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Neurology > Cerebrovascular Accident > Flashcards

Cerebrovascular Accident Flashcards

1
Q

Location of CST at the brainstem

A

Ventral and Medial

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2
Q

Location of CST at the Internal Capsule

A

Posterior Limb

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3
Q

Two parts of the cerebral peduncle

A

Tegmentum and Crus Cerebri

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4
Q

Location of CST in Midbrain

A

Middle 3rd - ventral part (crus cerebri)

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5
Q

Location of decussation of CST in the Medulla

A

Pyramid

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6
Q

Two decussations of CST

A

Lateral CST (90%) and Anterior CST (10%)

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7
Q

Lateral CST supplies what area?

A

Appendicular Muscles

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8
Q

Anterior CST supplies what area?

A

Axial Muscles

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9
Q

What is the boundary of an upper and lower motor neuron?

A

Anterior Horn Cell

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10
Q

UMNL or LMNL: Hypertonia

A

UMNL

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11
Q

UMNL or LMNL: Bulbar Palsy

A

LMNL

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12
Q

Atrophy of LMNL

A

Denervated Atrophy (Severe Muscle Wasting)

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13
Q

UMNL or LMNL: Increase DTR

A

UMNL

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14
Q

Gold Standard of UMNL

A

Babinski sign

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15
Q

UMNL or LMNL: Flaccidity

A

LMNL

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16
Q

Atrophy of UMNL

A

Disused Atrophy (Anti-gravity muscle)

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17
Q

UMNL or LMNL: Spasticity

A

UMNL

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18
Q

UMNL or LMNL: Pseudobulbar Palsy and Effect

A

UMNL

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19
Q

UMNL or LMNL: Spontaneous muscle activity

A

LMNL

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20
Q

What innervates the Bulbar tract?

A

Spinal Nerve

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21
Q

What innervates the Pseudobulbar tract?

A

Cranial Nerve

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22
Q

Sudden onset of neurologic dysfunction secondary to loss of blood supply

A

Cerebrovascular Accident

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23
Q

Duration of CVA

A

> 24 hours

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24
Q

Duration of TIA

A

<24 hours

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25
Q

“Mini-stroke”

A

Transient Ischemic Attack

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26
Q

Age of stroke in the young

A

<45 years old

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27
Q

“Stroke in Evolution”

A

Deteriorating Stroke

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28
Q

The common cause of Stroke in the Young

A

Hemorrhagic

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29
Q

The common cause of Reversible Ischemic Neurologic deficit

A

Brain swelling / Swelling

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30
Q

The common cause of Deteriorating Stroke

A

Thrombus

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31
Q

Duration of Reversible Ischemic Neurologic deficit

A

> 24 hours to weeks

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32
Q

Braddom: TIA

A

(-) evidence of infarction upon the brain imaging

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33
Q

Anterior Blood Circulation

A

LCC & RCC –> ICA and ECA –> OCA, MCA, ACA, AComm

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34
Q

Watershed of MCA

A

Lenticulostriate

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35
Q

The largest terminal branch of ICA

A

MCA

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36
Q

Only stroke syndrome that can be asymptomatic

A

ACA

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37
Q

Watershed of ACA

A

Heubner

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38
Q

Innervation of Lenticulostriate

A

Posterior limb of the internal capsule and basal ganglia

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39
Q

Innervation of Heubner

A

Anterior limb of the internal capsule and globus pallidus

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40
Q

Areas where there is the least blood supply

A

Watershead

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41
Q

Posterior Blood Circulation

A

L & R subclavian –> Axillary & Vertebral –> Basilar –> PCA

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42
Q

The location of the vertebral artery combines to become a basilar artery

A

C6

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43
Q

The location where vertebrobasilar artery splits to become PCA

A

Midbrain

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44
Q

Branch of the vertebrobasilar artery in the medulla

A

PICA

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45
Q

Branches of the vertebrobasilar artery in the pons

A

AICA and Superior CA

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46
Q

PICA supplies what area of the brain?

A

Cerebellum and Lateral Medulla

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47
Q

Superior CA supplies what area of the brain?

A

Cerebellum and Lateral-Superior Pons

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48
Q

AICA supplies what area of the brain?

A

Cerebellum and Lateral-Inferior Pons

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49
Q

True or False: If affectation is AICA, PICA, or SUCA, there is an affectation of CST

A

False

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50
Q

In general, the brainstem is supplied by what artery?

A

Vertebrobasilar Artery

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51
Q

Weber is supplied by what artery?

A

Vertebrobasilar Artery and PCA

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52
Q

Components of Circle of Willis

A

ICA, ACA, AComm, PComm, PCA, Vertebrobasilar Artery

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53
Q

5 non-modifiable risk factors of CVA

A

Age, Gender, Race, Family History, Previous Stroke

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54
Q

7 modifiable risk factors of CVA

A

Heart Disease, Hypertension, Smoking, DM, Obesity, Hyperlipidemia, Previous Stroke

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55
Q

Gender predominantly affected in CVA

A

M>F

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56
Q

Gender predominantly affected in CVA in age >85 years old

A

Female

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57
Q

A race predominantly affected in CVA

A

African-American

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58
Q

Hyperlipidemia: Bad LDL

A

<100mg/dL

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59
Q

Hyperlipidemia: Total Cholesterol

A

<200mg/dL

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60
Q

Hyperlipidemia: Good HDL

A

> 60mg/dL

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61
Q

Percentage of the prevalence of hemorrhagic

A

20%

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62
Q

Percentage of the prevalence of ischemic

A

80%

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63
Q

Two etiology under hemorrhagic stroke

A

Intracerebral and Subarachnoid Hemorrhage

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64
Q

The most common cause of ICH

A

Hypertension

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65
Q

“Pseudoaneurysm”

A

Charcot Bouchard Aneurysm

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66
Q

Abnormal dilation of blood vessel

A

Aneurysm

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67
Q

Charcot Bouchard Aneurysm is common at what location in the brain?

A

Basal Ganglia

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68
Q

Aneurysm caused by?

A

Idiopathic

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69
Q

Charcot Bouchard Aneurysm caused by?

A

Long term hypertension

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70
Q

Five ICH sites

A

Putamen, Subcortical White Matter, Thalamus, Pons, Cerebellum

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71
Q

The most common site of ICH

A

Putamen

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72
Q

The least common site of ICH

A

Cerebellum

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73
Q

The most common cause of young stroke

A

Subarachnoid Hemorrhage

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74
Q

Two cause of Subarachnoid Hemorrhage

A

Saccular Aneurysm and Arteriovenous Malformation

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75
Q

Saccular Aneurysm and Arteriovenous Malformation ruptured when?

A

4th-5th decade of life

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76
Q

Saccular Aneurysm and Arteriovenous Malformation occur when?

A

Congenital

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77
Q

“Berry Aneurysm”

A

Saccular Aneurysm

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78
Q

(+) Tangled web of arteries

A

Arteriovenous Malformation

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79
Q

The chief complaint of patients with Saccular Aneurysm Subarachnoid Hemorrhage

A

Worst headache in my life

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80
Q

The diameter of Berry Aneurysm that will lead to rupture

A

> 10mm

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81
Q

Saccular Aneurysm sites of hemorrhage

A

Anterior Circulation: AComm, MCA, and ICA

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82
Q

Saccular Aneurysm MC site of hemorrhage

A

AComm

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83
Q

Triad of AVM

A

Hemorrhage, Seizures, Migrane

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84
Q

Three etiology of Ischemic Stroke

A

Thrombotic, Embolic, Lacunar

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85
Q

Percentage of the prevalence of Thrombotic Ischemic Stroke

A

40%

86
Q

Percentage of the prevalence of Etiologic Ischemic Stroke

A

20-25%

87
Q

“Small Vessel Thrombosis”

A

Lacunar Stroke

88
Q

Sources of embolic ischemic stroke

A

Heart Embolism, Paradoxical Embolism

89
Q

Percentage of the prevalence of Lacunar Ischemic Stroke

A

15-20%

90
Q

Sites of Thrombotic Ischemic Stroke

A

MCA, CC, VBA

91
Q

“Large Vessel Thrombosis”

A

Thrombotic Stroke

92
Q

Lacunar Stroke: X Anterior Limb of Internal Capsule

A

Dysarthria, Clumsy Hand

93
Q

Lacunar Stroke: X Junction of Internal Capsule and Thalamus

A

Sensorimotor

94
Q

Most common lacunar stroke

A

Pure Motor

95
Q

Lacunar Stroke: X Cerebellum & Internal Capsule

A

Ataxic Hemiparesis

96
Q

Lacunar Stroke: X Posterior Limb of Internal Capsule

A

Pure Motor

97
Q

2nd most common lacunar stroke

A

Sensorimotor

98
Q

Lacunar Stroke: X Thalamus

A

Pure Sensory

99
Q

Least common lacunar stroke

A

Dysarthria, Clumsy Hand

100
Q

Lacunar Stroke: X Lenticulostriate

A

Pure Motor, Chorea, Dystonia

101
Q

Lacunar Stroke: X Heubner

A

Dysarthria Clumsy Hand, Athetosis

102
Q

Lacunar Stroke: X PCA

A

Pure Sensory, Hemiballismus

103
Q

Lacunar Stroke: X Vertebrobasilar

A

Ataxic Hemiparesis

104
Q

Hunt and Hess: Awake

A

I and II

105
Q

Hunt and Hess: Coma

A

V

106
Q

Hunt and Hess: Moderate-severe hemiparesis

A

IV

107
Q

Hunt and Hess: Mild HA, Slight Nuchal Rigidity

A

I

108
Q

Hunt and Hess: Confused / Drowsy

A

III

109
Q

Hunt and Hess: Posturing and Herniation

A

V

110
Q

Hunt and Hess: Stupor

A

IV

111
Q

Hunt and Hess: HA, Nuchal Rigidity, CN involvement

A

II

112
Q

Hunt and Hess: Mild focal neurological deficit

A

III

113
Q

Innervation of ACA in lobes

A

Medial frontal and parietal

114
Q

Innervation of PCA in lobes

A

Medial & Inferior temporal and occipital

115
Q

Innervation of MCA in lobes

A

Lateral frontal, parietal, and temporal

116
Q

Clinical Syndrome: Disconnection Apraxia

A

ACA

117
Q

Clinical Syndrome: Memory Loss

A

PCA and MCA

118
Q

Clinical Syndrome: Thalamic Pain Syndrome

A

PCA

119
Q

Clinical Syndrome: Dysphagia

A

MCA

120
Q

Clinical Syndrome: Amaurosis Fugax

A

ICA

121
Q

Clinical Syndrome: Hemianopsia

A

MCA and PCA

122
Q

“Alien Hand Syndrome”

A

Paratonia

123
Q

Paratonia: Resist

A

Gegenhalten

124
Q

Paratonia: Assist

A

Mitgehen

125
Q

Peripheral PCA Syndrome affectation

A

Temporal and Occipital

126
Q

Central PCA Syndrome affectation

A

SHET and Midbrain

127
Q

PCA Temporal lobe affectation

A

Memory Loss

128
Q

PCA Diencephalon affectation

A

C/L Hemiballismus and Thalamic Pain Syndrome

129
Q

PCA Midbrain affectation

A

Weber and C/L Hemiplegia

130
Q

PCA Occipital lobe affectation

A

Visual Problem

131
Q

Clinical Syndrome: Paratonia

A

ACA

132
Q

Clinical Syndrome: Balint Syndrome

A

PCA - peripheral

133
Q

Clinical Syndrome: Apraxia

A

MCA and ACA

134
Q

Clinical Syndrome: Urinary Bladder problem

A

ACA

135
Q

MCA Syndrome: Representation

A

Right

136
Q

MCA Syndrome: Quick and Impulsive

A

Right

137
Q

MCA Syndrome: Gerstmann’s Syndrome

A

Left

138
Q

MCA Syndrome: Denial

A

Right

139
Q

MCA Syndrome: Sad and Depressed

A

Left

140
Q

Left lobe apraxia

A

Ideomotor and Ideational Apraxia

141
Q

MCA Syndrome: Rigidity of Thought

A

Right

142
Q

Right lobe apraxia

A

Dressing and Constructional Apraxia

143
Q

MCA Syndrome: Language related memory loss

A

Left

144
Q

MCA Syndrome: Visuospatial related memory loss

A

Right

145
Q

MCA Syndrome: Affective Agnosia

A

Right

146
Q

memory loss

A

Left

147
Q

Main branch Aphasia

A

Global Aphasia

148
Q

4 clinical manifestation of Right Lobe

A

Neglect, Denial, Dressing and Constructional Apraxia

149
Q

MCA Syndrome: Unware

A

Right

150
Q

Upper branch Aphasia

A

Broca’s

151
Q

Lower branch Aphasia

A

Wernicke’s

152
Q

Gerstmann’s Syndrome

A

L & R discrimination, FInger agnosia, Agraphia, Acalculia (BA 312), and BA 39 (Angular Gyrus)

153
Q

MCA Syndrome: Body scheme deficit

A

Right

154
Q

MCA Syndrome: Difficulty in expressing positive emotion

A

Left

155
Q

MCA Syndrome: Difficulty in expressing negative emotion

A

Right

156
Q

MCA Syndrome: Crossed Aphasia

A

Right

157
Q

Brainstem Syndrome: X CST

A

Weber, Locked-in, Millard-Gubler, Dejerine

158
Q

Brainstem Syndrome: X Corticobulbar Tract

A

Locked-In

159
Q

Location of Millard-Gubler

A

Lateral Pons

160
Q

Location of Benedikt

A

Tegmentum of Midbrain

161
Q

Brainstem Syndrome: X STT

A

Benedikt, Wallenburg

162
Q

Brainstem Syndrome: Medial Basal of Midbrain

A

Weber

163
Q

Location of Wallenburg

A

Lateral Medulla

164
Q

Location of Locked-in

A

Bilateral Basal Pons

165
Q

Brainstem Syndrome: Dejerine

A

Medial Medulla

166
Q

Cranial Nerve Involvement of Dejerine

A

CN 12

167
Q

Cranial Nerve Involvement of Weber

A

CN 3

168
Q

Cranial Nerve Involvement of Millard-Gubler

A

CN 6-7

169
Q

Cranial Nerve Involvement of Locked-In

A

CN 5-12

170
Q

Cranial Nerve Involvement of Wallenburg

A

CN 5, 8, 9-11

171
Q

Cranial Nerve Involvement of Benedikt

A

CN 3

172
Q

Benedikt S/sx: X Medial Lemniscus

A

C/L Loss of position sense

173
Q

Wallenburg S/sx: CN 5

A

I/L Hemi-sensory face

174
Q

Benedikt S/sx: Superior Cerebellar Peduncle

A

C/L Ataxia

175
Q

Benedikt S/sx: Red Nucleus

A

C/L Chorea

176
Q

Wallenburg S/sx: Sympathetic Tract

A

I/L Horner Syndrome

177
Q

Wallenburg S/sx: Inferior Cerebellar Peduncle

A

I/L ataxia

178
Q

(+) Crossed Hemianesthesia

A

Wallenburg Syndrome

179
Q

Blood supply of Weber

A

PCA and VBA

180
Q

Blood supply of Dejerine

A

Anterior Spinal Artery

181
Q

Blood supply of Wallenburg

A

PICA

182
Q

Triad of Horner Syndrome

A

(1) Miosis (constricted pupil), (2) Partial ptosis, and (3) Anhidrosis (loss of hemifacial sweating)
* Exophthalmos: the sinking of the eyeball into the bony cavity that protects the eye

183
Q

Aphasia: Good Writing

A

Anomia

184
Q

Aphasia: Poor Fluency

A

Transmotor, Broca’s, Isolation of Language, Global

185
Q

Aphasia: Good Repetition

A

Anomia, Transmotor, Transsensory, Isolation of Language

186
Q

Aphasia: Poor Comprehension

A

Transsensory, Wernkicke’s, Isolation of Language, Global

187
Q

Aphasia: Good Fluency and Repetition

A

Transcortical Sensory

188
Q

Aphasia: Good Comprehension and Repetition

A

Transcortical Motor and Anomia

189
Q

Aphasia: Angular Gyrus

A

Anomia

190
Q

Aphasia: Surpamarginal Gyrus

A

Conduction

191
Q

Aphasia: Medial Frontal Border Zone

A

Transcortical Motor

192
Q

Aphasia: Wernicke + Broca

A

Global

193
Q

Aphasia: Medial Parietal Border Zone

A

Transcortical Sensory

194
Q

Pure word Aphasia: X Hesch’s Gyrus

A

Pure word Deafness

195
Q

Pure word Aphasia: Aphemia

A

Pure word Mutism

196
Q

Pure word Aphasia: Alexia without agraphia

A

Pure word Blindness

197
Q

Pure word Aphasia: Poor reading comprehension only

A

Pure word Blindness

198
Q

Pure word Aphasia: Poor Comprehension and Repetition

A

Pure word Deafness

199
Q

Pure word Aphasia: Poor Naming, Fluency, Repetition

A

Pure word Mutism

200
Q

Brunnstrom: Pron & Sup elbow flexion

A

Level 4

201
Q

Brunnstrom: Mastered movement of synergy pattern

A

Level 3

202
Q

Brunnstrom: Pron & Sup elbow extension

A

Level 5

203
Q

Brunnstrom: Minimal voluntary movements

A

Level 2

204
Q

Brunnstrom: Put hand behind

A

Level 4

205
Q

Brunnstrom: Horizontal Abduction

A

Level 5

206
Q

Functional Categories: (+) do household chores independently

A

Unlimited Household Walker

207
Q

Functional Categories: (+) go to uncrowded places

A

Least Limited Community Walker

208
Q

Functional Categories: Walks within parallel bars during exercise

A

Physiologic Walker

209
Q

Functional Categories: (+) do household chores with assistance

A

Limited Household Walker

210
Q

Functional Categories: (+) up and down curbs

A

Most Limited Community Walker

211
Q

Functional Categories: (+) go uncrowded places

A

Least Limited Community Walker

212
Q

Functional Categories: (+) up and down stairs

A

Least Limited Community Walker

Neurology (14 decks)

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