Block 4 PATH Exam -- Intro to Neuropathology Flash Cards

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Title: Block 4 PATH Exam -- Intro to Neuropathology
Description: Flashcards about normal histology and common pathological conditions of the CNS from PATH block IV
Number of Cards: 50
Save Count: 1
Author: AmitP23
Created: 2006-04-05
Tags: amitp23 neuropathology
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    • Question
    • Answer
    • Side 3
    • What is neuropil?
    • Brain tissue that lies between cell bodies
      Network of UNmyelinated neuronal processes
    • What are ependymal cells?
    • Cells where CSF is made and stored
    • Which cells are the macrophages of the CNS?
    • Microglia
    • What are the 3 layers of the cerebellum?
    • Molecular
      Purkinje
      Granular
    • Cell bodies in this region have melanin within them
    • Substantia nigra

      (melanin is a byproduct of DA metabolism)
    • LFB is used to stain what?
    • Myelin
      (LFB = Luxol Fast Blue)
    • What do silver stains highlight?
    • Axons, neurites
    • What is synaptophysin?
    • Pre-synaptic protein in neurosecretory vesicles

      Staining for this produces a brown stain
    • Microvacuolation happens in response to hypoxic/ischemic damage

      What is actually taking place, presenting as microvacuolation?
    • Swelling of mitochondria and SER/RER
    • Sequence of microscopic changes in hypoxic/ischemic lesions
    • 1 hour -- Microvacuolation
      4-12 hours -- RED NEURON (eosinophilia, pyknosis)
      15-24 hours -- PMN infiltration begins
      2 days -- Macrophage infiltration begins
      5 days -- PMN infiltration ceases

      ~ 1 week -- Proliferation of astrocytes
    • What are nissl bodies?
    • Granular ER & ribosomes in nerves
    • What 2 brain regions are particularly susceptible to hypoxic injury?
    • Sommer's sector (CA1) of hippocampus
      Purkinje cells of the cerebellum
    • What is a watershed area?
    • Where vascular beds from 2 arteries meet & form anastamoses
      (essentially, "border zones" between regions supplied by diff. arteries)
    • What are watershed areas particularly susceptible to?

      In what circumstances in particular?
    • Susceptible to infarcts

      Particularly susceptible during systemic HYPOtension
    • What brain regions are INFANTS more prone to hypoxic injury in?
    • Hippocampus
      Colliculi
    • What brain regions are ADULTS more prone to hypoxic injury in?
    • Outlying cortical regions
      Hippocampus
      Purkinje cell layer of cerebellum
    • What part of cells are Marinesco bodies found in?
    • Nucleus
    • What part of cells are Lewy bodies and Pick's bodies found in?
    • Cytoplasm
    • These structures are characteristic of Alzheimer's (2)
    • Neurofibrillay tangles
      Neuritic plaques
    • Where are axonal balls found (in contrast to Lewy bodies, etc.)?

      What are they a hallmark of?
    • Found in AXONS
      (as opposed to cell bodies)

      Hallmark of shearing injury
    • What are neuritic plaques composed of?
    • APP or Beta 4-amyloid
    • These are the myelinating cells of the CNS?

      Of the PNS?
    • Oligodendrocytes

      Schwann cells
    • What is gliosis?
    • Astrocyte production of glial scars after injury
    • What is GFAP?

      What is it used as a marker for?
    • Acid Glial Filament Protein

      Used as a marker for astrocytes
    • This type of astrocyte is responsible for acute response
    • Gemistocytic

      (Remember, "fried eggs in chicken wire")
    • This type of astrocyte is responsible for chronic response
    • Fibrillary
    • Leukodystrophy
      Leukoencephalopathy

      These are diseases of what?
    • White matter
    • An alpha-synuclein positive inclusion in an astrocyte is a sign of what?
    • Multi-system atrophy (MSA)
    • Mini-gemistocytic oligodendrocytes are a sign of what?
    • Neoplastic conditions
    • What is ependymal rosetting a sign of?
    • Injury
      (can be seen in aqueduct stenosis)
    • MACROglia are derived from what?
    • ECTOderm
    • MICROglia are derived from what?
    • MESOderm
      (despite name, these cells are NON-glial)
    • How long post hypoxic injury do microglia infiltrate?
    • ~ 2 days
    • From inner --> outermost, layers of meninges
    • Pia --> Arachnoid --> Dura
      ("The meninges PAD the brain")
    • What is the Virchow-robin space?
    • Tunnel-like extension of the subarachnoid space
      Surrounds vessels that pass into the brain or spinal cord
      (vessels enter from the subarachnoid space)

      Inner wall is pia mater
      Outer wall is brain tissue
    • What layer do large vessels that travel over the brain run through?
    • Subarachnoid space
    • What are the two major elements of the BBB?
    • Endothelial cells
      Astrocytes (foot processes around vessels)
    • What are the two types of cerebral edema?
    • Vasogenic
      Cytotoxic
    • What is vasogenic edema due to?

      What cells are involved?
    • Disruption of tight junctions between endothelial cells

      Expansion of EXTRAcellular compartment

      Brain capillaries are involved
    • What is cytotoxic edema due to?

      What cells are involved?
    • Cellular swelling

      Expansion of INTRAcellular compartment

      Astrocytes are involved
    • Flow of CSF
    • CP --> Interventricular foramen (Monro)
      Monro --> cerebral aqueduct
      Aqueduct --> lateral/median apertures (Luschka/Magendie)
      Apertures --> basal cisterns
      Cisterns --> Arachnoid villi --> Venous sinus
      Sinus --> Blood circulation
    • In COMMUNICATING hydrocephalus, what is there a problem in?
    • Production/Absorption of CSF
    • In NON-communicating hydrocephalus, what is the problem?
    • There is an obstruction to the flow of CSF
    • What is the foramen of Monro?
    • The connection between a lateral ventricle and the 3rd ventricle
    • What happens in a subfalcine herniation?
    • Cingulate gyrus shifts under the falx cerebri
    • What happens in a transtentorial herniation?
    • Medial structures are displaced downward through the tentorial hiatus
      (often involves medial temporal lobe)

      AKA uncal herniation
    • What happens in a tonsilar herniation?
    • Cerebellar tonsils get pushed down into the foramen magnum
    • What CN is most affected by an uncal herniation?
    • Ipsilateral CN III

      Results in mydriasis, ptosis, and lack of pupillary light reaction
    • What type of hydrocephalus is caused by outflow restriction @ arachnoid villi?
    • Communicating
      (counter-intuitive, but this is a communicating)

      Communicating refers to flow of CSF between ventricles
    • What is a duret hemorrhage?

      What is the result of one?
    • Tearing and bleeding of the basilar artery
      (due to downward herniation)

      These are usually fatal