Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NMSP Exam 1 > Intro to Neuropathology > Flashcards

Intro to Neuropathology Flashcards

(125 cards)

Start Studying
1
Q

Why is gliosis important?

A
  • Histopathologic indicator of CNS injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is gliosis characterized by?

A
  • Hypertrophy and hyperplasia of astrocytes (astrocytes act as a metabolic buffer and detoxifer)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do gemistocytes differ from dead red neurons?

A
  • Gemistocytes have a nucleus whereas dead red neurons do not
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are rosenthal fibers?

A
  • Thick, elongated, brightly eosinophilic, irregular structures occurring within astrocytic processes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What do rosenthal fibers contain?

A
  • Heat shock proteins( alpha-beta crystalline and HSP27)

- Ubiquitin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where are rosenthal fibers typically seen?

A
  • In areas of long standing gliosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is corpora amylacea?

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

What stain is used for corpora amylacea?

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

What does corpora amylacea look like?

A
  • Round, faintly basophilic

- Concentrically laminated strictures located adjacent to astrocytic end processes (resembles onion skinning)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does corpora amylacea contain?

A
  • Glycosaminoglycan polymers
  • Heat shock proteins
  • Ubiquitin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a correlation with corpora amylacea?

A
  • Increased with age (represents degenerative change)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do rosenthal fibers look like?

A
  • Beaded sausage to cork-screw shaped hyaline bodies of variable size
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the job of microglia?

A
  • Macrophages of the CNS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What surface markers are seen with microglia?

A
  • CR3

- CD68

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

What are microglial nodules?

A
  • When microglia aggregate around small foci of necrosi
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is neuronophagia?

A
  • Microglia concregate around cell bodies of dying neurons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are ependymal granulations?

A
  • Small irregularities on ventricular surfaces

- Disruption of ependymal lining and proliferation of subependymal astrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is vasogenic edema?

A
  • Increased extracellular fluid due to BBB disruption and increased vascular permeability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some causes of vasogenic edema?

A
  • Fluid shift from intravascular compartment to intercellular spaces
  • Paucity of lymphatics impairs resorption of excess extracellular fluid
  • Localized or generalized injury
  • Often follows ischemic injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is cytotoxic edema?

A
  • Increased intracellular fluid secondary to neuronal, glial, or endothelial cell membrane injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some causes of hydrocephalus?

A
  • Increased production –> choroid plexus papilloma
  • Obstruction –> interventricular foramina, congenital, or secondary
  • Decreased absorption –> outflow obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is an external sign of hydrocephalus?

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

What does a choroid plexus papilloma look like?

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

What is pyogenic meningitis?

A
  • Suppurative exudate covering brainstem and cerebellum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How can pyogenic meningitis cause hydrocephalus?
- Thickened leptomeninges
26
What should you think when you see pyogenic meningitis covering the base of the brain?
- TB or neurosyphilis
27
What are some congenital causes of hydrocephalus?
- Intrauterine infections (TORCH) - Agenesis/atresia/stenosis - AV malformation - Arnold chiari malformation - Dandy-Walker syndrome - Cranial Defects
28
What are some acquired causes of hydrocephalus?
- Infections - Mass lesions - Inflammation - Post hemorrhage - Choroid plexus papilloma - Sagittal sinus thrombosis - Hypervitaminosis A - Idiopathic
29
What is communicating hydrocephalus?
- CSF is not absorbed properly at the dural sinus level | - Ventricles tend to be symmetrically dilated
30
How does aqueductal stenosis cause hydrocephalus?
- Aqueduct is 1/3 the size of normal so it reduces the flow significantly
31
What is seen in hydrocephalus ex-vacuo?
- Dilation of the ventricles - Shrinkage of brain substance - CSF pressure is normal (makes it different)`
32
What are some causes of the shrinkage of brain substance in hydrocephalus ex-vacuo?
- Atrophy with increasing age - Stroke or other injury - Chronic neurodegenerative (huntington dz or Alz)
33
What is normal pressure hydrocephalus?
- Symmetric type of hydrocephalus that usually occurs in patients older than 60 - Develops slowly
34
What is normal pressure hydrocephalus typically confused with?
- Alzheimers or Parkinson
35
What are the classic symptoms of normal pressure hydrocephalus?
- Wet --> Urinary incontinence - Wacky --> Dementia - Wobbly --> Gait disturbances
36
What generally causes increased cranial pressure?
- Generalized brain edema - Expanding mass lesion - Increased CSF volume
37
What is herniation?
- Increased pressure beyond the compensatory ability of venous system to compress and displacement of CSF
38
What are some types of herniation?
- Subfalcine - Transtentorial - Tonsillar
39
What is a subfalcine herniation?
- Cingulate gyrus displaced under the falx
40
What is a transtentorial herniation?
- Medial aspect of the temporal lobe compressed against the tentorium
41
What signs may be seen in a transtentorial herniation?
- CN3 --> dilated pupil and impaired eye movement
42
What is a tonsillar herniation?
- Cerebellar tonsils displaced through the foramen magnum
43
Why is a tonsillar herniation life threatening?
- Respiratory and cardiac centers are compressed
44
What are some signs of increased intracranial pressure?
- Headache, change in behavior, N/V - Change in pupil reaction - False localizing signs - Seizures - Decreased coordination, ataxia - Papilledema
45
What causes Kernohan's notch phenomenon?
- Compression of the cerebral peduncle against the tentorium cerebelli due to transtentorial herniation
46
What is seen in Kernohan's notch phenomenon?
- Ipsilateral hemiparesis or hemiplegia (on side of herniation) - Caused by compression of the contralateral peduncle
47
What is special about Kernohan's notch phenomenon?
- As it progresses, it may compress the other side against kernohan's notch (cerebral peduncle and CNIII) causing ipsilateral weakness, contralateral dilated pupil (relative to original herniation)
48
What is a duret hemorrhage?
- Progression of transtentorial herniation often accompanied by secondary hemorrhagic lesions in the midbrain and pons
49
What causes a duret hemorrhage?
- Mass effect displaces the brain downward causing a disruption of the vessels that enter the pons along the midline, leading to hemorrhage
50
What kind of necrosis does the brain go through?
- Liquefactive (no architecture remains)
51
What is the progression seen in cerebral infarcts?
- First red dead neurons will show up - Around day 10, foamy macrophages are seen - Then there is tissue loss and gliosis
52
What is a hygroma?
- Separation of arachnoid from dura due to contraction of underlying brain parenchyma
53
What accounts for most CNS malformations?
- Neural tube defects
54
What may be a big cause to neural tube defects?
- Folate deficiency
55
What is spina bifida occulta?
- Asymptomatic, bony defect | - Flattened disorganized segment of cord associated with meningeal pouch
56
What is a myelomeningocele?
- Extension of CNS tissue through a defect in vertebral column (lumbosacral most common)
57
What is a meningocele?
- Only meninges protrude
58
What symptoms are seen in a myelomeningocele?
- Motor and sensory deficits of LE - Bowel and bladder control - Superimposed infections (through thin coverings of cord)
59
What is an encephalocele?
- Diverticulum of disorganized brain tissue extending through defect in cranium (usually posterior fossa)
60
What is a nasal glioma?
- Misnomer for extension of brain tissue through cribiform plate
61
What is anencephaly?
- Absence of most of the brain and calvarium | - Forebrain development disrupted at around 28 days GA
62
What are some defects in neural tube formation in the first trimester?
- Anencephaly - Encephalocele - Holoprosencephaly
63
What are some defects of neuronal proliferation in the second trimester?
- Microcephaly - Megalencephaly - Lissencephaly - Agenesis of corpus callosum
64
What are some major causes of microcephaly?
- Chromosome abnormalities - Fetal alcohol syndrome - HIV-1 acquired in utero - maybe Zike virus
65
What is lissenencephaly?
- Decreased number of gyri | - Brain looks smooth or has a cobblestone surface
66
What is polymicrogyria?
- Small, usually numerous, irregularly formed convolutions
67
What is neuronal heterotopias associated with?
- Epilepsy
68
What are neuronal heterotopias?
- Collections of neurons in inappropriate places along the pathway of migration
69
What genes are implicated in neuronal heterotopias?
- X chromosome (filamin A and DCX) | - Lissencephaly in males and subcortical band heterotopias in females
70
What is holoprosencephaly?
- Incomplete separation of cerebral hemispheres across midline
71
What does someone look like with holoprosencephaly?
- Cyclopia | - Arhinencephaly --> absence of olfactory cranial nerves
72
What pathway causes holoprosencephaly?
- SHH
73
What genetic abnormality is most likely seen with holoprosencephaly?
- Trisomy 13
74
What does agenesis of the corpus callosum look like?
- Bat wing on CT
75
What is seen in Chiari type 2?
- More severe, misshapen midline cerebellum with downward extension of vermis through foramen magnum
76
What is associated with Chiari type 2?
- Hydrocephalus | - Lumbar myelomeningeocele
77
What is seen in Chiari type 1?
- Low-lying cerebellar tonsils extend down vertebral canal
78
How does Chiari type 1 present?
- May be silent and show up incidentally | - May have headache or migraine due to CSF flow impairment
79
What is seen in Dandy-Walker malformation?
- Enlarged posterior fossa - Expanded roofless fourth ventricle - Cerebellar vermis absent or rudimentary
80
What replaces the vermis in Dandy-Walker malformation?
- Cyst with ependymal lining that is contiguous with leptomeninges on its outer surface
81
What is Joubert syndrome?
- Hypoplasia of vermis - Elongation of cerebellar peduncles - Altered brainstem shape
82
How does Joubert syndrome look on scans?
- "Molar tooth sign"
83
What is syringomyelia (or syrinx)?
- Fluid filled cleft like cavity in the inner portion of the cord
84
What are the classic symptoms of syrinx?
- Isolated loss of pain and temperature sensation in UE (cape like distribution)
85
How is a syrinx treated?
- Inserting a shunt to help drain the fluid OR | - Removing some of the bone (either from vertebrae or base of skull depending on the location of the syrinx)
86
What is cerebral palsy?
- Non-progressive neurologic motor deficit attributable to insults occurring during the prenatal and perinatal period
87
What does cerebral palsy look like?
- Spasticity - Dystonia - Ataxia/athetosis - Pareis
88
Where does an intraparenchymal hemorrhage occur?
- Seen in germinal matrix of premature infants | - Junction between thalamus and caudate nucleus
89
When does an intraparenchymal hemorrhage occur?
- Usually a few hours after birth but can occur at any time
90
What is periventricular leukomalacia?
- Infarcts in supratentorial white matter
91
What does periventricular leukomalacia look like?
- Chalky yellow plaques due to necrosis and calcification
92
What is multicystic encephalopathy?
- Extensive ischemic damage of both white and gray matter --> large destructive cystic lesions
93
What is ulegyria?
- Perinatal ischemic lesions in the depths of sulci | - Causes thinned out gliotic gyri
94
How do people fall when awake vs loss of consciousness?
- Awake: Fall backward onto occipital | - LOC: Fall forward onto frontal
95
What is a diastatic fracture?
- Fracture that crosses a suture
96
Why is the timing of fractures important?
- New fractures lines do not extend across previous fracture lines
97
What are some signs of a basal skull fracture?
- Orbital or mastoid hematoma | - Otorrhea/rhinorrhea --> CSF drainage
98
What could battle sign or raccoon eyes help point to?
- Basilar skull fracture
99
What is a concussion?
- Clinical syndrome | - Altered consciousness secondary to head injury
100
What are some direct parenchymal injuries?
- Contusions (blunt trauma) | - Lacerations (penetrations or tearing of the tissue)
101
What are the most common locations for direct parenchymal injuries?
- Frontal lobes/orbital ridges and temporal lobes - Regions of the brain that overlie rough and irregular inner skill surface - Crests of gyri are most susceptible where direct force is greatest
102
What does a contusion look like grossly?
- Wedge shaped --> Broad at point of impacts
103
What is a coup?
- Contusion at point of impact
104
What is a contrecoup?
- Diametrically opposed to coup | - Contusion opposite point of impact due to rebound
105
What are plaque jaune?
- Depressed, retracted, yellowish brown patches involving crests of gyri
106
What causes plaque jaune?
- Old trauma lesions --> often countercoup inferior frontal cortex, temporal and occipital lobes
107
What is diffuse axonal injury?
- Axonal swelling +/- focal hemorrhagic lesions
108
When does diffuse axonal injury present?
- Typically within hours and will persist much longer
109
What stain is used to help identify diffuse axonal injury?
- Silver stain - Amyloid precursor protein (APP) - Alpha synuclein immunostains
110
What can cause diffuse axonal injury?
- Direct action of mechanical forces | - Angular acceleration alone can produce even in the absence of impact
111
Why is shaking a baby bad?
- Brains are very soft and not fully developed | - Shaking them causes brain damage but does not kill them
112
How does several occasions of shaking a baby kill them?
- Is like second concussion syndrome | - Don't die instantly but after hours of brain swelling and DAI
113
How is shaken impact syndrome recognized?
- DAI/Cerebral edema - Subdural hematomas - Retinal hemorrhages - Sometimes, subgaleal hemorrhages - Sometimes, microscopic iron
114
What is post-traumatic hydrocephalus?
- Obstruction of CSF resorption due to hemorrhage in subarachnoid space
115
What is chronic traumatic encephalopathy?
- Dementing illness developed from repeated head trauma?
116
What is seen in CTE?
- Atrophy - Enlarged ventricles - Tau neurofibrillary tangles involving gyral depths - Perivascular regions in frontal and temporal lobes (characteristic pattern)
117
What is a traumatic brain injury (TBI)? What is it associated with?
- Some level of damage to the brain due to external mechanical force - Generally associated with diminished or altered state of consciousness
118
What are some major features of CTE?
- Neurofibrillary tangles/amyloid and tau depositions (similar to Alzheimer's) - Depigmentation of substantia nigra (similar to parkinsons)
119
What kind of paresis is seen in a spinal cord injury in the thoracic region?
- Paraplegia (just legs)
120
What kind of paresis is seen in a spinal cord injury in the cervical region?
- Quadriplegia (all limbs)
121
What kind of paresis is seen in a spinal cord injury in C4 or above?
- Respiratory compromise and paralysis of diaphragm
122
What do acute lesions of the spinal cord look like?
- Hemorrhage - Necrosis - Axonal swelling
123
What do chronic lesions of the spinal cord look like?
- Central areas become cystic and gliotic
124
What is the most likely cause of an epidural hematoma?
- Rupture of the meningeal artery --> usually due to skull fracture
125
What is the most likely cause of a subdural hematoma?
- Rupture of bridging veins between the brain and superior sagittal sinus

NMSP Exam 1 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions