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Patho II > The CNS > Flashcards

The CNS Flashcards

1
Q

What is the etiology of meningitis in adults?

A

Streptococcus pneumoniae

Neisseria meningitidis

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2
Q

What is postural instability?

A

an impairment of postural reflexes that cause a feeling of imbalance and a tendency to fall

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3
Q

What is the risk factor for myelomeningocele?

A

folate deficiency during the first several weeks of gestation

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4
Q

What are gliomas?

A

primary brain tumors that display histological features of glial cells; they generally effect the cerebral hemispheres

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5
Q

What is large artery, low flow TIA associated with?

A

tightly stenotic atherosclerotic lesions

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6
Q

What is an epidural hematoma?

A

occurs after blunt trauma and results from disruption of the middle meningeal artery and vein

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7
Q

What are the two parts of the central nervous system (CNS)?

A

The brain

Spinal Cord

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8
Q

What is loss of brain structural integrity mediated by?

A

release of various proteases, particularly the matrix metalloproteases (MMP)

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9
Q

Why does a patient with meningitis get a stiff neck?

A

flexion of spine leads to stretching of meninges

traction on the inflamed meninges is painful, resulting in limited range of motion through the cervical spine

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10
Q

What does tau cause?

A

inflammatory response

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11
Q

What is Chronic Traumatic Encephalopathy (CTE)?

A

a dementing illness that develops after repeated head trauma

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12
Q

What are the causes of intracranial hemorrhage?

A

hypertension/vascular wall injury
structural lesions
tumors

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13
Q

What causes periventricular leukomalacia?

A

decreased oxygen/blood flow in teh periventricular region of the brain

Damage to the glial cells

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14
Q

What is aseptic meningitis caused by?

A

viruses

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15
Q

What happens when cerebral blood flow is 25 mL/100gm/min?

A

onset of anaerobic glycolysis

Tissue acidosis

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16
Q

What are the leptomeninges?

A

pia and arachnoid mater

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17
Q

What is the function of the spinal cord?

A

conducts signals to and from the brain

controls reflexes

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18
Q

What are the consequences of hydrocephalus in children and adults?

A

expansion of the ventricles and increased ICP

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19
Q

What is multiple sclerosis (MS)?

A

a heterogenous disorder with variable clinical and pathologic features; DEMYELINATION DISORDER; starts as autoimmune disorder

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20
Q

What cerebrosvacular disease classes can cause Transient Ischemic Attack (TIA) or Ischemic stroke?

A

process occurs in the vessels
Process originates remotely
Process results from inadequate cerebral blood flow

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21
Q

What is Bacterial Meningitis?

A

infection of the arachnoid mater and the CSF in both the subarachnoid space and cerebral ventricles

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22
Q

What are the cardinal clinical symptoms of Alzheimers?

A

MEMORY IMPAIRMENT
executive function and judgement/problem soloving
behavioral and psychological symptoms

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23
Q

What does a myelomeningocele cause?

A

damage to the spinal cord and nerves

physical and intellectual disabilities

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24
Q

What causes the loss of brain structural integrity of brain tissue and blood vessels?

A

cerebral ischemia and infarction

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25
Q

What is the etiology of cerebral palsy?

A

prenatal factors and peri/postnatal factors

Prematurity

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26
Q

What is meningoencephalitis?

A

inflammation of the meninges and brain parenchyma

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27
Q

What happens when cerebral blood flow is 11 mL/100 g/min?

A

membrane failure and cell death

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28
Q

What is the presymptomatic period of Alzheimers Disease?

A

between onset of biochemical changes in the brain and the development of clinical symptoms of AD

due to genetic mutations in APP, PSEN1 and PSEN2

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29
Q

What is the pathophysiology of Traumatic Vascular Injury?

A

injured cerebral microvasculature causing MICROTHROMBI and NEURONAL DEATH
BBB disruption, edema and FOCAL ISCHEMIA
Bridging veins being stretched in elderly

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30
Q

Brain contusion on the opposite side of brain impact are?

A

Contrecoup

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31
Q

What initiates most activities of the nervous system?

A

sensory experiences exciting sensory receptors

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32
Q

What causes vasogenic edema?

A

BBB disruption and increased vascular permeability

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33
Q

What is the risk factors for meningiomas?

A

prior radiation therapy to the head and neck; increased incidence with age

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34
Q

What is the pathogenesis of MS?

A

1) inflammatory immune mediated disorder with autoreactive lymphocytes
2) microglia form complex with activated T cells causing destruction of the myelin and oligodendrocytes
3)

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35
Q

What causes sporadic onset of Alzheimers Disease?

A

APOE epsilon 4 mutation which inhibits the clearance of amyloid beta protein

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36
Q

What is cerebral autoregulation?

A

cerebral flow is maitained at a relatively constant level regardless of moderate variations in perfusion pressure

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37
Q

What two stroke types have athersclerotic risk factors?

A

Ischemic Thrombotic and Ischemic Embolic

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38
Q

What happens to the penumbra of the brain when blood flow is decreased to it?

A

has potential to recover because it is only undergoing apoptosis because some ATP is available

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39
Q

What is meningitis?

A

inflammation of the leptomeninges within the subarachnoid space

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40
Q

What are the steps of Wallerian Degeneration?

A

1) swelling in distal axon
2) neurofilaments hypertrophy
3) myelin sheath shrinks and disintegrates
4) axon degenerates and disappears

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41
Q

What GCS score is considered mild TBI?

A

13-15

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42
Q

What is the most important role of the nervous system?

A

control various bodily activities

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43
Q

What is a concussion/Acute Mild TBI?

A

GCS between 13-15 measured at approximately 30 minutes after the injury; altered mental state with or without LOC

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44
Q

What is the cause of Dismyelination?

A

genetics; abnormally produced myelin

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45
Q

What GCS score is considered moderate TBI?

A

9-12

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46
Q

What happens when autoregulation fails?

A

cerebral vasodilation and cerebral edema

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47
Q

The magnitude and distribution of a traumatic brain lesion depends on what three things?

A

the shape of the object causing the trauma
the force of impact
whether the head is in motion at the time of injury

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48
Q

What are the three mechanisms of TIA?

A

large artery, low Blood flow TIA
Embolic TIA
Lacunar or small penetrating vessel TIA

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49
Q

What is the pathogenesis of Meningitis?

A

1) Cytokine production
2) increased BBB permeability
Altered cerebral blood flow
increased ROS
3) neuronal damage, increased ICP, and cerebral edema
4) Clinical presentation of meningitis

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50
Q

What causes cytotoxic edema?

A

hypoxia/ischemia

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51
Q

What is Clinically Isolated Syndromes (CIS) of MS?

A

first attack of disease; patient hasn’t had any other symptoms and there are no lesions

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52
Q

How does DAI develop?

A

tissue shearing at interface of grey and white matter

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53
Q

What is the most common type of TBI?

A

Diffuse Brain Injury (DBI)

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54
Q

What are the most common tumors of the brain?

A

Gliomas

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55
Q

What is Parkinson’s Disease?

A

progressive neurodegenerative disorder in which dopamine is lacking

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56
Q

What is the function of the Cerebellum?

A

muscle tone, posture, and balance

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57
Q

What is the etiology of CTE?

A

repeated concussions

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58
Q

What occurs at the proximal end of the severed axon?

A

similar degeneration occurs but only back to the next node of ranvier

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59
Q

What is periventricular leukomalacia (PVL)?

A

necrosis of the white matter near the lateral ventricles that occurs most often in premature infants

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60
Q

What causes hydrocephalus?

A

reduced flow or decreased resorption of CSF

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61
Q

What are the clinical features of Metastatic brain tumors?

A

headache the will worsen due to Increased ICP

Seizures

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62
Q

What is periventricular white matter?

A

the white matter adjacent to the ventricles

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63
Q

What causes brain stem neurologic abnormalities?

A

Chiari malformation

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64
Q

What types of cerebral palsy would occur if children with prematurity survive?

A

Periventricular Leukomalacia (PVL)
Intraventricular Hemorrhage
Bronchopulmonary Dysplasia

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65
Q

What areas of the brain have sensory areas?

A 
All levels of Spinal Cord
Medulla
Pons
Mesencephalon
Cerebellum
Thalamus
Areas of Cerebral Cortex
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66
Q

What are upper motor neuron symptoms of ALS?

A

weakness with slowness
hyperreflexia
spasticity

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67
Q

The consequences of CNS trauma depend on what two things?

A

the location of the lesion

limited repair

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68
Q

What is associated with severe cognitive dysfunction?

A

Presence of placques and tangles

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69
Q

What is the function of the astrocyte foot in the BBB?

A

allows small and lipophilic molecules (like alcohol) to cross

Allows water uptake

Contributes to brain swelling

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70
Q

What are the two major types of Cerebral Edema?

A

Vasogenic and Cytotoxic

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71
Q

What are the four main disease patterns of MS?

A 
Clinically Isolated Syndromes (CIS)
Relapsing Remitting (RR)
Secondary Progressive (SP)
Primary Progressive (PP)
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72
Q

What does Wallerian degeneration cause?

A

scar formation

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73
Q

What are the motor functions of the nervous system?

A

Contraction of SKELETAL and SMOOTH (organs) Muscle

Secretion of chemical substances by exocrine and endocrine glands

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74
Q

How does sensory information enter the CNS?

A

by peripheral nerves

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75
Q

Why does a patient with meningitis have fever?

A

cytokines affect the thermoregulatory neurons of the hypothalamus
invading pathogens produce pyrogens that can reset the hypothalamic thermal set point

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76
Q

How do astrocytes react to acute nerve injury?

A

cellular swelling

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77
Q

What is the etiology of meningiomas?

A

abnormal chromosome 22

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78
Q

What is caused by severe global cerebral ischemia?

A

BRAIN DEATH including irreversible cortical injury and brainstem damage

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79
Q

What are the three major levels of CNS Function?

A

Spinal Cord Level
Subcortical/Lower Brain Level
Higher Brain/Cortical Level

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80
Q

What is traumatic brain injury (TBI)?

A

a heterogenous disease determined by the Glasgow Goma Scale

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81
Q

What are the areas of CNS affected by MS called?

A

placques or lesions

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82
Q

What is a myelomeningocele?

A

cleft in the vertebral column with a corresponding defect in the skin so that the meninges and spinal cord are exposed

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83
Q

What are neurons?

A

The brains immune cells; protect brain from injury and disease

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84
Q

What is ischemia?

A

Decrease in blood flow to the brain

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85
Q

What is the pathophysiology of Bacterial Meningitis and what is it called?

A

1) pathogen penetration
2) NF-kB activation
3) leukocyte transmigration that occur at the BBB

Mechanistic TRIAD

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86
Q

What is cerebrovascular disease?

A

pathophysiological process involving the blood vessels of the brain

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87
Q

What is the pathophysiology of a concussion/Acute Mild TBI?

A

direct external contact forces or from the brain being slapped against intracranial surfaces with acceleration/deceleration trauma

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88
Q

What grade are primary tumors?

A

Grade 1 or 2

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89
Q

What is the function of the cerebral cortex?

A

performs associative activities such as thinking, learning, and remembering

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90
Q

What is lacunar/small penetrating vessel TIA induced by?

A

stenosis

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91
Q

What causes hypoxia?

A

low a low partial pressure of oxygen

Impaired oxygen carrying capacity

Toxins that interfere with oxygen use

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92
Q

In what area of the severed axon does Wallerian degeneration occur?

A

the distal axon

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93
Q

What causes Diffuse Brain Injury (DBI)?

A

impact, acceleration, and deceleration forces

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94
Q

What grades are malignant or high grade tumors?

A

Grade 3 or 4

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95
Q

What is herniation?

A

the displacement of brain tissue past dural folds or through openings in the skull

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96
Q

What is Focal Cerebral Ischemia?

A

reductino or complete blockage of blood flow to a LOCALIZED area of the brain; cerebral arterial occlusion leads first to focal ischemia and then to infarction

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97
Q

What is Amyotrophic Lateral Sclerosis (ALS)?

A

persistently progressive neurodegenerative disorder causing:
Muscle weakness
disability
Eventually death

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98
Q

What are the clinical outcomes of global cerebral ischemia?

A

transient confusional state to irreversible damage to CNS tissue

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99
Q

What is TIA?

A

a TRANSIENT episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischemia WITHOUT ACUTE INFARCTION

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100
Q

What is the pathogenesis of Alzheimer’s Disease?

A

amyloid precursor protein (APP) is cleaved by beta-secretases and gamma secretases
PSEN1 and 2 mutations cause production of amyloid beta
Tau is hyperphosphorylated and aggregates

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101
Q

Why does a patient with meningitis have nausea and vomiting?

A

increased ICP stimulates the vomiting center

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102
Q

What is primary brain damage after ICH?

A

Tissue dysruption
Mechanical damage due to mass effect
Elevated ICP

These cause damage to the BBB and cerebral edema

103
Q

Name the cells of the Nervous system

A

Neurons

Neuroglia

104
Q

What are the three stages of compensation during presymptomatic period of Parkinsons?

A

1) early period = dopamine homeostatic mechniams capable of masking the disease
2) increased activity of basal ganglia
3) increased intensity of compensation in motor cortex as parkinsonian motor abnormalites emerge

105
Q

What is the function of the brain?

A 
Receives and Processes Sensory Info
Initiates Responses
Memories
Thoughts
Emotions
106
Q

What tumors commonly metastisize to the brain?

A 
Lung
Skin (melanoma)
Breast
Kidney
GI tract
107
Q

What are the causes of Focal Cerebral Ischemia?

A

Embolic infarctions and thrombotic occlusions

108
Q

What limits the regeneration of axons in the CNS?

A

increased incidence in scar formation

Different nature of myelin formed by the oligodendrocyte

109
Q

What is cytotoxic edema?

A

potentially REVERSIBLE increase in INTRACELLULAR fluid SECONDARY TO neuronal, glial, or endothelial membrane INJURY

110
Q

What is the effect of the scar formation from the Wallerian degeneration?

A

blocking of passage of neuronal impulses

111
Q

What is secondary brain damage after ICH?

A

thrombin activation
lysis of RBCs causing release of hemoglobin–> heme and iron by oxidative stress
Inflammatory reaction –> release of proinflammatory mediators

112
Q

What is the function of the thalamus?

A

interprets certain sensory messages such as those of pain, temperature, and pressure

113
Q

What are the four types of Focal Brain Injury?

A

Brain contusion
Intraparenchymal Brain Hemorrhage
Subdural Hematoma
Epidural Hematoma/Extradural Hematoma

114
Q

What is normal ICP in adults?

A

less than or equal to 15 mmHg

115
Q

What is intracranial compliance?

A

The balance of volume betweent the three compartments being maintained by:

displacement of CSF into thecal sac or

decrease in volume of the cerebral venous blood via venoconstriction and extracranial drainage

116
Q

What is cause of demyelination?

A

inflammation

117
Q

What happens when cerebral blood flow is 17 mL/100 g/min?

A

neuronal electrical failure

118
Q

What does VEGF do?

A

controls angiogenesis and is upregulated in GBM;

Increases vascular permeability, endothelial gaps, adn fenestrations which causes rapid growth of the tumor

119
Q

What is the DSM-5 definition of dementia?

A

Significant acquired cognitive impairment in one or more cognitive domains that represents a significant decline from previous baseline and interferes with independence in daily activities

120
Q

What are the clinical features of meningiomas?

A

Slow growing tumors

Express progesterone receptors and may grow more rapidly during pregnancy

121
Q

Brain contusions in the location of impact are?

A

Coup

122
Q

What are three common clinical settings of herniation?

A

Cerebral Edema
Increased CSF volume/Hydrocephalus
Mass Lesions

123
Q

What are the clinical consequences of CTE?

A

neuropsychologic deficits
speech and gait abnormalities
parkinsonism

124
Q

What is a subdural hematoma?

A

bridging blood vessels are severed in subdural space or cerebral cortical hemorrhage occurs by direct brain trauma

125
Q

What are the two types of intracranial hemorrhage?

A 
intracerebral hemorrhage (ICH)
Subarachnoid hemorrhage
126
Q

What is Global Cerebral Ischemia?

A

occurs in the setting of severe systemic hypotension ( <50mmHg)

127
Q

What does a mutation in IDH1 or IDH2 cause?

A

accumulation of the oncometabolite 2-hydroxyglutarate (2-HG)

128
Q

What is a brain contusion?

A

blunt trauma between the brain and the skull after accleration and deceleration of the head

129
Q

What is intraparenchymal brain Hemorrhage?

A

develops from tears in teh brain tissue and/or vasculature

130
Q

What causes upper motor neuron symptoms?

A

degeneration of frontal motor neurons

131
Q

What cerebrovascular disease class can cause primary hemorrhagic stroke?

A

process resulting from rupture of a vessel in the subarachnoid space or intercerebral tissue

132
Q

What is the function of the spinal cord level?

A

upper levels send signals to control centers within it

Control movement, reflexes, blood vessels, and GI tract

133
Q

What is rigidity?

A

Increased resistance to passive movement of a joint

134
Q

What blood pressure range is cerebral blood flow kept at in autoregulation?

A

60-150 mmHg

135
Q

What is critically important in regards to CSF?

A

that there is a balance between its absorption and production

136
Q

By what week of gestation is the neural tube formed?

A

week 4

137
Q

What is cerebral palsy?

A

heterogenous group of conditions involving permanent non-progressive central motor dysfunction that effects muscle tone, posture, and movement

138
Q

What happens when cerebral blood flow is 50 mL/100g/min?

A

Inhibition of protein synthesis begins

139
Q

What is pyrogenic meningitis caused by?

A

bacteria

140
Q

How does the infection damage the nervous system?

A

directly through injury of neurons or glia by the infectious agent
Indirectly through microbial toxins
The destructive effects of inflammatory response
The result of immune mediated mechanisms

141
Q

What is chronic meningitis caused by?

A

TB
Spirochetal
Cryptococcal

142
Q

What is the most common way microbes access the CNS?

A

hematogenous spread

143
Q

What causes global cerebral ischemia?

A

SHOCK

cardiac arrest
When blood flow to the brain is stopped or reduced

144
Q

What is Primary Progressive?

A

Progressive accumulation of disability from disease onset with occasional plateus, temporary minor improvements, or acute relapses

145
Q

What is effected by spinal cord abnormalities in myelomeningocele?

A

the trunk, legs, bladder, and bowel

146
Q

What produces CSF?

A

the choroid plexus of each ventricle

147
Q

What are the two most common causes of Cerebral palsy?

A

premature birth and low birth weight

148
Q

What does elevated HG-2 cause?

A

Global changes in DNA and histone methylation
Impairment of cellular differentiation
Tumorigenesis

149
Q

What is the pathophysiology of GBM?

A

upregulation of vascular endothelial growth factor (VEGF)

150
Q

What is the function of the brain stem?

A

regulates Heartbeat and breathing; plays a role in consciousness

151
Q

What are the causes of early onset dementia?

A 
Alzheimers Disease
presenilin 1 and 2 mututations
Amyloid precursor protein mutation
APOE-E4-associated disease
Parkinson disease dementia
Infectious diseases like prions
Inflammatory and autoimmune diseases like multiple sclerosis
152
Q

What is the function of oligodendrocytes?

A

produce myelin

153
Q

What is late onset Alzheimers Disease and what causes it?

A

happens to people older than 65

APOE e4

154
Q

What is clinical evidence found in viral meningitis?

A

there are NO bacterial pathogens in CSF of a patient who hasn’t yet received an antibiotic

155
Q

What is relapsing remitting?

A

there are clearly defined relapses with full recovery and remission; 85%

156
Q

What are the functions of CSF?

A

Acts as cushion/shock absorber which keeps the brain tissue buoyant

Delivers nutrients to the brain

Removes waste from the brain

Compensates for changes in intracranial blood volume

157
Q

What is Traumatic Vascular Injury?

A 
near universal feature of sever TBI
direct trauma and disruption of the vessel wall taht lead to hemorrhage in:
epidural space
subdural space
subarachnoid space
intra-parenchymal compartments
158
Q

What is tonsilar herniation?

A

brain passes through foramen magnum and crushes brainstem compromising vital respiratory and cardiac centers in the medulla

159
Q

What is the pathogenesis of Cerebral palsy?

A

focal white matter injuries

160
Q

What is perinatal?

A

end of 22 weeks gestation to 7 days after birth

161
Q

What are the 4 classes of cerebrovascular disease?

A

Process occurs in vessels = athrosclerosis
Process originates remotely = emboli
Process results from inadequate cerebral blood flow
Process results from rupture of a vessel in the subarachnoid space or intercerebral tissue

162
Q

What are ependymal cells?

A

line the spinal cord and ventricles of the brain

Crease CSF

Form choroid plexus

163
Q

What is the etiology of Viral meningitis?

A

ENTEROVIRUSES
Mumps virus
herpes simplex virus

164
Q

How can microbes access the CNS?

A

Hematogenous spread
Direct Implantation
Local extension
Peripheral Nerves

165
Q

What are the cognitive domains effected in dementia?

A 
Learning and memory
Language
Executive Functin
Complex attention
Perceptual-motor function
Social cognition
166
Q

What is a grade 2 astrocytoma associated with?

A

Inactivation of TP53 tumor suppressor gene
Point mutations in isocitrate dehydrogenase I (IDH1)
Mutation in the chromatin regulator gene

167
Q

What is hydrocephalus?

A

increase in volume of CSF within the ventricles

168
Q

What is intracerebral hemorrhage (ICH)?

A

blood goes directly to brain parenchyma

169
Q

What is the etiology of myelomeningocele?

A

unknown; theory is that it is due to defects in timing of DNA synthesis and epigenetic regulations

170
Q

What is the function of the cortical level?

A

complicated multifunctioning; it cannot function by itself and needs the help of the other two levels; it also helps the other two levels

171
Q

What is the core diagnostic criteria for MS?

A

brain lesions

172
Q

What type of meningitis is most common and least severe?

A

Viral Meningitis

173
Q

What are symptoms of MS?

A

Sensory in Limbs
Visual Loss
Motor Loss
Polysymptomatic onset

174
Q

What happens when cerebral blood flow is 35 mL/100g/min?

A

protein synthesis ceases

Glucose utilization transiently increases

175
Q

What should you not call Grade 2 tumors?

A

benign or low grade because they aren’t; they actually tend to reoccur

176
Q

What causes subarachnoid hemorrhage?

A

rupture of an aneurysm from base of the brain

177
Q

What is the pathology of ALS?

A

intracellular inclusions in degenerating neurons and glia

motor neuron degeneration and death with gliosis

spinal cord becomes atrophied

affected muscles show denervation atrophy

178
Q

At what cerebral blood pressure does autoregulation fail?

A

180 mmHg

179
Q

What are the consequences of hydrocephalus in infants?

A

enlargement of the head

180
Q

What are the major pathological mechanisms of MS?

A

DEMYELINATION
inflammation
axonal degeneration

181
Q

What are Astrocytes?

A

metabolic buffers and detoxifiers within the brain

modulate how neurons communicate

182
Q

Why does a patient with meningitis get a headache?

A

bacterial exotoxins, cytokines, and increase ICP stimulate nocireceptors in the meninges

183
Q

What is a neural tube defect?

A

portion of neural tube does not close or reopening of a region of the tube after closure

Can happen anywhere in NS: brain, spine, spinal column

184
Q

What is viral meningitis?

A

a feverish illness with clinical signs and symptoms of meningeal irritation
self-limiting
inflammation of meninges surrounding the brain and spinal cord

185
Q

What are the two types of traumatic brain injury (TBI)?

A

Diffuse Brain Injury (DBI)
and
Focal Brain Injury (FBI)

186
Q

What occurs when an axon is severed?

A

Wallerian Degeneration

187
Q

What is the transition from low-grade to malignant glioma associated with?

A

Cell cycle checkpoint inactivation
Tumor suppressor gene inactivation
Angiogenesis

188
Q

What are the clinical features or Parkinson’s?

A

rest tremor
Bradykinesia
Rigidity
Postural instability

189
Q

What are the three symptoms most commonly associated with bacterial meningitis?

A

Fever
Neck Stiffness
Altered Mental State

190
Q

What makes up primary brain tumor?

A

glial cells

191
Q

What are the clinical consequences of the loss of integrity of brain structural integrity?

A

breakdown of BBB
Development of cerebral edema
hemorrhage into brain parenchyma

192
Q

What is intracranial pressure (ICP)?

A

produced by the interaction between the three intracranial compartments

193
Q

What is the Blood Brain Barrier (BBB)?

A

cellular structures that selectively inhibit certain potentially harmful substances in the blood from entering the brain or CSF

limits substances to reach the brain

194
Q

What is the most common cause of dementia in older adults?

A

Alzheimer’s Disease

195
Q

What is the function of the subcortical level?

A

Subconscious activities

196
Q

What is subarachnoid hemorrhage?

A

blood goes directly into CSF under arterial pressure causing increased ICP

197
Q

What are the risk factors for ALS?

A

age

family history

198
Q

What is gliobastoma (GBM)?

A

The ‘monster’; is the most malignant form of astrocytoma

199
Q

What is the most common type of neural tube defect?

A

Spina Bifida

200
Q

What causes herniation?

A

increased ICP

201
Q

What is early onset Alzheimers and what causes it?

A

occurs in individuals younger than 65

Mutations in APP, PSEN1, and PSEN2

202
Q

What are the two types of brain damage after ICH?

A

primary and secondary brain damage

203
Q

What is vasogenic edema?

A

IRREVERSIBLE increase in EXTRACELLULAR FLUID

204
Q

What other genetic factors can cause Alzheimer’s Disease?

A

Mutations in ApoEe4 allele

205
Q

Sensory receptors take their information to what portion of the brain?

A

The somatostatin region

206
Q

What are the common symptoms of meningiomas?

A

headache and weakness in an arm or leg

207
Q

Where is dopamine found?

A

in basal ganglia in substantia niagra

208
Q

What is bradykinesia?

A

generalized slowness of movement

209
Q

What are the three intracranial compartments?

A

Cerebral Parenchyma 80%
CSF 10%
Blood 10%

210
Q

What disorder commonly features injury or apoptosis of oligodendrocytes?

A

acquired demyelinating disorders

211
Q

What is the function of the capillaries in the BBB?

A

they have continuous tight junctions which limits the passage of most substances to the brain

212
Q

What are the clinical hallmarks of ALS?

A

combination of upper and lower motor neuron signs and symptoms

213
Q

How Alzheimers Disease neuropathologic change ranked?

A

Amyloid beta placque distribution score
Neurofibrillary tangle distribution stage
Neuritic placque density score

214
Q

Why does a patient with meningitis have an altered mental status?

A

increased ICP causes brain herniation which causes damage to the reticular formation

215
Q

What are the three types of cells of the Neuroglia?

A

Astrocytes
Oligodendrocytes
Ependymal Cells

216
Q

How does the cell body respond to trauma?

A

swelling and apoptosis

217
Q

What is the pathophysiology behind Parkinson’s Disease?

A

basal Ganglia circuits

Compensatory mechanisms

218
Q

What occurs in basal ganglia circuits that causes Parkinsons Disease?

A

dopamine depletion in substantia nigra an nigrostatial pathways causes:
INCREASED INHIBITION of thalamus and REDUCED EXCITATORY input to the motor cortex

219
Q

What is the severe form of Diffuse Brain Injury (DBI)?

A

Diffuse traumatic axonal injury (DAI)

220
Q

What causes hydrocephalus in 90% of children with myelomeningocele?

A

Chiari 2 malformation

221
Q

What are the three compensatory mechanisms of Parkinson’s Disease?

A

increased synthesis of Dopamine in surviving neurons
Proliferation of dopamine receptors
Gap Junctions allowing rapid communication between neurons increases dramatically

222
Q

What Symptoms are associated with both types of meningitis?

A 
Fever
Headache
Stiff Neck
Altered Mental Status
Nausea and Vomiting
223
Q

What are muscles and glands that carry out motor functions called?

A

Effectors

224
Q

What GCS score is considered severe TBI?

A

8 or less

225
Q

What is secondary brain injury that causes TBI?

A

CELLULAR MECHANISM CASCADE happenings over days; can be decreased by preventing hypoxia and hyperperfusion
NT mediated excitotoxcity causing Glu, free radical injury to cell membranes
Electrolyte imbalances
Mitchondrial Dysfunction
Inflammatory Responses
Apoptosis
Secondary ischemia from vasospasm, focal microvascular occlusion

226
Q

What happens to the brain parenchyma when blood flow is decreased to it?

A

immediate death by necrosis because there isn’t any ATP

227
Q

What is the pathophysiology of Diffuse axonal injury (DAI)?

A

AXONAL SWELLING due to disruption of axonal neurofilament impairing axonal transport
SECONDARY INJURY due to release of excitatory NTs ACh, Glu, and generation of free radicals

228
Q

What is the milder form of DBI?

A

concussion

229
Q

What are the two types of ischemia?

A

Global and Focal

230
Q

What is primary brain injury that causes TBI?

A

TRAUMA
shearing mechanisms lead to DAI
focal cerebral contusions
Extra-axial hematomas - epidural, subdural, or subarachnoid

231
Q

What is secondary progressive?

A

initially has pattern of RR but then it gradually gets worse; with or without occasional relapses, remissions, or plateus

232
Q

What are the environmental risk factors for ALS?

A

smoking
environmental toxin exposure
military service

233
Q

What are three tumors produced from normal glial cells?

A

Astrocytomas
Oligodendrogliomas
Ependymomas

234
Q

What is the function of the Efflux transporters of the BBB?

A

help to expel foreign substances taht might sneak through the capillary membrane

235
Q

What is Chiari 2 malformation/

A

cerebellum and brainstem are pushed through the foramen magnum and ventricles are also enlarged

236
Q

What is the function of the hypothalamus?

A

controls carious homeostatic functions sucha s body temperature, respiration, and heartbeat

237
Q

What is ischemic stroke?

A

an infarction of CNS tissue due to ischemia, based on neuropathologic, neuroimagin, and/or clinical evidence of PERMANENT injury

238
Q

What changes occur in Alzheimer’s Disease?

A

neuritic placques
extracellular deposits of Amyloid beta peptides
Neurofibrillary degeneration seen as tau proteins

239
Q

What is the neuropathology of CTE?

A

extensive Tau immunoreactive degenerative changes that can be found in the superficial cortical layers of the brain

240
Q

Who are most prone to getting subdural hematomas?

A

the elderly and infants

241
Q

What are the four stroke types?

A

Intracerebral hemorrhage
Subarachnoid hemorrhage
Ischemic thrombotic
Ischemic Embolic

242
Q

What is early onset dementia?

A

occurs in adults ages 18-65

243
Q

What are the components of the BBB?

A

Capillaries
Astrocyte foot
Efflux transporters

244
Q

What do clinical deficits depend on when it comes to hypoxia and ischemia?

A

duration and magnitude and rapidity of the reduction of flow

245
Q

What is hypoxia?

A

decreased oxygen to the brain

246
Q

What is pathologic intrcranial hypertension (ICH)?

A

greater than or equal to 20 mmHg

247
Q

What causes lower motor neuron symptoms of ALS?

A

degeneration of lower motor neurons in brainstem and spinal cord

248
Q

What is a meningioma?

A

predominantly benign tumors of adults arising from the meninges

249
Q

What is the etiology of ALS?

A

abnormalities in RNA metabolism
excitotoxicity
Viral infections
Inflammatory responses

250
Q

What occurs 7 10 14 days after injury in the PNS?

A

new terminal sprouts project from proximal segment of the axon

251
Q

What are lower motor neuron symptoms of ALS?

A

weakness
atrophy
Fasciculations

252
Q

What causes intracerebral hemorrhage (ICH)?

A

HTN
trauma
vascular malformations

253
Q

Where can injury of the brain parenchyma be?

A

In frontal lobe = silent
Severely in the spinal cord
fatal in brainstem

Patho II (16 decks)

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