K11-Blok Bms (22 Feb '14)

DEPARTEMEN PATOLOGI
ANATOMI
FAKULTAS KEDOKTERAN
UNIVERSITAS SUMATERA UTARA
MEDAN
CNS PNS
Kumpulan dari neuron = nuclei Kumpulan neuron = ganglia
DEP. PATOLOGI ANATOMI FK-USU

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2014
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2014
PERIPHERAL NERVE
The pattern of disease,

reflects the unique structure & function of
nerves
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2014
INFLAMMATORY
NEUROPATHIES
Characterized by inflammatory cell infiltrates in :
Immune mechanisms
presumed to be the primary cause of the inflammation
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Immune-Mediated
Neuropathies

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Guillain-Barr Syndrome

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In some patients :

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INFECTIOUS
POLYNEUROPATHIES
Many infectious processes affect peripheral nerve
Cause unique and specific pathologic

changes in nerves
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Biopsies of sural nerves show :

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Leprosy
involvement Lepromatous &

Peripheral in tuberculoid
nerve leprosy

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Diphtheria
Peripheral Effects of diphtheria
exotoxin
nerve
involvement

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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)
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2014
Varicella zoster
The most common viral infections of
PNS

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Varicella zoster

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Varicella zoster

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Classical CNS Disease
Patterns
Degenerative
Inflammatory
Neoplastic
Traumatic
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BRAIN

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2013
CELLULAR
REACTIONS
Neurons
Acute (RED neuron, karyolysis)
Subacute
Chronic (cell loss, gliosis)
Axonal Inclusions (lipid, protein,
carbohidrate, viruses)
Glia, gliosis
Swelling
Fibers
Inclusions
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2013
ACUTE NEURONAL INJURY
RED NEURONS
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2013
Hallmark Chronic CNS inju
Neuronal loss
&
Gliosis

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2013
CNS
MALFORMATIONS

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Fetal -protein in :
Amniotic fluid &
Maternal circulation
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SPINA
BIFIDA

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POLYMICROGYRIA
Small gyri

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HOLOPROSENCEPHALY
Failure prosencephalon to develop, and separate, often leads to cyclops.
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CEREBRAL
EDEMA
(Normal weight 1200-1300
grams)

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CEREBRAL EDEM
Gyrus mendatar
Sulcus menyempit
Rongga ventrikel
tertekan
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2014
CEREBRAL
EDEMA
Subfalcine (SUPRA-
tentorial)
Cingulate (TENTORIAL)
Cerebellar tonsilar (SUB-
tentorial, or INFRA-
tentorial)

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2014
(SUPRA-tentorial)
(SUB-tentorial / INFRA-tentorial)
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CEREBRAL
EDEMA
D.D.: SYMPTOMS
EVERYTHIN HEADACHE
G HALLUCINATI
ONS
COMA
DEATH

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2014
HYDROCEPHALU
S

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2014
HYDROCEPHALU
S
Impaired RESORPTION
Increased PRODUCTION
OBSTRUCTION
COMMUNICATING (entire)
NON-COMMUNICATING (part)
HIGH Pressure
NORMAL Pressure
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2014
Fontanelle closure is the key factor
whether hydrocephalus will result in any
cranial enlargement
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PERINATAL Brain
Injuries
3 most
common
types of Intra parenchymal
perinatal Hemorrhage
brain
injuries Intra ventricular hemorrhage
(premies)
Periventricular leukomalacia
(i.e., infarcts)
Cerebral Palsy
refers to non-progressive diffuse cerebral
pathology apparent at childbirth

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Various patterns of CNS injury in newborn

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CNS TRAUMA
Skull Fractures
Parenchymal Injuries
Traumatic Vascular
Injury
Sequelae
Spinal Cord Trauma
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BRAIN TRAUMA
Contusion (bruise)
Laceration (tear)
Coup/Contre-Coup
Concussion

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2014
Skull fracture types
HAIRLINE DEPRESSED,
aka
DISPLACED
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HEMATOMAS/HEMORR
HAGE
EPIDURAL (fx)
SUBDURAL (trauma No fx)
SUBARACHNOID (arterial, no
trauma)
INTRAPARENCHYMAL (any)
INTRAVENTRICULAR (no
trauma, rare in adults,
common in premies)
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2014
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2014
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2014
EPIDURAL HEMATOMA
The lucid interval is a classic feature of

the epidural hematoma

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2014
SUBDURAL HEMATOMA
No lucid interval, but instead a
sudden & progressive worsening of
DEP. PATOLOGI ANATOMIsymptoms
FK-USU
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2014
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SUBARACHNOID
2014
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05/23/17 INTRAPARENCHYMAL
2014
49
Most are caused by rupture
of a small intraparenchymal
vessel.
Hypertension is the most
common
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INTRAPARENCHYMAL
2014
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SPINAL CORD
TRAUMA
Parallels BRAIN patterns of
injury on a cellular basis
Usually secondary to spinal
column displacement
Level of injury mirrors
motor loss: Death
Quadriplegia Paraplegia
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2014
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2014
Cerebrovascular
Diseases
(CVA, Stroke)
Ischemic ( blood and 02)
Global
Focal (regional):
ACUTE:
edema neuronal microvacuolization pyknosis
karyorrhexis neutrophils
CHRONIC:
macrophages gliosis
Hemorrhagic (rupture of
artery/aneurysm)
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2014
HYPERTENSIVE
CVA
Intracerebral
Basal Ganglia
Region
(lenticulostriate arteries of internal
capsule, putamen)

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HYPERTENSIVE CVA

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SUBARACHNOID
HEMORRHAGE
Rupture of large intracerebral
arteries which are the primary
branches of the anatomical
circle (of Willis)
Congenital (berry
aneurysms)
Atherosclerotic (atherosclerotic
aneurysms, or direct wall
rupture)
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2014
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2014
CNS DEGENERATIVE
DISEASES

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2014
THANK YOU
SELAMAT BELAJAR

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2014

K11-Blok Bms (22 Feb '14)

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DEPARTEMEN PATOLOGI

DEP. PATOLOGI ANATOMI FK-USU

The pattern of disease,

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

Cause unique and specific pathologic

DEP. PATOLOGI ANATOMI FK-USU

involvement Lepromatous &

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

Incomplete blood-nerve barrier

Selective demyelination of axons

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

The lucid interval is a classic feature of

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

DEP. PATOLOGI ANATOMI FK-USU

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