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Pathology bs > CNS > Flashcards

CNS Flashcards

1
Q

What are the order of layers of the brain from outside in?

A

dura mater
arachnoid
pia mater

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2
Q

What regulates the blood supply to the brain?

A

circle of willis

- often a site for aneurysms and bleeds

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3
Q

What does the brain not have that the rest of the body does?

A

lymphatic system - tumours can not metastasize to the brain this way

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4
Q

The skull is a bony box that can not expand. Therefore if the volume of tissue of fluid inside the skull increases what happens?

A
  • intracranial pressure rises

- results in herniation(abnormal protrusion) where part of the brain moves from one compartment of the skull to another

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5
Q

What do the neurons do compared to the glial cells?

A
  • Neurons - the processors

- Glial cells - supporting functions (includes schwann cells, astrocytes & oligodendrocytes)

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6
Q

Frontal lobe is responsible for …

A

planning

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7
Q

parental lobe which is responsible for …

A

movement

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8
Q

occipital lobe responsible for …

A

vision

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9
Q

cerebellum which is responsible for..

A

co-ordinating movement and balance

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10
Q

Brain stem is responsible for…

A

vital functions like regulation BP, resp rate ect.

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11
Q

pre central and post central gyrus are responsible for …

A

pre - motor cortex

post - sensory cortex

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12
Q

Frontal and temporal lobe are responsible for …

A

speech and language
includes brocas area in frontal lobe
includes wernickes area in temporal lobe

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13
Q

What is the brain stem composed of (3 areas)?

A

midbrain
pons
medulla

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14
Q

What is focal neurological signs?

A

a set of symptoms or signs in which causation can be localized to an anatomic site in the central nervous system

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15
Q

What is generalised neurological abnormalities?

A

Essentially an alteration in level of consciousness

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16
Q

If you have damage to the frontal lobe what are the likely signs?

A

Anosmia (inability to smell)
Inappropriate emotions
Expressive dysphasia (cant get words out )
Motor impairment

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17
Q

If you have damage to the parietal lobe what are the likely signs?

A 
Receptive dysphasia ( not understanding language)
Sensory impairment
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18
Q

If you have damage to the temporal lobe what is the likely signs ?

A
  • cortical deafness

- Receptive dysphasia

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19
Q

Diffuse neurological injury is usually manifest as impairment of consciousness. Most often due to what?

A
  • increased intracranial pressure
  • may occur as a primary response
  • or as a secondary to response to a focal injury (injury to specific area)
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20
Q

What are the 2 main pathologies types of strokes?

A
  • ischaemic (as result of blockage, atheroma or thrombosis or emboli)
  • haemorrhagic (as a result of berry aneurysm or hypertension related)
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21
Q

What is the only difference between a stoke and a TIA

A
  • the duration in which the symptoms last (TIA resolves within 24 hours)
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22
Q

In cerebrovascular disease survival depends on what 3 things ?

A
  • duration of ischaemia
  • what collateral circulation available
  • how much reduction of flow and quickly it happens
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23
Q

What are the treatments for TIA’s?

A
  • antiplatelet therapy (aspirin or clopidogrel)
  • control BP
  • lower cholesterol
24
Q

What are the risk factors for strokes?

A
  • hypertension
  • diabetes
  • heart disease
  • Previous transient ischaemic attacks
  • hyperlipidaemia
25
Q

What are causes of haemorrhagic events (strokes ect.)?

A
  • hypertension
  • vascular malformation (berry aneurysm )
  • neoplasia
  • trauma
  • drug abuse
  • iatrogenic
26
Q

What are the management of strokes?

A
  • thrombolysis (break up blood clot)
  • aspirin/ clopidogrel
  • physiotherapy
  • occupational therapy
  • SALT
  • supportive treatment
27
Q

intracerebral haemorrhage (haemorrhagic stroke) presents as what symptoms?

A
  • headache
  • rapid or gradual decrease in conscious level
  • localises depending on site of bleed
28
Q

Subarachnoid haemorrhage normally occur ?

A
  • spontaneous

- when berry aneurysm ruptures

29
Q

What are the symptoms of a subarachnoid haemorrhage?

A
  • thunderclap headache (bad!)
  • meningitis like signs (photophobia ect.)
  • requires neurosurgical input
30
Q

where does a subdural haemorrhage occur?

A
  • bleeding from bridging veins between cortex and venous sinuses
  • blood between dura and arachnoid
31
Q

What may cause a subdural haemorrhage?

A
  • often on anticoagulants
  • often minor trauma in the elderly
  • common in alcoholics
32
Q

Symptoms of subdural haemorrhage normally take days, weeks or months to present as it involves veins. What are the symptoms?

A
  • fluctuant conscience level
33
Q

What is an extradural haemorrhage ?

A

haemorrhage outside the dura

typically affecting the middle meningeal artery

34
Q

What may cause an extradural haemorrhage?

A

post head injury

often with fractured temporal or parietal bone

35
Q

What are the symptoms of extradural haemorrhage?

A
  • slowly falling conscious level

possibly with lucid periods

36
Q

What should a dementia assessment include?

A 
TSH – ensure thyroid function is normal
CT scan (Not all cases) to check for intracranial pathology
Vitamin B12, thiamine – alcoholism
37
Q

What is Alzheimer’s disease due to?

A
  • accumulation of AB amyloid, tau-neurofibrillary tangles and plaques
  • loss of neurones and synapses
38
Q

What does the accumulation in amyloid, tau-neurofibrillary tangles and plaques in Alzheimer’s disease lead to ?

A
  • defects of visual-spatial skills (gets lost)
  • memory loss
  • decreasing cognotion
  • ansognosia (lack of awareness)
39
Q

What is the treatment for Alzheimer’s disease?

A
  • MDT

- cholinesterase inhibitors (rivastigmine)

40
Q

What is epilepsy ?

A

A recurrent tendency to spontaneous, intermittent, abnormal electrical activity in part of the brain, manifest as seizures

41
Q

What can epilepsy be due to?

A
  • space occupying lesions
  • stroke
  • alcohol withdrawal
42
Q

What is treatment of epilepsy?

A
  • avoid triggers

- drugs such as sodium valproate, carmazepine, phenytoin, lamotrigine

43
Q

There are two types of infection in the brain these are diffuse or focal infection. Give an example of each.

A

diffuse infection - meningitis

focal infection - abscess

44
Q

What are the early symptoms of meningitis?

A
  • headache
  • cold hands and feet
  • pyrexial (fever)
45
Q

What are the late stages of meningitis?

A
  • neck stiffness
  • photophobia
  • kernigs sign (extension of knee causes pain in the neck)
  • non-blanching rash
  • seizures
46
Q

What are the 3 main examples of bacteria causing meningitis?

A

Neisseria meningitidis
Pneumococcus
Meningococcus

47
Q

What can a brain abscess symptoms present as?

A
  • headaches
  • seizures
  • temperature
48
Q

What does ring enhancing lesion in radiology suggest ?

A
  • brain abscess
49
Q

How can brain abscess occur?

A 
via blood 
- embolus from bacterial endocarditis 
- IV drug users at risk 
direct 
- from inner ear infection
50
Q

What is parkinsons disease?

A
  • movement disorder
  • sporadic or familial
  • can be drug induced
51
Q

What are the symptoms of parkinsons?

A
  • rigidity
  • bradykinesis (slowness of movement)
  • resting tremor
  • postural instability (prone to falls, start with difficulty)
52
Q

What is parkinsons a results of ?

A
  • decreased dopamine with the brain (in substantia nigra, which is decreased also )
53
Q

What are the presentations of a tumour in the brain?

A
  • headaches
  • seizures
  • cognitive or behavioural change
  • vomiting
  • altered consciousness
54
Q

Most tumours in the brain are secondary deposits from somewhere else. Where might these include?

A

breast

small cell lung carcinoma

55
Q

What are the two most common primary benign brain tumours?

A

meningiomas

astrocytomas

56
Q

A meningioma is a slow growing tumour where do they arise from?

A

derived from menigothelial cells

57
Q

Pituitary tumours can cause..

A

compression

hormonally active

Pathology bs (21 decks)

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