intro to neuropath; basic tissue reactions, brain edema, brain herniation

Question 1

cells of the gray matter

Answer 1

neurons, astrocytes, oligodendrocytes, microglia, neuropils

Question 2

astrocytes

Answer 2

like a fibroblast of CNS, respond to injury

Question 3

these cells make up the majority of tumors

Answer 3

astrocytes

Question 4

macrophage of brain

Answer 4

microglia

Question 5

Ciliated ______ cells cover surface of ventricle

Answer 5

ependymal

Question 6

leptomeninges

Answer 6

arachnoid mater and pia mater

Question 7

meningothelial cells

Answer 7

arachnoid cells

Question 8

Degeneration of the axon distal to the site of injury occurs within _____ and is called

Answer 8

• the first day - wallerian degeneration

Question 9

Influx of macrophages occurs within _____ of neuronal injury, and phagocytosis of the degenerating myelin occurs over _______

Answer 9

• 2–3 days - the next several weeks

Question 10

Proliferation of astrocytes leads to a reactive gliosis in ______

Answer 10

by one week

Question 11

Reactive astrocytes and microglial have_____ cytoplasm

Answer 11

hypertrophied

Question 12

Total CSF volume is ______, of which ____ are within the ventricles

Answer 12

• 150 ml - 25 ml

Question 13

____ ml of CSF are produced each day

Answer 13

500

Question 14

Obstruction of CSF flow causes________ of the ventricles (hydrocephalus) proximal to the blockage

Answer 14

enlargement

Question 15

an enlargement of one or more ventricles (ventriculomegaly) caused by an obstruction of the bulk flow of CSF

Answer 15

hydrocephalus

Question 16

theventriculomegalythatresultsfroma loss of brain tissue (brain atrophy)

Answer 16

Hydrocephalus ex vacuo

Question 17

common causes of hydrocephalus

Answer 17

• Aqueductal stenosis - Dandy-Walker malformation - Chiari II malformation - Post inflammatory or post hemorrhagic hydrocephalus - tumors

Question 18

may result from a congenitally malformed cerebral aqueduct or acquired

Answer 18

aqueductal stenosis

Question 19

a hindbrain malformation showing downward extension of the cerebellar vermis through the foramen magnum

Answer 19

Chiari II malformation

Question 20

Chiari II malformation is closely associated with ___________

Answer 20

lumbar meningomyelocele

Question 21

Post-inflammatory or post-hemorrhagic hydrocephalus

Answer 21

inflammatory cells or hemorrhage may block the cerebral aqueduct (non-communicating hydrocephalus) or clog the subarachnoid space/arachnoid villi (communicating hydrocephalus).

Question 22

Describe this

Answer 22

Dandy–Walker malformation. Note the very hypoplastic inferior cerebellar vermis and the cystic dilatation of the fourth ventricle.

Question 23

blood brain barrier

Answer 23

Controls extracellular environment of brain by regulating the movement of molecules from the blood into brain’s extracellular space and into the CSF.

Question 24

________ between endothelial cells restrict inter-endothelial passage of molecules.

Answer 24

Tight junctions

Question 25

Lipid-soluble molecules are (not/restricted) by BBB.

Answer 25

not restricted

Question 26

Keeps blood-borne infectious agents out of brain and CSF; may impede drug delivery to the brain and CSF

Answer 26

blood brain barrier

Question 27

BBB breakdown leads to

Answer 27

increased capillary permeability.

Question 28

Extracellular edema mainly localizes to the \_\_\_\_\_

Answer 28

white matter.

Question 29

BBB breakdown may be visualized _________ with a\_\_\_\_\_\_\_\_

Answer 29

* radiologically * contrast agent

Question 30

Increased vascular permeability may lead to an increase in \_\_\_\_\_\_\_, which can be detected by lumbar puncture (LP) and CSF analysis

Answer 30

CSF protein

Answer 31

mass effect

Question 32

an increase in brain volume due to an increase in fluid. The fluid may be extracellular or intracellular.

Answer 32

brain edema

Question 33

Brain edema accompanies many types of brain disease. Name some examples

Answer 33

trauma, infarcts, tumors, infections, inflammatory processes, hydrocephalus, water intoxication, and hepatic encephalopathy.

Question 34

Three types of brain edema

Answer 34

- vasogenic - cytotoxic - interstitial

Question 35

extracellular edema due to increased permeability of brain capillaries (BBB breakdown).

Answer 35

vasogenic brain edema

Question 36

Vasogenic brain edema takes place mainly in the \_\_\_\_\_

Answer 36

white matter.

Question 37

intracellular edema due to an osmotic imbalance between the cell and the extracellular fluid.

Answer 37

cytotoxic cellular brain edema

Question 38

cytotoxic brain edema mainly happens in the \_\_\_\_\_\_\_\_

Answer 38

gray matter

Question 39

extracellular edema in periventricular white matter due to the transependymal flow of CSF in hydrocephalus.

Answer 39

interstitial/hydrocephalic brain edema

Question 40

what kind of edema

Answer 40

vasogenic

Question 41

type of edema

Answer 41

cytotoxic edema

Question 42

type of edema

Answer 42

interstitial edema

Question 44

ICP is the pressure inside the \_\_\_\_\_\_\_\_.

Answer 44

cranium

Question 45

Monro-Kellie hypothesis

Answer 45

The cranium has a fixed volume and contains CSF, blood, and brain. Any increase in volume of one component means that one or both other components must be reduced in volume to not increase pressure

Question 46

Increased ICP is evidenced clinically

Answer 46

by headache, nausea, vomiting, and papilledema (swelling of the optic disc).

Question 47

causes of increased ICP

Answer 47

- mass lesion - hydrocephalus (communicating or non) - diffuse brain emergency - obstruction of a major dural venous sinus - idiopathic intacrainal hypertension

Question 48

as the ICP increased the CPP \_\_\_

Answer 48

decreases (cerebral perfusion pressure)

Question 49

uncal herniation shows dilated \_\_\_\_contra/ips\_\_\_ pupils from compression of the parasympathetic fibers in cranial nerve \_\_\_\_\_\_

Answer 49

- ipsilateral - CN III

Question 50

uncal herniation will result in contralateral ______ from compression of the ipsilateral cerebral peduncle

Answer 50

hemiplegia

Question 51

Coma, decerebration, abnormal respirations, and fixed, dilated pupils from compression of the upper brainstem are caused from

Answer 51

uncal herniation

Question 52

consequences of a mass lesion

Answer 52

Intracranial mass Increased intracranial pressure Decreased cerebral perfusion pressure Global brain ischemia then death OR Brain herniation Brainstem compression Death