Neurology W1 Flashcards
stroke, brain injury, concussion (71 cards)
Describe the ABCD rule of stroke prognosis
A = age, B=blood pressure, C=clinical features, D=duration
A clinical prediction tool used to determine the risk of stroke on the days following a TIA
How soon after a thrombotic stroke does tissue plasminogen activator need to be injected
Within first 3 hours of initial symptoms
A stroke in which side of the brain is more likely to cause aphasia?
Left
Wernicke’s aphasia description and location
Receptive/fluent, left temporal lobe
Broca’s aphasia description and location
Expressive/non-fluent, left frontal lobe
A pt’s left side is hemiparretic, which side should you lay them on and why
There left side as long as shoulder is positioned correctly - can decrease tone, prevent subluxation and free the good arm to be able to assist in mobility
What factors can impact prognosis post cva? name 4.
Decreased age, location of stroke, ability to voluntarily move fingers (pyramidal motor output intact), absence of aphasia or other cognitive deficits and absence of incontinence
Describe the penumbra of a stroke
The area of the brain at risk of dying as its located between the site of perfusion and necrosis- it can remain viable for several hours post stroke which is why time is of the essence in ischemic strokes
What is a Lacunar stroke?
Blockage of small deep penetrating arteries of the brain that feed the deep nuclei of the brain
basal ganglia & deep cereballer nuclei
In what area of the brain are hemorrhagic strokes more likely to occur (2)?
Cerebral cortex and basal ganglia
What potential symptoms are associated with a right sided CVA? Name 4
- visual agnosis (objects)
- prospagnosia (faces)
- anosognosia (deny)
- distorted awareness / impression of self (L sided neglect)
- short attention span
- dec musical/artistic abilities
What are some benefits towards performing transfers towards the hemiparetic side?
- retains motor control
- Dec extensor strategy by WB while maintain knee flex
- directs attention and vision to affected side
What is the major function of the frontal lobe
Primary motor cortex, Broca’s area (speaking), and cognition
What is the major function of the parietal lobe?
- Primary sensory cortex,
- short term memory
What is the major function of the occipital lobe?
Primary visual
What is the major function of the temporal lobes?
Primary auditory, wernicke’s area (receptive), long term memory, olfactory area
What things are located medially on the motor and sensory homonculus?
Motor: toes, feet, leg,
Sensory: genitals, feet, legs
An ACA stroke would affect upper or lower extremity more? (Think homonculus)
Legs (ACA supplies frontal lobe)
if a stroke occured in the left ACA, what deficits would be expected?
weakness & sensory loss of right LE
*emotional liability, changes to personality, disinhibition, memory impairment (frontal lobe)
*seizures
Internal carotid artery supplies…
Anterior 2/3 of cerebrum except for temporal and occipital lobes
Where is the most common site for an ischemic strokes?
Middle cerebral artery
if there was a stroke to the right MCA, what deficits would be expected?
weakness and sensory loss of left UE and face, difficulty with ADLS
*left sided homonymous hemianopsia
*left sided neglect
*anaosognosia
*aphasia (could be broca’s or wernickes)
*impaired hearing
a stroke in which areas are likely to cause horners syndrome?
internal carotid artery
*brainstem stroke (PICA, AICA, SCA)
what deficits will a stroke to the left PCA cause?
right sided homonymous hemianopsia, disorders of reading and colour vision
*thalamic pain syndrome
*CN 3 palsy, right sided hemiplegia and hemisensory loss
*chorea, hemiballismus
*memory impairments (temporal lobe)
