Neuropathology 1

Question 1

Where are schwann cells found?

Answer 1

PNS

Question 2

Where are oligodendrocytes found?

Answer 2

CNS

Question 3

Primary demyelinating disease

Answer 3

MS

Question 4

Secondary demyelinating disease?

Answer 4

• Central pontine myelinosis
• Progressive multifocal leucoencephalopathy (inborn)
• Sub-acute sclerosing panencephalitis
• AIDS
• Axonal degeneration

Question 5

Secondary demyelinating disease resulting from alcoholism/malnutrition/hyponatremia?

Answer 5

Central pontine myelinosis

Question 6

What are shadow plaques?

Answer 6

Plaques when they’re completely demyelinated

Question 7

Main histological features of MS?

Answer 7

Demyelination
Inflammation
Gliosis

Question 8

Main histological features of MS?

Answer 8

• Demyelination
• Inflammation
• Gliosis

Question 9

What does the ependyma do?

Answer 9

Lines the ventricular system

Question 10

Function of microglia?

Answer 10

Resident macrophages of the brain and CNS. They are the first and main form of immune defence in the CNS

Question 11

Name 3 types of glial cell

Answer 11

Oligodendrocytes
Microglia
Ependyma

Question 12

How can cells in the CNS become damaged?

Answer 12

Hypoxia
Trauma
Nutritional deficiency
Toxic insult
Metabolic abnormalities
Ageing
Infections
Genetic abnormalities

Question 13

What is an axonal reaction?

Answer 13

A reaction within the cell body that is associated with axonal injury

Question 14

Glial cells are derived from which layer?

Answer 14

The neuroectoderm

Question 15

These cells are phagocytic, respond to inflammation like microphages

Answer 15

Microglia

Question 16

A reaction within the CELL BODY that is associated with axonal injury

Answer 16

Axonal reaction

Question 17

What happens when neurones become damaged due to hypoxia

Answer 17

Glutamate receptors become activated and this results in uncontrolled calcium entry into the cell

Question 18

Response to axonal injury

Answer 18

• increased RNA and protein synthesis
• swelling of cell body
• peripheral displacement of nucleus
• enlargement of nucleolus
• central chromatolysis
• anterograde degeneration of axon occurs distal to site of injury
• breakdown of myelin sheath

Question 19

Most important histopathological indicator of CNS injury

Answer 19

Gliosis

Question 20

What happens to astrocytes in gliosis

Answer 20

Astrocytes undergo hyperplasia and hypertrophy

Question 21

In gliosis, what happens to the nucleus?

Answer 21

Nucleus enlarges and becomes vesicular

The nucleolus is prominent

Question 22

What happens to the cytoplasm in gliosis?

Answer 22

The cytoplasm expands and the ramifying process extend

Question 23

What happens if you disrupt ependymal cells?

Answer 23

The sub-epithelial ependymal astrocytes proliferate and this forms small irregularities on the ventricular surfaces

• these are called ependymal granulations

Question 24

Infectious agents including virus could produce changes in which type of cell?

Answer 24

Ependymal cells

Question 25

If injury occurs, what cell would you find elongated nuclei (rod cells) in?

Answer 25

Microglia

Question 26

What is neuronophagia?

Answer 26

When tonnes of microglia congregate around portions of dying neurons

Question 27

What are microglial nodules?

Answer 27

Microglia that have congregated around small foci of tissue necrosis

Question 28

What is apraxia?

Answer 28

Inability to perform purposeful actions

Question 29

Damage to anterior cerebral artery

Answer 29

Frontal lobe dysfunction Contralateral sensory loss in lower limb and foot Paresis of foot and arm (thigh and face generally spared)

Question 30

Damage to middle cerebral artery

Answer 30

Hemiparesis Hemisensory loss Aphasia/dysphasia Apraxia

Question 31

Which arteries supply the brainstem, cerebellum and occipital lobe?

Answer 31

The vertebrobasilar arteries

Question 32

What is Weber's syndrome?

Answer 32

Ipsilateral IIIrd nerve palsy | Contralateral hemiparesis/hemiplegia

Question 33

Damage to which part of the brain could cause Webers syndrom?

Answer 33

Midbrain

Question 34

Damage to which part of the brain could cause medial and lateral pontine syndrome?

Answer 34

Pons

Question 35

Damage to which part of the brain could cause lateral medullary syndrome?

Answer 35

Medulla

Question 36

Damage to the occipital lobe presents as _____

Answer 36

Homonymous hemianopia with macular sparing

Question 37

How does damage to the cerebellum present?

Answer 37

Ataxia Nystagmous Intention tremor Pendular reflexes

Question 38

Which is more vulnerable to hypoxic-ischemic damage: neurons or glial cells?

Answer 38

Neurons are more vulnerable than glial cells

Question 39

Definition of stroke

Answer 39

A sudden disturbance of CEREBRAL FUNCTION of VASCULAR ORIGIN that causes death or lasts over 24 hours

Question 40

What happens 4-12 hours after cerebral infarction?

Answer 40

4-12 hours: brain may appear normal

Question 41

What happens 15-20 hours after cerebral infarction?

Answer 41

Ischemic neuronal changes develop, defined margin between ischemic and normal brain

Question 42

What happens 24-36 hours after cerebral infarction?

Answer 42

Inflammatory reaction Extravastation of red blood cells Activation of astrocytes and microglia

Question 43

What happens 36-48 hours after cerebral infarction?

Answer 43

Necrotic area visible macroscopically | Becomes swollen and softer than surrounding tissue

Question 44

When do macrophages infiltrate into the infarction area?

Answer 44

Day 3

Question 45

What happens 1-2 weeks after cerebral infarction?

Answer 45

Liquefacation of tissue and gliosis

Question 46

Where do 90% of subarachnoid haemorrhages occur?

Answer 46

Arterial bifurcations in the territory of the internal carotid artery (10% in the vertebro-basilar circulation)

Question 47

90 % of lacunar infarcts are associated with what?

Answer 47

hypertension

Question 48

Hypertension is particularly associated with this type of infarct

Answer 48

Lacunar infarcts