ILO Stroke Week

Question 1

What are the two main types of stroke?

Answer 1

Ischaemic and haemorrhagic

Question 2

What is the most common type of stroke?

Answer 2

Ischaemic

Question 3

How long will a TIA last for?

Answer 3

Under 24 hours

Question 4

Name some risk factors that increase your risk of stroke

Answer 4

CVD, AF, obesity, diabetes, carotid artery disease, COCP, smoking

Question 5

What is the structure called the supplies the brain with blood?

Answer 5

Circle of Willis

Question 6

What are the 4 lobes of the brain?

Answer 6

• Frontal lobe
• Parietal lobe
• Occipital lobe
• Temporal lobe

Question 7

Whats the role of the temporal lobe?

Answer 7

Memory, hearing and emotions

Question 8

Whats the role of the occipital lobe?

Answer 8

To process the visual information and allow us to see things

Question 9

Whats the role of the parietal lobe?

Answer 9

This contains the primary sensory cortex and allows us to perceive all of the senses.

Question 10

Whats the role of the frontal lobe?

Answer 10

This p-lays a role in memory and perspective

Question 11

What are the two centres that allow us to speak?

Answer 11

Brocka’s and Wernickes

Question 12

What is the role of Brocka’s area?

Answer 12

To allow us to speak and form the words

Question 13

What is the role of Wernicke’s

Answer 13

To allow us to understand speech and talk back appropriately

Question 14

What lies below the midbrain?

Answer 14

The pons and then the medulla

Question 15

What is the midbrain?

Answer 15

Its a relay system

Question 16

Is the midbrain a CNS or a PNS structure?

Answer 16

CNS

Question 17

What is the most superior part of the brainstem?

Answer 17

Midbrain

Question 18

What makes up the brain stem?

Answer 18

Midbrain, pons and medulla

Question 19

What are the two parts of the midbrain?

Answer 19

Tectum and tegmentum

Question 20

What makes up the hind brain?

Answer 20

Pons, medulla, cerebellum and spinal cord

Question 21

What is the role if the brainstem?

Answer 21

It connects the brain to the spinal cord

Question 22

Name some things that the hindbrain controls

Answer 22

Breathing and heart rate

Question 23

At what part of the brainstem does the brain transitions into the spinal cord?

Answer 23

Medulla

Question 24

What is the role of the meninges?

Answer 24

To act as a shock absorber for the brain if there is any significant injury.

Question 25

What are the 3 layers of the meninges?

Answer 25

DAP - Dura matter - Arachnoid matter - Pia matter

Question 26

What is contained within the arachnoid matter?

Answer 26

Subarachnoid space

Question 27

What is the role of the ventricular system?

Answer 27

A communicating cavity that is responsible for the production, transport and removal of CSF

Question 28

What are the CSF 3 main functions?

Answer 28

1. Protection 2. Buoyancy 3. Chemical stability

Question 29

Where does the 4th ventricle receive its supply of CSF from?

Answer 29

The 3rd ventricle

Question 30

Where does the 4th ventricle drain into?

Answer 30

The central spinal canal and subarachnoid cisterns

Question 31

What are the two paired arteries that supply the brain with blood?

Answer 31

Vertebral arteries and the common carotid arteries

Question 32

What arises from the internal carotid artery?

Answer 32

Anterior and middle cerebral arteries

Question 33

What arises from the basilar artery?

Answer 33

Posterior cerebral artery

Question 34

When the internal carotid and the vertebral arteries anastomose, what do they form?

Answer 34

The circle of willis

Question 35

How can you determine whether a patient is having a haemorrhagic or an ischaemic stroke?

Answer 35

CT head NO CONTRAST!!

Question 36

On a head CT will you see a haemorrhagic or an ischaemic stroke immediately?

Answer 36

Haemorrhagic

Question 37

What is the window for thrombolysis (according to the NICE guidelines)

Answer 37

4 hours

Question 38

What do we use to thrombolyse patients?

Answer 38

Alteplase

Question 39

If you patient presents within 24 hours of stroke symptoms and is confirmed to be having an ischaemic stroke what should you prescribe?

Answer 39

Aspirin

Question 40

What is the long term treatment after a stroke?

Answer 40

- Clopidogrel - Sometimes dual antiplatelet therapy - Statins

Question 41

What medication do we use commonly to bring down a patients BP if it is severely high during a stroke?

Answer 41

Labetalol

Question 42

What is the acronym that is used to remember the signs and symptoms for stroke?

Answer 42

F face A arms S speech T time

Question 43

Do the sensory pathways move upwards (ascending) or downwards (descending)?

Answer 43

Upwards, they are the ascending pathways

Question 44

Do the motor pathways move upwards (ascending) or downwards (descending)?

Answer 44

Downwards, they are the descending pathways

Question 45

Where do the fibres decussate on the ascending (sensory) pathway?

Answer 45

The medulla oblongata

Question 46

Where in the brain do the sensory signals synapse?

Answer 46

Ventral posterior lateral nucleus of the thalamus

Question 47

What are the two mechanosensory pathways?

Answer 47

Dorsal column medial lemniscal system and the Trigeminal mechanosensory pathway

Question 48

Where does the Dorsal column medial lemniscal system run?

Answer 48

Head to rest of the body

Question 49

Where does the Trigeminal mechanosensory pathway run?

Answer 49

Head to neck

Question 50

In the motor pathway what is the tract that runs from head to body?

Answer 50

Corticospinal tract

Question 51

In the motor pathway what is the tract that runs from head to neck?

Answer 51

Corticobulbar tract

Question 52

What are the two major tracts that make up the motor pathways?

Answer 52

- Pyramidal tracts - Extrapyramidal tracts

Question 53

What are included in the pyramidal tracts of the motorsensory system?

Answer 53

Corticospinal and corticobulbar tracts

Question 54

Are pyramidal tracts responsible for voluntary or involuntary control?

Answer 54

Voluntary

Question 55

Are extrapyramidal tracts responsible for voluntary or involuntary control?

Answer 55

Involuntary

Question 56

Are there any synapses within the motor pathway, if so where are they?

Answer 56

No, all of the neurones synapse with LMN therefore, all neurones in the motorpathway are UMN

Question 57

Do fibres in the lateral corticospinal tract decussate or not? If so where?

Answer 57

Yes, they run contralaterally and they cross at the medulla

Question 58

Do fibres in the anterior corticospinal tract decussate or not? If so where?

Answer 58

No, they remain ipsilateral and the decussate when they are LMN

Question 59

Where do the neurones in the corticobulbar tract synapse?

Answer 59

Motor nuclei of the cranial nerves

Question 60

Where does the extrapyramidal tract run to and from?

Answer 60

From brainstem to spinal cord