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NBB Test 2 > Stroke Syndromes > Flashcards

Stroke Syndromes Flashcards

1
Q

A focal neurologic deficit of vascular origin. Caused by an abrupt incidence of vascular insufficiency or bleeding into, or immediately adjacent to the brain

A

Stroke (Also called a cerebrovascular accident)

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2
Q

There is higher incidence and prevalence of stroke in the

A

Southeastern US

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3
Q

Is heteromodal (combined inputs from many modalities) and makes up the majority of the human cortex

A

Association cortex

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4
Q

Is the frontal cortex anterior to the motor, premotor, and limbic areas

A

Prefrontal cortex

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5
Q

What are the three main functions of the frontal association cortex?

A

Restraint, Initiative, and Order

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6
Q

The ability to inhibit inappropriate behaviors

A

Restraint

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7
Q

The motivation to pursue positive/productive activities

A

Initiative

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8
Q

The capacity to correctly perform sequencing tasks and cognitive operations

A

Order

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9
Q

Cause large changes in affect, mood, and personality

A

Frontal Lobe Lesions

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10
Q

Characterized by loss of restraint, inappropriate social behavior, loss of ambition and judgement and inability to plan for the future

A

Frontal Lobe Lesions

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11
Q

Functions in the coordination of complex aspects of human cognition and behavior. These require the integration of thought with emotion

A

Prefrontal cortex

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12
Q

Characterized by abulia, laughing at serious matters, and limited insight

A

Prefrontal cortex lesions

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13
Q

Responsible for making decisions about the future, planning, and maintaining focus

-Responsible for working memory

A

Dorsolateral Prefrontal cortex

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14
Q

Failure on Delayed Response Task This requires working memory and planning to retrieve the food after a period of time

A

Dorsolateral prefrontal lesions causing working memory deficits

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15
Q

Dorsolateral Prefrontal Cortex is important for planning a

A

Goal directed movement

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16
Q

Responsible for behavioral inhibition and empathy

A

Ventromedial/Orbitofrontal Prefrontal Cortex

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17
Q

Lesions cause inappropriate behaviors and patients do not respond to images of sad, happy, or angry faces

A

Lesions to Ventromedial/Orbitofrontal Prefrontal Cortex

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18
Q

An Example of an Orbitofrontal/Ventromedial Lesion is

-Most common type

A

Frontotemporal lobe dementia

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19
Q

Damage to the right parietal association cortex causes

A

Contralateral hemineglect syndrome

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20
Q

Ignorance of visual, somatosensory, or auditory stimuli, despite intact primary sensation.

-Drawing, reading and writing can reveal

A

Sensory neglect

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21
Q

Motor inattention to one side of the body, despite normal reflexes and strength: eyes deviated to side of lesion

A

Motor Neglect

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22
Q

Patients perceive their body as upright even when it is tilted to the side. Patients will also tend to gaze towards the lesion (away from the neglected side)

A

Motor Neglect

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23
Q

Lack of awareness of neglect. Lack of personal hygiene and grooming. Disownershipof affected part

A

Anosognosia

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24
Q

The process of selectively focusing on one aspect of the environment

A

Attention

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25
Q

The right parietal association cortex functions in

A

Attention

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26
Q

A right hemisphere lesion causes severe

A

Left neglect

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27
Q

A left hemisphere lesion causes minimal

A

Right neglect

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28
Q

Attentional processes are largely in the

A

Right Hemisphere

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29
Q

We have better attention mechanisms to the

A

Left

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30
Q

Extinction tests can uncover

A

Neglect

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31
Q

Patients with neglect will have normal responses to individual stimuli/commands, but demonstrate “extinction” on the

A

Neglected side

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32
Q

Each side tested alone patient will see/feel

A

Sensory extinction

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33
Q

Move each arm separately, and then both together to look for neglected arm or Allokinesia

A

Motor extinction

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34
Q

Moving the wrong arm to the command

A

Motor extinction

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35
Q

Stroke deficits arise from the

A

Subcortical structures and pathways

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36
Q

Medial portions of the frontal lobe and anterior parietal lobe are supplied by the

A

ACA

37
Q

The regions supplied by the ACA have representations in

A

Lower limb motor and sensory function

38
Q

Contralateral hemiparesis and sensory deficits are greater in the leg than the arm with

A

ACA stroke

39
Q

What kind of aphasia do left sided ACA strokes cause?

A

Transcortical Motor Aphasia

40
Q

The ACA deep branches are called the

A

Recurrent Arteries of Heubner

41
Q

Supplies the anterior limb of the internal capsule and the caudate-putamen

A

Recurrent Arteries of Heubner (aka medial striate artery)

42
Q

Characterized by contralateral hemichorea and contralateral weakness in the face and arm

A

Recurrent Arteries of Heubner strokes

43
Q

Travels to the lateral cortex with several branches supplying subcortical regions

-Largest cerebral artery

A

Middle Cerebral Artery (MCA)

44
Q

Deep penetrating “lenticulostriate” vessels supply the

A

Internal Capsule and Basal Ganglia

45
Q

Prone to narrowing, particularly in patients with longstanding hypertension

A

Lenticulostriate arteries

46
Q

Lenticulostriate arteries are common sites of lacunar infarct. This causes

A

Contralateral hemiplegia (pure motor hemiparesis) and possibly basal ganglia signs

47
Q

Small lenticulostriateinfarcts may only affect

A

Ascending or descending pathways

48
Q

In the posterior limb of the internal capsule, motor pathways (FAL) are anatomically separate from somatosensory pathways (fal) with motor pathways being

A

Anterior to Somatosensory

49
Q

Lesions of the posterior limb of the internal capsule causes

A

Pure motor hemiparesis

50
Q

These lesions to the posterior limb of the internal capsule are from one of three arteries. What are they?

A
  1. ) Anterior choroidal artery
  2. ) Lenticulostriate artery
  3. ) Branch of PCA
51
Q

Usually supplies the region anterior to the central sulcus

A

Superior division of MCA

52
Q

Supplies the region posterior to central sulcus together wit temporal regions

A

Inferior divisions of MCA

53
Q

Causes contralateral UMN paralysis with upper limb deficits being greater than lower limb and the face

A

Superior divisions of MCA

54
Q

Strokes in the superior divisions of MCA affect the

A

Motor Cortex

55
Q

What do we see in the gaze of a patient with infarct in superior divisions of MCA?

A

Horizontal gaze to opposite side

56
Q

What other deficits do we see in a superior division MCA infarct if it is on the

  1. ) Left
  2. ) Right
A
  1. ) Speech motor

2. ) Attention

57
Q

An infarct to the inferior divisions of the MCA affects the

A

Sensory cortex (sensory loss is greater to upper limbs than lower and face)

58
Q

What other deficits do we see in a inferior division MCA infarct if it is on the

  1. ) Left
  2. ) Right
A
  1. ) Speech sensory

2. ) Attention

59
Q

With an inferior division of MCA infarct, we also see losses in

A

Visual field

60
Q

Supplies visual radiations

A

Inferior divisions of MCA

61
Q

Causes severe sensorimotor deficit in the contralateral body. (pre-and post-central gyri and internal capsule)

A

MCA stem stroke

62
Q

Transient paralysis of horizontal gaze to the opposite side, with gaze preference towards the side of the lesion. (frontal eye field)

A

MCA stem stroke

63
Q

If the MCA stem stroke is on the left side, we see

A

Global aphasia

64
Q

If the MCA stem stroke is on the right side, we see

A

Neglect

65
Q

Confusion-agitation from temporal lobe damage can occur with

A

MCA stem stoke

66
Q

Pure motor hemiparesis from a lesion in the internal capsule, ventral pons, or cerebral crus is an example of

A

Subcortical lesion

67
Q

Motor paresis and associated cortical signs from a lesion in the cortex is an axample of a

A

Cortical lesion

68
Q

A deep branch from the internal carotid artery

A

Anterior Choroidal Artery

69
Q

The anterior choroidal artery supplies the

A

Optic Tract and Internal Capsule

70
Q

Characterized by contralateral homonymous hemianopsia and contralateral hemiplegia

A

Anterior choroidal artery syndrome

71
Q

Symptom of anterior choroidal artery syndrome due to lesion to the optic tract

A

Contralateral homonymous hemianopsia

72
Q

Supplies midbrain, thalamus, medial temporal and occipital lobe

A

Posterior Cerebral Artery

73
Q

Left-sided PCA strokes cause

A

Transcortical sensory aphasia

74
Q

Inability to read because the information from the left visual field cannot cross into the language areas (for interpretation of written language)

A

Alexia

75
Q

Patients can write, because language and hand movements are intact, but cannot read what they write with

-Caused by PCA infarct

A

Alexia

76
Q

Deep or stem strokes can produce contralateral

A

Hemianesthesia

77
Q

Deep or stem PCA strokes may produce

A

Central pain syndrome

78
Q

5-10% of all strokes are

A

Watershed infarcts

79
Q

Cause “Man in a barrel” syndrome with sensory and motor loss of the proximal upper limbs, but little effect on the legs

A

MCA-ACA watershed infarcts

80
Q

Which type of aphasia are caused by ACA-MCA watershed infarcts?

A

Transcortical motor aphasia

81
Q

Which type of aphasia is caused by MCA-PCA infarcts?

A

Transcortical sensory aphasia

82
Q

Neurons shut down, but may be restored when cerebral blood flow drops below

A

20mL/100g/min

83
Q

Tissue necrosis (infarct) is seen when cerebral blood flow drops below

A

10mL/100g/min

84
Q

Blood clot forms usually at site of atherosclerosic plaque, causing occlusion

-High risk factor in persons with cerebrovascular disease

A

Thrombus

85
Q

A piece of material (usually blood) that lodges in a cerebral blood vessel.

-Commonly caused by atrial fibrillation

A

Embolus

86
Q

An angular gyrus lesion causing agraphia and/or alexia with mild aphasia

A

Gerstmann syndrome

87
Q

Causes acalculia and right-left confusion, finger agnosia -“touch your right ear with your left thumb”

A

Gerstmann syndrome

88
Q

Disconnection of right hemisphere vision from left hemisphere language

-Word blindness

A

Alexia without Agraphia

NBB Test 2 (33 decks)

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