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Nervous System > PNS Pathology > Flashcards

PNS Pathology Flashcards

1
Q

Branches of the Sciatic nerve

A

1) Tibial Nerve

2) Common peroneal nerve (becomes superficial and deep)

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2
Q

What is the result of damage to the tibial nerve?

A

1) Loss of plantar felxion (due to innervation of gastrocnemius, soleus, ect)
2) Loss of inversion (due to innervation of the tibialis posterior)
3) Provides sensory innervation for the plantar surface of the foot

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3
Q

Branches of the Brachial plexus

A

1) Musculoskeletal (C5-7)
2) Axillary (C5-6)
3) Median (C6-T1)
4) Ulnar (C8-T1)
5) Radial (C5-8)

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4
Q

Parts of the Brachial Plexus

A

1) Roots
2) Trunks
3) Division
4) Cords
5) Branches

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5
Q

What causes segmental demyelination of peripheral neurons?

A

1) Damage to the Schwann cell

2) Damage to the myelin sheath

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6
Q

What is a result of axonal degeneration?

A

1) Denervation atrophy

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7
Q

What is the morphology of denervation atrophy?

A

1) Decreased muscle fiber size
2) Fibers have a triangular shape
3) Round zone of disorganized myofibers in the center of the cell (target fiber)

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8
Q

Inflammation and segmental demyelination of spinal nerve roots and peripheral nerves due to an immune mediated process

A

Guillain-Barre Syndrome

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9
Q

What is the dominant histopathologic finding in Guillan-Barre Syndrome?

A

1) Inflammation of the peripheral nerve

2) Most intense inflammation occurs at the spinal cord and cranial roots

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10
Q

What is the earliest manifestation of Diphtheria in regards to neurologic symptoms?

A

1) Loss of sensory ganglia due to the incomplete blood brain barrier
2) Loss of proprioception and vibratory sense

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11
Q

What does myobacterium leprae infect in the nervous system? What type of leprosy is worse?

A

1) Infect the Schwann cells and cause demylination

2) Lepromatous leprosy

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12
Q

What cells are active in lepromatous leprosy? tuberculoid leprosy?

A

1) TH2

2) TH1 (activate macrophages)

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13
Q

Reactive infection that results in painful, vesicular skin eruptions in the distribution of the sensory dermatomes in the thoracic and trigeminal region

A

Varicella-Zoster virus

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14
Q

What is another name for Hereditary Motor and Sensory Neuropathy Type I?

A

Charcot-Marie-Tooth disease

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15
Q

What are findings of Charcot-Marie-Tooth Disease?

A

1) Progressive muscular atrophy of the leg below the knee

2) Pes cavus

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16
Q

What are causes for Charcot-Maire-Tooth disease (Type 1A and B)

A

1) Type 1A = segmental trisomy of chromosome 17

2) Type 1B = mutation of MPZ gene on chromosome 1

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17
Q

What are the Hereditary Neuropathies?

A

1) Charcot-Marie-Tooth Disease (HMSN type I)
2) HMSN type II
3) Dejerine-Sottas Neuropahty (HMSN type III)

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18
Q

What is hypertrophic neuropahty?

A

1) Enlargement of peripheral nerves due to layers of schwann cell hyperplasia
2) Occurs in hereditary demyelinating diseases

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19
Q

Slowly progressive autosomal recessive hereditary neuropathy that presents with delay of developmental milestones, absent DTRs and trunk/limb atrophy; Loss of axons

A

Dejerine-Sottas Neuropahty

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20
Q

What is the most common clinicopathologic pattern of peripheral neuropathy found in Adult onset diabetes?

A

1) Distal symmetric sensory and motor neuropathy

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21
Q

What are the common presentations observed in Diabetic patients neurologically?

A

1) Distal symmetric sensory and motor neuropathy
2) Loss of pain sensation
3) Loss of motor function
4) Autonomic dysfunction such as postural hypotension, sexual dysfunction, and failure to completely empty the bladder

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22
Q

What vitamin deficiencies result in axonal neuropathies?

A

1) Thiamine (B1)
2) B6
3) B12
4) Vitamin E

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23
Q

What is the cause of a traumatic neuroma (pseudoneuroma)?

A

1) the growth of an axon after trauma that does not have a correctly positioned distal segment

24
Q

What is Myasthenia gravis commonly associated with?

A

1) Thymoma

2) Thymus hyperplasia

25
Q

What is the cause of Myasthenia gravis

A

1) Autoimmune attack on the acetylcholine receptors located in the neuromuscular junction

26
Q

Gram positive spore produing rod and is anaerobic; causes flaccid paralysis

A

Clostridium botulinum

27
Q

Gram positive spore producing rod and is anaerobic; causes contraction paralysis

A

Clostridium tetanii

28
Q

How does Clostridium botulinum exotoxin work?

A

1) It works by preventing the release of acetylcholine from the presynaptic nerve terminals

29
Q

How does Clostridium tetani exotoxin work?

A

1) Exotoxin is taken up by the CNS and inhibits the inhibitory interneurons
2) Results in the unregulated contraction of muscles

30
Q

Pt. presents with photophobia, fever, headache, neck stiffness, and irritability; LP shows purulent CSF with increased protein, low glucose, and PMNs >90,000

A

Bacterial meningitis

31
Q

How do infectious brain abscesses occur?

A

1) Due to direct implantation
2) Local extension
3) Hematogenous spread

32
Q

What are some predispositions for infectious brain abscesses to occur?

A

1) Bacterial endocarditis
2) Immunosuppresion
3) Chronic pumonary sepsis
4) Congenital heart disease

33
Q

Where does CMV have a tendency to infect? What type of population does it infect?

A

1) Localize in the paraventricular subependymal regions of the brain
2) Fetuses and immunosuppressed

34
Q

Cytoplasmic, eosinophilic inclusions that can be found in the pyramidal neurons of the hippocampus and purkinje cells of the cerebellum with Rabies virus infection

A

Negri bodies

35
Q

Where are Negri bodies found?

A

1) In sites devoid of inflammation
2) Pyramidal neurons of the hippocampus
3) Purkinje cells of the cerebellum

36
Q

What are pathognomonic for Rabies infection?

A

1) Negri bodies

37
Q

How is rabies contracted?

A

1) Wound bite

2) Travels up the peripheral nerves into the CNS

38
Q

What is the incubation time of rabies dependent upon?

A

1) The travel of the rabies virus from the peripheral nerves to the cns

39
Q

What virus causes the presence of microglial nodules in a chronic inflammatory reaction? What do the microglial nodules contain?

A

1) HIV

2) Multinucleated giant cells

40
Q

What is the cause of progressive multifocal leukoencephalopathy? In what setting does progressive multifocal leukoencephalopathy occur?

A

1) JC virus

2) Occurs exclusively in the immunosuppressed

41
Q

What does the JC virus infect? What is the result?

A

1) Oligodendrocytes

2) Demyelination

42
Q

What is the result of damage to Schwann cells?

A

Segemental demeylination

43
Q

Inflammation and demyelination of spinal roots and peripheral nerve; T cell immune mediated; results in ascending paralysis

A

Guillain-Bare Syndrome

44
Q

Lesions with central liquefactive necrosis surrounded by fibrosis and swelling

A

Brain Abscess

45
Q

What does the JC virus infect?

A

Infects oligodendrocytes

46
Q

What areas of the brain are affected by Herpes Simplex Virus type 1?

A

Encpehlaitis of the inferior/medial regions of the temporal lobe and orbital gyri of the frontal lobe

47
Q

Infection that causes the destruction of anterior horns resulting in flaccid paralysis

A

Poliomyelitis

48
Q

What disease presents just like poliomyelitis?

A

Werdnig-Hoffman disease

49
Q

Cause of Tabes dorsals? What are findings?

A

1) Tertiary Trepenoma palidum infection

2) Loss of proprioception and vibration sense

50
Q

What limits the ability of the axons to regenerate?

A

Movement of the tubulin, actin, and intermediate filaments

51
Q

Chronic meningitis involving the base of the brain, gummas

A

Meningovascular neurosyphilis pattern

52
Q

What are the patterns of neurosyphilis?

A

1) Meningovascular neurosyphilis
2) Paretic neurosyphilis
3) Tabes dorsalis

53
Q

Invasion of organism in the frontal lobe of the brain that leads to mental deficits, general paresis (general paresis of the insane);

A

Paretic neurosyphilis

54
Q

Damage to the sensory nerves in the dorsal roots and columns resulting in proprioception and pain loss

A

Tabes dorsalis

55
Q

Pt. experiencing insomnia, headaches, periodic agitation, persistant fever, painful spasms with swallowing or inspiration, and dysphagia. Four weeks ago pt. explored a cave. Later pt. progresses to a coma. What does he have? What could have been done to prevent this?

A

1) Rabies encephalitis

2) Prophylactic killed vaccine

56
Q

Autoimmune condition that destroys schwann cells leading to inflammation and demyelination of peripheral nerves and motor fibers; ascending paralysis

A

Guillan Barre (Acute inflammatory demyelinating polyradiculopathy)

Nervous System (5 decks)

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