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Neuroanatomy Rewind Unit III > Stroke Review > Flashcards

Stroke Review Flashcards

1
Q

The sources supplying the circle of willis are the:

A

internal carotid arteries, basilar artery

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2
Q

The _____ artery supplies the medial, frontal, and parietal lobes

A

ACA

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3
Q

The _____ artery supplies the medial temporal and occipital lobes

A

PCA

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4
Q

The area of the precentral gyrus closest to the lingula is responsible for _______ (function) of the ________

A

motor; jaw, tongue and throat

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5
Q

70% of strokes are due to ______ occlusion or rupture

A

MCA

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6
Q

Another name for the branches of ______ is M2

A

MCA

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7
Q

The cerebellum is supplied by these 3 arteries:

A

superior cerebellar artery (SCA), AICA, PICA

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8
Q

The anterior limb of the internal capsule is supplied by the _______ arteries

A

lenticulostriate arteries

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9
Q

The posterior limb of the internal capsule is supplied by the _______ and _______ arteries

A

lenticulostriate, anterior choroidal

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10
Q

anterior choroidal artery is a branch of _______

A

internal carotid

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11
Q

A transient ischemic attack is defined as _________ and typically lasts _________ minutes

A

less than 24 hours with no brain damage, 15-20 minutes

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12
Q

A stroke is defined as ____________

A

more than 24 hours WITH brain damage

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13
Q

An ABCD^2 score of 6 equals a _______ risk of stroke over a 7 day period after a TIA

A

11%

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14
Q

The highest ABCD^2 score one can achieve is ____

A

9

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15
Q

The last 2 D’s in the ABCD^2 score stand for:

A

duration (≥10 minutes = 1pt; ≥60 minutes = 2pt), Diabetes (yes = 1pt)

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16
Q

A stroke of the internal capsule is referred to as a ______

A

capsular stroke

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17
Q

Occlusion of the __________ also leads to difficulty localizing and interpreting sounds

A

lenticulostriate arteries (because they also supply the sublenticular limb of IC)

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18
Q

The ________ (artery) is the most common site of spontaneous hypertensive hemorrhage in individuals with long-standing hypertension

A

lenticulostriate arteries

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19
Q

A person with chronic hypertension has a stroke, what symptom are they likely experiencing?

A

difficulty localizing and interpreting sounds

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20
Q

________ is the most frequent UMN syndrome

A

capsular stroke

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21
Q

UMN signs of capsular stroke are ________ and __________

A

UMN signs for contralateral UE and LE, UMN signs for contralateral face and neck

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22
Q

In a lesion to the CNT occurring in the internal capsule, the sidedness of the lesion to the UMN sign is:

A

bilateral

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23
Q

The ______ which also runs through the internal capsule contains fibers of the trigeminal motor nucleus, facial motor nucleus, nucleus ambiguus, accessory nucleus, and hypoglossal nucleus

A

CNT

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24
Q

If the CNT fibers in the internal capsule are lesioned, the damage to the facial motor nucleus, nucleus ambiguus, and hypoglossal nucleus causes _______ (sidedness) UMN signs

A

contralateral

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25
Q

The clinical signs of a lesion to the CNT fibers (specifically of CN V, CN VII, and CN X) in the internal capsule are _______, _________, and ________________________________

A

brisk jaw jerk reflex (V); spastic paralysis of lower facial muscles (VII); uvula deviates ipsilateral to lesion, dysarthria, difficulty swallowing

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26
Q

The clinical signs of a lesion to the CNT fibers (specifically to CN XI and XII) running in the internal capsule are __________ and _________

A

difficulty raising shoulder, difficulty turning head contralateral to lesion; tongue deviates contralateral to lesion

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27
Q

A patient has contralateral hemianesthesia of the left UE, LE, and face. Where is the lesion?

A

internal capsule

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28
Q

A patient has a right lateral medullary lesion, what 2 somatosensory symptoms will he have?

A

ipsilateral facial pain loss, contralateral UE and LE pain loss

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29
Q

A patient has a lesion to their spinal cord, what 2 somatosensory symptoms will they have?

A

ipsilateral touch loss, contralateral pain loss

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30
Q

An optic sign of MCA superior trunk stroke is ________ due to _________

A

contralateral gaze palsy or gaze preference toward side of lesion, damage to frontal eye field

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31
Q

A patient presents with dimished problem-solving ability. What is she suffering from and what artery is involved?

A

Broca’s aphasia, MCA superior trunk

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32
Q

A visual symptom of _______ stroke is contralateral superior quadrantanopia

A

MCA inferior trunk

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33
Q

The MCA inferior trunk supplies the ____________ and the _____________

A

lateral hemisphere inferior to lateral fissure, parietal lobe posterior to postcentral gyrus

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34
Q

A patient presents who always bumping into walls when trying to walk to the right, and has been having a hard time finding his dog around the house and says he would normally find her by listening for her whining. What type of stroke did this man probably suffer?

A

MCA inferior trunk stroke

35
Q

The 3 key clinical signs of an MCA inferior trunk stroke are:

A

Wernike aphasia (if left hemisphere), contralateral neglect, difficulty localizing and interpreting sounds

36
Q

A patient presents with loss of pin prick and vibratory sensation to the left UE and face, as well as spastic paralysis of her left arm and left facial paralysis. What type of stroke did she have?

A

MCA distal stem stroke

37
Q

MCA distal stem supplies the:

A

lateral hemisphere

38
Q

A patient with MCA distal stem stroke history will have _________ gaze palsy with __________ gaze preference

A

contralateral, ipsilateral

39
Q

An MCA distal stem stroke causes ___________ -anopia because it affects the _________

A

contralateral superior quadrantanopia, inferior optic temporal radiation including Meyer’s Loop (yes really, I know it’s weird but you didn’t make a mistake on this card)

40
Q

A patient presents with global aphasia, diminished problem solving ability, hemineglect, and difficulty localizing and interpreting sounds. What type of stroke did they suffer?

A

MCA distal stem stroke

41
Q

A patient who just had an MCA proximal stem stroke will present with UMN signs for __________ and UMN signs for __________.
They will also have somatosensory signs of hemianesthesia of the ____________

A

contralateral UE and LE, contralateral face and neck, contralateral UE, LE, and face

42
Q

The MCA proximal stem supplies the:

A

posterior limb of internal capsule and lateral hemisphere

43
Q

A person presents with left homonymous hemianopia and apparently had a stroke involving the MCA. What portion of MCA was affected?

A

MCA proximal stem

44
Q

The _______ supplies the medial hemisphere anterior to the occipital lobe

A

anterior cerebral artery

45
Q

A patient presents with spastic hemiplegia of the left LE. He also has loss of pin prick and vibratory sensation for the left LE. On further exam it is found that he is emotionally unstable. What kind of stroke did he have?

A

Anterior cerebral artery (ACA) stroke

46
Q

A patient is crying uncontrollably one moment and then becomes enraged the next. He also has weakness in the right leg. What kind of stroke did he probably have?

A

ACA stroke

47
Q

The optic tract, retrolenticular limb of IC, inferior portion of posterior limb of IC, hippocampus, and the amygdala are lesioned with occlusion of this artery:

A

anterior choroidal artery

48
Q

A patient presents with weakness to their contralateral UE and LE, contralateral homonymous hemianopia, transient anterograde amnesia, and transient emotional instability. What type of stroke did they have?

A

anterior choroidal artery stroke

49
Q

A lesion to PCA produces this visual clinical sign:

A

contralateral homonymous hemianopia (due to lesion of LGN)

50
Q

The PCA supplies the ________ and _________

A

medial hemisphere occipital and temporal lobes, midbrain

51
Q

These 5 structures can be found in the lateral midbrain:

A

ALS, medial lemniscus, ATTT, substantia nigra, crus cerebri

52
Q

These 5 structures can be found in the medial midbrain:

A

CN III or oculomotor nucleus, red nucleus, cerebellothalamic fibers, substantia nigra, crus cerebri

53
Q

These 3 syndromes are caused by a PCA stroke:

A

weber syndrome, claude syndrome, benedikt syndrome

54
Q

Signs of lateral midbrain damage after a PCA stroke are the following 3:

A

contralateral hemianesthesia including face, contralateral tremor, possible contralateral plegia or paresis of LE

55
Q

The mainly medial PCA stroke syndrome of the midbrain is:

A

claude syndrome

56
Q

Occlusion of the thalamogeniculate artery leads to the following 4 possible symptoms:

A

contralateral hemianesthesia including face, contralateral homonymous hemianopia, difficulty localizing and interpreting sounds, thalamic pain syndrome

57
Q

In alternating hemiplegias the lesion involves the __________ and _______, _______, or _________

A

corticospinal system (UMN’s), CN III, CN VI, CN XII

58
Q

In alternating hemiplegias, the symptoms include __________ and ____________

A

contralateral spastic paralysis, ipsilateral deficit of cranial nerve

59
Q

superior alternating hemiplegia involves lesion to the _________ and the ________

A

CST (UMNs), CN III (LMNs)

60
Q

superior alternating hemiplegia causes these 5 symptoms:

A

contralateral spastic paralysis (UMNs), ipsilateral deficit of CN III (LMNs), lateral strabismus, contralateral ataxia, and cerebellar outflow tremor

61
Q

One very obvious sign of superior alternating hemiplegia is:

A

ipsilateral eye is down and out

62
Q

UMN signs for the face and neck which are apparent in __________ are:
brisk jaw jerk reflex, spastic paralysis of lower face, uvula deviates ipsilateral to lesion, tongue deviates contralateral to lesion, difficulty raising ipsilateral shoulder, difficulty turning head contralateral to paralysis

A

superior alternating hemiplegia

63
Q

One key UMN sign of superior alternating hemiplegia is:

A

brisk jaw jerk reflex

64
Q

Middle alternating hemiplegia is also referred to as _______

A

Foville syndrome

65
Q

_____________ involves lesion to the CST (UMNs) and CN VI (LMNs)

A

middle alternating hemiplegia (Foville syndrome)

66
Q

A patient presents with contralateral spastic paralysis, ipsilateral deficit of CN VI, medial strabismus andhorizontal gaze palsy, and contralateral loss of tactile sensation to UE and LE. What is the diagnosis?

A

middle alternating hemiplegia

67
Q

UMN signs for face and neck in _________ are:
uvula deviates ipsilateral to lesion, tongue deviates contralateral to lesion, difficulty raising ipsilateral shoulder, difficulty turning head contralateral to paralysis

A

middle alternating hemiplegia

68
Q

inferior alternating hemiplegia is also referred to as ________

A

medial medullary syndrome

69
Q

inferior alternating hemiplegia involves lesion to _____ and ______

A

CST, CN XII

70
Q

A person with inferior alternating hemiplegia will have motor signs of _________ and _________, as well as sensory sign of __________

A

contralateral spastic paralysis, ipsilateral deficit of CN XII, contralateral loss of tactile sensation of UE and LE

71
Q

UMN signs of the face and neck for ___________ are difficulty raising ipsilateral shoulder and difficulty turning head contralateral to paralysis

A

inferior alternating hemiplegia

72
Q

UMN signs of the face and neck in inferior alternating hemiplegia are ___________ and ___________

A

difficulty raising ipsilateral shoulder, difficulty turning head contralateral to paralysis

73
Q

Wallenberg syndrome is due to occlusion of the __________, while inferior alternating hemiplegia is due to occlusion of ____________

A

vertebral artery or PICA, branch of ASA (anterior spinal artery)

74
Q

sensory signs of lateral medullary syndrome (wallenberg syndrome) are:

A

contralateral pain and temperature loss of body, ipsilateral pain and temperature loss for face

75
Q

motor and other signs of lateral medullary syndrome (wallenberg syndrome) are:

A

ipsilateral horner syndrome, hoarseness and contralateral deviation of uvula, contralateral nystagmus, vertigo, nausea, vomiting, ataxia

76
Q

Signs that originate from damage to the nucleus ambiguus in lateral medullary syndrome are ___________

A

hoarseness and contralateral deviation of uvula

77
Q

Horner syndrome is a result of the linkage between the _______ and the __________ being severed

A

hypothalamus, ANS

78
Q

The 3 possible areas of damage that produce Horner syndrome are:

A

hypothalamospinal neurons, preganglionic sympathetic neurons (T1-T3), and postganglionic sympathetic neurons (SCG)

79
Q

Horner syndrome due to damage to ____________ can happen in lateral medullary syndrome or cervical spinal cord transection

A

hypothalamospinal neurons

80
Q

Horner syndrome due to damage to _______________ can occur due to a sympathetic chain compression or thoracic spinal cord transection

A

preganglionic sympathetic neurons (T1-T3)

81
Q

Horner syndrome due to damage to _________ can be due to cavernous sinus tumor, carotid artery dissection, or jugular foramen syndromes

A

postganglionic sympathetic neurons (SCG)

82
Q

Likely clinical signs of ___________ are contralateral hemianalgesia, ipsilateral facial hemianalgesia, contralateral nystagmus, nausea, vomiting, vertigo, ataxia, ipsilateral horner syndrome, ipsilateral facial hemiparesis, and ipsilateral nerve deafness

A

AICA syndrome

83
Q

A patient is found to have left-sided hemianalgesia and right-sided facial hemianalgesia. It is also noted that he has right-sided facial hemiparesis and right-sided nerve deafness. What is the diagnosis?

A

AICA syndrome

84
Q

A patient is found to have right-sided hemianalgesia and left-sided facial hemianalgesia. He is also found to have right-sided deviation of the uvula and hoarseness. What is the diagnosis?

A

Wallenberg syndrome (lateral medullary syndrome)

Neuroanatomy Rewind Unit III (9 decks)

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