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Pathophysiology Semester 2 > Stroke > Flashcards

Stroke Flashcards

(56 cards)

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1
Q

What are the two major arteries supplying blood to the brain?

A

Internal Carotid Arteries and Vertebral Arteries

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2
Q

What is the purpose of the Circle of Willis?

A

Protects the brain via collateral circulation
• Anterior circle of Willis
◦ Internal carotid arteries pass up the anterior neck and then divide to form the anterior cerebral artery and the middle cerebral artery
◦ Anterior carotid artery’s join to form the anterior communicating artery
• Posterior circle of wills
◦ Vertebral arteries pass up through foramina in transverse processes of cervical vertebrae and joint in front of brain stem to form the basilar artery
◦ Basilar artery divides at the upper brainstem into two posterior cerebral arteries and is connected to the circle of Willis by the posterior communicating arteries

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3
Q

What is a stroke?

A

Disruption of blood supply to the brain resulting in sudden and lasting neurological deficits

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4
Q

What percentage of strokes are Ischaemic?

A

85%

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5
Q

What are the types of strokes?

A
  • Ischaemic
  • Haemorrhagic
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6
Q

What are the four categories in the Bamford/Oxford Classification of Strokes?

A
  • Total Anterior Circulation Stroke (TACS)
  • Partial Anterior Circulation Stroke (PACS)
  • Lacunar Stroke (LACS)
  • Posterior Circulation Stroke (POCS)
    Look at table
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7
Q

Fill in the blank: The _______ supplies blood to the medial and superior parts of the frontal lobe.

A

Anterior Cerebral Artery (ACA)

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8
Q

What does the Middle Cerebral Artery (MCA) supply?

A

The greater part of the lateral cerebral surface and deep structures including the internal capsule and basal ganglia

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9
Q

What is a transient ischaemic attack (TIA)?

A

Temporary disruption in the blood supply to part of the brain with symptoms similar to a stroke

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10
Q

True or False: Haemorrhagic strokes account for 15% of all strokes.

A

True

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11
Q

What are the main causes of Ischaemic strokes?

A
  • Atheroma
  • Thrombosis
  • Embolism
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12
Q

What is the treatment for Carotid Artery Stenosis?

A

Carotid Endarterectomy

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13
Q

What is thrombolysis?

A

Clot busting drug given to patients with acute ischaemic stroke to restore blood flow

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14
Q

What are the risks associated with thrombolysis?

A

Risks of causing bleeding anywhere in the body

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15
Q

What is the recommended time frame for urgent brain imaging in stroke patients?

A

Within 1 hour

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16
Q

What should be done for patients admitted with Intracranial Haemorrhage (ICH)?

A
  • Anticoagulant urgently reversed
  • BP lowered
  • Consider surgical intervention for hydrocephalus
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17
Q

What is the significance of collateral circulation in the Circle of Willis?

A

Ensures appropriate perfusion for the brain if one supply artery is damaged or blocked

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18
Q

Fill in the blank: The _______ supplies blood to the occipital lobe.

A

Posterior Cerebral Artery (PCA)

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19
Q

What is the most common vessel involved in Ischaemic strokes?

A

Middle Cerebral Artery (MCA)

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20
Q

What are the signs of a Total Anterior Circulation Stroke (TACS)?

A
  • Unilateral weakness of the face, arm, and leg
  • Homonymous hemianopia
  • Higher cerebral dysfunction
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21
Q

What type of stroke involves bleeding on the brain?

A

Intracranial or Intracerebral haemorrhage (ICH)

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22
Q

What is the role of thrombectomy in stroke management?

A

Clot removal with a catheter inserted through the femoral vein

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23
Q

What are the two types of haemorrhagic strokes?

Study These Flashcards
A
  • Intracranial haemorrhage (ICH)
  • Subarachnoid haemorrhage (SAH)
24
Q

What is the importance of reviewing risk factors after a stroke?

Study These Flashcards
A

To provide treatment and advice to reverse these risk factors if possible

25
What are the common clinical features of stroke?
Hemiplegia, sensory deficit, ataxia, dysarthria, dysphasia, reduced attention, homonymous hemianopia, dysphagia, dizziness, reduced memory ## Footnote These features can manifest in various combinations and severity.
26
What factors affect recovery post-stroke?
Size and location of stroke, pre-morbid status, patient motivation, patient insight, patient engagement, nutrition and hydration, environment, therapy, age ## Footnote Each factor plays a significant role in the rehabilitation process.
27
What is neuroplasticity?
The brain's ability to reorganize itself by forming new neural connections throughout life. ## Footnote Understanding neuroplasticity is crucial for neurological physiotherapy.
28
What produces muscle tone?
Neural factors, active contraction, reflex contraction, mechanical factors, physical inertia of limb, viscoelastic properties of the muscle, thixotropy ## Footnote Muscle tone is essential for maintaining posture and facilitating movement.
29
What is hypotonicity?
Diminished resistance to passive movement, often caused by CNS or PNS lesions. ## Footnote It can result in low muscle tone or flaccidity.
30
What is hypertonicity?
Increased resistance to passive movement, typically caused by damage to the CNS. ## Footnote It includes conditions such as spasticity and rigidity.
31
What is spasticity?
A form of hypertonicity characterized by local, segmental, or generalized muscle tightness. ## Footnote It is often observed in stroke patients.
32
What is the difference between expressive and receptive dysphasia?
Expressive dysphasia relates to difficulty in producing speech, while receptive dysphasia involves difficulty in understanding speech. ## Footnote Both can vary in severity and are associated with damage to specific brain areas.
33
What are the sensory impairments associated with stroke?
Impaired cutaneous sensation, impaired stereognosis, impaired proprioceptive awareness, visual field deficits ## Footnote These impairments can significantly impact daily functioning.
34
What is the role of the CST in muscle contraction?
CST (Corticospinal Tract) is involved in excitatory signals for muscle contraction. ## Footnote It plays a critical role in the voluntary movement pathway.
35
What defines normal muscle tone?
A state of readiness in a muscle at rest, providing enough resistance to maintain posture without restricting movement. ## Footnote There is a wide variation in what is considered 'normal'.
36
What are the types of stroke classification based on pathology?
Ischaemic and haemorrhagic ## Footnote This classification helps in understanding the underlying cause of the stroke.
37
Fill in the blank: The primary motor cortex is located in the _______.
frontal lobe
38
True or False: Muscle weakness can be a primary and secondary problem post-stroke.
True ## Footnote Weakness arises from both lack of innervation and muscle atrophy due to disuse.
39
What is ataxia?
Reduced coordination ## Footnote It can affect balance and overall movement control.
40
What are some cognitive symptoms that may arise after a stroke?
Perceptual problems, dyspraxia, memory issues, inattention, lack of insight, processing problems ## Footnote These symptoms can complicate rehabilitation efforts.
41
What is homonymous hemianopia?
A visual field deficit where the same side of the visual field is lost in both eyes. ## Footnote This condition can severely impact spatial awareness.
42
What are the components of the motor pathway involved in stroke?
Brainstem, cortex, spinal cord, gamma motor neuron, muscle spindles, lower motor neurons, upper motor neurons, alpha motor neuron ## Footnote These components work together to facilitate voluntary movement.
43
What is the significance of sensory feedback in muscle contraction?
It provides information about muscle length and tension, aiding in coordinated movement. ## Footnote Sensory feedback is crucial for motor control.
44
Fill in the blank: Dystonia is characterized by _______.
involuntary muscle contractions
45
What is neuroplasticity?
The adaptive capacity of the CNS and its ability to modify its own structural organisation and functioning. ## Footnote This definition is based on the work of Bach y Rita (1980).
46
What role does neuroplasticity play in post-stroke recovery?
It contributes to neuronal reorganisation and is thought to be the underlying principle by which post-stroke recovery occurs.
47
True or False: Neural regeneration occurs in the CNS.
False
48
Where does neuroplasticity occur?
Only within the brain.
49
What is 'unmasking' in the context of neuroplasticity?
The process where dormant pathways become more effective once primary pathways are removed or incapacitated.
50
How do dormant pathways increase in synaptic strength?
With continued use.
51
What is co-lateral sprouting?
The formation of new synapses that occurs at the same time as the reorganisation (unmasking).
52
What is a key point to promote plasticity?
Using a particular neural pathway will make it stronger.
53
Fill in the blank: Practicing an activity leads to _______.
[learning]
54
What factors can maximize repetition in therapy?
* Interesting and varied activities * Motivation (e.g., involvement of family and friends, goal-oriented working) * Home programmes * Education and clear communication
55
How does aerobic exercise influence neuroplasticity post-stroke?
It promotes plasticity and must be specifically prescribed to suit an individual's needs.
56
What is the role of physiotherapists in promoting neuroplasticity following a stroke?
They can maximize repetition through various strategies including motivation and creating stimulating environments.

Pathophysiology Semester 2 (10 decks)

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