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22 Flashcards

1
Q

what are the characteristics of reversible neuronal injury?

A

Swelling of soma (spheroids),move nissl body (central chromatolysis), possible axonal sprouting

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2
Q

acute neuronal injury is usually caused by what?

A

acute hypoxia

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3
Q

Red neurons have to do with what kind of neuronal injury? when do they appear?

A

Irreversible, 12-24 hours

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4
Q

Spheroids have to do with what kind of injury?

A

Axonal

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5
Q

Astrocytes perform what?

A

Gliosis (fibrosis)

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6
Q

what is an activated astrocyte called?

A

gemistocytic astrocyte

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7
Q

what produces myelin in the CNS?

A

Oligodendrocytes

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8
Q

what performs phagocytosis (neuronophagia) in the CNS?

A

Microglia

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9
Q

what line the ventricles and spinal cord?

A

ependymal cells

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10
Q

what cell produces CSF? (chorioid plexus)

A

Ependymal cells

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11
Q

an infection of ependymal cells can cause what?

A

cytomegalovirus (CMV)

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12
Q

Rabies =

A

negri body

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13
Q

CMV =

A

owls eye appearance

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14
Q

what are two neurodegenerative diseases?

A

Parkinson, alzheimer

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15
Q

Parkinson disease =

A

lewy bodies

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16
Q

what is associated with alzheimers

A

neurofibrillary triangles, B-amyloid plaques (Tau proteins

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17
Q

lipofuscin =

A

aging, lipid accumulation

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18
Q

what are to types of cerebral edema?

A

Vasogenic, cytotoxic

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19
Q

Vasogenic edema effects what?

A

blood brain barrier

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20
Q

Cytotoxic edema effects what?

A

neuronal/glial membrane

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21
Q

Vasogenic edema is what kind?

A

extracellular

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22
Q

Cytotoxic edema is what kind?

A

intracellular

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23
Q

with cerebral edema what happens overall to the brain?

A

Makes it soft

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24
Q

what happens to gyri because of edema?

A

Flattened

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25
Q

what happens to sulci because of edema ?

A

narrowed

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26
Q

What increase with cerebral edema?

A

Inter cranial pressure

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27
Q

what are the three characteristics of cerebral edema?

A

flat gyri, narrow sulci, ventricular compression

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28
Q

an increase in volume of CSF within the ventricles causes what?

A

hydrocephalus

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29
Q

what causes hydrocephalus?

A

altered flow or resorption

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30
Q

what type of hydrocephalus is bilateral and even?

A

communicating

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31
Q

what type of hydrocephalus is localized and uneven

A

Noncommunicating

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32
Q

a child

A

cranial enlargement

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33
Q

congenital hydrocephalus happens in how may of every 1000 births?

A

3

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34
Q

what is the treatment for hydrocephalus ?

A

Ventriculoatrial shunt

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35
Q

what is the hydrocephalus called that is secondary to infarction or neurodegeneration ?

A

hydrocephalus Ex Vacuo

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36
Q

what is shifting/protrusion of CNS tissue?

A

herniation

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37
Q

what are the 3 steps of a herniation?

A

vessels compress, displacement of CSF, Cerebrum shifts, 1

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38
Q

in an herniation where is brain tissue shifting?

A

Across dura or through the foramen magnum

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39
Q

what disrupts vessels of the pons and what shape is it?

A

Duret hemorrhage, “flame shaped” (transtentiorial)

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40
Q

what type of herniation is most common?

A

subfalcine (cingulate)

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41
Q

what type of herniation is associated with CN III “blown pupil”

A

transtentorial (uncinate)

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42
Q

Duret hemorrhage is associated with what the of herniation ?

A

Transtentoiral

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43
Q

Decorticate rigidity is what type of abnormal posturing?

A

Brachial flexion

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44
Q

Decerebrate registry has to do with what kind of abnormal posture?

A

extension of all 4 limbs

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45
Q

Decorticate rigidity means there is an injury were?

A

between cortex and red nucleus (midbrain)

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46
Q

Decerebrate rigidity means there is an injury where?

A

brainstem. between vestibular and red nuclei

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47
Q

a dilation of a pupil =

A

mydriasis

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48
Q

Mydriasis is associated with what type of herniation?

A

transtentorial

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49
Q

what is the most common type of Arnold Chiari ?

A

type 1

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50
Q

what is the most severe type of arnold chair?

A

type 2

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51
Q

Arnold Chiari type one occurs in___?

A

adults

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52
Q

Arnold Chiari type 2 occurs in_____?

A

infants

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53
Q

what is the 3rd leading cause of mortality in the US?

A

cerebrovascular disease

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54
Q

What are the 3 types of strokes ?

A

thrombotic occlusion, embolic occlusion, vascular rupture

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55
Q

An acute dysfunction due to cerebral infection is what?

A

STROKE

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56
Q

what is a mini stroke?

A

transient ischemic attack (TIA)

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57
Q

What causes a TIA

A

temorary neurological dysfunction (

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58
Q

both Stroke and mini stroke are due to infarction

A

No, TIA’s are not

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59
Q

What is the acronym for FAST

A

FACE, ARM, SPEECH, TIME

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60
Q

ischemia or hypoxia will eventually lead to what?

A

liquefactive necrosis

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61
Q

Functional Hypoxia is due to what?

A

Decreased partial pressure from high altitude, CO poisoning

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62
Q

what can cause ischemia ?

A

hypotension, occlusion, chokehold

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63
Q

what permanent ischemia lead to?

A

stoke

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64
Q

bells palsy effects what cranial nerve?

A

VII (facial)

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65
Q

what is the viral association with Bells palsy

A

HSV-1

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66
Q

Contralateral lower facial weakness is associated with what?

A

Stroke

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67
Q

Asymmetrical forehead weakness is associated with what?

A

Bells Palsy

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68
Q

What parts of the face does both bells palsy and stoke affect?

A

Mouth, cheeks

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69
Q

Widespread ischemic-hypoxic injury is called what?

A

Global cerebral Ischemia

70
Q

what happened to the brain during severe ischemia ?

A

Widespread Neuronal Death

71
Q

what limits focal cerebral ischemia?

A

Collateral flow (not in deep tissues though)

72
Q

what is the most common cause of focal ischemia?

A

Emboli (from cardia mural thrombi)

73
Q

in a cerebral infarct when can we see nuclear fragmentation (liquefaction)

A

48 hours-2 weeks

74
Q

what is the most common cause of intracranial hemorrhage?

A

Injury to vessel wall (HTN)

75
Q

Primary brain parenchymal hemorrhage are_____

A

spontaneous

76
Q

what is another name for primary brain parenchymal hemorrhage

A

Micro bleed

77
Q

what is the most common cause of a micro bleed ?

A

Hypertension

78
Q

If a primary brain parenchymal hemorrhage is small it is_____if it is large its______

A

silent, lethal

79
Q

What is associated with “worst headache I’ve ever had”

A

Subarachnoid Hemorrhage

80
Q

What is the most common cause of a Subarachnoid hemorrhage?

A

Ruptured saccular (berry) aneurysm

81
Q

Are subarachnoid hemorrhage’s caused by trauma ?

A

NO

82
Q

80 to 90% of all inracrainail aneurysms are due to what?

A

saccular (berry) aneurysm

83
Q

Saccular aneurysm are a risk factor for what?

A

Polycystic Kidney Disease

84
Q

What is the most common cerebrovascular malformation ?

A

Arteriovenous malformation

85
Q

Tangles of worm like arteries that connect to a fistula are called what?

A

arteriovenous malformation

86
Q

who is most likely to develop an arteriovenous malformation?

A

Men, 10-30 years old.

87
Q

A lacunar infarct is associated with what disease?

A

Hypertensive cerebrovascular disease

88
Q

what is a lacunar infarct?

A

Occlusion of a single artery in deep brain tissue

89
Q

What is primary angiitis of the CNS?

A

Type of vasculitis of multiple parenchymal and subarachnoid vessels

90
Q

When assessing an emergey what are the steps you should take?

A

ABCD. airways breathing circulation, disability

91
Q

Repetitive CNS trauma can cause what

A

CTE (aka dementia pugilistic, punch drunk)

92
Q

Is CNS trauma an open or closed injury?

A

can be either

93
Q

A coup injury =

A

at impact sites

94
Q

contrecoup injury =

A

opposite of impact

95
Q

What type of traumatic parenchymal injury can be coup or counter coup

A

Contusion (brain bruise)

96
Q

A diffuse Axonal injure (DAI) is associated with what?

A

Angular acceleration/shaking and white cell damage

97
Q

what cause 50% of post traumatic comas?

A

Diffuse axonal injury

98
Q

What is traumatically induced brain disfunction?

A

Concussion

99
Q

what does a neuroimage of a concussion look like?

A

It is normal

100
Q

what can be used to rule out hemorrhage in a concussion?

A

CT

101
Q

___%of people recover in___days without treatment from a concussion

A

80%, 10

102
Q

what percent of people with a concussion suffer from post concussive syndrome ?

A

15-20

103
Q

Tearing of cerebral tissue is called ?

A

Laceration

104
Q

when evaluating a concussion what do you do?

A

cognitive (check memory), neurological assessment (serial monitoring every 5 min)

105
Q

what is it called when you get a second concussion that can be lethal?

A

second impact syndrome

106
Q

Dural artery damage is a?

A

Epidural hematoma

107
Q

A rapid tear or a vein is a?

A

subdural hematoma

108
Q

A epidural hematoma most commonly involves what artery?

A

Middle meningeal artery

109
Q

which is more life threatening a subdural hematoma or a epidural hematoma

A

Epidural hematoma because it is often do to a skull fracture

110
Q

What is the most common CNS malformation?

A

Neural tube defects

111
Q

What CNS anomalies is a body defect and asymptomatic ?

A

Spinal bifida occulta

112
Q

what CNS anomaly is an extension of CNS through vertebral defect?

A

Myelomeningocele

113
Q

What abnormality is CNS diverticulum through cranium?

A

Encephalocele

114
Q

What are two spinal cord abnormalities ?

A

Hydromyelia, syringomyelia

115
Q

What disease has a loss of pain/temp in a “shawl” like distribution

A

Syringomyelia (Syrinx)

116
Q

What cause cause cerebral palsy?

A

premature!! infarct, intraparechymal hemorrhage

117
Q

Is cerebral palsy progressive? ***

A

NOOOOOOOOo

118
Q

What type of CNS infection is most common?

A

Hematogenous

119
Q

**Meningitis is_____inflammation of ________

A

subarachnoid, LEPTOMENINGES

120
Q

What are the two neurological exams for meningitis ?

A

Kerning Sign, Brudzinski sign

121
Q

what is the most lethal kind of meningitis?

A

Acute Pyogenic

122
Q

What pathogen causes acute pyogenic meningitis in neonates ?

A

E. Coil, Group B strep

123
Q

What type of meningitis is self limiting?

A

Aseptic

124
Q

spirochetal meningitis is from what?

A

lyme disease or syphilis

125
Q

Bacterial accesses are what kind of infection?

A

localized

126
Q

bacterial abscesses can cause what ki nd of necrosis ?

A

liquefactive

127
Q

Viral encephalitis is what type of infection?

A

Diffuse

128
Q

Fungal encephalitis is what type of infection?

A

Mixed

129
Q

What type of infection is most common among the immunosuppred (AIDS)

A

fungal

130
Q

What is an auto immune attack on white matter?

A

MS

131
Q

MS is what type hypersensitivity ?

A

IV

132
Q

What autoimmune disease is “relapse remitting”

A

MS

133
Q

what cranial nerve is effected by MS?

A

CN II

134
Q

Inactive MS means there is still a little myelin breakdown happening?

A

yes

135
Q

what are two thiamine deficiency disease?

A

wenike-korsakoff, beriberi

136
Q

What is another name for Thiamine ?

A

Vitamin B1

137
Q

what is another name for cobalamin?

A

vitamin B 12

138
Q

what nutritional disease causes cord demyelination?

A

Cobalamin

139
Q

what mimics hypoxia ?

A

hypoglycemia

140
Q

hyperglycemia is assailed with what?

A

uncoiled diabetes

141
Q

what is the most common cause of dementia in elderly

A

Alzheimers disease (AD)

142
Q

Altered motor function

A

Parkinsonism

143
Q

Parkinson disease is caused by damage to dopaminergic neurons where?

A

substantia nigra

144
Q

what is the most common cause of death in someone who has altzhemers?

A

pneumonia

145
Q

alzheimer disease is associated with what other disease?

A

Down syndrome

146
Q

a-synuclein =

A

lewy body

147
Q

what is characteristic is associated with a lewy body

A

pale halo

148
Q

what type of regitidy is associated with parkinson?

A

cogwheel

149
Q

what disease is associated with sever atrophy of the brain?

A

huntington

150
Q

what parts of the brain specifically are effected by huntington disease?

A

Caudate and putamen

151
Q

what movement disorder is associated with Huntington disease ?

A

chorea

152
Q

what chromosome is associated with huntington disease

A

4

153
Q

Does ALS effect upper motor neurons or lower?

A

both

154
Q

Denervation atrophy is associated with what disease?

A

ALS

155
Q

what cell are associated with ALS?

A

Betz cells

156
Q

what muscles does ALS spare?

A

extraoccular

157
Q

what is the most common cause of death with someone with ALS

A

respiratory paralysis

158
Q

asymmetric distal extremity weakness is associated with what disease?

A

ALS

159
Q

what are 3 gliomas?

A

astrocytoma, oligodendroglioma, ependymoma

160
Q

are most astrocytomas diffuse?

A

yes

161
Q

are diffuse astrocytomas malignant?

A

yes

162
Q

what is the most aggressive glioma

A

glioblastoma

163
Q

what is the benign astrocytoma?

A

Pilocytic

164
Q

what glioma is associated with the frontal lobe?

A

oligodendroglioma

165
Q

Years of seizures is a symptom of what glioma?

A

oliogodendroglioma

166
Q

what is the most comma pediatric glioma?

A

Ependymoma

167
Q

what embryonal neoplasm is exclusively cerebellar?

A

medulloblastoma

168
Q

Homer wright rosettes are associated with what tumor?

A

medulloblastoma

169
Q

what is the most common lymphoma among AIDS patients?

A

diffuse large b cell lymphoma

170
Q

What lymphoma is Extra nodal

A

diffuse large b cell lymphoma

171
Q

what is mostly benign but invasive tumor that compresses areas of the brain?

A

meningioma

172
Q

Whorled cell cluster are associated with what?

A

meningioma

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