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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
where does liquefative necrosis occur?
in the CNS and bacterial infections
26
what is present in a cerebral infarct
red neurons, neutrophils, lymphocytes, macrophages, neovvascularization, tissue loss, gliosis missing neuropils
27
what is a hygroma?
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)
28
an old cystic infart shows?
decretuction and cavitation
29
both _ and _ influences are involved in malformations and developmental disorders of the brain
genetic and environmental ## Footnote toxic compounds, medications, drugs
30
the _ the malformation occurs the more severe the phenotype
earlier
31
what are the most common malformations/developmental disorders of the brain
neural tube defects forebrain anomalies psoterior fossa anomalies syringomyelia and hydromyelia
32
what are neural tube defects
when a portion of the neural tube fails to close or repopens (accounts for most CNS malformations)
33
what are neural tube defects caused by
folate deficiency
34
neural tube closure is normally complete by day?
28
35
what is spinal dysraphism/spina bifida?
this is fallttened disorganized segment of cord associated with a meningial pouch oculta: bony defect
36
what is myelomeningocele and meninigomyelocele what is is associated with?
extension of the CNS tissue/cord through an open defect in the spine menigiomyelocle: just meningies poke through arnold chiarai II
37
what are the symptoms of a myelomeningocele
Motor/sensory deficits of LE, bowel and bladder control problems, infections through the thin coverings of the cord
38
myelomeningoceles are most common in what locations?
lumbosacral
39
arnold chiari II is?
when cerebellar and brainstem tissue herniate through the foramen magnum and cause symptoms like hydrocephalus
40
what is a encephalocele
this is a diverticulum of disorganized brain tissue that will extend through the posterior fossa or other portion of the cranium
41
an encephalocele can cause a _ _ which is extension of brain tissue through the cribiform plate
nasal glioma
42
what is ancencephaly - what is disrupted from developing
this is when most of the brain and calvarium is gone and forebrain development has been disrupted during the 28 day period
43
ancencephaly has areas of cerebrovasculosa which is?
portions of disorganized and flattened brain renmants, with ependymal , choriod, and meningothelial cells
44
the time of onset of prenatal injury predicts the type of maldevelopment that will occur 1st trimester 2nd trimester 3rd: trimester
1st: neural tube defects (encephalocele and anencephaly, holoprosencephaly) 2nd: neural proliferation and migration (lissencephalia and micro/magalogyria) 3rd: neural organization and myelination
45
what is holoprosenphaly
single ventricle with olfactory and optic nerve disturbances ## Footnote the proencephalon doesn't divide into 2
46
what is microcephaly megalocephaly
microcephaly- decrease in neurons megalo- increase in neurons ## Footnote 2nd trimester maldevelopment
47
what is lissencephalia
when the gyri dont form (issue with migration in 2nd trimester) ## Footnote smooth brain
48
what is hydranencephaly
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
thrd trimester development with neural organization and myelination if defective can result in
seizures
50
what is arnold chiari malformation
a congenital malformationof the hind brain that causes posterior fossa structures to displace downward into the spinal canal (posterior fossa is small) ## Footnote can cause headaches
51
forebrain anomlies are abnormalities in _ and _ seen usually in the second trimester what are the forebrain anomlies
generation and migration of neurons megalo/micocephaly lissencephaly polymicrogyria neuronal hetertopias holoprosencephaly agenesis of the corpus callosum
52
what is megalo/microcephaly what causes microcephaly (3)
increase of decrease in neurons in the neocortex fetal alcohol syndrome, HIV-1, zika virus ## Footnote micro-small head
53
lissencephaly
decreases number of gyri smooth/cobblestone appearance
54
agyria
no gyri
55
polymicrogyria
many small irrgular formed convolutions with less than 4 gray matter layers with entrapment of meningeal tissue normally 6 layers
56
what are neurona; heterotopias and what are they commonly associated with?
collections of neurons in innaproriate places during migration common in epilepsy heterotopia= harmatoma
57
lissencephaly in _ and subcortical band heteropias is _
males females
58
arrhineceophaly
absence of olfactory cranial nerves
59
agenesis of the corpus collosum appearance symptoms
bat wing (lateral ventricles) intellectual disability
60
what is an arnold chiari malformation
this is a small posterior fossa divided into 2 types of malformations Type I and Type II
61
what is chiari type II
severe malformation that occurs when there is downward extensions of the vermis thorugh the foramen magnum (large)
62
chiari type II is mostly aossociated with?
lumbar myelomeningocele hyrodecephalus
63
what is chiari type I
cerebellar tonsils extended down the vertebral canal and are silent
64
chiari type I can be symptomatic when?
if it impairs CSF flow
65
what is dandy-walker syndrome malformation
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
what is joubert syndrome
hypoplasia of the vermis with elongation of cerebellar peduncles and altered brainstem shape (molar tooth sign) ## Footnote molar tooth- superior cerebellar peduncles pulled downward
67
what is syringomyelia
a fluid filled cleft like cavity in the inner portion of the cord interrupts fibers that cross through the white commisure
68
sx. of a syrinx (syringomyelia)
pain and temperature sensation loss of the upper extremities ## Footnote bilateral!!!
69
what is a hydromyelia
expansion of the ependymal-lined central canal of the cord

NMSP (13 decks)

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