Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

The Nervous System: Pathology > Pathology of cerebro-vascular diseases > Flashcards

Pathology of cerebro-vascular diseases Flashcards

1
Q

What is the WHO definition of stroke

A

Focal neurological deficit (loss of function affecting a specific region of the central nervous system) due to disruption of blood supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the overall cause of a stroke

A

Interruption of supply of oxygen and nutrients and causing damage to brain tissue

either due to ischaemia or haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is virchows train components that if changed can cause interruption of supply of oxygen

A

Vessel wall

Blood flow and pressure

Blood constituents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What changes in the vessel wall can result in interrupted blood supply

A

Abnormality of wall
(atheroma, vasculitis)

Outside pressure (strangulation, spinal cord compression, compression of veins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What changes in the blood flow and pressure can result in interrupted blood supply,

A

Decreased blood flow,

Increased blood pressure bursting vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What changes in the blood constituents can result interrupted blood supply,

A

Thrombosis of arteries and rarely veins

Bleeding due to anticoagulation,

Reduced platelets and clotting factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the three main causes of localised interrupted blood supply

A

Atheroma + thrombosis of artery causing ischaemia

Thromboembolism (for example, from left atrium) causing ischaemia

Ruptured aneurysm of a cerebral vessel causing haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the pathophysiology of atheroma and thrombosis

A

There is a narrowing of the artery wall due to atheroma then the formation of a thrombosis (from platelets and fibrin) forming on top reducing the blood flow and resulting in ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where does atheroma and thrombosis typically occur cause ischaemia to the brain

A

The internal carotid artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In internal carotid artery thrombosis where do you typically get ischaemia

A

In the middle cerebral artery territory (which is on the lateral side of the brain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the two category of symptoms that can arrises from ischaemia (lack of oxygen) to the brain

A

Transient symptoms
<24hours

Long standing symptoms >24 hours (stroke)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why does a stroke result in irreversible ischaemia

A

As the brain tissue is no longer viable as long term ischameia has causes localised brain death (infarct) which is irreversible as neurones cant regenerate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the pathogenies of ischaemic stroke

A

Brain is very sensitive to oxygen ischaemia

A few minutes hypoxia or anoxia will cause brain ischaemia
which can lead to infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a localised area of brain death caused

A

Regional cerebral infarct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the morphology of regional cerebral infarct

A

Classically wedge-shaped reflecting arterial perfusion territory

is Soft and then becomes cystic

Which then leads to loss of brain tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the features of regional cerebral infarct when its has a wedge shape reflecting arterial territory appearance

A

Tissue degeneration

Yellow colouration

Congested vessels

Swelling of surrounding brain tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is seen in the histology of an infarct

A

Gliosis - the CNS equivalent of fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does gillosis occur in cerebral infarct

A

Foamy marocphages try to repair the loss of neurones and cause clinical deficit of gliosis

19
Q

What additional features are seen with loss of brain tissue

A

Cyst like spaces

Yellow colouration to edge of infarcted area

20
Q

Why is the location of ischaemia in the brain very important

A

Small affected area of one part of brain may not cause too much impairment however
Similar size of affected area in another part of brain may be devastating

21
Q

Where is a thrombo-embolism most likely to arise from

A

Left atrium appendage of the heart

22
Q

How does the thrombo-embolism result in ischaemia type infarct

A

thrombsis in the left atrial appendage breaks offand embolises to the aorta and then in the direction of the carotid, which eventually block right middle cerebral artery as are smaller arteries

23
Q

The thromboembolsim ischaemic type infarct is similar to what

A

Atheroma/thrombosis iscahemic type infarct

24
Q

Why do patient with thrombo-embolism and arrhythmias have a higher risk of further embolisation

A

Due to arrhythmias causing stagnant blood

25
Q

How do aneurysm form beyond carotid and vertebral arteries

A

Due hypertension, expanding and weakening the thin cerebral arteries wall

26
Q

Why is the cerebral arteries walls thin and weak, what is the benefit of this

A

As have no muscle - so the vessels in the brain don’t constrict - therefore nothing will affect cerebral inflow

27
Q

What causes the aneurysm to rupture in the cerebral arteries

A

If severe hypertension

28
Q

What is the affect of rupture aneurysm in the cerebral arteries

A

Haemorrhage - decreased blood flow to the brain

Spasm of artery - decrease blood flow distally leading to additional ischaemia

29
Q

What is the two common sites of ruptured vessels causing haemorrhagic stroke

A

Basal ganglia

circle of willis

30
Q

What causes haemorrhage strokes to occur in the basal ganglia

A

Microanueysms from in hypertensive patient

31
Q

What causes haemorrhoid stroke to occur in the circle of willis

A

Berry aneurysm to form in hypertensive patient

32
Q

where are berry aneurysm visible

A

visible outside brain tissue

33
Q

What is three overall reasons for generalised interrupted blood supply or hypoxia

A

Low O2 in blood (hypoxia with intact circulation of blood)

Inadequate supply of blood(flow of blood not occurring)

Inability to use O2

34
Q

The inability t to use O2 is a rare occasion, what is an example of this occasion

A

Cyanide poisoning

35
Q

What is cause of low O2 in blood

A

C02 poisoning, Near drowning, Respiratory arrest

36
Q

What is causes of inadequate supply of blood

A

Cardiac arrest with immediate resus’n,

Hypotension,

Brain swelling (eg trauma)

37
Q

What pattern of ischaemia and infarct can be caused by hypotension

A

Zonal pattern of ischaemia leading to watershed infarcts

38
Q

How does zonal pattern of ischaemia occur due to hypotension

A

Low pressure blood means the central part of the artery territory are better perfused but the water shed areas (at the periphery) are poorly perfused, prolonged poor perfusion leads to watershed infarcts

39
Q

How does a cardiac arrest result in infarction

A

During cardiac arrest there is no perfusion and oxygen reaching the brain this can cause laminar cortical necrosis resulting in infarction

40
Q

How does brain swelling cause infarction

A

vessels compressed due to trapped in a skull leads to ischameia to the brain

41
Q

What is the main cause of watershed infarcts

A

Poor perfusion due to hypotension

42
Q

What is the main cause of regional infarcts (complex patten)

A

decreased blood flow caused by narrowed cerebral vessels due to atheroma

43
Q

What causes laminar cortical infarction

A

Complete loss of perfusion e.g. cardiac arrest

44
Q

What can be seen in laminar infarction

A

Lines of necrosis and thinning

The Nervous System: Pathology (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions