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SP16- Gen Path Exam 3 > Neuropathology > Flashcards

Neuropathology Flashcards

1
Q

The brain parenchyma consists of neurons supported by a framework of _____ cells.

A

glial

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2
Q

What are three types of glial cells?

A
  1. astrocytes
  2. oligodendrocytes
  3. ependymal cells
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3
Q

What are the “functional units” of the brain?

A

neurons

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4
Q

Are neurons larger in the cerebellum or the cerebral cortex?

A

cerebral cortex

more importantly…just note that neurons have varying sizes throughout the brain ~5 to 100 micrometers

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5
Q

_____ bodies are granules of rough endoplasmic reticulum (RER) with free ribosomes and are the sites of protein synthesis within the neuron

A

Nissl

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6
Q

What is a common change in neurons that is associated with hypoxic/ischemic injury of the brain?

A 
Cytoplasmic Eosinophilia (red neurons)
-loss of ribonucleoproteins and denaturation of cytoskeletal proteins
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7
Q

What are astrocytes?

A

the major supporting cells of the brain

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8
Q

How do astrocytes respond to brain injury?

A

they produce a dense network of cytoplasmic processes surrounding the area of injury (similar to a fibrous scar that occurs elsewhere in the body) = REACTIVE GLIOSIS

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9
Q

Injury to _______ results in demyelinating disorders such as MS.

A

oligodendrocytes

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10
Q

What is the purpose of oligodendrocytes?

A

formation and maintenance of central myelin

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11
Q

_____ cells line the ventricles of the brain.

A

Ependymal

cells vary in shape/size…columnar or cuboidal

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12
Q

_______, such as phagocytes and macrophages, are derived from ______.

A

microglia

circulating monocytes

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13
Q

What purpose do microglia serve?

A
  • they act as antigen presenting cells in inflammatory conditions
  • they appear as ROD CELLS in some infections
  • they act as scavengers during tissue necrosis
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14
Q

How quickly do neurons respond to CNS injury?

A

within 12 hours

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15
Q

______ are primarily responsible for repair and scar formation after CNS injury and will form Rosenthal fibers

A

astrocytes (star-like)

“the STAR players come in to save the day”

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16
Q

Where is CSF produced?

A

choroid plexus

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17
Q

True or False: Cerebral edema is a common form of secondary brain damage.

A

True

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18
Q

How often does cerebral edema cause brain damage secondary to initial brain injury?

A

75% of the time

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19
Q

In cerebral edema, the blood brain barrier is disrupted and the ________ is increased.

A

vascular permeability

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20
Q

Secondary to glial or endothelial injury, there is an increase in ______ associated with cerebral edema.

A

water

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21
Q

Cerebral edema = Swollen _____ + Narrowed _____ + brain _____ toward the area of less pressure.

A

swollen gyri
narrowed sulci
shifting

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22
Q

What are three classical indications of increased intracranial pressure?

A
  1. headache
  2. vomiting
  3. papilledema (swelling of the optic disc)
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23
Q

What is a “brain herniation” and what are the three main types?

A

displacement of brain tissue from one intracranial compartment to another (consequence of brain edema)

  1. Transentorial (uncinate)
  2. Subfalcine (cingulate)
  3. Tonsilar (displaces cerebellar tonsils)
24
Q

What is the danger associated with a subfalcine herniation?

A

Subfalcine = cingulate
(“i SUck at CINGing…it’s not AN ART for me”)

uni or bilateral expansion of the cerebral hemisphere displaces the cingulate gyrus under the falx cerebri = may compress the ANTERIOR CEREBRAL ARTERY

25
What is the danger associated with an uncinate herniation?
Uncinate = Transtentorial ("my UNCle is color BLIND") medial temporal lobe compression may affect CN III or Posterior Cerebral Artery and cause VISUAL DISTURBANCES
26
What is the danger associated with a tonsillar herniation?
displacement of the cerebral tonsils through the foramen magnum could be LIFE THREATENING as the brain stem becomes compromised (breathing/cardiac regulatory centers are in the medulla oblongata)
27
What is hydrocephalus?
accumulation of excess cerebrospinal fluid within the ventricular system due to decreased reabsorption or increased production by the choroid plexus -results in increased intracranial pressure
28
True or False: In an infant, hydrocephalus will result in head expansion.
True, the skull is still flexible | for adults...results in intracranial pressure because the cranium is hard/stable
29
True or False: Increased intracranial pressure results in higher perfusion rates.
False, increased pressure = decreased perfusion = displacement/damage
30
Cerebrovascular diseases are the ____ leading cause of death in the US.
3rd | 1 = heart, 2 = cancer
31
What is a stroke?
an acute, non-epileptic neurologic deficit lasting longer than 24 hours
32
A stroke results from ____ major processes. What are they?
TWO 1. Hypoxia (ischemia, infarction) 2. Hemorrhage (vessel rupture)
33
What are the pathogenic MECHANISMS of cerebrovascular disease?
- thrombus occludes vessel - "moving thrombus" occludes vessel - rupture of blood vessel
34
A brain ______ is a circumscribed lesion caused by local interruption of blood flow.
infarction
35
What is the most common underlying cause of brain infarction?
atherosclerosis
36
Which blood vessel is most frequently affected by brain infarction due to atherosclerosis?
the MIDDLE CEREBRAL ARTERY
37
Describe the evolution of a brain infarction.
~12 hours: grossly/histologicallly normal 24-36 hours (acute): red neurons, neutrophil infiltrate Day 3 (subacute): macrophage infiltration 1 month: softened, irregular, cavitation 6 months (chronic): smooth walled cavity with gliosis
38
What would you expect to see 30 hours after a brain infarction?
neurons that are red (eosinophilic) | neutrophils in the parenchyma
39
What would you expect to see on day 3 or 4 after a brain infarction?
foamy macrophages in the cytoplasm | punctate hemorrhage
40
An intraparenchymal brain hemorrhage is most likely due to _____ and the most common site is the _______.
``` hypertension basal ganglia (and the pons) ```
41
Where do most subarachnoid hemorrhages occur?
at arterial bifurcations of the CIRCLE OF WILLIS (rupture of "berry aneurysms") "WILL likes SUBs and BERRYs"
42
Vascular malformations are most commonly from abnormal ______ in the developing brain.
angiogenesis
43
What type of vascular malformation is most common?
AVMs (arteriovenous malformation)
44
Traumatic brain injury accounts for ____% of accidental deaths.
25
45
Epidural hematomas are _____ bleeds.
arterial ****usually the middle meningeal artery**** (vowel with vowel: E with A)
46
Subdural hematomas are _______ bleeds.
venous | consonant with consonant: S with V
47
Which is more aggressive, an epidural or subdural hematoma?
Epidural (more aggressive)
48
Where does the blood collect in an epidural hematoma?
between the skull bone and the dura mater (high pressure area)
49
Where does the blood collect in a subdural hematoma?
between the dura and archnoid membranes
50
True or False: There is the presence of a "lucid interval" following rupture of bridging veins.
False, veins = subdural lucid interval = arterial = epidural
51
A _______ is the loss of consciousness with full recovery.
concussion
52
A _______ is the disruption and hemorrhage of superficial brain, caused by blunt force trauma.
contusion
53
What is a brain laceration?
tearing of brain parenchyma
54
True or False: Areas of the brain that come in contact with the skull are more prone to develop contusions.
True
55
True or False: The contusion immediately below the site of impact is call the contrecoup lesion.
False impact site = coup region at opposite pole from impact = contrecoup
56
True or False: Exit and entry wounds from a gun shot injury are easily decipherable.
True, the exit wound is always more extensive
57
Why is the exit wound more extensive?
the bullet will "tumble and mushroom" as it passes through the skull

SP16- Gen Path Exam 3 (12 decks)

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