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Neurology- First Aid > Neural anatomy 2 > Flashcards

Neural anatomy 2 Flashcards

1
Q

what artery connects the two anterior cerebral arteries

A

anterior communicating artery

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2
Q

where do the lenticulostriate arteries branch off from

A

MCA

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3
Q

what does the anterior choroidal artery branch off of

A

MCA

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4
Q

what do the vertebral arteries branch off of

A

the subclavian arteries

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5
Q

name the arteries branching off of the vertebral, then basilar artery starting from most inferior to most superior

A

PICA, AICA, SCA

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6
Q

what are watershed zones and what happens when they’re poorly perfused

A

areas the lie between the major cerebral arteries; severe hypotension causes upper leg/ upper arm weakness, and defects in higher-order visual processing

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7
Q

cerebral blood flow is modulated by ________?

A

PCO2

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8
Q

what is the point of therapeutic hyperventilation

A

to decrease PCO2 in order to decrease intracranial pressure in cases of acute cerebral edema via decreased cerebral perfusion by vasoconstriction

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9
Q

what are the areas of lesion for an MCA stroke

A

motor cortex, somatosensory cortex, temporal lobe

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10
Q

what are the deficits seen in an MCA stroke and what areas of cortex do they correspond with

A

contralateral paralysis of the face and upper limb-motor cortex
contralateral loss of sensation-sensory cortex
receptive aphasia (if in dominant side, usually left)
hemineglect (if in nondominant side, usually right)

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11
Q

what areas are affected by an ACA

A

motor cortex and sensory cortex

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12
Q

what are the deficits seen in an ACA stroke and what areas of cortex do they correspond with

A

contralateral paralysis of lower limb-motor cortex

contralateral loss of sensation in lower limb-sensory cortex

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13
Q

what are the areas affected by a lenticulostriate stroke

A

striatum and internal capsule

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14
Q

what are the deficits seen in a lenticulostriate stroke

A

contralateral hemiparesis and hemiplegia

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15
Q

what condition is commonly associated with infarction of the lenticulostriate arteries

A

lacunar infarcts secondary to unmanaged hypertension

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16
Q

what are the areas lesioned by an ASA infarct

A

lateral corticospinal tract, medial lemniscus, hypoglossal nerve

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17
Q

what are the deficits seen with an ASA infarct

A

contralateral hemiparesis (upper and lower limbs), contralateral decreased proprioception, ipsilateral hypoglossal dysfunction (tongue deviates toward lesion)

18
Q

what common syndrome is seen with ASA infarcts

A

medial medullary syndrome

19
Q

what areas are lesioned by a PICA infarct

A

lateral medulla= vestibular nuclei, lateral spinothalamic tract, spinal trigeminal nucleus, nucleus ambiguus, sympathetic fibers
inferior cerebellar peduncle

20
Q

what symptoms are seen with a PICA infarct

A

vomiting, vertigo, nystagmus; decreased pain and temperature sensation from ipsilateral face and contralateral body; dysphagia, hoarseness, decreased gag reflex; ipsilateral Horner syndrome; ataxia, dysmetria

21
Q

what is the name of the syndrome seen with a PICA infarct

A 
Wallenberg syndrome
(don't PICA hoarse that can't eat (dysphagia))
22
Q

what areas are lesioned with an AICA infarct

A

lateral pons- vestibular nucleus, facial nucleus, spinal trigeminal nucleus, cochlear nucleus, sympathetic fibers
middle and inferior cerebellar peduncles

23
Q

what are the symptoms of an AICA infarct and what’s the syndrome called?

A

Lateral pontine syndrome- vomiting, vertigo, nystagmus, facial paralysis, decreased lacrimatio and salivation, decreased taste from anterior 2/3 of tongue, decreased corneal reflex, decreased facial pain and temp. sensation, decreased ipsilateral hearing, ipsilateral Horner syndrome, ataxia, dysmetria

24
Q

what infarction should you automatically think of when there is a facial droop

A

AICA (lateral pontine syndrome)

25
Q

what areas are lesioned by a PCA infarct

A

occipital cortex, visual cortex

26
Q

what are the deficits seen with a PCA

A

contralateral hemianopia with macular sparing

27
Q

what gets lesioned in a basilar artery infarct

A

pons, medulla, lower midbrain, corticospinal and corticobulbar tracts, ocular cranial nerve nuclei, PPRF (paramedian pontine reticular formation)

28
Q

what clinical presentation do you see with infarction of the basilar artery

A

locked in syndrome: preserved consciousness and blinking, quadriplegia, loss of voluntary facial, mouth and tongue movements

29
Q

what are the symptoms seen with infarction of the anterior communicating artery

A

visual field defects

30
Q

what is the most common kind of lesion in the anterior communicating artery

A

aneurysm; berry aneurysms can impinge cranial nerves and can less commonly lead to stroke

31
Q

where do berry aneurysms occur

A

in the bifurcations of the arteries in the circle of Willis

32
Q

what kind of hemorrhage is seen when berry aneurysms rupture

A

subarachnoid hemorrhage

33
Q

what visual defect is common with berry aneurysms

A

bitemporal hemianopia via compression of the optic chiasm

34
Q

name three conditions that are associated with berry aneurysms

A

ADPKD, Ehlers-Danlos, Marfan

35
Q

what are some risk factors for berry aneurysm

A

advanced age, hypertension, smoking, race (increased risk in blacks)

36
Q

what kind of lesion commonly occurs in the posterior communicating

A

saccular aneurysm

37
Q

what symptoms are seen when there is a lesion of the PComm

A

CN III palsy: eye is “down and out”, ptosis, and pupil dilation

38
Q

do strokes or aneurysms more commonly cause PComm lesions

A

aneurysms

39
Q

what kind of aneurysm is a Charcot-Bouchard microaneurysm

A

aneurysm of small vessels (e.g. basal ganglia or thalamus), associated with chronic hypertension

40
Q

what is central post-stroke pain syndrome

A

neuropathic pain due to thalamic lesions; initial numbness and tingling followed in weeks to months by allodynia (unprovoked pain) and dysaesthesia (discomfort)

41
Q

what percentage of stroke patients experience central post-stroke pain syndrome

A

10%

Neurology- First Aid (7 decks)

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