Ch10 Cerebral Hemispheres Flashcards
MCA superior division includes
Arms, shoulder, face on the opposite side
MCA superior division feeds
Broca’s area (Left SMCA);
Broca’s area deals with
language expression (talking, writing)
MCA inferior division feeds
body sensation and hearing; LEFT SMCA “Wernicke’s area”
Wernicke’s area is resposible for
understanding language
which MCA is more susceptible to high BP and bleeding hemorrhagic strokes
MCA deep territory
MCA deep territory includes
lenticulostriae arteries- basal ganglia and internal capsule;
MCA stem includes
all of the above problems
(superior, inferior, and deep)
ACA effect
leg function (sensory and motor)
confusion and mental changes, etc. (higher<br></br>order thinking)
decision making skills
PCA affect
occipital lobe (vision)
inferior temporal lobes (short term memory; can’t make long term memories after that)
Warning Signs of Ischemia
F- Face – has face fallen on one side, can they smile?
A- Arms – can they raise both arms and keep them there?
S- Speech – is their speech slurred?
T- Time – time to call 911, see any single one of these signs; timing – instantaneous is more likely a stroke
Transient Ischemic Attack is
Neurological deficit <24 hours duration
Transient Ischemic Attack typically lasts about
10 minutes
small clot which dissolves after 10 minutes is called
embolus
what is found in vessel wall and causes vasospasm
thrombus
Diagnosis will show TIA vs other neurological disorder by
vascular distribution of deficit
Stroke symptoms
neurological deficit
headache
neck pain
possibly seizures
Stroke’s 2 major categories
- Hemorrhagic 15%
- Ischemic 85% - thrombic or embolic
Stationary clot is the cause of
Thrombic stroke
Thrombic stroke symptoms progression
“gradual” couple of minutes compared to instant with other
Thrombic stroke symptoms timing:
in morning when BP is low
Thrombic stroke Deficits:
always the same distribution in repeated attacks
Embolic stroke Symptoms progression:
deficits are maximum at onset
Embolic stroke Symptoms timing:
sudden onset, with exercise
Embolic stroke Deficits::
repeat events will be different locations
Embolism Sources
- Air – deep sea divers
- Septic Emboli – from bacterial endocarditis (rheumatic fever)
- Cholesterol emboli – from long bone fracture
- Cardiac emboli from atherosclerosis
Hypertensive Stroke is due to vascular changes of
hypertension and atherosclerosis
Hypertensive Stroke Affected areas:
basal ganglia
thalamus
cerebellum
or pons
what causes the damage to the prevoius areas?
lenticulostriae arteries
deep penetrating arteries
Stroke Risk Factors includes
Hypertension
Family history of stroke
Diabetes
Past history of stroke
Hypercholesterolemia
Heart disease or anomaly
Cigarette smoking
Carotid Artery Stenosis is due to
atherosclerosis
Carotid Artery Stenosis affects which artries?
ACA
MCA
ophthalmic artery (ipsilateral one eye blindness)
Carotid Artery Stenosis signs may be revealed by
bruit
Carotid dissection often presents with
ipsilateral turbulent sound with heart beat
and
Horner’s syndrome
Vertebral artery dissection leads to
suboccipital headache
posterior neck pain