patologi anatomy brain and mind system

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  • DEPARTEMEN PATOLOGI ANATOMIFAKULTAS KEDOKTERAN UNIVERSITAS SUMATERA UTARA MEDAN 2013

  • PNSKumpulan neuron = ganglia CNSKumpulan dari neuron = nuclei **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • *DEP. PATOLOGI ANATOMI FK-USU 2013*

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • BRAIN*DEP. PATOLOGI ANATOMI FK-USU 2013*

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Have :Cell bodyDendrites intergrating signalsAxon *DEP. PATOLOGI ANATOMI FK-USU 2013*

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • *DEP. PATOLOGI ANATOMI FK-USU 2013*

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • *DEP. PATOLOGI ANATOMI FK-USU 2013*

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Glial divided into :*DEP. PATOLOGI ANATOMI FK-USU 2013*

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • CELLULAR REACTIONSNeuronsAcute (RED neuron, karyolysis)Subacute, chronic, cell loss, gliosisAxonalInclusions (lipid, prot., carb., viruses)Glia, gliosisSwellingFibersInclusions**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • ACUTE NEURONAL INJURYRED NEURONS**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • **DEP. PATOLOGI ANATOMI FK-USU 2013Hallmark Chronic CNS injuryNeuronal loss &Gliosis

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Normal motor units :Two adjacent motor units**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Abnormal motor units Segmental demyelination:Axon & myocytes remain intact**DEP. PATOLOGI ANATOMI FK-USU 2013Random internodes of myelin are injuredRemyelinated by multiple Schwann cells

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Abnormal motor units Axonal degeneration:Resulting :**DEP. PATOLOGI ANATOMI FK-USU 2013Axon & myelin sheath undergo anterograde degeneration (green)Denervation atrophy of the myocytes within its motor unit

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Abnormal motor units Reinnervation of muscle:Sprouting of adjacent (red) uninjured motor axons leads to fiber type grouping of myocytes

    Injured axon attempts axonal sprouting**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Abnormal motor units Myopathy :Scattered myocytes of adjacent motor units are small (degenerated / regenerated)

    Neurons & nerve fibers are normal**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • *DEP. PATOLOGI ANATOMI FK-USU 2013*

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • PERIPHERAL NERVESame categories of disease as other tissues

    The pattern of disease, reflects the unique structure & function of nerves**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • INFLAMMATORY NEUROPATHIESCharacterized by inflammatory cell infiltrates in :Immune mechanisms presumed to be the primary cause of the inflammation**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Immune-Mediated Neuropathies **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Is a life-threatening disease PNS**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Guillain-Barr Syndrome **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • In some patients : **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • INFECTIOUS POLYNEUROPATHIES Many infectious processes affect peripheral nerveCause unique and specific pathologic changes in nerves **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Biopsies of sural nerves show :**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Lepromatous & tuberculoid leprosy Peripheral nerveinvolvement in**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Peripheral nerve involvement**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Earliest changes seen in :Sensory ganglia

    Incomplete blood-nerve barrier allows entry of the toxin

    Selective demyelination of axons extends into adjacent anterior & posterior roots (mixed sensorimotor nerves) **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • The most common viral infections of PNS**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Varicella zoster**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Varicella zoster**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • *DEP. PATOLOGI ANATOMI FK-USU 2013*

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Classical Disease PatternsDegenerativeInflammatoryNeoplastic**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Classical CNS Disease PatternsDegenerativeInflammatoryNeoplasticTraumatic**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • CNS MALFORMATIONSNeural TubeAnencephaly, Encephalocele, Spina BifidaForebrainPolymicrogyria, Holoprosencephaly, Agenesis of Corpus CallosumPosterior Fossa (Infratentorial)Arnold Chiari (infratentorial herniation), Dandy-Walker (cerebellar cyst)Syringomyelia/Hydromyelia**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Fetal -protein in :Amniotic fluid & Maternal circulation**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • SPINABIFIDA**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • POLYMICROGYRIASmall gyri**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • HOLOPROSENCEPHALYFailure prosencephalon to develop, and separate, often leads to cyclops.**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • CEREBRAL EDEMA(Normal weight 1200-1300 grams)**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Gyrus mendatarSulcus menyempitRongga ventrikel tertekanCEREBRAL EDEMA**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • CEREBRAL EDEMASubfalcine (SUPRA-tentorial)Cingulate (TENTORIAL)Cerebellar tonsilar (SUB-tentorial, or INFRA-tentorial)**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • CEREBRAL EDEMAD.D.:EVERYTHINGSYMPTOMSHEADACHEHALLUCINATIONSCOMADEATH**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • HYDROCEPHALUS**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • HYDROCEPHALUSImpaired RESORPTIONIncreased PRODUCTIONOBSTRUCTIONCOMMUNICATING (entire)NON-COMMUNICATING (part)HIGH PressureNORMAL Pressure**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • PERINATAL Brain InjuriesCerebral Palsy refers to non-progressive diffuse cerebral pathology apparent at childbirthThree most common types of perinatal brain injuriesIntraparenchymal HemorrhageIntraventricular hemorrhage (premies)Periventricular leukomalacia (i.e., infarcts)**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Various patterns of CNS injury in newborns**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • CNS TRAUMASkull FracturesParenchymal InjuriesTraumatic Vascular InjurySequelaeSpinal Cord Trauma**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • BRAIN TRAUMAContusion (bruise)Laceration (tear)Coup/Contre-CoupConcussion**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • HAIRLINEDEPRESSED, akaDISPLACED**DEP. PATOLOGI ANATOMI FK-USU 2013Skull fracture types

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • HEMATOMAS/HEMORRHAGEEPIDURAL (fx)SUBDURAL (trauma No fx)SUBARACHNOID (arterial, no trauma)INTRAPARENCHYMAL (any)INTRAVENTRICULAR (no trauma, rare in adults, common in premies)**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • **DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • *DEP. PATOLOGI ANATOMI FK-USU 2013*

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • EPIDURAL HEMATOMA**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • SUBDURAL HEMATOMA**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • SUBARACHNOID**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • INTRAPARENCHYMAL**DEP. PATOLOGI ANATOMI FK-USU 2013

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • Primary Brain Parenchymal Hemorrhage*DEP. PATOLOGI ANATOMI FK-USU 2013*

    DEP. PATOLOGI ANATOMI FK-USU 2013

  • INTRAVENTRICULAR**DEP. PATOLOGI ANATOMI FK-USU 2013