2 - Stroke Related Neuroanatomy-Neurophysiology Flashcards

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1
Q

What anatomical direction is this?

A

Axial

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2
Q

What anatomical direction is this?

A

Coronal

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3
Q

What anatomical direction is this?

A

Sagittal

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4
Q

What anatomical direction are these?

A

A = Superior/Dorsal

B = Posterior/Caudal

C = Inferior/Ventral

D = Anterior/Rostral

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5
Q

Name the Layers of the Brain.

A

A = Scalp

B = Cranium

C = Dura Mater

D = Arachnoid

E = Subarchnoid Space

F = Pia Mater

G = Cerebral Cortex

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6
Q

Name the 4 Major Lobes of the Brain.

A

Frontal

Parietal

Temporal

Occipital

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7
Q

What Is “Controlled” By These Specific Areas Of The Brain?

A

A = Motor Control

B = Cognition, planning, + problem solving

C = Speech

D = Smell

E = Hearing

F = Facial recognition

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8
Q

What Is “Controlled” By These Specific Areas Of The Brain?

A

A = Touch + pressure

B = Taste

C = Body awareness

D = Language

E = Reading

F = Vision

G = Cerebellum

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9
Q

What are these neruo sulci?

A

A = Precentral

B = Superior frontal

C = Inferior Frontal

D = Lateral frontal (Sylvian Fissure)

E = Superior temporal

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10
Q

What are these neruo sulci?

A

A = Central (Rolandic)

B = Postcentral

C = Intraparietal

D = Lateral occipital

E = Lunate

F = Interior temporal

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11
Q

What is the homunculus?

A

An metaphorical representation of the way motor + sensory information is organized neurologically

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12
Q

What is the motor area of the brain called?

A

Precentral Gyrus

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13
Q

What is the sensory area of the brain?

A

Postcentral Gyrus

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14
Q

Which of Brodmann’s Areas are important to SLPs?

(4)

A

44 + 45 (Broca’s)

22 + 40 (Wernicke’s)

41 + 42 (Auditory Association)

39 (Angular Gyrus)

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15
Q

What happens when Brodmann’s Areas 44 + 45 are injured?

(2)

A

Broca’s Aphasia

Apraxia of Speech

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16
Q

What happens when Brodmann’s Areas 22 + 40 are injured?

A

Wernicke’s Aphasia

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17
Q

What happens when Brodmann’s Areas 41 + 42 are injured?

A

Processing issues in Wernicke’s Aphasia

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18
Q

What happens when Brodmann’s Area 39 is injured?

(2)

A

Acalculia

Agraphia

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19
Q

Label the following neruo landmarks.

A

A = Anterior cingulate cortex

B = Ventromedial prefrontal cortex

C = Orbitofrontal prefrontal cortex

D = Dorsolateral prefrontal cortex

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20
Q

What is the ACC?

A

Anterior cingulate cortex

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21
Q

What does the ACC do?

(4)

A

Reward anticipation

Decision making

Empathy

Emotions

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22
Q

What happens when there is damage to the ACC?

(2)

A

Apathy

Poor motivation

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23
Q

What is the VMPC?

A

Ventromedial prefrontal cortex

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24
Q

What does the VMPC do?

A

Processing of risk + fear

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25
Q

What happens when there is damage to the VMPC?

(2)

A

Poor inhibition

Poor decision making

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26
Q

What is the OFPC?

A

Orbitofrontal prefrontal cortex

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27
Q

What does the OFPC do?

(2)

A

Empathy

Civil + appropriate social behavior

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28
Q

What happens when there is damage to the OFPC?

(5)

A

Impaired emotional reactivity + processing

Personality change

Poor impulse control

Increased aggression

Mood issues

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29
Q

What is the DLPC?

A

Dorsolateral prefrontal cortex

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30
Q

What does the DLPC do?

A

Organizing behavior to solve complex problems

(new learning, searching memory)

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31
Q

What happens when there is damage to the DLPC?

(5)

A

Poor organization strategies

Poor word list generation

Poor word fluency

Poor sorting behavior

Poor concreteness

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32
Q

What is the Insula Cortex?

What does it play a large role in?

A

Patch of cortex behind the frontal, parietal, and temporal lobes

Expressive speech + motor output

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33
Q

What is the Arculate Fasciculus?

What is it important for?

A

Association fibers connecting the temporal lobe (Wernicke’s) to the frontal lobe (Broca’s)

Language processing

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34
Q

What is the Basal Ganglia?

What does it do?

A

Area within the diencephalon (top of brain stem) that receives input from multiple sites in cortex

Refines muscle movements

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35
Q

What can happen if the Basal Ganglia is damaged?

(3)

A

Problems with movement + sensation

Loss of voluntary movement

Change in appearance of involuntary movements

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36
Q

What is the Thalamus?

What is it believed to do? (2)

A

Two egg shaped nuclei located in the diencephalon (top of brain stem) next to basal ganglia

Major relay center for descending motor information and ascending sensory information

Regulates overall electrical energy in cortex

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37
Q

What does the Thalamus play an important role in?

(3)

A

Maintaining consciousness, alertness, + attention

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38
Q

What does the Internal Capsule contain? (2)

What supplies blood to this area?

A

Both ascending + descending axons

Fibers coming to and from the cerebral cortex

Lenticulostriate arteries

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39
Q

Label the following arteries.

A

A = Anterior cerebral artery

B = Posterior cerebral artery

C = Internal carotid artery

D = Basilar artery

E = Vertebral artery

40
Q

Label the following arteries.

A

A = Circle of Willis

B = (Right) Middle Cerebral Artery

C = Basilar Artery

D = (External) Carotid Arteries

E = Vertebral Arteries

41
Q

Label the following arteries.

A

A = Anterior Cerebral Artery

B = (Left) Middle Cerbral Artery

C = Posterior Cerebral Artery

D = Internal Carotid Arteries

42
Q

What major arteries suppy the following areas?

A

A = Anterior cerebral artery

B = Middle cerebral artery

C = Posterior cerebral artery

43
Q

What major arteries supply the following areas.

A

A = Anterior cerebral artery

B = Middle cerebral artery

C = Posterior cerebral artery

44
Q

Label the following arteries.

A

A = Anterior cerbral artery (ACA)

B = Lenticulostriate arteries

C = MCA inferior division

D = MCA superior division

45
Q

What are the following areas called?

What are they?

A

Watershed areas

Border zones between the territories between two major arteries in the brain

46
Q

Fill in the following chart.

A

A = Silent CNS Infarction

B = Ischemic Stroke

C = TIA

D = Ischemic Stroke

47
Q

What is a CNS Infarction?

(2)

A

Brain, spinal cord, or retinal cell death due to ischemia.

Can also be cause by hemorrhage

48
Q

What is an Intracerebral Hemorrhage?

A

Focal collection of blood within the brain

49
Q

What is a Subarchnoid Hemorrhage?

A

Bleeding within the subarchnoid space

50
Q

What is the difference between Ischemia + Infarction?

A

Ischemia = Physiological tissue changes

Infarction = Tissue death

51
Q

Do similiar neuro injuries always result in the same loss of function?

A

No

52
Q

What area of the brain will result in Expressive Language deficits?

A

Anterior damage

53
Q

What area of the brain will result in Receptive Language deficits?

A

Posterior damage

54
Q

What is an Ischemic Stroke?

A

One cause by blockage

55
Q

What is an Hemorrhagic Stroke?

A

One cause by bleeding

56
Q

What is a Thrombosis Ischemia?

How fast do these occur?

What is an added risk?

A

Stroke caused by a build up of plaque or a blood clot

Slower since the build up of the clot is gradual

An area of the blockage can break off and cause an embolic stroke

57
Q

What is a Embolism (Ischemia)?

(2)

A

Stroke cause when a piece of plaque or a blood clot breaks off

This piece travels to a vessel that is too small for it to pass and it causes a blockage

58
Q

What is Hypoperfusion (Ischemia)?

What will it cause?

What specific areas may also be affected?

A

Damage that occurs when blood flow is decreased to all parts of body, but is not fully stopped

Brain damage

Watershed areas

59
Q

What is an Intracerebral Hemorrhage?

A

Bleeding within the brain

60
Q

What is an Extracerebral Hemorrhage?

A

Bleeding occuring within the meninges

61
Q

What kind of stroke is this?

A

Ischemic

62
Q

How common are Ischemic Strokes?

Intracerbral Hemorrhage?

Subarchnoid Hemorrhage?

A

87%

10%

3%

63
Q

What kind of strokes are the following?

A

A = Ischemic

B - Hemorrhage

64
Q

Where do Infarctions tend to occur?

A

Closest to the clot

65
Q

Where do Ischemias tend to occur?

A

Further from the clot where it might receive a secondary blood supply from a nearby artery

66
Q

What is the Physiological response to an Ischemic Stroke?

(5)

A

Edema

Transneural degeneration

Denervation hypersensitivity

Diaschisis

Collateral sprouting

67
Q

What is Edema?

A

Tissue swelling

68
Q

What is Transneural Degeneration?

A

Neuron death due to disruption of input/output of nearby neurons

69
Q

What is Denervation Hypersensitivity?

A

Extreme sensitivity due to interruptions of neural supply/activity

70
Q

What is Diaschisis?

A

Distal loss of function due to connection in damaged area

71
Q

What is Collateral Sprouting?

A

When neurons adjacent to damaged area take over some of the lost function

72
Q

Are stroke a singular event?

(2)

A

No - they often reoccur

They can last over several days

73
Q

What is an Ischaemic Core?

A

The brain tissue near a blockage that is destined to die

74
Q

What is a Penumbra?

A

The brain area near a blockage that is salageable

75
Q

What do clots normally form around?

A

Atherosclerotic plaques

76
Q

What is a clot called?

A

Thrombus

77
Q

What is a traveling particle in the blood stream called?

A

Embolus

78
Q

What are treatment options of Ischemic Strokes?

(3)

A

Carotid Endarterectomy

Carotid Stenting

Tissue Plasminogen Activator (tPA - medication)

79
Q

What is a Carotid Endarterectomy?

A

A surgical removal of the plaque causing a blockage

80
Q

What is a Carotid Stent?

What are the risks?

A

A device inserted at the plaque build up that expands the vessel

Part of the clot breaks off or the vessel wall is weakened

81
Q

What is Tissue Plasminogen Activator (tPA )?

When is it a treatment option?

A

A clot dissolving medication

Within 2-4 hours of an ischemic stroke

82
Q

What is the most common Extracerebral Hemorrhagic Stroke?

A

Subarachoid (3%)

83
Q

How often do Intracerbral Strokes occur?

A

7-9%

84
Q

What are the major risk factors for Hemorrhagic Stroke?

(4)

A

AA ethnicity

Hypertension (HTN)

High blood pressure

LDL (bad) cholesterol + triglyerides inversely related to ICH (good)

85
Q

What are some risk factors NOT associate with Hemorrhagic Stroke?

(7)

A

Sex

Smoking

Alcohol intake

BMI

Waist-to-hip ratio

Waist circumference

Diabetes

86
Q

What is the BIGGEST risk factor for Hemorrhagic Stroke?

A

Blood pressure

87
Q

Can infraction occur with a hemorrhagic stroke?

A

Yes due to pressure on the tissue

88
Q

Where are Intracerebral Hemorrhages most likely to occur?

(5)

A

Central lobes

Basal ganglia

Thalamus

Pons

Cerebellum

89
Q

What is an Aneursym?

A

A swelling of a blood vessel

90
Q

What is an Anterior Venus Malformation (AVM)?

What does this increase the risk of?

A

A congenital condition where arteries and veins grow together into a web

Risk of vessel rupture

91
Q

What are some medical treatments for Hemorrhagic Stroke?

(2)

A

Microsurgical clipping

Cerebral Stenting

92
Q

What is Microsurgical Clipping?

How is it inserted?

A

Small metal clip is place at the neck of the aneurysm to stop blood flow

Inserted via craniotomy (opening the skull)

93
Q

What is Cerebral Stenting?

Why does it work?

A

Coils of platinum wire are passed through a catheter to fill the aneurysm

The coils fill the aneursym and cause blood to clot obliterating the aneursym

94
Q

What are TIA’s also referred to as?

A

Mild Strokes

(May need to clarify with patient)

95
Q

What is CSF Leakage?

How is it treated?

A

Too much cerebral spinal fluid is produce putting excessive pressure on the brain

Extra fluid is removed via a shunt