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FA - Neurology > Neuro8 > Flashcards

Neuro8 Flashcards

Effects of Stroke Aneurysms

1
Q

What are the Arteries of the Anterior Circulation of the CNS?

A

Middle Cerebral A. (MCA)
Anterior Cerebral A. (ACA)
Lateral Striate A.

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2
Q

What are the Arteries of the Posterior Circulation of the CNS?

A

Anterior Spinal A. (ASA)
Posterior Inferior Cerebellar A. (PICA)
Anterior Inferior Cerebellar A. (AICA)
Posterior Cerebral A. (PCA)

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3
Q

What does the MCA supply?

A

Motor cortex - Upper Limb & Face

Sensory cortex - Upper Limb & Face

Temporal lobe (Wernicke's area)
Frontal lobe (Broca's area)
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4
Q

What does the ACA supply?

A

Motor cortex - Lower limb

Sensory cortex - Lower limb

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5
Q

What does the Lateral Striate A. supply?

A

Striatum, Internal Capsule

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6
Q

Contralateral paralysis of the upper limb and face is d/t a stroke of what artery and region?

A

MCA

Motor cortex upper limb & face

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7
Q

Contralateral loss of sensation of upper limb and face is d/t a stroke of what artery and region?

A

MCA

Sensory cortex - upper limb & face

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8
Q

What are the symptoms of stroke to Wernicke’s area (temporal lobe) or Broca’s area? What artery is involved?

A

Aphasia (if in dominant hemisphere; usually Left)
Hemineglect (Nondominant side)

MCA

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9
Q

Contralateral paralysis and loss of sensation of the lower limbs is d/t a stroke of what artery and region?

A

ACA

Motor & Sensory cortex - lower limb

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10
Q

Contralateral Hemiparesis/Hemiplegia is d/t a stroke of what artery and region?

A

Lateral Striate Artery

Striatum, Internal Capsule

*Common location of LACUNAR infarcts, 2˚ to unmanaged hypertension

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11
Q

What does the Anterior Spinal A. (ASA) supply?

A
  • Lateral Corticospinal tract
  • Medial Lemniscus
  • Caudal Medulla-Hypoglossal n.
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12
Q

What does PICA supply?

A

Lateral Medulla:

  • Vestibular nuclei
  • Lateral spinothalamic tract
  • Spinal Trigeminal nucleus
  • Nucleus Ambiguus
  • Sympathetic fibers
  • Inferior Cerebellar Peduncle
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13
Q

What does AICA supply?

A

Lateral Pons

  • Cranial nerve nuclei
    • Vestibular nuclei
    • Facial nucleus
    • Spinal trigeminal nucleus
    • Cochlear nuclei
    • Sympathetic fibers

Middle & Inferior Cerebellar Peduncles

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14
Q

What does the PCA supply?

A

Occipital cortex

Visual cortex

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15
Q

Contralateral hemiparesis of the lower limbs is d/t a stroke of what artery and region?

A

ASA - Lateral corticospinal tract

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16
Q

Decreased contralateral proprioception is d/t a stroke of what artery and region?

A

ASA - Medial lemniscus

17
Q

Ipsilateral hypoglossal dysfunction is d/t a stroke of what artery and region?

A

ASA - Caudal medulla–Hypoglossal n.

*tongue deviates ipsilaterally – “lick your wound”

18
Q

What is Medial Medullary Syndrome?

A

Infarct of paramedian branches of ASA & Vertebral arteries

  • Alternating Hemiplegia affecting:
    • Lateral Corticospinal tract
      • Contralateral hemparesis (lower limb)
    • Medial Lemniscus
      • Contralateral loss of proprioception
    • Hypoglossal n.
      • Ipsilateral loss of hypoglossal function
19
Q

What is Lateral Medullary (Wallenberg’s) Syndrome?

A

Infact of PICA

  • Vestibular nuclei - vestibular system: vomiting, vertigo, nystagmus
  • Inferior cerebellar peduncle - Ipsilateral cerebellar signs including ataxia, dysmetria (past pointing), dysdiadokokinesia
  • Central tegmental tract - palatal myoclonus
  • Lateral spinothalamic tract - contralateral deficits in pain and temperature sensation from body (limbs and torso)
  • Spinal trigeminal nucleus & tract - ipsilateral loss of pain, and temperature sensation from face
  • Nucleus ambiguus - vagus nerve and glossopharyngeal nerve - ipsilateral laryngeal, pharyngeal, and palatal hemiparalysis: dysphagia, hoarseness, diminished gag reflex (efferent limb - CN.X)
  • Descending sympathetic fibers - ipsilateral Horner’s syndrome (ptosis, miosis, & anhydrosis)

“Can’t Swallenberg - Mark Walberg was a PICA”

20
Q

Nucleus Ambiguus effects are specific to a lesion of what Artery?

A

PICA

“Don’t PICK A (PICA) horse (hoarseness) that cant eat (dysphagia)”

21
Q

What is Lateral Pontine Syndrome?

A

Blockage of AICA

  • Lateral spinothalamic tract:
    • Contralateral loss of pain and temperature from the trunk and extremities.
  • Facial nucleus & facial Nerve:
    (1) Ipsilateral paralysis of the upper and lower face (lower motor neuron lesion).
    (2) Ipsilateral loss of lacrimation and reduced salivation.
    (3) Ipsilateral loss of taste from the anterior two-thirds of the tongue.
    (4) Loss of corneal relfex (efferent limb).
  • Spinal trigeminal nucleus and tract:
    • Ipsilateral loss of pain and temperature sensation from the face (facial hemianesthesia)
  • Vestibular Nuclei and intraaxial nerve fibers:
    • Nystagmus, nausea, vomiting, and vertigo
  • Cochlear nuclei and intraxial nerve fibers:
    • Hearing loss - ipsilateral central deafness
  • Middle & inferior cerebellar peduncle:
    • Ipsilateral limb and gait ataxia
  • Descending sympathetic tract:
    • Ipsilateral Horner’s syndrome (ptosis, miosis, & anhydrosis)
22
Q

Facial Nucleus effects are specific to a lesion of what artery?

A

AICA

“Facial droop means AICA’s pooped”

23
Q

Ataxia and Dysmetria are d/t a stroke of what artery and region?

A

AICA - Middle & Inferior Cerebellar peduncles

24
Q

A lesion to the PCA would cause what type of symptoms?

A

Contralateral hemianopia w/ Macular Sparing

*Occipital cortex, visual cortex

25
Q

Lesions of the communicating arteries of the CNS are typically due to what?

A

Aneurysms (NOT strokes)

26
Q

What are the common sites for a saccular (Berry) aneurysms?

A

Anterior Communicating & Posterior Communicating

27
Q

An aneurysm of the Acomm will lead to what symptoms?

A

Visual field defects

28
Q

Aneurysm of the PComm will lead to what symptoms?

A

CNIII palsy

*Eye is DOWN-and-OUT w/ Ptosis & Pupil Dilation

29
Q

Where do Berry Aneurysms occur?

A

Bifurcation in the circle of Willis

30
Q

What is the most common site of a Berry Aneurysm?

A

Bifurctation of the Anterior Communicating Artery

31
Q

Rupture of a Berry Aneurysm leads to what?

A 
Subarachnoid Hemorrhage ("WHOML")
Hemorrhagic Stroke

*Can also cause Bitemporal Hemianopia via compression of Optic Chiasm

32
Q

Berry aneurysms are associated with what medical conditions?

A

ADPKD
Ehlers-Danlos syndrome
Marfan’s syndrome

33
Q

What are Charcot-Bouchard microaneurysms associated with and what do they affect?

A

Chronic Hypertension

Affects Small Vessels (e.g., in basal ganglia, thalamus)

FA - Neurology (22 decks)

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