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HNN Block > Week 4 > Flashcards

Week 4 Flashcards

1
Q

What are the 3 types of stroke?

A
  • Ischemic (artery blockage)
  • intracerebral haemorrhagic (bleed in brain)
  • Subarachnoid haemorrhage (bleed into subarachnoid space)
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2
Q

What is the most common type of stroke?

A

Ischemic stroke (85% of cases)

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3
Q

What are the symptoms of middle cerebral artery obstruction?

A

-Neglect
- Apraxia (impaired fine motor functions)
- Anosognosia (not aware they’ve had stroke
- Contralateral arm/leg weakness

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4
Q

What are the symptoms of a anterior cerebral artery stroke?

A
  • Muteness
  • Perseveration (get ‘stuck’ on a topic/idea)
  • Abulia (lack of motivation to act or think)
  • Contralateral arm/leg weakness
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5
Q

What are the symptoms of posterior cerebral artery obstruction?

A
  • Contralateral hemianopia (loss of lateral visual field)
  • Memory loss
  • Confusion
  • Alexia
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6
Q

What are the symptoms of Cerebellar artery obstruction?

A

Ipsilateral ataxia (clumsiness)

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7
Q

What are lacunar strokes, and what are the symptoms?

A

Smaller arteries in the brain are obstructed

  • Contralateral motor/sensory/both loss
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8
Q

Why are scans need for stroke?

A

Needed to determine if caused by blockage or bleed as the medications for these two may exacerbate the other if given incorrectly

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9
Q

how can you differentiate between infarcts and bleeds on the CT scans of a stroke patient?

A

Infarcts take several ours to show up (~8 hrs) and show large dark spots where there has been tissue damage due to lack of blood

Haemorrhages show up immediately as large white patches

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10
Q

how can you tell between a large vessle stroke in the right hemisphere vs the left?

A

Left
- left gaze preference
- aphasia

Right
- right gaze preference
- neglect

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11
Q

What treatments can be used for stroke?

A

Thrombolysis (infarcts only)

tPa (blood thinner, for infarcts only)

Surgery (remove clots and clip bleeds)

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12
Q

What are the 3 systems of motor control?

A
  • Corticospinal
  • Basal Ganglia
  • Cerebellar
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13
Q

What four brain regions are involved with the initiation and activation of muscle movements?

A
  • Primary motor cortex
  • Supplementary motor area
  • Premotor cortex
  • Posterior parietal cortex
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14
Q

What is the role of the primary motor cortex?

A

To plan and execute movements

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15
Q

What is the role of the supplementary motor cortex?

A

Plays role in motor planning initiation of movements based on past experience (motor memory)

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16
Q

What is the role of the Premotor cortex?

A

Regulates posture and is responsive to visual and sensory cues

17
Q

What is the role of the posterior parietal cortex?

A

Receives sensory/proprioceptive/visual inputs to determine the position of body parts in space and assess the context in which movements are made

18
Q

What is responsible for inhibiting the stretch reflex?

A

Reticulospinal tracts in the spinal cord

19
Q

What is spacsticity?

A

A velocity dependant increase in muscle tone

20
Q
A
21
Q

Describe the Direct pathway of the basil ganglia

A

Striatum inhibits the internal globus palidus, which would normally inhibit the thalamus. Therefore the thalamus sends excitatory signals to the motor cortex

22
Q

Describe the indirect pathway of the basal ganglia

A

Striatum inhibits external globus palidus which would normal inhibit the subthalamic nucleus. Therefore the subthalamic nucleus excites the internal globus palidus which inhibits the thalamus. Therefore there is an inhibitory effect on the motor cortex

23
Q

What are the main neurotransmitters in the basal ganglia pathways?

A

The cortex uses glutamate to signal the striatum

The rest of the pathways all use GABA

24
Q

What is the dividing line between the hemispheres of the cerebellum called?

A

The Vermis

25
Q

What structure holds the cereblellum to the brainstem?

A

Peduncles (superior/middle/inferior)

26
Q

What arteries supply the cerebellum?

A

Superior cerebellar

Anterior inferior cerebellar

Posterior inferior cerebellar

27
Q

What are the cerebellar zones and their functions?

A

Vestibulocerebellum
- Balance and spacial orientation

Spinocerebellum
- Fine tune axial and limb movements

Neocerebellum
- Plan movement and evaluate sensory info

28
Q

Define a diffuse axon injury

A

Grey matter and white matter are different densities so when the brain jiggles during trauma axons between these areas can be sheared

29
Q

Name three excitatory neurotransmitters

A
  • Glutamate
  • Aspartate
  • Nitric Oxide
30
Q

Name 4 types of inhibitory

A
  • Glycine
  • GABA
  • Serotonin
  • Dopamine
31
Q

Name 2 neurotransmitters that are both excitatory and inhibitory

A
  • Acteylcholine
  • Norepinephrine
32
Q

What is the MOA of levadopa?

A

crosses the blood brain barrier and is converted to dopamine

33
Q

What drug is usually given with levodopa and why?

A

Dopa decarboxylase inhibitor, to prevent levodopa being converted to DA n the peripheral nervous system which can cause heart problems

34
Q

What are the mechanisms of action for Ropinirole and pramipexole?

A

They are direct dopamine receptor antagonists

35
Q

What is the MOA of Selegiline?

A

inhibits MAOb which prevents DA being broken down in the synaptic cleft

36
Q

What are the 4 components of the blood brain barrier?

A
  • Endothelial cells
  • Pericytes
  • Astrocytes
  • Basement membrane
37
Q

What is the difference between pharmacokinetics and pharmacodynamics?

A

Pharmacokinetics = ADME

Pharmacodynamics = MOA, therapeutic effects, and side effects

38
Q

What are the pharmacokinetics of Levodopa?

A

A = Facilitate transport in the small intestines
D = Low protein binding allowing transport across BBB
M = Prodrug converted to DA by dopa decarboxylase
E = Rapidly excreted by kidneys

38
Q

What are the pharmacodynamics of levodopa?

A

MOA = Levodopa is a prodrug which is converted to DA in the brain

Therapeutic effects = improves symptoms of Parkinson’s

Side effects = Nausea, postural hypertension, dyskinesia

HNN Block (5 decks)

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