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Pathology > Pathology: Nervous System > Flashcards

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
Q

Encephalocele

A

herniation of brain tissue through skull defect

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26
Q

Disorder of Forebrain Development: Holoprosencephaly

A

failure in outgrowth and cleavage of prosencephalic vesicle

27
Q

Perinatal Injury: Germinal Matrix Hemorrhage

A

intraventricular hemorrhage in premature infants
related to: hypoxia, acidosis, hypercarbia
may die, or develop hydrocephalus

28
Q

Perinatal Injury: Necrosis of White Matter

A

seen in both term and premature

related to: poor oxygenation

29
Q

Epidural and Subdural Infections

A

rare, high mortality
due to trauma, spread from paranasal sinus or mastoid
spinal epidural&raquo_space;> cranial epidural
staph, strep, or anaerobic organisms

30
Q

Acute Pyogenic Meningitis (Bacterial)

A

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
Q

Viral Meningitis (Aseptic)

A

less severe effects than bacterial - stiff neck, headache, fever, altered mental status
CSF: lymphocytes, normal glucose

32
Q

Chronic Meningitis

A

TB, Cryptococcus neoformans (AIDS), syphilis

causes vascular obstruction due to proliferative changes - leads to infearction

33
Q

Viral Encephalitis

A

Arbovirus - West Nile Virus (arthropod borne)
Herpes Simplex - HSV1 - hemorrhagic, necrotizing, temporal lobe, inclusions
CMV - neonates, immunocompromised
HIV - progressive neurologic disease

34
Q

Spongiform Encephalopathies

A

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
Q

What is the most common primary neoplasm of the CNS?

A

Glioma

36
Q

Gliomas

A

Astrocytomas
Oligodendrogliomas
Ependymomas

37
Q

Primitive Neuroectodermal Tumors (PNET)

A

Medulloblastoma

38
Q

Meningiomas

A

Arise in meningothelial cells in dura

39
Q

Metastatic Tumors

A

lung, breast, melanoma

40
Q

Astrocytoma

A

most common primary brain tumor
evolves from low grade or arises de novo as tumor
poor prognosis - malignant

41
Q

Ependymoma

A

arise in ependymal lined ventricle or spinal canal

42
Q

Medulloblastoma

A

tumor of children less than 5 yr
located in cerebellum
highly malignant

43
Q

Meningioma

A

arise from leptomeninges
attached to dura
benign in adult
multiple seen in NF2

44
Q

What is the most common demyelinating disorder?

A

Multiple Sclerosis

45
Q

Multiple Sclerosis

A

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
Q

Progressive Multifocal Leukoencephalopathy (PML)

A

demyelination in response to JC virus infecting oligodendroglial cells
seen in AIDS patients

47
Q

Nutritional Disorders - Vitamin B12 Deficiency

A

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
Q

Nutritional Disorders - Thiamine Deficiency

A

Wernick’s encephalopathy: confusion, ataxia and abnormalities in eye movements
Korsakoff’s psychosis: memory disturbances
common in alcoholics

49
Q

Acquired Metabolic Disorders

A

hepatic encephalopathy

50
Q

Toxic Disorders

A

heavy metals, lead, carbon monoxide, drugs

51
Q

Toxic & Metabolic Diseases

A

bilateral symmetry
selective neuroanatomic vulnerability
systemic effects

52
Q

Carbon Monoxide posioning

A

bilateral pallidal (globus palladus) hemorrhage and necrosis

53
Q

Dementia

A

Alzheimer’s Disease is most common cause

54
Q

Movement Disorders: Parkinson’s Disease

A

rigidity and slowness of movement
loss of dopamine producing neurons - substantial nigra
slow onset - progressive defecits
death from other causes

55
Q

Movement Disorders: Huntington’s Chorea

A

progressive hereditary disorder; involuntary movements

56
Q

Disease of upper and lower motor neurons: ALS

A 
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
Q

Alzheimer Disease

A

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
Q

Peripheral Neuropathy

A

Diabetes Mellitus
Genetic/Inherited Neuropathies
Guillan-Barre syndrome

59
Q

Guillan-Barre Syndrome

A

ascending paralysis, develops after a viral illness

demyelination of peripheral nerves

60
Q

Neoplasms of peripheral nerves

A

Schwannoma

Neurofibroma

61
Q

Schwannoma

A

sporadic or occurs in NF-2
benign tumor
Schwann cell neoplasm

62
Q

Neurofibroma

A

sporadic of familial
mostly benign
plexiform NF can progress into malignant tumor

63
Q

Neurofibromatosis

A

Type 1: neurofibroma, cafe-au-lait, Lisch nodule, optic glioma
Type 2: Schwannoma, NF, Ependymoma, meningioma

Pathology (4 decks)

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