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Flashcards in Central Nervous System Deck (119)
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1

[response to injury: determine the cell]

shrinkage of soma
Pynosis
Absence of nucleolus
Intense eosinophilia

acute res

2

[response to injury: determine the cell]

hyperplasia
hypertrophy
accumulation of GFAP

astrocyte

3

[response to injury: determine the cell]

proliferation

microglia

4

the most important histopathologic finding that indicates CNS injury

gliosis

5

[type of cerebral edema]

generalized hypoxic-ischemic injury

cytotoxic or vasogenic

6

[type of cerebral edema]

localized: adjacent to inflammation and neoplasm

vasogenic

7

[type of cerebral edema]

hydrocephalus

interstitial

8

[type of hydrocephalus]

localized: limited to upstream obstruction

non-communicating

9

[type of hydrocephalus]

ventricular system that communicates with subarachnoid space

communicating

10

[type of hydrocephalus]

increased CSF as compensation to decreased parenchymal mass;
no ventricular dilation

hydrocephalus ex vacuo

11

[type of herniation]

herniate through the falx cerebri

subfalcine

12

[type of herniation]
herniate across tentorium cerebelli

transtentorial

13

[type of herniation]

herniation of cingulate gyrus

subfalcine

14

subfalcine herniation compresses this artery

anterior cerebral artery

15

[type of herniation]

herniation of the medial aspect of the temporal lobe

transtentorial

16

Transtentorial herniation can compress this part of the brain

CN III
contralateral cerebral peduncle

17

[type of herniation]

pupillary dilation
hemiparesis ipsilateral to the lesion

transtentorial

18

[type of herniation]

herniation through the foramen magnum

tonsillar

19

[type of herniation]

herniation of cerebellar tonsils

tonsillar

20

tonsillar herniation can lead to compression of this structure

brainstem

21

[neural tube defect]

extension of the spinal cord and meninges through a defect in vertebral column

myelomeningocele

22

[neural tube defect]

extension of the meninges through a defect in the vertebra

meningocele

23

[neural tube defect]

diverticulum of a malformed brain tissue through a defect in the cranium

usually in the posterior fossa but can occur across the cribiform plate in anterior fossa

encephalocele

24

[neural tube defect]

failure of the closure of the anterior neural tube

anencephaly

25

[neural tube defect]

skin dimpling, a patch, a hair patch over the defect

spina bifida occulta

26

[posterior fossa anomalies]

enlarged posterior fossa
hypoplasia of the cerebellar vermis

cystic dilation of the fourth ventricle

Dandy-walker malformation

27

[posterior fossa anomalies]

Small posterior fossa with mishapen cerebellar tonsils

Non-communicating hydrocephalus (due to aqueductal stenosis)

Lumbar myelomeningocele

Arnold-Chiari Malformation

Chiari II

28

[posterior fossa anomalies]

low-lying cerebellar tonsils
clincally silent or hydrocephalus

Lumbar myelomeningocele

Arnold-Chiari Malformation

Chiari II

29

[perinatal injury]

nonprogressive neurologic motor deficits (dystonia, spasticity, ataxia/athetosis, paresis) occurring during perinatal and prenatal periods

cerebral palsy

30

[perinatal injury]

increased risk in preterm infants, most often near developing thalamus and caudate; can lead to hyrdocephalus

intraprenchymal hemorrhage

31

[perinatal injury]

surpatentorial periventricular white matter infarcts

multicystic encephalopathy: cystic lesions throughout cerebral hemispheres in extensive ischemic damage

periventricular leukomalacia

32

[parenchymal injuries, trauma]

most common site of contusion

frontal lobes along orbital ridges and temporal lobes

33

[parenchymal injuries, trauma]

axonal swellings develop coma shortly post-trauma

diffuse axonal injury

34

[parenchymal injuries, trauma]

depressed, retracted, yellowish brown patches involving the crest of gyri (plaque jaune)

old traumatic lesion

35

[parenchymal injuries, trauma]

can become epileptic foci

old traumatic lesions

36

[traumatic vascular injury]

lucid intervals, rapidly evolving neurologic symptoms

epidural hematoma

37

[traumatic vascular injury]

lentiform density

epidural hematoma

38

[traumatic vascular injury]

fracture to pterion ruptures ___ artery

middle meningeal artery

39

[traumatic vascular injury]

rupture in middle meningeal artery is associated with ____

epidural hematoma

40

[traumatic vascular injury]

extremes of age, slowly evolving neurologic symptoms; delayed onset

subdural hematoma

41

[traumatic vascular injury]

bridging veins

subdural hematoma

42

[traumatic vascular injury]

crescent-shaped density

subdural hematoma

43

[traumatic vascular injury]

occurs with generalized reduction of cerebral perfusion

global cerebral ischemia

44

[traumatic vascular injury]

neurons most sensitive to ischemia

1. pyramidal layer of hippocampus
2. Cerebellar purkinje cells
3. pyramidal cells of cerebral cortex

45

[traumatic vascular injury]

neurons most sensitive to ischemia

1. pyramidal layer of hippocampus
2. Cerebellar purkinje cells
3. pyramidal cells of cerebral cortex

46

[traumatic vascular injury]

between areas of perfusion of major cerebral vessels susceptible to ischemia

watershed areas

47

[traumatic vascular injury, ischemic changes]

red neuron, cerebral edema, infiltration of neutrophils

acute

48

[traumatic vascular injury, ischemic changes]

liquefactive necrosis, influx of macrophages, reactive gliosis

subacute

49

[traumatic vascular injury, ischemic changes]

removal of necrotic tissue, gliosis

chronic

50

[traumatic vascular injury, ischemic changes]

edema, neuronal microvascularization, pyknosis + karyorrhexis, increased neutrophils

acute changes

51

[traumatic vascular injury, ischemic changes]

increased microglial cells, gliosis

chronic changes

52

[traumatic vascular injury, ischemic changes]

reduction or cessation of blood flow to a localized area of brain due to arterial occlusion of hypoperfusion

Focal Cerebral Ischemia

53

[hypertensive cerebrovascular disease]

small perforating vessels; involved: basal ganglia, pons, deep, white matter, thalamus

Histo: small cavitary infarcts

lacunar infarct

54

[hypertensive cerebrovascular disease]

small perforating vessels

rupture of small vessels due to hypertension

Histo: tissue destruction, pigment-laden macrophages and gliosis

slit hemorrhages

55

[diagnosis]

diffuse cerebral function
headaches, confusion, vomiting, convulsions, leading to coma

edematous brain without herniation; petechiae and fibrinoid necrosis of arterioles in gray and white matter

hypertensive encephalopathy

56

most common cause of deep parenchymal hemorrhages

hypertension

57

most common cause of lobar intraparenchymal hemorrhage

cerebral amyloid angiopathy

58

most common location of hypertensive intracranial hemorrhage

putamen (50-60%)
Thalamus, pons, cerebellar hemispheres are rae

59

[intraparenchymal hemorrhage]

charcot-bouchard microaneurysm in basal ganglia

hypertensive ICH

60

most common cause of subarachnoid hemorrhage

ruptured saccular berry aneurysm

61

most common intracranial aneurysm

saccular aneurysm

62

most common location of intracranial saccular aneurysm

ACA-ACoA junction

63

[vascular malformation]

vessels of the subarachnoid space and brain

enlarge vessels with intervening brain tissue

AVM

64

[vascular malformation]

located in the cerebellum, pons and subcortical region

enlarged vessels without intervening brain tissue

Cavernous malformation

65

[vascular malformation]

located in pons

small, thin-walled vessels with intervening brain tissue

capillary telangiectasia

66

[vascular malformation]

ectatic venous channels, variable location, developmental venous anomalies

venous angiomas

67

[meningitis]

most common cause of meningitis in infants

E. coli and GBS

68

[meningitis]

most common cause of meningitis in adolescents

N. meningitidis

69

[meningitis]

most common cause of meningitis in elderly

S. pneumoniae
L. monocytogenes

70

[meningitis]

Infiltrate: PMN
sugar: very low
protein: high
culture positive

bacterial

71

[encephalitis]

exudates on basal cisterns
obliterative endartrisits
hydrocephalus

TB

72

[meningitis]

infiltrate: lymphocytes
protein: high
sugar: very low

TB

73

[neurosyphilis]

frontal lobe affected

severe dementia, progressive impairment with mood alteration

paretic

74

[neurosyphilis]

dorsal columns

locomotor ataxia
charcot joints
lightning pains
agryll-robertson pupil

tabes dorsalis

75

[meningitis: type of virus]

hemorrhagic necrotizing temporal lobe encephalitis

HSV

76

[meningitis: type of virus]

subacute encephalitis involving paraventricular subependymal region

periventrucular necrosis and calcification

CMV

77

[meningitis: type of virus]

flaccid paralysis, muscle wasting, hyporeflexia

neuronophagia of the anterior horn motor neurons of the spinal cord

poliomyelitis

78

[meningitis: type of virus]

widespread neuronal degeneration most severe in brainstem

presence of negri bodies

Rabies

79

[meningitis]

brain abscesses near the gray-white junction (cerebral cortex)

CT: ring enhancing lesions,

Central foci of necrosis surronded by tachyzoites and bradyzoites

toxoplasma

80

[meningitis]

affects basal leptomeninges
soap bubble appearance

gelatinous material within the subarachnoid space and small cysts in basal ganglia

cryptococcus

81

[prion disease]

subtle memory change to progressive dementia

startle myoclonus

cerebellar ataxia
spongiform transformation

CJD

82

most common demyelinating disorder

multiple sclerosis

83

viral cause of progressive multifocal leukoencephalopathy

JC virus

84

[diagnosis]

unilateral optic neuritis
nystagmus
intention tumor
scanning speech

moderate pleocytosis, elevated protein, increased IgG

multiple sclerosis

85

__ triad of MS

nystagmus
intention tumor
scanning speech

charcot triad

86

[MS plaques]

evidence of partial and incomplete remyelination

shadow plaque

87

[neurodegenerative disease]

AB, Tau

alzheimer

88

[neurodegenerative disease]

alpha-synuclein, tau

parkinson

89

[neurodegenerative disease]

polyglutamine aggregates

huntington

90

[neurodegenerative disease]

TPD-43, FUS

ALS

91

[neurodegenerative disease]

lesion in the cortex

dementia

92

[neurodegenerative disease]

lesion in the basal ganglia and brainstem

parkinsonism

93

[neurodegenerative disease]

lesion in the spinal cord and cerebellum

ataxia

94

[neurodegenerative disease]

lesion in the motor neurons

muscle atrophy

95

[diagnosis]

insidious impairment of higher intellectual function, slow, unrelenting

presence of neuritic plaques, neurfibrillary tangles

alzheimer

96

[diagnosis]

tremor, rigidity, bradykinesia

pallor of substansia nigra
presence of lewy body

parkinson

97

[diagnosis]

loss of striatal neurons that dampen motor output,

excessive motor output, generalized jerky, hyperkinetic, dystonic

caudate atrophy, loss of striatal neurons, frontal lobe atrophy

dilation of lateral and third ventricle

huntington

98

[diagnosis]

progressive ataxia, spasticity, weakness, sensory neuropathy, cardiomyopathy

betz cells, involvement of CN VIII, X, XII

degeneration of cerebellum, and clarke column

friedrich ataxia

99

[diagnosis]

loss of UMN in cerebral cortex
loss of LMN in the spinal cord and brainstem

atrophic B4,6
bunina bodies

ALS

100

[diagnosis]

seen in remaining neurons, PAS (+), remnant of vacuoles

seen in ALS

bunina bodies

101

[diagnosis: type of enceph]

psychotic symptoms
ophthalmoplefia
ataxia, confusion, ophthalmoplegia

reversible with B1

Wernicke enceph

102

[diagnosis: type of enceph]

short term memory disturbances, confabulation

confabulation, hallucinations, amnesia

chronic

irreversible with B1

Korsakoff Syndrome

103

[metabolic diseases]

resemble ischemic brain injury

hypoglycemia
carbon monoxide

104

[metabolic diseases]

may damage anterior vermis of the cerebellum

ethanol

105

most common primary tumor of the brain

gliomas

106

[diagnosis: brain tumor]

children: cerebellum
Adults: cerebral cortex

astrocytoma

107

[diagnosis: brain tumor]

4th-5th decade of life

cerebral cortex (white matter)

oligodendroglioma

108

[diagnosis: brain tumor]

1st to 2nd decade: near the 4th ventricle

Adults: spinal cord

ependymoma

109

[WHO Grading of astrocytoma]

Atypia + mitosis

Grade III, anaplastic

110

[WHO Grading of astrocytoma]

Atypia + mitosis + endovascular proliferation or necrosis

pseudopalisading pattern of cells around necrosis

Glioblastoma, IV

111

[diagnosis: brain tumor]

limited infliltration

bipolar cells with thin hair-like processes, rosenthal fibers
eosinophilic granular bodies

pilocytic astrocytoma

112

[diagnosis: brain tumor]

fried-egg appearance

aleration of 1p19q co-deletion

tumor cells arrayed around neurons

oligodendroglioma

113

ependymoma located here is almost imposible to remove

4th ventricle

114

[diagnosis]

children with hydrocephalus, cerebellum

can disseminated to CSF "drop metastasis"

radiosensitive, homer-wright rosettes, small, round blue cells

medulloblastoma

115

most common origin of primary CNS lymphoma

B cell lymphoma

116

most common subtype of primary CNS lymphoma

DLBCL

117

most common primary CNS lymphoma in ICC

EBV(+)

118

meningothelial cells of arachnoid

meningioma

119

[diagnosis: brain tumor]

located in parasagittal, dura over lateral brain convexity

psammoma bodies

meningioma