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Neuro > intro to neuropath; basic tissue reactions, brain edema, brain herniation > Flashcards

intro to neuropath; basic tissue reactions, brain edema, brain herniation Flashcards

1
Q

cells of the gray matter

A

neurons, astrocytes, oligodendrocytes, microglia, neuropils

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2
Q

astrocytes

A

like a fibroblast of CNS, respond to injury

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3
Q

these cells make up the majority of tumors

A

astrocytes

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4
Q

macrophage of brain

A

microglia

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5
Q

Ciliated ______ cells cover surface of ventricle

A

ependymal

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6
Q

leptomeninges

A

arachnoid mater and pia mater

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7
Q

meningothelial cells

A

arachnoid cells

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8
Q

Degeneration of the axon distal to the site of injury occurs within _____ and is called

A
  • the first day - wallerian degeneration
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9
Q

Influx of macrophages occurs within _____ of neuronal injury, and phagocytosis of the degenerating myelin occurs over _______

A
  • 2–3 days - the next several weeks
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10
Q

Proliferation of astrocytes leads to a reactive gliosis in ______

A

by one week

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11
Q

Reactive astrocytes and microglial have_____ cytoplasm

A

hypertrophied

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12
Q

Total CSF volume is ______, of which ____ are within the ventricles

A
  • 150 ml - 25 ml
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13
Q

____ ml of CSF are produced each day

A

500

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14
Q

Obstruction of CSF flow causes________ of the ventricles (hydrocephalus) proximal to the blockage

A

enlargement

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15
Q

an enlargement of one or more ventricles (ventriculomegaly) caused by an obstruction of the bulk flow of CSF

A

hydrocephalus

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16
Q

theventriculomegalythatresultsfroma loss of brain tissue (brain atrophy)

A

Hydrocephalus ex vacuo

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17
Q

common causes of hydrocephalus

A
  • Aqueductal stenosis - Dandy-Walker malformation - Chiari II malformation - Post inflammatory or post hemorrhagic hydrocephalus - tumors
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18
Q

may result from a congenitally malformed cerebral aqueduct or acquired

A

aqueductal stenosis

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19
Q

a hindbrain malformation showing downward extension of the cerebellar vermis through the foramen magnum

A

Chiari II malformation

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20
Q

Chiari II malformation is closely associated with ___________

A

lumbar meningomyelocele

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21
Q

Post-inflammatory or post-hemorrhagic hydrocephalus

A

inflammatory cells or hemorrhage may block the cerebral aqueduct (non-communicating hydrocephalus) or clog the subarachnoid space/arachnoid villi (communicating hydrocephalus).

22
Q

Describe this

A

Dandy–Walker malformation. Note the very hypoplastic inferior cerebellar vermis and the cystic dilatation of the fourth ventricle.

23
Q

blood brain barrier

A

Controls extracellular environment of brain by regulating the movement of molecules from the blood into brain’s extracellular space and into the CSF.

24
Q

________ between endothelial cells restrict inter-endothelial passage of molecules.

A

Tight junctions

25
Q

Lipid-soluble molecules are (not/restricted) by BBB.

A

not restricted

26
Q

Keeps blood-borne infectious agents out of brain and CSF; may impede drug delivery to the brain and CSF

A

blood brain barrier

27
Q

BBB breakdown leads to

A

increased capillary permeability.

28
Q

Extracellular edema mainly localizes to the _____

A

white matter.

29
Q

BBB breakdown may be visualized _________ with a________

A
  • radiologically
  • contrast agent
30
Q

Increased vascular permeability may lead to an increase in _______, which can be detected by lumbar puncture (LP) and CSF analysis

A

CSF protein

31
Q
A

mass effect

32
Q

an increase in brain volume due to an increase in fluid. The fluid may be extracellular or intracellular.

A

brain edema

33
Q

Brain edema accompanies many types of brain disease. Name some examples

A

trauma, infarcts, tumors, infections, inflammatory processes, hydrocephalus, water intoxication, and hepatic encephalopathy.

34
Q

Three types of brain edema

A
  • vasogenic
  • cytotoxic
  • interstitial
35
Q

extracellular edema due to increased permeability of brain capillaries (BBB breakdown).

A

vasogenic brain edema

36
Q

Vasogenic brain edema takes place mainly in the _____

A

white matter.

37
Q

intracellular edema due to an osmotic imbalance between the cell and the extracellular fluid.

A

cytotoxic cellular brain edema

38
Q

cytotoxic brain edema mainly happens in the ________

A

gray matter

39
Q

extracellular edema in periventricular white matter due to the transependymal flow of CSF in hydrocephalus.

A

interstitial/hydrocephalic brain edema

40
Q

what kind of edema

41
Q

type of edema

A

cytotoxic edema

42
Q

type of edema

A

interstitial edema

44
Q

ICP is the pressure inside the ________.

45
Q

Monro-Kellie hypothesis

A

The cranium has a fixed volume and contains CSF, blood, and brain. Any increase in volume of one component means that one or both other components must be reduced in volume to not increase pressure

46
Q

Increased ICP is evidenced clinically

A

by headache, nausea, vomiting, and papilledema (swelling of the optic disc).

47
Q

causes of increased ICP

A
  • mass lesion
  • hydrocephalus (communicating or non)
  • diffuse brain emergency
  • obstruction of a major dural venous sinus
  • idiopathic intacrainal hypertension
48
Q

as the ICP increased the CPP ___

A

decreases

(cerebral perfusion pressure)

49
Q

uncal herniation shows dilated ____contra/ips___ pupils
from compression of the parasympathetic fibers in cranial nerve ______

A
  • ipsilateral
  • CN III
50
Q

uncal herniation will result in contralateral ______ from compression of the ipsilateral cerebral peduncle

A

hemiplegia

51
Q

Coma, decerebration, abnormal respirations, and fixed, dilated pupils from compression of the upper brainstem are caused from

A

uncal herniation

52
Q

consequences of a mass lesion

A

Intracranial mass

Increased intracranial pressure

Decreased cerebral perfusion pressure

Global brain ischemia then death

OR

Brain herniation

Brainstem compression

Death

Neuro (27 decks)

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