Neurous System Disorders Flashcards
(102 cards)
1
Q
What is the specific metabolic requirement of CNS
A
High oxygen demand
2
Q
What area of the brain is most affected by alzheimers disease?
A
Hippocampus & Cortex
3
Q
What is affected by Parkingsonism?
A
Substantia nigra
Dopamine- producing
4
Q
What is affected by B12 deficiency?
A
Dorsal colums & Corticospinal tracts
5
Q
What reaction of neurons to injury involves RED NEURONS?
A
Acute neuronal injury
- lack nissl
- after 12-24hours of irreversible injury
6
Q
What reaction of neurons to injury involves central chromatolysis?
A
Axonal reaction
- reactions in the cell body that accompany axonal regeneration
- reactions indicate that neuron is “in crisis”
7
Q
What type of degeneration refers to changes that occur in distal axon?
A
Wallerian degeneration
8
Q
What infected cells are associated with virus?
A
Polio, viral encephalitis, rabies (Negri bodies)
9
Q
What is the “wear and tear” pigment?
A
lipofuscins
-accumulations of these within neurons under conditions that include old age & chronic hypoxia
10
Q
What is associated with Lewy bodies?
A
Parkingson’s Disease
11
Q
What is associated with neurofibrillary tangles/ lipofuscins?
A
Alzheimer’s disease
12
Q
What is associated with Tay Sachs? and Also Niemann Picks disease?
A
Cherry red spot
-metabolic storage disease
Gangliosides= Tay Sachs
Sphingomyelins= Niemann Picks
13
Q
Whats the function of astrocytes?
A
repair and produces glial scars
14
Q
Whats the function of microglia?
A
Mesoderm cells that fuction as phagocytes of CNS ( increase in response to injury & infection of components of CNS)
15
Q
What is the function of oligodendrocytes?
A
Production of Myelin, unlike Schwann cell, they may wrap around several axons
16
Q
What are diseases of oligodendrocytes that affect myelin in CNS?
A
Multiple sclerosis
- demyelinating disease
- common degenerative disease
17
Q
What is the most common cause of brain edema?
A
vasacular (vasogenic) edema & swelling
-causes increased vascular permeability
18
Q
What are contributing causes of edema and swelling?
A
infections, ischemia, trauma, metabolic disturbances
19
Q
What happens to the CSF and ventricles in hydrocephalus?
A
Volume of CSF increases and ventricles are dilated
20
Q
What is hydrocephaly ex vacuo?
A
Ventricles are expanded secondary to atrophy of brain; in these cases, CSF pressure is not increased.
-Brain atrophy (alcohol abuse, alzheimer’s)
21
Q
What is obstructive hydrocephaly (non communicating)?
A
CSF does not reach subarachnoid space since its circulation is blocked internally
- no increase in CSF pressure
- INTERNAL
22
Q
What is communicating hydrocephaly?
A
CSF enters subarachnoid space but circulation or its absorption is blocked
- External
- cerebral (dural) venous sinuses & associated veins
23
Q
What are early features of increased intracranial pressure?
A
- headache, mental dullness, nausea, vomiting
- manifestation of hydrocephaly
24
Q
what is the swelling at optic disc due to compression & obstruction of central retinal vein?
A
Papilledema “choked disk”
25
What is associated with distortion of cranial vault & vertebral column?
trauma
| -injure underlying neurological structures
26
What is interstitial bleeding due to blunt trauma (bruise)?
contusion
- no damage to cranium (closed head injury)
- coup/countercoup
27
What is associated with tearing (damage) of brain surface with bleeding into surrounding region (CSF)
laceration
- no damage to cranium (closed head injury)
- edema & swelling of affected components
28
What is a clinical syndrome associated with closed head injury, usually in the absense of bleeding?
Concussion
| -brain truma with no damage to cranium ("closed head" injury)
29
What are the general features of meningitis?
infection of menenges & CSF
| -systemic signs: stiff neck, headaches, photophobia, rash & fever
30
What type of meningitis is characterized by prurulent exudates in menenges?
```
Acute pyogenic (bacterial) meningitis
-more severe then viral menengitis
```
31
What is the most common meningitis in adolecents and young adults?
```
Nesseria meningitidis (meningococcus)
-especiallly during epidemics
```
32
What type of meningitis is characterized by elevated lymphocytes, moderately elevated protein, normal glucose?
```
Acute lymphocytic (viral) meningitis
-more common than bacterial meningitis
```
33
What type of meningitis is characterized by insidious origin, progressive headaches, malase, vomiting?
chronic meningitis
- causes TB, fungi, brucellosis
- CSF: increased "mononuclear cells" (elevated protein)
34
What is the most common type of encephalitis?
viral
| - mononuclear cell infiltrate, intracellular inclusion bodies, latency, tropism
35
What determines which neurons of parts of the brain are affect?
Tropism
36
What are common examples of enchephalitis?
Arbor viruses, childhood infections, herpes simplex types 1 and 2, poliomyelitis, rabies, HIV
37
What is the most common epidemic form of viral encephalitis?
```
Arbor viruses (arthopod borne)
-"equine" types (reservoir is birds, not horses)
```
38
What are unconventional agent encephalopathies that primarily affect nervous system of humans & animals
Prion diseases
| - Hallmarks: microscopic vaculolization of brain tissue & accumulation of abnormal forms of prion proteins
39
What is subacute spongiform encephalopathy that involves areas of gray matter that undergoes extensive atrophy?
Creutzfeldt Jacob disease
40
What is bovine spongiform encephalopathy (BSE) that are associated with prions?
Mad cow disease
| - human exposure appears to contruibute to varient CJD
41
What causes abscesses?
Hematogenous, dissemination & local extention
| -bacterial infection (focal)
42
What is the most common cause of granulomas?
TB
43
What is the collapse of vertebral bodies leading to gibbus deformity?
Potts disease
44
What is the most common casue of stroke
Focal ischemic influx
| -focal loss of neurological function of vascular origin
45
What is ischemic influx caused by?
Atherosclerotic disease
| -commonly caused by thrombi & thrombi
46
What is commonly associated with atherosclerotic lesions?
thrombi
47
What is commonly associated with fragments of atherosclerotic plaques?
emboli
48
Where are ischemic encephalopathy infarcts found?
can involve entire brain "vegetable state" or may be limited to more succeptible parts or in the "watershed" regions of brain and spinal cord
49
What is bleeding within the brain?
Intracerebral spontaneous hemorrhage
| -most causes are due to rupture of small intraparenchymal arteries
50
Where are common locations of intracerebral spontaneous hemmorhage?
basal ganglia, internal capsule & brain stem
51
What is arterolar sclerosis with occusion of small "penetrating" arteries & arteriols give rise lacunar infarcts?
hypertension
- lacunar infarcts: small lesions
- rupture of small penetrating arteries may give rise to " slit hemorrhages"
52
Rupture of congenital berry annurysms is most common form of what type of hemmorhage? the onset is sudden with signs of meningeal irritation
subarachnoid hemorrhage
53
Where are berry aneurisms located?
Circle of Willis
54
What type of hematoma is from rupture of lacerations of the middle meningeal artery?
epidural hematoma
- blood accumulates between dura and skull
- lucid interval at first few hours
55
What type of hematoma is from rupture of small communicating veins that coure between cortex & dural venoous sinuses, blood accumulates in "potental space" between dura & arachnoid?
Subdural hematoma
| -trauma is common cause
56
What are the clinical presentations of parkingsonism?
Stooped posture, festinating gait, cogwheel rigidity of limbs, sluggish voluntary movement, "pill- rolling" tremor at rest, rigid & expressionless facial expression (mask-like facies)
57
What is associated with Parkinsonism?
Lewy bodies
| -consisting of filamentous deposits
58
What has progressive symptoms of parkinsonism in absence of exposure to toxic agents or other etiologies?
idiopathic parkingsons disease (paralysis agitans)
| -"senile" & "presenile" patterns
59
What is the common age of the spontaneous onset of idiopathis parkinsons disease?
late middle age 50-60 years and progresses slowly
60
What type of parkinsonism is more common in younger subjects?
secondary to encephalitis
61
What is associated with degeneration of cortical neurons in addition to substantia nigra with demantia and parkingsonism?
diffuse lewy body disease
62
What effects associated with dementia?
memory loss, poor judgement, delusions of grandeur, disorientation
63
What is the usual diagnosis that is related to idiopathic dementia?
progressive memory losses with decreasing ability to participate in activities of daily living
64
What is a common cause of death in Alzheimer's?
motor dysfunction with aspiration pneumonia
| -headaches are not usually observed
65
What is a common ventricular dialation in dementia?
ex vacuo ventricular dialation
66
What is a characteristic microscopic feature of Alzheimer's?
Increased number of neuritic plaques ("senile plaques")
67
What are histologic features of Alzheimers Disease?
neurofibrilary tangles (tau protein), amyloid angiopathy, & granulovacuolar degeneration
68
What are unknown pathogenesis of alzheimer's?
Aluminum toxicity, slow viruses, prions, familial factors, familial patterns (chromosome 21), individuals with downsyndrome
69
What results from upper motor neuron degenerative disease?
Spastic paralysis
70
What results from lower motor neuron degenerative disease?
Flaccid paralysis
71
What results from combined motor neuron degenerative disease ?
Both UMN and LMN
72
What is the most common motor neuron disorder?
Amyotropic lateral sclerosis
73
Where is the loss of motor neurons most striking with amyotropic lateral sclerosis (" Lou Gehrig's disease")>
Anterior horn cells, cranial motor nuclei and UMN (Betz cells)
74
What is the most common cause of myelin loss (selective demyelination) in CNS?
Multiple (disseminated) sclerosis
75
What do 65% of patients exhibit with multiple sclerosis?
HLA antigens of D class
76
What is associated with autoimmunity to components of the myelin sheath contributes to damage?
Patchy demyelination & glial scarring within CNS
77
What are the common locations of multiple sclerosis?
Optic nerve & chiasm periventricular white matter, brain stem, cerebellar peduncles, dorsal columns of spinal cord
78
What exacerbations multiple (disseminated) sclerosis?
Stress, other illnesses, increased body temperatures, dietary management, stress management/avoidence, exercise, medical therapies include efforts to "desensitize" and control anti myelin reactions
79
what are the most common primary tumours of CNS?
Derivatives of glial elements
80
What are clinical effects of neurosyphilis paresis?
Argyll Robertson pupil
| -progressive neronal loss with cerebral atrophy
81
What is the difference between how "extra-axial" tumors and "intra-axial" tumors arise?
"extra-axial": Outside CNS
| "intra-axial": within CNS
82
Which gliomas make up 80% of intra axial tumors?
Astrocytoma gliomas
83
What are symptoms of neurosyphilis tabes dorsalis?
Variable: lightning pains, painful paresthesias, ataxia, loss of deep tendon reflexes (these contribute to joint damage --> charcot joint: neuropathic atrophy
84
What is associated with neurosyphilis meningeo-vascular lesions (scars)?
chronic meningitis: with thickening (scarring) obliterative arthritis: gummas (syphilitic nodules) may extend into cortex, brain stem or cord
85
Where do intra-axial tumors arise in adults? in children?
Adults: supratentoral location
Children: infratentoral location
86
What age are medulloblastoma most commmon
2-4 years of age young children
87
What tumor is associated with pheochromocytoma?
Neuroblastic tumours
88
What vitamine deficiency causes myelin degeneration & loss of axons, usually in legs initially?
B12 deficiency
89
What is the "glove & stocking" distribution of systemic diabetes disease?
distribution of neurologica manifestations where sensory fibres (greatest length) are affected most greatly
90
What age are retinoblastoma most common
2-4 years of age
| -neurocyte & neuroblastomas
91
What is the difference between axonal degeneration and segmental demylination?
Axonal degeneration= dying back of affected nerve fibers reflectes inability of neuron to maintain its axons
Segmental demylination= underlying axon initially preserved; related to metabolic, inflammatory or toxic injury to neurilemma
92
What causes polyneuropathy?
Systemic in nature (diabetes & vitamin deficiencies)
93
What causes mononeuropathy?
localized mechanical factors & other forms of isolated pathology
94
How are the & sensory nerves affected in peripheral disorders
Selectively or concurrently
| -peripheral somatic nerve
95
What are the causes of mononeuropathy?
Spinal compression at IVF, radial nerve injury, peroneal nerve injury, ulnar nerve entrapment, carpal tunnel syndrome
96
What is the inflammatory mechanism that leads to nerve compression & weakness of facial nerve?
Bells palsy
97
Most common acute paralytic disease of young adults in US?
Guillain- Barre syndrome
98
What inflammation leads to vesicular lesions in skin & mucus membranes at site of initial exposure & infects neurons that innervate these locations?
Herpes simplex
99
Difference between menengitis and encephalitis?
encephalitis effects brain tissue directly
meningitis effects the meningies
100
What is an inflammation characterized by episodic flare-ups with painful segmental cutaneous vesicular eruptions?
shingles (herpes zoster)
101
What is associated with spontaneous episodes of lightning pain affecting one or more devisions of V?
Idiopathic: tic douloureux
102
Whats the most common neurological disorder in adults?
Multiple sclerosis
