1 Stroke Flashcards

1
Q

What is a stroke and what affects the neurological deficit?

A
  • Sudden onset of focal neurological deficits fitting a vascular destribution
  • Neurological deficit depends on location and extent of lesion
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2
Q

What are some common neurological deficits from stroke?

A
  • Impaired control over movement
  • Impaired sensation/perception
  • Impaired speech/language
  • impaired contive function
  • Visual field deficit
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3
Q

What is an Ischemic Stroke?

A
  • Obstructed blood vessesl (84%)
  • Clot by thromus or embolis
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4
Q

What are the two types of Ischemic stroke?

A
  • Thombosis: Athersclerosis
  • Embolism: DEtached mass carried by blood

Blockage deprives braina of oxygen and glucose: Infarction

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5
Q

What is a Hemorrhagic stroke?

A

Occurs when weakned blood vessel wall ruptures (17%)

  • Aneurysm and ateriovenous malformations (AVM)
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6
Q

Describe a Transient Ischemic Attack (TIA)

A
  • AKA Mini stroke (temporary block of artery)
  • Acuose loss of focal function with sympotns < 24 hurs (usually 2 hr duration)
  • due in inadequte cerebral circuation
  • No permanent damage or disability
  • From tiny emboli - break up and quickly dissolve
  • WARNING SIGN: 30% of people with TIA have stroke within 5yrs
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7
Q

Describe the onset of Thrombosis Stroke

A
  • During night or after nap
    • headache + loss of motor/sensory in body
    • (thrombosis > embolus or hemorrhage
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8
Q

Describe the onset of an Embolus stroke

A
  • Occurs during ordinary activity - circulation more active (symptoms during daily activites)
    • Embolus > Hemorrage or thrombosis
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9
Q

Describe the onset of a Hemorrhage stroke

A

Stress (exertion -cough, sneeze, valsalva)

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10
Q

What is the Anterior Cerebral Artery?

A

ACA supplies medial part of the frontal lobe, parietal lobe

Anterior part of corpus collosum,, basal ganglia, internal capsule

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11
Q

What is the middle cerebral artery?

A
  • Supplies LATERAL surface of the hemisphere (not medial parts or inferior parts)
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12
Q

What is the Posterior Cerebral Artery?

A
  • Supply INFEROMEDIAL part of temporal lobe, occipital lobe, visual cortex, and splenium of corpus collosum
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13
Q

Describe the ACA stroke

A
  • Loss of:
  • Motor function
    • CONTRALATERAL LE
  • Somatosensory
    • CONTRALATERAL LE
  • Cognitive: Executive funciton
    • Planning, motor, descision making, impulse control, selective attension

Affects ACA and Homunculus

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14
Q

Describe the MCA Stroke

A
  • Largest branch from ICA
  • Loss of:
  • Motor:
    • CONTRALATERAL LOWER FACE, ARM, some trunk
  • Somatosensation:
    • CONTRALATERAL FACE, ARM, some trunk
  • Vision:
    • HOMONYMOUS HEMIANOPSIA
  • Dominant Hemisphere:
    • L - Motor speech, speech reception, reading, writing, calculating
  • Non Dom Hemisphere:
    • Hemineglect, agnosia
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15
Q

Describe a PCA stroke

A
  • CONTRALATERAL visual field defect
  • ex) L infarction = Acute loss in R half of visual field
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16
Q

Describe the Rule of 4’s for Brainstem stroke (location)

A
  • 4 CN in each section (not 1-2)
  • CN divisible by 12 are MIDLINE OR MEDIAL
    • 3 4 6 12 = MOTOR ONLY
  • Not divisible by 12 are LATERAL
    • 5 7 8 9 10 = Sensory (11 is lateral)
17
Q

Describe the rule of 4’s for Motor Syndromes

A
  • Midline
    • Medial longitudial fasiculus (eye)
    • Motor tracts of UMN (corticospinal)
    • Medial Lemniscus (proprioception, vibration)
    • Motor nuclei of CN
18
Q

Describe Rule of 4 Sensory syndromes

A
  • SIDE (LATERAL)
    • Spinothalamic (pain temp)
    • Spinocerebellar (RAM)
    • Sympathetic chain (Dilation, sweating, etc)
    • Sensory CN nuclei
19
Q

Which CN are in the Midbrain Pons and Medulla?

A
  • Midbrain: 3 4
  • Pons 5 7 8 (lateral), 6 (medial)
  • Medulla: 9 10 11 (lateral), 12 (medial)