neuro 460 - 464 Flashcards
based on below symptoms, what is the location of stroke?
dysphagia, hoarseness, dec gag reflex
PICA
stroke in PICA is also called
lateral medullary (Wallenberg) syndrome
what effects (other than dysphagia and hoarseness) are specific to PICA?
nucleus ambiguus effects (motor innervation CN9, 10)
what are the unique clinical symptoms of AICA lesion?
paralysis of face, facial droop (due to facial nucleus)
AICA lesion is also called?
Lateral pontine syndrome
what are other symptoms of AICA lesion (other than facial droop)?
dec lacrimation, dec salivation, dec taste from ant 2/3 of tongue
what stroke lesion will result in ipsilateral hypoglossal dysfunction such as tongue deviating ipsilaterly?
ASA
ASA stroke is also known as
Medial medullary syndrome
what are the other ASA stroke symptoms (other than ipsilateral hypoglossal dysfunction)?
- dec contralateral proprioception (due to medial lemniscus)
- contralateral hemiparesis of the upper/lower limbs (due to lateral corticospinal tract)
pt with contralateral hemianopia with macular sparing, where is the stoke lesion?
PCA
what artery is the common location of lacunar infarct 2’ to HTN?
lenticulostriate artery
clinical symptoms of lenticulostriate artery stroke?
contralateral hemiparesis/hemiplegia
contralateral paralysis of the lower limb & contralateral loss of sensation of lower limb is due to what stroke?
ACA (ant. cerebral)
name 4 unique clinical symptoms of MCA stroke
- contralateral paralysis (upper limb/face)
- contralateral loss of sensation (upper limb/face)
- aphasia if in dominant (usually Lt) hemisphere
- hemineglect if lesion affects nondominant (usually Rt. side)
clinical symptom of lesions in frontal eye fields?
eyes look toward lesion
location of the primary motor is precentral or postcentral?
precentral
what is post central?
primary somato sensory
in what situations do you see therapeutic hyperventilation (dec pCO2) helps dec intracranial pressure?
acute cerebral edema (stroke, trauma) via vasoconstriction
cerebral perfusion is primarily driven by
pCO2
what area is associated with extraocular movement during REM sleep?
paramedian pontine reticular formation
what infection is associated with Kluver Bucy syndrome (disinhibited behavior: hyperphagia, hypersexuality, hyperorality)?
HSV-1
what area of the brain is responsible for disinhibition and deficit in concentration, orientation, judgement and may have reemergence of primitive reflex?
frontal lobe
gerstmann syndrome is associated with what part of the brain lesion?
dominant parietal temporal cortex (usually Lt. hemisphere)
what are the symptoms of Gerstmann syndrome
agraphia, acalculia, finger agnosia, Lt to Rt. disorientation
what is the consequence of damaging reticular activating system (midbrain)?
- reduced levels of arousal and wakefulness (coma)
- loss of consciousness
- stupor
what lesion will result in limb ataxia and falling toward the side of the lesion?
cerebellar hemisphere
what lesion will result in truncal ataxia and dysarthria?
cerebellar vermis
what is the diff btw aphasia and dysarthria?
aphasia is language deficit and dysarthria is movement deficit
where is Broca area?
inf. frontal gyrus of frontal lobe
where is wernicke area?
sup. temporal gyrus of termporal lobe
what type of aphasia leads to poor repetition, but fluent speech and intact comprehension?
conduction
what type of aphasia is associated with prosody?
broca (prosody: breif phase w/o intonation)
describe the broca aphasia
nonfluent with intact comprehension
describe the Wernicke aphasia
fluent with imparied comprehension
infarct of what blood vessel can lead to broca aphasia?
infarct of the superior division in MCA
infarct of what blood vessel can lead to Wernicke aphasia?
infarct of the inf. division of MCA
what type of aphasia leads to poor comprehension with fluent speech and intact repetition?
transcortical sensory (similar to Wernicke except for the poor repetition in Wernicke)
what type of aphasia is associated with nonfluent aphasia (halting speech), good comprehension with intact repetition?
transcrotical motor
what is the equation for CPP?
MAP - ICP
If CPP is zero, what does that mean?
no cerebral perfusion –> brain death
so in response to inc ICP, what does the body do?
inc MAP to maintain CPP
in what response/reflex do you see acute inc in ICP?
Cushing (hypertension, bradycardia, irregular breathing)
