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NMSP > Introduction to Neuropathology- Martin (part 2) > Flashcards

Introduction to Neuropathology- Martin (part 2) Flashcards

1
Q

increased ICP (intracranial pressure) is generally due to?

A

generalized brain edema- more common

expanding mass lesion- more common

also increased CSF volume

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2
Q

herniation in the brain is ?

A

increased pressure beyond the compensatory ability of the venous system to compress + displacement of the CSF

tissue will protude past the rigid dural folds or through the openings in the skull

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3
Q

what is a subfalcine (cingulate) herniation

A

this is when the cigulate gyrus is displaced under the FALX

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4
Q

what is transtentorial herniation (uncinated, uncal)

A

this is when the medial aspect of the temporal lobe is compressed against the tenorium

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5
Q

what happens in a transtentorial herniation

A

CN III is compressed and leads to a dilated pupil and impaired eye movement

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6
Q

tonsillar herniation is ?

A

when the cerebrellar tonsils are displaced through the foramen magnum this is life threatening!!

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7
Q

what does tonsillar herniation lead to?

A

respiratory and cardiac center compression

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8
Q

increased cranial pressure sign

A

papilledema

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9
Q

what is papilledema and the signs of ICP

A

this is due to increased intracranial pressure and the **subarachnoid space expands **with increased csf pressure

signs: headache, n/v, lethargy, change in pupil reaction, seziures, ataxia, papllidema, false localizing signs

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10
Q

what is kernohans notch phenomenon?

A

this is when a transtentorial herniation causes the cebrebral peduncle compresses against the tentorium cerebelli

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11
Q

kernohans notch phenomenon creates a visible notch in the _ _ and it is caused by an injury creating pressure on the _ hemisphere of the brain , it is characterized by a _ _ _

A

cerebral peduncle

opposite

false localizing sign

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12
Q

the kernohans notch phenomenon is unique in that it is not only a _ _ _ but its also _

A

false localizing sign

ipsilateral

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13
Q

if you have a right hemisphere tran-tentorial herniation the notch is on the _ cerebral peduncle and there is a _ side motor impairement

A

left

right

notch on the contralateral side

motor impairement on the same side

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14
Q

what is a duret hemorrhage

A

progression of a transtentorial herniation that is accompanied by hermorhagic lesions in the midbrain and pons!

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15
Q

what is the difference between a central transtentorial and an uncal transtentorial herniation

A

central: downwards displacement of the diencephalon and brainstem

uncal: inferior displacement of the medial temporal llobe past the free edge of tentorium cerebelli (kernohan’s notch phenomenon)

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16
Q

hypoxia

A

low partial pressure of oxygen

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17
Q

ischemia

A

carrying capacity of oxygen in the blood is impaired or there is inhibition of oxygen use

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18
Q

infarct

A

necrosis from insufficinecy of blood supply

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19
Q

cessation of blood flow may be due to?

A

decreased perfusion pressure (hypotension)

small vessel or large vessel obstruction

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20
Q

how does hypoxia present in purkinje cells

A

shrunken eosinophilic and pyknotic

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21
Q

how does hypoxia look in sommers sector (CA1)

A

this is in the hippocampus and it presents with a decreased number of cells

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22
Q

what is necrosis

A

denaturation of intracellular proteins and enzymatic digestion of lethally injured cells

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23
Q

in necrosis where are the enzymes that are killing the dying cells coming from?

A

they are coming from the dying cells themselves

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24
Q

liquifactive necrosis?

A

digestion of tissue into liquid viscous mass with NO structural remnants

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25
Q

where does liquefative necrosis occur?

A

in the CNS and bacterial infections

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26
Q

what is present in a cerebral infarct

A

red neurons, neutrophils, lymphocytes, macrophages, neovvascularization, tissue loss, gliosis missing neuropils

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27
Q

what is a hygroma?

A

this is the seperation of arachnoid from the dura due to an old infarct contracting the underlying brain parenchyma and degrading it (fulid filled hole)

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28
Q

an old cystic infart shows?

A

decretuction and cavitation

29
Q

both _ and _ influences are involved in malformations and developmental disorders of the brain

A

genetic and environmental

toxic compounds, medications, drugs

30
Q

the _ the malformation occurs the more severe the phenotype

A

earlier

31
Q

what are the most common malformations/developmental disorders of the brain

A

neural tube defects
forebrain anomalies
psoterior fossa anomalies
syringomyelia and hydromyelia

32
Q

what are neural tube defects

A

when a portion of the neural tube fails to close or repopens (accounts for most CNS malformations)

33
Q

what are neural tube defects caused by

A

folate deficiency

34
Q

neural tube closure is normally complete by day?

A

28

35
Q

what is spinal dysraphism/spina bifida?

A

this is fallttened disorganized segment of cord associated with a meningial pouch

oculta: bony defect

36
Q

what is myelomeningocele and meninigomyelocele

what is is associated with?

A

extension of the CNS tissue/cord through an open defect in the spine

menigiomyelocle: just meningies poke through

arnold chiarai II

37
Q

what are the symptoms of a myelomeningocele

A

Motor/sensory deficits of LE, bowel and bladder control problems, infections through the thin coverings of the cord

38
Q

myelomeningoceles are most common in what locations?

A

lumbosacral

39
Q

arnold chiari II is?

A

when cerebellar and brainstem tissue herniate through the foramen magnum and cause symptoms like hydrocephalus

40
Q

what is a encephalocele

A

this is a diverticulum of disorganized brain tissue that will extend through the posterior fossa or other portion of the cranium

41
Q

an encephalocele can cause a _ _ which is extension of brain tissue through the cribiform plate

A

nasal glioma

42
Q

what is ancencephaly

  • what is disrupted from developing
A

this is when most of the brain and calvarium is gone and forebrain development has been disrupted during the 28 day period

43
Q

ancencephaly has areas of cerebrovasculosa which is?

A

portions of disorganized and flattened brain renmants, with ependymal , choriod, and meningothelial cells

44
Q

the time of onset of prenatal injury predicts the type of maldevelopment that will occur

1st trimester
2nd trimester
3rd: trimester

A

1st: neural tube defects (encephalocele and anencephaly, holoprosencephaly)

2nd: neural proliferation and migration (lissencephalia and micro/magalogyria)

3rd: neural organization and myelination

45
Q

what is holoprosenphaly

A

single ventricle with olfactory and optic nerve disturbances

the proencephalon doesn’t divide into 2

46
Q

what is microcephaly

megalocephaly

A

microcephaly- decrease in neurons

megalo- increase in neurons

2nd trimester maldevelopment

47
Q

what is lissencephalia

A

when the gyri dont form (issue with migration in 2nd trimester)

smooth brain

48
Q

what is hydranencephaly

A

this is cranial cavity with a cystic sac from interuptions in intrauterine cerebral flow

babies cerebral hemispheres are replaced by sacs of fluid- due to interuppted interuterine cerebral flow

49
Q

thrd trimester development with neural organization and myelination if defective can result in

A

seizures

50
Q

what is arnold chiari malformation

A

a congenital malformationof the hind brain that causes posterior fossa structures to displace downward into the spinal canal (posterior fossa is small)

can cause headaches

51
Q

forebrain anomlies are abnormalities in _ and _ seen usually in the second trimester

what are the forebrain anomlies

A

generation and migration of neurons

megalo/micocephaly
lissencephaly
polymicrogyria
neuronal hetertopias
holoprosencephaly
agenesis of the corpus callosum

52
Q

what is megalo/microcephaly

what causes microcephaly (3)

A

increase of decrease in neurons in the neocortex

fetal alcohol syndrome, HIV-1, zika virus

micro-small head

53
Q

lissencephaly

A

decreases number of gyri smooth/cobblestone appearance

54
Q

agyria

A

no gyri

55
Q

polymicrogyria

A

many small irrgular formed convolutions with less than 4 gray matter layers with entrapment of meningeal tissue

normally 6 layers

56
Q

what are neurona; heterotopias and what are they commonly associated with?

A

collections of neurons in innaproriate places during migration

common in epilepsy

heterotopia= harmatoma

57
Q

lissencephaly in _ and subcortical band heteropias is _

A

males

females

58
Q

arrhineceophaly

A

absence of olfactory cranial nerves

59
Q

agenesis of the corpus collosum appearance

symptoms

A

bat wing (lateral ventricles)

intellectual disability

60
Q

what is an arnold chiari malformation

A

this is a small posterior fossa divided into 2 types of malformations

Type I and Type II

61
Q

what is chiari type II

A

severe malformation that occurs when there is downward extensions of the vermis thorugh the foramen magnum (large)

62
Q

chiari type II is mostly aossociated with?

A

lumbar myelomeningocele

hyrodecephalus

63
Q

what is chiari type I

A

cerebellar tonsils extended down the vertebral canal and are silent

64
Q

chiari type I can be symptomatic when?

A

if it impairs CSF flow

65
Q

what is dandy-walker syndrome malformation

A

this is when there is an enlarged posterior fossa with an expanded 4th ventricle and it allows for superior displacement

there is no vermis but cysts instead

66
Q

what is joubert syndrome

A

hypoplasia of the vermis with elongation of cerebellar peduncles and altered brainstem shape (molar tooth sign)

molar tooth- superior cerebellar peduncles pulled downward

67
Q

what is syringomyelia

A

a fluid filled cleft like cavity in the inner portion of the cord

interrupts fibers that cross through the white commisure

68
Q

sx. of a syrinx (syringomyelia)

A

pain and temperature sensation loss of the upper extremities

bilateral!!!

69
Q

what is a hydromyelia

A

expansion of the ependymal-lined central canal of the cord

NMSP (13 decks)

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