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MedNeuro Block 1 > Stroke > Flashcards

Stroke Flashcards

1
Q

Definition of Stroke

A

Illness of brain with acute onset

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2
Q

Three Criteria of stroke

A

Sudden Onset
Focal Neurological Deficit
Cerebrovascular Cause

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3
Q

Does a stroke result in altered consciousness?

A

not usually

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4
Q

Stoke present bilateral/unilateral/both

A

Unilateral

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5
Q

Is fainting a sign of a stroke?

A

no… bc its bilateral

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6
Q

What are some warning signs of a stroke?

A 
Hemifacial paralysis
Vision loss
Numbness on one side
Loss of speech or Comprehension of speech
Unsteady Gait
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7
Q

Most common cerebrovascular cause of stroke?

A

Ischemia~ 85% time

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8
Q

Less common cerebrovascular cause of stoke?

A

Hemmorhagic stroke~ 15%

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9
Q

What are two types of ischemic stoke?

A

Thrombotic and Embolic

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10
Q

Difference between thrombus and emobois

A

Thrombus is clot forming in brain dt fibrin strands clumping together
Embolis is a clot that forms somewhere else and is kicked out by the heart and travels up to brain

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11
Q

What are two types of Hemorrhagic stoke?

A

Intracerebral (Hypertension HTN)

Subarachnoid (aneurysm)

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12
Q

What is the least common type of stoke?

A

Hemorrhagic brought on by aneurysm

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13
Q

Where does a Hemorrhagic intracerebral stroke occur?

A

D/t high bp and is the blood within the parachyma–NOT in the subarachnoid space

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14
Q

Where does an aneurysm occur?

A

In the subarachnoid space–you are born with this and can rupture at any time and fill the fissures around brain.

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15
Q

What does ICH stand for?

A

Intracerebral Hemorrhage

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16
Q

On a CAT… what color is blood?

A

White

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17
Q

What are the two cause of a subarachnoid hemorrhage?

A

Aneurysm rupture and trauma… get patient history

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18
Q

What defines an Ischemic stroke?

A

Arterial occlusion with brain infarction = tissue in brain is dead

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19
Q

Stoke happens to …

A

the patient

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20
Q

infarct happens to…

A

the brain

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21
Q

Where does the PCA come from?

A

Vertebral arteries–> Basal Artery–> gives off PCA

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22
Q

Where does the ACA arise?

A

Internal carotids –> one of it’s terminal branches.. runs medially and anteriorly

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23
Q

Where does the MCA arise?

A

Internal carotids–> one of it’s terminal branches–> runs laterally in the sylvian fissure

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24
Q

Where do most strokes occur?

A

2/3 in MCA

25
Q

What is the Penumbra

A

source of stroke… key area to fix when trying to deal with a stroke

26
Q

During a stroke… where does collateral blood flow come from? Why?

A

from neighboring regions… d/t autoregulation

27
Q

What do we look for on an MRI?

A

White tissue… shows where blood is located.

28
Q

Where is an ACA stroke going to show up on MRI?

A

Midline in front

29
Q

What does a perfusion scan tell us?

A

Where we aren’t getting any blood

30
Q

What will our penumbra look like on perfusion scan?

A

RED

31
Q

What colors represent decreased perfusion?

A

green/yellow/red

32
Q

Why is a perfusion scan beneficial vs an MRI?

A

Gives us more information about specific location of infarct.. pinpoints region that needs to be salvaged to stop spread of tissue loss

33
Q

What does a peneumbra look like on MRI?

A

bright white core

34
Q

What will images look like for MCA occlusion?
angiograph?
MRI?
CAT?

A

angiograph will show occlusion of blood vessel lateral to circle of willis
MRI will help show dense core of penumbra
CAT scan will show us ride range are of low blood flow in bright white… usually to outside of hemi

35
Q

What is a method of intervention for stroke?

A

catheter angiogram

36
Q

Some examples of disease states that meet:

acute onset an focal neuro deficit but not cerebrovascular cause?

A

Parkinsons, some trauma, MS, migraines

37
Q

Is postural dizziness a sign of stroke?

A

no

38
Q

Patient with garbled, nonsensical speech, sudden onset… meet criteria for stroke?

A

yes

39
Q

Patient with lateropulsion, dizziness and emesis meet criteria for stroke?

A

yes

40
Q

What are Unmodifiable risk factors for stroke?

A

age, gender, race, heredity

41
Q

Modifiable risk factors for stroke?

A 
Hypertension
Hyperlipidemia
Heart disease
Hyperhomocyteinemia
Obesity
Diabetes/inactive
smoking/heavy alcohol use
carotid disease
42
Q

Why do people have stokes?

A

ALL about risk factors

43
Q

3 stages of stroke management

A

Acute therapy
Recovery
Prevention of secondary stroke

44
Q

Options for acute therapy

A

Thrombolysis–clot busting via drug intervention

TPA-tissue plasminogen activator; MUST BE DONE RIGHT AFTER STROKE

45
Q

Key for recovery from stroke?

A

Limit neuro damage: prevent complications, rehab and education of new habits

46
Q

Prevention of secondary stroke steps are:

A

Based on risk factor modification

And are specific to mechanism of stroke

47
Q

Physical symptoms of Left PCA stroke?

A

Right body numbness

Right homonymous hemianopia (vision loss)

48
Q

Physical symptoms of Left MCA stroke?

A

Right arm and face weakness

Aphasia : difficulty talking

49
Q

Physical symptoms of Right MCA stroke?

A

Left arm and face weakness; no speech deficiets

50
Q

Physical symptoms of right superior MCA stroke?

A

Weakness and/or sensory loss of LEFT face, hand, arm and trunk

51
Q

Sensory loss from left face, hand and arm

Left hemineglect

A

Right inferior MCA stroke

52
Q

Sensory loss from RIGHT face, hand and arm

Wernickes aphasia: posterior aspect of superior temporal gyru

A

Left inferior infarct of MCA

53
Q

Left Superior infarct of MCA: symptoms

A

Weakness and/or sensory loss of RIGHT face, hand, arma and trunk
Brocas aphasia

54
Q

Follwing symptoms describe: personal neglect—unaware of left half of body or environment: may not acknowledge that one half of body belongs to them or may only acknowldege half of environment

A

Cortical injury

55
Q

Internal carotid artery has which two terminal branches?

A

ACA and MCA

56
Q

Sing and Symptoms of Infarct of ACA on Left side

A

Right leg and foot weakess and behavioral changes d/t frontal lobe

57
Q

precentral gyrus which is supplied by ACA is repsonsible for what?

A

contralateral leg and foot WEAKNESS if infarct

58
Q

postcentral gyrus which is supplied by ACA is repsonsible for what?

A

Contralateral leg and foot SENSATION loss

MedNeuro Block 1 (6 decks)

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