| Feature | Gray matter (neuropil) | White matter |
|---|---|---|
| Neuron cell bodies | Numerous | Few |
| Myelinated axons | Few | Many (axon tracts) |
| Astrocyte type | Protoplasmic (with endfeet) | Fibrous (lie along axons) |
| Oligodendrocyte type | Perineuronal (hug cell bodies; no myelin) | Interfascicular (make myelin) |
| Microglia | Present in both | |
| Capillary endothelium + basement membrane | Present in both | |
Protoplasmic + Perineuronal live with the cell-body Parenchyma (gray). Fibrous + Interfascicular line the Fiber tracts (white).
Glia are not electrically silent bystanders: astrocytes have neurotransmitter receptors and respond with Ca²⁺ signals, but they still never fire action potentials. "Generates an action potential" always points to a neuron.
| Job | What it means |
|---|---|
| Guide (development) | Radial glia form scaffolding that migrating neurons climb along. |
| Grow (growth factors) | Secrete growth factors that regulate neuron morphology, proliferation, differentiation and survival. |
| Guard (physical barrier) |
|
| Govern (homeostasis) |
|
Don't mix up the two astrocyte barriers: BBB (endfeet + endothelium, around vessels) vs glia limiting membrane (endfeet + pia, at the brain surface). And GFAP marks astrocytes; myelin basic protein marks CNS myelin; neurofilament marks neurons.
Grow, Guide, Guard, Govern: growth factors, migration scaffolding, barriers/scar, homeostasis. The star (astro) is the stage manager: sets the stage (barrier), feeds the actors (energy) and sweeps up after each scene (glutamate/GABA, K⁺).
| Interfascicular oligodendrocyte | Perineuronal oligodendrocyte | |
|---|---|---|
| Where | White matter | Gray matter |
| Myelinates? | Yes: the main job of oligodendrocytes | No: surrounds neuronal cell bodies |
| Proposed role | Myelin → fast conduction | Support neurons via secreted soluble molecules (growth factors?) |
"Demyelinating disease + CNS" = oligodendrocyte (MS, PML). "Demyelinating disease + ascending weakness, areflexia" = Schwann cell (Guillain–Barré). Same process, different glia, different nervous system.
Myelin ↑ membrane resistance and ↓ capacitance → ↑ length constant → faster conduction. Demyelination → slowed conduction / conduction block (e.g., MS: optic neuritis, internuclear ophthalmoplegia). Larger diameter also ↑ velocity.
Saltatory = salta (Spanish/Latin "jump"). Picture a frog hopping from lily pad (node) to lily pad, skipping the insulated water (internode).
| State | Shape | Behavior |
|---|---|---|
| Resting | Ramified: small body, many fine branches | Surveying the environment |
| Activated | Amoeboid: large body, retracted processes | Macrophage-like: phagocytose, release lots of cytokines |
| Activation phenotype | Inflammatory profile | Effect on neurons |
|---|---|---|
| M1 | Pro-inflammatory (TNF-α, IL-1β) | Neurotoxic |
| M2 | Anti-inflammatory | Neuroprotective |
Real activation is more complicated: there are likely additional subtypes and transition states between M1 and M2.
Microglia are the odd ones out: mesoderm-derived (yolk-sac macrophage lineage), whereas astrocytes, oligodendrocytes and ependymal cells come from neuroectoderm, and Schwann/satellite cells from neural crest.
M1 = 1st responder: attacks (toxic). M2 = 2nd: cleans up and repairs (protective). Ramified = "branches out to watch"; amoeboid = "rolls up its sleeves to eat".
| Cell | Origin | Marker / feature | Classic disease links |
|---|---|---|---|
| Astrocyte | Neuroectoderm | GFAP; endfeet; K⁺/glutamate | Astrocytoma, GBM, pilocytic astrocytoma; reactive gliosis |
| Oligodendrocyte | Neuroectoderm | Myelinates many CNS axons; "fried egg" | MS, PML, leukodystrophies, oligodendroglioma |
| Microglia | Mesoderm (yolk-sac macrophage) | CNS phagocyte | HIV (multinucleated giant cells), neuroinflammation |
| Ependymal cell | Neuroectoderm | Ciliated cells lining ventricles/central canal; choroid plexus ependyma make CSF | Ependymoma (perivascular pseudorosettes) |
| Schwann cell | Neural crest | S-100; myelinates one PNS axon segment | Guillain–Barré, schwannoma (CN VIII; bilateral = NF2) |
| Satellite cell | Neural crest | Surround neuron bodies in PNS ganglia | Surround the sensory ganglion neurons where HSV/VZV hide latent |
Adult, cerebral hemispheres; can cross the corpus callosum ("butterfly glioma"); ring enhancement; pseudopalisading necrosis + vascular proliferation; GFAP+. Median survival ~1 yr.
Child, cerebellum; cystic with mural nodule; Rosenthal fibers, eosinophilic granular bodies; GFAP+; benign (grade I).
Adult, frontal lobe, seizures, often calcified; "fried egg" cells, "chicken-wire" capillaries; 1p/19q co-deletion.
Child, 4th ventricle → hydrocephalus; perivascular pseudorosettes.
CN VIII at cerebellopontine angle → hearing loss, tinnitus; S-100+; bilateral = NF2.
A ring-enhancing lesion is not automatically GBM: in an AIDS patient think toxoplasmosis or primary CNS lymphoma; with fever think abscess; multiple at gray–white junction think metastases. Also: Rosenthal fibers = pilocytic (benign), pseudopalisading = GBM (malignant).
| Multiple sclerosis | Guillain–Barré syndrome | |
|---|---|---|
| Myelin cell hit | Oligodendrocyte (CNS) | Schwann cell (PNS) |
| Classic patient | Young woman; relapsing-remitting episodes | After Campylobacter or viral infection |
| Signs | Optic neuritis, INO, UMN signs, sensory loss, Lhermitte sign | Ascending symmetric weakness, areflexia, autonomic instability |
| CSF | ↑ IgG, oligoclonal bands | ↑ protein, normal cells (albuminocytologic dissociation) |
| Imaging | Periventricular plaques ("Dawson fingers") | Nerve conduction: slowed velocity |
PML = Polyoma Melts Lipid (myelin): JC virus eats the white-matter wiring in the immunosuppressed. MS = Myelin Spots hugging the ventricles.
| Condition | What microglia do | Result |
|---|---|---|
| HIV | Are targeted (infected) by the virus | Inflammation + neuron death (HIV-associated neurocognitive disorder) |
| Alzheimer's / Parkinson's | Increased activation | Chronic brain inflammation |
| Stroke, trauma | Activated microglia secrete neurotoxic TNF-α, IL-1β | Secondary neuron death beyond the initial injury |
| Bacterial meningitis | Excess TNF-α, IL-1β | BBB opens → leukocyte infiltration → worse infection/inflammation |
HIV enters the CNS in infected monocytes ("Trojan horse") and infects microglia/macrophages (CD4 + CCR5); infected microglia fuse into multinucleated giant cells with microglial nodules. Neurons are not infected but die from toxic cytokines/viral proteins → HIV-associated dementia. Bacterial meningitis: dexamethasone before/with antibiotics blunts this cytokine surge (best evidence for S. pneumoniae).
In HIV-associated dementia the cell infected is the microglia, not the neuron. In PML the cell infected is the oligodendrocyte (JC virus). Both happen in AIDS, so read the stem for "multinucleated giant cells" (HIV) vs "demyelinating white-matter lesions" (PML).
This ties the whole cast together: neurons die first (highest metabolic demand), then neutrophils, microglia/macrophages clean up, and astrocytes scar.
Most hypoxia-sensitive neurons: hippocampal CA1 pyramidal cells, cerebellar Purkinje cells, neocortex layers 3, 5, 6 (laminar necrosis). Brain infarcts undergo liquefactive necrosis.
Neurons are permanent (post-mitotic) cells, like cardiac myocytes; lost neurons are replaced by gliosis. Irreversible ischemic injury → "red neurons" at 12–24 h (shrunken, eosinophilic cytoplasm, pyknotic nucleus, Nissl lost).
| Scheme | Categories |
|---|---|
| Structural | Unipolar · pseudounipolar (spinal ganglion) · bipolar (retina) · multipolar (most abundant) · amacrine |
| Directional | Afferent: periphery → brain/spinal cord · Efferent: away from brain/spinal cord (or away from the circuit in question) · Interneuron: connects neurons within a local circuit |
| Functional | Sensory vs motor · excitatory / inhibitory / modulatory · by neurotransmitter (e.g., dopaminergic) |
| Anatomical location | Cortical, hippocampal, cerebellar, etc. |
Afferent Arrives (to the CNS); Efferent Exits. Bipolar = Bipolar cells of the retina; Pseudounipolar = Posterior (dorsal) root ganglion.
| Structure | Main function | Key detail |
|---|---|---|
| Dendrites | Receive input | Unmyelinated, branched; postsynaptic receptors; spines; information travels distal → proximal toward the soma |
| Cell body (soma) | Metabolic + synthetic center; integrates input | Euchromatic nucleus, nucleolus, RER (Nissl), Golgi, mitochondria |
| Axon hillock | Origin of the axon; where the AP starts | No Nissl; highest Na⁺ channel density at initial segment |
| Axon | Conducts APs; transport highway | Usually one; microtubules, neurofilaments, SER; ± myelin; carries information away from the soma |
| Axon terminal | Releases NT | Site of small-molecule NT synthesis; presynaptic element |
| Synapse | Transfers information neuron → neuron/effector | Pre + cleft + post |
| Polymer | Size | Role in neurons | Board link |
|---|---|---|---|
| Microtubules | ~25 nm (thickest) | Tracks for axonal transport (kinesin/dynein); axon and dendrite shape | Tau (MAP) → neurofibrillary tangles in Alzheimer; vincristine/taxanes → neuropathy |
| Intermediate filaments (neurofilaments) | ~10 nm | Structural strength; set axon caliber | Neurofilament = neuronal marker (GFAP = astrocyte IF) |
| Actin (micro)filaments | ~7 nm (thinnest) | Growth cones, dendritic spines, presynaptic terminal | Spine shape changes in plasticity |
Fragile X syndrome (FMR1 CGG repeat) also shows excess long, thin, immature spines, the classic board example of a "dendritic spine disorder"; it is the most common inherited cause of intellectual disability and a known cause of autism.
Spine → glutamate → excitation. A grown-up spine "mushrooms": big flat head to hold lots of receptors.
The soma is the support and metabolic center. Neurons make huge amounts of protein for a huge cell, so the soma looks like a factory:
| Need | Feature | Why |
|---|---|---|
| Gene expression + protein synthesis | Euchromatic nucleus | Open chromatin, ready for RNA synthesis |
| Prominent nucleolus | Lots of rRNA for ribosomes | |
| Extensive rough ER | Protein synthesis (clumps = Nissl substance) | |
| Extensive Golgi | Post-translational modification and sorting | |
| Energy | Numerous mitochondria | ATP for pumps and synapses |
| Other | Many transport vesicles; dense scaffold (IFs, microfilaments, microtubules) | Ship enzymes and neuropeptides (only made here); some postsynaptic receptors; structural support |
Chromatolysis is a reaction to axonal injury (reversible, repair mode), not cell death. Loss of Nissl with a shrunken, eosinophilic soma and pyknotic nucleus = red neuron (irreversible ischemia). Swollen vs shrunken is the tell.
"Where are neurotransmitters made?" Small molecules → in the terminal (enzymes delivered anterogradely). Neuropeptides → in the soma (need RER/Golgi), then shipped. Don't answer "soma" for acetylcholine.
| Synapse type | Typical effect |
|---|---|
| Axodendritic (often on spines) | Usually excitatory (glutamate) |
| Axosomatic | Often inhibitory (GABA), strong control near the hillock |
| Axoaxonic | Modulates release (presynaptic inhibition) or blocks the initial segment |
| Feature | PNS | CNS |
|---|---|---|
| Myelin glia | Schwann cells break down myelin and form tubes that guide regrowth | Oligodendrocytes do not guide; myelin debris is inhibitory |
| Debris clearance | Fast: macrophages enter readily | Slow: microglia, BBB limits macrophage entry |
| Scar | Minimal | Glial scar (reactive astrocytes) |
| Regeneration | Possible (~1–3 mm/day) | Poor |
| Anterograde | Retrograde | |
|---|---|---|
| Direction | Away from the soma → axon terminals and dendrites | Toward the soma from terminals and dendrites |
| Motor | Kinesin | Dynein |
| Microtubule end | Toward the + end | Toward the − end |
| Cargo | Biosynthetic enzymes, organelles, receptors, neuropeptides | Endocytic vesicles, organelles, proteins, neurotrophins (growth factors) |
| Hijackers | Reactivated HSV/VZV traveling back to skin | Rabies, herpes viruses, tetanus toxin (also poliovirus) |
Kinesin Kicks cargo out to the terminal; Dynein Drags it back Down to the soma. Also: "retrograde returns".
Animal bite → replicates in muscle → binds nicotinic ACh receptor, enters nerve terminals → retrograde to spinal cord → brain → fatal encephalitis. Negri bodies (Purkinje, hippocampus). Long incubation (weeks–months); shorter for bites near the head.
Skin/mucosa → sensory terminals → retrograde to ganglion (trigeminal, dorsal root) → latency. Reactivation travels anterograde back → dermatomal lesions (cold sores, shingles).
Wound → toxin enters motor terminals → retrograde to spinal cord → taken up by inhibitory Renshaw interneurons → cleaves synaptobrevin → blocks GABA/glycine release → spastic paralysis, trismus, risus sardonicus.
Botulinum toxin acts at the peripheral presynaptic terminal (blocks ACh release at the NMJ → flaccid paralysis); tetanus toxin travels retrograde into the CNS to block inhibitory release (→ spastic paralysis). Both cleave SNARE proteins; the location differs.
1A 61-year-old man has 6 weeks of headaches and personality change. MRI shows a heterogeneous, ring-enhancing mass that crosses the corpus callosum into both frontal lobes. Biopsy shows necrotic foci surrounded by rows of tumor cells and prominent vascular proliferation; tumor cells are strongly GFAP-positive. Which cell type gave rise to this tumor?
2A 34-year-old woman with relapsing-remitting multiple sclerosis has been treated with natalizumab for 3 years. She develops progressive right arm weakness, aphasia and confusion over 2 months. MRI shows multiple non-enhancing lesions in subcortical white matter without mass effect. Which cell is the primary target of the responsible agent?
3A 9-year-old boy is bitten on the calf by a raccoon. Seven weeks later he develops fever, agitation, hydrophobia and pharyngeal spasms. The agent traveled from the bite site to the central nervous system mainly by which mechanism?
4A mouse line carries a loss-of-function mutation in a microtubule plus-end-directed motor protein expressed in motor neurons. Which finding is most expected in these neurons?
5A 27-year-old woman has painful monocular vision loss that resolves, then months later develops numbness of the legs. MRI shows ovoid periventricular white-matter lesions perpendicular to the ventricles. CSF shows oligoclonal IgG bands. Which process best explains her lesions?
6A patient with Parkinson disease is given levodopa with carbidopa. Dopamine itself is ineffective when given intravenously because it cannot enter the brain. Which structure is chiefly responsible for keeping dopamine out?
7A 70-year-old man has a left MCA ischemic stroke and receives thrombolysis with good reperfusion. Over the next 3 days, follow-up imaging shows enlargement of the infarct. Experimental blockade of TNF-α and IL-1β limits this expansion. Which cells are the main source of these cytokines in the brain parenchyma?
8A 66-year-old woman is resuscitated after a 12-minute cardiac arrest and dies 20 hours later. Microscopy of the hippocampal CA1 region would most likely show which change in pyramidal neurons?
9A 25-year-old man has a complete laceration of the ulnar nerve at the elbow that is surgically repaired. Two weeks later, which change is most likely in the cell bodies of the injured motor neurons in the spinal cord?
10In a myelinated CNS axon, action potentials travel quickly because the impulse is regenerated only at discrete points. At which location is the density of voltage-gated Na⁺ channels along the myelinated portion of the axon greatest?
11Golgi-stained cortical neurons from a patient with a neurodevelopmental disorder show increased numbers of long, thin dendritic protrusions and few spines with large flat heads on short necks. Which statement about the missing spine type is correct?
12A 42-year-old man with untreated HIV (CD4 count 60/µL) has slowly progressive memory loss, apathy and psychomotor slowing. Brain biopsy shows microglial nodules and multinucleated giant cells. Which statement best describes the cellular basis of his disease?
13An unvaccinated 50-year-old man steps on a rusty nail. Ten days later he has jaw stiffness, a fixed grimace and generalized muscle spasms triggered by noise. The responsible toxin reaches its target cells by which route, and what does it block there?