Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular system 16/17 > Stroke > Flashcards

Stroke Flashcards

1
Q

What is the commonest cause of long term disability?

A

Stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a stroke?

A

Neurological loss of function of sudden onset lasting over 24 hours of vascular origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a transient ischaemic attack?

A

Neurological loss of function lasting less than 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the symptoms of stroke?

A 
Loss of power
Loss of sensation
Loss of speech
Loss of vision
Loss of coordination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What might some patients experience during a stroke?

A 
Headache
Vomiting
Neck stiffness
Photophobia
Loss of consciousness
Fit 
Incontinence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is dysarthria and dysphasia?

A

Dysarthria - Poor articulation in speech

Dysphasia - inability to formulate language

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is nystagmus?

A

Involuntary eye movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes a stroke?

A

Damage to part of the brain due to either:
- occlusion of a vessel by an emboli
- haemorrhage at ruptured vessel
Both result in ischaemia of brain tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the tissue surrounding an ischaemic event that is low in oxygen but not infarcted called?

A

Penumbra, still viable for several hours after event so can be saved if treated fast enough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What blood vessels make up the anterior circulation to the face and neck?

A

External carotid arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What blood vessels make up the posterior circulation to the brain?

A

Internal carotid arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What blood vessels make up the circle of willis in the brain?

A

Where both the external and internal carotid arteries anastomoses in the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can you quickly identify the responsible artery for a stroke?

A

Compare symptoms to area of brain it is linked to and its associated blood vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What vascular system supplies the brain stem, cerebellum and occipital lobes of the brain?

A

The vertebra-basilar system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What vascular system supplies most of the hemispheres and the cortical deep white matter of the brain?

A

The carotid system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What part of the brain is linked to speech?

A

Broca’s area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What part of the brain is linked to movement?

A

Motor cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What part of the brain is linked to sensation?

A

Sensory cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What part of the brain is linked to swallowing, breathing, heart rate, wakefulness etc?

A

Brainstem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What part of the brain is linked to smell?

A

Frontal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What part of the brain is linked to vision?

A

Occipital lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What part of the brain is linked to hearing?

A

Temporal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What part of the brain is linked to comprehension of language?

A

Parietal lobe

Wernickes area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What part of the brain is linked to judgement, foresight and voluntary movement?

A

Frontal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What part of the brain is linked to intellectual and emotional functions?

A

Temporal lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What part of the brain is linked to coordination?

A

Cerebellum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the homunculus, and what is its relevance for stroke?

A

Distorted scale model of a human representing the relative space human body parts occupy on the somatosensory cortex and the motor cortex

Can link symptoms to part of the brain fast

28
Q

At what two points in the deep white matter cause significant damage in the event of a stroke?

A

Internal capsule and pons

Fibres are packed very close together here

29
Q

What % of strokes are caused by infarction?

A

85%

30
Q

What % of strokes are caused by haemorrhage?

A

15%

31
Q

List some causes of ischaemic stroke due to infarction

A 
Large artery atherosclerosis
Cardioembolic - AF most common cause
Small artery occlusion - hypertension 
Undetermined/cryptogenic
Arterial dissection
Venous sinus thrombosis
32
Q

List some causes of haemorrhagic stroke

A

Primary intracerebral haemorrhage
Secondary haemorrhage
- subarachnoid haemorrhage
- arteriovenous malformation

33
Q

What is the most common cause of cardioembolic strokes?

A

Atrial fibrillation

34
Q

What is associated with small artery occlusion (lacunar) strokes?

A

Hypertension

Blockage of small arteries feeding the deep white matter (internal capsule and pons)

35
Q

What can cause the rare carotid dissection?

A

Trauma
Idiopathic
Exertion e.g. rowing, heavy lifting

36
Q

How does artery dissection cause stroke?

A

Tear in artery wall leads to the formation of a clot at the site of the injury, which can later embolise and block an artery and cause a stroke

37
Q

What is the importance of localisation of a stroke?

A 
Confirms diagnosis of stroke
Allows better imaging selection
Gives indication of cause
Gives indication of prognosis
Gives indication of treatment needed
38
Q

What are the 4 stroke subtype?

A

TACS - total anterior circulation stroke
PACS - partial anterior circulation stroke
LACS - lacunar stroke
POCS - posterior circulation stroke

39
Q

Describe unilateral field loss of vision

A

Vision in whole of one eye, due to compression of nerve supplying that eye

Compression of nerve after chiasma

40
Q

Describe bitemporal hemianopia vision loss

A

Loss of vision in both the internal portions of each eye (cant see directly in the middle between your eyes)

Compression at chiasma

41
Q

Describe homonymous hemianopia vision loss

A

Loss of vision on either the left or right portions of both eyes

Damage of nerve in occipital lobe

42
Q

What % of strokes are total anterior circulation strokes?

A

20%

43
Q

What are the usual symptoms of TACS?

A

Weakness
Sensory deficit
Homonymous hemianopia
Higher cerebral dysfunction

Usually due to occlusion of proximal MCA or ICA

44
Q

What are the usual symptoms of PACS?

A

Restricted motor/sensory deficit e.g. one limb, hand, high cerebral dysfunction alone
Like TACS but 2/3 of TACS criteria

Due to occlusion of branches of MCA, more restricted cortical infarcts

45
Q

What % of strokes are partial anterior circulation strokes?

A

35%

46
Q

What % of strokes are lacunar strokes?

A

20%

47
Q

What are the usual symptoms of LACS?

A

Pure motor commonest
Pure sensory
Sensorimotor
Ataxic hemiparesis

Due to intrinsic disease of single basal perforating arteries (end arteries)

48
Q

What % of strokes are posterior circulation strokes?

A

25%

49
Q

What are the usual symptoms of POCS?

A

Variable, bilateral motos/sensory deficit

  • disordered eye movement
  • coma
  • disordered breathing
  • tinnitus
  • vertigo
  • Horners syndrome
  • ipsilateral cranial nerve palsy
  • visual deficit
50
Q

Which stroke subtype has the greatest mortality rate after 1 year?

A

TACS

51
Q

Which stroke subtype has the greatest recurrence rate at 1 year?

A

POCS

52
Q

List some risk factors for stroke

A 
Hypertension
Atrial fibrillation
Cocaine use
Age
Sex - females protected until menopause
Race - increased risk in far eastern pop
Family history
53
Q

Describe the investigations used for stroke

A 
Blood tests
ECG
Imaging
 - CT
 - MRI
 - Carotid doppler
 - ECHO - clots in heart (AF)
54
Q

What are the benefits of CT vs MRI for each type of stroke?

A 
CT
 - quick
 - shows up blood (useful in haemorrhagic)
MRI
 - takes 30 mins
 - claustrophobic and noisy 
 - shows ischaemic stroke better than CT
55
Q

What imaging is best for haemorrhagic stroke?

A

CT

56
Q

What imaging is best for ischaemic stroke?

A

MRI

57
Q

How can you further harm someone with a stroke?

A

Alteplase (fibrinolytic agent) in wrong patient

Can cause further damage or restoring blood flow to already dead tissue will have no effect

58
Q

What are the SIGN guidelines for stroke treatment?

A 
Ambulance priority (blue light)
Rapid triage
Immediate access to stroke specialists 
Rapid brain imaging
Rapid specialist assessment
59
Q

Describe FAST and strokes

A

Facial weakness
Arm weakness
Speech problems
Time to call 999

60
Q

When are patients suitable for thrombolysis?

A

Patients with neurological deficit due to a ischaemic stroke if they are scanned within 4.5 hours of symptom onset

61
Q

What are some contraindications for thrombolysis?

A

Age - not in patients <16yo or >80yo

Recent MI, bleeding or very high BP

62
Q

What is a hemicraniectomy?

A

Decompression surgery following stroke with massive cerebral oedema, only offered within 48hrs of stroke onset

63
Q

What treatments are offered to stroke patients?

A

Stroke unit(?)
Thrombolytics within 4 hrs
Aspirin for 2 days
Hemicraniectomy within 2 days if needed

64
Q

What % of patients experience trouble swallowing after strokes?

A

50%

65
Q

What is the relative % risk of an early recurrent stroke within 3 months of a previous TIA or stroke?

A

14%

66
Q

What secondary prevention treatment is given to prevent second strokes/TIAs?

A

Clopidogrel or aspirin, dipyrimadole
Statin
Hypertension drugs
Anticoagulants when needed

67
Q

What surgery is performed for carotid stenosis?

A

Carotid endarterectomy - targets anterior circulation if external carotids are >70% occluded

Cardiovascular system 16/17 (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions