neuro 460 - 464

Question 1

based on below symptoms, what is the location of stroke?

dysphagia, hoarseness, dec gag reflex

Answer 1

PICA

Question 2

stroke in PICA is also called

Answer 2

lateral medullary (Wallenberg) syndrome

Question 3

what effects (other than dysphagia and hoarseness) are specific to PICA?

Answer 3

nucleus ambiguus effects (motor innervation CN9, 10)

Question 4

what are the unique clinical symptoms of AICA lesion?

Answer 4

paralysis of face, facial droop (due to facial nucleus)

Question 5

AICA lesion is also called?

Answer 5

Lateral pontine syndrome

Question 6

what are other symptoms of AICA lesion (other than facial droop)?

Answer 6

dec lacrimation, dec salivation, dec taste from ant 2/3 of tongue

Question 7

what stroke lesion will result in ipsilateral hypoglossal dysfunction such as tongue deviating ipsilaterly?

Answer 7

ASA

Question 8

ASA stroke is also known as

Answer 8

Medial medullary syndrome

Question 9

what are the other ASA stroke symptoms (other than ipsilateral hypoglossal dysfunction)?

Answer 9

1. dec contralateral proprioception (due to medial lemniscus)
2. contralateral hemiparesis of the upper/lower limbs (due to lateral corticospinal tract)

Question 10

pt with contralateral hemianopia with macular sparing, where is the stoke lesion?

Answer 10

PCA

Question 11

what artery is the common location of lacunar infarct 2’ to HTN?

Answer 11

lenticulostriate artery

Question 12

clinical symptoms of lenticulostriate artery stroke?

Answer 12

contralateral hemiparesis/hemiplegia

Question 13

contralateral paralysis of the lower limb & contralateral loss of sensation of lower limb is due to what stroke?

Answer 13

ACA (ant. cerebral)

Question 14

name 4 unique clinical symptoms of MCA stroke

Answer 14

1. contralateral paralysis (upper limb/face)
2. contralateral loss of sensation (upper limb/face)
3. aphasia if in dominant (usually Lt) hemisphere
4. hemineglect if lesion affects nondominant (usually Rt. side)

Question 15

clinical symptom of lesions in frontal eye fields?

Answer 15

eyes look toward lesion

Question 16

location of the primary motor is precentral or postcentral?

Answer 16

precentral

Question 17

what is post central?

Answer 17

primary somato sensory

Question 18

in what situations do you see therapeutic hyperventilation (dec pCO2) helps dec intracranial pressure?

Answer 18

acute cerebral edema (stroke, trauma) via vasoconstriction

Question 19

cerebral perfusion is primarily driven by

Answer 19

pCO2

Question 20

what area is associated with extraocular movement during REM sleep?

Answer 20

paramedian pontine reticular formation

Question 21

what infection is associated with Kluver Bucy syndrome (disinhibited behavior: hyperphagia, hypersexuality, hyperorality)?

Answer 21

HSV-1

Question 22

what area of the brain is responsible for disinhibition and deficit in concentration, orientation, judgement and may have reemergence of primitive reflex?

Answer 22

frontal lobe

Question 23

gerstmann syndrome is associated with what part of the brain lesion?

Answer 23

dominant parietal temporal cortex (usually Lt. hemisphere)

Question 24

what are the symptoms of Gerstmann syndrome

Answer 24

agraphia, acalculia, finger agnosia, Lt to Rt. disorientation

Question 25

what is the consequence of damaging reticular activating system (midbrain)?

Answer 25

1. reduced levels of arousal and wakefulness (coma) 2. loss of consciousness 3. stupor

Question 26

what lesion will result in limb ataxia and falling toward the side of the lesion?

Answer 26

cerebellar hemisphere

Question 27

what lesion will result in truncal ataxia and dysarthria?

Answer 27

cerebellar vermis

Question 28

what is the diff btw aphasia and dysarthria?

Answer 28

aphasia is language deficit and dysarthria is movement deficit

Question 29

where is Broca area?

Answer 29

inf. frontal gyrus of frontal lobe

Question 30

where is wernicke area?

Answer 30

sup. temporal gyrus of termporal lobe

Question 31

what type of aphasia leads to poor repetition, but fluent speech and intact comprehension?

Answer 31

conduction

Question 32

what type of aphasia is associated with prosody?

Answer 32

broca (prosody: breif phase w/o intonation)

Question 33

describe the broca aphasia

Answer 33

nonfluent with intact comprehension

Question 34

describe the Wernicke aphasia

Answer 34

fluent with imparied comprehension

Question 35

infarct of what blood vessel can lead to broca aphasia?

Answer 35

infarct of the superior division in MCA

Question 36

infarct of what blood vessel can lead to Wernicke aphasia?

Answer 36

infarct of the inf. division of MCA

Question 37

what type of aphasia leads to poor comprehension with fluent speech and intact repetition?

Answer 37

transcortical sensory (similar to Wernicke except for the poor repetition in Wernicke)

Question 38

what type of aphasia is associated with nonfluent aphasia (halting speech), good comprehension with intact repetition?

Answer 38

transcrotical motor

Question 39

what is the equation for CPP?

Answer 39

MAP - ICP

Question 40

If CPP is zero, what does that mean?

Answer 40

no cerebral perfusion --> brain death

Question 41

so in response to inc ICP, what does the body do?

Answer 41

inc MAP to maintain CPP

Question 42

in what response/reflex do you see acute inc in ICP?

Answer 42

Cushing (hypertension, bradycardia, irregular breathing)