Neuro Flashcards
Which vessel is most commonly affected by cerebrovascular accidents?
the MCA (middle cerebral artery)
What structures does the MCA supply?
- -Lateral surfaces of the frontal, parietal and upper temoral lobes
- -the internal capsule
- -most of the basal ganglia
What symptoms would be expected with occlusion of the MCA?
- -aphasia (e.g., Broca’s or Wernicke’s) if the stroke occurred in the language-dominant hemisphere (usually left)
- -Hemineglect if the stroke occurred in the non-dominant hemisphere (usually right)
- -anesthesia of the contralateral face and upper limb
- -Spastic paresis of the contralateral lower face and upper limb.
Describe Broca’s aphasia
characterized by slow, nonfluent speech with deficits in word-finding. Because comprehension is normal, patients are able to follow commands, they are typically aware of the problem, and can be frustrated.
Repetition, writing, and reading aloud is often impaired, but reading comprehension is often preserved.
Describe Wernicke’s aphasia
Speech is nonsensical but fluent (word salad), and the patient as a lack of both comprehension and awareness of his or her syndrome.
What symptoms would arise from occlusion of the ACA?
spastic paralysis and anesthesia (loss of sensation) of the contralateral lower limb.
urinary incontinence may be present (usually present with bilateral damage)
What does the posterior cerebral artery (PCA) supply?
- -occipital lobe
- -thalamus
- -part of the temporal lobe
How does occlusion of the PCA present?
with a homonymous hemianopia of the contralateral visual field with macular sparing
What artery supplies the lateral medulla?
The PICA (posterior inferior cerebellar artery)
What syndrome is caused by occlusion of the PICA?
Wallenberg syndrome (lateral medullary syndrom)
How does Wallenberg syndrome present?
- -Ipsilateral limb ataxia
- -ipsilateral loss of pain and temperature sense from the face
- -contralateral loss of pain and temperature sense of the body
- -ipsilateral Horner’s syndrome
- -hoarseness
- -dysphagia
- -nausea and vomiting
- -vertigo
- -nystagmus
“Don’t pick a (PICA) horse (hoarseness) that can’t eat (dysphagia)
How would a lesion of the trigeminal nerve present?
- -Ipsilateral loss of sensation to the face (anesthesia of the ipsilateral face)
- -The trigeminal nerve (V1) is also the afferent limb of the corneal reflex, which would also be impaired.
What is the corneal relfex?
Involuntary bilateral blinking of the eyelids after stimulation of the cornea
What are the histopathologic features of Alzheimer’s Disease?
(1) neurofibrillary tangles consisting of hyperphosphorylated tau protein
(2) extracellular senile plaques consisting of A-beta amyloid
(3) Granulovacuolar degeneration and Hirano bodies
What are Hirano bodies?
rod-shaped, crystal-like and eosinophilic intracellular aggregates of actin