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Q4 Clin Med III (GI) > Exam 3 Cerebrovascular Dz > Flashcards

Exam 3 Cerebrovascular Dz Flashcards

1
Q

2 main categories of Strokes?

A

Ischemic (85%)

Hemorrhagic

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2
Q

Arteries that supply Cerebral Arteries and Cerebellum?

A

Internal Carotid

Vertebral

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3
Q

Internal Carotids are branches of what aa?

Branches into?

A

Common Carotids

Anterior cerebral -> Middle cerebral

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4
Q

Vertebral aa are branches of what aa?

A

Subclavians

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5
Q

Vertebral aa fuse into what a?

A

Basilar

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6
Q

Basilar Artery supplies what?

Branches into?

A

midbrain
cerebellum

posterior cerebral a

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7
Q

Circle of Willis does what?

A

Back-up blood supply

Connects Internal Carotids and Basilar

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8
Q

Ischemic Strokes result from? (4)

A

Carotid/Large IC vessel thrombus
Lacunar dz (deep vessels)
CV embolus
Vasculitis, Vasospasm, Hyper-coag

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9
Q

IC Hemorrhagic Strokes result from? (4)

A

HTN
AV malformation
Amyloid angiopathy
Anticoag therapy

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10
Q

Subarach Hemorr Stroke results from? (4)

A

Trauma
Congenital berry aneury
Amyloid angiopathy
Inflamm dz

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11
Q

Thrombus is?

A

Occlusion from dz at site

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12
Q

Embolus is?

A

Occlusion from fragment from another site

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13
Q

Aneurysm is?

A

Balloon dilation of vessel

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14
Q

Arteriovenous Malformation is?

A

Tumor of bv

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15
Q

Thrombi/Emboli ischemia damages neurons which leads to?

A

Release of glutamate ->
↑ Ca2+ absorb in neighbor neurons ->
Kills the neighbors ->
Spreads cascade of death outward

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16
Q

Transient Ischemic Attacks (TIA) are?

↑ risk of what?

A

Sudden onset of focal neuro deficit,
resolves w/i 24 hrs

CVA (5-10% per yr)
Highest risk during 1st 3 mo

17
Q

TIA presentation: Amaurosis Fugax?

A

Transient unilateral vision loss from blocked ophthalmic artery

“Shade being pulls across eye”

From ipsilateral carotid artery dz

18
Q

CVA exam findings?

A

Vitals = N
Fund exam = Hollenhorst plaques
Carotid bruits
P murmur/arrhy

19
Q

CVA neuro exam findings:

Mental Status?

CNs?

Motor?

A

Mental Status = ∆ in consciousness, speech dist

CNs =
ptosis, abn pupils, fields cut
numb face/asymm
loss of gag/tongue deviation

Motor = change in strength
R v L, U v L, pronator drift

20
Q

CVA neuro exam findings:

Sensory?

Reflex?

Cerebellar?

A

Sensory = lost sensation (R/L, Up/Low)

Reflex = asymm, hyper in affected area

Cereb = abn finger-nose/heel-shin, + Romberg, ataxia

21
Q

Review Vascular Territories/Homonculus slide 20-21

A

.

22
Q

Anterior Circulation CVA: Internal Carotid presentation? (5)

A 
APHASIA
Ipsilat monocular vision loss
Contralat homonymous hemianopsia
Contralat sensorimotor deficit (prox > dist)
Contralat CN VII palsy
23
Q

Anterior Circulation CVA: Anterior Cerebral Artery presentation? (6)

A 
↓ concentration
Personality ∆
Sphincter incontinence
Contralat sens/motor deficit extremities (dist > prox, leg > arm)
Face spared
24
Q

Anterior Circulation CVA: Middle Cerebral Artery presentation? (10)

A

Aphasia
Contralat homonymous hemianopsia
Contralat sensorimotor deficit (prox > dist)
Contralat CN VII palsy

Dominant hemisphere:
Agnosia
R/L disorientation
Agraphia (can't write)
Alexia (can't see/read words)

Non-Dominant hemisphere:
Apraxia (loss of learned actions)
Hemi-neglect (unaware of one side of body)

25
Q

Expressive Aphasia/Brocca’s is?

Receptive Aphasia/Wernicke’s is?

Global Aphasia?

A

Understands but can’t produce words

Doesn’t understand, speaks nonsense

Both

26
Q

Posterior Circulation CVA: Posterior Cerebral Artery presentation? (4)

A

Contralat hemisensory loss
Contralat homonymous hemianopsia
Cortical blindness
Color agnosia (can’t interpret)

27
Q

Posterior Circulation CVA: Vertebrobasilar Circulation presentation? (4)

A 
Coma
Diplopia (double vision)
Vertigo
Weakness (corticospinal tracts)
Sensory loss (spinothalamic tracts)
Ataxia/imbalance
28
Q

Watershed Infarct it?

A

Infarct b/w vascular territorities

2° to low flow from hypoTN

29
Q

Lacunar Infarct is?

Seen where in brain?

a/w?

Presentation?

A

Small, subcortical infarcts
2° to penetrating artery occlusion

Basal ganglia (Middle cerebral artery)
Pons (Basilar artery)

a/w HTN

Pure motor or sensory loss

30
Q

Non-focal Symptoms are? (4)

Result of?

Caused by? (3)

A

HA
∆ mental status
N/V
Papilledema

↑ ICP

Intracerebral hemorr
Subarachnoid hemorr
CVA w/ edema

31
Q

Complications of CVA? (7)

A 
Aspiration PNA
DVT/PE
UTI
Decubiti
Contractures
Poor nutrition/hydration
Depression

Q4 Clin Med III (GI) (32 decks)

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