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PATH 375 > 10 - Central Nervous System > Flashcards

10 - Central Nervous System Flashcards

1
Q

What diseases result when:
- loss of neurons?
- abnormal function of neurons?
- abnormal excitation of neurons?

A
  • Alzheimer’s
  • Parkinson’s
  • Epilepsy
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2
Q

What is intracranial pressure (ICP) characterized by? What are 3 causes? Symptoms?

A

Characterized by pressure of CSF, can result in brain herniation if not relieved

Causes:
- brain parenchyma tumor, cerebral edema
- CSF outflow obstruction
- hemorrhaging, hematoma

Symptoms: headache, nauseua, vision change, loss of consciousness, death

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3
Q

What’s the diff btwn epidural and subdural hematoma, subarachnoid and intracerebral hemorrhage?

A

Epidural:
- arterial hemorrhage btwn skull and dura
- usually due to trauma, symptoms not immediate

Subdural:
- venous hemorrhage btwn dura and arachnoid
- due to cerebral atrophy, symptoms have slower onset than epidural

Subarachnoid:
- hemorrhage btwn arachnoid and pia
- usually due to trauma, rupture of aneurysms (Berry aneurysm)

Intracerebral:
- hemorrhage into substances of brain from intracerebral vessels
- usually due to trauma, stroke, and tumor

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4
Q

What is global ischemia characterized by and the two major patterns of injury?

A

General reduction of oxyen supply leads to stroke

  1. Multiple small foci or ischemic necrosis:
    - results in multi-infarct dementia (progressive mental deterioriation)
  2. Hypoperfusion from cardiac failure:
    - pump failure => cardiogenic shock
    - loss of fluid => hypovolemic shock
    - loss of peripheral vascular tone => hypotonic shock
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5
Q

What’s the difference btwn global and focal ischemia?

A

Global: generalized ischemic necrosis
Focal: more localized and more fixable

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6
Q

Characterization of hemorrhagic strokes and 4 causes

A

Characterized by stroke resulting from blood vessel rupture

Causes:
1. HTN
2. cerebral amyloid angiopathy
3. cerebral arteriovenous malformation
4. intracranial aneurysm

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7
Q

What is a major cerebrovascular disease

A

Stroke

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8
Q

What are the 4 classifications of CNS trauma?

A
  1. Concussion: head trauma leading to altered consciousness
  2. Contusion: bruising of soft tissue
  3. Laceration: tearing of soft tissue
  4. Spinal cord injury: hyperextension, hyperflexion, can result in ligament rupture and possible loss of feeling
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9
Q

Difference btwn coup and contrecoup injury?

A

Coup = contusion at site of impact
Contrecoup = contusion at opposite site of impact

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10
Q

Difference btwn hyperflexion and hyperextension?

A

Hyperflexion = head goes forward
Hyperextension = head goes backwards

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11
Q

What are the 3 causes of CNS infections?

A
  1. hematogenous/vascular spread
  2. direct extension from adjacent structures (e.g. fractures)
  3. ascending neural route
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12
Q

what are the 4 main CNS infections

A
  1. Myelitis: inflammation of spinal cord parenchyma
  2. Encephalitis: inflammation of brain parenchyma (virus)
  3. Meningitis: inflammation of meninges
  4. Cerebral abscess: localized pus-forming infection by bacteria
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13
Q

Three main classifications of meningitis?

A
  1. Acute pyogenic (bacterial)
    - Group B strep
    - N. meningitidis
    - S. pneumoniae
  2. Aseptic (viral)
  3. Chronic
    - TB, fungal, lyme, syphilis
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14
Q

How do the following cause CNS infections: virus, prions, protozoa, fungi

A

Virus:
- usually encephalitis
- other examples: herpes, HIV, AIDS, measles, rubella

Prions:
- small particles with no RNA/DNA but only infects nervous system
- most common = Creutzfeldt-Jakob disease (CID)
- example: bovine spongiform encephalopathy in cows

Protozoa:
- toxoplasmosis as opportunistic during AIDS

Fungi:
- causes infection in immunocompromised

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15
Q

What is the most common disease caused by prions?

A

Creutzfeldt-Jakob disease (CJD)

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16
Q

What is multiple sclerosis characterized by? What does its pathology involve? Symptoms?

A
  • autoimmune demyelinating disease characterized by chronic relapsing and remitting course
  • pathology involves white matter and leads to plaques
  • affects both sensory and motor pathways (limb weakness, loss of sensation with tingling, blurred vision)
17
Q

What are the two metabolic disorders? What are they deficient in and what accumulates?

A

Tay-Sachs Disease
- deficiency in hexosaminidase A
- accumulation of gangliosides in neurons leading to toxicity

Niemann-Pick Disease
- deficiency in sphingomyelinase
- accumulation of sphinomyelin in neurons leading to toxicity

18
Q

What are the three nutritional deficiency diseases and what do they cause?

A

1. Thiamine (Vit B1) Deficiency
- Wernicke encephalopathy (disturbance of ocular function)
- Korsakoff syndrome (amnesia)

2. Vitamin B12 Deficiency
- causes uncoordinated movement, sensorimotor peripheral neuropathy

3. Nicotinic acid (Vit B3) Deficiency
- causes dermatitis, diarrhea, and delirium

19
Q

What are the indirect (2) and direct (3) effects of chronic alcoholism?

A

Indirect:
- nutritional and metabolic disturbances
- repeated head trauma

Direct:
- Cerebellar atrophy = uncoordinated movement
- Cortical atrophy = mental deterioration
- myelopathy and sensory-motor neuropathy = sensory deficiency, tremor, muscle fatigue

20
Q

Main characteristics of Alzheimer’s (3)

A
  1. atrophy of brain (frontal and occipital cortical gyri) due to loss of neurons
  2. form of dementia with insidious impairment of intellectual function and progressive disorientation/memory loss
  3. histological changes include neurofibrillary tangles and neuritic plaques
21
Q

Main characteristics of Parkinson’s (3)

A
  1. subcortical neurodegenerative disease due to decreased dopaminergic neurons in substantia nigra
  2. TRAP symptoms: Tremor, Rigidity, Akinesia, Postural instability
  3. Palor of substantia nigra, loss of melanin-rich neurons (remaining have Lewy bodies)
22
Q

Main characteristics of Huntington’s (3)

A
  1. Autosomal dominant, atrophy of basal ganglia and frontal cortex
  2. Mutation in HTT gene causing CAG expansions
  3. Characterized by involuntary, gyrating movements and progressive dementia
23
Q

Main characteristics of Amyotrophic Lateral Sclerosis (ALS) (3)

A
  1. aka Lou Gehrig’s disease
  2. progressive, fatal motor neuron disease due to loss of motor neurons in spinal cord
  3. motor weakness and progressive wasting of muscles leading to muscle loss and death (paralysis of resp mscles)
24
Q

What are the two primary CNS neoplasms?

A

Glioma & Meningioma

25
Q

Characteristics of glioma. Which type is most prominent?

A
  1. Tumors arising from glial cells:
    - astrocytoma
    - oligodendroglioma
    - ependymoma
  2. Astrocytic tumors: astrocytoma and glioblastoma
    - glioblastoma is highly aggressive with poor prognosis
26
Q

Characterizations of meningioma (2)?

A
  • neoplasm arising from meninges, normally benign but can be fatal depending on location
  • good prognosis

PATH 375 (6 decks)

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