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Anatomic Pathology 2 > Pathology of the Nervous System > Flashcards

Pathology of the Nervous System Flashcards

1
Q

What are neurons?

A

long-lived cells; organized into layers and clusters within gray matter

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2
Q

What are astrocytes?

A

supportive cells that regulate the microenvironment and respond to CNS injury; they are part of the blood brain barrier

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3
Q

What do oligodendrocytes do?

A

provide myelin sheaths around axons, surround neurons, and help regulate the microenvironment

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4
Q

What are microglia?

A

CNS phagocytes

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5
Q

What are microglia derived from?

A

monocytes

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6
Q

Where are ependymal cells located and what do they do?

A

they line ventricles and help produce CSF

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7
Q

What are the layers of the meninges?

A

dura mater, arachnoid, and pia mater

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8
Q

Which layer of the meninges is the vascular layer?

A

the arachnoid

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9
Q

Which layer of the meninges is the inner layer bonded to the neurophil?

A

pia mater

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10
Q

Which layer of the meninges is the tough fibrous covering?

A

the dura mater

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11
Q

What is the CNS made up of?

A

blood vessels, gray matter, and white matter

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12
Q

Where do the blood vessels penetrate the brain and the cord through?

A

the arachnoid

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13
Q

What are the blood vessels of the CNS surrounded by?

A

potential space (Virchow-robin space)

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14
Q

What is the blood brain barrier made up of?

A

capillary endothelium, basement membrane, and astrocytes

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15
Q

What is the root word for gray matter?

A

polio

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16
Q

What groups are the neuronal cell bodies of gray matter organized into?

A

layers, nuclei, and ventral and dorsal horns

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17
Q

what are the layers of the gray matter?

A

serebral and cerebella corticies

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18
Q

What are the nuclei in gray matter?

A

medulla and brain stem

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19
Q

What is the root word for white matter?

A

leuko

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20
Q

What is the white matter composed of?

A

myelinated axon tracks

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21
Q

Where are the upper motor neurons located?

A

with in the brain - they are cell bodies

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22
Q

What do the axons of the upper motor neurons make up?

A

descending motor tracts in the cord

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23
Q

What is the function of the upper motor neurons?

A

they initiate and regulate motor stimuli to lower motor neurons

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24
Q

What is the result of upper motor neuron injury?

A

spastic paresis/paralysis due to loss of inhibatory stimuli

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25
Q

Where are the lower motor neurons located?

A

within the ventral horns of the spinal cord and motor nuclei of cranial nerves of the brain

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26
Q

What do the axons of the lower motor neurons make up?

A

ventral nerve roots; extend to motor-end plays at the neuromuscular junction

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27
Q

Are the upper motor neurons or the lower motor neurons part of the reflex arc?

A

the lower motor neurons

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28
Q

What does lower motor neuron injury cause?

A

flaccid paresis/paralysis

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29
Q

What is the peripheral nervous system made up of?

A

neurons, axons, and the reflex arc

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30
Q

What neurons are part of the peripheral nervous system?

A

lower motor neurons, sensory neurons, and peripheral ganglia and plexuses

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31
Q

Where in the peripheral nervous system are sensory neurons located?

A

in the dorsal root ganglia

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32
Q

What system are the peripheral ganglia and plexuses a part of?

A

the autonomic nervous system

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33
Q

What axons are part of the peripheral nervous system?

A

sensory and motor

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34
Q

What do the sensory axons synapse with?

A

ascending sensory tracts in the dorsal and lateral funiculi; cranial nerves

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35
Q

What do the motor axons of the peripheral nervous system extend to?

A

motor-end plats or autonomic ganglia

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36
Q

What are the spinal and cranial nerves made up of?

A

a mixture of axons from sensory and motor neurons

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37
Q

What do schwann cells do?

A

produce myelin around each axon

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38
Q

What are the layers of fibrous tissue in the peripheral nervous system?

A

endoneurium, perineurium, and epineurium

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39
Q

Which nervous system does Wallerian degeneration happen in?

A

peripheral

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40
Q

What is the pathogenesis of Wallerian (axonal) degeneration?

A
  1. axon proximal to injury swells and dies back 2. axon distal to injury deteriorates 3. debris is cleaned up by macrophages
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41
Q

What lesinos are associated with Wallerian degeneration?

A

spheroids + dilated axon sheaths + macrophages

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42
Q

If the axon sheath is intact in Wallerian degeneration, what happens?

A

the myelinated axon regrows

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43
Q

What s central chromatolysis?

A

sublethal change in neuronal morphology leading to peripheral dispersal of Nissl substance

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44
Q

What is demyelination?

A

specific loss of myelin

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45
Q

what is neural fibrosis and atrophy secondary to?

A

chronic or disruptive injury

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46
Q

What exudate is associated with neuritis/ganglioneuritis/polyradiculoneuritis?

A

lymphoplasmocytic to pyogranulomatous exudate

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47
Q

What causes neuritis/ganglioneuritis/polyradiculoneuritis?

A

autoimmune mechanisms (polyneuritis equi) ascending infectious agents (rabies, listeria monocytogenes)

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48
Q

What nerve does ganglioneuritis from rabies cause?

A

inflammation to the trigeminal ganglion

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49
Q

What is a neuroma?

A

a non-neoplastic mass due to abnormal regrowth of a nerve

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50
Q

What are peripheral nerve sheath tumors derived from?

A

Schwann cells or fibroblasts

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51
Q

What are peripheral nerve sheath tumors common in?

A

subcutis and brachial plexus

52
Q

Are peripheral nerve sheath tumors benign or malignant?

A

they can be both

53
Q

What can malformations in the CNS be due to?

A

genetic defects or injury to part of the brain/cord during development (in utero or toxins)

54
Q

What are some examples of CNS malformations?

A

hydrocephalous, hydranencephaly, cerebellar hypoplasia, and Dander-Walker malformation

55
Q

What is hydrocephalus (generally)?

A

dilation of the ventricular system of the brain associated with accumulation of CSF

56
Q

What are the types of hydrocephalus?

A

internal and external

57
Q

Which type of hydrocephalous is the most common?

A

internal hydrocephalous

58
Q

What is internal hydrocephalus due to?

A

obstruction of the ventricular system

59
Q

What is external hydrocephalus due to?

A

failure to absorb CSF by arachnoid villi

60
Q

What is hydranencephaly?

A

a CSF-filled cavity replacing the cerebral hemispheres

61
Q

What causes hydranencephaly?

A

destructive lesion in the brain

62
Q

What is cerebellar hypoplasia?

A

a developmental failure of the cerebellum to attain the appropriate size and structure

63
Q

What lesions are associated with cerebellar hypoplasia?

A

small cerebellum and lack and/or disarray of purkinje neurons

64
Q

What clinical signs are associated with cerebellar hypoplasia?

A

hypermetria, dysmetria, ataxia, and intention tremors

65
Q

What causes cerebellar hypoplasia?

A

in utero viral infection of external granular layer of cerebellum and inherited in some species

66
Q

What are some examples of in utero infections that can cause cerebellar hypoplasia?

A

feline parvovirs and bovine viral diarrhea virus

67
Q

What is axonal degeneration similar to?

A

Wallerian degeneration in the PNS

68
Q

Describe axonal degeneration.

A

little to no axonal regeneration; lack of a basement membrane

69
Q

What are the types of demyelination?

A

primary and secondary

70
Q

What is primary demyelination?

A

specific injury to oligodendrocytes

71
Q

What is secondary demyelination?

A

general injury to axon and myelin sheath

72
Q

What is central chromatolysis?

A

early injury in the CNS; dispersal of Nissl substance

73
Q

What is hydropic degeneration?

A

swelling due to impaired ion pumps

74
Q

What is apoptosis in the CNS?

A

single cell ‘programmed death’; no inflammation

75
Q

What is CNS necrosis?

A

1 or more cells die in response to injury; elicits inflammation

76
Q

What is CNS spongiform change due to?

A

prion diseases

77
Q

What are intracellular accumulations in the CNS due to?

A

enzyme deficiency storage diseases

78
Q

What morphological changes are associated with neuronal necrosis?

A

shrinken, hypereosinophilic, +/- pyknotic nucleus, adjacent activated astrocytes, satellitosis with oligodendrocytes; red=dead

79
Q

What can cause neuronal necrosis?

A

hypoxia/ischemia, toxins, excitotoxins, and viruses

80
Q

What do excitotoxins do?

A

stimulate neurons to death

81
Q

What is the outcome of neuronal necrosis?

A

neurons that are lost are not typically replaced

82
Q

What are TSEs associated with?

A

neuronal spongiform change

83
Q

What does TSE stand for?

A

transmissible spongiform encephalopathies

84
Q

What are some examples of TSEs?

A

scrapie (sheep), BSE (cattle), Chronic wasting disease (elk, deer), Cruetzfeldt-Jakob disease and Kuru (humans)

85
Q

What causes neuronal spongiform change?

A

protease resistant prion protein

86
Q

What is the pathogenesis of neuronal spongiform change?

A

normal cellular prion protein becomes mis-folded and they lack nucleic acid; replicate by converting PrPc into PrPsc

87
Q

How are infectous causes of neuronal spongiform change transmitted?

A

orally then they replicate in lymphoid tissue, get to the CNS by leukocyte traffic or retrograde migration up the cranial nerves

88
Q

What regions of the brain are affected by neuronal spongiform change?

A

medulla oblongata at obex, brain stem nuclei, cerebellum, and retina

89
Q

What storage diseases are associated with galactocerebrosidase?

A

galactocerebrosidosis

90
Q

What storage diseases are associated with beta mannosidase?

A

beta mannosidosis

91
Q

What happens in storage disease?

A

There is an accumulation of substrate leading to enlarged neurons with intracellular accumulation

92
Q

What are the causes of storage disease?

A

inherited or acquired

93
Q

What are some causes of parenchymal swelling?

A

cytotoxic edema and increased vascular permeability

94
Q

What is cytotoxic edema?

A

hydropic degeneration

95
Q

What is increased vascular permeability associated with?

A

inflammation

96
Q

What is the result of parenchymal swelling?

A

due to the closed space there is herniation which leads to ischemia and necrosis

97
Q

Where does CNS hemmorhage typically occur?

A

in the leptomeninges (subdural hemorrhage) or parenchyma

98
Q

What is the neuropil?

A

the parenchyma

99
Q

Hemmorhage is toxic to the ______.

A

neuropil

100
Q

What is hematomyelia?

A

progressive hemorrhage and necrosis that spreads; typically occurs in the spinal cord

101
Q

What are the causes of hemorrhage in the spinal cord?

A

trauma, vasculitis, or coagulopathy

102
Q

What exudate types are associated with inflammation in the CNS?

A

serofibrious, purulemt, lymphocytic/lymphoplasmacytic, and pyogranulomatous and granulomatous

103
Q

Where does inflammation in the CNS occur?

A

leptomeninges, Virchow-robin spaces/perivascular, neuropil, and ventricles

104
Q

What is enceohalonalacia?

A

necrosis of the brain

105
Q

What is myelomalacia?

A

necrosis of the spinal cord

106
Q

What is polioencephalomalacia?

A

necrosis of gray matter in the brain

107
Q

What is leukopolioencephalomalacia?

A

necrosis of white matter in the brain

108
Q

What is poliomyelomalacia?

A

necrosis of gray matter in the spinal cord

109
Q

What is leukomyelomalacia?

A

necrosis of white matter in the spinal cord

110
Q

Necrosis causes what to the brain tissue?

A

liquefaction

111
Q

What is liquefied brain tissue cleaned up by?

A

gitter cells causing a hole

112
Q

Where in the CNS does fibrosis occur?

A

only in the leptomeninges

113
Q

What do microglia and macrophages become in fibrosis?

A

gitter cell

114
Q

What are gitter cells?

A

brain phagocytes

115
Q

What is gliosis?

A

basically the analog of fibrosis but in the parenchyma as the result of astrocyte proliferation

116
Q

What are activated astrocytes?

A

hypertrophied astrocytes due to sublethal injury

117
Q

What are fibrous astrocytes?

A

elongated astrocytes that attempt to fill inlost neuropils

118
Q

What is satellitosis?

A

a form of astrocytosis that occurs around neurons

119
Q

What are gemistocytic astrocytes?

A

hypertrophied astrocytes due to proliferation of gliofibrulary acidic protein (intermediate filament of astrocytes)

120
Q

What is myelitis?

A

inflammation of the spinal cord

121
Q

What is poliomyelitis?

A

inflammation of the gray matter of the spinal cord

122
Q

What is leukomyelitis?

A

inflammation of the white matter of the spinal cord

123
Q

What is myelomalacia due to?

A

inflammation or ischemia

124
Q

What is ischemic myelopathy secondary to?

A

intervertebral disk disease or IV disk cartilage emboli

125
Q

What neoplasmas are associated with the CNS?

A

neuroblastomas/medulloblastomas, astrocytomas, oligodendroglioma, ependymoma, meningioma, lymphosarcoma

Anatomic Pathology 2 (48 decks)

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