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Psyc351b > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

What is a stroke?

A

The abrupt onset of a focal neurological deficit such as disruption in strength, speech, vision or cognition that is consistent with a vascular distribution and lasts more than 24 hours with a positive image.

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2
Q

Name the two arteries.

A
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3
Q

Name the appropriate cerebrovascular territories.

A
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4
Q

How many strokes are there in Canada each year?

A

50,000.

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5
Q

How many Canadians die from a stroke each year?

A

14,000.

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6
Q

How many Canadians live with the effects of stroke?

A

426,000.

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7
Q

What is lost in every minute of delay in treating a stroke?

A
  1. 9 million brain cells
  2. 8 billion synapses

12km of axonal fibre

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8
Q

How many children per year experience perinatal stroke?

A

200-300.

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9
Q

What does the FAST acronym mean?

A

Face drooping
Arm weakness
Speech difficulty
Time to call 911

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10
Q

What are the two classes of stroke and what is their incidence?

A

Hemorrhagic, 15% and ischemic, 85%.

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11
Q

What are the two kinds of hemorrhagic stroke?

A

Intracerebral and subarachnoid.

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12
Q

What are the two kinds of ischemic strokes?

A

Acute ischemic stroke, transient ischemic attack.

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13
Q

Name the stroke.

A

Intracerebral hemorrhagic.

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14
Q

Name the stroke.

A

Subarachnoid hemorrhagic.

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15
Q

What are the causes of intracranial hemorrhagic stroke?

A
  • Hypertension
  • Blood vessel malformation
  • Tumors
  • Alcohol abuse
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16
Q

What is cerebral arteriosclerosis?

A

Thickening and hardening of the arteries

Plaque composed of fat, cholesterol, calcium and other substances found in blood

17
Q

What are the risk factors for ischemic stroke?

A
  • Age
  • Hypertension
  • Diabetes
  • Smoking
  • Obesity
18
Q

What is an infarction?

A

The area that is permanently damaged from an ischemic stroke.

19
Q

What is the ischemic penumbra?

A

The area around the infraction that is still viable. The usual target of interventions.

20
Q

What is thrombosis?

A

Formation of a clot or plug in the blood vessel.

21
Q

What is an embolism?

A

A clot of plug brought from a larger vessel to a smaller one.

22
Q

What is a thrombotic ischemic stroke?

A

The most common type of stroke. It results from a clot in a large artery due to atherosclerosis.

23
Q

What is an embolic ischemic stroke?

A

Stroke caused by an emboli, a fragment of thrombus, air, fat, bacteria or tumor cells. It happens in younger patients, usually affects the MCA.

24
Q

What are lacunar strokes?

A

Small vessel strokes that compose 15-25% of ischemic strokes. It affects the small, penetrating branches of the Circle of Willis, MCA, or vertebrobasilar artery.

25
Q

What does lacunar stroke cause in the brain?

A

Deep brain structure infarcts 3mm to 2cm in depth

  • Basal ganglia
  • Cerebral white matter
  • Thamalus
  • Pons
  • Cerebellum
26
Q

Describe the presentation for each syndrome:

  • Pure motor hemiparesis–an infarct in the internal capsule or pons
  • Pure motor hemiparesis with motor aphasia–an infarct of the internal capsule and corona radiata
  • Ataxic hemiparesis–an infarct in the pons
  • Dysarthria and clumsy hand syndrome–an infarct in the pons or internal capsule
  • Pure sensory stroke–an infarct in the thalamus
A
  • Contralateral hemiparesis of face, arm leg, with dysarthria
  • Hemiparesis of face, arm and leg with inability to speak
  • Paresis of contralateral leg and side of face, ataxia of contralateral arm and leg
  • Dysarthria, dysphagia (hard to eat), contralateral facial and tongue weakness, paresis and clumsiness of contralateral hand and arm
  • Contralateral sensory loss to all modalities usually affecting the face, upper and lower extremities
27
Q

What is a transient ischemic attack?

A

AKA “mini-stroke”, a sudden, focal neurologic deficit lasting less than 24 hours, confined to an area of the brain or eye perfused by a specific artery.

28
Q

Describe a transient ischemic attack.

A
  • Lasts seconds to minutes; only 25% last more than one hour
  • Evidence of infarction: 20% on CT and 50% on MRI
  • Risk of full stroke within 90 days 20% higher after TIA
29
Q

What are the symptoms of a TIA?

A
  • Sudden tingling or numbness on one side of the face
  • Confusion of time, place or person
  • Speech loss or impairment for understanding and/or communicating
  • Sudden slurring of speech
  • Dizziness
  • Visual disturbances: blurring, double vision
  • Difficult reading, writing or thinking
  • Weakness in arm or leg on one side of the body
30
Q

What are the important common effects of a left hemispheric stroke?

A
  • Aphasia or dysarthria
  • Normal perception
  • Intact judgement with good insight on limitations
  • Slow and caution behavioural style development; require frequent instruction and feedback
  • Better at emotional understanding and expression
31
Q

What are the important common effects of a right hemispheric stroke?

A
  • Intact language ability, but dysarthria
  • Denial of paralysis, left side neglect
  • Impaired spatial perception and judgement
  • Impaired ability to locate and name body parts
  • Impaired judgement or insight into limitations, overestimating physical ability, impulsivity, inappropriate emotional understanding and expression
32
Q

What are some neurological consequences of strokes?

A
  • Cognitive deficits of attention, memory, executive function and perception
  • Communication problems
  • Post-stroke fatigue
  • Psychiatric illness
  • Behavioural issues
33
Q

How do you treat an ischemic stroke? An hemorrhagic stroke?

A
  • Clot busting medication, removing plaque from carotid artery
  • Blood pressure stabilization, surgical removal of hematoma
34
Q

What are some treatments and therapies for stroke survivors?

A
  • Physical therapy
  • Occupational therapy
  • Speech language therapy
  • Cognitive rehabilitation
  • Psychotherapy
  • Recreational therapy
35
Q

What are some stroke recovery facts?

A
  • 10% recovery almost completely
  • 25% recover with minor impairments
  • 40% have moderate impairment requiring special care
  • 10% require full-time care
  • 15% die shortly after
36
Q

What are the diagnostic criteria for Alzheimer’s disease?

A

A. Criteria met for major or minor neurocognitive deficit

B. Insidious onset and gradual progression of impairment in one or more cognitive domains

C. Probable or possible AD criteria:

    1. Genetics
    1. All three of the following:
      * Evidence of decline in memory and one other domain
      * Steadily progressive, gradual decline in cognition without plateaus
      * No evidence of mixed etiology

D. Not better explained by another neurodegenerative disorder or disease

37
Q

What are the diagnostic criteria for Major Neurocognitive Disorder?

A

A. Evidence of significant cognitive decline from a previous level of performance in one or more areas of cognitive domains based on:

  1. Concern of the individual, a knowledgeable informant, or the clinician about significant cognitive decline
    2.

Psyc351b (2 decks)

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