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gen path final > Neuropath 1 > Flashcards

Neuropath 1 Flashcards

1
Q

Most common change of neurons associated with hypoxia/ischemia:

A

eosinophilic (red) neurons

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2
Q

what is “Nissl substance”?

A
  • granular basophilic material found in NEURONS

- act like a Rough endoplasmic reticulum

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3
Q

what physiological changes cause red neurons?

A

Loss of ribonucleo-proteins, and denaturation of cytoskeletal proteins

(results in cytoplasmic eosinophilia and nuclear pyknosis )

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4
Q

_________ are the major supporting cells in the brain.

How do these cells respond to injury?

A

Astrocytes

  • Responds to injury by proliferation
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5
Q

______________ (a response to injury from Astrocytes) is analogous to fibrous scar

A

Reactive gliosis

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6
Q

During reactive gliosis, Astrocyte cytoplasmic processes are highlighted by _______________

A

glial fibrillary acidic protein (GFAP)

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7
Q

what is the role of oligodendrocytes?

A

Formation and maintenance of central myelin

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8
Q

injury to oligodendrocytes results in what?

A

demyelinating diseases

(e.g. multiple sclerosis

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9
Q

_________________ is a neoplasm of oligodendrocytes

A

oligodendroglioma

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10
Q

__________ cells line the ventricles of the brain.

what is a neoplasm of these cells called?

A

Ependymal cells

neoplasm = Ependymoma

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11
Q

what do Microglia cells appear as in histo slides? what is their role?

A
  • appear as rod cells

Functions:

  • antigen presenting during inflammation
  • Neurophagia (eat up neurons) during injury
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12
Q

what is the result of acute neuron damage?

A

** break down in bloodbrain barrier **

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13
Q

what are Rosenthal fibers ? what produces them? when are they produced?

A
  • Rosenthal fibers = protein aggregates
  • made by astrocytes
  • response to inflammation
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14
Q

how to microglial cells respond after neural injury?

A

A) Microglial nodules
B) neurophagia-at injured sites

(Microglia = Bone marrow derived, CNS phagocytes)

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15
Q

what is the Choroid Plexus ? what does it produce? where is it found?

A
  • made of modified EPENDYMAL cells
  • Produces cerebrospinal fluid (CSF)
  • Intraventricular in location
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16
Q

what is the term for a neoplasm of the Choroid plexus

A

Choroid plexus PAPILLOMA

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17
Q

_______________ is defined as an increased water content within brain parenchyma .

what can cause this condition

A

Cerebral Edema (Brain swelling)

  • caused by: trauma, hypoxia, tumor, infection
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18
Q

what % of patients with brain injuries have cerebral edema?

A

75%

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19
Q

Cerebral edema is the major cause of elevated ______________

A

elevated intracranial pressure

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20
Q

what are the 2 etiologies of Cerebral edema?

A

1) Vasogenic - Blood-brain barrier disruption and increased vascular permeability
2) Cytotoxic- Increase in water content secondarily to glial or endothelial injury

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21
Q

anatomic signs of Cerebral edema:

A

Swollen gyri
Compressed sulci
Brain shifting

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22
Q

name the 3 types of brain herniation:

A

1) Transtentorial (uncal)
2) Cingulate gyral (subfalcine)
3) Cerebellar tonsillar

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23
Q

brain herniation is the result of what?

A

brain swelling

its defined as: Displacement of brain tissue from one intracranial compartment to another

24
Q

______________ is defined as the accumulation of excess cerebrospinal fluid within the ventricular system

A

Hydrocephalus

25
Q

Causes of Hydrocephalus:

A

1) Decreased CSF resorption

2) Increased CSF production

26
Q

what can cause a decrease in CSF resorption?

A

CSF flow obstructed by:

1) tumor
2) hemorrhage
3) inflammation i.e. meningitis

27
Q

increased CSF production is a rare condition that is caused by tumors of what location?

A

tumors of the choroid plexus

ependymal cell cancer

28
Q

Brain swelling is a major factor contributing to increased _______________

A

intracranial pressure

29
Q

what is a papilledema? what causes it?

A
  • papilledema = swelling of the optic disc

- caused by brain swelling

30
Q

Cerebral edema is the result of excess fluid in brain _____________

A

parenchyma

parenchyma = neurons & glial cells

31
Q

why does increased brain volume (from any origin) cause brain damage?

A

from:

1) decreased perfusion
2) brain tissue displacement

*** brain is in bony case, so it has nowhere to go

32
Q

________________ diseases are a collective term for pathology of brain vessels

A

Cerebrovasular Diseases

“Stroke”

33
Q

what are the 3 categories of cerebrovascular diseases?

A

1) Thrombus occludes vessel
2) “Moving thrombus” (embolus) occludes vessel.
3) Rupture of blood vessel.

34
Q

T/F: cerebrovascular diseases can present locally or throughout the brain

A

true

35
Q

what are the characteristics of CNS vascular diseases (strokes)?

A
  • acute onset
  • non-epileptic patient
  • neurological deficit that lasts > 24 hours.
36
Q

explain the 2 processes that cause strokes:

A

Hypoxia/ischemia/infarction
- due to impaired blood supply of CNS tissues

Hemorrhage
- rupture of CNS vessels

37
Q

what are the 3 forms of PRIMARY (non-traumatic) Brain hemorrhage?

A
  • intra-parenchymal hemorrhage
  • subarachnoid hemorrhage
  • vascular malformations
38
Q

characteristics of brain infarctions:

A
  • Circumscribed, destructive lesions caused by local interruption of blood flow.
  • 70-80% of all cerebrovascular accidents
  • Atherosclerosis= most common underlying cause
39
Q

what is the most common underlying cause of brain infarctions?

A

Atherosclerosis

40
Q

what is the most common artery involved in brain infarctions?

A

Middle Cerebral Artery (MCA)

41
Q

Effects of Brain infarction after 24-36 hours (acute):

A
  • eosinophilic (red) neurons

- neutrophil infiltration

42
Q

what occurs 3 days after a brain infarction?

A
  • macrophage infiltration

they have “foamy cytoplasm”

43
Q

what is the most common cause of Intra-parenchymal Hemorrhages? what site do they usually effect?

A
  • Hypertension most common underlying cause.

- Sites = basal ganglia (most common), also in the Pons

44
Q

name the clinical effects of intra-parenchymal hemorrhages:

A

Severe headache
hemiparesis
hemisensory loss

(ONE SIDE loss of motor or sensory)

45
Q

what is the clinical sign for subarachnoid hemorrhages? what are their characteristics?

A
  • cause SEVERE HEADACHE
  • Ruptured saccular ‘berry’ aneurysms
  • Most arise at arterial bifurcations of the circle of Willis.
46
Q

name the most common vasculature malformation that leads to brain hemorrhages:

A

Arteriovenous malformations (AVM)

= most common

47
Q

what are the most likely results of an AVM?

A

likely to result in intraparenchymal and/or subarachnoid bleeds

48
Q

____________________ are caused by abnormal angiogenesis in developing brain

A

vascular abnormalities

49
Q

Characteristics of Epidural Hematoma:

A

A) cause = Blunt force skull fracture

B) Rupture of a meningeal artery = ARTERIAL bleed

C) “lucid interval”, then progressive loss of consciousness

50
Q

Characteristics of subdural Hematoma:

A
  • Blood between dura and arachnoid membrane.
  • venous bleed
  • Acute – whiplash injury, shaken baby syndrome
  • Chronic – elderly with brain atrophy.
51
Q

Do epidural or subdural hematomas spread quicker

A

EPIDURAL

epi = arterial bleed
- mean you have a lot higher pressure forcing blood into cranium

52
Q

what are the 3 types of Traumatic Parenchymal Injury ?

A

1) concussion
2) contusion
3) Laceration

53
Q

Define concussion, contusion and laceration

A

A) Concussion – loss of consciousness with full recovery.

B) Contusion – disruption and hemorrhage of superficial brain, caused by blunt trauma

C) Laceration – tearing of brain parenchyma.

54
Q

Contusions immediately underneath the impact area are called a _________ lesion

A

“coup” lesion

55
Q

Contusions developed in a region away from the point of impact are called a _________ lesion

A

“contrecoup” lesion

56
Q

what are the 3 main parts of a gun shot wound injury?

A

1) Entry
2) exit wounds
3) *wound canal *

57
Q

characteristics of a CHRONIC brain infarction:

A

A) Softening & liquefaction of parenchyma

B) after 6 months- leads to SMOOTH walled cavities

gen path final (8 decks)

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