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joeli unit 3 > CVA, ICH, Cerebral flow > Flashcards

CVA, ICH, Cerebral flow Flashcards

1
Q

which artery provides posterior circulation

A

vertebral artery

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2
Q

supplies brainstem, cerebellum, posterior cerebrum

A

vertebral A

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3
Q

ACA affects mostly

A

the leg

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4
Q

MCA affects mostly

A

the arm and face

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5
Q

PCA affects

A

vision and hearing

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6
Q

PICA affects/causes

A

cerebellar signs

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7
Q

supplies brainstem and cerebellar

A

basilar artery

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8
Q

large artery of basilar artery causes

A

permanent disability, coma, death

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9
Q

what other specific types of symptoms can occlusion of basilar artery cause

A

bulbar symptoms (facial weakness, dysphonia, dysarthria, limited jaw movement, ocular symptoms)

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10
Q

basilar artery can cause pontine ischemia affecting which cranial nerves

A

5
6
7
8

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11
Q

most common symptom if extracranial vertebral artery affected

A

dizziness

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12
Q

what can cause extracranial vertebral artery ischemia/occlusion

A

atherosclerosis
compression near upper cervical vertebra in elderly

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13
Q

what does the epidural space contain

A

meningeal arteries

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14
Q

causes of subdural hematoma

A

shearing force
atrophy in brain in elderly
AD
shaken baby

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15
Q

most common type of stroke (80-85%)

A

ischemic stroke

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16
Q

stroke caused by LOCAL obstruction

A

thrombosis

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17
Q

what can cause thrombotic stroke

A

arteriosclerosis

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18
Q

stroke caused by debris originating elsewhere and moving to cerebral vasculature

A

embolism

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19
Q

what can cause embolic stroke

A

clot caused by atrial fibrillation

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20
Q

stroke caused by general circulatory problem which can be due to cardiac failure leading to widespread hypoperfusion

A

systemic hypoperfusion

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21
Q

hemorrhagic stroke/bleed within the brain

A

intracerebral stroke

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22
Q

hemorrhagic stroke/bleed surrounding the brain into CSF

A

subarachnoid

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23
Q

HTN, trauma, drug use causes what type of hemorrhagic stroke

A

intracerebral

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24
Q

where does lacunar infarct commonly occur

A

basal ganglia
pons
subcortical white matter

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25
Q

lacunar infarct is primarily caused by

A

lipohyalinosis

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26
Q

what is the biggest risk factor is lacunar infarct

A

HTN

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27
Q

in the ischemic cascade we switch from __ to ____

A

aerobic pathway to anaerobic pathway

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28
Q

decreased and absent blood supply and how it affects glucose and oxygen

A

decreased glucose and oxygen

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29
Q

increase in sodium causes what

A

influx of water causing CYTOTOXIC EDEMA

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30
Q

what other ion besides sodium will remain in the cell during the ischemic cascade

A

calcium

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31
Q

increased in calcium causes too much release of what NT

A

glutamate

32
Q

calcium buildup causes what enzymes to be released

A

protease
lipase

33
Q

anaerobic pathway causes increased

A

lactic acid

34
Q

area affected directly by ischemia

A

ischemic core

35
Q

area surrounding ischemic core

A

ischemic penumbra

36
Q

alteplase should be given within

A

4.5 hours, ideally within 3

37
Q

mechanical thrombectomy can be performed for what

A

large artery
anterior circulation clot

38
Q

when can mechanical thrombectomy be performed

A

within 24 hours of last known well

39
Q

first image performed in someone suspected for stroke

A

non-contrast CT

40
Q

when should imaging be performed

A

within 25 min

41
Q

when should image be interpreted

A

within 45 min

42
Q

apraxia is what type of disorder

A

a cognitive disorder

43
Q

is apraxia a primary motor disorder

A

no

44
Q

apraxia commonly results due to damage to what lobe

A

parietal

45
Q

aphasia usually occurs do to damage to what hemisphere

A

left hemisphere

46
Q

in what type of aphasia do patients sometimes have right hemiparesis

A

broca’s aphasia

47
Q

in what type of aphasia do patients sometimes have right superior visual field defect

A

wernicke’s aphasia

48
Q

in what type of aphasia is motor spared

A

wernicke’s aphasia

49
Q

what types of cells regulate cerebral blood flow

A

pericytes

50
Q

where is CSF primarily produced

A

lateral and third ventricles

51
Q

how much CSF is produced

A

600-700 mL

52
Q

in what space does communicating hydrocephalus occur

A

subarachnoid

53
Q

common causes of communicating hydrocephalus

A

subarachnoid hemorrhage
infection/meningitis

54
Q

common causes of non-communicating hydrocephalus

A

tumor
stenosis

55
Q

occlusion of what 4 places can cause hydrocephalus

A

interventricular foramen
cerebral aqueduct
foramen of magende
foramen of Luschka

56
Q

early response in increased ICP

A

CSF displaced into lumbar cistern
decreased cerebral blood flow

57
Q

late response in increased ICP

A

reduced production of CSF
increased absorption of CSF

58
Q

when body is unable to compensate for increased ICP

A

brain herniation

59
Q

what lobe is herniated downwards in uncle herniation

A

temporal lobe

60
Q

what nerve is affected in uncal herniation

A

cranial nerve 3

61
Q

compression of cranial nerve 3 causes

A

ipsilateral dilation of pupil

62
Q

uncal herniation compresses what two arteries

A

PCA
basilar A

63
Q

compression of PCA in uncal herniation can cause

A

occipital CVA + homonymous hemianopia

64
Q

compression of basilar A in uncal herniation can cause

A

decreased supply to brainstem

65
Q

what herniation is associated with kernohan’s notch

A

uncal herniation

66
Q

external herniation

A

transcalvarial herniation

67
Q

cingulate gyrus herniates under falx cerebri

A

cingulate herniation

68
Q

what artery is compressed in cingulate herniation

A

ACA –> CVA

69
Q

which type of herniation often precedes other supratentorial hernations

A

cingulate herniation

70
Q

diencephalon slipped under tentorium

A

central herniation

71
Q

what nerve palsy do we see in central herniation

A

CN6

72
Q

someone with tonsillar herniation commonly presents with

A

headache
neck pain

73
Q

what arteries does the subclavian supply

A

brachial A
axillary A

74
Q

from what artery does the subclavian artery steal from

A

vertebral A

75
Q

does blood flow anterogradely or retrogradely in subclavian steal

A

retrogradely

joeli unit 3 (7 decks)

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