Neuropathology

Question 1

Explain the term ‘neuroplasticity’

Answer 1

Adaptive capacity of the CNS and its ability to modify its own structural organisation and functioning

Question 2

Describe the ability of the CNS and PNS to regenerate post damage

Answer 2

CNS - only possible in hippocampus and olfactory bulb

PNS - wallerian regeneration (~1mm/day)

Question 3

Explain the terms ‘balance’ and ‘gait’

Answer 3

Balance - static or dynamic equilibrium of the body,morels five to the support base
Gait - pattern of movement of the limbs during locomotion. Stance and swing phase.

Question 4

Explain long term potentiation in the context of neuro-rehabilitation

Answer 4

Unmasking dormant pathways

Collateral sprouting

Question 5

List methods by which bacteria/viruses gain entry to the CNS

Answer 5

Direct spread e.g. middle ear infection, skill fracture
Blood e.g. sepsis, infective endocarditis
Iatrogenic e.g. VP shunt, surgery, LP

Question 6

Show some knowledge of meningitis and encephalitis

Answer 6

Meningitis = inflammation of the leptomeninges, with or without septicaemia
Causative organisms - E.coli, L. monocytogenes (neonates), H. influenza type B (2-5), N. menongitidis (5-30), S. pneumoniae (>30), M. tuberculosis (chronic granulomatous inflammation)
Complications - death, cerebral infarction –> neurological deficit, cerebral abscess, subdural empyema, epilepsy
Encephalitis = inflammation of brain parenchyma –> neuronal cell death
Classically viral, inclusion bodies, herpes, polio, rabies

Question 7

Explain different types of brain herniation and their symptoms

Answer 7

Subfalcine - same side as mass, cingulate gyrus pushed under free edge of fall cerebri
Tentorial - uncus pushed under tentorial notch
*damage to ipsilateral oculomotor nerve, haemorrhage into brainstem –> Duret haemorrhage
Tonsilar - cerebellar tonsils pushed into foramen magnum
Symptoms - headache, vomiting, papilloedema, mydriasis, coma

Question 8

Name tumours of the brain

Answer 8

Meningioma - benign

Astrocytoma - malignant

Question 9

State the bleed type of haematomas of the meninges

Answer 9

Extradural - arterial bleed (MMA)
Subdural - venous bleed (bridging veins)
Subarachnoid - arterial bleed (circle of Willis)

Question 10

Understand the timeline of delivery of physiotherapy to patients admitted to stroke wards

Answer 10

Subacute - 1 week - 6 months

Ongoing - 6 months onwards