Intro to Neuropathology - Fremont Smith

Question 1

toxic/metabolic causes of neuropath

Answer 1

DEENO

drugs, endo, electrolytes, nutrition, organ failure

Question 2

acute and urgent

Answer 2

trauma and vascular issues

Question 3

sub-acute and urgent

Answer 3

epilepsy

Question 4

chronic and urgent

Answer 4

hydrocephalus

Question 5

pain

Answer 5

only meninges have pain fibers

Question 6

crossed effect

Answer 6

brainstem lesion

-head and limbs C/L symptoms

Question 7

relapse and remission over years

Answer 7

multiple sclerosis

Question 8

loss of mental power

Answer 8

dementia - not disease entity

-can happen with any pathology causing brain damage

Question 9

blood on CT

Answer 9

bright white

fibrinolysis - clot isodense with brain at 1 week
hypodense week 2-3

density of clot -used to date and time bleed

Question 10

CT scan

Answer 10

hypodense - black - air, fat - dark grey - water

hyperdense - white - bone and blood

Question 11

“blood can be very bad”

Answer 11

blood
cisterns
brain
ventricles
bones

Question 12

lens shape

Answer 12

epidural

Question 13

crescent shape

Answer 13

subdural

Question 14

cistern

Answer 14

opening of SA space of brain created by separation of arachniod and pia mater

look if blood or if cistern open - on CT scan

4 key cisterns - circummescencephalic, suprasellar, quadrigeminal, sylvian

Question 15

brain exam on CT

Answer 15

symmetry
grey-white differentiation - early sign of CVA
shift
hyperdensity - lighter / hypodensity - darker

Question 16

ventricles on CT

Answer 16

look for 3rd, 4th, and lateral ventricles - dilation or compression

Question 17

bone on CT

Answer 17

white - hyperdense

-look for fractures

Question 18

ring lesion

Answer 18

on CT - white around lesion - from neovascularization

Question 19

MRI of brain

Answer 19

T1 - like CT scan

T2 - water bright - seem edema, gliosis, and gray matter prominent

Question 20

flair MRI

Answer 20

to make CSF dark - for small abnormalities

Question 21

spiral CT

Answer 21

with contract - to view blood vessels

Question 22

MRA

Answer 22

magnetic resonance angiography

• gadolinium to enhance contrast
• method of choice for vessel narrowing, thrombosis, and dissection**

Question 23

CNS myelin

Answer 23

oligodendrocytes

Question 24

PSN myelin

Answer 24

schwann cells

Question 25

neuropil

Answer 25

extracellular space of brain | -axons, dendrites, and collections

Question 26

empty space around neuron

Answer 26

can be just artifact

Question 27

nissl substance

Answer 27

seen in the cell body of neuron only | -rough ER

Question 28

silver stain

Answer 28

shows axons and dendrites

Question 29

axon severed - first change seen

Answer 29

nissl to periphery - chromatolysin**

Question 30

neocortex layers

Answer 30

MGP GPM ``` 1-molecular 2-external granular 3-external pyramid 4-internal granular 5-internal pyramid 6-multiform ```

Question 31

cerebral cortex

Answer 31

3 parts - archicortex - limbic system to cortex - paleocortex - to olfactory system - neocortex - 90%

Question 32

central chromatolysis

Answer 32

if axon severed - nissl granule dissintegrate - neuron body balloons reversible change that develops during repair of neuron that has been disconnected from target

Question 33

red neuron

Answer 33

irreversible - hypoxia, ischemia, hypoglycemia neuron shrink, become eosinophilic (mito condense), nuclei pyknotic aka anoxic neuron

Question 34

tau protein

Answer 34

in microtubule of axon

Question 35

T lymphocytes

Answer 35

can cross BBB

Question 36

astrocytic processes

Answer 36

help maintain BBB 10x more astrocytes than neurons

Question 37

GFAP

Answer 37

stain for astrocytes -glial fibrillary acidic protein

Question 38

indicator of chronic CNS injury

Answer 38

gliosis - astrocyte hyperplasia and hypertrophy

Question 39

microglial cells

Answer 39

CNS macrophages

Question 40

death of neuron

Answer 40

12-24 hours - as red neuron

Question 41

glia limitans

Answer 41

interdigitating astrocytic process on surface of cortex -around vessels - until become caps allow inflammation to get into brain parenchyma

Question 42

hepatic encephalopathy

Answer 42

get alzheimer type II astrocytes indicate cerebral edema increased ammonia - injures brain

Question 43

six causes of dementia

Answer 43

``` stroke and ischemic encephalopathy hippocampal sclerosis head trauma hydrocephalus CNS infection metabolic CNS disorder demyelinating disease neurodegenerating disease neuropsych disorder severe medical illness or organ failure ```