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Path E3 > Neuropath > Flashcards

Neuropath Flashcards

1
Q

Hypoxic injury

A

Loss of ribonucleoproteins and desaturation of cytoskeletal proteins leads to cytoplasmic eosinophilia and nuclear pykknosis

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2
Q

Red neurons

A

Neuron shrinks and becomes eosinophilia

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3
Q

Astrocytes responds to

A

Injury by proliferation of cytoplasmic process and intermediate filaments

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4
Q

Reactive gliosis by astrocytes

A

Analogous to fibrous scar

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5
Q

Oligodendrocytes injury results in

A

Demyelinating disease (MS)

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6
Q

Microglia

A

Antigen presenting cell

Can sometimes appear as rod cells

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7
Q

Neuron response to injury

A

Shrinkage Cell Body
Nuclear and nuclei degeneration
Breaks down in blood brain barrier with acute injuries

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8
Q

Astrocytes response to injury

A

Primarily responsible for repair and scar formation

Rosenthal fibers

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9
Q

Rosenthal fibers

A

Thick eosinophilic protein aggregates seen in chronic gliosis

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10
Q

Microglia cells response to injury

A

Microglia nodules

Neuropnphagia (eating of neurons) at injured site

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11
Q

Ependymal Cell Response to injury

A

Certain pathogens cause extensive ependymal injury with viral inclusions

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12
Q

Cerebral Edema Etiology

A

1) Disrupted blood brain barrier; increased vascular permeability (vasogenic)
2) Increase in water content secondarily to glial or endothelial injury (cytotoxic)

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13
Q

Cerebral edema causes

A

Compressed ventricle
Brain shifting
Swollen gyro
Narrowed sulci

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14
Q

Cerebral Edema: Brain Swelling leads to

A

Brain swelling leads to increased intracranial pressure

Present as Severe headache vomiting papilledema (swelling of optic disc)

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15
Q

Brain herniation

A

Displacement of brain tissue from one intracranial compartment to another-may result from brain swelling, tumor

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16
Q

3 types of brain herniation

A

Subfalcine (cingulate)
transtentorial (uncinate)
Tonsillar (the worst)

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17
Q

Uncinate will compress

A

CN 3

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18
Q

Hydrocephalus

A

Accumulation of excess CSF within ventricular system

Expanded ventricles with increased crainial pressure

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19
Q

Hydrocephalus caused by

A

Decreased CSF resorption (CSF flow obstructed by: Tumor, hemorrhage or inflammation)

-Increased CSF production (tumors of choroid plexus)

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20
Q

Cerebrovascular Diseases Mechanism

A

“Stroke”

1) thrombus occluded vessels
2) Moving thrombus (embolus) occluded vessels
3) Rupture of blood vessel

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21
Q

Stroke

A

Acute non epileptic neurological deficit lasting > 24 hours

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22
Q

Strokes result from 2 major processes

A

Occlusion/hypoxia

Hemorrhage

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23
Q

Brain hemorrhages

A

Intra-parenchymal hemorrhage

Subarachnoid hemorrhage

Vascular malformations

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24
Q

Most frequently affected with brain infarction

A

Middle cerebral artery

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25
Brain infection risk factors
Hypertension, smoking, diabetes Atherosclerosis is the most common underlying cause
26
Acute infarction
24-36 hours Neurons become eosinophils Neutrophils infiltrate into brain parenchyma
27
Subacute infarction
3rd-5th day Involved tissue becomes softer in consistency Macrophages with foamy cytoplasm begin to infiltrate
28
Chronic infarction
Weeks to months Softening and liquefaction results in smooth walled cystic cavity Loss of brain tissue
29
Intraparenchymal hemorrhage
Basal ganglia most commonly affected Pons thalamus and cerebellum also affected
30
Subarachnoid hemorrage
Severe headaches Rupture saccular berry anyersms Most arise at artisan bifurcations of the circle of Willis
31
Vascular malformations hemorrhage
Arteriovenous malformation most common Collection of abnormal blood vessel Sucharachnoid or parenchyma hemorrhage results in neurologic deficits
32
Epidural hematoma
Rupture of a meningeal artery-arterial bleeding Lucid interval
33
In epidural hematoma blood between
Skull and dura mater
34
Subdural hematoma blood between
Dura and arachnoid membrane
35
subdural hematoma disruption of
Bridging veins-Venous bleeding Acute- Whiplash shake a baby Chronic-elderly with brain atrophy
36
Concussion
Loss of consciousness with full recovery
37
Contusion
Disruption and hemorrhage of superficial brain caused by blunt trauma
38
Laceration
Tearing of brain parenchyma
39
Coup lesion
Impact site that hits the bone in contusion
40
Contrecoup
Contusion that develops on site opposite front he point of impact
41
Route of infection into CNS
1) Hematogenous spread 2) Extension of local infection 3) Direct implantation 4) Via peripheral nerves
42
Acute bacterial meningitis
Inflammation of leptomeninges and subarachnoid space
43
Cerebral abscess
Focal suppurative infection
44
Encephalitis
Diffuse inflammation of brain parenchyma; infections usually viral
45
Inflammation of leptomeninges spread through
Subarachnoid space
46
Acute bacterial meningitis caused by
Pyogenic bacteria
47
Acute bacterial meningitis risk factors
Extreme age Debilitated state Poor hygiene Crowded living conditions
48
Acute bacterial meningitis the brain is swollen with
Purulent exudate under subarachnoid space over cerebral hemisphere and purulence within the ventricles
49
Brain Abscess
Usually bacteria or fungal
50
Brain abscess cavity contains
Pus surrounded by a thick wall of granulation tissue and fibrosis
51
Tuberculous Meningitis (Chronic) will present as
>2-3 weeks of headache, lethargy, nausea, and vomiting
52
Tuberculous Meningitis (Chronic) exudate
Will be gelatinous and may appear Nodular
53
Cryptococcal Meningitis
Spherical budding yeast, found in soil and bird excrement
54
Cryptococcal Meningitis will present
With low grade fever, debility, headache
55
Cryptococcal Meningitis mostly seen
In both healthy and HIV patients
56
Cryptococcal Meningitis exudate
Slimy exudate capsular material
57
Encephalitis
Diffuse inflammation of brain parenchyma
58
Encephalitis infection is
Viral in origin Hepesviruses-most common
59
Viral encephalitis untreated is usually
Fatal
60
Viral inclusion bodies
Within nucleus of infected neuron Protein aggreagate of herpes virus
61
Encephalitis: perivascular lympocytosis
Lymphocytes collected around blood vessel
62
Neuronophagia and microglia nodules found in
Encephalitis
63
Multiple Sclerosis
Most common primary demyelinating disorder
64
MS caused by
Autoimmune (T Cell mediated) plus genetics
65
MS usually afffects
Young adults females
66
Irregular areas of demyelination
MS plaques
67
Alzheimer’s familal
10%
68
Alzheimer’s microscopically
Senile plaque of amyloid despoists Neurofibrially tangles - filamenotous aggregates within neuronal cytoplasm
69
Parkinson’s is a degeneration of
Dopamine-secreting pigmented neurons of substantia nigra in the midbrain
70
Parkinson’s symtopms
``` Rigidity Expressionless face Stooped Posture Fine tremor Slower gait ```
71
Lewy bodies
Intracytoplasmic eosinophlic inclusions known as Lewy bodies within pigmented neurons
72
Huntington’s Disease grossly
Atrophy of the basal ganglia
73
Huntington’s Disease type
AD | Gene located in chromosome 4
74
Huntington’s Disease will present with
Spontaneous involuntary movements and dementia
75
Huntington’s Disease
Hereditary, progressively fatal disorder
76
Primary neural tumor arise from
Cells of the brain spinal cord or their coverings
77
Neural tumors _____ is more important than ______
Location | Type
78
Neural tumors rarely
Metastasize outside the CNS
79
Secondary nervous system tumors
Lung Breast Prostate -Mets to brain: far more common than Mets FROM the brain
80
Most common Adult Brain tumors
Astrocytomas
81
WHO grades
II well differentiated III anaplastic IV glioblastoma
82
Astrocytoma Grade II
Mild cellualrity and nuclear pleomorphism
83
Astrocytoma Grade III
Highly cellular with mitosis figures
84
Grade IV glioblastoma
Necrosis and microvascular proliferation
85
Oligodendroglioma
Cerebral hemisphere, well circumscribed often calcified
86
Oligodendroglioma Cells with
Uniform round nuclei and perinuclear halo
87
Ependymoma lesions are
Well circumscribed lesions arising from ventricular wall
88
Ependymoma cells are
Elongated with processes radiating around blood vessels
89
Meningioma derived from
Arachnoid matter
90
Meningioma predominance
Female
91
Meningioma lesions will be
Firm lobulated lesions with a pushing border into underlying brain
92
Psammoma bodies
Calcification
93
Meningioma microscopically
Cellular whorls Psammoma bodies
94
Pediatric brain tumors
Pilocytic astrocytoma
95
Pilocytic Astorcytoma
Grade I tumor | Usually in the cerebellum, often cystic
96
PA: Rosenthal fibers
Astrocytes with hair like processes
97
Medulloblastoma
Cerebellum, aggressive growth pattern Grade IV tumor
98
Medulloblastoma Cells disseminate through
CSF

Path E3 (8 decks)

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