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31 Cards in this Set
- Front
- Back
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Astrocytes
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main cells responsible for repair and scar formation in the brain
→Gliosis (fibrosis of the brain) |
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Oligiodendrocytes
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forms myelin in the CNS
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Acute neuronal injury
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red neurons
→hypoxia/ischemia →cell death |
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Chronic neuronal injury
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progressive neurologic disease
astrocytes hypertrophy and become hyperplastic → gliosis |
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Rosenthal fibers
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Astrocytes → eosinophilic structures in long standing gliosis
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Corpora amylacea
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degenerative change in astrocytes with increasing age
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Cerebral vascular disease
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abnormality of the brain resulting from pathological blood vessels:
thrombosis, embolism, hemorrhage usually due to atherosclerosis, embolism, hypertension, ruptured aneurysm |
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Hypoxia
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decreased oxygen supply
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Ischemia
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decreased blood supply
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Encephalopathy
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disease of the brain involving structure alteration
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Global cerebral ischemia
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diffuse hypoxia/ischemia, encephalopathy
low flow state, hypotention, hypoperfusion resulting in edematous brain with white gyri and narrow sulci poor demarcation between grey and white matter |
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Global cerebral ischemia
12-24 hours |
acute neuronal change (red neurons), neutrophils, microvacuolization, nuclear pyknosis (shrinking) and karyorrhexis (fragmentation)
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Global cerebral ischemia
24 hours - 2 weeks |
tissue necrosis, reactive gliosis, macrophages, vascular proliferation
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Global cerebral ischemia
2 weeks and on |
repair, necrotic tissue removal, gliosis
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Ischemic pathogensis
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Ischemia → overstimulation of glutamate receptors → uncontrolled Ca++ influx → apoptosis
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Cerebral infarction
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oculsion of arterial supply to the brain
→ localized ischemia |
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Transient Ischemic Attack
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cerebral infarction
→ reversal of neurological functions by removal of oclusion loss of function depends on influenced arteries may last from seconds to hours and may have many attacks neuro exam between attacks are normal |
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Artherosclerosis
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arterial degeneration
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Cerebral thrombosis
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stationary occlusion of blood vessels secondary to atherosclerosis
most commonly: origin of middle cerebral a. and end of basilar a. (carotid bifurcations) frequently associated with hypertension and diabetes |
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Thrombotic infarction
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pale infarcts (non-hemorrhagic)
softening and swelling of brain → liquefied tissue leaving fluid filled cavities may be preceded many brief transient ischemic attacks most commonly during sleep Tx: anti-coagulants |
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Embolic infarction
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Red infacts (hemorrhagic)
most commonly from thrombus within heart due to fat, tumor cells, fibrocartilage, amniotic fluid most frequently in the middle cerebral a. →strokes |
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Hemorrhagic infarcts
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Red infarcts
usually embolic hemorrhages because of reperfusion to damaged vessels directly after removal of occlusion |
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Lacunar infarct
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secondary to hypertention
small branches of cerebral arteries occluded may be asymptomatic leaves small cavity (lacune) after softened tissue is removed |
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Intracranial hemorrhages
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due to chronic hypertension
cerebral arteries degenerated hemorrhage may damage brain tissue and compress vascular structures → edema, ischemia |
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Intracerebral hemorrhage
(intraparenchymal) |
hypertension→atherosclerosis→necrosis of arteries
middle age to elderly rupture of small intraparenchymal vessel putamen, thalamus, pons |
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Charcot Bouchard aneurysm
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intracerebral hemorrhage
chronic hypertension micro-aneurysm → vascular rupture espically in basal ganglia |
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Lobar Hmorrhage
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Hypertensive hemorrhage in subcortical white matter
symptoms varies with location |
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Pontine Hemorrhage
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Coma → death within 48 hours
pinpoint pipils impaired horizontal eye movemnt |
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Cerebellar hemorrhage
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headache, dizziness, vomitting, disequillibrium
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Subarachnoid hemorrhage
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congential, atherosclerotic, hypertensive, embolic, infections, traumatic
most frequently saccular (berry) aneurysm of anterior part of circle of willis blood in subarachnoid space causes high pressure → severe sudden headache usually when patient is active during sex or straining stool |
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Arteriovenous malformation
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common cause of subarachnoid hemorrhage
arteries connect with veins without capillary bed males age 10-30 seizures, strokes, ischemia evidence of prior hemorrhage: greatly enlarged blood vessels separated by gliotic tissue |
