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NMSP > Introduction to Neuropathology- Martin (part 1; hydrocephalus) > Flashcards

Introduction to Neuropathology- Martin (part 1; hydrocephalus) Flashcards

1
Q

what are neurons

A

these are the signal transmitting cells of the nervous system

they are permant and do not divide

dendrites recive the input and axons send the input out

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2
Q

cell bodies and dendrites can be seen on _ staining

A

Nissel staining

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3
Q

what are the neuron makers?

A

neurofilament protein and synaptophysin

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4
Q

an astrocyte is derived from _ and what does it do?

A

it is derived from neuroectoderom

it is a supporting cell that aids in repair, a resivor of fuel, aids in removal of neurotransmitter, and is a component of the blood brain barrier.

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5
Q

what is the astrocyte marker?

A

GFAP

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6
Q

astrocytes are _ in shape on nissel stain

A

oval

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7
Q

oligodendrocytes are _ in shape on nissel stain

A

round

fried egg appearance

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8
Q

what are oligodendrocytes?

A

these cells myelinate axons of neurons in the CNS

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9
Q

oligodentrocytes are derived from _

they are injured in what type of disease pathways

A

neuroectoderm

multiple sclerosism, progressive multifocal leukoencephalopthy, leurkodystrophies

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10
Q

what are schwann cells

A

cells that promote axonal regeneration

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11
Q

schwann cells are derived from?

A

neural crest

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12
Q

each schwann cells mylinates only _ PNS axon

A

1

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13
Q

schwann cells are incured in:

A

guillain barre syndrome

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14
Q

schwann cell marker

A

S100

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15
Q

acute neruonal injury is _ hours and is associated with _ neurons

A

12-24 hours

red neurons

this is the earliest morphologic indicator of acute insult

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16
Q

what are the morphologic changes in acute neuronal injury

A

shrinkage of the cell body, pyknosis, loss of the nucleolus, loss of nissl substance, INTENSE EOSINOPHILIA of the cytoplasm

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17
Q

what causes acute inury to neurons

A

hypoxia, hypoglycemia, trauma

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18
Q

what is pyknosis

A

condensation of the chromatin in a nucleus

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19
Q

what is the best indicator of neuronal injury

A

subacute/chronic degeneration

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20
Q

what happens in subacute/chronic neuronal injury

A

there is progressive degeneration of cells and reactive gliosis, apoptosis

gliosis is the fibrous proliferation of glial cells in an area of injury

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21
Q

what causes subacute/chronic neuron damage

A

protein accumulation, ALS, alzheimers

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22
Q

when neurons are damaged what is the response of the axons?

A

increased protein synthesis with axonal sprouting

  1. enlarging of the cell body
  2. peripheral displacement of the nucelus
  3. enlarged nuclolus
  4. nissl shifted to the periphery
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23
Q

what is central chromatolysis

A

shifting of nissl and nucleus from the center of the cell to the periphery

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24
Q

what is nissl substance

A

a reticulum network in neurons that is involved in protein synthesis and cellular metabolism

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25
Q

in neuronal injury there are neuronal inclusions that occur, what are the intraCYTOPLASMIC inclusions

A

lipofuscin, proteins and carbohydrates

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26
Q

rabies has what cytoplasmic inclusions

A

negri bodies

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27
Q

alzheimers has what cytoplasmic inclusions

A

neurofibillary tangles

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28
Q

parkinsons has what cytoplasmic inclusions

A

lewy bodues

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29
Q

what cytoplasmic inclusions does CJD have?

A

vacuolization of perikaryon and neuronal processes

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30
Q

what are some intra NUCLEAR inclusions

A

herpes COWDRY bodies

CMV inclusions

cmv has inclusions in the nucleus and the cytoplasm

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31
Q

gliosis also known as _ is the most important histopathologic indicator of _ injry

A

astrogliosis

CNS injury (acute or subacute)

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32
Q

what is gliosis

A

hypertrophy and hyperplasia of astrocytes

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33
Q

astrocytes act as _ buffers and _ in the brain (their foot processes contribute to the BBB)

A

metabolic buffers

detoxifiers

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34
Q

what are gemistocytes

A

this is when astrocytes enlarge their nuceli, become vescular and develop a prominite nucleoli

the cytoplasm will expand and become a bright pink color that will dislocate the nucleus to the side

glial cell; a reactive astrocyte

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35
Q

what is a alz type 2 astrocyte

A

this is an astrocyte in wilsons disease, hyperammonimia etc. that is a gray matter cell, it has a large nucleus, pate stainng chromatin, glycogen droplets, and prominent nuclear stuctures

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36
Q

what pathologic processes have ALZ type 2 astrocytes

A

hyperammonemia, wilsons disrase, hereditary metbaolic disorders of the urea cycle

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37
Q

what are rosenthal fibers

A

thick pink irregular structures in astrocytic procsess

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38
Q

rosenthal fibers contains?

A

2 heat shock proteins
B-crystalline and HSP27

and ubquitin

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39
Q

longstanding areas of gliosis is assocaited wtih _ fibers and is seen in what disease process

A

rosenthal fibers

seen in pliocytic astroctyoma

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40
Q

alexzander disease characterisitcs (4)

A

leukodystrophy

periventricular, perivascular, and subpial rosenthal fibers

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41
Q

what is the corpora amylacea

A

these are polygucosan bodies that stain postiviely for PAS+

round basophilic strictures that are adjacent to astrocytic endo processes

variant of astrocytes
-associated with aging and neurodegenerative disease

42
Q

what is the corporea amyleacea comprised of

A

glycosaminoglycans, heat shock proteins, and ubiquitin

43
Q

corpora amylacea is representative of _ change

A

degenerative

the number of bodies increases as age increases

44
Q

what are microglia

A

macrophages of the CNS

45
Q

microglia are derived from

A

mesoderm of phagocytic cells

46
Q

what are the surface markers of microglia

A

CD68 and CR3

47
Q

microglia respond to injury by?

A

proliferating
developing elongated nuceli (neurosyphillis)

forms microglial nodules and neuronophagia

48
Q

what are microglial nodules

A

these are microglia aggregates around areas of necrosis

49
Q

what is neuronophagia

A

this is when microglia will aggregate around the cell bodies of dying neurons

50
Q

oligodendrocytes are harmed in _ disorders and _

A

demylinating disorders

and

leukodystrophies

51
Q

what is PML

A

this is a progressive multifocal leukoencepalopathy with intranuclear inclusions

52
Q

what is MSA

A

multisystem atrophy that has glial cytoplasmic inclusions (a synuclein)

53
Q

ependymal cells normally line _ and are _ _ cells. BUT in times of injury they form ?

A

ventricles

ciliated columnar

ependymal granulations

54
Q

what are ependymal granulations

A

disruption of the ependymal lining and proliferation of subependymal astrocytes. (irregularities on ventricular surfaces)

55
Q

_ damages ependymal cells

viral process

A

CMV

56
Q

cerebral edema is?

A

the accumulation of fluid in the brain parenchyma

57
Q

what is vasogenic edema

A

an increased in extracellular fluid due to BBB disrutption and increased vascular permeability

58
Q

in vasogenic edema there is a shift of fluid from a _ compartment to _ spaces

A

intravascular

intercellular spaces

59
Q

in vasogenic edema paucity of _ impairs resporption of excess extracellular fluid

A

lymphatics

60
Q

vasogenic edema often follows what

A

ishemic injury

61
Q

what is cytotoxic edema

A

an increase in intracellular fluid secondary to neuronal, glial, or endothelial injury

generalized ischemic insult or metabolic derrangment

62
Q

either cytotoxic or vasogenic edema can flatten the gyri, narrow the sulci, compress the ventricles, and lead to _

A

herniation

63
Q

hydrocephalus is a response to?

A

increased CSF in the ventricles

increase in ventricle size proportunate to fluid volume

64
Q

what absorbs CSF in hydrocephalus

A

the transventricular and nerve root sleeves

65
Q

what dilates in hydrocephalus

A

frontal and temporal horns

  • also ventricles
66
Q

what elevates in hydrocephalus

A

corpus callosum

67
Q

what thins in hydrocephalus

A

cerebral mantle

68
Q

what stretches/perforates in hydrocephalus

A

septum pellucidum

69
Q

what enlarges in hyrodcephalus

A

third venrtile and downwards

70
Q

what is a result of intracranial pressure in hydrocephalus

A

papilledema

71
Q

what is the pathogensis of hydrocephalus

A

increased production of the choriod plexus papilloma

obstruction

and decreased absorption

72
Q

describe the obstruction pathogenesis of hydrocephalus

A

it can be congenital

can be secondary to infections

can be clots or tumors in the intraventriular foramina

73
Q

describe the absoprtion pathogenesis in hydrocephalus

A

there is decreased absorption due to an outflow obstruction

74
Q

what does the histololgy of a choroid plexus papilloma look like

A

thick fibrous core/stalk

looks kinda like broccoli

75
Q

what is pyogenic meningitis

A

this is when suupurative exudate cover the brainstem and cerebellum

76
Q

what are some congenital causes of hydrocephalus

A

TORCH CAAAD

Torch (intraunterine infections)

C- cranial defects (achondroplasia, craniostenosis)

A- ageneisi/atresia

A- arnold chiari

A- AV malformation

D- dandy walker syndrome

77
Q

what are some reasons for acquired hydrocephalus

what vitamin?

A

infection- meningitis, meninigoencephalitis

mass lesions- neoplasms

inflammation- abcess

post-hermorrhage

sagital sinus thrombosis

hypervitaminosis A

idiopathic

78
Q

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

A

communicating

79
Q

in communicating hydrocephalus the ventricles are _

A

symmetrical

80
Q

what is an example of a pathologcal process that has communicating hydrocephalus

A

neurosyphillis and arachnoid fibrosis

meningitis

81
Q

what is human cysticerosis

A

this is ingestionof T solium eggs from fecal contamination that causes calcified cysts in the brain along with hydrocephalus

82
Q

_ stenosis can cause hydrocephalus

A

aqueductal

83
Q

what is hydrocephalus ex- vacuo?

A

dilation of the ventricles

shrinking og the brain substance

atrophy (frontal)

84
Q

what causes hydrocephelus ex-vacuo

A

atrophy

stroke

chronic neurodegenerative disorders (like huntingtons or alzhemiers)

85
Q

CSF pressure in hydrocephalus ex-vacuo is?

A

normal

86
Q

what is normal pressure hydrocephalus? (NPH)

A

this is a SYMMETRIC type of hydrocephalus that is in people older than 60. It develops slowly overtime and occurs when CSF drainage is blocked gradually

there CSF pressures are not as elevated as like in other types

87
Q

symptoms of NPH

A

dementia like manifestations

gait distubrance

urinary incontinence

88
Q

dementia due to NPH can be similar to that of _ disease

A

alzheimer disease

89
Q

gait abnormalities in NPH may suggest _ disease

A

Parkinsons

90
Q

NPH is sometines misdiagnosed for what disorders?

A

parkinsons or alzhemeimers

91
Q

the neurological manifestations of NPH can or cannot be reversed

A

can

92
Q

two types of NPH

A

idiopathic and secondary

93
Q

secondary NPH is caused by?

A

subarachnoid hemorrhage, head trauma, tumor, infection

94
Q

NPH is the elderly is mostly of the _ type

A

idiopathic

95
Q

what is the classic triad of clinical findings in NPH

A

urinary incontinence, gait disturbance, and dementia

(wet, wacky, and wobbly_

gait distubrances (initial symptom)

96
Q

parkinsonian gait is seen in NPH what is this

A

short, shuffling steps and forward leaning posture, they have a tendency to fall backwards and broad based gait

magnetic gait

97
Q

dementia in NPH is predominately in the _ lobe

A

frontal lobe

has lead to the misdiagnosis of Alzheimer disease

98
Q

in NPH there may be an obvious discrepancy between impaired _ and intact or much less impaired _

A

recall

recognition

99
Q

NPH dementia is though to result from traction on frontal and _ fibers that run in the _ region

A

limbic

periventricular

100
Q

urinary incontinence in NPH appears _ in the illness and is generally of spastic hyperreflexic, increased-urgency type associated with decreased _ of bladder contractions and _ instability

A

later

inhibition

detrusor

NMSP (13 decks)

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