Term
| What are the 3 unqiue perfusion characteristics of the CNS |
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Definition
1. CSF 2. No lymphatics 3. Blood brain barrier |
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Term
| Are neurons capable of regeneration? |
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Definition
| Yes, but for the most part they are not |
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Term
| What kind of matter are neurons? |
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Definition
|
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Term
| What are neuron cell bodies called in the CNS? How about the PNS? |
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Definition
|
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Term
| What is an Axonal reactoin? |
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Definition
| The response of a neuronal cell body after the axon has been cut, it's regeneitve w/ increased protein synthesis |
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Term
| What are the characteristics of Axonal reaction? |
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Definition
1. Enlargement of the cell body 2. Periperhal displacement of the nucleus 3. Peripheral displacement of Nissl substance 4. Pink cytoplasm (eosinophilia) |
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Term
| If you see an cell body w/ Central chromatolysis What has happened? |
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Definition
| The axon was cut and seperated from the cell body |
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Term
| Axonal reaction would eventually lead to _____ |
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Definition
|
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Term
| How would an axon look like in Axonal degeneration |
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Definition
1. Swollen organelles 2. Breakdown of the axon 3. Breakdown of myelin membranes |
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Term
| Wallerian degeneration is _________ but in the PNS |
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Definition
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Term
| Acute neuronal injury refers to what? |
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Definition
| Changes seen 6-12 hrs after injury |
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Term
| If you see shrinkage of the cell body, eosinophila of the cytoplasm & condensation of the nucleus, what's going on? |
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Definition
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Term
| Acute neuronal injury is also call ____ |
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Definition
|
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Term
| If you see Acute Neuronal injury you're likely to see? |
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Definition
| Accompanied by swelling of neuronal process |
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Term
| Where are you more likely to see neuronal degeneration |
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Definition
| Slowly progressing neurologic diseases |
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Term
| What has atrophied in Alzheimers? in parkinsons? And in huntingtons |
|
Definition
1. Cerebral 2. Substantia nigra 3. Caudate nucleus |
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Term
| Glia cells are devired from _____ & Schwann cells from ____ |
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Definition
1. Neural tube 2. Neural crest |
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Term
| Glia includes ____, _____ & _____ |
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Definition
1. Astrocytes 2. Oligodendrocytes 3. Ependymal glia |
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Term
| What kind of appearance to do oligodendrites have? |
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Definition
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Term
| Astrocytes are found in what kind of matter |
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Definition
|
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Term
| What's the function of the astrocytes |
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Definition
| Help form the blood brain barrier via it's foot processes |
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Term
| What is the main cell responding to irreversible brain injury |
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Definition
|
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Term
Name the responses of astrocytes to brain injury Hint 7 |
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Definition
1. Swelling 2. Proliferation (form glial scar) 3. Synthesis of GFAP (related to actin) 4. Formation of intracytoplasmic Rosenthal fibers 5. Formation of extracytoplasmic corpora amylacea 6. Formation of intracytoplasmic argyrophilic fibrils 7. Formation of Alzheimer type II |
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Term
| The term gliosis & astrocytosis refer to |
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Definition
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Term
| What causes accumulation of pink cytoplasm in brain injury |
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Definition
|
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Term
| Alexander disease is due to a |
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Definition
|
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Term
| Oligodendrites are found in the CNS ____ matter where they are made and their function is to maintain the _______ ______ |
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Definition
|
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Term
| What is the function of Ependymal cells |
|
Definition
| They're tight functions that prevent CSF from crossing into adjacent brain tissue |
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Term
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Definition
|
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Term
| What does the Choroid plexus produce? How does it do it? |
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Definition
1. CSF 2. Filters the blood & alters the protein, gluose composition of the filtrate |
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Term
| What is the origin of the Choriod plexus |
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Definition
| Ectodermal epithelium that invades the ventriicles of the neural tube and form the papillary tissue in the lateral, third & fourth ventricle |
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Term
| What forms the dura mater, leptomengines & virchow-robin space |
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Definition
|
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Term
| Name the 3 types of Brain edema |
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Definition
1. Vasogenic 2. cytotoxic (cellular) 3. Interstitial |
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Term
| What's the most common cause of brain edema |
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Definition
|
|
Term
| The BBB is made up of what? |
|
Definition
| Endothelium + Basement membrane + astrocytic foot processes |
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Term
| This is caused by the breakdown the BBB |
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Definition
|
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Term
| Vasogenic edema may be ____ or ____ |
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Definition
|
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Term
| What kind of edema involves swelling of the neurons, glia & endothelial cells due to an influx of extracellular water |
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Definition
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Term
| Cytotoxic edema occurs in _____ |
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Definition
|
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Term
| Give the mechanism of cytotoxic edema |
|
Definition
| Low ATP leads to lack of ATPase pump activity and sodium acculmuates inside the cell followed by water |
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|
Term
| How do you correct cytotoxic edema |
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Definition
|
|
Term
| Why don't you want to give lots of water to a dehydrated person with high sodium? |
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Definition
| It can lead to cytotoxic edema |
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|
Term
| Cytotoxic edema can coexist w/ ______ _____ |
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Definition
|
|
Term
| Define Interstital edema? |
|
Definition
| CSF escaping the ventricle through the ependymal lining increasing intracranial pressure |
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Term
|
Definition
| The brain moves due to volume increase |
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Term
| Name the two ways you can get Herniation from |
|
Definition
1. edema 2. Any tissue added to the cranial space |
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Term
| What are the 4 characteristic sides of herination |
|
Definition
1. Subfalcine 2. Transtentorial 3. Tonsillar 4. Transcalvarial herniation |
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|
Term
| If the cingulate gyrus is pushed underneath the falx you get |
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Definition
|
|
Term
| Which arteries does an subfalcine herniation more likely to compress causing an infarct |
|
Definition
| Anterior cerebral arteries |
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|
Term
| Transtentorial herniation occurs when the temporal lobe is pushed through the _______ & compresses the ______ |
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Definition
|
|
Term
Name the complications of a Transtentorial herniation Hint 5 |
|
Definition
1. Crushing of the ipsi or contralateral cerebral peduncle against bone causing weakness of one side of the body 2. Alters consciousness 3. Crushes the posterior cerebral artery, may cause infarct in the midbrain 4. Crushes the CN III causing ipsilateral or contralateral blown pupil 5. Midbrain/pons compression w/ injury to the branches of the basilar artery causing midline hemorrhages |
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|
Term
| When pressure causes the medial portions of the cerebellar hemispheres to compress the medulla, what kind of herniation is this? |
|
Definition
|
|
Term
|
Definition
| Increased volume of CSF leads to enlargement of the ventricles |
|
|
Term
| How much CSF is in a normal adult? How often is it completely renewed? |
|
Definition
| 140-150 ml and renews every 6-8 hrs |
|
|
Term
| What are the 5 causes of Hydrocephalus |
|
Definition
1. Non-obstructive "communicating" 2. Obstructive "non-communicating" 3. Hydrocephalus 4. Normal pressure 5. Choroid plexus neoplasms secreting CSF (RARE) |
|
|
Term
| Meningitis can lead to diminished arachnoid granulation transfer to the venous circulation impairing CSF, this can lead to |
|
Definition
| Non-obstructive hydrocephalus |
|
|
Term
| If there is impaired CSF flow w/in the subarachnoid space this can lead to |
|
Definition
| Non-obstructive hydrocephalus |
|
|
Term
| When does Osbructive hydrocephalus occur? |
|
Definition
| Due to a mass occluding the flow of CSF w/in the ventricular system |
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|
Term
| Enlargement of the ventricles due to loss of the tissue around them is |
|
Definition
|
|
Term
| Give examples of Hydrocephalus |
|
Definition
|
|
Term
| Normal pressure hydrocephalus may occur because grandula leptomeningeal fibrosis is equilibrated by decreased _____ |
|
Definition
|
|
Term
| What is the 3rd leading cause of death in the U.S |
|
Definition
|
|
Term
| 6-12 hrs after irreversible injury what appears? |
|
Definition
|
|
Term
| 24-48 hrs after irreversible injury who does the area look like? |
|
Definition
|
|
Term
| 48-2 weeks after irreversible injury what is seen? |
|
Definition
| necrosis, macrophages & reactive gliosis |
|
|
Term
| Grossly who does an irreversible injury look like 24-2 weeks |
|
Definition
|
|
Term
| 2 weeks to years later how does an area look like if it had irreversible injury |
|
Definition
| shrunken, collapse area or a cyst lined by gliosis and white matter replaced by a yellow glial scar |
|
|
Term
| What kind of scar does not play a role in infarct but could be seen in trauma |
|
Definition
|
|
Term
| Anemic or bland infarcts are found where |
|
Definition
| carotid system or vertebral system |
|
|
Term
| what are the sources of emboli |
|
Definition
| Carotid, aortic atherosclerosis, cardiac mural thrombi |
|
|
Term
| Cardiorespiratory arrest or hypotension can cause what kind of infarcts |
|
Definition
|
|
Term
| How do global infarcts present? |
|
Definition
| Encephalopathy w/out any local neurologic signs, may be brain dead, no coronal activity w/ flat EEG, brainstem damage |
|
|
Term
| if the infarct is distributed throughout the entire hemisphere, what is the cause of it? |
|
Definition
| a thombus plugging the blocked carotid artery due to antherosclerosis |
|
|
Term
| A MCA distributed infarct is almost always due to |
|
Definition
| an emboli to the MCA branch point at the circle of willis from a cardiac mural thrombus or carotid bifurcation (rare) |
|
|
Term
| Non-traumatic brain hemorrhages can be divided into |
|
Definition
| intraparenchymal & subarachnoid types |
|
|
Term
| What's an intraparenchymal hemorrhage |
|
Definition
| Blood collects and compresses or destroys the brain and eventually leaves a cyst |
|
|
Term
| In the USA intraparenchymal hemorrhages are associated w/ |
|
Definition
|
|
Term
| What's an Charcot-Bouchard aneurysm |
|
Definition
| the arteriole dilates and thins and this may rupture and hemorrhage |
|
|
Term
|
Definition
| small infarcts in the tissue immediately surround the arteriole |
|
|
Term
| What's the most common cause of Non-traumatic subarachnoid hemorrhage |
|
Definition
|
|
Term
| The common sites of berry aneurysms is |
|
Definition
| branch points of the circle of willis |
|
|
Term
| An adult w/ polycystic disease is at increase risk for |
|
Definition
|
|
Term
| Berry aneurysm rupture are common in what decade and in what gender? |
|
Definition
|
|
Term
| If a patient complains of a worst headache ever he most likely has... |
|
Definition
|
|
Term
| What are complications of surviving a berry anuerysm |
|
Definition
| Rebleeding, vasospasm of nearby artereies & scarring of the leptomeninges leading to hydrocephalus |
|
|
Term
| What are the 4 categories of Traumatic injuries |
|
Definition
1. Skull fractures
2. Parenchymal injuries
3. Traumatic vascular injury
4. Spinal cord injuries |
|
|
Term
| A skull fracture injury may be |
|
Definition
| open, closed or penetrating |
|
|
Term
| name the 4 Parenchymal injuries |
|
Definition
1. Concussion
2. Contusions
3. Laceration
4. White matter injury |
|
|
Term
| If you have neurological syndromes, loss of consciousness, respiratory arrest and are flexia, what happened? |
|
Definition
|
|
Term
|
Definition
| Brusing of the gyri at the site of injury or opposite site |
|
|
Term
| Mechanical forces can contribute to what kind of parenchymal injury |
|
Definition
|
|
Term
| White matter injuries happen in 50% of coma patients due to |
|
Definition
| Axonal swelling & hemorrhages in the corpus callosum and brain stem |
|
|
Term
| Name the 3 types of Traumatic vascular injuries |
|
Definition
1. Epidural hematoma
2. Subdural hematoma
3. Traumatic intraparenchymal & subarachnoid hemorrhage |
|
|
Term
| Where does the blood accumulate in a epidural hematoma |
|
Definition
| Between the dura and calvarial surface |
|
|
Term
| Which hematoma would result from a tear of the middle meningeal artery |
|
Definition
|
|
Term
| Where is the blood coming from in a subdural hematoma? Where is it collecting? |
|
Definition
| A leaky briding vein and it collects between the dura and outer layer of the archnoid |
|
|
Term
| Most of the injuries associated w/ Spinal cord are due to |
|
Definition
| Displacement of the spinal column |
|
|
Term
A subarachnoid hemorrhage can be due to?
Hint 3 |
|
Definition
| Trauma, coagulopathy & berry aneurysm |
|
|
Term
| A subdural space can occur in ___ head injuries causes tears of ________ _____ |
|
Definition
|
|
Term
| What's the major cause of coma in accidents w/out contusional injuries |
|
Definition
|
|
Term
| If the temporal bone is associated w/ trauma, what happened |
|
Definition
| Tear of the dural artery w/ rapidly explanding epidural hematoma and increased ICP |
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