

Under 2, hydrocephalus causes

A

Cranium expansion

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27
Q

Older than 2, hydrocephalus causes

A

Increase ICP

Enlarged ventricles

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28
Q

Half of all cases of hydrocephalus are

A

Idiopathic

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29
Q

Hydrocephalus Ex Vacuo

A

Due to infarction or neurodegeneration

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30
Q

Herniated brain tissue can shift where?

A

Across dural structures

Through foramen magnum

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31
Q

Herniation often follows

A

Increase in ICP

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32
Q

Types of herniation

A

Subfalcine (cingulate)

Transtentorial (uncinate)

Tonsillar

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33
Q

MC type of herniation

A

Subfalcine (cingulate)

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34
Q

Untreated hydrocephalus can cause

A

Respiratory arrest

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35
Q

Subfalcine herniation

A

Cingulate gyrus,under falx

Abnormal posturing
Coma

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36
Q

Transtentorial herniation

A

Uncinate fasciculus (temporal lobe) under tentorium

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37
Q

CN3 involvement, blown pupil, and diplopia can result from

A

Transtentorial herniation

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38
Q

Tonsillar herniation

A

Cerebellar tonsils through FM

Headache, cardiorespiratory arrest

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39
Q

Duret hemorrhage

A

Disrupts vessels in pons

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40
Q

Flame shaped bleeds indicates

A

Duret hemmorrhage

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41
Q

Duret hemorrahage can result from

A

Transtentorial herniation

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42
Q

Types of abnormal posturing

A

Decorticate rigidity

Decerebrate rigidity

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43
Q

Decorticate rigidity

A

Brachial flexion

Injury between cortex and red nuclei

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44
Q

Decerebrate rigidity

A

All limbs extended, flexed wrists

Injury in brainstem between red nuclei and vestibular nuclei

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45
Q

Mydriasis

A

Dilation of pupil

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46
Q

Anisocoria

A

Unequal pupil size

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47
Q

MC chiari malformation

A

Type 1

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48
Q

Type 1 chiari malformation

A

Mild
Low lying cerebellar tonsils
Downward extension through FM
Adults

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49
Q

Arnold-Chiari malformation

A

Small post fossa
Misshapen midline cerebellum
Downward extension through FM
Associated with myelomeningocele

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50
Q

Type 2 chiari malformation effects

A

Infants or in utero

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51
Q

Chiari malformations aka

A

Post fossa abnormalities

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52
Q

Tx for chiari malformations

A

Neurosurgical decompression

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53
Q

5th MC mortality in US

A

CVD

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54
Q

MC cause of neurological morbidity

A

CVD

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55
Q

3 mechanisms that cause CVD

A

Thrombotic occlusion
Embolic occlusion
Disruption of vessel wall

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56
Q

Stroke causes ___ to CNS tissues

A

Liquefactive necrosis

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57
Q

2 primary forms of stroke

A

Ischemic

Hemorrhagic

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58
Q

Ischemia

A

Lack of blood to area

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59
Q

Hemorrhagic

A

Injure CNS tissue + disrupt BBB

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60
Q

Features of stroke

A

Unilateral facial drooping
Difficulty speaking
Contralateral paralysis

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61
Q

Stroke preserves

A

Motor to upper face

  • can close eyes tightly
  • can wrinkle forehead symmetrically
62
Q

With a TIA, normal function returns in

A

24 hrs from time of onset

63
Q

Paralysis of CN7

A

Bell’s palsy

64
Q

MC age for Bell’s palsy

A

15-45 yo

65
Q

Features of Bell’s palsy

A

Asymmetrical forehead weakness

Unilateral paralysis of face

66
Q

Potential causes of hypoxia

A

Altitude
CO
Anemia
Cyanide

67
Q

Global cerebral ischemia

A

Low blood perfusion to entire brain

68
Q

___ provides some collateral flow to brain

A

Circle of Willis

69
Q

Isolated area of low blood flow

A

Focal cerebral ischemia

70
Q

Deep tissues have minimal collateral supply, which include

A

Thalamus
Basal ganglia
Deep white matter

71
Q

MC cause of focal cerebral ischemia

A

Emboli

72
Q

Cerebral infarction: 12-48 hrs

A

Neutrophils
Red neurons
Edema

73
Q

Cerebral infarction: 48 hrs-2 weeks

A 
Nuclear fragmentation (karyorrhexis)
Liquefaction
74
Q

Hemorrhagic stoke involves

A

Reperfusion

75
Q

Cerebral infarction: weeks-years

A

Macrophages
Gliosis
Cavitation

76
Q

Causes of intracranial hemorrhage

A

Vascular injury
Malformations
Tumors
Trauma

77
Q

Bleeding inside brain

A

Intracranial hemorrhage

78
Q

MC cause of intracranial hemorrhage

A

HTN

79
Q

Extravasation of blood will

A

Coagulate

Compress parenchyma

80
Q

HTN MC cause of _____, which involves spontaneous microbleeds

A

Primary brain parenchymal hemorrhage

81
Q

Berry aneurysm aka

A

Saccular aneurysm

82
Q

Saccular aneurysm occur at branch points of

A

Circle of Willis

83
Q

“ Worst headache I’ve ever head” indicates

A

Subarachnoid hemorrhage

84
Q

MC cause of subarachnoid hemorrhage

A

Ruptured saccular aneurysm

85
Q

1st episode of subarachnoid hemorrhage results in

A

25-50% lethal

86
Q

Subarachnoid Bleeding is ____, and 1/3 come from increased ICP

A

Non-traumatic

87
Q

Clinical decision rule for subarachnoid hemorrhage

A
  1. > 40 yo
  2. Neck pain or stiffness
  3. LOC
  4. Thunderclap HA
  5. Limited neck flexion
88
Q

Saccular aneurysm associated with

A

Polycystic kidney disease

89
Q

Method used to evaluate potential brain bleeds

A

CT scan

90
Q

Polycystic kidney disease due to

A

Autosomal dominant PKD1 or 2 gene

91
Q

Asymptomatic until 30s, flank pain, hematuria, HA all describe

A

Polycystic kidney disease

92
Q

PKD can also cause cysts in ___ and saccular aneurysms

A

Liver

93
Q

Berry aneurysm MC in

A

Anterior circulation of branch points of circle of Willis

94
Q

Saccular aneurysm may scar and produce

A

Hydrocephalus

95
Q

Arteriovenous malformation (AVM)

A

Tangle of arteries and veins

Fistula

96
Q

AVM MC

A

Cerebrovascular malformation

97
Q

AVM MC in ___ ages ___

A

Males

10-30 yo

98
Q

“Worm-like” mass describes

A

AVM

99
Q

___ weakens vessels walls that can easier rupture

A

HTN

100
Q

Diastolic BP > 130 =

A

Severe ICP

101
Q

HTN encephalopathy can break down

A

BBB

102
Q

HTN encephalopathy can cause widespread

A

Cerebral edema

103
Q

4 types of intracranial hemorrhages

A

Primary brain parenchymal

Subarachnoid

Ruptured AVM

Lacunar infarction and slit hemorrhage

104
Q

__ 2X more likely to have CNS trauma

A

Males

105
Q

CNS trauma can result in ___ and ___

A

Morbidity

Mortality

106
Q

Suspected CNS injury, assess…

A

Airway
Breathing
Circulation
Disability

107
Q

Chronic traumatic encephalopathy (CTE)

A

Dementia pugilistica

Repetitive trauma

108
Q

Confusion

A

Cerebral hemorrhage

109
Q

Laceration

A

Tears in cerebral parenchyma

110
Q

__ more susceptible to contusion

A

Gyri (frontal and temporal)

111
Q

Coup injury

A

At impact site

112
Q

Contrecoup injury

A

Opposite site of impact

113
Q

Laceration can be caused by

A

Bullet
Knife
Nail

114
Q

Traumatic parenchymal injuries include

A

Contusions
Lacerations
Diffuse axonal injury

115
Q

Diffuse axonal injury

A

Movement of one brain region, relative to another

116
Q

DAI can cause

A

Diffuse white matter damage

Widespread edema

Coma

Death

117
Q

DAI can be caused by

A

Angular acceleration

118
Q

Shaken baby syndrome components

A

Subdural hematoma
Cerebral edema
Bilateral retinal bleeding

119
Q

Shaken baby syndrome can cause

A 
Severe brain damage 
Blindness 
Reduced cognition 
Motor impairment 
25% fatal
120
Q

In concussion, MRI and CT are

A

Normal

121
Q

Concussion

A

Reversible alteration in consciousness from head injury

122
Q

Post concussive syndrome

A

Prolonged symptoms of concussion, weeks to months

123
Q

__ of concussions result in post concussive syndrome

A

15-20%

124
Q

___ may be lethal, so concussion excludes return to play

A

Second impact syndrome

125
Q

____ associated with skull fracture

A

Epidural hematoma

126
Q

Subdural hematoma MC occur in

A

Infants

Geriatrics

127
Q

Dural artery damage that compresses brain tissue and may cause lucidity during bleed

A

Epidural hematoma

128
Q

Rapid movements tear veins, subdural bleeding that compresses brain

A

Subdural hematoma

129
Q

Epidural hematoma MC involves

A

Middle meningeal A

130
Q

Epidural hematoma is ___ within hours

A

Lethal

131
Q

____ more common than subdural hematoma

A

Epidural hematoma

132
Q

Neural tube fails to close

A

Neural tube defects

133
Q

MC CNS malformation

A

Neural tube defects

134
Q

Risks for neural tube defect

A

Low folate

Previous child

135
Q

Types of neural tube defects

A

Spina Bifida Occulta
Myelomeningocele
Anencephaly
Encephalocele

136
Q

Myelomeningocele

A

Extension of CNS through vertebral defect (lumbosacral)

137
Q

Anencephaly

A

Absence of brain, rostral aspect

138
Q

Encephalocele

A

CNS diverticulum, cranial

139
Q

Encephalocele involves what characteristics

A

Craniofacial abnormalities

Larger = more severe

140
Q

Hydromyelia

A

Extended 4th ventricle

141
Q

Syringomyelia aka

A

Syrinx

142
Q

Syrinx

A

Cyst within cord in adults

143
Q

Syrinx can cause

A

Loss of pain/temperature sensation (shawl-like distribution)

Possible tissue atrophy or areflexia

144
Q

Syrinx associated with

A

Type 1 chiari

145
Q

Intraparenchymal hemorrhage

A

Deep (near ventricles)

146
Q

Perinatal brain injuries

A

Intraparenchymal hemorrhage

Infarct

Cerebral palsy

147
Q

Forms chalky plaques

A

Infarct

148
Q

Non-progressive motor defects

A

Cerebral palsy

149
Q

Things that can infect CNS

A

Bacteria
Viruses
Fungi

150
Q

Epidural abscess

A

Infection in epidural space

151
Q

Subdural empyema

A

Infection of subdural space

Systems Path 1 (12 decks)

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