Cerebrovascular Accident Flashcards
What is the primitive name of the Brain?
Encephalon
Part of extracellular fluid
CSF
Produced by choroid plexus
CSF
Enumerate in proper order the CSF flow
Choroid Plexus > Lateral Ventricles > Foramen of Monroe > 3rd Ventricle > Sylvian Aqueduct > 4th Ventricle > F. Luschka, F. Magendie, F. Luschka > Subarachnoid Space > Terminates at S2 Level > Reabsorbed at Arachnoid Villi
Membranous connective tissue that encloses the brain and spinal cord
Meninges
What are the functions of the meninges?
Protect the spinal cord from mechanical damage & infection
- Outermost covering
- Strongest/ toughest layer
Dura Mater
What is the other name for the Dura Mater?
Pachymeninx
It is the middle layer of the meninges
Arachnoid Mater
What is the other name for Arachnoid Mater?
Leptomeninx
The innermost layer of the meninges
Pia Mater
What is the other term for Pia Mater?
Leptomeninx
Layer found in between the skull and dura mater
Extradural Space
Layer located between dura et arachnoid mater
Subdural Space
Layer located between arachnoid mater et pia mater
Subarachnoid Space
- Largest part of the brain
- aka “big brain”
- has 2 hemispheres
Cerebrum
What lateral side of the body is affected when pt has CVA?
Contralateral Side
What are the functions of the L Hemisphere?
(MALL) M- Math Analysis - Analytical - Logical thinking - Language
What are the functions of the R Hemisphere?
(MICA) M- Memory & music I- Insights C- Creativity A- Arts
Largest lobe of the brain
Frontal Lobe of Cerebrum
What are the functions of the Frontal Lobe?
(MPS)
M- Motor Function
P- Personality and Behavior
S- “ Seat Intelligence”
What is the function of the Parietal Lobe of the Cerebrum?
General Sensation
What are the general sensations?
(PTPT) P- Pain T- Temperature P- Pressure T- Touch
What is the function of the Occipital Lobe?
For Vision
What are the functions of the temporal lobe?
Hearing, Memory, Smelling
What is BA 4?
- Primary Motor Area
- Precentral Gyrus
- Execution of motor function on the contralateral side of the body
If there is a lesion is BA 4 what is it?
Flaccidity
What is BA 6?
- Premotor Area
- aka “Secondary Motor Area”; “Motor Association Area”
What are the functions of BA 6?
- Motor Planning
- Initiation of Movement
- Coordination
If BA 6 has a lesion what is it?
@ C/L Side (SITA) S- Spasticity I- Incoordination T- Tremor A- Akinesia (Motor Deficit)
What is BA 8?
Frontal Eye Field
What is the function of BA 8?
Conjugate eye movements
If there is a lesion in BA 8, what is it?
Frontal Gaze Pattern
What are BA 9, 10, 11, 12?
Prefrontal Areas
What are the functions of BA 9, 10, 11, 12?
- Seat Intelligence
- Personality et Behavior
If there are lesion in BA 9, 10, 11, 12,what is it?
Personality and Behavior changes
What is BA 44 et 45?
Broca’s Area
What is BA 44 et 45 for?
- Associated c praxis speech
- Motor Speech Area
If there is lesion in BA 44 et 45, what is it?
Broca’s Aphasia
What are BA 3, 1, 2?
Primary Sensory Area- aka Post-central Gyrus
What are the functions of BA 3, 1, 2?
- Receives all general sensation, location and sensory perception
If there is lesion in BA 3, 1, 2, what is it?
Hemianesthesia/ Anesthesia
What is BA 5 et 7?
- Secondary Sensory
- Aka “Somesthetic Area; “Sensory Association Area”
What are the functions of BA 5 et 7?
- Interprets sensation perceived by BA 3, 1, 2:
- Stereognosis
- Bargonosis
- Paresthesia
- Kinesthesia
- Proprioception
- Graphesthesia except for pain & temperature
What is BA 39?
Angular Gyrus
What are the functions of BA 39?
- Naming
- Reading
- Writing
- Mathematical Ability
- Right & Left Orientation
If there is lesion in BA 39, what is it?
Gertzman Syndrome
What is BA 40?
Supramarginal Gyrus
What are the functions of BA 40?
Tactile et Language Perception
If there is a lesion in BA 40, what is it called?
Apraxia
What is BA 43?
Gustatory Area
What is the function of BA 43?
Taste Area
If there is a lesion in BA 43, what is it called?
Aguesia
What is BA 17?
- Primary Visual Area
- aka Striate Cortex
What is the function of BA 17?
Vision
If there is a lesion in BA 17, what are they called?
- Homonymous Hemianopsia (unilateral vision)
- Cortical blindness (ipsilateral lesion)
What is BA 18 et 19?
- Secondary Visual Area
- Visual Association Area
- Parastriate Cortex
What are the functions of BA 18 et 19?
Interprets images perceived by BA 17
If there are lesions in BA 18 et 19, what are they called?
- Visual Agnosia
- Color Agnosia
- Dyschromatopsia
- Alexia without agraphia
What is 41 et 42?
- Primary Auditory Areas
- Heschl’s Gyrus
What is the function of BA 41 et 42?
Hearing
If there are lesions in BA 41 et 42, what are they called?
- Contralateral Deadness (unilateral lesion)
- Cortical deafness (bilateral lesion)
What is R BA 22?
Auditory Association Area
Whatis the function of R BA 22?
Interprets sound other than language
If there is a lesion in R BA 22, what is it called?
Auditory agnosia
What is L BA 22?
Wernicke’s Area
What is the function of L BA 22?
Interprets language
If there is a lesion in L BA 22, what is it called?
Wernicke’s Aphasia
(Can utter clearly but cannot comprehend others
Representation of human body based on a neurological map
Homunculus
Blood supply of brain divided anteriorly et posteriorly
Circle of Willis
Where is opthalmic artery located?
1st branch of ICS
Artery that is involved in asymptomatic stroke
Anterior Cerebral Artery
What does Ant. Cerebral Artery supplies?
Medial frontal et parietal lobe
Terminal branch of ICA
Largest branch of ICA
Most occluded artery
Middle Cerebral Artery
What are the areas that are being supplied by Middle Cerebral Artery?
Lateral frontal
Parietal Lobe
Temporal Lobe
Connects the right and left ACA
Anterior Communicating Artery
Terminal brand of SCA
Aka “Medial Striate Artery”
Recurrent Artery of Huebner
What are the areas being supplied by the Recurrent Artery of Huebner?
Globus Pallidus
Anterior Limb of Internal Capsule
Terminal Branch of MCA
Aka “Lateral Striate Artery”
Lenticulostriate Artery
What are the areas that are being supplied by the Lenticulostriate Artery?
Neostrium
Posterior Limb of Internal Capsule
Branch of vertebral artery
PICA
What areas are supplied by PICA
Medulla Oblongata
Cerebellum
1st branch of basilar artery
AICA
What areas that are being supplied by AICA?
Pons
Cerebellum
What areas that being supplied by Superior Cerebellar Artery (SCA)
Midbrain
Cerebellum
terminal branch of basilar artery
Posterior Cerebral Artery (PCA)
What areas are being supplied by the PCA?
Medial & inferior temporal lobe
Occipital Lobe
DiencephalonMidbrain
Branch of ICA that connect the ICA & PCA
Posterior Communicating Artery
Enumerate the components of the Circle of Willis
A. Anterior Communicating Artery B. ACA C. ICA D. Posterior Communicating Artery E. PCA
Sudden loss of neurologic function caused by an interruption of blood flow to the brain
Cerebrovascular Accident
What are the other names of CVA?
Brain attack
Stroke
Apoplexy
What is a Transient Ischemic Attack?
- Refers to the temporary interruption of blood supply to the brain
- do not last more than 24 hours
- there is no evidence of residual brain damage
What is a Reversible Ischemic Neurologic Deficit (RIND)?
- Development of more severe neurological impairment
- Often associated with active occlusive thrombosis of a major cerebral artery
- > 24 hrs but not more than 21 days
- secondary to subsiding brain edema
A term used to describe a stroke affecting patients younger than age 45
Associated with hemorrhagic stroke
Young Stroke
Enumerate the Non-Modifiable Risk Factors of CVA
(AGRF) A- Age G- Gender R- Race F- Family Hx
Enumerate the Modified Risk Factors of CVA
A. Hypertension B. Heart Disease C. Diabetes Mellitus D. Smoking E. Sedentary Lifestyle F. Hyperlipidemia G. Obesity H. Personality and Behavior
Interruption/restriction of blood supply to the brain
Ischemic Stroke
What is Thrombotic Stroke?
- MC Stroke
- Aka “Large Vessel Thrombosis”
- Formation /Development of blood clot within the cerebral arteries or their branches
What is the major contributing factory to Thrombotic Stroke?
Atherosclerosis
What are the sites affected in Thrombotic Stoke?
- VBA
- MCA
- Common Carotid Artery
What is Embolic Stroke?
- it is due to Embolus acquired from A fib
Onset: Sudden or Abrupt
What is Lacunar Stroke?
- aka “Small Vessel Thrombosis”
- Onset: Gradual et Suddenseen in deep perforating branches of the large blood vessels
What are the sites in Lacunar Stroke?
- PCA
- Lenticulostriate Artery
- Recurrent Artery of Huebner
What are the areas affected in Lacunar Stroke?
- Basal Ganglia (MC)
- Cerebellum
- Pons
- Internal Capsule
- Thalamus
What is Hemorrhagic Stroke?
- bleeding into the brain
- Secondary ruptured blood vessel or abnormal vascular structures in the brain