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Pathology: Nervous System Flashcards

1
Q

Neurons

A

cell body in gray matter
processes extend as nerves
affected by: necrosis, degeneration, neoplasia, infection

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2
Q

Cells of Nervous System: Astrocytes

A

supporting cells
reactive, proliferate in response to injury
can form tumors

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3
Q

Cells of Nervous System: Oligodendrocytes

A

form myelin in CNS
involved in demyelinating disorders
“White matter”

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4
Q

Cells of Nervous System: Ependymal Cells

A

line ventricles

may be involved in infectious processes

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5
Q

Cells of Nervous System: Microglia

A

derived from circulating monocytes
scavengers of CNS
turn into foamy macrophages

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6
Q

Vasogenic Cerebral Edema

A

BBB disrupted, fluid escapes into CNS parenchyma (extracellular edema)

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7
Q

Cytotoxic Cerebral Edema

A

Related to hypoxia and ischemia, results in generalized edema (intracellular edema)

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8
Q

Herniation

A 
brain parts are pushed through the path of least resistance
Three Patterns:
1. Transtentorial (uncal gyrus)
2. Subfalcine (cingulate gyrus)
3. Cerebrallar Tonsillar
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9
Q

Non-Communicating Hydrocephalus

A

obstruction WITHIN the ventricular system

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10
Q

Communicating Hydrocephalus

A

obstruction OUTSIDE the ventricular system

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11
Q

Hydrocephalus

A

increased CSF

if it occurs before closure of skull -> enlarged head and dilated ventricles

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12
Q

Hydrocephalus Ex Vacuo

A

dilation of ventricles due to loss of brain tissue

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13
Q

Intraparenchymal Hemorrhage

A

most common cause: hypertension
most common site: basal ganglia, thalamus, pons
large hematoma can cause cerebral edema and herniation
clinical: abrupt headache, vomiting, unconsciousness, may go into coma and die

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14
Q

Infarct

A

any obstruction of blood flow to brain
Lacunar (<1.5 cm)
can be asymptomatic or can cause paralysis if in the internal capsule

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15
Q

Subarachnoid Hemorrhage

A 
abrupt onset of severe headache
vomiting, unconsciousness, stiff neck
CSF: bloody
50% mortality
Berry Aneurysm (Circle of Willis)
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16
Q

Vascular Malformation

A

direct communication of artery and vein - prone to rupture, creates “noise”

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17
Q

Coup Trauma

A

beneath the site of trauma, to an IMMOBILE head

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18
Q

Contrecoup Trauma

A

opposite to the site of trauma, due to a rapidly MOVING head striking an immobile surface

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19
Q

Epidural Hematoma

A

middle meningeal artery ruptured

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20
Q

Subdural Hematoma

A

emissary vein, bridging veins rupture

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21
Q

Causes of Congenital Malformations

A

infections
toxins
genetic abnormalities

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22
Q

Meningomyelocele

A

spinal cord and meninges herniate through a posterior vertebral defect
associated with: hydrocephalus, Arnold-Chiari malformation

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23
Q

Spina Bifida Occulta

A

mild neural tube defect
defect in posterior vertebrae NO protrusion of meninges or spinal cord tissue
marked by tuft of hair
10% of population

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24
Q

Ancephaly

A

defect of anterior end of neural tube

absence of brain

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25
Encephalocele
herniation of brain tissue through skull defect
26
Disorder of Forebrain Development: Holoprosencephaly
failure in outgrowth and cleavage of prosencephalic vesicle
27
Perinatal Injury: Germinal Matrix Hemorrhage
intraventricular hemorrhage in premature infants related to: hypoxia, acidosis, hypercarbia may die, or develop hydrocephalus
28
Perinatal Injury: Necrosis of White Matter
seen in both term and premature | related to: poor oxygenation
29
Epidural and Subdural Infections
rare, high mortality due to trauma, spread from paranasal sinus or mastoid spinal epidural >>> cranial epidural staph, strep, or anaerobic organisms
30
Acute Pyogenic Meningitis (Bacterial)
cause neonatal: strep, E. coli, listeria monocytogenes young: h. influenza, strep pneumonia old: Neisseria meningitides, strep pneumonia clinical: stiff neck, headache, fever altered mental status CSF: turbid, increased neutrophils RAPID DIAGNOSIS and TREATMENT
31
Viral Meningitis (Aseptic)
less severe effects than bacterial - stiff neck, headache, fever, altered mental status CSF: lymphocytes, normal glucose
32
Chronic Meningitis
TB, Cryptococcus neoformans (AIDS), syphilis | causes vascular obstruction due to proliferative changes - leads to infearction
33
Viral Encephalitis
Arbovirus - West Nile Virus (arthropod borne) Herpes Simplex - HSV1 - hemorrhagic, necrotizing, temporal lobe, inclusions CMV - neonates, immunocompromised HIV - progressive neurologic disease
34
Spongiform Encephalopathies
transmitted by prion (no DNA or RNA) Cruetzfeldt-Jacob disease, Mad Cow disease characteristics: vacuoles in gray matter, progressive dementia, death within 1 year of onset
35
What is the most common primary neoplasm of the CNS?
Glioma
36
Gliomas
Astrocytomas Oligodendrogliomas Ependymomas
37
Primitive Neuroectodermal Tumors (PNET)
Medulloblastoma
38
Meningiomas
Arise in meningothelial cells in dura
39
Metastatic Tumors
lung, breast, melanoma
40
Astrocytoma
most common primary brain tumor evolves from low grade or arises de novo as tumor poor prognosis - malignant
41
Ependymoma
arise in ependymal lined ventricle or spinal canal
42
Medulloblastoma
tumor of children less than 5 yr located in cerebellum highly malignant
43
Meningioma
arise from leptomeninges attached to dura benign in adult multiple seen in NF2
44
What is the most common demyelinating disorder?
Multiple Sclerosis
45
Multiple Sclerosis
Clinical: acute or slow onset, visual disturbances, (OPTIC chiasm), paresthesias, spasticity, gait disturbances, emotional changes Cause: unknown, autoimmune? CSF: increased gamma globulin, oligoclonal bands of immunoglobulin
46
Progressive Multifocal Leukoencephalopathy (PML)
demyelination in response to JC virus infecting oligodendroglial cells seen in AIDS patients
47
Nutritional Disorders - Vitamin B12 Deficiency
subacute combined degeneration of the spinal cord associated with pernicious anemia causes vacuolar demylination in the long tracts of the spinal cord (corticospinal and posterior columns)
48
Nutritional Disorders - Thiamine Deficiency
Wernick's encephalopathy: confusion, ataxia and abnormalities in eye movements Korsakoff's psychosis: memory disturbances common in alcoholics
49
Acquired Metabolic Disorders
hepatic encephalopathy
50
Toxic Disorders
heavy metals, lead, carbon monoxide, drugs
51
Toxic & Metabolic Diseases
bilateral symmetry selective neuroanatomic vulnerability systemic effects
52
Carbon Monoxide posioning
bilateral pallidal (globus palladus) hemorrhage and necrosis
53
Dementia
Alzheimer's Disease is most common cause
54
Movement Disorders: Parkinson's Disease
rigidity and slowness of movement loss of dopamine producing neurons - substantial nigra slow onset - progressive defecits death from other causes
55
Movement Disorders: Huntington's Chorea
progressive hereditary disorder; involuntary movements
56
Disease of upper and lower motor neurons: ALS
``` loss of motor neurons in motor cortex, brainstem, and anterior horn progressive muscle weakness insidious onset, sporadic case little dementia or cognitive decline median survival 5 years ```
57
Alzheimer Disease
most common cause of dementia slowly progressive memory loss, behavior changes common sporadic or familial brain atrophy, neuritic plaques, tangles of beta amyloid death from other causes; often infection
58
Peripheral Neuropathy
Diabetes Mellitus Genetic/Inherited Neuropathies Guillan-Barre syndrome
59
Guillan-Barre Syndrome
ascending paralysis, develops after a viral illness | demyelination of peripheral nerves
60
Neoplasms of peripheral nerves
Schwannoma | Neurofibroma
61
Schwannoma
sporadic or occurs in NF-2 benign tumor Schwann cell neoplasm
62
Neurofibroma
sporadic of familial mostly benign plexiform NF can progress into malignant tumor
63
Neurofibromatosis
Type 1: neurofibroma, cafe-au-lait, Lisch nodule, optic glioma Type 2: Schwannoma, NF, Ependymoma, meningioma

Pathology (4 decks)

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