CNS Neuropathology - Parks

Question 1

What type of edema follows trauma?

Answer 1

vasogenic edema

Question 2

what type of edema follows stroke and hypoxic-ischemia insult?

Answer 2

cytotoxic edema

Question 3

Tumors, inflammation, and encephalitis show what type of edema?

Answer 3

vasogenic

Question 4

in which type of edema are neurons and glia injured which causes the edema

Answer 4

cytotoxic

Question 5

vasogenic edema is fluid leaking into what space?

Answer 5

interstitial space from a damaged BBB; fluid shifts from vascular to extracellular space

Question 6

Describe the process of forming cytotoxic edema?

Answer 6

hypoxia results in a decrease in ATP production, which shuts down the ATP pumps, which causes Na to flow into the cell and water follows the salt

Question 7

What does an edematous brain look like?

Answer 7

flattening of the gyri and loss of the sulci

Question 8

Which parts of the inside of the skull are fixed?

Answer 8

Falx and tentorium

Question 9

What are the three types of herniation?

Answer 9

subfalcine
transtentorial aka uncal
cerebellar tonsillar through the mangum foramen

Question 10

Which type of herniation can effect cardiac and respiratory function?

Answer 10

uncal herniation

Question 11

which artery can an uncal herniation close off?

Answer 11

the basilar artery

Question 12

what is another name for the uncus?

Answer 12

anterior medial temporal gyrus

Question 13

The uncus compresses CN (blank) as it traverses the subarachnoid space, causing enlargement of the (ipsi/contra) pupil

Answer 13

CN 3

IPSI pupil

Question 14

The coma that follows uncal herniation is due to compression of the midbrain on the (ipsi/contra) side to the original contusion

Answer 14

contralateral side

Question 15

Lateral displacement of the midbrain may compress the opposite cerebral peduncle, proudcing Babinksi and hemiparesis on the contralateral side. This is called (blank’s) sign

Answer 15

Kernohan-Woltman sign

Question 16

Besides the basilar artery, which other arteries can an uncal herniation impinge?

Answer 16

anterior and posterior cerebral arteries

Question 17

Right uncal herniation will result in (right/left) Kernohan notching of the brainstem

Answer 17

left Kernohan notching

Question 18

Kernohan’s sign is associated with what level of consciousness?

Answer 18

coma

Question 19

Blockage of the ventricular system from an uncal herniation can result in what?

Answer 19

hydrocephalus

Question 20

Where does a Duret hemorrhage occur?

Answer 20

midbrain and pons

Question 21

What is the prognosis of a Duret hemorrhage?

Answer 21

fatal

Question 22

Stretching of the midbrain and pons from an uncal herniation can result in the the impingement or severing of which penetrating branch of the basilar artery, which leads to infarct or hemorrhage?

Answer 22

parademian branch of basilar artery

Question 23

What are the three brainstem respiratory centers?

Answer 23

1. pneumotaxic center
2. caudal pons
3. retrotrapezoid nucleus

Question 24

A Duret hemorrhage can kill which nuclei that controls arousal and sleep-wake function that will directly lead to coma?

Answer 24

Reticular activating system

Question 25

Occipital lobe is supplied by which artery?

Answer 25

PCA

Question 26

Gross brain specimens with dark areas indicates what?

Answer 26

dead brain; infarct; ischemic necrosis

Question 27

What stage of development of the fetus is most critical to the CNS?

Answer 27

first five weeks

Question 28

When does the neural tube close?

Answer 28

day 28-30

Question 29

What are the major types of NTDs?

Answer 29

1. anencephaly 2. cariorachischisis 3. open spina bifida 4. closed spina bifida 5. encehpalocele 6. iniencephaly

Question 30

List the following in terms of increasing severity: Meningocele Spina bifida occulta Myelomeningocele

Answer 30

Spina bifida occulta Meningocele Myelomeningocele

Question 31

which type of NTD has nerves from the cord in the pouch?

Answer 31

myelomeningocele

Question 32

Myelomeningocele will result in what deficits?

Answer 32

incontinence (sacral nerves) and problems walking

Question 33

What protein can we measure in maternal serum that may indicate an open NTD?

Answer 33

AFP

Question 34

AFP is elevated in what condidtion?

Answer 34

open NTD

Question 35

which vitamin helps reduce the risk of NTD?

Answer 35

folate

Question 36

T/F: megavitamins should be taken during pregnancy

Answer 36

false

Question 37

what is the RDA of folate for pregnant women?

Answer 37

0.4mg qday

Question 38

What is one of the most frequent congenital malformations of the CNS?

Answer 38

congenital hydrocephalus

Question 39

What are the risk factors for CHC?

Answer 39

1. Lack of prenatal care 2. Maternal diabetes (gestational DM) 3. Maternal high blood pressure 4. Maternal consumption of alcohol 5. Certain infections (parvovirus b19) 6. Maternal antidepressant use (selective serotonin reuptake inhibitors = SSRIs

Question 40

Where is CSF formed?

Answer 40

choroid plexus

Question 41

where is CSF resorbed?

Answer 41

arachnoid villi

Question 42

What can cause scarring of the arachnoid villi that results in hydrocephalus?

Answer 42

meningitis

Question 43

Are cases of hydrocephalus more commonly caused by issues of resorption or overproduction?

Answer 43

resorption

Question 44

What is noncommunicating hydrocephalus?

Answer 44

Localized obstruction within ventricular system. Only that focal ventricle enlarges while the other ventricles do NOT enlarge.

Question 45

What is communicating hydrocephalus?

Answer 45

Entire ventricular system enlarges. This usually from reduced CSF resorption

Question 46

What is the hydrocephalus triad?

Answer 46

dementia (last to show; = severe) urinary incontinence gait apraxia

Question 47

Adults that have tumors that cause hydrocephalus get what symptom?

Answer 47

headaches

Question 48

T/F: alzheimer's may cause hydrocephalus

Answer 48

true