neuro 460 - 464 Flashcards

1
Q

based on below symptoms, what is the location of stroke?

dysphagia, hoarseness, dec gag reflex

A

PICA

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2
Q

stroke in PICA is also called

A

lateral medullary (Wallenberg) syndrome

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3
Q

what effects (other than dysphagia and hoarseness) are specific to PICA?

A

nucleus ambiguus effects (motor innervation CN9, 10)

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4
Q

what are the unique clinical symptoms of AICA lesion?

A

paralysis of face, facial droop (due to facial nucleus)

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5
Q

AICA lesion is also called?

A

Lateral pontine syndrome

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6
Q

what are other symptoms of AICA lesion (other than facial droop)?

A

dec lacrimation, dec salivation, dec taste from ant 2/3 of tongue

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7
Q

what stroke lesion will result in ipsilateral hypoglossal dysfunction such as tongue deviating ipsilaterly?

A

ASA

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8
Q

ASA stroke is also known as

A

Medial medullary syndrome

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9
Q

what are the other ASA stroke symptoms (other than ipsilateral hypoglossal dysfunction)?

A
  1. dec contralateral proprioception (due to medial lemniscus)
  2. contralateral hemiparesis of the upper/lower limbs (due to lateral corticospinal tract)
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10
Q

pt with contralateral hemianopia with macular sparing, where is the stoke lesion?

A

PCA

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11
Q

what artery is the common location of lacunar infarct 2’ to HTN?

A

lenticulostriate artery

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12
Q

clinical symptoms of lenticulostriate artery stroke?

A

contralateral hemiparesis/hemiplegia

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13
Q

contralateral paralysis of the lower limb & contralateral loss of sensation of lower limb is due to what stroke?

A

ACA (ant. cerebral)

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14
Q

name 4 unique clinical symptoms of MCA stroke

A
  1. contralateral paralysis (upper limb/face)
  2. contralateral loss of sensation (upper limb/face)
  3. aphasia if in dominant (usually Lt) hemisphere
  4. hemineglect if lesion affects nondominant (usually Rt. side)
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15
Q

clinical symptom of lesions in frontal eye fields?

A

eyes look toward lesion

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16
Q

location of the primary motor is precentral or postcentral?

A

precentral

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17
Q

what is post central?

A

primary somato sensory

18
Q

in what situations do you see therapeutic hyperventilation (dec pCO2) helps dec intracranial pressure?

A

acute cerebral edema (stroke, trauma) via vasoconstriction

19
Q

cerebral perfusion is primarily driven by

A

pCO2

20
Q

what area is associated with extraocular movement during REM sleep?

A

paramedian pontine reticular formation

21
Q

what infection is associated with Kluver Bucy syndrome (disinhibited behavior: hyperphagia, hypersexuality, hyperorality)?

A

HSV-1

22
Q

what area of the brain is responsible for disinhibition and deficit in concentration, orientation, judgement and may have reemergence of primitive reflex?

A

frontal lobe

23
Q

gerstmann syndrome is associated with what part of the brain lesion?

A

dominant parietal temporal cortex (usually Lt. hemisphere)

24
Q

what are the symptoms of Gerstmann syndrome

A

agraphia, acalculia, finger agnosia, Lt to Rt. disorientation

25
Q

what is the consequence of damaging reticular activating system (midbrain)?

A
  1. reduced levels of arousal and wakefulness (coma)
  2. loss of consciousness
  3. stupor
26
Q

what lesion will result in limb ataxia and falling toward the side of the lesion?

A

cerebellar hemisphere

27
Q

what lesion will result in truncal ataxia and dysarthria?

A

cerebellar vermis

28
Q

what is the diff btw aphasia and dysarthria?

A

aphasia is language deficit and dysarthria is movement deficit

29
Q

where is Broca area?

A

inf. frontal gyrus of frontal lobe

30
Q

where is wernicke area?

A

sup. temporal gyrus of termporal lobe

31
Q

what type of aphasia leads to poor repetition, but fluent speech and intact comprehension?

A

conduction

32
Q

what type of aphasia is associated with prosody?

A

broca (prosody: breif phase w/o intonation)

33
Q

describe the broca aphasia

A

nonfluent with intact comprehension

34
Q

describe the Wernicke aphasia

A

fluent with imparied comprehension

35
Q

infarct of what blood vessel can lead to broca aphasia?

A

infarct of the superior division in MCA

36
Q

infarct of what blood vessel can lead to Wernicke aphasia?

A

infarct of the inf. division of MCA

37
Q

what type of aphasia leads to poor comprehension with fluent speech and intact repetition?

A

transcortical sensory (similar to Wernicke except for the poor repetition in Wernicke)

38
Q

what type of aphasia is associated with nonfluent aphasia (halting speech), good comprehension with intact repetition?

A

transcrotical motor

39
Q

what is the equation for CPP?

A

MAP - ICP

40
Q

If CPP is zero, what does that mean?

A

no cerebral perfusion –> brain death

41
Q

so in response to inc ICP, what does the body do?

A

inc MAP to maintain CPP

42
Q

in what response/reflex do you see acute inc in ICP?

A

Cushing (hypertension, bradycardia, irregular breathing)