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Cardiovascular system > Stroke- pathology and investigation 1 > Flashcards

Stroke- pathology and investigation 1 Flashcards

1
Q

what is a stroke?

A

a neurological deficit ( loss of function) of sudden onset and lasting more than 24 hours. It is of vascular origin.

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2
Q

what is a transient ischaemic attack?

A

a neurological deficit of sudden onset and vascular origin that last less than 24hours

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3
Q

what are the symptoms of a stroke?

A 
loss of power
loss of sensation
loss of speech (dysphasia)
loss of vision
loss of coordination
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4
Q

what is aphasia/ dysphasia?

A

language disorder marked by deficiency in the generation of speech

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5
Q

what must be found out during the history taking of a stroke?

A 
time of onset
witnesses
headache
vomiting
neck stiffness
photophobia
loos of consciousness
fit 
incontinence
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6
Q

if a stroke patient has headache, vomiting, neck stiffness or photophobia what does this suggest?

A

haemorrhage

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7
Q

what are the findings on examination of a stroke patient?

A 
motor function- clumsy or weak limbs
sensory function- loss of feeling
speech- dysarthria/ dysphasia
neglect/visuospatial problems
vsion-loss in one eye, or hemianopia
gaze palsy
ataxia
vertigo
incoordination
nystagmia
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8
Q

what is nystagmia?

A

condition in which the eyes make repetitive and uncontrolled movements, sign of stroke

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9
Q

what is ataxia?

A

neurological sign consisting of lack of voluntary coordination of muscle movements, sign of stroke

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10
Q

what is gaze palsy?

A

an inability to move both eyes in a single direction

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11
Q

what are the causes of strokes?

A
  • blood vessel occlusion by thrombus or embolus
  • haemorrhage
  • disease of vessel wall eg. atherosclerosis
  • disturbance of the normal properties of blood eg. thick blood from cancer
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12
Q

what is penumbra?

A

tissue that is alive but not perfused. It is at risk of infarction but can be saved if reperfused

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13
Q

what are the three circulations within the brain?

A

anterior circulation
posterior circulation
circle of WIllis

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14
Q

what is the Broca’s area of the brain responsible for?

A

speech

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15
Q

what is the frontal lobe responsible for?

A

judgement, foresight and voluntary movement

smell

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16
Q

what is the motor cortex of the brain responsible for?

A

movement

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17
Q

what is the sensory cortex of the brain responsible for?

A

heat, pain and other sensations

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18
Q

what is the parietal lobe responsible for ?

A

comprehension of language

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19
Q

what is the temporal lobe responsible for?

A
  • hearing

- intellectual and emotional functions

20
Q

what is the occipital lobe responsible for?

A

sight (primary visual area)

21
Q

what is the Wernicke’s area of the brain responsible for?

A

speech comprehension

22
Q

what is the cerebellum responsible for?

A

coordination

23
Q

what is the brainstem responsible for?

A 
swallowing
breathing
heart beat
wakefullness centre
other involuntary functions
24
Q

if a stroke is small but affects deep white fibres what will the result be?

A

it will result in a large deficit as the fibres are packet close together here

25
Q

what are the 5 causes of ischaemic stroke?

A
  • large artery atherosclerosis
  • cardioembolic
  • small artery occlusion
  • cryptogenic
  • rare causes such as arterial dissection and venous sinus thrombosis
26
Q

what are two kinds of haemorrhagic stroke?

A 
primary intracerebral haemorrhage
secondary haemorrhage (subarachnoid or atriovenous malformation)
27
Q

what does the internal carotid artery supply?

A

the brain

28
Q

what does the external carotid artery supply?

A

the face

29
Q

what is the main problem caused by brain stem strokes?

A

inability to swallow

30
Q

what is the most common cause of cardioembolic stroke?

A

atrial fibrillation

31
Q

why is it important to localise stroke?

A
  • confirms the diagnosis of a stroke
  • allows better selection of imaging
  • gives an indication of cause
  • gives an indication of prognosis
32
Q

what is unilateral field loss?

A

loss of vision in one eye

33
Q

what is bitemporal hemianopia?

A

loss of vision from one half of each, the loss is in the opposite halves

34
Q

what is homonymous hamianopia?

A

loss of sight from one side in both eyes, the loss is from the same side in both eyes

35
Q

what is a total anterior circulation stroke due to?

A

occlusion of proximal middle cerebral artery or internal carotid artery

36
Q

what are the symptoms/signs of total anterior circulation stroke?

A 
weakness
 sensory deficit
Homonymous hemianopia (loss of vision)
Higher cerebral dysfunction (eg dysphasia, dyspraxia)
37
Q

what is dyspraxia?

A

the partial loss of the ability to co-ordinate and perform skilled, purposeful movements and gestures with normal accuracy. (apraxia is the total loss)

38
Q

what is partial anterior circulation (PACS) caused by?

A

occlusion of branches of MCA

39
Q

what are the symptoms of PACS?

A 
2/3 features TACS
ie.
weakness
 sensory deficit
Homonymous hemianopia (loss of vision)
Higher cerebral dysfunction (eg dysphasia, dyspraxia)
40
Q

what is occluded in lacunar stroke (LACS)?

A

a lacunar artery

41
Q

what are the symptoms of LACS?

A

either:
-pure motor problem problem: Complete or incomplete weakness of 1 side, involving the whole of 2 of 3 body areas (face/arm/leg)
-pure sensory
Sensory symptoms and/or signs, same distribution
-sensorimotor
combination of above
-ataxic hemiparesis

often silent

42
Q

what is ataxic hemiparesis?

A

paresis of contralateral leg and side of the face, ataxia of the contralateral leg and arm

43
Q

which classification of stroke has the best prognosis?

A

LACs

44
Q

which classification of stroke has the poorest prognosis?

A

TACs

45
Q

which classification of stroke has the highest recurrence rate?

A

PACs

Cardiovascular system (40 decks)

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