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NSB! > Introduction to Neuropathology > Flashcards

Introduction to Neuropathology Flashcards

1
Q

During neurulation, the notochord is formed from the mesoderm and then stimulates the ectoderm to differentiate into the neural tube which folds and separates from the ectoderm and goes on to form the neural tube. In addition, the neural crest cells are created from the ectoderm layer. What do the neural tube and neural crest cells go on to form?

A
  • neural tube = CNS

- neural crest = PNS

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2
Q

What are pyramidal cells?

1 - form of multipolar neuron found in hippocampus and amygdala
2 - form of unipolar neuron found in hippocampus and amygdala
3 - form of bipolar neuron found in hippocampus and amygdala
4 - form of pseydopolar neuron found in hippocampus and amygdala

A

1 - form of multipolar neuron found in hippocampus and amygdala

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3
Q

What are ependymal cells?

1 - epithelial cells lining the venous sinuses
2 - ciliated epithelial glial cell that form the choroid plexus
3 - ciliated epithelial cells that line the ventricles
4 - epithelial cells that form the olfactory nerve

A

2 - ciliated epithelial glial cell that form the choroid plexus

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4
Q

What are the main functions of the glial cells called astrocytes?

1 - support, communication, BBB, maintenance, repair
2 - immune function, communication, BBB, maintenance, repair
3 - support, myelinate neurons, BBB, maintenance, repair

A

Astrocytes :

  • support,
  • communication,
  • BBB,
  • maintenance,
  • repair
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5
Q

What are the immune cells of the CNS?

1 - macrophages
2 - microglia
3 - astrocytes
4 - neutrophils

A

2 - microglia

- think M for monocytes

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6
Q

What is the main antigen presenting cell in the CNS?

A
  • microglia

- can recruit macrophages as well

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7
Q

The majority of the brain has the blood brain barrier (BBB), which does not let a lot pass. What is the structure of the BBB that helps it maintain such a tight barrier?

A
  • endothelial cells held together by tight junctions
  • basement membrane
  • pericytes
  • astrocyte end foot
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8
Q

There are 2 main instances in the brain that do not posses the tight BBB. What are these 2 instances?

A

1 - choroid plexus (create CSF)

2 - circumventricular organs (facilitate communication between blood in CNS and PNS), such as the pituitary gland

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9
Q

What are the 3 basic layers of the meninges of the brain?

A

1 - dura mater
2 - arachnoid mater
3 - pia mater

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10
Q

The dura mater meningeal layer has 2 layers, what are these?

1 - endosteal layer and meningeal layer
2 - periosteum layer and meningeal layer
3 - pia layer and meningeal layer
4 - endosteal layer and subarachnoid layer

A

1 - endosteal layer and meningeal layer

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11
Q

The dura mater meninges has 2 layers, endosteal/periosteal layer (closest to the bone) and the meningeal layer. These 2 layers are normally in close contact, but the areas where they do separate create space. What are these spaces called?

A
  • venous sinuses
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12
Q

In the subarachnoid layer of the meninges there is something that protrudes into the venous sinus and allows CSF to flow out of the brain. What are these protrusions called?

1 - arachnoid dendrites
2 - arachnoid microtubules
3 - arachnoid granulations
4 - glymphatics

A

3 - arachnoid granulations

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13
Q

Below the pia mater, the deepest and closest meningeal layer to the brain is a glial membrane composed of astrocyte foot processes. These function to prevent the over-migration of neurons and neuroglia, the supporting cells of the nervous system, into the meninges. What is this called?

1 - glia radialatans
2 - glia limitans
3 - glymphatics
4 - glymphoma

A

2 - glia limitans

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14
Q

The cerebral cortex is a grey matter area on the outside of the brain, composed of neuronal cell bodies. How many laters does the cerebral cortex have?

1 - 2
2 - 4
3 - 6
4 - 8

A

3 - 6 layers

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15
Q

In the brain inflammation facilitates the delivery of effector molecules to aid in rapid repair through signals, such as cytokines by vasodilating blood vessels. What happens to the microglia (immune cells) which are generally dormant?

A

Microglia:

  • become activated
  • can be seen histologically
  • top left is inactive, all others are various forms of activation
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16
Q

In the brain inflammation facilitates the delivery of effector molecules to aid in rapid repair through signals, such as cytokines. Due to increase permeability and dilation of blood vessels there is oedema. There are 2 kinds of oedema, what are they?

A

1 - vasogenic (extracellular)

2 - cytotoxic (intracellular)

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17
Q

In inflammation blood vessels of the brain vasodilate and have an increase in permeability. This can cause 2 types of oedema, vasogenic and cytotoxic. What is vasogenic oedema?

1 - fluid collects intracellularly, BBB is disrupted, white matter is affected and is common in tumours
2 - fluid collects intracellularly, BBB is in tact, white matter is affected and is common in tumours
3 - fluid collects extracellularly, BBB is disrupted, grey matter is affected and is common in tumours
4 - fluid collects extracellularly, BBB is disrupted, white matter is affected and is common in tumours

A

4 - fluid collects extracellularly, BBB is disrupted, white matter is affected and is common in tumours

  • fluid accumulation in extracellular space (spaces surrounding then brain)
  • disruption of the BBB
  • white matter affected (causes demyelination)
  • common in tumours and abscess
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18
Q

In inflammation in the brain blood vessels vasodilate and have an increase in permeability. This can cause 2 types of oedema, vasogenic and cytotoxic. What is cytotoxic oedema?

1 - fluid collects intracellularly, BBB intact, white matter is affected and is common in ischaemia
2 - fluid collects intracellularly, BBB intact, grey matter is affected and is common in ischaemia
3 - fluid collects extracellularly, BBB is disrupted, grey matter is affected and is common in tumours
4 - fluid collects extracellularly, BBB is disrupted, white matter is affected and is common in tumours

A

2 - fluid collects intracellularly, BBB intact, grey matter is affected and is common in ischaemia

  • swelling caused by intracellular accumulation of fluid
  • BBB not disrupted
  • affects grey and white matter
  • common in ischemia
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19
Q

Astrocytes are involved in repair in the brain. During inflammation when there is tissue damage, astrocytes will repair this tissue. Is this good or bad repair generally?

1 - generally good with no glial scars
2 - generally good with the help of macrophages
3 - repairs with help of macrophages but glial scars form
4 - repairs with help of macrophages and no glial scars form

A

3 - repairs with help of macrophages but glial scars form

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20
Q

In the image below, which is vasogenic and cytotoxic oedema indicated by the solid lines?

A
  • left = vasogenic
  • right = cytotoxic
  • dashed lines show the brain herniating to other side of the brain
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21
Q

In chronic inflammation there will be damage to the nerves, called neuronal degeneration. This can cause retrograde/wallerian degeneration, what is this?

1 - following axonal damage, distal axon degenerates
2 - following axonal damage, the whole axon degenerates
3 - following axonal damage, proximal axon degenerates
4 - following axonal damage, distal and proximal end of axon degenerates

A

1 - following axonal damage, distal axon degenerates

- neuron dies or can regenerate depending on extend of injury

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22
Q

In chronic inflammation there will be damage to the nerves, called neuronal degeneration. This can cause retrograde/wallerian degeneration, which is damage to the axon distally, which can then cause neuronal death. We can also have trans-synaptic degeneration, what is this?

1 - following axonal damage, distal axon degenerates
2 - following axonal damage, injury spreads to unaffected neurons through synapse
3 - following axonal damage, proximal axon degenerates
4 - following axonal damage, distal and proximal end of axon degenerates

A

2 - following axonal damage, injury spreads to unaffected neurons through synapse

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23
Q

In chronic inflammation there will be damage to the nerves, called neuronal degeneration. This can cause demyelineation, what is this?

A
  • myelin coveing axon is destroyed and nerve cannot conduct as effectively if at all
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24
Q

In chronic inflammation there will be damage to the nerves, called neuronal degeneration. This can cause gliotic scars formed by astrocytes that are trying to repair the damage. What is one common neurological disorder these gliotic scars could then cause?

1 - parkinsons disease
2 - Alzheimers disease
3 - epileptic foci
4 - multiple sclerosis

A

3 - epileptic foci

  • scar causes abnormal neural flow and connections
  • can cause epileptic foci leading to epilepsy
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25
Q

The symptoms a patient presents in neuropathophysiology is determined by what?

A
  • location of the pathology in the nervous system
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26
Q

When trying to diagnose patients with neuropathy, we need a differential diagnosis and use the acronym VITAMIN C, what does this stand for?

A
  • V = vascular
  • I = inflammation/infection
  • T = toxins/drugs
  • A = autoimmune
  • M = metabolic
  • I = idiopathic
  • N = neoplastic (malignant/cancerous)
  • C = congenital/genetic
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27
Q

Glioblastoma is a common cancer that can present in the brains of adults, what is it?

1 - form of cancer formed from choroid cells
2 - form of cancer formed from dura mater
3 - form of cancer formed from glial cells, commonly astrocytes
4 - form of cancer formed from glial cells, commonly oligodendrocytes

A

3 - form of cancer formed from glial cells, commonly astrocytes

  • aggresive form of cancer resembling a butterflies that crosses the midline of the brain
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28
Q

Meningioma is a common cancer that can present in the brains of adults, what is it?

1 - form of cancer formed from choroid cells
2 - form of cancer formed within the meningeal layers
3 - form of cancer formed from glial cells, commonly astrocytes
4 - form of cancer formed from glial cells, commonly oligodendrocytes

A

2 - form of cancer formed within the meningeal layers

- outside the brain in the meninges, but still presses on the brain

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29
Q

Is a tumour more likely in a glial or neuronal cell?

A
  • glial cells due to their ability to divide and proliferate
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30
Q

What does para-neoplastic syndrome?

1 - tumour in glial cells that triggers an abnormal immune response
2 - tumour in glial cella
3 - tumour in neuronal cells
4 - tumour in neuronal cells that triggers abnormal immune response

A

4 - tumour in neuronal cells that triggers abnormal immune response

  • symptoms are due to immune cells response
  • triggers an autoimmune process
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31
Q

Paraneoplastic syndromes are when the immune cells detect a cancer and an abnormal immune response is stimulated, triggering an autoimmune process. Which cells are heavily involved in this?

A
  • T cells

- attack normal brain tissue

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32
Q

Paraneoplastic syndromes are when the immune cells detect a cancer and an abnormal immune response is stimulated, triggering an autoimmune process. If the PNS is involved this can lead to Lambert Eaton, what is this?

1 - type II hypersensitivity, immune cells attack pre-synaptic receptors so no depolarisation
2 - type II hypersensitivity, immune cells attack pre-synapse, no Ca2+ released despite action potential
3 - type V hypersensitivity, cytotoxic T cels cells attack attack pre-synapse so no vesicles to release neurotransmitters
4 - type II hypersensitivity, immune cells attack post-synaptic receptors so no depolarisation

A

2 - type II hypersensitivity, immune cells attack pre-synapse, no Ca2+ released despite action potential

  • leads to impaired pre-synapse response to action potential
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33
Q

Paraneoplastic syndromes are when the immune cells detect a cancer and an abnormal immune response is stimulated, triggering an autoimmune process. If the PNS is involved this can lead to Lambert Eaton, which is a type II hypersensitivity. Here the immune system attacks Ca2+ channels on NMJ and nerves, leading to impaired pre-synapse response to action potentials. What tissue is heavily affected by this syndrome?

A
  • skeletal muscles become weak

- temporarily improve with activity

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34
Q

Paraneoplastic syndromes are when the immune cells detect a cancer and an abnormal immune response is stimulated, triggering an autoimmune process. If the PNS is involved this can lead to Lambert Eaton, which is a type II hypersensitivity. Here the immune system attacks Ca2+ channels on NMJ and nerves, leading to impaired pre-synapse response to action potentials. This causes muscle weakness, that can temporarily get better with exercise. What tumour is heavily linked with this?

1 - bladder cancer
2 - bone cancer
3 - breast cancer
4 - lung cancer

A

4 - lung cancer

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35
Q

Paraneoplastic syndromes are when the immune cells detect a cancer and an abnormal immune response is stimulated, triggering an autoimmune process. If the CNS is affected this can lead to NMDA (glutamate receptors) encephalitis (inflammation of the brain). What is this?

1 - antibodies target NMDA receptors meaning less glutamate neuronal activity
2 - antibodies target AMPA receptors meaning less glutamate neuronal activity
3 - antibodies target dopamine receptors meaning less glutamate neuronal activity
4 - antibodies target serotonin receptors meaning less glutamate neuronal activity

A

1 - antibodies target NMDA receptors meaning less glutamate neuronal activity

  • can cause a neuropsychiatric condition
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36
Q

Paraneoplastic syndromes are when the immune cells detect a cancer and an abnormal immune response is stimulated, triggering an autoimmune process. If the CNS is affected this can lead to NMDA (glutamate receptors) encephalitis (inflammation of the brain). This is where antibodies attack NMDA receptors, which are glutamate receptors affecting mood and emotions, causing neuropsychiatric condition. How can this syndrome initially present?

A
  • flu like symptoms with a headache
  • paranoia, unstable mood, anxiety
  • seizures
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37
Q

Paraneoplastic syndromes are when the immune cells detect a cancer and an abnormal immune response is stimulated, triggering an autoimmune process. If the CNS is affected this can lead to NMDA (glutamate receptors) encephalitis (inflammation of the brain). This is where antibodies attack NMDA receptors, which are glutamate receptors affecting mood and emotions, causing neuropsychiatric condition. This syndrome can present initially like flu like symptoms with a headache the progress to paranoia, unstable mood, anxiety and even catatonia (statue like presentation). What type of cancer is this highly linked with?

1 - bladder cancer
2 - ovarian teratoma
3 - breast cancer
4 - lung cancer

A

2 - ovarian teratoma

- germ cell tumour with multiple tissue types (hair, bone, skin)

38
Q

What is meningoencephalitis?

A

meningoencephalitis:

  • serious neurological condition causing inflammation of the outer protective layers of the brain
  • generally caused by a viral infection leading to inflammation
  • meningo = inflammation of meninges
  • encephalo = inflammation of the brain
39
Q

Meningoencephalitis is a serious neurological condition affecting both the meninges and the brain:

  • meningo = inflammation of meninges
  • encephalo = inflammation of the brain

It is commonly caused by an infection leading to inflammation. What are some common problems a patient may present with?

A
  • headache
  • sensitivity to light
  • neck stiffness
  • confused state
40
Q

What is the leptomeningeal (from the Greek lepto, meaning ‘fine’ or ‘slight’)?

A
  • combination of the arachnoid and pia mater
41
Q

Meningoencephalitis is a serious neurological condition affecting both the meninges and the brain:

  • meningo = inflammation of meninges
  • encephalo = inflammation of the brain

It is commonly caused by a viral infection leading to inflammation. If we suspect this condition, what is the most useful test to diagnose?

1 - MRI
2 - lumbar puncture/spinal tap
3 - blood test
4 - CT scan

A

2 - lumbar puncture/spinal tap

- can see if the CSF is infected

42
Q

What is luschka magendie, also called the media aperture?

1 - opening of the venous sinuses
2 - end of the arachnoid granulations where they enter the venous sinuses
3 - opening from 4th ventricle into the cisterna magna and then into the subarachnoid space
4 - where lateral ventricle meets the 3rd ventricle in the brain

A

3 - opening from 4th ventricle into the cisterna magna and then into the subarachnoid space
- opening that drains CSF

43
Q

What are the 3 most likely causes of an increase pressure associated with CSF?

A

1 - blockage of flow (stenosis, cyst etc)
2 - CSF over production (papilloma)
3 - reduced re-absorption into venous sinuses

44
Q

When we talk about hydrocephalus (increased fluid, generally CSF, in the brain), what does communicative and non-communicative refer to?

A
  • relates to the flow of CSF between the ventricles
  • communicative = flow remains
  • non-communicative = flow obstructed
45
Q

The brain can be damaged by trauma. What are the 2 groups that this can fall into?

1 - trauma and direct
2 - direct and indirect
3 - trauma and indirect
4 - lesion and trauma

A

2 - direct and indirect

  • direct (coup, french for blow) is first bang on front of head
  • indirect (contra-coup, french for counter blow) is second bang as brain hits back of cranium
46
Q

The brain can be damaged by trauma, which can be direct (coup, french for blow) or indirect (contra-coup, french for counter blow). How can this occur if someone banged their heads at the front?

A
  • front trauma to the head would be coup

- the force of the front head trauma would cause the brain to move and hit the back of the head, counter coup

47
Q

In boxing head trauma is common and can lead to coup (direct) & counter-coup (indirect) and cause loss of sight or blurred vision, why?

A
  • punch to front of head of face is the coup

- but back of brain could hit the skull and damage occipital lobe, which would be the counter coup

48
Q

What does concussion mean relating to neurology?

1 - clinical syndrome relating to consciousness
2 - clinical syndrome relating to cognitive state
3 - clinical syndrome relating to dementia
4 - clinical syndrome relating to awareness

A

1 - clinical syndrome relating to consciousness

- causes headaches, drowsiness or amnesia

49
Q

What does contusion mean relating to neurology?

1 - pathological term relating to consciousness
2 - pathological term relating to fluid on the brain
3 - pathological term relating to lesions of the brain
4 - pathological term relating to bruising of the brain

A

4 - pathological term relating to bruising of the brain

- can cause confusion and neural deficits

50
Q

Although the consequences of the coup (direct) or counter-coup (indirect) trauma can be dangerous, there are also secondary consequences we must be aware of. What are the 2 most common in the brain?

1 - lesions and cerebral oedema/ischaemia
2 - blood vessel damage and cerebral oedema/ischaemia
3 - bruising and cerebral oedema/ischaemia
4 - cerebral oedema/ischaemia and neuronal atrophy

A

2 - blood vessel damage and cerebral oedema/ischaemia

51
Q

Acceleration - Deceleration injuries can also be dangerous. What are these?

A
  • brain is shifted in the skull
  • causes cell damage
  • common in car crashes and shaken baby syndrome
52
Q

Acceleration - Deceleration injuries can also be dangerous. This is when the brain is shifted in the skull, causing cell damage and is common in car crashes and shaken baby syndrome. The cell damage can be due to diffuse axonal injury, which is essentially stretching of the axons. What can this cause?

1 - axonal degeneration, neuronal cell death, activated glial cells causing oedema
2 - axonal hyperplasia, neuronal cell death, activated glial cells causing oedema
3 - axonal degeneration, neuronal cell hypertrophy, activated glial cells causing oedema
4 - axonal degeneration, neuronal cell death, glial cells apoptosis

A

1 - axonal degeneration, neuronal cell death, activated glial cells causing oedema

53
Q

Increased cerebral pressure is generally caused by an increase in the fluid and oedema in the brain. This causes the brain to be squashed in the cranium. What can this lead to in the blood vessels?

A
  • compression of blood vessels
  • vessels dilate and increase BP
  • vessel permeability increases
  • leads to ischemia and further fluid loss
54
Q

If a patient has an increase in cerebral pressure, what are the 3 most common symptoms they can present with?

1 - headaches, loss of sensations, loss of consciousness
2 - headaches, muscle weakness, loss of consciousness
3 - pain, loss of sensations, loss of consciousness
4 - headaches, vision changes (papilloedema), loss of consciousness

A

4 - headaches, vision changes (papilloedema), loss of consciousness

55
Q

In addition to the common symptoms of headaches, vision change and loss of consciousness, increased cerebral pressure (ICP) can also cause Cushings reflex, what is this?

1 - increased ICP causes increased BP, irregular breathing and increased heart rate
2 - decreased ICP causes increased BP, irregular breathing and decreased heart rate
3 - decreased ICP causes increased BP, irregular breathing and increased heart rate
4 - increased ICP causes increased BP, irregular breathing and decreased heart rate

A

4 - increased ICP causes increased BP, irregular breathing and decreased heart rate
- called the Cushing reflex or cushings triad.

56
Q

Encephalopathy relates to damage to the brain. If there has been trauma to the brain this can lead to chronic traumatic encephalopathy. This is most commonly caused by repeated blows to the head as in boxing, football etc.. What 2 proteins have been detected in the brains of patients with this type of chronic head injury?

1 - BDNF and tau protein
2 - tau protein and alpha-synuclein
3 - B-amyloid and tau protein
4 - alpha-synuclein and B-amyloid

A

3 - B-amyloid and tau protein

  • tau protein (maintains intracellular microtubule structure in neurons) INTRACELLULAR
  • B-amyloid (aggregates of proteins that form plaques in the brain) EXTRACELLULAR
57
Q

What is tau protein?

1 - protein found inside neurons, maintains microtubule structure
2 - protein found inside neurons, maintains vesicles
3 - protein found outside neurons, maintains pre-synapse
4 - protein aggregates that form extracellular plaques in the brain

A

1 - protein found inside neurons, maintains microtubule structure

  • increased accumulation of tau immunoreactive astrocytes
58
Q

What is the only way we can definitively diagnose a patient with a neurological disorder such as parkinsons?

A
  • tissue sample from brain

- generally from autopsy when deceased

59
Q

A haematoma is an abnormal collection of blood outside of a blood vessels. If we have an epidural haematoma, where is the fluid?

1 - generally between dura and arachnoid mater
2 - between dura mater and cranium
3 - below the subarachnoid
4 - within the brain parenchyma means functioning tissue, which is the brain

A

2 - between dura mater and cranium

  • epi is greek for upon
  • durals = dura mater
60
Q

A haematoma is an abnormal collection of blood outside of blood vessels. If we have an subdural haematoma, where is the fluid?

1 - generally between dura and arachnoid mater
2 - between dura mater and cranium
3 - below the subarachnoid
4 - within the brain parenchyma means functioning tissue, which is the brain

A

1 - generally between dura and arachnoid mater

  • sub = below
  • dural = dura mater
61
Q

A haematoma is an abnormal collection of blood outside of a blood vessels. If we have an subarachnoid haematoma, where is the fluid?

1 - generally between dura and arachnoid mater
2 - between dura mater and cranium
3 - below the subarachnoid
4 - within the brain parenchyma means functioning tissue, which is the brain

A

3 - below the subarachnoid

- sub = below

62
Q

A haematoma is an abnormal collection of blood outside of a blood vessels. If we have an intraparenchymal haematoma, where is the fluid?

1 - generally between dura and arachnoid mater
2 - between dura mater and cranium
3 - below the subarachnoid
4 - within the brain parenchyma means functioning tissue, which is the brain

A

4 - within the brain parenchyma means functioning tissue, which is the brain

63
Q

What is the difference between Haematoma and Haemorrhage?

A
  • Haematoma = collection of blood

- Haemorrhage = leaking or bursting of blood vessel

64
Q

Looking at the MRI image below, what type of haematoma’s can we see here from:

  • epidural
  • subarachnoid
  • subdural
  • intraparenchymal
A 
1 = epidural 
2 = subdural
3 = subarachnoid
4 = intraparenchymal
65
Q

There are 4 types of haematoma’s that can occur in the brain:

1 - epidural
2 - subarachnoid
3 - subdural
4 - intraparenchymal

Which is most likely to result in a quick death despite the patient talking?

A

1 - epidural

  • fracture to skull, meningeal artery is ripped open causing high pressure on brain
  • VERY DANGEROUS
66
Q

Cerebrovascular disease is a group of conditions and diseases that affect the blood vessels to where?

A
  • the brain
  • cerebro = cerebral cortex
  • vascular = blood vessels
67
Q

Cerebrovascular disease is a group of conditions and diseases that affect the blood vessels to the brain and is a leading cause of disease worldwide with similar risk factors as coronary artery disease. What is a stroke?

A
  • reduction in blood supply to the brain

- neurological deficits last >24 hours

68
Q

What are the 3 main places that a stroke can affect?

A

1 - brain
2 - spinal cord
3 - retina

69
Q

Often called a mini stroke, but more accurately called a transient ischaemic attack can also cause symptoms. What is transient ischaemic attack?

A
  • a brief period of blood loss to a part of the brain

- transient episode of neurological dysfunction

70
Q

Are ischemic or hemorrhagic strokes more common?

A
  • ischaemic stroke (lack of blood supply)

- accounts for 78% of strokes

71
Q

Ischaemic stroke (lack of blood supply) is the most common stroke, accounting for 78% of strokes. What are some of the things that can happen to the blood vessels to cause this?

A
  • occlusion
  • thrombus (blood clot)
  • embolus (particle or mass, air, fat, etc..)
  • vasospasms
  • hypotension
72
Q

What are the 2 ways in which we can block blood vessels in the brain, leading to an ischaemic stroke?

A
  • thrombus (blood clot)

- embolus (particle or mass, such as fat, air, etc…)

73
Q

Virchows triad is when 3 factors that are critically important in the development of venous thrombosis occur. What are the 3 factors?

1 - venous stasis, activation of blood coagulation, endothelial damage
2 - infection, activation of blood coagulation, endothelial damage
3 - venous stasis, activation of blood coagulation, endothelial hyperplasia
4 - venous stasis, excessive aspirin, endothelial damage

A

1 - venous stasis, activation of blood coagulation, endothelial damage

(1) venous stasis (slow moving blood due to inactivity)
(2) activation of blood coagulation (trauma)
(3) endothelial damage (lifestyle factors)

74
Q

Virchows triad is when 3 precipitating factors occur that can then lead to venous thrombosis. The 3 factors are:

1 - venous stasis (slow moving blood due to inactivity)
2 - activation of blood coagulation (trauma)
3 - endothelial damage (lifestyle factors)

How can Virchows triad cause a stroke?

A
  • atrial fibrillation causes blood to become stagnant (stasis) and thicken (coagulation) and damage endothelial cells
  • thrombosis (blood clot) can break away and become lodged in blood vessels in the brain
75
Q

How can an atherosclerosis cause cause a stroke?

A
  • lipid plaque can build up and lead to partial or complete blockage
  • can also break off forming thrombosis (blood clots)
76
Q

When a patient has a stroke, what drives the patients symptoms that they present with?

A
  • the location of the stroke in the brain

- for example if frontal, cognitive function will be impaired

77
Q

What does ischaemic penumbra mean?

A
  • penumbra = latin for almost
  • part of an acute ischaemic stroke that has reduced O2 due to core lesion
  • but can be salvaged if reperfused
78
Q

In an ischaemic stroke what is the core lesion?

1 - location downstream of original blockage causing dead tissue
2 - location where original blockage occurred
3 - location where tissue has died downstream of original blockage

A

1 - location downstream of original blockage causing dead tissue
- core lesion blocks blood to further tissue, leading to further tissue death

79
Q

What does time is tissue mean in terms of stroke?

A
  • longer it takes to re-perfuse = more tissue death
80
Q

Haemorrhage strokes account for aprox 20% of strokes. What is this?

A
  • blood vessels rupture causing incredible headache

- signs of bleeding will appear following the sealing of the haemorrhage

81
Q

Global brain injury can be caused by anoxic (latin for lack of) brain injury. What is anoxic brain injury?

A
  • a complete lack of O2 to the brain
82
Q

Global brain injury can be caused by anoxic brain injury, which is a complete lack of O2 to the brain. This can be grouped into hypoxia or ischaemia. What are the most common causes of hypoxia?

A
  • essentially anything that stops blood to the brain
  • drowning
  • strangulation
  • asphyxia
  • CO2
83
Q

Global brain injury can be caused by anoxic brain injury, which is a complete lack of O2 to the brain. This can be grouped into hypoxia or ischaemia. What are the most common causes of ischaemia?

A
  • essentially anything that reduces blood flow
  • cardiac arrest
  • increased intracranial pressure
  • hypovolemia (low extracellular fluid)
84
Q

What protein is commonly found in the brain tissue of patients with parkinsons?

1 - tau protein
2 - alpha synuclein
3 - B-amyloid
4 - BDNF

A

2 - alpha synuclein

85
Q

What are lewy bodies?

A
  • protein deposits found in neurons

- common cause of lewy body dementia

86
Q

What neuropathology’s are lewy bodies, protein aggregates common in?

A
  • lewy body dementia

- parkinsons

87
Q

What is cranial nerve XII (12) and what is its function?

A
  • hypoglossal nerve

- innervates the tongue

88
Q

Cranial nerve XII (12) is the hypoglossal nerve, whose function is to innervate the tongue. Does the left CN XII supply the left or right side of the tongue?

A
  • ipsilateral
  • means left supplies left side of the tongue
  • means right supplies right side of the tongue
89
Q

Cranial nerve XII (12) is the hypoglossal nerve, whose function is to innervate the tongue. CN XII (12) is ipsilateral, meaning left supplies left side of the tongue and right supplies right side of the tongue. If there is a lesion on one of these nerves what would happen with the tongue?

A
  • the tongue would deviate to the side with the lesion

- lesion of left side of CN XII means tongue moves towards the left

90
Q

In the brain inflammation facilitates the delivery of effector molecules to aid in rapid repair through signals, such as cytokines. What happens to the blood vessels in the brain when there is inflammation?

1 - vasodilation, increased permeability, increased adhesion signalling
2 - vasodilation, decreased permeability, decreased adhesion signalling
3 - vasodilation, decreased permeability, increased adhesion signalling
4 - vasoconstriction, increased permeability, increased adhesion signalling

A

1 - vasodilation, increased permeability, increased adhesion signalling

NSB! (53 decks)

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