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Neuropysch > Day 1 review > Flashcards

Day 1 review Flashcards

1
Q 
• Faster and cheaper
• Radiation
• Better for bone, blood and trauma
• Bone and blood – bright
• Fat and air – dark
higher resolution but requires radiation and dye
A

CT

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2
Q
  • Slower and more expensive

* Better for soft tissue

A

MRI

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3
Q

– fat and brain are bright; csf and air are dark

A

• T1

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4
Q

– CSF and fat are bright; air and bone are dark

A

• T2

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5
Q

• MRA – no dye or radiation, good for

A

aneurysms and stenosis

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6
Q

Use ___ for acute stroke to evaluate for hemorrhage

A

CT:
• Hemorrhage will be bright
• CTA to evaluate source of bleeding
• No findings in early acute ischemic stroke

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7
Q

is most sensitive for acute stroke findings

Soft tissue like spinal cord

A

• MRI

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8
Q
  • Extracellular
  • White matter
  • Tumor, abscess, hematoma, contusion
  • Inflammatory, chemo and cytokines
  • Breakdown of BBB in tumor,
  • Responds to steroids
A

Vasogenic

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9
Q

Intracellular
• Gray matter
• Ischemia, meningitis, trauma, hepatic enceph.
• Cellular swelling from sodium (and then water)
• Dysfunctional membrane pumps
• Does not respond to steroids

A

Cytotoxic

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10
Q

• Subfalcine hernation – side to side, hemispheric lesion with a_____ infarct

A

ACA

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11
Q

Transtentorial/uncal – temporal lobe pushes through onto brainstem : what are the 3

A

PCA infarct, CNIII compression, Duret hemorrhage

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12
Q

– through foramen magnum • Respiratory arrest and death

A

Tonsillar hernation

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13
Q
  • Ventricular system open with Decreased absorption at arachnoid granulations
  • Meningitis, hemorrhage, thrombosis
  • Or CSF overproduction
  • Choroid plexus tumor
A

Communicating hydrocephalus

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14
Q
  • Obstruction of ventricular system

* Tumor, aqueductal stenosis, thickened meninges

A

Noncommunicating hydrocephalus

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15
Q

Common location of contusions

A

orbital and temporal regions, crests of gyri

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16
Q

What happens in acute contusions?

A

see superficial hemorrhage and edema

17
Q

What happens in Chronic contusions

A

– cavitated, macrophages with hemosiderin, fibrillary astrocytes

18
Q

____on the injury side,_____ on the opposite

A

Coup

contracoup

19
Q
  • axonal shearing in white matter
  • Petechial hemorrhages
  • Maximum deficit at onset
A

Diffuse Axonal

20
Q
  • Skull fracture (high speed)
  • Accumulates slowly (lucid interval)
  • Always life threatening
  • Middle meningeal artery
  • Convex appearance
A

Epidural hematoma

21
Q
  • Any trauma, common in elderly
  • Can present acute, subacute or chronic
  • Bridging veins
  • Can become chronic
  • Concave appearance
A

Subdural hematoma

22
Q
  • ______ worse than hypoxia alone
  • Reduced O2 delivery to tissues,
  • If low BP, worst in ________
A

Ischemia

watershed/borderzone areas

23
Q

AReas susceptible to ischema

A
  • Hippocampus CA1, cortical lamina 3-5, cerebellar purkinje cells most sensitive
  • Neurons>oligodendrocytes>astrocytes
  • Red is dead (dead neurons appear red after ischemia)
24
Q
  • soft swollen brain, loss of G/W distinction

* 8-12hr Red neurons; up to 48hr neutrophils

A

• Acute focal ischemia

25
Q
  • liquefactive necrosis

* Macrophages, necrotic tissue, reactive astrocytes, vascular proliferation

A

Subacute focal ischemia

26
Q

• Cavitation, glial scar

A

presentes in Chronic focal ischemia

27
Q
  • Bleeding can occur after an infarct if reperfusion into ischemic brain
  • More common in :
A

embolic stroke, cortical lesions

***Tends to be petechial blood with surrounding ischemic brain edema

28
Q

Describe Large vessel atherosclerosis

A
  • Carotid bifurction, MCA origin, basilar origin
  • Plaque rupture causes thrombosis
  • Complete vessel occlusion can cause stroke if collateral circulation isn’t adequate
29
Q

Small vessel hyaline arteriolosclerosis

A
  • Seen in HTN and DM
  • Small perforator vessels (basal ganglia, Internal capsule, thalamus, pons, white matter)
  • Lacunar strokes 1-1.5cm
30
Q

Embolism

• Tend to go to distal branches at cortex with ____ Most common vessel

A

MCA

*Shower of emboli can happen A/P, L/R

31
Q

Embolism from cardiac source cause by:

A

• Atrial fibrillation, valvular disease, MI with akinetic segment • Endocarditis

32
Q

Artery to artery embolism

• Carotid plaque, intracranial stenosis

A

another source of embolism

33
Q

venous clotting,leads to bleeds from back pressure in draining veins :Parasagittal bleeds

A

CVT

34
Q

Hypertension causing intercerbral hemorrhage

• Causes _______at small penetrating vessels (same ones that cause lacunes)

A

hyaline arteriolosclerosis

35
Q

areas susceptible to hyaline arteriolosclerosis causing intercerbral hemorrhage

A

• Basal ganglia, pons, cerebellum, thalamus, IC and white matter

36
Q

How does intracerebral hemorrhage differ from hemorrhagic infarct?

A

not having surrounding infarcted tissue

• Large clot (hematoma) rather than petechial blood

37
Q
  • AVM
  • Congenital abnl of vessels with arterio-venous direct connection
  • High bleed risk
  • Presents with seizures, bleeding, focal deficit
A

AVM: intracerebral hemorrhage

38
Q
  • Lobar hemorrhage
  • elderly
  • Beta amyloid on congo red stain
A

Amyloid angiopathy: intracerebral hemorrhage

39
Q
  • Develop with age, medial defect is congenital
  • Bifurcations of circle of willis, ACOM>MCA>ICA>basila
  • Worse with smoking ,HTN
A

Berry aneurysm; subarachnoid hemorrhage

Neuropysch (18 decks)

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