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Neuromuscular Practice > Stroke > Flashcards

Stroke Flashcards

1
Q

What is the definition of a stroke?

A

Sudden onset of focal nuerologic deficits fitting a vascular distribution

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2
Q

What functions originate in the frontal lobe of the brain?

A

voluntary movement, judgement, and foresight

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3
Q

What functions originate in the parietal lobe of the brain?

A

somatosensation: primary and association

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4
Q

What functions originate in the Temporal lobe of the brain?

A

Auditory: primary and association

Memory

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5
Q

What functions originate in the occipital lobe of the brain?

A

vision: primary and association

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6
Q

What functions originate in the cerebellum?

A

coordination and balance

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7
Q

What is the function of Broca’s area?

What is the function of Wernicke’s area?

A

Motor speech

Speech comprehension

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8
Q

What functions are unique to the left side of the brain?

What functions are unique to the right side of the brain?

A

Left side- Speech, logic, reasoning, time, objectivity, rhythm

Right side-tone, emotion, intuition, present, subjectivity, melody

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9
Q

What is an ischemic stroke?

A

stroke which results from obstructed blood vessels such as from a clot by thrombus (atherosclerosis) or embolis (detached mass carried by blood)

most common type of stroke

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10
Q

What is a hemorrhagic stroke?

A

occurs when weakened blood vessel wall ruptures via aneurysms and arteriovenous malformations

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11
Q

What is a transient ischemic attack (TIA)?

A

A clot temporarily blocks an artery (a “mini-stroke”)
Clinical syndrome of acute loss of focal function with symptoms lasting less than 24 hours (usually less than 2) and is due to inadequate cerebral circulation

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12
Q

What percentage of people that have a transient ischemic attack develop a stroke within 5 years?

A

30%

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13
Q

`How can you differentiate between an ischemic and hemorrhagic stroke in an MRI image?

A

Ischemic stroke imaging will show large dark mass representing the edema which can be seen as early as 2-3 hours before an attack

hemorrhagic stroke will show a bright red spot representing acute blood pooling

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14
Q

When a patient has a stroke from stress what is the most likely type of stroke they suffer?

A

Hemorrhage

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15
Q

If a person has a stroke while sleeping what is likely the cause of the stroke they suffered?

A

stroke from thrombosis

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16
Q

If a person has a stroke during normal activities of the day what is the likely cause of the stroke?

A

Embolus

17
Q

True or False: While TIAs cause no permanent damage or disability they are a sign of impending stroke

A

True

18
Q

What things can be done to help prevent a stroke after a TIA?

A

lifestyle changes, surgery and medications

19
Q

What are the 3 arteries which can cause a cortical stroke if blocked? What does each supply?

A

Anterior Cerebral Artery-supplies medial part of the frontal and parietal lobes as well as the anterior part of the corpus callosum, basal ganglia and internal capsule

Middle cerebral artery- supply lateral surface of the hemisphere, except for the medial part of the frontal and parietal lobes (ACA) and the inferior temporal lobe (PCA)

Posterior cerebral artery-supply the inferomedial part of the temporal lobe, occipital pole, visual cortex, and splenium of the corpus callosum

20
Q

If a person suffers an ACA stroke what will they have deficits in?

A

loss of motor function in contralateral LE
loss of somatosensation in contralateral LE
loss of cognitive executive functions such as planning, memory, decision making, impulse control, and selective attention

21
Q

If a person suffers an MCA stroke what will they have deficits in?

A
  • loss of motor function to contralateral lower face, arm, and some trunk
  • Loss of somatosensation in contralateral face, arm, and some trunk
  • Loss of vision, usually homonymous hemianopia
  • Loss of motor speech, speech reception, reading, writing, and calculating in dominant hemisphere
  • Possible hemi-neglect and agnosia in non-dominant hemisphere
22
Q

If a person suffers an PCA stroke what will they have deficits in?

A

symptoms depend on location of the infarct but include contralateral visual field defect

23
Q

Which cranial nerves or located at the midline of the brainstem and what is their function?

A

CNs that are divisible by 12 (3, 4, 6 and 12) and they are motor only

24
Q

Which cranial nerves are found laterally on the brainstem?

A

CN not divisible by 12 so CN 5, 7, 8, 9, and 10 and they are sensory
the only exception is CN 11 which is lateral but is motor

25
Q

What 4 motor syndromes are effected by damage to the midline of the brainstem?

A

Medial Longitudinal fasciculus (eye motor)
Motor tract of the UMN (corticospinal tract)
Medial lemniscus (proprioception and vibration)
Motor nuclei of CN

26
Q

What 4 sensroy syndromes are effected by the lateral part of the brainstem?

A 
Spinothalamic tract (pain/temp)
spinocerebellar tract (RAM)
Sympathetic chain (dilation, weating, etc.)
Sensory CN nuclei
27
Q

True or False: 28% of all strokes occur in people under 65 years old

A

True

28
Q

What are the non-modifiable risk factors for stroke?

A

Gender (women higher than men)
Age (stroke risk doubles for each decade after age 55)
Genetics/Ethnicity (people of color have higher risk)

29
Q

What are some modifiable risk factors for stroke?

A 
Blood Pressure (higher=more risk)
Cardiac disease
lipids (higher=more risk)
diabetes
TIA (transient ischemic attack)
smoking
weight (30% above average=significant increase)
Inactivity
30
Q

What are the warning signs of a stroke? (hint: Act FAST)

A 
Facial Weakness (ask pt. to smile)
Arms Weakness (ask pt. to raise both arms)
Speech difficulties (ask pt. to repeat a simple phrase)
Time is brain! (if you see these signs call 9-1-1)
31
Q

What is the current standard of brain imaging for a stroke?

A

CT scans

32
Q

True or False: CT scans are more accurate at diagnosing a stroke than an MRI.

A

False, MRI is more accurate and better at detecting ischemic stroke damage within 12 hrs of first stroke symptoms

33
Q

What two zones are created by an ischemia?

Describe each.

A

Infarcted Core- severe local ischemia; hypoxia depletes oxygen and glucose, results in tissue necrosis

Penumbra- surrounding ischemic areas, mild to moderate ischemic tissue where cells receive enough oxygen and glucose to remain alive for a limited time, but do not respond electrically. A salvageable region

34
Q

What type of surgical techniques are used for an acute stroke?

A

MERCI clot retrieval
Carotid Endarterectomy: to remove atherosclerotic plaque in TIAs or mild strokes
Stereotactic Microsurgery: for AVMs/aneurysms
Angioplasty-open partially blocked vessels

Neuromuscular Practice (10 decks)

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