Stroke

Question 1

prevalence stroke:

Answer 1

10/1000

Question 2

Tia meaning and time lapse

Answer 2

transient ischemic attack

<24 h symp

Question 3

CVA meaning and time lapse

Answer 3

cerobrovascular incident (symp >24H)

Question 4

hemorrhagic stroke

Answer 4

blood leaks into brain

Question 5

ischemic stroke

Answer 5

blood clot stops blood supply to area in brain

Question 6

penumbra

Answer 6

the area surround a ischemic event such as trombotic or embolic stroke

Question 7

ischemia occurs when…

Answer 7

blood flow is blocked, the release of free radicals causes damage to brain tissue

Question 8

Etiology of Ischemic stroke (80% of cases)

Answer 8

trombosis –> embolism –> arterial occulsion –> brain infarction

Question 9

Hemorrhagic stroke etiology (20%)

Answer 9

always intracranial

rupture of artery causes bleeding

Question 10

two versions of hemorrhagic stroke

Answer 10

1. intracerebral: hematoma directly in brain tissue

2. extracerebral: build up of blood anywhere within skull and meninges

Question 11

Early treatment of stroke

Answer 11

thrombolysis, platelet aggregation inhibitors, anticoagulants

Question 12

treatment within 3-4.5 hours

Answer 12

trombolysis with intravenous rtPA and IAT (risk = hemorrhage)

Question 13

new is intra arterial thrombolysis, whats special?

Answer 13

it can be done in up to 6 hours.

Question 14

Anterior circulation consists of (3)

Answer 14

internal carotid artery splits up into anterior cerebral artery and middle cerebral artery

Question 15

posterior circulation consists of

Answer 15

vertebral arteries perforate transverse processus of cervical vertebrae via the foramen magnum. left and right fuse en form basilar artery. This one supplies the cerebellum and brain stem

Question 16

circle of willis

Answer 16

site of large aneurysms

Question 17

functional anatomy cortex.
Neocortex:
anteriorly:
posteriorly:

Answer 17

neocortex: mental functions
anteriorly: action related areas (frontal lobe)
posteriorly: perception areas (parietal, occipital and temporal lobes)

Question 18

motor cortex

Answer 18

responsible for movement and arranged in anatomical order (called somatotopy)

Question 19

somatotopy

Answer 19

arranged in anatomical order

Question 20

the primary sensory area is arranged how?

Answer 20

topographically organized

Question 21

how is the primary auditory cortex arranged?

Answer 21

tonotopy: all sound frequencies layed out over length of auditory gyrus

Question 22

supply areas:

1. anterior cerebral art:
2. middle cerebral art
3. posterior cerebral art

Answer 22

1. anteromedial side
2. lateral side and deep structures
3. posterobasal side

Question 23

Types of strokes (6)

Answer 23

1. middle cerebral artery
2. anterior cerebral artery
3. carotid artery occlusion
4. posterior cerebral artery stroke
5. basilar artery stroke
6. miscellaneous stroke

Question 24

middle cerebral artery stroke symptoms:

Answer 24

most common
central facial palsy (opposite of where stroke occurred)
distal parts show most paresis
lower part of face dysfunctions

Question 25

difference between superficial lesion and deep lesion in middle cerebral stroke

Answer 25

superficial leg is spared and with deep lesion arm and leg are paretic

Question 26

why is the leg spared in a superficial lesion

Answer 26

mostly supplied by anterior artery

Question 27

contralateral hemisensory loss

Answer 27

mixture of problems in pain/temp sense

Question 28

contralateral hemianopia

Answer 28

loss of one of the visual field of one (most of the times both) eye(S).

Question 29

homonymus hemianopia

Answer 29

same side both visual fields are affected

Question 30

what is remarkable for the left lesions?

Answer 30

language (aphasia) alexia (reading) agraphia (writing) apraxia (motor planning)

Question 31

what is remarkable for right lesions?

Answer 31

``` spatial function and attention unilateral neglect (left side) distance judgement wrong, can't read maps or draw. ```

Question 32

aphasia

Answer 32

language disorder

Question 33

types of aphasia: 1. broca 2. wernicke 3. global 4. anomic 5. progressive

Answer 33

1. speech impairment (aware) 2. can't understand words (unaware) 3. severe impairment in all language modalities 4. difficulty word finding 5. slow loss of language

Question 34

apraxia

Answer 34

difficulty performing skilled movement

Question 35

ideational appraxia

Answer 35

no idea or concept of what to do

Question 36

location ideotional appraxia

Answer 36

parietal praxis center and parietotemporal cortex

Question 37

ideomotor apraxia

Answer 37

cant perform on verbal command, inability to copy gestures, knows what to do but not how

Question 38

location ideomotor apraxia

Answer 38

LH, left parietal lobe, frontal praxis centre

Question 39

Anterior cerebral artery stroke symptoms

Answer 39

paresis, sensory loss of contraleteral leg

Question 40

Carotid artery occlusion depends on ...

Answer 40

circle of willis

Question 41

basilar artery stroke

Answer 41

devestating and acute with no recovering, coma

Question 42

lacunar

Answer 42

small infarct in deep cerebral white matter

Question 43

multiple infarctions means...

Answer 43

vascular dementia

Question 44

hemorrhagic vs ischemic

Answer 44

hemorrhagic has more headache, vomit and same prognosis as patients with infarctions

Question 45

lethality infarctions after 30 days

Answer 45

15-20%

Question 46

lethality hemorraghes after 30 days

Answer 46

60-70%

Question 47

diaschisis

Answer 47

(sudden inhibition of function produced by acute focal disturbance in a portion of the brain at a distance from the original site of injury, but anatomically connected with it through fiber tracts

Question 48

denervation hypersensitivity

Answer 48

the sharp increase of sensitivity of post‐synaptic membranes to a chemical transmitter after denervation → a compensatory change

Question 49

neurogenisis

Answer 49

the process in which neurvous system cells are produced by neural stem cells

Question 50

sprouting/synaptogenisis

Answer 50

the formation of two synapses between neurons

Question 51

basis for rehabilitation

Answer 51

body function and structure activities participation

Question 52

FAC

Answer 52

functional ambulation category

Question 53

TCT

Answer 53

trunc control test, sitting balance

Question 54

ARAT

Answer 54

the action research arm test

Question 55

primary and secondary changes

Answer 55

primary: cognitive, emotional, behavorial, social secondary: withdrawal, avoidence, depression

Question 56

anticipatory awareness

Answer 56

knowing when problems occur and being able to use compensatory strategies to prevent them

Question 57

emergent awareness

Answer 57

recognizing problems as they occur in daily life

Question 58

intellectual awareness

Answer 58

'they say i've changed' but unable to provide examples of problematic situations