Cerebrovascular Accident Flashcards
1
Q
Location of CST at the brainstem
A
Ventral and Medial
2
Q
Location of CST at the Internal Capsule
A
Posterior Limb
3
Q
Two parts of the cerebral peduncle
A
Tegmentum and Crus Cerebri
4
Q
Location of CST in Midbrain
A
Middle 3rd - ventral part (crus cerebri)
5
Q
Location of decussation of CST in the Medulla
A
Pyramid
6
Q
Two decussations of CST
A
Lateral CST (90%) and Anterior CST (10%)
7
Q
Lateral CST supplies what area?
A
Appendicular Muscles
8
Q
Anterior CST supplies what area?
A
Axial Muscles
9
Q
What is the boundary of an upper and lower motor neuron?
A
Anterior Horn Cell
10
Q
UMNL or LMNL: Hypertonia
A
UMNL
11
Q
UMNL or LMNL: Bulbar Palsy
A
LMNL
12
Q
Atrophy of LMNL
A
Denervated Atrophy (Severe Muscle Wasting)
13
Q
UMNL or LMNL: Increase DTR
A
UMNL
14
Q
Gold Standard of UMNL
A
Babinski sign
15
Q
UMNL or LMNL: Flaccidity
A
LMNL
16
Q
Atrophy of UMNL
A
Disused Atrophy (Anti-gravity muscle)
17
Q
UMNL or LMNL: Spasticity
A
UMNL
18
Q
UMNL or LMNL: Pseudobulbar Palsy and Effect
A
UMNL
19
Q
UMNL or LMNL: Spontaneous muscle activity
A
LMNL
20
Q
What innervates the Bulbar tract?
A
Spinal Nerve
21
Q
What innervates the Pseudobulbar tract?
A
Cranial Nerve
22
Q
Sudden onset of neurologic dysfunction secondary to loss of blood supply
A
Cerebrovascular Accident
23
Q
Duration of CVA
A
> 24 hours
24
Q
Duration of TIA
A
<24 hours
25
"Mini-stroke"
Transient Ischemic Attack
26
Age of stroke in the young
<45 years old
27
"Stroke in Evolution"
Deteriorating Stroke
28
The common cause of Stroke in the Young
Hemorrhagic
29
The common cause of Reversible Ischemic Neurologic deficit
Brain swelling / Swelling
30
The common cause of Deteriorating Stroke
Thrombus
31
Duration of Reversible Ischemic Neurologic deficit
>24 hours to weeks
32
Braddom: TIA
(-) evidence of infarction upon the brain imaging
33
Anterior Blood Circulation
LCC & RCC --> ICA and ECA --> OCA, MCA, ACA, AComm
34
Watershed of MCA
Lenticulostriate
35
The largest terminal branch of ICA
MCA
36
Only stroke syndrome that can be asymptomatic
ACA
37
Watershed of ACA
Heubner
38
Innervation of Lenticulostriate
Posterior limb of the internal capsule and basal ganglia
39
Innervation of Heubner
Anterior limb of the internal capsule and globus pallidus
40
Areas where there is the least blood supply
Watershead
41
Posterior Blood Circulation
L & R subclavian --> Axillary & Vertebral --> Basilar --> PCA
42
The location of the vertebral artery combines to become a basilar artery
C6
43
The location where vertebrobasilar artery splits to become PCA
Midbrain
44
Branch of the vertebrobasilar artery in the medulla
PICA
45
Branches of the vertebrobasilar artery in the pons
AICA and Superior CA
46
PICA supplies what area of the brain?
Cerebellum and Lateral Medulla
47
Superior CA supplies what area of the brain?
Cerebellum and Lateral-Superior Pons
48
AICA supplies what area of the brain?
Cerebellum and Lateral-Inferior Pons
49
True or False: If affectation is AICA, PICA, or SUCA, there is an affectation of CST
False
50
In general, the brainstem is supplied by what artery?
Vertebrobasilar Artery
51
Weber is supplied by what artery?
Vertebrobasilar Artery and PCA
52
Components of Circle of Willis
ICA, ACA, AComm, PComm, PCA, Vertebrobasilar Artery
53
5 non-modifiable risk factors of CVA
Age, Gender, Race, Family History, Previous Stroke
54
7 modifiable risk factors of CVA
Heart Disease, Hypertension, Smoking, DM, Obesity, Hyperlipidemia, Previous Stroke
55
Gender predominantly affected in CVA
M>F
56
Gender predominantly affected in CVA in age >85 years old
Female
57
A race predominantly affected in CVA
African-American
58
Hyperlipidemia: Bad LDL
<100mg/dL
59
Hyperlipidemia: Total Cholesterol
<200mg/dL
60
Hyperlipidemia: Good HDL
>60mg/dL
61
Percentage of the prevalence of hemorrhagic
20%
62
Percentage of the prevalence of ischemic
80%
63
Two etiology under hemorrhagic stroke
Intracerebral and Subarachnoid Hemorrhage
64
The most common cause of ICH
Hypertension
65
"Pseudoaneurysm"
Charcot Bouchard Aneurysm
66
Abnormal dilation of blood vessel
Aneurysm
67
Charcot Bouchard Aneurysm is common at what location in the brain?
Basal Ganglia
68
Aneurysm caused by?
Idiopathic
69
Charcot Bouchard Aneurysm caused by?
Long term hypertension
70
Five ICH sites
Putamen, Subcortical White Matter, Thalamus, Pons, Cerebellum
71
The most common site of ICH
Putamen
72
The least common site of ICH
Cerebellum
73
The most common cause of young stroke
Subarachnoid Hemorrhage
74
Two cause of Subarachnoid Hemorrhage
Saccular Aneurysm and Arteriovenous Malformation
75
Saccular Aneurysm and Arteriovenous Malformation ruptured when?
4th-5th decade of life
76
Saccular Aneurysm and Arteriovenous Malformation occur when?
Congenital
77
"Berry Aneurysm"
Saccular Aneurysm
78
(+) Tangled web of arteries
Arteriovenous Malformation
79
The chief complaint of patients with Saccular Aneurysm Subarachnoid Hemorrhage
Worst headache in my life
80
The diameter of Berry Aneurysm that will lead to rupture
>10mm
81
Saccular Aneurysm sites of hemorrhage
Anterior Circulation: AComm, MCA, and ICA
82
Saccular Aneurysm MC site of hemorrhage
AComm
83
Triad of AVM
Hemorrhage, Seizures, Migrane
84
Three etiology of Ischemic Stroke
Thrombotic, Embolic, Lacunar
85
Percentage of the prevalence of Thrombotic Ischemic Stroke
40%
86
Percentage of the prevalence of Etiologic Ischemic Stroke
20-25%
87
"Small Vessel Thrombosis"
Lacunar Stroke
88
Sources of embolic ischemic stroke
Heart Embolism, Paradoxical Embolism
89
Percentage of the prevalence of Lacunar Ischemic Stroke
15-20%
90
Sites of Thrombotic Ischemic Stroke
MCA, CC, VBA
91
"Large Vessel Thrombosis"
Thrombotic Stroke
92
Lacunar Stroke: X Anterior Limb of Internal Capsule
Dysarthria, Clumsy Hand
93
Lacunar Stroke: X Junction of Internal Capsule and Thalamus
Sensorimotor
94
Most common lacunar stroke
Pure Motor
95
Lacunar Stroke: X Cerebellum & Internal Capsule
Ataxic Hemiparesis
96
Lacunar Stroke: X Posterior Limb of Internal Capsule
Pure Motor
97
2nd most common lacunar stroke
Sensorimotor
98
Lacunar Stroke: X Thalamus
Pure Sensory
99
Least common lacunar stroke
Dysarthria, Clumsy Hand
100
Lacunar Stroke: X Lenticulostriate
Pure Motor, Chorea, Dystonia
101
Lacunar Stroke: X Heubner
Dysarthria Clumsy Hand, Athetosis
102
Lacunar Stroke: X PCA
Pure Sensory, Hemiballismus
103
Lacunar Stroke: X Vertebrobasilar
Ataxic Hemiparesis
104
Hunt and Hess: Awake
I and II
105
Hunt and Hess: Coma
V
106
Hunt and Hess: Moderate-severe hemiparesis
IV
107
Hunt and Hess: Mild HA, Slight Nuchal Rigidity
I
108
Hunt and Hess: Confused / Drowsy
III
109
Hunt and Hess: Posturing and Herniation
V
110
Hunt and Hess: Stupor
IV
111
Hunt and Hess: HA, Nuchal Rigidity, CN involvement
II
112
Hunt and Hess: Mild focal neurological deficit
III
113
Innervation of ACA in lobes
Medial frontal and parietal
114
Innervation of PCA in lobes
Medial & Inferior temporal and occipital
115
Innervation of MCA in lobes
Lateral frontal, parietal, and temporal
116
Clinical Syndrome: Disconnection Apraxia
ACA
117
Clinical Syndrome: Memory Loss
PCA and MCA
118
Clinical Syndrome: Thalamic Pain Syndrome
PCA
119
Clinical Syndrome: Dysphagia
MCA
120
Clinical Syndrome: Amaurosis Fugax
ICA
121
Clinical Syndrome: Hemianopsia
MCA and PCA
122
"Alien Hand Syndrome"
Paratonia
123
Paratonia: Resist
Gegenhalten
124
Paratonia: Assist
Mitgehen
125
Peripheral PCA Syndrome affectation
Temporal and Occipital
126
Central PCA Syndrome affectation
SHET and Midbrain
127
PCA Temporal lobe affectation
Memory Loss
128
PCA Diencephalon affectation
C/L Hemiballismus and Thalamic Pain Syndrome
129
PCA Midbrain affectation
Weber and C/L Hemiplegia
130
PCA Occipital lobe affectation
Visual Problem
131
Clinical Syndrome: Paratonia
ACA
132
Clinical Syndrome: Balint Syndrome
PCA - peripheral
133
Clinical Syndrome: Apraxia
MCA and ACA
134
Clinical Syndrome: Urinary Bladder problem
ACA
135
MCA Syndrome: Representation
Right
136
MCA Syndrome: Quick and Impulsive
Right
137
MCA Syndrome: Gerstmann's Syndrome
Left
138
MCA Syndrome: Denial
Right
139
MCA Syndrome: Sad and Depressed
Left
140
Left lobe apraxia
Ideomotor and Ideational Apraxia
141
MCA Syndrome: Rigidity of Thought
Right
142
Right lobe apraxia
Dressing and Constructional Apraxia
143
MCA Syndrome: Language related memory loss
Left
144
MCA Syndrome: Visuospatial related memory loss
Right
145
MCA Syndrome: Affective Agnosia
Right
146
memory loss
Left
147
Main branch Aphasia
Global Aphasia
148
4 clinical manifestation of Right Lobe
Neglect, Denial, Dressing and Constructional Apraxia
149
MCA Syndrome: Unware
Right
150
Upper branch Aphasia
Broca's
151
Lower branch Aphasia
Wernicke's
152
Gerstmann's Syndrome
L & R discrimination, FInger agnosia, Agraphia, Acalculia (BA 312), and BA 39 (Angular Gyrus)
153
MCA Syndrome: Body scheme deficit
Right
154
MCA Syndrome: Difficulty in expressing positive emotion
Left
155
MCA Syndrome: Difficulty in expressing negative emotion
Right
156
MCA Syndrome: Crossed Aphasia
Right
157
Brainstem Syndrome: X CST
Weber, Locked-in, Millard-Gubler, Dejerine
158
Brainstem Syndrome: X Corticobulbar Tract
Locked-In
159
Location of Millard-Gubler
Lateral Pons
160
Location of Benedikt
Tegmentum of Midbrain
161
Brainstem Syndrome: X STT
Benedikt, Wallenburg
162
Brainstem Syndrome: Medial Basal of Midbrain
Weber
163
Location of Wallenburg
Lateral Medulla
164
Location of Locked-in
Bilateral Basal Pons
165
Brainstem Syndrome: Dejerine
Medial Medulla
166
Cranial Nerve Involvement of Dejerine
CN 12
167
Cranial Nerve Involvement of Weber
CN 3
168
Cranial Nerve Involvement of Millard-Gubler
CN 6-7
169
Cranial Nerve Involvement of Locked-In
CN 5-12
170
Cranial Nerve Involvement of Wallenburg
CN 5, 8, 9-11
171
Cranial Nerve Involvement of Benedikt
CN 3
172
Benedikt S/sx: X Medial Lemniscus
C/L Loss of position sense
173
Wallenburg S/sx: CN 5
I/L Hemi-sensory face
174
Benedikt S/sx: Superior Cerebellar Peduncle
C/L Ataxia
175
Benedikt S/sx: Red Nucleus
C/L Chorea
176
Wallenburg S/sx: Sympathetic Tract
I/L Horner Syndrome
177
Wallenburg S/sx: Inferior Cerebellar Peduncle
I/L ataxia
178
(+) Crossed Hemianesthesia
Wallenburg Syndrome
179
Blood supply of Weber
PCA and VBA
180
Blood supply of Dejerine
Anterior Spinal Artery
181
Blood supply of Wallenburg
PICA
182
Triad of Horner Syndrome
(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
Aphasia: Good Writing
Anomia
184
Aphasia: Poor Fluency
Transmotor, Broca's, Isolation of Language, Global
185
Aphasia: Good Repetition
Anomia, Transmotor, Transsensory, Isolation of Language
186
Aphasia: Poor Comprehension
Transsensory, Wernkicke's, Isolation of Language, Global
187
Aphasia: Good Fluency and Repetition
Transcortical Sensory
188
Aphasia: Good Comprehension and Repetition
Transcortical Motor and Anomia
189
Aphasia: Angular Gyrus
Anomia
190
Aphasia: Surpamarginal Gyrus
Conduction
191
Aphasia: Medial Frontal Border Zone
Transcortical Motor
192
Aphasia: Wernicke + Broca
Global
193
Aphasia: Medial Parietal Border Zone
Transcortical Sensory
194
Pure word Aphasia: X Hesch's Gyrus
Pure word Deafness
195
Pure word Aphasia: Aphemia
Pure word Mutism
196
Pure word Aphasia: Alexia without agraphia
Pure word Blindness
197
Pure word Aphasia: Poor reading comprehension only
Pure word Blindness
198
Pure word Aphasia: Poor Comprehension and Repetition
Pure word Deafness
199
Pure word Aphasia: Poor Naming, Fluency, Repetition
Pure word Mutism
200
Brunnstrom: Pron & Sup elbow flexion
Level 4
201
Brunnstrom: Mastered movement of synergy pattern
Level 3
202
Brunnstrom: Pron & Sup elbow extension
Level 5
203
Brunnstrom: Minimal voluntary movements
Level 2
204
Brunnstrom: Put hand behind
Level 4
205
Brunnstrom: Horizontal Abduction
Level 5
206
Functional Categories: (+) do household chores independently
Unlimited Household Walker
207
Functional Categories: (+) go to uncrowded places
Least Limited Community Walker
208
Functional Categories: Walks within parallel bars during exercise
Physiologic Walker
209
Functional Categories: (+) do household chores with assistance
Limited Household Walker
210
Functional Categories: (+) up and down curbs
Most Limited Community Walker
211
Functional Categories: (+) go uncrowded places
Least Limited Community Walker
212
Functional Categories: (+) up and down stairs
Least Limited Community Walker
