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53 Cards in this Set
- Front
- Back
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List the anatomic & physiologic features that are uniques to the CNS?
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1. Rigid skull & spinal column = volume of which is fixed after early childhood
2. Autoregulation of Blood flow = cerebral blood flow is regulated to a large extent independently from systemic blood circulation 3. No lymphatic system 4. CSF system 5. Limited immune surveillance = immunologically secluded from the rest of the body 6. Unique response to injury 7. Vulnerability of lack of perfusion 8. Lack of regeneration |
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Define Vasogenic Edema
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accumulation of fluid between the neurons & glia & most prominently in the Virchow-Robin spaces around the blood vessels
Develops as a consequence of BBB dysfunction = fluid escapes from the vascular space into the interstitial space of the parenchyma across the cytoplasm of Endothelial cells |
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Define Cytotoxic Edema
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Fluid accumulates inside cells
Most frequently caused by ischemia &/or hypoxia = lead to hydropic swelling of neurons & glial cells |
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Define Interstitial Edema
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Result of increased bulk of CSF thru the Ependymal lining = dysfunction of the brain-CSF barrier
Typically a complication of Hydrocephalus |
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What intracranial pressure is associated with edema?
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> 200 mm water
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What pathologies are seen in Cerebral Edema?
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1. Soft brain
2. Flat gyri 3. Narrow slit-like sulci 4. compressed Ventricles 5. possible Herniation |
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What is a Subfalcine Herniation? What is an alternate name? What artery may be compressed?
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Results from a unilateral hemispheric mass lesion that expands the volume of one hemisphere, dislocates the midline structures & forces the ipsilateral Cingulate gyrus to be compressed underneat the FALX CEREBRI
Alternate = Cingulate Herniation Anterior Cerebral Artery |
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What is a Transtentorial Herniation? What is an alternate name? What can be compressed & how is it manifested?
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Caused by expansion of one or both Supratentorial tissue compartments. Uncus gyri hippocampi is displaced & herniated underneath the free edge of the Tentorium
Alternate = Uncinate Hernia 3rd Cranial nerve = dilation of the Ipsilateral Pupil + abnormal eye movement on the same side |
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What is a Tonsilar Herniation? What may it cause?
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Life-threatening condition b/c the herniated cerebellar tonsils that are forced into the Foramen Magnum compress vital Respiratory & Cardiac centers within the Medulla Oblongata
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Duret Hemorrhage
-common with a Trantentorial Herniation -midbrain with blood |
What is seen here?
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Midbrain herniation + Oculomotor nerve palsy (eye down & out) + Mydriasis...what herniation?
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Transtentorial Herniation
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Increase in the CSF volume that causes enlargement of the Ventricles
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Hydrocephalus
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What makes the CSF?
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Choroid Plexus
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How is Hydrocephalus manifested in Newborns before the closure of Sutures?
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Ventricles dilate & enlarge the head circumference
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What is "Hydrocephalus Ex Vacuo?
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Dilated appearance of the ventricles when the brain mass is decreased
Ex. Alzheimer's disease |
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Hydrocephalus
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What are these pictures showing?
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Describe the flow of CSF
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1. Choroid Plexus
2. Lateral Ventricles 3. Interventricular Foramen (Foramen of Monroe) 4. Third Ventricle 5. Cerebral Aqueduct (Aqueduct of Sylvius) 6. Fourth Ventricle 7. Foramen of Magendie & Luschka 8. Subarachnoid Space over brain & Spinal Cord 9. Reabsorption into Venous Sinus blood via Arachnoid Granulations |
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What things cause Focal Lesions?
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Tumor
Infarct Abscess |
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What things typically cause Multifocal lesions? (3)
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1. Metastases
2. Small infarcts 3. Abscesses |
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System Degeneration
-typically slowly progressive -Ex: Motor Neuron Disease (ALS) |
What generally is this showing?
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Diffuse Disorder
-Neuronal = Lysosomal storage disease -White Matter = Leukodystrophy |
What generally is this showing? What could be possible causes?
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List the types of Glia found in the CNS
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1. Astrocytes
2. Oligodendrocytes 3. Ependymal cells 4. Microglia |
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Material consisting of granular Endoplasmic Reticulum & Ribosomes & occuring in nerve cell bodies & dendrites
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Nissl Substance
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any of the long, thin, microscopic fibrils that run through the body of a neuron and extend into the axon and dendrites
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Neurofibrils
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cytoplasmic Nissl Substance within neuron
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What does this picture exemplify?
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Cerebellar cortex showing large Purkinje cells and smaller dark granule cell neurons (at lower right).
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What cells are seen in this picture?
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What are 2 unique principles of Neurons?
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1. Selective vulnerability = very sensitive to Ischemia
2. Post-mitotic cells = no regeneration |
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What pathology is seen during Acute Injury of neurons? What most commonly causes it?
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Pynknotic nuclei & an acidophilic cytoplasm = Red neuron
Ischemia, Anoxia, Hypoglycemia |
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What things occur in the process of "Axonal Reaction"?
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1. Perikaryon swells
2. Chromatolysis = degranulation of Nissl Substance (RER) -> loss of basophilia |
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What is Wallerian Degeneration?
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degeneration of nerve fibers Distal to the injury
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What is Transsynaptic Degeneration?
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Atrophy of nerve cells due to loss of input
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Neuromelanin
Lipofuscin = 'wear & tear' pigment |
What is the white arrow pointing at? What is seen within the cytoplasm of some cells?
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Neurofibrillary Tangle in Hippocampal CA1 neuron
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What is seen here?
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Lewy bodies = Parkinson Disease
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What are the arrows pointing at?
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Which Glia are derived from the Neuroectoderm?
Which Glia is derived from the Mesoderm? |
Astrocytes
Oligodendrocytes Ependymal cells Microglia |
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Glial that are in close contact with neurons & have small oval nuclei with star-like processes
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Astrocytes
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Glia that have cytoplasmic extensions that attach to blood vessels, forming part of the BBB
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Astrocytes
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Glia that contain "Glial Fibrillary Acidic Protein" (GFAP)
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Astrocytes
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What is another term for Gliosis?
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Astrocytosis
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Reactive Gliosis (Astrocytosis)
-pink-staining cells |
What is seen here?
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Reactive Astrocytosis
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What is seen here?
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Gemistocytes
-a form of Astrocytosis |
What is seen here?
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Metabolic Astrocyte
-clear nuclei in Cerebral Cortex -stimulated to proliferate when there is some sort of metabolic disease occurring |
What is the arrow pointing at?
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Rosenthal Fiber
-usually seen in chronic disease -often seen around old sites of injury |
What is the arrow pointing at?
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Corpora Amylacea = inclusions within Astrocytes
-seen in aging -gliosis |
What are seen here?
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What are the properties of Oligodendrocytes?
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1. few processes
2. small dark round nuclei 3. make, maintain myelin -1 Oligo: wraps up to 50 axons 4. Injury: myelin loss or abnormal myelin 5. Tumors: Oligodendrogliomas |
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Oligodendrocyte in normal White Matter
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What is the arrow pointing at?
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Columnar ciliated cells lining the Ventricular System
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Ependymal cells
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Normal Ependymal cells with cilia
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What is seen here?
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Patchy Ependymal loss - when they are injured, they don't come back
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What important property of Ependymal cells is exemplified here?
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Choroid Plexus
Secrete CSF |
What cells are seen here? What is their functinon?
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Phagocytic cells of mesenchymal origin of the CNS
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Microglia
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Microglial Nodule
-elongated rods, club-shaped |
What is seen here?
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