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NMSP Exam 1 > Intro To Neuro Pathology > Flashcards

Intro To Neuro Pathology Flashcards

1
Q

In the central nervous system, myelinating cells are called…

A

Oligodendrocytes

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2
Q

What is selective vulnerability

A

set of neurons sharing one or more properties demonstrating response to one insult

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3
Q

Describe the acute “red neuron” response to injury

A

Seen at 12- 24 hrs
earliest sign of insult

Shrinkage of cell body
Pyknosis
Loss of nucleolus and nissl substance
Intense eosinophilia

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4
Q

Describe the subacute and chronic response of neurons to injury

A

Cell loss and reactive gliosis (like scar tissue but is NOT scar tissue)

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5
Q

Describe Axonal Reaction

A

Increased protein synthesis associated with axonal sprouting

  • enlarged cell body
  • Peripheral displacement of nucleus
  • enlarges nucleolus
  • Nissl removed from center of cell to periphery (central chromatolysis)
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6
Q

Describe intracytoplasmic and intranuclear inclusions

A

Intracytoplasmic: lipofuscin, proteins, or carbohydrates
– Rabies, lewy bodies, CJD

Intranuclear: Herpes Cowdry body. CMV( both nuclear and cytoplasmic)

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7
Q

What is the most important histopathologic indicator of CNS injury

A

Gliosis, regardless of etiology

  • -Hypertrophy & Hyperplasia of astrocytes
  • -Astrocytes act as metabolic buffers & detoxifiers in the brain
  • -Foot processes contribute to BBB
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8
Q

Describe the characteristics of gemistocytes

A

Enlarged nuclei, becomes vesicular with prominent nucleoli, cytoplasm expands, BRIGHT PINK & dislocates nucleus eccentrically.

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9
Q

What is an Alz Type 2 Astrocyte

A

NOTHING TO DO WITH ALZ DISEASE

Gray matter cell, 2-3X nucleus, pale staining central chromatin, intranuclear glycogen droplet, prominent nuclear membrane & nucleolus.

Hepatic Encephalopathy and Wilson Dz

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10
Q

Describe Rosenthal fibers

A

Thick, elongated, brightly eosinophilic, irregular structures occurring within astrocytic processes (benign and slow)

  • -contains HSP
    • Areas of long standing gliosis: Pilocytic Astrocytoma (Alexander Dz)
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11
Q

Describe corpora amylacea

HINT OGRES are like ONIONS (slide 20 lecture1)

A

Polyglucosan bodies (PAS+)

Round faintly basophilic, concentrically laminated strictures located adjacent to astrocytic end processes

Contain glycosaminoglycan polymers, HSP, and ubiquitin - increase with age and degen

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12
Q

What is the function of microglia

A

macrophages of the CNS

surface CR3 & CD68 markers

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13
Q

Differentiate Microglial nodules vs Neuronophagia

A

Microglial Nodules: Microglia Aggregate Around small foci of necrosis

Neuronopgia: Microglia congregate around dying neuron

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14
Q

What is the ependymal cell response to injury

A

leads to ependymal granulations

seen in CMV

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15
Q

What are the two types of cerebral edema

A

Vasogenic: Increase in extracellular fluid

Cytotoxic Edema: increase in intracellular fluid secondary to cell membrane injury

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16
Q

What is a hallmark finding of increased cranial pressure?

A

Papilledema

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17
Q

What pathogenic reason would occur that would result in increased production of CSF

A

Choroid plexus papilloma

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18
Q

How does pyogenic meningitis contribute to an increased ICP

A

Suppurative exudate covering brainstem

Thickened leptomeninges -> obstructive Hydrocephalus

19
Q

What is communicating hydrocephalus

A

CSF is not absorbed properly at the dural sinus level thus the ventricles tend to be symmetrically dilated

20
Q

What are the findings of Hydrocephalus Ex-vacuo and why might it be hard to tell

A

Dilation of ventricles
Shrinkage and atrophy of brain matter

CSF pressure is normal

21
Q

What is the triad of Normal pressure hydrocephalus

A

Wet - urinary incontinence
Wacky - Dementia
Wobbly - Gait disturbance

22
Q

What are the three kinds of cerebral herniation

A

Subfalcine - Cingulate gyrus under Falx

Transtentorial - Medial aspect of the temporal lobe compressed against tenorum (C3 disturbances)

Tonsillar - Cerebellar tonsils displaced through the foramen magnum - life threatening

23
Q

Describe Kernohan’s phenomenon

A

compression of cerebellar peduncle against tentorium cerebelli -> ipsilateral deficit

Creates false localizing sign ex

Right hemisphere transtentorial herniation -> kernohan’s notch in left cerebellar peduncle -> right sided motor impairment

24
Q

Describe a Duret Hemorrhage

A

progression of transtentorial herniation often with secondary hemorrhagic lesions in midbrain or pons

25
What form of necrosis does the brain undergo
Liquefactive
26
What type of defects account for most of the CNS malformations
Neural Tube Defects - failure to close by day 28 -Folate deficiency
27
What is myelomeningocele?
extension of CNS through the defect -> motor and sensory defects
28
what are some associated causes of Microcephally
Zika (remember when people were worried about that) Fetal Alcohol Syndrome HIV-1
29
What is a neuronal heterotopia
Commonly associated with epilepsy, collections of normal neurons in inappropriate places
30
Describe Chiari Type 1
Low lying cerebellar tonsils extend down into vertebral canal: silent unless CSF impeded
31
Describe Chiari Type 2
more severe, misshapen midline cerebellum with downward extension of vermis through F magnum occurs with hydrocephalus and lumbar myelomeningocele
32
Describe Dandy walker malformation
Enlarged posterior fossa; expanded roofless fourth ventricle = cerebellar vermis absent or rudimentary
33
What buzzword sign is associated with Joubert Syndrome
Molar tooth sign hypoplasia of vermis, elongation of cerebral peduncles
34
What is a syringomyelia
fluid-filled cleft like cavity in the inner portion of the cord -classic sx syrinx: isolated loss of pain and temp sensation of upper extremities
35
what is hydromyelia
expansion of ependymal-lined central canal of the cord
36
Describe Intraparenchymal hemorrhage
Seen in germinal matrix of premature infants most common perinatal brain injury
37
describe periventricular leukomalacia
infarcts in supratentorial white matter - premature infants; chalky yellow plaques = necrosis and calcification
38
what is a distatic fracture
fracture crosses a suture line
39
what are the signs of a basilar skull fracture
orbital or mastoid hematomas Raccoon eyes Oto/rhinorrhea: CSF drainage
40
What are some downstream effects of CTE on the brain
Microhemorrhages Neurofibrillary tangles/amyloid and tau deposits Depigmentation of substantia nigra
41
What is diffuse axonal injury
Axonal swelling +/- focal hemorrhaging lesions | direct action of mechanical forces. Do not NEED impact; angular acceleration sufficient
42
What is shaken baby syndrome
Shake a baby to stop it from crying 75-80% dont die but develop brain damage
43
How do we recognize shaken babies
Diffuse Axonal Injury Subdural hematoma Retinal hemorrhages Child is never normal after the fatal shaking

NMSP Exam 1 (17 decks)

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