HOYADOCS
Block 6 · CNS · CNS01 · Rev 1.2 · Updated Oct 23, 2026
CNS01 · Neuroscience · Study Guide

Cells of the CNS: Glia and Neurons

Learning objectives

  1. LO 1Name each type of CNS glial cell and explain what makes it distinctive and what jobs it performs.
  2. LO 2Explain how glial cells cause or worsen neurologic disease (tumors, demyelination, neuroinflammation).
  3. LO 3Describe how a neuron is built (cytoskeleton, dendrites, soma, axon hillock, axon, terminal, synapse) and what each part is for.
  4. LO 4Explain why neurons depend on axonal transport, which motors run it, and what travels each way.
★ Step 1 HY ⚠ Step 1 trap ✎ Memory tool “ Buzzwords

MAPBig picture

CNS cells Glia (LO 1–2) Neurons (LO 3–4) Astrocyte GFAP+ · star-shaped BBB endfeet · K⁺/glutamate scar (astrogliosis) → astrocytoma, GBM Oligodendrocyte myelinates many axons interfascicular (white) perineuronal (gray) → MS, PML Microglia resident macrophage ramified → amoeboid M1 toxic · M2 protective → HIV, stroke, AD/PD Structure dendrite → soma → hillock → axon → terminal → synapse → autism spines Transport kinesin: out (antero) dynein: back (retro) runs on microtubules → rabies, HSV, tetanus Glia keep neurons working: insulation · barrier · ion & neurotransmitter cleanup · immune defense

LO 1The glial cells of the CNSWho they are, where they live, what they do

By the end: you can place each glial type in gray or white matter, name its marker or defining feature, list its jobs, and explain how myelin speeds conduction.
Q1. What cell types are in the CNS, and how do gray and white matter differ?
  • Two big families: neurons and glia (non-neuronal cells). The three differentiated glia of the mature CNS are astrocytes, oligodendrocytes and microglia.
  • Other cells you will meet: specialized (non-fenestrated) capillary endothelium + its basement ("basilar") membrane, and ependymal cells lining the ventricles.
FeatureGray matter (neuropil)White matter
Neuron cell bodiesNumerousFew
Myelinated axonsFewMany (axon tracts)
Astrocyte typeProtoplasmic (with endfeet)Fibrous (lie along axons)
Oligodendrocyte typePerineuronal (hug cell bodies; no myelin)Interfascicular (make myelin)
MicrogliaPresent in both
Capillary endothelium + basement membranePresent in both
  • Why is white matter white? All that lipid-rich myelin (≈80% lipid).
CheckA biopsy of the corpus callosum is stained for glia. Which astrocyte and oligodendrocyte subtypes dominate?
The corpus callosum is white matter → fibrous astrocytes and interfascicular (myelinating) oligodendrocytes, plus microglia.
Memory tool

Protoplasmic + Perineuronal live with the cell-body Parenchyma (gray). Fibrous + Interfascicular line the Fiber tracts (white).

Q2. What makes a cell a "glial" cell, and how do the three types look?
  • Non-neuronal: they do not fire action potentials.
  • Have complex processes extending from the cell body (for contact and communication).
  • Can divide and give rise to new glia (all three types proliferate) → contrast: mature neurons do not divide.
  • Jobs: help define synaptic contacts, maintain neurons' signaling ability, maintain CNS homeostasis.
Drawings of an astrocyte with dense star-shaped processes, an oligodendrocyte with fewer long processes, and a small microglial cell
Size order: astrocyte (largest, dense star) > oligodendrocyte (fewer, long processes reaching axons) > microglia (smallest).
CheckWhy do primary brain tumors arise from glia rather than from mature neurons?
Glia keep the ability to divide; mature neurons are post-mitotic. Disordered glial division → gliomas.
Step 1 trap

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.

Q3. What are astrocytes and what do they do?
GFAP immunostain showing brown star-shaped astrocytes with an endfoot contacting a vessel
GFAP stain (brown): star-shaped astrocytes, one sending an endfoot onto a vessel.

Astrocyte features

  • Most abundant and largest glial cell; star-shaped ("astro").
  • Can divide → astrogliosis (reactive proliferation).
  • Protoplasmic (gray matter) have specialized endfeet; fibrous in white matter.
  • Processes contact neuronal cell bodies, dendrites, axons, vessels and capillaries.
  • One astrocyte can contact ~10⁵ synapses.
  • Astrocytes produce glial fibrillary acidic protein (GFAP), an intermediate filament: the marker that identifies them.

The four big jobs: Grow, Guide, Guard, Govern

JobWhat 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)
  • Blood–brain barrier with CNS endothelial cells → keeps out proteins and charged molecules.
  • Glia limiting membrane: astrocyte endfeet + pial cells against the pia mater.
  • Scar formation after injury (walls off damaged tissue, especially if the BBB is breached).
Govern (homeostasis)
  • Regulate extracellular ions (K⁺ buffering) needed for neuronal depolarization.
  • Control blood flow by signaling vessels when more O₂/glucose is needed (the basis of the fMRI signal).
  • Control water flow and metabolite removal.
  • Supply energy and substrates for neurotransmission.
  • Rapidly remove neurotransmitters from the cleft → recycle glutamate and GABA.
blood Astrocyte (GFAP+) Tight junctions between endothelial cells Astrocyte endfeet wrap the vessel Basement membrane Endothelium: no fenestrae, few vesicles Crosses: small, lipid-soluble, nonpolar (O₂, CO₂, ethanol, L-dopa via a carrier) Blocked: proteins, charged/polar molecules (e.g., dopamine)
The blood–brain barrier: endothelial tight junctions do most of the sealing; astrocyte endfeet induce and maintain them.
Electron micrograph of a synapse: presynaptic terminal (green), postsynaptic dendritic spine (yellow) and an astrocyte process (blue) beside the synapse
The tripartite synapse: presynaptic terminal (green), postsynaptic spine (yellow) and an astrocyte process (blue) right next to the cleft.

Astrocytes at the synapse

  • Processes sit beside the synapse and take up released glutamate and GABA.
  • Glutamate → glutamine (glutamine synthetase) → handed back to the neuron to remake transmitter.
  • Have NT receptors (respond with Ca²⁺ rises), but no action potentials.
CheckWhat two cell types together form the BBB, and what forms the glia limiting membrane?
BBB = CNS endothelial cells + astrocyte endfeet. Glia limiting membrane = astrocyte endfeet + pial cells at the brain surface.
Step 1 HY — astrocytes & the BBB
  • BBB = tight junctions of non-fenestrated endothelium + basement membrane + astrocyte foot processes.
  • Levodopa crosses (carrier), dopamine does not; carbidopa stays peripheral, which is the point of pairing them.
  • No BBB at circumventricular organs (area postrema → vomiting; OVLT → osmolarity; posterior pituitary, median eminence).
  • Tumor/infarct disrupts the BBB → vasogenic edema.
  • Hyperammonemia: astrocytes detoxify NH₃ into glutamine → swollen Alzheimer type II astrocytes in hepatic encephalopathy.
  • Injury → reactive gliosis: the CNS scars with astrocytes, not collagen.
Step 1 trap

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.

Memory tool

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⁺).

Buzzwords
"GFAP-positive" → astrocyte origin "endfeet" → protoplasmic astrocytes / BBB "radial glia" → neuronal migration scaffold "astrogliosis / glial scar" → reactive astrocytes "tripartite synapse" → astrocyte at the cleft
Q4. What are oligodendrocytes, and what is myelin made of?
Interfascicular oligodendrocytePerineuronal oligodendrocyte
WhereWhite matterGray matter
Myelinates?Yes: the main job of oligodendrocytesNo: surrounds neuronal cell bodies
Proposed roleMyelin → fast conductionSupport neurons via secreted soluble molecules (growth factors?)
  • Found in both gray and white matter; can divide.
  • One oligodendrocyte myelinates several axons (one internode on each; up to dozens) ↔ a PNS Schwann cell myelinates one internode of one axon.
  • Myelin = oligodendrocyte plasma membrane wrapped repeatedly and tightly around an axon segment (a myelin segment).
    • Protein + phospholipid with a high lipid:protein ratio (~80% lipid : 20% protein).
    • Contains proteins unique to CNS myelin, e.g., myelin basic protein (MBP), used as an identifier.
    • Insulates the axon → high resistance → impulses travel quickly.
CNS: oligodendrocyte cell body 1 cell → internodes on many axons PNS: Schwann cell Schwann nucleus node of Ranvier 1 cell → 1 internode of 1 axon
Why it matters: lose one oligodendrocyte and several axons lose myelin at once; the PNS can regrow along Schwann-cell tubes.
Colorized electron micrograph of myelinated axons: blue axoplasm with microtubule dots surrounded by thick dark concentric myelin lamellae
EM of myelinated axons: blue axoplasm (dots = microtubules/neurofilaments) wrapped in many dark, tightly compacted membrane layers.
CheckA section of gray matter shows oligodendrocytes clustered around neuron cell bodies. Are they making myelin?
No. Those are perineuronal oligodendrocytes: they hug cell bodies and are thought to support neurons with secreted molecules. Myelin comes from interfascicular (white-matter) oligodendrocytes.
CheckWhich protein is unique to CNS myelin and later becomes an autoimmune target?
Myelin basic protein (MBP).
Step 1 HY — oligodendrocyte vs Schwann cell
  • Oligodendrocyte: CNS, neuroectoderm, many axons, "fried egg" look on H&E; destroyed in MS, PML, leukodystrophies.
  • Schwann cell: PNS, neural crest, one axon segment, S-100+; target in Guillain–Barré; tumor = schwannoma.
  • Schwann cells also promote axon regeneration; oligodendrocyte myelin debris inhibits it.
Step 1 trap

"Demyelinating disease + CNS" = oligodendrocyte (MS, PML). "Demyelinating disease + ascending weakness, areflexia" = Schwann cell (Guillain–Barré). Same process, different glia, different nervous system.

Q5. How does myelin make conduction fast? (internodes, nodes, saltatory conduction)
  • The sheath is not continuous: each myelinated stretch = an internode; the bare gap between = a node of Ranvier.
  • Internode: insulated, high resistance, few channels → current flows down the axon instead of leaking out.
  • Node: lower resistance, packed with voltage-gated Na⁺ channels → the action potential is regenerated here (K⁺ channels cluster nearby).
  • The AP "leaps" node → node = saltatory conduction (Latin saltus, to leap).
  • Payoff: faster and cheaper. Without myelin, channels (and Na⁺/K⁺-ATPase work) would be needed along the whole axon.
AP jumps node → node (saltatory conduction) Internode: myelin, high resistance Node of Ranvier: Na⁺ channels, low resistance fast + low ATP cost
CheckAn axon of the same diameter loses its myelin. Predict conduction velocity and energy use.
Velocity falls (current leaks out of a low-resistance membrane; no saltatory jumps, sometimes complete conduction block) and energy cost rises (channels and pumps needed along the whole axon).
Step 1 HY

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.

Memory tool

Saltatory = salta (Spanish/Latin "jump"). Picture a frog hopping from lily pad (node) to lily pad, skipping the insulated water (internode).

Q6. What are microglia and how do they switch on?

Microglia features

  • Smallest glia; in both gray and white matter; can divide.
  • The resident immune cells of the brain (macrophage-like).
  • Actively migrate to monitor the CNS; survey for damage/infection and phagocytose debris.
  • Hallmark: rapid activation in response to pathology.
  • Surface receptors bind viral, bacterial and other pathogen molecules → activation.
  • Development + plasticity: clear cells dying by normal programmed cell death and prune synapses throughout life.
Silhouettes of microglia ranging from highly branched ramified cells at the top to a small round amoeboid cell at the bottom
From ramified (branched, resting/surveying) at top to amoeboid (activated) at bottom.
StateShapeBehavior
RestingRamified: small body, many fine branchesSurveying the environment
ActivatedAmoeboid: large body, retracted processesMacrophage-like: phagocytose, release lots of cytokines
Activation phenotypeInflammatory profileEffect on neurons
M1Pro-inflammatory (TNF-α, IL-1β)Neurotoxic
M2Anti-inflammatoryNeuroprotective

Real activation is more complicated: there are likely additional subtypes and transition states between M1 and M2.

CheckWhich glial cell removes excess synapses during development?
Microglia, by synaptic pruning (phagocytosing spines/synapses). They also clear developmentally dying neurons.
Step 1 HY — origin

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.

Memory tool

M1 = 1st responder: attacks (toxic). M2 = 2nd: cleans up and repairs (protective). Ramified = "branches out to watch"; amoeboid = "rolls up its sleeves to eat".

Q7. Board extension: how do the CNS glia compare with ependymal cells and PNS glia?
CellOriginMarker / featureClassic disease links
AstrocyteNeuroectodermGFAP; endfeet; K⁺/glutamateAstrocytoma, GBM, pilocytic astrocytoma; reactive gliosis
OligodendrocyteNeuroectodermMyelinates many CNS axons; "fried egg"MS, PML, leukodystrophies, oligodendroglioma
MicrogliaMesoderm (yolk-sac macrophage)CNS phagocyteHIV (multinucleated giant cells), neuroinflammation
Ependymal cellNeuroectodermCiliated cells lining ventricles/central canal; choroid plexus ependyma make CSFEpendymoma (perivascular pseudorosettes)
Schwann cellNeural crestS-100; myelinates one PNS axon segmentGuillain–Barré, schwannoma (CN VIII; bilateral = NF2)
Satellite cellNeural crestSurround neuron bodies in PNS gangliaSurround the sensory ganglion neurons where HSV/VZV hide latent
CheckWhich glial cell is derived from mesoderm?
Microglia. Everything else in the CNS glial family is neuroectodermal; PNS glia are neural crest.
Buzzwords
"fried egg cells" → oligodendrocytes / oligodendroglioma "S-100" → Schwann cell (neural crest) "myelin basic protein" → CNS myelin, MS antigen "ramified vs amoeboid" → resting vs activated microglia "saltatory" → node-to-node AP

Image drill · Michigan SecondLook

How to use: name what you see, then tap the card to check. Images credited to the Michigan SecondLook Anki Deck (University of Michigan Medical School).
Unlabeled image for SecondLook drill item 11 · Name the black, star-shaped cells and two of their jobs. (tap for answer)
Astrocytes: star-shaped cells with many radiating processes.
Functions: structural support; metabolic support and K⁺/ion homeostasis; modulate synaptic activity; take up and recycle neurotransmitters (glutamate → glutamine); contribute to the blood–brain barrier (end-feet); promote myelination and repair (glial scar).Annotated answer image for item 1
Image: Michigan SecondLook Anki Deck · SecondLook Neuroanatomy (Michigan Virtual Microscopy Slide Collection), University of Michigan Medical School · CC BY-NC-SA 4.0
Unlabeled image for SecondLook drill item 22 · Which cells line the surfaces at the arrows, and what do they make? (tap for answer)
Ependymal cells: a cuboidal-to-columnar, ciliated epithelium that lines the ventricles and the central canal of the spinal cord.
Over the choroid plexus they form the choroid plexus epithelium, which secretes cerebrospinal fluid (CSF).Annotated answer image for item 2
Image: Michigan SecondLook Anki Deck · SecondLook Neuroanatomy (Michigan Virtual Microscopy Slide Collection), University of Michigan Medical School · CC BY-NC-SA 4.0
Unlabeled image for SecondLook drill item 33 · What do the arrows mark, and where are the voltage-gated Na⁺ channels? (tap for answer)
Nodes of Ranvier: gaps between myelin segments (the axon runs through the middle of each node).
Voltage-gated Na⁺ channels cluster at the nodes, between the paranodal junctions, not under the myelin.
Result: saltatory conduction; the action potential jumps node to node, up to ~100× faster.Annotated answer image for item 3
Image: Michigan SecondLook Anki Deck · SecondLook Neuroanatomy (Michigan Virtual Microscopy Slide Collection), University of Michigan Medical School · CC BY-NC-SA 4.0

ApplyLO 1 application questions

A1A researcher knocks out the glutamate transporters on astrocytes in mice. What happens to synaptic glutamate, and why might neurons die?
Glutamate lingers in the cleft → excitotoxicity. Astrocytes normally clear glutamate rapidly (and recycle it as glutamine); without uptake, NMDA/AMPA receptors are over-stimulated → Ca²⁺ overload → neuron death.
A2A drug is a large, highly charged molecule. Will it reach the brain parenchyma from the bloodstream? Which structure stops it?
No. The BBB (endothelial tight junctions supported by astrocyte endfeet) restricts proteins and charged molecules; small lipid-soluble drugs cross, charged ones do not.
A3A single oligodendrocyte dies. Why can this affect more axons than the death of a single Schwann cell?
One oligodendrocyte myelinates internodes on several axons; a Schwann cell supplies one internode of one axon. So each oligodendrocyte loss demyelinates multiple axons at once.
A4After a contusion, brain tissue around the lesion becomes densely positive for GFAP over the next weeks. Interpret.
Reactive astrogliosis forming a glial scar. Astrocytes proliferate and wall off the injury (especially where the BBB is damaged); GFAP marks them.

LO 2Glia in neurologic diseaseTumors, demyelination and neuroinflammation

By the end: you can link each disease to the glial cell at fault: astrocytes → gliomas/GBM; oligodendrocytes → MS, PML and other myelin injury; microglia → HIV, neurodegeneration, secondary stroke injury and meningitis.
Q1. Which glial cells form tumors, and what is glioblastoma?
  • Gliomas can arise from almost any glial cell (they can divide → can divide badly).
  • Astrocytomas are the most common glial tumor.
    • Graded I–IV by degree of differentiation (better differentiated = lower grade).
  • Glioblastoma (multiforme), GBM = malignant grade IV astrocytoma; poor survival.
Left: contrast MRI with a ring-enhancing mass in the right temporal lobe (arrows). Right: H and E of normal cortex with scattered neurons beside densely hypercellular glioblastoma
Left: contrast MRI, ring-enhancing temporal-lobe GBM (arrows). Right: normal cortex (sparse cells, pink neuropil) vs glioblastoma (sheets of crowded, atypical glial nuclei).

Glioblastoma astrocyte

Adult, cerebral hemispheres; can cross the corpus callosum ("butterfly glioma"); ring enhancement; pseudopalisading necrosis + vascular proliferation; GFAP+. Median survival ~1 yr.

Pilocytic astrocytoma astrocyte

Child, cerebellum; cystic with mural nodule; Rosenthal fibers, eosinophilic granular bodies; GFAP+; benign (grade I).

Oligodendroglioma oligodendrocyte

Adult, frontal lobe, seizures, often calcified; "fried egg" cells, "chicken-wire" capillaries; 1p/19q co-deletion.

Ependymoma ependymal

Child, 4th ventricle → hydrocephalus; perivascular pseudorosettes.

Schwannoma Schwann

CN VIII at cerebellopontine angle → hearing loss, tinnitus; S-100+; bilateral = NF2.

CheckWhat is the most common glial tumor overall, and what is its most malignant form?
Astrocytoma; the most malignant is GBM (grade IV astrocytoma).
Step 1 HY — glial tumors
  • GFAP+ tumor = astrocytic (GBM, pilocytic astrocytoma).
  • GBM: pseudopalisading necrosis, butterfly glioma, ring-enhancing; Rx resection + radiation + temozolomide (+ bevacizumab).
  • Current classification: "glioblastoma" is reserved for IDH-wildtype grade 4 adult tumors; boards still say GBM.
  • Adults: mostly supratentorial (GBM, meningioma, metastases). Children: mostly infratentorial (pilocytic astrocytoma, medulloblastoma, ependymoma).
Step 1 trap

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).

Q2. How do oligodendrocytes and myelin fail in disease (MS, PML, other injury)?

Multiple sclerosis (MS)

  • An idiopathic inflammatory demyelinating disease in which oligodendrocytes and myelin sheaths degenerate.
BBB breachbarrier compromised
→
Antigen exposedCNS-unique myelin proteins (e.g., MBP)
→
Autoimmunityinfiltrating peripheral immune cells (T and B cells)
→
Demyelinationoligodendrocyte + myelin loss → slowed/blocked conduction
Axial FLAIR MRIs showing multiple bright ovoid white-matter lesions next to the lateral ventricles
FLAIR MRI: multiple bright periventricular white-matter plaques of MS.

Progressive multifocal leukoencephalopathy (PML)

  • A rare, fatal viral disease caused by the JC virus (human polyomavirus 2).
  • The virus destroys oligodendrocytes → multifocal white-matter demyelination.
  • Seen with immunosuppression (AIDS, natalizumab, rituximab).

Other cerebral injury that damages myelin

  • Infarcts, infections, premature birth, hypoxia/ischemia, leukodystrophies.
Multiple sclerosisGuillain–Barré syndrome
Myelin cell hitOligodendrocyte (CNS)Schwann cell (PNS)
Classic patientYoung woman; relapsing-remitting episodesAfter Campylobacter or viral infection
SignsOptic neuritis, INO, UMN signs, sensory loss, Lhermitte signAscending symmetric weakness, areflexia, autonomic instability
CSF↑ IgG, oligoclonal bands↑ protein, normal cells (albuminocytologic dissociation)
ImagingPeriventricular plaques ("Dawson fingers")Nerve conduction: slowed velocity
CheckWhy does a breach of the BBB matter in MS?
It lets peripheral immune cells meet CNS-unique myelin proteins like MBP that they were never tolerized to → autoimmune attack on myelin and oligodendrocytes.
Step 1 HY — demyelination
  • MS Rx: acute attack → high-dose steroids; disease-modifying → interferon-β, glatiramer, natalizumab (anti-α4 integrin; blocks leukocyte entry across the BBB, but ↑ PML risk), ocrelizumab, fingolimod.
  • PML: AIDS with CD4 <200; non-enhancing multifocal white-matter lesions; JC virus.
  • Leukodystrophies: metachromatic (arylsulfatase A), Krabbe (galactocerebrosidase, globoid cells), adrenoleukodystrophy (VLCFA, ABCD1, X-linked).
  • Osmotic demyelination (central pontine myelinolysis): overly rapid correction of hyponatremia.
Memory tool

PML = Polyoma Melts Lipid (myelin): JC virus eats the white-matter wiring in the immunosuppressed. MS = Myelin Spots hugging the ventricles.

Q3. When do microglia hurt the brain?
ConditionWhat microglia doResult
HIVAre targeted (infected) by the virusInflammation + neuron death (HIV-associated neurocognitive disorder)
Alzheimer's / Parkinson'sIncreased activationChronic brain inflammation
Stroke, traumaActivated microglia secrete neurotoxic TNF-α, IL-1βSecondary neuron death beyond the initial injury
Bacterial meningitisExcess TNF-α, IL-1βBBB opens → leukocyte infiltration → worse infection/inflammation
Primary injuryischemia / trauma
→
Microglia activateM1 / amoeboid
→
TNF-α, IL-1βpro-inflammatory, neurotoxic
→
2° neuron deathlesion grows over days
CheckWhich two cytokines from microglia link stroke secondary injury and meningitis-related BBB opening?
TNF-α and IL-1β.
Step 1 HY — HIV in the brain

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).

Step 1 trap

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).

Buzzwords
"multinucleated giant cells, microglial nodules" → HIV encephalitis "JC virus / polyomavirus" → PML, oligodendrocytes "oligoclonal bands" → MS "pseudopalisading necrosis" → GBM "butterfly glioma" → GBM crossing corpus callosum "Rosenthal fibers" → pilocytic astrocytoma
Q4. Board extension: in what order do neurons and glia respond after an ischemic injury?

This ties the whole cast together: neurons die first (highest metabolic demand), then neutrophils, microglia/macrophages clean up, and astrocytes scar.

After irreversible ischemic injury 12–24 h 24–72 h 3–5 d 1–2 wk > 2 wk Red neurons Nissl lost, eosinophilic Neutrophils acute inflammation Microglia / macrophages eat myelin debris Reactive gliosis + new vessels Glial scar / cyst astrocyte (GFAP) wall CNS heals by astrocytic gliosis, not by fibroblast collagen.
Step 1 HY

Most hypoxia-sensitive neurons: hippocampal CA1 pyramidal cells, cerebellar Purkinje cells, neocortex layers 3, 5, 6 (laminar necrosis). Brain infarcts undergo liquefactive necrosis.

Image ID drill: name the cell or disease

Brown-stained star-shaped cells with processes ending on a vesselCell and stain?
Astrocytes (GFAP stain) with an endfoot on a vessel.
Electron micrograph of axons wrapped by dark concentric lamellaeWhat wraps these axons?
Compact myelin; in the CNS from oligodendrocytes (~80% lipid).
Black silhouettes of branched and round glial cellsName the states.
Microglia: ramified (resting) → amoeboid (activated).
MRI with periventricular bright lesionsDiagnosis?
Multiple sclerosis: periventricular white-matter plaques; oligodendrocyte loss.
MRI ring-enhancing mass and hypercellular histologyTumor and cell of origin?
Glioblastoma: grade IV astrocytoma, GFAP+.

ApplyLO 2 application questions

A1A 58-year-old with headaches and new seizures has a mass crossing the corpus callosum. Biopsy shows necrosis surrounded by lined-up tumor cells. Cell of origin and stain?
Astrocyte; GFAP+ glioblastoma. Butterfly pattern + pseudopalisading necrosis = GBM, a grade IV astrocytoma.
A2A patient with MS has been on natalizumab for 3 years and develops progressive hemiparesis and cognitive decline with new non-enhancing white-matter lesions. What happened?
PML from JC virus reactivation, destroying oligodendrocytes. Natalizumab blocks immune-cell entry into the CNS, which lowers MS relapses but removes immune surveillance of JC virus.
A3Perfusion is restored 3 h after a stroke, but the infarct keeps enlarging over the next days. Which cells and molecules contribute?
Activated (M1-like) microglia releasing TNF-α and IL-1β → secondary neuron death.
A4In pneumococcal meningitis, why does inflammation itself make things worse?
Microglial TNF-α and IL-1β open the BBB → more leukocytes flood in, amplifying inflammation and injury (the rationale for adjunctive dexamethasone).

LO 3How a neuron is builtCytoskeleton, dendrites, soma, axon hillock, axon, terminal and synapse

By the end: you can trace a signal through every part of a neuron, say what each part is specialized for, classify neurons four ways, and predict how a neuron reacts when its axon is cut.
Q1. What makes neurons special compared with glia?
  • Main job: receive, process and send information.
  • Structurally specialized for long-distance electrical signaling and communication via synapses.
  • Scale: ~100 billion neurons, ~100 trillion synapses.
  • Never work alone: organized into neural circuits that together produce behavior (movement, learning, memory). "Brain cells fire in patterns."
  • Do not divide once mature and differentiated.
  • Highly metabolically active: need lots of O₂, ATP and glucose.
CheckWhy are neurons the first cells to die in global hypoxia?
They have the highest metabolic demand (O₂, glucose, ATP for pumps and synaptic activity) and little reserve, and they cannot divide to replace losses.
Step 1 HY

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).

Q2. How are neurons classified?
Multipolar most abundant; motor, pyramidal Bipolar retina, olfactory epithelium to periphery to spinal cord Pseudounipolar dorsal root (spinal) ganglion Unipolar one process from soma
Structural classes (purple = soma/dendrites, blue = axon). Amacrine cells (retina) are a fifth class: no true axon.
SchemeCategories
StructuralUnipolar · pseudounipolar (spinal ganglion) · bipolar (retina) · multipolar (most abundant) · amacrine
DirectionalAfferent: periphery → brain/spinal cord · Efferent: away from brain/spinal cord (or away from the circuit in question) · Interneuron: connects neurons within a local circuit
FunctionalSensory vs motor · excitatory / inhibitory / modulatory · by neurotransmitter (e.g., dopaminergic)
Anatomical locationCortical, hippocampal, cerebellar, etc.
CheckA sensory neuron in a dorsal root ganglion has one stalk that splits into a peripheral and a central branch. Structural class and directional class?
Pseudounipolar, afferent.
Memory tool

Afferent Arrives (to the CNS); Efferent Exits. Bipolar = Bipolar cells of the retina; Pseudounipolar = Posterior (dorsal) root ganglion.

Q3. What are the parts of a neuron and what does each do?
Soma: nucleus, Nissl (RER), Golgi Axon hillock → AP trigger zone myelin internode Node of Ranvier Axon: conducts APs Terminal: NT made + released Dendrites: receive anterograde · kinesin (soma → terminal) retrograde · dynein (terminal → soma)
Information flows dendrite → soma → hillock → axon → terminal; supplies flow both ways along the axon.
StructureMain functionKey detail
DendritesReceive inputUnmyelinated, branched; postsynaptic receptors; spines; information travels distal → proximal toward the soma
Cell body (soma)Metabolic + synthetic center; integrates inputEuchromatic nucleus, nucleolus, RER (Nissl), Golgi, mitochondria
Axon hillockOrigin of the axon; where the AP startsNo Nissl; highest Na⁺ channel density at initial segment
AxonConducts APs; transport highwayUsually one; microtubules, neurofilaments, SER; ± myelin; carries information away from the soma
Axon terminalReleases NTSite of small-molecule NT synthesis; presynaptic element
SynapseTransfers information neuron → neuron/effectorPre + cleft + post
  • Neurons also have an extensive plasma membrane and a complex, specialized cytoskeleton (next question).
Q4. What is the neuronal cytoskeleton made of, and why does it matter?
  • Gives neurons their shape and makes function possible; it is dynamic: supports growth of processes, the polarized shape, and transport to and from the soma.
  • Regulated by associated proteins, e.g., microtubule-associated proteins (MAPs).
PolymerSizeRole in neuronsBoard link
Microtubules~25 nm (thickest)Tracks for axonal transport (kinesin/dynein); axon and dendrite shapeTau (MAP) → neurofibrillary tangles in Alzheimer; vincristine/taxanes → neuropathy
Intermediate filaments (neurofilaments)~10 nmStructural strength; set axon caliberNeurofilament = neuronal marker (GFAP = astrocyte IF)
Actin (micro)filaments~7 nm (thinnest)Growth cones, dendritic spines, presynaptic terminalSpine shape changes in plasticity
CheckWhich cytoskeletal element do kinesin and dynein walk on?
Microtubules.
Step 1 HY — cytoskeleton
  • Tau is a MAP that stabilizes axonal microtubules; hyperphosphorylated tau → neurofibrillary tangles (Alzheimer, frontotemporal dementia/Pick bodies).
  • Intermediate filament stains: neurofilament (neurons), GFAP (glia/astrocytes), vimentin (mesenchyme), desmin (muscle), cytokeratin (epithelium).
  • Microtubule drugs (vincristine, paclitaxel) cause peripheral neuropathy by disrupting axonal transport.
Q5. What do dendrites and dendritic spines do?
  • Extensions of the soma that are not myelinated; usually extensively branched ("tree-like").
    • Primary dendrites branch off the soma; secondary dendrites branch off those.
  • Receive signals via postsynaptic receptors for neurotransmitters; information travels distal → proximal and converges on the soma.
  • Dendritic spines = small protrusions.
    • Spine heads are the major site of postsynaptic ionotropic glutamate (excitatory) signaling.
    • Mature spines are mushroom-shaped (flat head, short shaft) → more surface for receptors.
    • Spine number and shape change with activity (plasticity).
  • Clinical: autism is associated with more thin, immature spines → neurocognitive changes.
Diagram of dendritic spine shapes: filopodia, long thin, thin, stubby, mushroom and branched, above a micrograph of a dendrite studded with spines
Spine shapes from immature to mature: filopodia → long thin → thin → stubby → mushroom (mature) and branched; below, a real dendrite covered in spines.
CheckWhat is the mature spine shape, and what neurotransmitter dominates at spine heads?
Mushroom (flat head, short shaft); glutamate via ionotropic receptors (AMPA/NMDA).
Step 1 HY

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.

Memory tool

Spine → glutamate → excitation. A grown-up spine "mushrooms": big flat head to hold lots of receptors.

Q6. Why does the neuronal cell body look the way it does?

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:

NeedFeatureWhy
Gene expression + protein synthesisEuchromatic nucleusOpen chromatin, ready for RNA synthesis
Prominent nucleolusLots of rRNA for ribosomes
Extensive rough ERProtein synthesis (clumps = Nissl substance)
Extensive GolgiPost-translational modification and sorting
EnergyNumerous mitochondriaATP for pumps and synapses
OtherMany transport vesicles; dense scaffold (IFs, microfilaments, microtubules)Ship enzymes and neuropeptides (only made here); some postsynaptic receptors; structural support
CheckA Nissl stain shows the soma and proximal dendrites but not the axon. Why?
Nissl dyes stain rough ER/ribosomes, which are present in the soma and dendrites but absent from the axon hillock and axon.
Step 1 HY — Nissl & axon injury
  • Nissl substance = RER; in soma + dendrites, not in axon or axon hillock.
  • Axon cut → chromatolysis in the soma (peaks ~1–2 wk): soma swells, Nissl disperses, nucleus moves to the periphery = ↑ protein synthesis for repair.
  • Distal axon → Wallerian degeneration; proximal stump retracts and sprouts.
Step 1 trap

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.

Q7. What does the axon do, from hillock to terminal?
  • Arises from the soma at the axon hillock; ends at the axon terminal (presynaptic terminal).
    • Most neurons have a single axon.
    • The terminal is the site of small-molecule NT synthesis (e.g., ACh, glutamate, GABA, monoamines); neuropeptides are made in the soma and shipped down.
  • Transmits information via action potentials (rapid change in charge across the axonal membrane) to other neurons or effector cells (e.g., muscle).
  • Axoplasm: dense bundles of microtubules and neurofilaments (structure + transport of metabolites and organelles), smooth ER (lipid synthesis), mitochondria. No RER.
  • Myelin: CNS axons by oligodendrocytes, PNS axons by Schwann cells; others unmyelinated. Myelin ↑ conduction (internodes, nodes rich in ion channels, saltatory conduction).
CheckWhere is the action potential initiated, and why there?
At the axon hillock / initial segment: it has the highest density of voltage-gated Na⁺ channels, so it has the lowest threshold.
Step 1 trap

"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.

Q8. What is a chemical synapse made of, and where can synapses form?
  • Synapses let neurons work in circuits, transferring information neuron → neuron.
  • Three parts: presynaptic element (axon terminal with vesicles, mitochondria) → synaptic cleft → postsynaptic element (neurotransmitter receptors).
  • Postsynaptic contacts can be on dendrites (axodendritic), the cell body (axosomatic), along an axon or at axon terminals (axoaxonic). Many synapse types exist.
  • Add the astrocyte process and you have the tripartite synapse (LO 1).
Synapse typeTypical effect
Axodendritic (often on spines)Usually excitatory (glutamate)
AxosomaticOften inhibitory (GABA), strong control near the hillock
AxoaxonicModulates release (presynaptic inhibition) or blocks the initial segment
Buzzwords
"Nissl substance" → RER in soma/dendrites "mushroom spine" → mature spine "axon hillock / initial segment" → AP trigger zone "chromatolysis" → soma response to axon injury "Wallerian degeneration" → distal axon breakdown "red neurons" → 12–24 h after ischemia
Q9. Board extension: what happens when an axon is cut (CNS vs PNS)?
Somachromatolysis: swells, Nissl disperses, nucleus peripheral
Proximal axonretracts, then sprouts
Distal axonWallerian degeneration: axon + myelin break down, macrophages clear
FeaturePNSCNS
Myelin gliaSchwann cells break down myelin and form tubes that guide regrowthOligodendrocytes do not guide; myelin debris is inhibitory
Debris clearanceFast: macrophages enter readilySlow: microglia, BBB limits macrophage entry
ScarMinimalGlial scar (reactive astrocytes)
RegenerationPossible (~1–3 mm/day)Poor

Image drill · Michigan SecondLook

How to use: name what you see, then tap the card to check. Images credited to the Michigan SecondLook Anki Deck (University of Michigan Medical School).
Unlabeled image for SecondLook drill item 11 · Two cell types: name them. What is the Nissl substance? (tap for answer)
Neurons (large cells with prominent cell bodies) and glial cells (small, dark nuclei: the support cells).
Neuronal cell body = soma = perikaryon.
Nissl substance = rough endoplasmic reticulum (plus free ribosomes).Annotated answer image for item 1
Image: Michigan SecondLook Anki Deck · SecondLook Neuroanatomy (Michigan Virtual Microscopy Slide Collection), University of Michigan Medical School · CC BY-NC-SA 4.0

ApplyLO 3 application questions

A1A drug selectively blocks voltage-gated Na⁺ channels at the axon initial segment. What happens to the neuron's output?
Fewer or no action potentials are initiated, even with normal dendritic input, because the hillock/initial segment is the trigger zone.
A2A neuropathology study of a child with autism examines cortical dendrites. What spine change do you expect?
More thin, immature spines (fewer mature mushroom spines) → impaired connections and neurocognitive changes.
A3Ten days after a sciatic nerve laceration, the motor neuron cell bodies in the anterior horn look swollen with peripheral nuclei and pale cytoplasm. Interpret.
Chromatolysis: the soma disperses its Nissl and ramps up protein synthesis to regrow the axon. A reparative, not dying, response.
A4Which organelle would you find in a neuron's soma but not in its axon, and what stain shows it?
Rough ER (Nissl substance); shown by a Nissl stain (e.g., cresyl violet).

LO 4Axonal transportKinesin out, dynein back, and the pathogens that hitch a ride

By the end: you can explain why neurons need transport, name the motor and cargo for each direction, and predict which infections and toxins use it.
Q1. Why do neurons need a dedicated transport system?
  • Proteins (enzymes, receptors, neuropeptides) and organelles are made in the soma, yet the terminal may be up to a meter away.
  • The terminal and dendrites also need to send signals and worn-out material back.
  • So transport is critical for neuron function, is bidirectional and needs specialized motor proteins walking on microtubules.
Anterograde · kinesin → toward + end (terminal) enzymes, organelles (mitochondria), receptors, neuropeptides, synaptic vesicle proteins soma terminal − + microtubule Retrograde · dynein → toward − end (soma) endocytic vesicles, old organelles, neurotrophins (growth factors) hijacked by rabies, herpes viruses, tetanus toxin
Q2. What moves in each direction, and which motor carries it?
AnterogradeRetrograde
DirectionAway from the soma → axon terminals and dendritesToward the soma from terminals and dendrites
MotorKinesinDynein
Microtubule endToward the + endToward the − end
CargoBiosynthetic enzymes, organelles, receptors, neuropeptidesEndocytic vesicles, organelles, proteins, neurotrophins (growth factors)
HijackersReactivated HSV/VZV traveling back to skinRabies, herpes viruses, tetanus toxin (also poliovirus)
CheckA muscle releases a growth factor that must reach the motor neuron nucleus. Direction and motor?
Retrograde, dynein. Neurotrophins travel from the terminal back to the soma.
Memory tool

Kinesin Kicks cargo out to the terminal; Dynein Drags it back Down to the soma. Also: "retrograde returns".

Step 1 HY — speeds & defects
  • Fast transport (~200–400 mm/day) carries membrane-bound vesicles/organelles; slow transport (~1–8 mm/day) carries cytoskeletal proteins and soluble enzymes (sets the ~1 mm/day pace of nerve regrowth).
  • Dynein also powers cilia/flagella: dynein arm defect = primary ciliary dyskinesia (Kartagener).
  • Vincristine (blocks polymerization) and paclitaxel (blocks depolymerization) both cause peripheral neuropathy, since long axons depend most on transport.
Q3. How do pathogens use retrograde transport?

Rabies virus

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.

Herpes viruses (HSV, VZV)

Skin/mucosa → sensory terminals → retrograde to ganglion (trigeminal, dorsal root) → latency. Reactivation travels anterograde back → dermatomal lesions (cold sores, shingles).

Tetanus toxin

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.

Bite / woundagent at peripheral nerve terminal
→
Endocytosisinto the terminal
→
Dyneinretrograde up the axon
→
Soma / CNSspinal cord → brain
CheckHow did HSV-1 reach the trigeminal ganglion after a lip infection?
Retrograde axonal transport (dynein) from sensory terminals in the lip to the neuron's cell body in the ganglion.
Step 1 trap

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.

Buzzwords
"kinesin" → anterograde, + end "dynein" → retrograde, − end "Negri bodies" → rabies "trismus, risus sardonicus" → tetanus "neurotrophin signaling to nucleus" → retrograde

ApplyLO 4 application questions

A1A mutation impairs kinesin. What fails to reach the axon terminal?
Anterograde cargo: biosynthetic enzymes (including those that make small-molecule NTs), organelles like mitochondria, receptors and neuropeptides → the terminal starves.
A2A hiker bitten on the ankle by a bat has symptoms months later; another bitten on the face has symptoms in weeks. Explain.
Distance of retrograde transport. Rabies virus must travel by dynein up the axon to the CNS; a shorter path (face) means a shorter incubation.
A3A patient with lymphoma receiving vincristine develops numbness in the feet first. Why the longest nerves first?
Vincristine disrupts microtubules → impaired axonal transport; the longest axons (to the feet) depend most on transport, so they fail first (length-dependent neuropathy).
A4A farmer with a puncture wound develops jaw stiffness and painful spasms. How did the toxin get to its target?
Retrograde axonal transport of tetanus toxin from motor terminals to the spinal cord, where it blocks GABA/glycine release from inhibitory interneurons.

MCQPractice questionsClick an answer to see the explanation.

Score: 0 / 0

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?

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