NEURO 10 Flashcards
Where are face and hand areas of sensorimotor homunculi located
lateral convexities of cerebral cortex
Where are leg areasass of sensorimotor humunculi located
interhemispheric fisure
Where is Broca’s area
dominant (left) hemisphere in inferior frontal gyrus
Where is Wernicke’s area
Superior temporal gyrus adjacent to primary auditory cortex
What is important for attention to CL body and space
association cortex in nondominant (right) hemisphere (mainly parietal lobe)
Primary visual cortex for CL visual hemifield lies where
calcarine fissure of occipital lobe
optic radiations pass under __ and ___ which can be damaged with infarcts
parietal and temporal cortex
Where do the vertebral arteries arise from
subclavian arteries
anterior cerebral arteries anastomose to form
anterior communicating artery
how are anterior and posterior circulations linked
posterior communicating arteries
Branches of supraclinoid (intracranial) segment of internal carotid
OPAAM Opthalmic Posterior communicating Anterior choroidal Anterior cerebral Middle cerebral arteries
Segments of internal carotid
cervical through temporal bone to become petrous, begins S shaped turn (carotid siphon) turning into cavernous segment before beinding posterorly to enter subarachnoid space as supraclinoid segment
What supplies deep structures of brain
small penetrating branches from initial segments of main cerebral arteries near circle of WIllis
Anterior cerebral artery located where in brain
travels in interhemispheric fissure, sweeps back over corpus callosum
Anterior cerebral artery supplies what
most of cortex on anterior medial surface of brain
Middle cerebral artery located where
Sylvian fissure
What does middle cerebral artery bifurcate into
superior and inferior divsion
what does superior division of middle cerebral artery supply
cortex above sylvian fissure, lateral frontal lobe, peri-Rolandic cortex
inferior division of middle cerebral artery supplies
cortex below syvian fissure, lateral temporal lobe, part of parietal lobe
Posterior cerebral artery supplies
inferior and medial temporal and occipital cortex
most important penetrating vessels at base of brain
lentriculostriate arteries, part of middle cerebral artery, prone to narrowing in hypertension
Anterior choroidal artery supplies
globus pallidus, putamen, thalamus, posterior limb of internal capsule (motor pathways)
Recurrent artery of Heubner
comes off initial portion of anterior cerebral artery to supply head of caudate, anterior putamen, globus pallidus, and internal capsule
Left MCA superior division infarct
Affected territory
Deficit
Left anterior temporal lobe
R face/arm weakness UMN
Broca’s aphasia
Left MCA inferior division infarct
Left inferior temporal lobe
Wernicke’s aphasia
R. visual deficit
R face and arm cortical type sensory loss
Left MCA deep territory
Left internal temporal lobe
R pure motor hemiparesis UMN
Left MCA stem
entire temproal lobe on left
R hemiplegia, hemianestheia, homonymous hemianopia, global aphasia
L gaze preference
Right MCA superior division infarct
Affected territory
deficit
Right superior tempora lobe
L face and arm weakness UMN
Right MCA inferior division infarct
Inferior termporal lobe on R
L hemineglect, visual field and somatosensory deficits, right gaze preference
Right MCA deep territory infarct
Internal R temporal lobe
L pure motore hemiparesis of UMN, L hemineglect
R MCA stem infarct
entire R temporal lobe
L hemiplegia, hemianesthesia, homonymous hemianopia, hemineglect, right gaze preference
L ACA infarct
R leg weakness UMN, cortical type sesnory loss
R ACA infarct
L leg weakness UMN, cortical type sensory loss
L PCA infarct
R homonymous hemianopia
R PCA infarct
L homonymous hemianopia
alien hand syndrome
ACA infarct can damage supplementary motor areas
Watershed infarcts produce what symptom
proximal arm and leg weakness (man in barrel syndrome)
Watershed infarrct in dominant hemisphere cause
transcortical aphasia
MCA PCA watershed infarct can cause disturbances of
higher order visual processing
most common cause of transient loss of consciousness
syncope, vasovagal transient episodes of hyptension, arrhythmias, non-neurologic causes
dofference between embolic and thrombotic infarcts
occur suddenly, maximal deficits at onset
stuttering course
large vessel infarcts
major blood vessels such as the mca, usually caused by emboli
small vessel infarcts
affects basal ganglia, thalamus and internal capsule, midbrain, bons, medulla
also called lacunar infarcts
Pure motor hemiparesis (dysarthria hemiparesis)
Clinical features
location of infarct
Unilateral face, arm, leg UMN weakness w/ dysarthria
Posterior limb of internal capsule, ventral pons, corona radiata, cerebral peduncle
Ataxic hemiparesis
Clinical features
location of infarct
Unilateral face, arm, leg UMN weakness, ataxia
Posterior limb of internal capsule, ventral pons, corona radiata, cerebral peduncle
Pure sensory stroke (thalamic lacunae)
Clinical features
Locations
sensory loss to CL face and body
Ventral posterior lateral nucleus of thalamus
Sensorimotor stroke (thalamocapsular lacunae)
Clinical features
Locations
Sensory loss to CL face and body, unilateral face, arm, leg UMN weakness
Posterior limb of internal capsule
Basal ganglia lacunae
Clinical features
Locations
Asymptomatic or causes hemiballismus
Caudate, putamen, globus pallidus or subthalamic nucleus
Proteinaceous emboli found in what disease
marantic endocarditis
What emboli found in cervical trauma
disc emboli
cortical signs
aphasia, neglect, homoymous visual field defects, cortical sensory loss
Subcortical lesion symptom
pure motor hemiparesis
stroke risk factors
hypertension, diabetes, hypercholesterolemia, cigareete smoking, family hisotry, vascular disease, afib, patent foramen ovale, decreased ejection fraction
what has to be done before patient can get tPA
CT to rule out hemorrhage
Time frame for tPA administration after stroke
preferably under 3 horus
contradindications to tPA administration
evidence/history of intracranial hemorrhage, AVM, anerysm, internal bleeding, abnormal platelet or coag studies, uncontrolled hypertension
what is given to stroke patients who cant have tPA
aspirin
amaurosis fugax
IL monocular visual loss
Carotid dissection symptoms
turbulent sound w/ each heartbeat, IL Horner’s syndrome
Vertebral dissection
posterior neck and occipital pain
which cranial nerves pass through cavernous sinus
III, IV, V1, V2, VI
Common causes of sagittal sinus thrombosis
hypercoaguable states, pregnancies and postpartum
symptoms of sagittal sinus thrombosis
headaches, papilledema, seizures, depressed consciousness
Empty delta sign
indicative of sagittal sinus thrombosis, central darker filled defect filled w/ IV contrast in sinus
