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Intro. to Pathophysiology
Cancer, Nervous System, Brain/Non-Brain Disorders
409
Physiology
Undergraduate 4
06/18/2010

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Term
Cancer is clinically defined as...
Definition
...a disorder of cell differentiation and growth.
Term
Cancer results in _____ (new growth) and leads to _____ (new growths).
Definition
Neoplasia; neoplasms
Term
Neoplasms. You typically think of _____.
Definition
Tumors
Term
A tumor has _____ (normal/abnormal) cells by both _____ and _____.
Definition
Abnormal; look; function
Term
T/F Cancers bypass checkpoints, meaning theres too little growth and too much regulation.
Definition
False; too much growth and not enough regulation
Term
Describe 2 characteristics of cancer growth.
Definition
1. Uncoordinated
2. Lacks normal regulatory controls over cell growth and division
Term
Cancer is associated with the altered expression of _____ _____, which do what?
Definition
Cellular genes; regulate proliferation and differentiation
Term
This indicates site of origin, has a specific marker that's unique to where it came from, and knowledge of it can help with treatment.
Definition
Primary tumor
Term
Define metastasis.
Definition
Can be carried by any body fluid including blood and lymph.
Term
Generally speaking, what kind of tissue does cancer arise from?
Definition
Actively dividing tissue
Term
What are 3 main tissues form which cancer arises?
Definition
1. Epithelial tissue
2. Mesynchymal tissue
3. Immune cells
Term
Cancers that arise in epithelial tissue are called _____.
Definition
Carcinomas
Term
Sarcomas arise in _____ tissue.
Definition
Mesenchymal
Term
All blood cells come from _____.
Definition
Mesenchyme
Term
List the 2 sub-categories of mesenchyme.
Definition
1. Lymphoid
2. Myeloid
Term
Which blood cell(s) originate from lymphoid mesenchyme?
Definition
Lympocytes
Term
Which blood cell(s) originate from myeloid mesenchyme?
Definition
All except lymphocytes
Term
Mesenchymal tissue includes
Definition
Term
Mesenchymal tissue does not include
Definition
Term
List the 3 categories of immune cell cancer.
Definition
1. Leukemia
2. Lymphoma
3. Myeloma
Term
Leukemia involves _____ _____ _____ and uaually targets _____.
Definition
Circulating blood cells; leukocytes
Term
Lymphoma involves _____ tumors.
Definition
Solid
Term
Myeloma involves _____ _____.
Definition
Bone marrow
Term
Which of the 3 immune cell cancers can be acute or chronic?
Definition
Leukemia and lymphoma
Term
T/F Regarding normal cell division, the body lacks mechanisms to ensure the correctness of the process.
Definition
False; has mechanisms
Term
What theory explains cancerous cell division. Elaborate.
Definition
Multi-hit theory; requires multiple gene mutations involved in the regulation of cell growth
Term
Define tumor.
Definition
Neoplasm (new growth)
Term
The appearance of a tumor (differs form/is the same as) that of the surrounding normal cells.
Definition
Differs from
Term
What body reaction typically occurs with neoplasia?
Definition
Swelling
Term
Tumors can be _____ or _____.
Definition
Benign; malignant
Term
Which type of tumor typically ends in -carcinoma or -sarcoma?
Definition
Malignant
Term
Which type of tumor is encapsulated and rarely metastasizes?
Definition
Benign
Term
Which type of tumor is localized?
Definition
Benign
Term
Which type of tumor is limited in size?
Definition
Benign
Term
Which type of tumor more closely resembles the tissue of origin?
Definition
Benign
Term
Which type of tumor retains "normal" cell function.
Definition
Benign
Term
Which type of tumor grows slowly?
Definition
Benign
Term
Which type of tumor has little vasculature?
Definition
Benign
Term
Which type of tumor rarely has necrotic areas?
Definition
Benign
Term
Which type of tumor rarely kills the host?
Definition
Benign
Term
Which type of tumor is not angeogenic?
Definition
Benign
Term
Define angeogenic.
Definition
The ability to make its own blood supply.
Term
Define necrotic area.
Definition
Areas of dead tissue due to fast growth and resulting lack of blood supply.
Term
What is a specific example of a malignant tumor?
Definition
Adenocarcinoma
Term
Which type of tumor typically ends in -oma?
Definition
Benign
Term
What is the name for a benign tumor of glandular origin
Definition
Adenoma
Term
Which type of tumor is not encapsulated?
Definition
Malignant
Term
Which kind of tumor can invade local tissue and metastasize?
Definition
Malignant
Term
Which kind of tumor has the potential to kill the host if left untreated?
Definition
Malignant
Term
Which kind of tumor grows rapidly?
Definition
Malignant
Term
Which kind of tumor has necrotic areas?
Definition
Malignant
Term
Which kind of tumor doesn't function like the normal surrounding tissue?
Definition
Malignant
Term
Which kind of tumor is angeogenic?
Definition
Malignant
Term
Generally speaking, where does cancer grow?
Definition
Anywhere there are rapidly dividing cells
Term
List 4 examples of prime cancer growth locations.
Definition
1. Bone marrow
2. Bladder
3. Breast
4. Skin
Term
Describe aspects of antisocial cancer cell behavior.
Definition
Proliferation despite lack of growth hormone; achieve unlimited replication by escaping "die" signals; lose features of differentiation; contribute poorly to surrounding tissue function; genetically unstable so they accumulate mutations at a higher rate; invade and overrun; migrate and colonize
Term
List 2 gene classes specifically realted to cancer/neoplasms.
Definition
1. Proto-oncogenes
2. Tumor suppressor genes
Term
What are the functions of proto-oncogenes?
Definition
Regulate cell division; encode growth factors and receptors; signal transduction and transcription
Term
What is the function of tumor suppressor genes?
Definition
Encode proteins that prevent unwanted proliferation
Term
Give 2 examples of tumor suppressor genes.
Definition
1. P53
2. BRCA 1, 2
Term
When is P53 expressed?
Definition
In response to tumor damage
Term
The loss of what gene occurs in half of all cancer patients?
Definition
P53
Term
P53 causes what?
Definition
Death by apoptosis
Term
Patients with an inherited defect of this gene have an 85% risk of developing breast cancer.
Definition
BRCA 1
Term
Carcinogens cause mutations in an organisms _____.
Definition
DNA
Term
What type of mutation do carcinogens cause?
Definition
Germline mutations
Term
Regarding carcinogens, malignant cell population expands if a mutation changes what?
Definition
Cell control mechanism
Term
What do mutated cell populations do to tissues and organs.
Definition
They disrupt the physiology and function
Term
List the 3 steps of carcinogenesis.
Definition
1. Initiation
2. Promotion
3. Progression
Term
Define carcinogenesis initiation.
Definition
Genetic mutations activate proto-oncogenes and inactivate tumor suppressor genes.
Term
Define carcinogenesis promotion.
Definition
Mutant cell proliferation (not check-pointing)
Term
Define carcinogenesis progression.
Definition
Exhibition of malignant behavior
Term
What is the destination and goal of a metastasis?
Definition
Anywhere; make an environment in which they can proliferate
Term
Describe the level of difficulty involving metastasis.
Definition
Even for a malignant tumor, it's difficult and involves many failures b/c they must first gain access to body fluid
Term
In metastasis, what helps identify the tissue of origin?
Definition
Tumor markers
Term
Can metastasis be used to predict tumor behavior?
Definition
Yes b/c it's not typically random
Term
Tumors need a new blood supply if _____ in diameter.
Definition
> 2mm
Term
Angeogenesis occurs in (early/late) stage tumors.
Definition
Late
Term
T/F Angeogeneis cannot lead to rapid growth.
Definition
False; can
Term
What growth factor is typically involved in angeogenesis? Why?
Definition
VEGF; to counter hypoxia, low oxygen flow, and other signs of significant metabolic rate
Term
What does VEGF do?
Definition
Makes more blood vessles and smooth muscle
Term
What does VEGF stand for?
Definition
Vascular Endothelial Growth Factor
Term
What is a great target for limiting tumor growth and metastasis?
Definition
VEGF/angeogenesis
Term
What is the paradox concernign angeogenesis.
Definition
Can't get cancer patients to stop angeogenesis; can't get diabetics to start
Term
Give 2 reasons for tumor grading and staging.
Definition
1. Guide therapy
2. Predict tumor behavior
Term
Define tumor grading.
Definition
Histological characterization to determine new growth and structural tumor characteristics (what it looks like)
Term
Define tumor staging.
Definition
Description of location and patter of spread of a tumor
Term
(Grading/Staging) is used most often clinically.
Definition
Staging
Term
Stating uses international _____.
Definition
TNM
Term
Regarding staging, what does TNM stand for?
Definition
Tumor, Node, Metastasis
Term
Elaborate on each aspect of international TNM.
Definition
Tumor - look, location
Node - lymph node involvement
Metastasis - other locations
Term
T/F Tumor staging is consistent between organ systems.
Definition
False; it can vary
Term
List 3 aspects that tumor staging focuses on.
Definition
1. Location
2. Size
3. Pattern of spread
Term
What is the acronym describing adult cancer warning signs (ACSs)?
Definition
CAUTION
Term
What does the C in CAUTION stand for?
Definition
Change in bowel/bladder habits
Term
What's the A in CAUTION?
Definition
A sore that doesn't heal
Term
What's the U in CAUTION?
Definition
Unusual bleeding/discharge
Term
What's the T in CAUTION?
Definition
Thickening/lump in breast or elswhere; swollen limb
Term
What's the I in CAUTION?
Definition
Indigestion/difficulty swallowing
Term
What's the O in CAUTION?
Definition
Obvious change in wart/mole/freckle
Term
What's the N in CAUTION?
Definition
Nagging cough/horseness
Term
List the final major ACS that isn't part of the CAUTION acronym.
Definition
Pain
Term
What is the acronym used to list the cancer warning signs for children?
Definition
CHILDREN
Term
What's the C in CHILDREN?
Definition
Continued, unexplained weight loss
Term
What's the H in CHILDREN?
Definition
Headaches w/ AM vomiting
Term
What's the I in CHILDREN?
Definition
Increased swelling or persistent pain in bones/joints
Term
What's the L in CHILDREN?
Definition
Lumpj/mass in abdomen/neck/elsewhere
Term
What's the D in CHILDREN?
Definition
Development of whitish appearance in pupils
Term
What's the R in CHILDREN?
Definition
Recurrent fever independent of infection
Term
What's the E in CHILDREN?
Definition
Excessive bleeding/bruising
Term
What's N in CHILDREN?
Definition
Noticeable paleness/prolonged fatigue
Term
List the 3 very general effects of cancer.
Definition
1. Widely vaired depending on location and migration
2. Warning signs published to increase treatment seeking
3. Improvements in early evaluation and prevention
Term
List 8 general symptoms/side effects of cancer/treatment.
Definition
1. Pain
2. Cachexia
3. Bone marrow suppression
4. Immunodeficiency
5. Nausea
6. Hair loss
7. Mucosal sloughing
8. Paraneoplastic syndromes
Term
What 3 things cause pain in cancer patients?
Definition
1. Metastasis
2. Tissue invasion/damage
3. Treatment
Term
T/F Cancer related pain is usually preventable or well-maintained at least until the end.
Definition
True
Term
Define cachexia.
Definition
Overal wasting away
Term
Cachexia is typically associated with _____ _____ and sometimes with _____.
Definition
Systemic illness; AIDS
Term
Cachexia results from what 4 things?
Definition
1. Decreased appetite
2. Increased metabolic rate
3. Food competition
4. Treatment
Term
Cachexia results in what 3 things?
Definition
1. Overall wt. loss
2. General weakness/fatigue
3. Energy mobilization
Term
Cachexia is partially a result of incrased metabolic rate. Why does metabolic rate occur?
Definition
Cells are rapidly dividing
Term
Bone marrow suppression results in what 3 things?
Definition
1. Anemia
2. Leukopenia
3. Thrombocytopenia
Term
Why does bone marrow suppression-related anemia occur?
Definition
Becuase RBC production is decreased and there's chronic and acute bleeding
Term
Define leukopenia.
Definition
Low WBC count
Term
Define thrombocyteopenia.
Definition
Low platelet count
Term
This result of bone marrow suppression is a predisposition to hemorrhages/clotting disorders.
Definition
Thrombocytopenia
Term
Cancer-related immunodefiency generally results from _____.
Definition
Leukopenia
Term
Define paraneoplastic syndrome.
Definition
When a tumor is producing an inappropriate hormone that cannot be shut off b/c that specific location doesn't have a negative feedback mechanism for the inappropriate hormone
Term
List 2 examples of paraneoplastic syndrome.
Definition
1. Cushing's hyponatremia
2. Hypercalcemia
Term
List the 3 main therapy options for cancer.
Definition
1. Surgery
2. Radiation
3. Chemotherapy
Term
T/F Cancer survival rate has not changed much.
Definition
False; the average 5 year survival rate is >60%
Term
Which form of cancer therapy is best for localized, solid, accessible tumors?
Definition
Surgery
Term
Which form of cancer therapy causes minimal damage to other cells?
Definition
Surgery
Term
Which form of cancer therapy is difficult in densly vascular/innervated areas?
Definition
Surgery
Term
T/F Surgery is never used in combination with other forms of cancery therapy.
Definition
False; often used in combination
Term
List 4 risks of surgical cancer therapy.
Definition
1. Disfigurement
2. Pain
3. Infection
4. Blood loss
Term
Define heterogeneity.
Definition
All tumor cells are different.
Term
What is the goal of radiation cancer therapy?
Definition
To cause nuclear DNA damage in rapidly dividing cells that have little time to repair
Term
What is the main problem with radiation cancer therapy?
Definition
Non-specific
Term
When is radiation cancer therapy best?
Definition
For tumors in vital, inaccessible places; for "escaped" tumors
Term
Cancer radiation therapy can be difficult b/c of tumor cell _____.
Definition
Heterogeneity
Term
Which cancer therapy is used for localized tumors or to decrease the tumor size in combination with surgery?
Definition
Radiation
Term
What are the side effects of cancer radiation therapy?
Definition
Depends on the specific tissue
Term
Which form of cancer therapy is both major and systemic, having no option for local treatment?
Definition
Chemotherapy
Term
T/F Chemotherapy may be primary or used in combination w/ another mode of therapy.
Definition
True
Term
Chemotherapy is good at...
Definition
...killing rapidly dividing cells.
Term
List 3 mechanisms of chemotherapy.
Definition
1. Disruption of enzyme production
2. Inhibition of DNA/RNA/protein synthesis
3. Prevention of mitosis
Term
List 2 things that can improve a cancer prognosis.
Definition
1. Early detection
2. Localized tumor site
Term
What kind of tumor has a higher treatment success rate? Give an example.
Definition
Specific of patterned metastasis; Hodgkin's
Term
List 4 minor cancer therapies.
Definition
1. Hormone blockers
2. Immunotherapy
3. Gene therapy
4. Stem cell trnasplantation
Term
What might be the way of the future for cancer therapy?
Definition
Gene therapy
Term
When is stem cell transplantation most often implicated?
Definition
In bone marrow cancers
Term
List the 2 main parts of the nervous system.
Definition
1. CNS
2. PNS
Term
What constitutes the CNS?
Definition
Brain, spinal cord
Term
The CNS includes cell bodies that (can/cannot) divide and repair.
Definition
Cannot
Term
T/F The CNS is regenerative.
Definition
False; is non-regenerative
Term
List a ver important general characteristic of the CNS.
Definition
Entirely bone-encased
Term
The PNS is further split into what two main categories?
Definition
1. Afferent
2. Efferent
Term
Which part of the PNS involves sensory imput?
Definition
Afferent
Term
Which part of the PNS invovles receptor-based information?
Definition
Afferent
Term
The afferent PNS is further split into what 2 categories?
Definition
1. General
2. Special
Term
List some general afferent PNS characteristics.
Definition
Mechanical (pressure), pain, temperature, touch
Term
List some special afferent PNS characteristics.
Definition
Any special senses like taste and smell
Term
Which part of the PNS involves motor output?
Definition
Efferent
Term
The efferent PNS is further split into what 2 categories?
Definition
1. Somatic
2. Autonomic
Term
The somatic efferent PNS includes _____ structures, which includes what specifically?
Definition
Voluntary; skeletal muscle
Term
What aspect of the efferent PNS has motor units, both large and small?
Definition
Somatic
Term
This part of the PNS has cholinergic neurons and cholinergic (nicotinic) receptors only.
Definition
Somatic efferent
Term
What part of the PNS includes Na being let into the cell? What kind of cell?
Definition
Somatic efferent; skeletal muscle
Term
The somatic efferent PNS is (excitatory/inhibitory/both).
Definition
Excitatory only
Term
Is it possible to inhibit a somatic efferent PNS signal? If so, how?
Definition
Yes, must happen centrally (before it ever gets to the PNS)
Term
What 2 things are capable of inhibiting a somatic efferent PNS signal. Describe a major characteristic of both.
Definition
1. GABA
2. Glycine
Always inhibitory
Term
In the somatice efferent PNS, muscle are either _____ or _____ _____.
Definition
Contracting; resisting contraction
Term
A somatic motor neuron can innervate _____ skeletal muscle cells.
Definition
Term
Somatic efferent PNS pathways are _____-neuron pathways.
Definition
1
Term
The autonomic efferent PNS is (voluntary/involuntary).
Definition
Involuntary
Term
The autonomic efferent PNS innervates _____, which includes what 3 things?
Definition
Viscera
1. Smooth muscle
2. Cardiac muscle
3. Glands
Term
The autonomic efferent PNS is broken down into what 2 system?
Definition
1. Sympathetic
2. Parasympathetic
Term
What 2 parts of the nervous system typically have similar targets?
Definition
Sympathetic and parasympathetic of the autonomic efferent PNS
Term
The autonomic efferent PNS has _____-neuron pathways.
Definition
2
Term
The term viscosity refers to a charachteristic of which efferent PNS system?
Definition
Autonomic
Term
Define viscosity in terms of the ANS (autonomic nervous system).
Definition
Term
The sympathetic autonomic efferent PNS responses are typically dexcribed as what?
Definition
Fight or flight
Term
What is a very important aspect of the sympathetic responses? Why?
Definition
They can only do a single thing in a single place, so you never find more than one type of adrenergic receptor in a single location; neurotransmitters don't have brains
Term
What does the parasympathetic autonomic efferent PNS do?
Definition
Housekeeping or rest and digest
Term
List the 3 general jobs of the nervous system.
Definition
1. Input
2. Integration
3. Output
Term
Which of the 3 general nervous system functions involves the PNS?
Definition
Input and output
Term
Which of e 3 general nervous system functions involves the CNS?
Definition
Integration
Term
PNS input is concerned with what?
Definition
Sensory receptor information
Term
What is a key word related to PNS output?
Definition
Motor
Term
Lis the 2 rules of dual autonomic innervation.
Definition
1. Involuntary tissues get both sympathetic and parasympathetic messages
2. Sympathetic and parasympathetic messages are in opposition
Term
List 6 exceptions to the rules of dual autonomic innervation.
Definition
1. Cardiac contractility manifests as stroke volume by only the sympathetic beta 1 adrenergic receptors
2. Adrenal medulla uses a modified motor neuron that's only activated by nicotine and Ach
3. Pupils - papillary constricted are muscarinic and papillary radial are alpha 1 adrenergic
4. Blood vessels are sympathetic only
5. Salivary glands - excitatory only; parasympathetic makes thin and sympathetic makes thick
6. Sweat glands are sympathetic only, but have muscarinic receptor
Term
What is the exception to the blood vessel exception to the rules of autonomic innervation?
Definition
BV in genitalia arouse by parasympathetic means
Term
Peripheral receptors of the nervous system can be based on what 2 things?
Definition
1. Mechanisms
2. Neurotransmitter
Term
List the 2 mechanisms upon which peripheral receptors are based.
Definition
1. Ionotropic
2. Metabotropic
Term
T/F Almost all peripheral nerves carry afferent and efferent neurons.
Definition
True
Term
List characteristics of ionitropic peripheral receptors.
Definition
1. Direct
2. End of somatic motor pathway
3. Physically linked to an ion channel
4. Peripherally always excitatory
5. Rare
Term
Are ionotropic receptors always excitatory?
Definition
Peripherally yes; centrally no
Term
List characteristics of metabotropic peripheral receptors.
Definition
1. Indirect
2. Require a 2nd messenger system
3. Physically linked to a 2nd messenger system
4. Common
5. Inhibitory and excitatory
Term
Are metabotropic receptors always both inhibitory and excitatory?
Definition
Yes, both peripherally and centrally
Term
Give an example of a metabotropic peripheral receptor.
Definition
Cyclic AMP
Term
List the 2 peripheral receptor neurotransmitter classifications.
Definition
1. Cholinergic
2. Adrenergic
Term
Ach and Ach-like things turn on these peripheral NT receptors.
Definition
Cholinergic
Term
List the 2 types of cholinergic peripheral receptors.
Definition
1. Nicotinic
2. Muscarinic
Term
Which cholinergic peripheral receptor is ionotropic? Metabotropic?
Definition
Nicotinic is ionotropic; muscarinic is metabotropic
Term
Where are nicotinic cholinergic peripheral receptors located?
Definition
Skeletal muscle motor end plate and autonomic ganglia (where pre and postganglionic neurons synapse)
Term
What binds most strongly to nicotinic receptors? Most commonly?
Definition
Nicotine; Ach
Term
Muscarinic cholinergic peripheral receptors have _____ targets.
Definition
Parasympathetic
Term
What binds most strongly to muscarinic receptors? Most commonly?
Definition
Muscarine; Ach
Term
What is an exception to the muscarinic cholinergic peripheral receptor classification.
Definition
Sweat glands have sympathetic targets, but are still muscarinic
Term
T/F Sympathetic activity can cause both dilationa and constriction.
Definition
True
Term
Adrenergic peripheral receptors are all (ionotropic/metabotropic).
Definition
Metabotropic
Term
Although they have preferences, adrenergic peripheral receptors will typically bind to what?
Definition
Epi and norepi
Term
Adrenergic peripheral receptors are only _____.
Definition
Sympathetic
Term
T/F All sizes of blood vessels and airways change in size.
Definition
False; large blood vessels and airways don't really change in size
Term
List the 4 types of adrenergic peripheral receptors.
Definition
1. Alpha 1
2. Alpha 2
3. Beta 1
4. Beta 2
Term
List the characteristics of an alpha 1 adrenergic peripheral receptor.
Definition
1. Excitatory
2. Excludes heart
3. Prefers norepi
Term
List the characteristics of an alpha 2 adrenergic peripheral receptor.
Definition
1. Inhibitory
2. Excludes blood vessels and airways
3. Prefers norepi
Term
List the characteristics of a beta 1 adrenergic peripheral receptor.
Definition
1. Excitatory
2. Heart
3. Equal affinity to epi and norepi
Term
List the characteristics of a beta 2 adrenergic peripheral receptor.
Definition
1. Inhibitory
2. Blood vessels and airways
3. Prefers epi
Term
Glial cells live _____ or _____, but not _____.
Definition
Centrally; peripherally; both
Term
Which major divison of the nervous system has regenerative abilities?
Definition
PNS
Term
List the PNS specific glial cells.
Definition
1. Schwann
2. Satellite
Term
What are the functions of Schwann cells.
Definition
Produce myelin, help in regeneration and re-growth of neurons
Term
How many axons can a Schwann cell myelinate?
Definition
1
Term
Dexcribe the thickness of myelin produced by a Schwann cell.
Definition
Standard and consistent
Term
What are the functions of satellite cells?
Definition
Help in re-growth and repair, make growth factors
Term
List characteristics of satellite cells.
Definition
1. Live in bare areas of neuronal cell membrane
2. Tropic to neurons
Term
List 2 "bare" areas on a neuronal cell membrane.
Definition
1. Cell body
2. Nodes of Ranvier
Term
T/F The CNS has regenerative capabilities.
Definition
False; doesn't have
Term
List the 4 CNS specific glial cells.
Definition
1. Microglial
2. Oligodendrocytes
3. Ependymal
4. Astrocytes
Term
A microglial cell is an example of what?
Definition
A tissue specific macrophage
Term
What is the smallest glial cell?
Definition
Microglial
Term
Describe the physical attributes of a microglial cell.
Definition
Elongated cell body, disk-shaped nucleus, many processes
Term
What is the function of microglial processes? What is it not?
Definition
Act as feeler and receptors; unlike dendrites, wich collect information
Term
What do microglial cells specifically tell us about the CNS?
Definition
It has some protection agains infection
Term
Oligodendrocytes are considered what?
Definition
CNS myelin makers
Term
What is another vital function of oligodendrocytes?
Definition
Prevent adult neuronal regeneration and re-growth
Term
How many axons do oligodendrocytes myelinate?
Definition
Multiple
Term
Describe the thickness of the myelin produced by oligodendrocytes.
Definition
Less consistent
Term
What is the function of ependymal cells?
Definition
Make, secrete, and reabsorb CSF
Term
Where are ependymal cells found in the CNS?
Definition
In linings of fluid-filled spaces in the cranium (ventricles)
Term
Which of the CNS glial cells is most abundant?
Definition
Astrocytes
Term
Astrocytes have many functions, list them.
Definition
1. Form blood-brain barrier
2. Structural scaffolding
3. Get rid of waste
4. Metabolic and nutritional support
5. Regulate intra/extracellular ion concentrations
Term
What is the shape of an astrocyte?
Definition
Star
Term
List the 2 types of astrocytes.
Definition
1. Fibrous
2. Protoplasmic
Term
Where are fibrous astrocytes located?
Definition
White matter
Term
Besides fibrous astrocytes, what else resides in white matter?
Definition
Myelinated axons
Term
List 3 things that make up the blood-brain barrier.
Definition
1. Blood vessels
2. Single layer of endothelial cells
3. Astrocytes
Term
Where are protoplasmic astrocytes located?
Definition
Grey matter
Term
Besides protoplasmic astrocytes, what else resides in grey matter?
Definition
Cell bodies and unmyelinated axons
Term
What is the most abundant form of brain cancer?
Definition
Fibrous astrocytoma
Term
List the 6 parts of the brain that we've covering.
Definition
1. Cerebral cortex
2. Cerebellum
3. Basal nuclei
4. Thalamus
5. Hypothalamus
6. Brainstem
Term
What part of the brain is responsible for most functions in general?
Definition
Cerebral cortex
Term
More specifically, list the functions of the cerebral cortex.
Definition
1. Learning
2. Language
3. Memory
4. Motor output
5. Personality
6. Sensory processing
Term
What part of the cerebral cortex is responsible for motor output?
Definition
Primary motor cortex
Term
List the functions of the cerebellum.
Definition
1. Fine motor control
2. Balance
3. Coordination
4. Cerebral cortex filter
Term
Where are basal nuclei located?
Definition
Embedded in the white matter in the grey matter of the hemispheres
Term
What region of the brain is affected in Parkinson's?
Definition
Basal nuclei
Term
What is the function of basal nuclei?
Definition
Inhibitory filter of useless movements from hemispheres
Term
What NT is specific to the basal nuclei? Is it inhibitory or excitatory?
Definition
Dopamine; inhibitory
Term
Is dopamine always inhibitory?
Definition
No
Term
What is the thalamus?
Definition
Relay station or sorter of incoming information
Term
What does the thalamus do for us?
Definition
Crude awareness of sensation
Term
What part of the brain acts as a physical link b/w the nervous and endocrine systems?
Definition
Hypothalamus
Term
Besides being a physical link b/w nervous and endocrine systems, what other functions does the hypothalamus have?
Definition
1. Makes oxytocin and ADH
2. Regulates fluid balance
3. Regulates temperature
4. Regulates the ANS
Term
ADH is also known as _____.
Definition
Vasopressin
Term
Another name for the hypothalamus is the _____ _____.
Definition
Thirst center
Term
What is the origin for most cranial nerves?
Definition
Brainstem
Term
What is the function of the brainstem?
Definition
Controls vitals like respiratory and cardiovascular
Term
List the 4 main categories of brian disorders.
Definition
1. Abnormal autoregulation
2. Increases in intercranial pressure
3. NT disorders
4. Ischemia/reperfusion injuries
Term
Define autoregulation.
Definition
An intrinsic regulatory mechanism that constantly maintains blood flow
Term
Another word for blood flow is _____.
Definition
Perfusion
Term
Besides in the brain, where else does perfusion autoregulation occur?
Definition
Kidneys
Term
List 2 forms of autoregulation.
Definition
1. Myogenic
2. Endothelial
Term
List the characteristics of myogenic autoregulation.
Definition
1. Local
2. Intrinsic to cerebral blood vessels
3. Constrict when stretched
4. Protective response to maintain constant perfusion
Term
List the characteristics of endothelial autoregulation.
Definition
1. Local
2. Single layer of cells that line all blood vessels
3. Independent of happenings elsewhere
4. Product on-site vasodilators/vasoconstrictors
Term
T/F Some of the on-site vasodilators/vasoconstrictors produced by endothelial autoregulation are considered hormones.
Definition
False; none are b/c they're not put directly into bloodstream
Term
Which of the on-site vasodilators/vasoconstricors of enothelial autoregulation does not require receptors?
Definition
Nitric oxide
Term
List the 3 on-site vasodilators produced by endothelial autoregulation.
Definition
1. Adenosine
2. Nitric oxide
3. Prostacyclin
Term
List the 3 on-site vasoconstrictors produced by endothelial autoregulation.
Definition
1. Endothelin
2. Thromboxane
3. PGF 2 alpha
Term
Is it common for autoregulation to fail?
Definition
No, it's rare
Term
If autoregulation fails on the side of being too much, what results?
Definition
Increased ICP; symptoms depend on location of blood accumulation
Term
If autoregulation fails on the side of being too little, what results?
Definition
Ischemia reperfusion
Term
Define intercranial pressure (ICP).
Definition
Pressure on the cranium by everything inside
Term
What 3 things does ICP depend on?
Definition
1. Tissue
2. CSF
3. Blood
Term
Increases in ICP result in (typical/differing) manifestations.
Definition
Differing
Term
List 3 things that can increse cerebral tissue volume.
Definition
1. Swelling
2. Tumor
3. Any CNS infection
Term
Swelling that increases cranial tissue volume results from what?
Definition
Secondary brain injury
Term
Define secondary brain injury.
Definition
Swelling that occurs as a result of a traumatic primary brain injury
Term
What is the treatment for swelling that increases cranial tissue volume?
Definition
Medically induced coma, anti-inflammatory meds
Term
A tumor that increases cranial tissue volume is not ______ based.
Definition
Neuron
Term
List 2 examples of tumors that increase cranial tissue volume.
Definition
1. Oligodendroma
2. Astrocytoma
Term
What is the most common of all adult brain cancers?
Definition
Astrocytoma
Term
What is the treatment for tumors that increase cranial tissue volume?
Definition
Local radiation, surgery, chemo
Term
List 2 examples of CNS infections that increase cranial tissue volume.
Definition
1. Meningitis
2. Encephalitis
Term
What does meningitis affect?
Definition
1+ dural meninges (dura, arachnoid, pia)
Term
Meningitis can be _____ or _____.
Definition
Bacterial; viral
Term
Although this version is easier to treat, which type of meningitis wreaks more havock?
Definition
Bacterial
Term
What is the treatment for bacterial meningitis?
Definition
Antibiotics
Term
Which type of meningitis is less contagious?
Definition
Viral
Term
What is the treatment for viral meningitis?
Definition
Symptoms and wait
Term
Define encephalitis.
Definition
Brain infection
Term
Encephalitis can be _____, _____, or _____.
Definition
Bacterial; viral; fungal
Term
Which forms of encephalitis are easier to treat?
Definition
Bacterial and fungal
Term
Which type of encephalitis is more difficult to treat?
Definition
Viral
Term
What is another word for an increase in CSF?
Definition
Hydrocephaly
Term
List 3 forms of hydrocephaly.
Definition
1. Communicating
2. Non-communicating
3. Normal pressure
Term
Which type of hydrocephaly is more common in adults?
Definition
Communicating
Term
What occurs in communicating hydrocephaly?
Definition
Inability to maintain reabsorption of CSF (making more than we can reabsorb)
Term
Does communicating hydrocephaly occur because there's something wrong with the ependymal cells?
Definition
No, they're perfectly normal
Term
Which 2 forms of hydrocephaly cause an increase in ICP?
Definition
Communicating and non-communicating
Term
Which form of hydrocephaly is more common in kids?
Definition
Non-communicating
Term
What occurs in non-communicating hydrocephaly?
Definition
Obstruction in ventricular system
Term
The cerebral ventricular system is where _____ cells are located.
Definition
Ependymal
Term
What happens in normal pressure hydrocephaly?
Definition
CSF increases but ICP stays normal
Term
What must normal pressure hydrocephaly suggest?
Definition
Falling tissue volume
Term
Give 3 examples of instances where cerebral tissue decreases in normal pressure hydrocephaly.
Definition
1. Elderly
2. Tissue removal
3. Loss of neuronal volume (Alzheimer's, stroke)
Term
What is cerebral blood volume maintained by?
Definition
Autoregulation
Term
Symptoms of increased cerebral blood volume depend on _____.
Definition
Location
Term
List 3 things that increase cerebral blood volume.
Definition
1. Aneurysm
2. Hemorhage
3. Hematoma
Term
What is an aneurism?
Definition
Weak spot in vessel wall that bulges
Term
Aneurisms are almost always (veinous/arterial). Why?
Definition
Arterial; higher pressure
Term
Most aneurysms are (symptomatic/asymptomatic). Thus people are (aware/unaware) of the problem before rupture.
Definition
Asymptomatic; unaware
Term
In was case would an aneurysm cause symptoms?
Definition
If it's pushing on something
Term
What is the treatment for an aneurism?
Definition
Clamp bulges
Term
What is a hemorrhage?
Definition
Active bleed
Term
What vessels does fluid typically leak from into interstitial space in a hemorrhage?
Definition
Arterial
Term
Of the 3 things that increase cranial blood volume, which are named based on location?
Definition
Hemorrages and hematomas
Term
What is the treatment for a hemorrhage?
Definition
Turning-up clotting cascade, patch
Term
What is a hematoma?
Definition
Bruise; very acute capillary damage that causes fluid accumulation into interstitial space that slows and stops
Term
What is the treatment for a hematoma?
Definition
Manage symptoms and monitor for worsening
Term
(Peripherally/centrally) dopamine increases cardiac contractility.
Definition
Peripherally
Term
Define NT disorder.
Definition
Something that changes ability to make and release NTs
Term
List 3 NT disorders.
Definition
1. Parkinson's
2. Alzheimer's
3. Huntington's
Term
Define Parkinson's.
Definition
Commonly occurring degenerative disorder of basal ganglia involvling failure of dopaminergic neuron pathways
Term
Is Parkinson's genetic?
Definition
Yes
Term
What part of the nervous system does Parkinson's affect?
Definition
CNS
Term
Parkinson's essentially results from a loss of _____.
Definition
Dopamine
Term
List manifestations of Parkinson's.
Definition
Goofy gait, tremor at rest, stooped posture, bilateral, muscle stiffness
Term
What are the treatments of Parkinson's?
Definition
Symptoms, L-dopa
Term
Define Alzheimer's.
Definition
Degenerative disorder that affects brain and causes dimentia, especially late in life
Term
What is the most common form of dimentia?
Definition
Alzheimer's
Term
What 2 major structual changes can be seen in the autopsy of an Alzheimer's victim?
Definition
1. Beta amyloid plaques
2. Neurofibrillary tangles
Term
What are beta amyloid plaques?
Definition
In Alzheimer's, protein plaques that inhibit exchange
Term
What are neurofibrillary tanges made of?
Definition
Abnormal tau proteins
Term
Alzheimer's involves the death of _____ neurons and the loss of _____.
Definition
Cholinergic; Ach
Term
List some manifestations of Alzheimer's.
Definition
Depression, anger, anxiety, agitation, repetitive behavior, cognitive impairment, normal pressure hydrocephaly
Term
What are the treatments for Alzheimer's?
Definition
Cholinesterase inhibitor, memory exercises, environmental modifications
Term
Define Huntington's.
Definition
Severe degeneration of basal ganglia in cerebral cortex
Term
Is Huntington's genetic?
Definition
Yes
Term
Huntington's is typically passed from _____ to _____.
Definition
Woman; woman
Term
What part of the nervous system does Huntington's affect?
Definition
PNS and CNS
Term
T/F Huntington's affects certian parts of the body.
Definition
False; affects entire body
Term
Describe the pathogenesis of Huntington's.
Definition
Loss of GABAergic neurons; changes how glutamine fits into protein structure
Term
GABAergic neurons have an affect on what?
Definition
Dopamine pathways in the ganglia
Term
List the manifestations of Huntington's.
Definition
Loss of control of voluntary movement (bizarre), progressive dysfunction of thought, memory loss, mood change, irritability
Term
What are the treatments for Huntington's?
Definition
None
Term
Define ischemia.
Definition
Lack of blood flow
Term
Define reperfusion.
Definition
Return of blood supply after ischemia
Term
The symptoms of stroke are almost entirely dependent on _____.
Definition
Location
Term
List 2 types of ischemia/reperfusion injuries.
Definition
1. Stroke
2. TIA
Term
Almost all strokes are _____.
Definition
Ischemic
Term
Define atheroma formation.
Definition
Fatty clot on vessel wall
Term
_____ cells line blood vessels.
Definition
Endothelial
Term
List 4 functions of endothelial cells.
Definition
1. Make vasoactive factors
2. Prevent platelet and leukocyte adhesion
3. Prevent inflammation/immune response
4. Control vascular remodeling
Term
What growth factor is involved in the endothelial function of controlling vascular remodeling?
Definition
VEGF (vascular endothelial growth factor)
Term
By what means does smooth muscle grow?
Definition
Hyperplasia (make and replace)
Term
List the 9 steps in atheroma formation.
Definition
1. Endothelial damage
2. Lipoprotein adhesion
3. Macrophage infiltration
4. Macrophages phagocytose lipoproteins
5. Foam cells
6. Fatty streak
7. More leukocytes enter
8. Platelet activation
9. Smooth muscle cell proliferation
Term
Regarding atheroma formation, list 2 forms of endothelial damage.
Definition
1. Mechanical
2. Chemical
Term
Give examples of mechanical endothelial damage.
Definition
Hypertension, bifurcated (branched) artery
Term
Give examples of chemical endothelial damage.
Definition
Smoking, high blood glucose
Term
Which liproproteins stick in atheroma formation?
Definition
LDLs, VLDSs
Term
What is a foam cell?
Definition
Macrophage that has ingested lipoproteins
Term
What is a fatty streak?
Definition
Foam cell accumulation
Term
Regarding atheroma formation, what do platelets activate?
Definition
Serotonin, PDGF (platelet derived growth factor)
Term
Regarding atheroma formation, what does serotonin do?
Definition
Vasoconstricts
Term
Regarding atheroma formation, what does PDGF do?
Definition
Smooth muscle cell proliferation
Term
Regarding atheroma formation, list the 2 forms of smooth muscle cell proliferation.
Definition
1. Thrombus
2. Embolus
Term
What is a thrombus?
Definition
Stable smooth muscle cap around atheroma
Term
Give some characteristics of a thrombus.
Definition
Builds in size; can close lumen, but allows some blood flow
Term
Strokes caused by _____ have slower onset b/c it slowly changes blood flow.
Definition
Thrombus
Term
What is an example of a thrombus?
Definition
Deep vein thrombosis (after surgery)
Term
What is an embolus?
Definition
Incomplete, unstable clot that dislodges and moves somewhere else
Term
What does an embolus cause?
Definition
More ischemia and very little blood flow
Term
Strokes from _____ come out of nowhere.
Definition
Embolus
Term
What is an example of an embolus?
Definition
Pulmonary embolism
Term
Where does a pulmonary embolism end up?
Definition
Pulmonary area
Term
Most pulmonary embolisms are _____ in nature.
Definition
Cardiovascular
Term
Define risk factor.
Definition
Factor that increases likelihood of something happening
Term
Are risk factors cause and effect?
Definition
No
Term
List the 4 primary risk factors of stroke.
Definition
1. Smoking
2. Hypertension
3. Dyslipidemia
4. Physical inactivity
Term
What is the parameter of a primary risk factor?
Definition
One factor by itself increases likelihood
Term
What is the parameter of a secondary risk factor?
Definition
Factor must be paired w/ another factor
Term
List secondary risk factors for stroke.
Definition
1. Gender
2. Race
3. Age
4. Alcoholism
5. Stress
6. Diet
7. Type II diabetes
8. Positive family history
Term
(Males/Females) are at higher risk of stroke.
Definition
Males
Term
What races are at higher risk of stroke?
Definition
African/Native Americans
Term
(Youth/Elderly) are at higher risk of stroke.
Definition
Elderly
Term
What kind of diet increases risk of stroke?
Definition
High fat or high salt (when salt sensitive)
Term
What does TIA stand for?
Definition
Transient ischemic attack
Term
What is a TIA?
Definition
A mini stroke
Term
Where does a TIA occur?
Definition
In area of endothelial damage that healed before thrombus formation
Term
What are the treatments for TIA?
Definition
Baby aspirin, blood thinners, stop smoking, exercise
Term
How does baby aspirin help with TIA?
Definition
Blunts clotting cascade
Term
List 2 non-brain disorders.
Definition
1. MS
2. Gullain Barre
Term
What is the only difference between MS and Gullain Barre?
Definition
MS targets specific protein in CNS myelin; Gullain Barre targets specific protein in PNS myelin
Term
In MS and Gullain Barre, do the oligodendrocytes and Schwann cells function normally?
Definition
Yes
Term
What are the characteristics of MS and Gullain Barre?
Definition
1. Demyelination
2. Auto-immune
3. Type II HS
4. Result of immune response is scarred axon
Term
List manifestations of MS and Gullain Barre.
Definition
No conduction through axon, changes in vision, reduced grip strength
Term
What is the treatment for MS and Gullain Barre?
Definition
Immunosuppression (corticosteroids)
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