Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro 1 > Pathology > Flashcards

Pathology Flashcards

1
Q

Difference between paralysis, paresis, plegia, palsy

A

Paralysis: weakness so severe that muscle cannot be contracted

Paresis: weakness or partial paralysis

Plegia: severe weakness or paralysis
(Di-, hemi-, quadri-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lower motor neuron syndrome

A
  1. Weakness/paralysis
  2. Atrophy
  3. Hypo or areflexia
  4. Decreased tone/flaccid paralysis
  5. Fibrillations (as measured by EMG)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

EMG signs of denervation when muscle at rest

A

Fibrillation: short duration spontaneous biphasic or triphasic potentials produced by single muscle fibers, which are indicative of denervated muscle

Fasciculations: large potentials caused by spontaneous activity in one or several motor unit; large potentials suggest denervation and reinnervation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ALS

A

Degenerative disease of upper and lower motor neurons

Ventral horn involvement leads to lower motor neuron syndrome, while lateral corticospinal tract involvement leads to upper motor neuron syndrome

Loss of motor neurons in ventral horn cause fasciculations

No sensory loss.

Most are sporadic, but familial cases can be caused by a zinc-copper superoxide dismutase mutation (needed to bind free radicals)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Common causes of lower motor neuron syndrome

A
  1. Lesions in peripheral, spinal, or cranial nerves
  2. Lesions in cauda equina
  3. Strokes or tumors affecting alpha motor neurons in ventral horn or brainstem
  4. Polio
  5. ALS
  6. Guillain Barre
  7. Werdnig-Hoffman
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Polio

A

Virus that affects alpha motor neuron’s ventral horn, so can lead to lower motor neuron syndrome

Can see period where patient is neurologically stable for years followed by progressive weakness in same muscles originally affected. This is because sprouting allows for recovery and stable period, but sprouts cannot be sustained.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Spinal Muscle Atrophy

A

Group of diseases caused by degeneration of anterior horns due to abnormalities in chromosome 5

Progressive disease that begins in infancy

4 types; first type is Werdnig-Hoffman

Affects motor neurons in the spinal cord and cranial nerve motor nuclei

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Werdnig-Hoffman disease

A

Spinal Muscle Atrophy, Type I, inherited degeneration of anterior motor horn
Aka floppy baby

Autosomal recessive inheritance

Deadly

Symptoms:
Weakness and wasting in limb muscles, respiratory muscles, and bulbar muscles (as shown by sucking, swallowing, and breathing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Upper Motor Neuron Lesions

A

Spinal shock followed by

  1. Paresis
  2. Hyper-reflexia
  3. Hypertonia
  4. Posturing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Variations on posturing with upper motor neuron syndrome

A

Decorticate when lesion above midbrain (upper limbs flexed, lower limbs extended)

Decerebrate when lesion below the midbrain (all limbs extended)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Babinski reflex

A

Indicates corticospinal tract lesion (upper motor neuron syndrome) if toes curl up (extensor plantar response) instead of down when lateral plantar surface is stroked

Normal in babies (before myelination)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hoffman’s sign

A

Hold patient’s finger loosely and flick the fingernail downward, which should cause finger to rebound into extension.

If thumb flexes and adducts, it is positive Hoffman’s, indicated upper motor neuron syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bell’s Palsy

A

Paralysis of half the face due to lesion in CN VII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Common causes of upper motor neuron syndrome

A

Trauma

Stroke

MS

ALS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cerebral Palsy

A

Non-progressive neurological disorder that appears in infancy or early child

Impacts body movement and muscle coordination; may cause intellectual disability

Can be caused by ischemia at birth, hypo-perfusion, trauma, or hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Radiculopathy

A

Damage to spinal nerve, most commonly caused by herniated discs but also caused by osteophytes and spinal stenosis

Symptoms:

  • Burning, tingling pain that radiates from back along a dermatome
  • Numbness
  • worsening of symptoms with coughing, sneezing, or straining; worsening of symptoms with flexing the head (in case of cervical radiculopathy)
  • muscle weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Horner’s Syndrome

A

Interruption of sympathetic pathway to the head, eye, or neck caused by a lesion at T1 or above

Symptoms:

  • miosis
  • anhidrosis of face
  • ptosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Spinal shock

A

Spinal cord injury that causes immediate flaccid paralysis below the lesion

Usually lasts 1-6 weeks

Due to loss of descending facilitation that keep spinal cord circuits in continuous state of activation/readiness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

WHO Grading System for Pathohistological Features of Tumors

A

I: curable with complete surgical resection
II: even complete resection may not be curative (~7-10 years)
III: not surgically curable; may kill on its own or up on version to grade IV (~3-7 years)
IV: not surgically curable; chemo/rad-to can extend life, but response is typically short-lived; quickly kills (~12-18 months)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Glioma

A

Tumor arising from glia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pilocytic astrocytoma

A

Grade I/IV
Usually in kids, arising below tentorium
Cyst with nodule
Low grade, minimally infiltrative
Elongated cells with hairlike processes; Rosenthal fibers (thick eosinophilic processes)
GFAP+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Diffuse astrocytoma

A

Grade II, III, or IV
Irregular, elongated, crowded nuclei
GFAP+
Infiltrates normal brain to make surgical resection very difficult
The later the onset, the higher the grade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Glioblastoma

A

Astrocytoma
Grade IV
Most common malignant CNS tumor
Malignant, poorly differentiated tumor of glial cells
Application of receptor tyrosine kinases, proto-oncogenes (especially EGFR) which promotes its own growth
Butterfly lesion-crosses corpus callosum
May see microvascular proliferation or palisading necrosis (living cells at the edge of the necrosis)
GFAP+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Oligodendroglioma

A 
Neoplasm of oligodendroglial cells
Calcified tumor in white matter 
Grade II or III
Usually in cerebral (frontal lobe) hemispheres
Often hemorrhagic; causing seizures
Genetics: co-deletion of 1p an 19q 
Fried egg nuclei 
May see chickenwire vasculature or calcifications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Ependymoma

A

Tumor of ependymal cells
Grade II or III
Usually in children beneath tentorium (4th ventricle)
Most common in 4th ventricle (very aggressive in children) or spinal cord (low grade and surgically treatable)
Perivascular pseduorosettes (tumor cells line up against blood vessels with pink material inbetween)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Pituitary adenoma

A

Low grade neuroendocrine tumor
Most common is a null-cell adenoma (not making hormones)
Most common hormone productions adenoma=protlactinoma
If it presses against optic chiasm can cause superior quadrantonopia
Prolactinoma-amenorrhea, galactorrhea
Growth hormone-acromegaly
ACTH-Cushing’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Craniopharyngioma

A

Pituitary tumor in young kids
Supra tentorial in child and adult
Can cause inferior quadrantonopia
Derived from remnants of Rathke’s pouch (origin of anterior pituitary)
See squamous epi, “wet keratin”, and cholesterol clefts
Look at root of word!! Crani-, pharyng-
Calcifications seen on imagining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Schwannoma

A

Benign tumor; Grade I
Caused by bi-allergic inactivation of NF2 gene
Symptoms caused by compression of nerves, particularly vestibular nerve, which made lead to tinnitus and deafness
Bland-spindle shaped cells
Hypercellular=Antoni A
Hypocellular=Antoni B
Verocay bodies=nuclei lining up together
especially at cerebellar pontine angle, involving CN8.
S100+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Meningioma

A

Dural based tumor of meningothelial cells
Will see dural tail on MRI
Grade I-III
50% have NF2 mutation
Histo shows whorls and calcifications (psammomatous)
Most common benign tumor
Tumor expresses estrogen receptor; more common in women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Hemangioblastoma

A

Grade I lesion
Occurs from mutation in VHL, allowing for constitutive activation of HIF
Usually occurs in cerebellum, but also seen in spine, brainstem, and retina
Histo: foamy cells and dense capillary network

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Medulloblastoma

A 
Grade IV
Derived form neuroectodermal tissue 
Most common malignant tumor in children
Tumor of primitive neurons 
Synaptophysin+ 
In cerebellar/posterior fossa 
True (Homer-Wright) rosettes
32
Q

Analgesia

A

Los of pain sensation

33
Q

Anesthesia

A

Loss of touch sensation

34
Q

Paresthesias

A

Temporary mild pain

35
Q

Neuropathic pain/central pain syndrome

A

Chronic intense pain

36
Q

Tabes Dorsalis

A

Caused by tertiary syphilis infection leading to degeneration of dorsal columns

Symptoms: impaired sensation, propioception, and progressive sensory ataxia

37
Q

Subacute combined degeneration of dorsal columns and spinocerebellar tract from vitamin B12 or E deficiency

A

Causes demyelination of dorsal columns, lateral corticospinal tracts, and spinocerebrallar tracts causing ataxic gait, paresthesia, and impaired position and vibration sense

38
Q

Brown-Sequard Syndrome

A

Hemiplegia caused by damage to one half of spinal cord resulting in loss of ipsilateral proprioception and contralateral pain/temperature loss

39
Q

Phantom Limb

A

Reorganization of somatosensory cortex in amputees causing neurons that were innervated by the limb no respond to stimulation of other body parts.

40
Q

Syringomyelia

A

Cystic degeneration of the spinal cord due to trauma or associated with Arnold Chiari malformation

Usually at C8-T1, causing “cape or shawl” pattern loss of pain and temperature (due to knock out of white commissure), but spares fine touch and proprioception

Syrinx can expand to knock out ventral and lateral horn (affecting motor and sympathetic systems; causing Horner syndrome and lower motor neuron syndrome)

41
Q

Friedeich Ataxia

A

Degenerative disorder of the cerebellum and spinal cord tract presenting as ataxia with loss of vibratory sense, propioception, muscle weakness in lower extremities, and loss of reflex

Autosomal recessive, characterized by trinucleotide repeat in frataxin gene (needed for mitochondrial iron regulation)

present in early childhood

Can present as hypertrophic cardiomyopathy.

42
Q

Dejerine Roussy Syndrome

A

Lesion of thalamus causing contralateral burning pain

43
Q

Diabetes

A

Reduced blood supply to peripheral nerves is cause of sensory neuropathy

Usually in glove and stocking pattern (polyneuropathy), but sometimes acute mononeuopathy

Small fibers most affected

Fascicles show decreased number of myelinated and unmyelinated axons and thickening of walls of blood vessels.

Symptoms begin in feet, then move more proximal legs and distal upper limbs

Symptoms: paresthesia, dysesthias, numbness, tingling, burning
Sometimes there is motor weakness in distal limbs

44
Q

Guillain-Barre

A

Aka acute inflammatory demyelinating polyneuropathy

Acute inflammatory attack on peripheral myelin following a viral infection

Causes demyelination and polyneuropathy leading to motor symptoms

Decreased nerve conduction velocity and increased protein in CSF

Treat with plasmapheresis or IV immunoglobulin therapy

45
Q

Wallerian degeneration

A

When nerve fiber is injured, causing degeneration of the axon distal to the injury

May cause sensory neuropathy

46
Q

Herpes Zoster

A

Infection of dorsal root ganglion that produces sensory symptoms in corresponding dermatome

Increases excitability of sensory neurons in dorsal root ganglion causing lowering of threshold and spontaneous firing

Pain sensation will be in dermatomal distribution (usually thoracic; but in immunocomprised, can infect CN V)

Treat with antivirals (acyclovir, valcylovir, famcyclovir)

Can still have pain after rash has subsided

TORCHeS

47
Q

Congenital insensitivity to pain

A

Recessive mutation in pain receptor Nav 1.7 that cases loss of function of pain

48
Q

Inherited erythromelagia

A

Dominant mutation causing gain of function pain sensation (so experience increased pain) in temperature

49
Q

Paroxysmal extreme pain disorder

A

Dominant mutation in Nav1.7 causing increased pain around the mouth and anus

50
Q

Hyperalgesia

A

Sensitization pathway: When stimuli that are normally considered slightly painful are now significantly more painful

51
Q

Allodynia

A

The induction of pain by what is normally an non-painful stimulus

52
Q

Neuropathic pain

A

Pain that develops as a result of damage to the nervous system

Can manifest as burning, shooting, or stinging pain mixed with numbness

May include changes in pain threshold, quality of pain, and spontaneous pain

Treated with antidepressants and anti-epileptic drugs

53
Q

B12 Deficiency

A

Most common metabolic neuropathy

Can affect peripheral nerves, optic nerves, spinal cord, and brain

Symptoms include distal limbs, usually starting in upper limb

Dorsal columns are most affected; loss of sense of vibration. Followed by corticospinal.

Decrease in nerve conduction velocity

May see ataxia and spasticity if it has caused subacute combined degeneration

54
Q

Charcot Marie Tooth

A

Hereditary motor and sensory neuropathy

CMT1 is the most common, causing motor sensory neuropathy primarily affecting distal muscles

Slow progressive

Decreased NCV

Onion bulb appearance due to constant demyelination and remyelination

55
Q

Papilledema

A

Swelling of optic disk due to increased ICP, impairing venous return

Usually bilateral

Acute or longer onset

56
Q

Scotoma

A

Smaller visual loss

56
Q

Anopia

A

Loss of entire eye visual field

57
Q

Potential effect of internal carotid aneurysm

A

If expanding medially, could press against lateral part of optic chiasm, causing nasal field loss in one eye

58
Q

Middle cerebral branch aneurysm affecting temporal lobe can cause

A

Meyer’s loop lesion, “pie in the sky” vision loss

59
Q

Middle cerebral branch aneurysm affecting parietal lobe can cause

A

Optic radiation lesion, “pie on the floor” vision loss

60
Q

Lesion before optic chiasm

A

Defects are ipsilateral and monocular

61
Q

Lesion at optic chiasm

A

Defects are binocular, bitemporal, heteronymous

62
Q

Lesion past optic chiasm

A

Defects are binocular, contralateral, homonymous

63
Q

Lesion with abnormal pupillary reflex

A

Optic nerve and optic tract lesion

64
Q

Lesion with normal pupillary reflex

A

Optic radiation and visual cortex lesions

65
Q

Posterior cerebral artery infarct

A

Would affect primary visual cortex in occipital lobe

Contralateral homonymous hemianopia WITH MACULAR SPARING

66
Q

Lesion to occipital pole

A

Macular visual field defect

67
Q

Macular degeneration

A

Age related vision loss due to deposition of fatty tissue behind the retina (dry macular degeneration) or neovascularization of the retina (wet macular degeneration)

Lose vision in the middle of the eye due to macular loss

68
Q

Prosopagnosia

A

Damage to fusiform gyrus causing inability to recognize people by looking at their faces

Damage specifically to area dedicated to face

Most commonly caused by closed head trauma or bilateral stroke

69
Q

Cortical blindness

A

Caused by lesion in V1 affecting all visual inputs

70
Q

Apperceptive Agnosia

A

Lesion in V2/V3 can affect combination of form and shape inputs (can’t copy letters or shapes patient sees)

71
Q

Achromatopsia

A

Inability to see color because of a lesion in V4

72
Q

Akinetopsia

A

Inability to see motion because of lesion in V5

Static items are visual but disappear once they start moving

Slow moving objects may be detected, but direction of motion may not be obvious

73
Q

Glaucoma

A

excess aqueous humor leads to optic nerve damage, ocular hypertension, and visual field loss

Managed with beta blockers (block ciliary epithelium from producing aqueous humor)

Sometimes requires surgery

74
Q

Conjunctivitis

A

inflammation of conjunctiva, usually bilateral and due to viral infection; can also be caused by bacterial infection, allergy, or autoimmune condition

Neuro 1 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions