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Clinical Medicine Final Exam > Neurology > Flashcards

Flashcards in Neurology Deck (120)
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1

What is the pathophysiology of cerebrovascular accident (CVA/stroke)?
where does it originate from?

thromboembolism

** internal carotid, middle cerebral, or basilar arteries

2

what does a CVA stroke result in?

sudden onset of a FOCAL neurologic deficit secondary to an abnormality in cerebral circulation

3

What are two stroke subtypes?

1. ischemic stroke
2. hemorrhagic stroke

4

Define ischemic stroke.

occlusion in a blood vessel interrupts blood flow to a region in the brain

5

t/f: an ischemic stroke has predictable patterns of symptoms based on part of the brain affected

t

6

What artery is normally occluded in an ischemic stroke?

• Occlusion of ICA blood vessel

7

Define hemorrhagic stroke.

- Intracerebral or subarachnoid hemorrhages interrupt cerebral blood flow due to compression
- (unpredictable pattern of symptoms)

8

hemorrhagic strokes arise from __________ or _______ hemorrhages

intracerebral
subarachonoid

I>S

9

BLOOD SUPPLY TO BRAIN: Blood reaches the brain via the __________ or the ____________
// Blood supply communicates inside the brain at the __________

ICA
vertebrobasilar artery
circle of Willis

10

What are 8 risk factors of CVA? What are the 3 most important?

- Older age
- Male > female
- HYPERTENSION
- HYPERLIPIDEMIA
- DIABETES MELLITUS
- Tobacco use
- Heavy alcohol consumption
- Oral contraceptive use

11

t/f: Stroke signs/symptoms vary depending on the affected vessel

t

12

where does the middle cerebral artery supply?

the lateral surface of cerebral hemispheres

13

If a patient has a middle cerebral artery stroke – what do they experience?

contralateral hemiparesis and contralateral sensory loss

14

MCA infarction affects the face and arms because of what?

homunculus

15

In MCA stroke: Si/sp on contralateral side - Ischemia is occurring (ANTERIOR/POSTERIOR) to the decussation of the tracts in the pons and medulla

anterior

16

Left MCA infarct will also result in __________.

aphasia

17

What two areas does the left hemisphere contain?

broca's area
Wernicke area

18

What is Broca’s area responsible for?

language production

19

What is Wernicke’s are responsible for?

language comprehension

20

Define aphasia.

loss of ability to understand or process speech

21

What is it called when there is an infarction exclusively in Broca’s area?

expressive aphasia

22

What is it called when there is an infarction exclusively in Wernicke’s area?

RECEPTIVE/FLUENT APHASIA

23

how will an occlusion in posterior cerebral artery manifest?

including temporal lobe optic radiations often present as a homonymous quadrantanopia

posterior involving occipital lobe may present as homonymous hemianopia, which patient may interpret as “poor vision” in eye opposite ischemic lobe

24

t/f: Symptoms truly reflect presence/absence of infarction in CVA

f

25

in CVA what is the goal of the initial evaluation?

quickly reverse the conditions contributing to the problem, and to uncover the cause

26

Diagnosis of CVA requires what?

stat ct without contrast

27

Why would blood work be helpful in a CVA? What type of blood work?

to help determine etiology
CBC,
fasting blood glucose, cholesterol panel

28

What are 3 (D) sequelae of CVA?

- Death, disability, or deficit

29

In CVA, if disabled, what 6 things can occur?

o Pneumonia
o Myocardial infarction
o Pulmonary embolism
o Deep vein thrombosis
o Falls and subsequent serious injury
o Depression

30

t/f: treatment of CVA depends on etiology

t