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CVA Flashcards

1
Q

What are the two types of stroke?

A

ischemic (80)

hemmorrhagic (20)

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2
Q

Ischemic stroke

A

Most common

Result from thrombosis (static clot) or emboli (traveling clot, thrombi, tissue, fat, air, bacteria)

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3
Q

Hemorrhagic stroke

A

Bleeding into brain tissue
Can result from HTN, aneurysms, or head injury
Tend to be the MOST FATAL

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4
Q

Risk factors for stroke:

A

atherosclerosis
hypertension
cardiac disease
diabetes, metabolic syndrome

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5
Q

What is a Transient Ischemic Attacks?

A

brief warning episodes of dysfunction

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6
Q

Cerebral anoxia

A

lack of oxygen supply to the brain (irreversible anoxic damage to the brain begins after 4-6 mins)

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7
Q

Cerebral infarction:

A

irreversible cellular damage

death of a portion of the brain

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8
Q

Cerebral edema

A

accumulation of fluids within brain; causes further dysfunction; elevates intracranial pressures, can result in herniation and death

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9
Q

Lacunar infarcts:

A

Small clots located in the deep regions of the brainstem & subcortical structures

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10
Q

Where are lacunar infarcts usually found?

A

Found in deeply penetrating arteries that supply the internal capsule, basal ganglia, and brainstem

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11
Q

What do lacunar infarcts results from?

A

occlusion of smaller branches of larger cerebral arteries

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12
Q

Where do lacunar infarcts usually occur?

A

MCA and PCA

also Anterior Cerebral, Vertebral, & 
Basilar arteries

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13
Q

Emboli

A

Clots that dislodge from their site of origin & travel to a cerebral blood vessel where they become trapped and interrupt blood flow

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14
Q

Aneurysm:

A

Bulge occurring in a blood vessel wall as a result of a clot formation

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15
Q

Where do Berry aneurysms commonly occur?

A

in the Circle of Willis or the junction of 2 vessels

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16
Q

Transient Ischemic Attack (TIA)

A

“Mini strokes”

Characterized by focal ischemic cerebral incidents that last for less than 24 hours

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17
Q

Signs and symptoms of a TIA:

A

Numbness & mild weakness on 1 side of the body
Transient visual disturbances (blurred vision, fading vision)
Dizziness
Falls
Confusion & possible blackout

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18
Q

Common Areas of Arterial Occlusions in the Cortex

A

Middle Cerebral Arterial (MCA) Occlusion
Posterior Cerebral Arterial (PCA) Occlusion
Anterior Cerebral Arterial (ACA) Occlusion

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19
Q

What sensation is lost with ACA stroke?

A

sensation of lower limb

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20
Q

What sensation is lost with MCA stroke?

A

hemianesthesia affecting face and UL more than LL

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21
Q

What sensation is lost with PCA stroke?

A

hemianesthesia

slow pain in preserved

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22
Q

What sensation is lost with Basilar artery stroke?

A

bilateral sensory loss

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23
Q

What motor function is impaired with ACA stroke?

A

apraxia
hemiplegia (LE more affected then UE and face)
impaired gait

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24
Q

What motor function is impaired with MCA stroke?

A

Face and UE more impaired then LE; if striate artery involved additionally LE paresis or paralysis

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25
What motor function is impaired with PCA stroke?
hemiparesis
26
What happens to motor function with a PCA stroke if the lesion is near origin of artery?
vertical gaze palsy oculomotor nerve palsy loss of medial deviation of the eyes with preserved convergence vertical skew deviation of eyes
27
What motor function is impaired with Basilar artery stroke?
``` tetraplegia abducens nerve palsy locked in syndrome oculomotor nerve palsy decorticate or decerebrate paresis or paralysis of muscles of tongue,lips, palate, pharynx and larynx ```
28
Cognition with ACA stroke?
difficulty with convergent thinking
29
Cognition with left MCA stroke?
aphasia
30
Cognition with right MCA stroke?
difficulty understanding spatial relationships, neglect, impairment of nonverbal communication, dressing apraxia, constructional apraxia
31
Cognition with PCA stroke?
difficulty reading
32
Cognition with Basilar artery stroke?
reduced consciousness
33
Emotions and behavior with ACA stroke?
flat affect, impulsiveness, perseveration, confusion, motor inactivity
34
Emotions and behavior with right hemisphere MCA?
easily distracted poor judgement impulsiveness
35
Emotions and behavior with left hemisphere MCA?
apraxia compulsiveness overly cautious
36
Emotion and behavior with PCA stroke?
memory loss
37
Emotion and behavior with Basilar artery stroke?
none
38
Special senses and autonomic function with ACA stroke?
no changed
39
Special senses and autonomic function with MCA stroke?
homonymous hemianopia
40
Special senses and autonomic function with PCA stroke?
homonymous hemianopia, cortical blindness, hallucinations, lack of depth perception, impaired eye movements (except lateral and inferomedial), visual agnosia
41
Special senses and autonomic function with Basilar artery stroke?
vertigo, diplopia, vomiting, nausea, nystagmus, hearing loss, pupil contstriction
42
What does the ACA suply?
anterior 2/3 of the medial cerebral cortex
43
What does the MCA supply?
Supply the lateral cerebral cortex, basal ganglia and large portions of the internal capsule
44
Signs and symptoms of left hemisphere stroke:
dysarthria cautious behavior language/speech disorders difficulty understanding and producing language hemiparesis or hemiplegia and hemisensory loss (R side body and face)
45
Signs and symptoms of right hemisphere stroke:
hemiparesis or hemiplegia and hemisensory loss (L side body and face) left neglect impulsive behavior (unaware) unable to produce and comprehend emotional content of speech do not recognize errors
46
Where does the 2 vertebral arteries arise?
arise off the subclavian arteries
47
What do the 2 vertebral arteries supply?
supply the ventral surface of the medulla and the posterior inferior aspect of the cerebellum
48
Vertebral artery branches:
anterior spinal artery posterior spinal artery posterior inferior cerebellar artery
49
Basilar artery branches
superior cerebellar artery pontine arteries anterior inferior cerebellar artery
50
Posterior cerebral artery
central thalamoperforate arteries and thalamogeniculate arteries choroidal arteries callosal cortical branches
51
What does the basilar artery supply?
the ventral portion of the pons and terminates in the posterior cerebral artery
52
Medial Medullary Syndrome
Occlusion of the vertebral anterior branch of the lower basilar artery
53
What is impaired ipsilateral to lesion in Medial Medullary Syndrome?
paralysis of ½ of tongue
54
What is impaired contralateral to lesion in Medial Medullary Syndrome?
hemiplegia UE/LE | impaired sensation
55
Lateral Medullary Syndrome
occlusion of vertebral posterior inferior cerebellar or basilar artery Wallenberg's Syndrome
56
What is impaired ipsilateral to lesion in Lateral Medullary Syndrome?
Cerebellar symptoms (ataxia, vertigo, nystagmus) Loss of pain and temperature face Sensory loss UE, trunk or LE
57
What is impaired contralateral to lesion in Lateral Medullary Syndrome?
Loss of pain and temperature to body and face
58
Horner's Syndrome:
miosis, ptosis, decreased sweating), Dysphagia, impaired speech
59
Basilar Artery Syndrome
brainstem signs and symptoms and PCA signs and symptoms | locked in syndrome
60
Locked in syndrome
Tetraplegia Lower bulbar paralysis (CN V-XII) level of Pons Mutism (anarthria) Preserved consciousness Preserved vertical eye movements and blinking
61
Medial Inferior Pontine Syndrome
Occlusion of the paramedian branch of the basilar artery
62
What is impaired ipsilateral to lesion in Medial Inferior Pontine Syndrome?
Cerebellar ataxia Nystagmus Paralysis of conjugate gaze to side of lesion Diplopia
63
What is impaired contralateral to lesion in Medial Inferior Pontine Syndrome?
Hemiparesis UE, LE | Impaired sensation
64
Lateral Inferior Pontine Syndrome
Occlusion of the anterior inferior cerebellar artery
65
What is impaired ipsilateral to lesion in Lateral Inferior Pontine Syndrome?
``` Cerebellar ataxia Nystagmus Vertigo Facial paralysis Paralysis of the conjugate gaze to the side of the lesion Deafness, tinnitus Impaired facial sensation ```
66
What is impaired contralateral to lesion in Lateral Inferior Pontine Syndrome?
Impaired pain and temperature sensation half of body
67
PCA Syndrome
PCA and posterior communicating arteries supply the midbrain, temporal lobe, diencephalon, and posterior third of cortex
68
PCA Syndrome effects:
Contralateral sensory loss Involuntary movements-choreoathetosis, tremor Transient contralateral hemiparesis Homonymous hemianopsia
69
3 Major symptoms of cerebellar disorders include
Incoordination Ataxia Intention tremors
70
Cerebellar Arterial Occlusion
Posterior Inferior Cerebellar Arterial Occlusion Anterior Inferior Cerebellar Superior Cerebellar Occlusion
71
Posterior Inferior Cerebellar Arterial Occlusion supplies:
Cerebellar peduncles & medulla
72
What does cerebellar arterial occlusion often involve?
the brainstem structures that are supplied by the cerebellar arteries
73
Posterior Inferior Cerebellar Arterial Occlusion
Ipsilateral Hypertonicity & Hyperactive Reflexes | Vertigo, Nausea, Nystagmus
74
Anterior Inferior Cerebellar & 
Superior Cerebellar Arterial Occlusion May Result In:
``` Ipsilateral ataxia Ipsilateral hypotonicity Hyporeflexia Dysmetria Adiadochokinesia (and Dysdiadochokinesia) Movement Decomposition Asthenia Rebound phenomenon Staccato voice Ataxic gait Intention tremor Incoordination ```
75
Anterior Spinal Artery Occlusion supplies:
Medulla (pyramids, the vestibular, hypoglossal, glossopharyngeal & vagal nerve nuclei)
76
Anterior Spinal Artery Occlusion
Contralateral Hemiplegia Deviation of tongue to affected side Dysphagia & loss of Gag Reflex Nystagmus & Balance Disturbances
77
Vertebral Artery Occlusion supplies:
lateral aspect of the low medulla including accessory nuclei
78
Vertebral Artery Occlusion
Dysphagia may occur if accessory nerve nuclei are lost

Adult Neuro (26 decks)

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