Nervous System Pathology Flashcards

1
Q

Revise cell death, neoplasia, inflammation, & repair in the nervous system

A
  • Benign turmous cant kill us except in the brain
  • malignat tumours kill us by metastasing -> in the brain the do in the CNS they don’t
  • Glioblastomas is not a childhood cancer they occur in adults unlike other blastomas, the most common primary cancer of the CNS.
  • Inflammation: Acute is a part of the repair process but it can kill us in the brain because it’s a closed system and it increases ICP.
  • repair is not granulation tissue it is glial cells
  • if we get apoptosis it is irreversible in brain
  • if we get necrosis we heal through organisation
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2
Q

Purpose of Myelin

A

to insulate the axon and speeds up nerve impulses

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3
Q

Demyelination causes what

A

The nerve impluses slow down until its lost

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4
Q

Subarachnoid Haemotomas

A

below arachnoid…

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5
Q

Subdural Haematomas

A
  • frequently results from tearing of the bridging veins between the dura mater and arachnoid layers
  • veins tear due to displacement of the skull
  • elderly w atrophied brain more at risk
  • subdural haematomas progress more slowly w vauge symptoms
  • large tears put pt at risk of herniation & death dueto increased ICP
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6
Q

Epidural Haematomas

A
  • usually results from rupture of fural arteries
  • usually high arterial pressure results in rapid accumulation of blood/haematoma between the skull & duera
  • in some cases blood accumulates slowly
  • high areterial pressure results in rapid accumulation of blood/haematoma betwen the skull and dura
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7
Q

CFS in pyogenic (acute bacterial) Meningitis

A

bacteris is extracellular causing strong acute response. CFS is pusy or cloudy. bacteria is using up all the glucose ->hypoglycaemia and lots of protein

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8
Q

CFS in viral meningitis

A

don’t often see any changes you may get lymphocytes and a slight rise in proteins. clear CFS

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9
Q

What is meningitis

A

an inflammation of the fluid (CFS) and membranes (meninges) surrounding your brain and spinal cord. (CNS)

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10
Q

How does ageing impact the CNS?

A
  • major risk factor for atherosclerosis

- increases incidence for: metastatic cancers, alzheimers, parkinsons’s disease

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11
Q

What is meningitis

A

an inflammation of the fluid (CFS) and membranes (meninges), meningeal layers) surrounding your brain and spinal cord. (CNS)

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12
Q

What occurs on a cellular level when tissues undergo atrophy?

A

Atrophy involves autophagy (cell shrinkage/self-eating) & apoptosis (programmed cell death). As we age, autophagy is usually impaired, so we just see apoptosis.

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13
Q

Causes of Brain Atrophy:

A
  • Age related atrophy (inevitable), can be accelerated by alcohol/drug abuse, vascular disease caused by smoking, hypertension, hyperlipidaemia, diabetes, visceral & central obesity
  • SOL that accumulates slowly e.g. tumour
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14
Q

What does Brain atrophy predispose us to?

A

as brain atrophoes we make more CSF so that the volume within the skull remains constant, but the brain is now able to move more within the skull predisposing us to subdural hematomas

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15
Q

Is meningioma an example of benign or malignant tumour?

A

Benign but as its in the brain it can still be lethal

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16
Q

What is the most common malignat tumour of the CNS?

A

In children astrocytoma is the 2nd most common cancer overall (leukaemia is the most common).
In adults, ~50% are metastatic cancers usually carcinomas or melanomas & ~50% are glioblastoma

17
Q

What occurs in the normal brain tissue surrounding the tumour and are these cellular changes reversible?

A

Tumours cause secondary oedema and raise intracranial pressure. Because this occurs gradually the brain undergoes atrophy, the cells undergoing apoptosis. This is not reversible as the lost neurons cannot be replaced. Should the tumour be excised, the space will be filled with glia or CSF.

18
Q

What further complication may occur when there is necrosis and bleeding within the tumour in the brain?

A

Necrosis, bleeding, and the subsequent inflammation can lead to a sudden increase in intracranial pressure that may lead to fatal herniation of the brain.

19
Q

In cases when the tumour is inoperable, do you think that it is adventurous to have a tumour with a high or low mitotic rate?

A

If the patient is not receiving radiotherapy a slow growing tumour will mean a longer life.
If radiotherapy is being used, a fast-growing tumour will be more responsive to treatment.

20
Q

Why is the brain often affected with metastatic cancers?

A

Arterial blood. The brain is very metabolically active and therefore recieved a lot of artieral blod

21
Q

What intracranial pathology might be expected from a case of trauma to the head?

A

Epidural, subdural, subarachnoid haematoma, intracerebral haemorrhage, cerebral contusion, and laceration, coup-contrecoup injury, diffuse brain (axonal) injury, concussion.

22
Q

what is a stroke

A

necrosis in teh brain from ischemia or haemorrhage resulting in altered brain function

23
Q

Risks predisposing to atherosclerosis?

A

diabetes, increasing age, male, menopause in females, smoking, systemic hypertension, hyperlipideamia/dyslipidaemia

24
Q

Chronic conditions that atherosclerosis of the cartoid & cerebral arteries can cause

A
  • vascular dementia
  • sub-dural hematomas
  • tearing of bridging veins -> increases ICP -> herniation & death
  • ischaemis stroke
  • ‘mini-strokes’ or TIAs -> atrophy & dementia
25
Q

Acute conditions that atherosclerosis of the cartoid & cerebral arteries can cause

A
  • thrombus -> ischaemic stroke
  • thrombus -> embolus -> ischaemich stroke
  • aneurysm -> atrophy or -> rupture -> haemorrhagic stroke -> herniation & death
26
Q

List four ways in which the brain and meninges may become infected (meningitis)

A
  • trauma/surgery
  • through blood
  • extension form local sites e.g. ears, eyes, sinus infection
  • via PNS
27
Q

What is Encephalitis

A

Inflammation of brain tissue from infection or autoimmune response