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NS Pathology > اول ٦ صفحات > Flashcards

اول ٦ صفحات Flashcards

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1
Q

Acute injury of Neurons

A

Necrosis:
• 12-24hrs Ischemia/hypoxia (very susceptible)

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2
Q

neurons that have lost their
nucleus, intensely eosinophilic

A

Red Neurons

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3
Q

axonal swelling

A

SPHEROIDS

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4
Q

Apoptosis

A

aging

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5
Q

Chronic or subacute injury example

A

Parkinson Disease, Alzheimer disease

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6
Q

Neuronal processes in Chronic or subacute injury

A

thickened & tortuous (Dystrophic Neurites)

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7
Q

Neuronal loss & replacement by gliosis in progressive diseases

A

Chronic or subacute injury

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8
Q

Axonal injury leads to

A

Central Chromatolysis

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9
Q

progressive depletion of
dopaminergic neurons in the basal ganglia,
particularly the substantia nigra.

A

Parkinson disease

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10
Q

Inclusions

A

viral infections

Nuclear or cytoplasmic

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11
Q

Gliosis

A

↑number & size of Astrocytes

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12
Q

Swollen reactive astrocytes with acidophilic cytoplasm (↑GFAP)

A

Gemistocytes

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13
Q

Aggregates of thick eosinophilic astrocytic fibers, in old gliosis or some tumors

A

Rosenthal fibers

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14
Q

Synthesis & maintenance of myelin// inclusion in specific viral infection (JC virus)

A

Oligodendrocytes

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15
Q

Inclusions characteristic of CMV

A

Ependymal cells

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16
Q

lines the ventricles and the spinal canal

A

Ependymal cells

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17
Q

Macrophages in infarction

A

Gitter cells

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18
Q

Elongated cells in syphilis

A

Rod cells

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19
Q

Aggregates of microglia around injured cells

A

Microglial nodules

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20
Q

Aggregate around dead neurons

A

Neuronophagia

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21
Q

Increased Intracranial Pressure

A

↑ in CSF pressure > 15 mm

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22
Q

Increased Intracranial Pressure PATHOPHYSIOLOGY

A

Inside the skull: Brain 70%, CSF 15% , Blood 15%

Expansion in any component is first compensated by ↓ in the rest i.e. ↓ CSF, ↓ blood, ↓ ventricular size

If P. ↑ >15-20mm.Hg , compensation fails

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23
Q

Herniation of Cingulate gyrus under
falx cerebri into the subfalcine space

A

SUBFALCINE HERNIATION

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24
Q

Pressure on Anterior Cerebral Artery →
Cerebral infarction

A

SUBFALCINE HERNIATION

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25
herniation of medial temporal lobe(insula) through tentorium cerebelli
TRANSTENTORIAL HERNATION
26
TRANSTENTORIAL HERNATION manifestation
Occipital infarction 3rd.& 6th. Cranial Nerves. → ipsilateral dilated pupil &impaired eye movement Cerebral peduncle compression to opposite side → ipsilateral hemiparesis
27
Herniation of cerebellar tonsil and medulla through foramen magnum
TONSILLAR HERNIATION
28
BRAIN STEM: Pressure on respiratory & cardiac centers Associated with which type of herniation
TONSILLAR HERNIATION
29
Cardiorespiratory failure & death
TONSILLAR HERNIATION
30
Dry Flat Gyri
Cerebral Edema
31
Cerebral Edema types
Vasogenic Edema Cytotoxic edema
32
Vasogenic Edema
due to↑ permeability with dysfunction of blood brain barrier Intercellular white matter Infarcts, contusions, tumors, abscesses
33
Cytotoxic Edema
• due to neuronal & glial injury • Intracellular • More in grey matter • More in toxic & metabolic causes
34
CAUSES OF INCREASED ICP
1. Cerebral Edema: Dry Flat Gyri 2. Infarction & Hemorrhage 3. Infections - Abscesses & meningitis 4. Tumors - Primary & Secondary 5. Trauma - especially in diffuse brain damage 6. Hydrocephalus
35
Excess CSF in ventricular system with enlarged ventricles, caused by
I. ↓ resorption in inflammation & obstruction II. Overproduction of CSF in some tumors
36
Chronic HYDROCEPHALUS with compensation
children → Large head, thin skull, open fontanel
37
Some viruses have selective sites
• CMV - Ventricles • HSV - Temporal lobe & orbital frontal area • Polio - Anterior horn cells of spinal cord • Herpes Zoster - Thoracic dorsal root ganglia
38
Thoracic dorsal root ganglia infected by
Herpes Zoster
39
Anterior horn cells of spinal cord infected by
Polio
40
Temporal lobe & orbital frontal area infected by
HSV
41
Ventricles
CMV
42
HSV-2 in adults may cause
meningitis
43
Acute Bacterial Meningitis of Neonates
Streptococci & E.coli
44
Acute Bacterial Meningitis>6m
H. influenza, S. pneumoniae
45
Acute Bacterial Meningitis in Shunt operations
Staphylococci
46
Acute Bacterial Meningitis Elderly
S. pneumonia & L. monocytogenes
47
Acute Bacterial Meningitis in Adolescents & young adults
N. meningitidis
48
Waterhouse- Friderichsen Syndrome
N. meningitidis
49
C.S.F. findings (lumbar puncture):
• ↑Pressure, ↑Protein, ↓sugar, numerous neutrophils, demonstrable bacteria
50
COMPLICATIONS OF BACTERIAL MENINGITIS مهم تعرف الفرق عن تبع الفيروس
1. Obstructive hydrocephalus 2. Cerebral infarction 3. Cerebral abscess 4. Epilepsy 5. Cranial nerve palsy 6. Deafness (8th cranial nerve)
51
MORPHOLOGY in Acute Bacterial Meningitis:
Exudate in subarachnoid space, especially around base, full of neutrophils & organisms
52
ACUTE ASEPTIC MENINGITIS (VIRAL MENINGITIS) by which microorganisms
Enterovirus, echovirus, coxackie v., mumps v., EBV, HIV قراءة مش بصم
53
ACUTE ASEPTIC MENINGITIS (VIRAL MENINGITIS(
➢ Hematogenous spread. ➢ Mild self-limiting often seasonal
54
ACUTE ASEPTIC MENINGITIS (VIRAL MENINGITIS)
CSF is clear, slight ↑ protein, normal sugar, ↑↑ lymphocytes مهم شو نوع الخلايا +++ انه السكر طبيعي
55
BRAIN ABSCESS
➢ CSF: ↑protein, ↑cells, normal sugar.
56
BRAIN ABSCESS morphology
• Localized suppuration surrounded by granulation tissue, reactive astrocytes & severe edema leading to ↑ ICP. • Later gliosis & collagen formation
57
BRAIN ABSCESS how you will be infected
➢ Direct infection from paranasal sinuses, mastoiditis & middle ear → Frontal or temporal lobes , mostly single ➢ Hematogenous route, • More in parietal lobe • May be multiple
58
HUMAN IMMUNODEFICIENCY VIRUS (HIV)
At least 60% of AIDS pts. develop CNS dis
59
HIV
aseptic viral meningitis in 10%
60
Commonest cause of dementia in the young
Chronic HIV: Meningoencephalitis
61
Pathology of HIV
.white matter, basal ganglia & spinal cord. • Demyelination, microglial nodules with multinucleated giant cells>> • Brain atrophy
62
CYTOMEGALO VIRUS (CMV) in aids patients
subacute encephalitis any region & any cell mainly ependymal & subependymal cells. hemorrhagic necrosis large cytoplasmic & intranuclear inclusions brain destruction, microencephaly & calcification
63
Rare cases develop paralysis of respiratory muscles Virus??
POLIOVIRUS
64
Atrophy of the anterior (motor) spinal roots, and neurogenic atrophy of denervated muscle in case of
Chronic POLIOVIRUS
65
Acute POLIOVIRUS affects which region
Affect anterior horn motor neurons of the spinal cord
66
RABIES degeneration and inflammatory reaction, most severe in
midbrain, & floor of 4th. Ventricle
67
Negri bodie
RABIES
68
Negri bodies
:cytoplasmic eosinophilic inclusions in pyramidal neurons of the hippocampus & Purkinje cells of cerebellum
69
مهم مهم بصم
➢ All common features of viral encephalitis seen with intranuclear viral inclusions in neurons & glial cells.(cowdry type A )

NS Pathology (3 decks)

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