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NUNC > Imaging Spotter Pathology > Flashcards

Imaging Spotter Pathology Flashcards

1
Q

What appearance does a subdural haematoma have on CT?

A

-cresent shaped, thin layer of blood covering large area

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2
Q

What about an extradural haematoma?

A

-limited tracking due to cranial suture lines so biconvex shape

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3
Q

Damage to what often causes subdural haematomas?

A

-bridging veins connecting superficial cortical surface to the superior sagittal sinus

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4
Q

What people are at more risk or subdural haematoma?

A
  • people who fall

- brain atrophy e.g. alcholics, elderly, dementia

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5
Q

What is the Nissl stain used to demonstrate?

-the large “Nissl bodies” represent..

A
  • neuronal cell bodies e.g. the 6 layers of cortex

- represent aggregates of rough ER (ie. high protein synthesis and high MR)

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6
Q

Selective frontal lobe atrophy with cognitive decline is indicitive of…

A

fronto-temporal dementia

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7
Q

What developmental anomly consists of a tangle of arterial and venous channels of differing sizes?
Symptoms? Phenomenon?

A
  • AVM- Arterio-Venous Malformation
  • seizures, headaches, brain haemorrhage/focal neurological deficits
  • steal phenomenon=fast flow from arterial to venous blood channels so steals blood from the surrounding brain tissue
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8
Q

What would cause a dilation of one lateral ventricle?

A

-monoventricular hydrocephalus due to foramen of monro blocking CSF outflow

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9
Q

What risks are associated with ventriculoperitoneal (VP) shunts? What can be done instead?

A
  • infection, brain haemorrhage, often fail so need shunt revision
  • fenestration of septum pellucidum
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10
Q

What is the centrum semiovale
In what condition is it deymyelinated?
What is preserved

A

the central white matter of the hemisphere on axial cut

  • metachromatic leukodystrophy
  • subcortical U fibres preserved
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11
Q

subcortical U fibres supply is by

A

penetrating cortical vessels

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12
Q

a well-defined mass pressing on brain from “outside” relating to orbitofrontal cx is likely a …

A

an olfactory groove meningioma (may cause personality change and behavioural disinhibiton)

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13
Q

What exits the foramen ovale?

What makes the point of the exlamation mark with this?

A

V3 - mandibular

foramen spinosum is point, this is for the MMA

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14
Q

What tract projects from thalamus through sagittal stratum to occipital lobe?
Based on its origin/termination what is it aka..

A

Optic radiations

aka geniculo-calarine tract

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15
Q

A large tumour, irregular margin, diffusely invading brain tissue, ring enhancing lesion is likely a

A

malignant glioblastoma

ring enhancing as tumours blood vessels lack a BBB so contrast medium leaks here

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16
Q

Abnormal hyperintensity of the pulvinar and mediodorsal nuclei of both thalami is know as the what sign?
What is it suggestive of?

A

The hockey stick sign

Suggests Creutzfeldt-Jacob prion Disease or spongiform encephalopathy

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17
Q

The carotid canal holding ICA is where?

Where does the ICA then pass through, which CNVI?

A
  • petrous portion of temporal bone

- then through the carotid sinus

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18
Q

What tract runs from the occipital to temporal pole?

Which visual steam is this associated with?

A

ILF-inferior longitudinal fasiculus

-ventral stream/”what” pathway

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19
Q

Occulusion of PICA commonly causes which syndrome? CNs affected?
Sypmtoms

A
  • lateral medullary/Wallenburg’s
  • post to olive CNS (IX, X, XI)
  • dysphonia, dysphagia, hoarse voice, bovine cough…
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20
Q

Why does medial medullary s. of Dejerine cause contra loss of vibration/proprioception (+CNXII palsy and contra hemi)

A

due to damage to medial lemniscus that runs from front to back in the medial meddula

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21
Q

What does the internal granule cell layer (IV) recieve? Where is it prominent?

A
  • recieves subcortical ascending projections from the thalamus
  • prominent in sensory areas (V1, A1, S1)
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22
Q

What sign indicates an early hemispheric stroke?

A

The insula ribbon sign

-grey-white distinction of insular cx is reduced on affected side

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23
Q

What visual field defect may you expect to see with a lingual gyrus lesion?

A

-a contralateral superior quadrantanopia

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24
Q

What is Von Hippel-Lindau Syndrome (VHL)? What is a common finding in the cerebellum appearing as a cystic lesion with a mural nodule?

A
  • VHL is associated with tumour and cyst formation in parts of body
  • cerebellar haemangioblastoma is common (this is highly vascular and benign)
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25
Q

What is another possible cerebellar cystic lesion with an enhancing mural nodule?

A

A pilocytic astrocytoma

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26
Q

What is the Golgi silver stain good for demonstrating?

A

-neuronal processes (axons+dendrites)

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27
Q

What is LFB (Luxol Fast Blue) stain used for demonstrating?

A

-white matter, so will show clearly if an area is demyelinated (paler)

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28
Q

What may bright white spots in postcapillary venules adjecent to CSF spaces indicate on a T2-FLARE scan.

A
  • MS, common in middle aged females

- white spots are inflammatory demyelination

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29
Q

Where does the dentato-rubro-thalamic pathway project through to reach…

A

Through SCP to reach VL nucleus of thalamus, pars caudalis

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30
Q

A rupture of a Charcot microaneurysm affecting the lateral lenticulostriate artery on CT..

A

..basal ganglia haemorrhage centered on putamen.

-fresh blood is hyperdense (bright white)

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31
Q

What are the features of SMA syndrome? NB only affects voluntary motion

A
  • reduced spontaneous movements

- difficulty performing voluntary motor acts to command contra limbs

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32
Q

Explain subfalcine herniation

A
  • lesion causes midline shift
  • medial frontal lobe is pushed under the free edge of the tentorium
  • +effacement of lat ventricle
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33
Q

Irregular ring enhancing lesion in temporal lobe with cerebral oedema on MRI is likely not to be a glioblastoma, but an

A

abcess, infection from middle ear roof thin bone (tegmen tympani)

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34
Q

SLF 3 is the arcuate fasiculus part, what is it involved in?

A
  • language

- as connects Broca’s to Wernicke’s

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35
Q

How would you treat an aneurysm at the top of the basilar artery?

A

-endovascular coiling via interventional radiography

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36
Q

A uniform unilateral subtle lesion on insula with no expansion/distortion in a young person is likely a

A

low grade glioma - benign

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37
Q

What is the Band of Giacomini in the uncus hippocampus a part of?

A

Part of the dentate nucleus

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38
Q

Post-ressus from cardiac arrest, MRI infarct between MCA and ACA territories is a

A

watershed infarct, caused by any profound drop in arterial BP

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39
Q

What structure lies within the petrous portion of the temporal bone? Innervated by CNVIII, which terminates where

A
  • the cochlea

- CNVIII cochlear part terminates in the dorsal and ventral cochlear nuclei of the meddula

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40
Q

Where are the dorsal and ventral cochlear nuclei of the meddula found specifically

A

on the anterior and posterior surfaces of the restifrom body/ICP

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41
Q

Bifucation of basilar artery leads to which 2 vessels

A

L and R PCA

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42
Q

Electrodes of DBS to treat idiopathic Parkinson’s disease are placed where?

A

-subthalamic nuclei

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43
Q

What may a signal change in a coronal MRI of the hypothalamus (above mamillary bodies) be caused by?

A

Wernicke’s encepalpathy

e.g. alcoholics/vit B1-thiamine deficiency

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44
Q

What is the pathogenesis of a cerebellar stroke due to a vertebral artery dissection?

A
  • traumatic tearing of lining of vertebral artery

- leads to occlusion due to thrombus formation

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45
Q

Reduced dopamine release in caudate nucleus and putamen (but not globus pallidus) is indicitive of

A

idiopathic parkinsons disease

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46
Q

A well-circumscribed rounded lesion, very vascular with a “blush of cappilaries” on angiogram is likely

A

-a meningioma (extra-axial)

These are typically attached to the dura

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47
Q

Fresh blood in the basal cistern is likely a

A
  • subarachnoid haemorrhage

- due to ruptured berry aneurysm in circle of Willis

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48
Q

Superior Fronto-Occipital Fasiculus (SFOF) course

A

from frontal, lateral to head of caudate, inf to radiations of corpus callosum, to occipital lobe

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49
Q

What round cystic lesion may present in the insula…?

A

-a cavernous haemangioma

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50
Q

The developmental abnormality, harmartoma, may occur ….

and lead to….

A

in the hypothalamus

..leading to gelastic seizures

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51
Q

What does the inferior anastomotic vein of Labbe connect?

A

-the superficial middle cerebral vein to the transverse cerebral sinus

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52
Q

Anterior part of falx cerebri is a common site of origin for what tumour?

A

Meningiomas

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53
Q

What is missing in Urbach-Witte disease? What is it replaced by? Symptoms

A

No amygdala, replaced with calcium.

Lack anxiety and fear

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54
Q

3rd ventriculostomy to treat hydrocephalus placed..

A

-in the tuber cinereum (thinnest, most membranous) part of floor, space is opened here for CSF to drain out

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55
Q

CNV arises from the juction of basal pons and MCP. From which p. arch does it derive?

A
  • from the 1st/mandibular pharyngeal arch

- gives rise to upper and lower jaws + muscles

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56
Q

the cingulum bundle is the main association pathway of the

A

limbic lobe

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57
Q

The dorsal cingulum lies

A

under the cinguate gyrus

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58
Q

The ventral cingulum lies

A

under the parahippocampal gyrus

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59
Q

The anterior group of thalamus projects to the cingulate cx in which circuit?

A

Papez circuit, involved in memory

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60
Q

Lobule 7 of cerebellum has which 3 cognitive functions

A

-language, working memory, visuospatial reasoning

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61
Q

What does the superior anastomotic vein of Trolard connect?

A

-the superficial middle cerebral vein to the superior sagittal sinus

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62
Q

Where does the superficial middle cerebral vein drain into? 2 sinuses

A

the sphenoparietal and cavernous sinuses

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63
Q

Where does the corticospinal tract cross the midline?

A
  • at inf boarder of medullary pyramids at the cervicomedullary junction
  • at level of foramen magnum
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64
Q

neocerebellum is which lobe?

A

posterior

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65
Q

What is the name of the mouth embryologically that gives rise to Rathke’s pouch?

A

The stomodium

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66
Q

intensity refers to MRI scans, what does density refer to?

A

CT scans

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67
Q

What do the lateral ventricles look like in agenesis of the corpus callsoum? What bundle is seen next to them?

A

The lat. ventricle is like viking helmet horns

The bundles of Probst

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68
Q

In children, what tumour has rosenthal fibres present?

A

Pilocytic astrocytoma

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69
Q

What brain tumour does VHL (on chromosome 3) predispose you to?

A

Haemangioblastoma

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70
Q

What stain is used as a marker for astrocytes?

A

GFAP

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71
Q

What tumour is commonly found blocking the IV foramen of Monro which causes acute high intercranial pressure leading to drop attacks?

A

Colloid Cyst

72
Q

The paracentral lobule is vertically above…

A

the splenium of CC

73
Q

Vascularisation of a tumour generally indicates…

A

malignancy

74
Q

Glioblastomas are ring enhancing, grade 4 common in middle age, can cross white matter. Whereas astrocytoma..

A

astrocytoma.. are present more in younger people

can cause fits

75
Q

Pineoblastoma vs pineocytoma

A

Pineoblastoma-bad, calcifies

Pineocytoma - benign

76
Q

What are pineal germ cell tumours called? What do they secrete?

A

Germinoma

Release tumour markers eg hCG..

77
Q

What does hydrocephalus ex vacuo mean?

A

Large ventricles only due to atrophy of brain

78
Q

Huntingtons triple repeat disorder is _ _ _

Huntingtin is encoded on chromosone #

A

CAG

Chromosome 4

79
Q

A hyperintense hippocampus indicates

This causes

A

hippocampal sclerosis, causes temporal lobe epilepsy (main cause, followed by low grade glioneuroma)

80
Q

What condition looks like potatos in brain and presents with epilepsy and a facial rash?

A

Tuberosclerosis

If all over the place it is called focal corticodysplasia which is due to abnormal brain migration

81
Q

What 2 things could a ring enhancing lesion with oedema be?

A
  • an abcess

- a glioblastoma

82
Q

What tumour from the lining of ventricles “push” brain and cause gross hydrocephalus?

A

Apendemoma

83
Q

On a T2 scan how does white matter appear?

A

Black

84
Q

Paraventricular hyperintensity on a T2 FLARE could be:

  • in a young female
  • in a child
  • in a premature baby
A
  • in a young femal = MS
  • in a child = leukoencepalopathy
  • in a premature baby = periventricular leukomalacia
85
Q

Infiltrated tumour in tectum is likely a

A

tectal plate glioma

86
Q

Irregular smooth mass lesion in sella turcica that is non enhancing and non calcified is likely a

A

pituitary adenoma

macro>1cm, micro<1cm-secreted hormones, meso

87
Q

Hippocampus atrophies with hydrocephalus ex vacuo in which condition?

A

Alzheimer’s

88
Q

An extra-axial tumour causing midline shift and efacement of lateral ventricle is likely a

A

meningioma from arachnoid granulation cap cells

p.s. if you see “whorl” think meningioma

89
Q

periventricular hyperintensity in cuffs of inflammation..are called

A

Dawson’s fingers

90
Q

Cistern in front of pons is the

A

pontine cistern

91
Q

Tela Chorodia is the lining of the

A

Velum interpositum

92
Q

Tag on splenium is the

A

crux of fornix

93
Q

What might an irregular, ring + contrast enhancing lesion that causes midline shift be?

A

A glioblastoma

94
Q

Where do the following terminate? (ant commisure)

  • precommisural fornix
  • retrocommisural fornix
A
  • pre goes to septal area in paraterminal gyrus

- retro goes to mammilary body

95
Q

What eminence is found in the temporal horn of lateral ventricle caused by?

A

Collateral eminence due to collateral sulcus

96
Q

what feature of the C2 axis is seen on MRI?

A

Odontoid peg

97
Q

Diffusion weighted MRI appears…

A

very fuzzy/pixelated

98
Q

What supplies the head of the caudate?

A

-median striate arteries

99
Q

What are the 4 parts of internal carotid?

A
  • cervical
  • petrous
  • cavernous with loop de loop/siphon
  • supra clinoid
100
Q

What do you called something that is unpaired e.g. abnormal ACA

A

Azygous (no twin) eg. ACA

101
Q

Superior frontal gyrus on an axial cut does an L shaped turn to become the….

A

Motor area M1 (precentral gyrus)

102
Q

What does an aneurysm in the Great Cerebral Vein of Galen in a baby cause?

A

High output cardiac faliure

103
Q

Working memory is area

A

46

104
Q

Inferior longitudinal fasiculus (ILF) is the ___ visual stream

A

-ventral visual stream/what pathway

105
Q

What time of tumour often grows in the clivus?

A

Caudoma

106
Q

Medial lemniscus is for..

A

..dorsal columns (vibration, proprioception)

107
Q

Neurofibromatosis Type II is a genetic condition, it may predispose you to…

A

..bilateral neuroma/acoustic schwannomas

108
Q

What vessel lies in the thalamocaudate groove?

A

Terminal vein

109
Q

The fimbriodentate groove is in the

A

hippocampus

110
Q

area 28 is entorhinal cx, what is area 35?

A

perirhinal cx

111
Q

Where is the groove for the superior petrosal sinus?

A

Petrous ridge of temporal bone

112
Q

Inf petrosal sinus groove runs down

A

the clivus

113
Q

What sinus is under the lesser wing of the sphenoid bone? What drains here?

A

The sphenoparietal sinus, the superficial middle cerebral vein drains here

114
Q

What runs in the ambient cistern?

A

Basal veins of Rosenthal

115
Q

What sinus has its groove in the foramen magnum

A

Marginal sinus

116
Q

Which sulci lie above gyrus rectus?

A

-superior and inferior rostral sulci

117
Q

What splits like a wine glass either side of the inf. colliculi?

A

The lateral lemniscus

118
Q

Which nucleus is in wall of 4th ventricle next to dorsal vagus motor nucleus?

A

Abducens nucleus which then the nerve runs up to Dorello’s canal

119
Q

Which fibres are found in the genu of the internal capsule?

A

Corticobulbar fibres

120
Q

What vessel may be seen near bunny’s face in hippocampus area?

A

PCA

121
Q

Weigert stains using potassium dichromate to preserve myelin lipids then staining these with haematoxylin, makes…

A

white matter appear black

122
Q

Pars reticularis of substantia nigra is invisible with eye,it is just anterior to pars compacta and is said to be

A

displaces internal globus pallidus

it projects to the superior colliculus

123
Q

The parvocellular neurones of red nuceli project to the

A

thalamus

124
Q

The magnocellular neurones of red nuceli project to the … running in the

A

rubrospinal tract to the neck..

running in the lateral fasiculus with the spinothalamic tract

125
Q

the central tegmental tract leaves the red nuclei to enter the
(it has the ventral tegmental decussation)

A

ION of the meddulla

126
Q

The dorsal tegmental decussation is associated with which tract?

A

Rubrospinal

127
Q

3 parts of elbow in medulla?

A
  • ant. lateral system
  • elbow: medial lemnisus (to VPL)
  • hand: trigeminal lemnisus (to VPM)
128
Q

Where is the lateral lemniscus’s course?

A

In the inf. collicul -> inf brachium -> MGN -> sublenticular internal capsule -> Heshel’s

129
Q

What role does the raphespinal tract have?

A

-pain gaiting using 5 HT in the substantia gelatinosa (lamina I, II, III)

130
Q

What thin layer is seen thethering the 2 superior cerebellar peduncles?

A

superior medullary valum

131
Q

What nucleus is around the 4th ventricle in the CNS but is a “ganglion” (normally a PNS structure)

A

The mesencephalic trigeminal nucleus for jaw proprioception

132
Q

The 2 petrous nerves unite to form the….

for..

A

Vidian nerve supplies the nasal mucosa

133
Q

The parasympathetic output of CN 7 and 9 is for the

A

superior and inferior salivatory nuclei

134
Q

The solitary tract is surrounded by the C shaped nucleus, this lies behind the…

A

dorsal vagus motor nucleus in the medulla

135
Q

In the area vestibuli, the medial vestibular nucleus appears blocky, how doews the inf. vestibular nucleus appear?

A

Speckled

136
Q

If you see the ICP with 2 other stuctures resembling a triangle like (putamen, gp ext and gp int) the outer part is the ICP, then..

A

-the spinal tract of the trigeminal nerve followed by the
-paler nucleus of the spinal tract of the trigeminal nerve
(nucleus has pars: oralis, interpolaris and caudalis)

137
Q

Which nuclei lie on either side of the inf. olivary complex?

A

Dorsal and medial accessory nuclei of the olive

138
Q

What tract is v. superficial in the lateral medulla?

A

Ventral spinocerebellar tract

139
Q

What does the central grey surround?

A

The central cord of the spinal cord

140
Q

Where does the spinal accessory nerve come out?

A

Ant horn of C1-C5 to the dentate ligament

141
Q

How does Opalski syndrome differ to Babinski-Nageotte?

A

Lower down

142
Q

What is the facial colliculus syndrome?

A
  • Ipsi CNVI (lateral conjugate gaze palsy)

- ipsi CNVII palsy

143
Q

Dense MCA sign suggests what?

A

Ischemic/thrombosis occluding artery

144
Q

What NT does the septal nuclei release?

A

ACh

145
Q

Semantic FTD (dementia) is loss especially of

A

lateral temporal lobe so you lose ability to categorise/name things

146
Q

Arterio-venous malformations that cause skin changes e.g. port wine stain (Sterge Weber) would be an example of what kind of condition?

A

A Neurocutaneous s. (of ectodermal tissue)

e.g. NFM Type II, tubero sclerosis..

147
Q

Overdrainage of ventricles leads to..

Risks..

A

Slit ventricles

  • chronic subdural haematoma
  • low pressure headaches
148
Q

What is leukodystrophy

A

AR condition of white matter dysfunction

149
Q

Monro-Kelly doctrine states what?

A

With a space occupying lesion, intercranial pressure will go up after a point of decompensation

150
Q

Name 3 hot points for meningioma formation:

A
  • petrous ridge
  • CPA
  • olfactory groove
151
Q

The retrofungal tract goes to the LGN. What tract leaves the LGN to reach the calcarine sulcus?

A

Geniculocalcarine tract

152
Q

What function is the extreme capsule involved with?

A

language

153
Q

What are the 6 layers of the cerebral cortex?

1) Molecular

A

2) ext. granule
3) ext pyramidal
4) int. granule
5) int. pyramidal
6) polymorphic

154
Q

A cystic lesion in the medulla with a mural nodule could be …. or … (both are WHO grade I )

A
  • pilocytic astrocytoma with rosenthal fibres

- a haemangioblastoma

155
Q

Luxol fast blue is a copper phthalocyanine dye that is attracted in lipoproteins of the …
Which appears..

A

myelin sheath. With the stain, myelin fibers appear blue

nerve cells appear purple

156
Q

What is chromatolysis a part of?

A

The axon reaction

157
Q

Where does the SCP project to ? (the cerebellothalamic fibres)

A

The VL pars caudalis of the thalamus

158
Q

What may a subfalcine herniation cause secondarily?

A

An ACA stroke

159
Q

Most common sites for a Berry Aneurysm (which can cause vasospasm) are:

A
  • Ant comm.
  • Trifurcation of MCA
  • Post comm
160
Q

What vein runs in the foramen cecum?

A

Emissary vein

161
Q

Sphenoparietal sinus is contiunous with the

A

cavernous sinus

162
Q

Amyloid B followed by Tao-neurofibrilary tangles is indicitive of

A

Alzehimers

163
Q

What is the most common cause of subarachnoid haemorrhage

A

Berry Aneurysms

164
Q

A slow growing diffuse benign tumour that may cause seizures could be a

A

low grade glioma

165
Q

What tumours calcify on CT, have fried egg cells and chicken wire blood vessels?

A

Oligodendrogliomas

166
Q

What non-calcified tumours look like stars/spiders microscopically?

A

Astrocytomas

167
Q

3 features of insula lobe seizures could include:

A
  • time distortion
  • fear
  • epigastric rising sensation
168
Q

What is the name for the shark teeth with the fimbria “fringe” attached?

A

The Denticulate Margin

169
Q

In what condition does the PPN (pedunculopontine nucleus) degenerate?

A

Parkinson’s so can do DBS here

170
Q

What nuclei does the fastigial nucleus project to via the…

A

The vestibular nuclei via the ICP

171
Q

What occurs in transcortical motor aphasia

A

non-fluent aphasia with preservation of repitition due to preserved arcuate fasiculus

172
Q

Non dominant lobe Broca damage–>

Wernicke’s damage –>

A 
Broca = amusia
Wernicke's = aprosmodia
173
Q

What hormone does pineal gland secrete?

A

Melatonin

174
Q

Pyramis/biventral is lobule number

A

8 (like bow tie)

175
Q

the caudate and lentiform nuclei collectively are the

A

dorsal striatum

176
Q

You lose lateral substantia nigra first so you have sparing of the

A

medial caudate

NUNC (4 decks)

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