Quiz #1 Flashcards

1
Q

Cerebrovascular Accident what is it?

A

Is an umbrella terms applied to a condition where a blood flow to the brain is disrupted by either a clotting or rupture.

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2
Q

How many primary strokes (CVA) are there ?

A

Ischemic and Hemorrhagic.

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3
Q

Which types of strokes are most common?

A

Ischemic

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4
Q

Ischemic strokes are result of?

A

Thrombosis (static clot) or emboli (traveling cloth).

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5
Q

Hemorrhagic strokes involve what to the brain tissue?

A

Bleeding

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6
Q

What hemorrhagic stroke can result from?

A

Hypertension, aneurysms, or head injury.

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7
Q

Which types of strokes are most fatal ?

A

Hemorrhagic strokes

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8
Q

What are risk factors of stroke ?

A
Age
Sex (Men)
Race
Hypertension
High cholesterol levels 
Cigarette smoking
Diabetes mellitus
Obesity 
Heart Disease
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9
Q

Thrombotic Strokes

A

Formed by plaque in a vessel wall.
Most common type of ischemic strokes and occurs in atherosclerotic blood vessels.
It occurs gradually over several days
Frequently seen with older person with arteriosclerotic heart disease.
Is not associated with exertion or activity and can occur with person at rest.

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10
Q

What are common sites for Thrombotic Strokes?

A

Large vessels of the brain including;
Origin of the internal carotid arteries
Vertebral Arteries
Junction of the basilar and vertebral arteries.

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11
Q

Lacunar Infracts

A

Small clots located in deep regions of the brainstem and subcortical structures.
Commonly occlusion is in a small branches of the large cerebral arteries.
Most notably in the middle, posterior cerebral arteries and can occur in anterior cerebral, vertebral and basilar arteries.
Found is a single deeply penetrating arteries that supply the internal capsule, basal ganglia and brainstem.
Due to small size that do not cause severe impairments.

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12
Q

Embolic Strokes

A

Clothes that separate and travel to a cerebral blood vessel until they become trap.
Affects a smaller cerebral vessels.
Most frequent cite is middle cerebral artery
These strokes have sudden onset and are associated with cardiac disease such as; rheumatic heart disease, ventricular aneurysm and bacterial endocarditis and after myocardial infraction.

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13
Q

Hemorrhagic Storke

A

Frequently fatal
If client can survive, prognosis is generally good.
Involves bleeding to the brain after rupture of a blood vessel wall.
This type of stroke results in edema and compression of brain tissue. If not treated immediately can be fatal.
Commonly occur suddenly and are associated with exertion and activity.

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14
Q

Aneurysm is ?

A

Bulge occurring in a blood vessel wall as a result of cloth forming.
Tend to enlarge with time and weaken vessels walls until rupture occurs.

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15
Q

Most aneurysms are ?

A

Small saccular structures called Berry Aneurysms

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16
Q

Berry Aneurysms commonly occur?

A

Commonly occur in the circle of Willis or the junction of 2 vessels.

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17
Q

Transient Ischemic Attack

A

Referes as mini strokes
Characterized by focal ischemic cerebral incidents that last less then 24 hours.
Most of the last less then 1 to 2 hours
May provide a warning of an impending larger stroke

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18
Q

The causes of TIA?

A

atherosclerotic disease and emboli

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19
Q

What are signs of TIA?

A

Numbness and mild weakness on one side of the body
Transient visual disturbance (blurred vision, fading vision)
Dizziness
Falls
Confusion and possible blackout

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20
Q

What are the Major Arteries ?

A
Internal Carotids (2)
Vertebral Arteries (2)
Anterior Spinal Artery (1)
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21
Q

Internal Carotids supply blood to which part of the brain?

A

Supply the brain

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22
Q

Vertebral Arteries supply blood to which part of the brain?

A

Lateral medulla areas

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23
Q

Anterior Spinal Artery supply blood to which part of the brain?

A

Anterior portion of the medulla and spinal cord.

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24
Q

Three Arteries that Supply the Cerebellum ?

A

Posterior Inferior Cerebellar Arteries
Anterior Inferior Cerebellar Arteries
Superior Cerebellar Arteries
Basilar Artery

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25
Q

Posterior Inferior Cerebellar Arteries supply blood to which part of the brain?

A

Dorsolateral medulla, inferior surface of the cerebellum and the deep cerebellar nuclei

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26
Q

Anterior Inferior Cerebellar Arteries supply blood to which part of the brain?

A

Inferior surface of the cerebellum and the deep cerebellar nuclei

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27
Q

Superior Cerebellar Arteries supply blood to which part of the brain?

A

Superior aspect of the cerebellum and parts of deep cerebellar nuclei.

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28
Q

Basilar Artery supply blood to which part of the brain?

A

Does not supply cerebellum but gives raise to the superior cerebellar arteries.
Anterior and lateral aspects of the pons.

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29
Q

Three Main Cerebral Arteries

A

Posterior Cerebral Arteries
Middle Cerebral Arteries
Anterior Cerebral Arteries

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30
Q

Posterior Cerebral Arteries supply blood to which part of the brain?

A

Medial and inferior surface of the temporal and occipital lobes, thalamus and hypothalamus

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31
Q

Middle Cerebral Arteries supply blood to which part of the brain?

A

Lateral surface of the frontal, temporal and parietal lobes

Inferior surface of part of the frontal and temporal lobes

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32
Q

Anterior Cerebral Arteries supply blood to which part of the brain?

A

Superior, lateral and medial aspects of the frontal and parietal lobes.
Basal ganglia and the corpus callosum

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33
Q

Circle of Willis is for what?

A

Is a circuit of interconnecting arteries that function to prevent lack of blood flow to the brain due to occlusion.

34
Q

What are the components of the circle of Willis ?

A
Posterior cerebral artery 
posterior communicating arteries 
internal carotid arteries 
anterior cerebral arteries 
anterior communicating artery
35
Q

Middle Cerebral Arterial Occlusion are the most common?

A

occlusions that result in CVA.

36
Q

Middle Cerebral Arterial Occlusion in the Left Hemisphere will result in?

A
Contralateral hemiplegia 
Contralateral hemiparesthesia 
Aphasia (Broca or Wernicke or other)
Cognitive Involvement 
Affective Involvement such as lability and depression (CATASTROPHIC RESPONSE).
37
Q

Middle Cerebral Arterial Occlusion in the Right Hemisphere will result in?

A

Contralateral hemiplegia
Contralateral hemiparesthesia
Perceptual deficits (LEFT NEGLECT SYNDROM)
Apraxia - multimodal associated area, premotor area/or primary motor cortex in lesioned.
Cognitive Involvement
Affective Involvement - Euphoria or report a sense of well being. If neglect syndrom is present the patient is often unaware of his or her deficits.

38
Q

Posterior Cerebral Arterial Occlusion will result in?

A

Memory loss due to temporal lobe involvement
Visual perceptual deficits resulted from damage to the occipital lobe
Visual field cuts resulted from occlusion to the optic chiasm

39
Q

Anterior Cerebral Arterial Occlusion will result in?

A

Contralateral Hemiplegia - affecting lower extremities
Contralateral Hemiparesthesia - often of the lower extremities
Cognitive involvement
Affective involvement depending on which side same as in MCA.

40
Q

Cerebellar Arterial Occlusion what are 3 major sympotoms?

A

Incoordination
Ataxia
Intention tremors.

41
Q

Posterior Inferior Cerebellar Arterial Occlusion will result in?

A

Ipsilateral hypertonicity and hyperactive reflexes.
Vertigo, Nausea, Nystagmus, Diplopia
Ipsilateral Loss of pain and temperature on the face
Contralateral Loss of pain and temperature on the trunk and extremities
Dysphagia and Dysarthria
Ipsilateral Horner Syndrome

42
Q

Anterior Inferior Cerebellar Arterial Occlusion will result in?

A
Ipsilateral Ataxia 
Ipsilateral hypotonicity and hyporeflexia
Dysmetria
Adiadochokinesia
Movement Decomposition
Asthenia
Rebound Phenomenon
Staccato voice
Ataxic gair
Intention Tremors 
Incoordination
Nystagmus 
Bell Palsy
43
Q

Anterior Spinal Artery Occlusion will result in?

A

Bilateral loss of motor function and loss of pain/temperature below the lesion.

44
Q

Vertebral Arterial Occlusion will result in?

A

Dysphasia may occur if the accessory nuclei are lost

45
Q

Basilar Arterial Occlusion will result in?

A

Contralateral Hemiplegia
Contralateral Sensory loss
Ipsilateral Sensory loss of the face
Medial or internal strabismus
Ipsilateral loss of the messeter reflex and the corneal reflex
Bell Palsy and hyperacusis can occur in the facial nerve
Deviation of the tongue of the affected side
Nystagmus and balance disturbance

46
Q

The nervous system is divided into the following?

A

Central Nervous System

Peripheral Nervous System

47
Q

The CNS is composed of the following?

A

Brain

Spinal Cord

48
Q

The PNS is composed of the following?

A

Cranial Nerves
Autonomic Nervous system
Somatic Nervous system

49
Q

The brain has 6 major component parts. What are they?

A
Cerebral lobes
Cerebellum
Basal Ganglia
Diencephalon
brainstem
Limbic system
50
Q

The ANS is composed of the following?

A

Parasympathetic nervous system

Sympathetic nervous system

51
Q

The SNS is responsible for the?

A

Innervation of skeletal muscles.

52
Q

Innervation of Visceral Muscles and Glands what types of organs?

A

Cardiac muscle
Lungs
Gastrointenstinal track
Secretory Glands.

53
Q

Parasympathetic nervous system responsible for?

A
Hemostasis
Slowing body down
Decreased blood pressure
Decreased heart rate
Peristalsis
54
Q

Sympathetic Nervous system responsible for?

A
Arousal
Fight/flight
Increased blood pressure
increased heart rate 
cessation of peristalsis
55
Q

Schwann Cells (myeline) Can regenerate ?

A

Yes. These are present in PNS

56
Q

Oligodendrocytes (myeline) Can regenerate?

A

No. These are present in CNS

57
Q

Multiple Sclerosis: Disease of the Myelin What is it?

A

Random demyelination of the CNS
Characterized by periods of exacerbation and remission over many years.
In the early stages of MS there is normal or near-normal neurologic function as the disease progresses, remissions grow shorter and are marked by less improvement.
Signs and symptoms can be variable.

58
Q

MS sensory symptoms what are they?

A

Numbness, paresthesias, Lhermitte sign (causalgia radiating down the back and lower extremities, elicited by neck flexion)

59
Q

MS motor symptoms what are they?

A

Abnormal gait, bladder and sexual dysfunction, vertigo, nystagmus, fatigue and speech disturbance.
MS of the spinal cord produces asymmetrical weakness.
Ataxia of the limbs .
Considered to be a disease process that affects the upper motor neurons

60
Q

MS Optic nerve

A

Visual field acuity

61
Q

MS Corticospinal Tracts

A

Muscle strength

62
Q

MS Corticobulbar tracts

A

Speech and swallowing functions

63
Q

MS Cerebellar tracts

A

Gait and coordination

64
Q

MS Spinocerebellar tracts

A

Balance

65
Q

MS Medial Longitudinal Fasciculus

A

Conjugate gaze of the extraocular eye muscles

66
Q

MS Dorsal columns

A

Discriminative touch, pressure, vibration, proprioception and kinesthesia.

67
Q

Amyotrophic Lateral Sclerosis: Death of Upper and Lower Motor Neurons diagnosis…

A

Severe degenerative neurologic disorder affecting motor function.
Both CNS and PNS.
Affecting The UMNs of the cerebral cortex and the lower motor neurons (LMN)s of the ventral horn of the spinal cord are both affected causing atrophy and spasticity
Sensory and cognitive functions remain intact.

68
Q

UMN lesions result in the following

A

Muscle weakness
Spasticity
Loss of fine motor control

69
Q

Either UMN and LMN lesions can account for the following

A

Dysphagia
Dysarthria (difficult articulating words clearly
Dysphonia (difficulty projecting one’s voice audibly)

70
Q

LMN lesions result in the following

A

Fasciculations
Muscle Weakness
Muscle Atrophy
Hyporeflexia

71
Q

Common early symptoms of ALS?

A

Muscle cramps involving the distal legs
A slow, progressive weakness and atrophy of the distal muscles groups of one upper extremity, followed with wider spread of muscle weakness in surrounding body areas.
Death occurs from respiratory musculature
Advanced stages of the disease muscle of the palate, pharynx, tongue, neck and shoulders are affected
UMN and LMN will affect multiples limbs and head

72
Q

Myasthenia Gravis: Disorder of the Neuromuscular Junction

A

Chronic autoimmune disorder affecting the neuromuscular junctions of voluntary muscles.
The production of acetylcholine that destroys receptors
Results are in severe muscular weakness and fatigue
First affecting eye and head musculature - - limbs and sometimes respiratory muscles
The use of Corticosteroid meds to suppress the immune response and the use of anticholinesterase to reduce the breakdowns of acetylcholine

73
Q

Frontal Lobes

A

Cognition, Short-term memory, expressive language, motor planning, mathematical calculations and working memory
Executive functions, self-insight and regulation of emotions
Develops mostly after birth completed until late adolescence or early adulthood.

74
Q

Posterior Lobes

A

Sensory detection, perception and interpretation

75
Q

Temporal Lobes

A

Functions are audition hearing, comprehension of language and long-term memory

76
Q

Occipital Lobes

A

Interpretation of visual stimuli from the optic pathways

77
Q

Right Hemisphere is responsible for?

A

interpretation of perceptual and spatial information (reading maps, creating music and art).
Interpretation of information that requires abstraction
Interpretation of tonal inflections in language
Taking the literal interpretation of a story and forming abstract symbolism and metaphors
Interpretation of emotional messages underlying the concrete meaning of words

78
Q

Left Hemisphere

A

Plays a role in human language (expression and interpretation of written and spoken words)
Aphasia (language dysfunctions.

79
Q

Gray Matter

A

Covers part of the central nervous system (CNS) are called cortex
Non-myelinated brain matter
Forms nuclei body
surrounds the surface of the cerebrum and cerebellum

80
Q

White Matter

A

Located beneath the gray matter in the internal regions of the cerebrum and cerebellum
Consist of myelinated fibers tracts or neuronal axons