Term
| What does the central sulcus divide the brain into? |
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Definition
| The post-central gyrus and the pre-central gyrus |
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Term
| In a stroke, what is the term for the area of the brain that is dead? What is the term for the area of the brain that is dying/injured? |
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Definition
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Term
| Is the primary motor cortex pre central or post central? The primary somatosensory cortex? |
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Definition
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Term
| What are two other names for the lateral sulcus? |
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Definition
| lateral fissure and sylvian fissure |
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Term
| Are Broca's and Wernicke's area on the left or right side of the brain? |
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Definition
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Term
| What does a homunculus show? |
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Definition
| The area of the motor and sensory cortex that sends signals to certain areas of the body |
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Term
| Give an example, using dopamine, of how one NT can be both inhibitory and excitatory |
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Definition
-Too much dopamine= schizophrenia
-Too little dopamine= parkinson's |
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Term
| What are the top 3 killers in the USA? |
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Definition
1. MI
2. Colorectal cancer
3. Stroke |
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Term
| Most strokes involve what main cerebral artery? |
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Definition
| The middle cerebral artery |
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Term
| Name 3 patients adenosine is given to |
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Definition
-MI
-a-fib
-infants who are hypoxic to improve cerebral circulation |
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Term
| What do the deep branches of the medial cerebral artery supply? |
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Definition
| The basal ganglia (parkinson's and huntington's disease associated with the BG) |
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Term
| The medial cerebral artery inferior division supplies what part of the homunculus? |
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Definition
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Term
| Name 5 consequences of a LEFT middle cerebral stem infarct |
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Definition
-right hemiplegia (paralysis)
-right hemianesthesia (loss of sensation)
-right homonymous (ipsilateral) hemianopsia
-left gaze preference
-GLOBAL APHASIA |
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Term
| Name 5 consequences of a right middle cerebral stem infarct |
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Definition
-L hemiplegia
-L hemianesthesia
-L homonymous hemianopsia
-RIGHT gaze preference
-Left hemineglect (won't pay attention to stimuli from the L) |
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Term
| Name the 3 types of aphasia with lost repetition and their respective areas of the brain |
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Definition
-Expressive (Broca's aphasia)
-Receptive (Wernicke's aphasia)
-Conductive (lesion separates receptive area from motor area) |
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Term
| Name the 2 types of apashia with preserved repetition (trans-cortical aphasias) |
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Definition
-isolation syndromes (destruction of border zones between ACA, MCA, and PCA, isolating the motor and receptive language areas from the rest of the cortex of the same hemisphere)
-partial isolation syndromes |
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Term
| What is the position of Broca's area with respect to the lateral sulcus? |
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Definition
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Term
| Effortful sparse speech, no prosody (rhythm, stress, intonation), mostly nouns and verbs, no prepositions articles or conjunctions, occurring with right hemiparesis is characteristic of which type of aphasia? |
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Definition
| expressive aphasia--Broca's |
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Term
| Describe the position of Wernicke's area with respect to the later sulcus |
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Definition
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Term
| Impaired comprehension, fluent speech, unaware of deficit, speech devoid of meaning, paraphasias (malformed inappropriate words), literal paraphasias (grass is greel), and neologism (grass is grumps) is characteristic of which type of aphasia? |
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Definition
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Term
| Broca's and Wernicke's area have ________ connections |
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Definition
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Term
| What is conductive aphasia? |
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Definition
| When the reciprocal connections between Broca's and Wernicke's is screwed up |
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Term
| Lesion separating receptive from motor area, severely affected repetition, fluent speech with paraphasias, and relatively preserved comprehension is characteristic of which type of aphasia? |
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Definition
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Term
| Speech areas cut off from the rest of the hemisphere, repetition remarkably preserved, inability to comprehend, read, or write, fluent paraphasic speech is characteristic of which type of aphasia? |
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Definition
| Isolation syndromes-- transcortical aphasia |
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Term
| Name 2 consequences of an anterior cerebral artery infarct |
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Definition
Contralateral lower extremity:
-sensory loss
-weakness |
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Term
| What are the consequences of a bilateral cerebral artery infarct? how about right and left? |
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Definition
-bilateral= cortical blindess
-Right and left= CONTRAlateral homonymous hemianopia |
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Term
| The PCA involves the _________ lobe, which is why cortical blindness is a consequence of a PCA infarct |
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Definition
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Term
| What is a watershed infarct? |
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Definition
| Deficient blood supply to two adjacent arteries leads to the region BETWEEN the two vessels (watershed zones) being the most susceptible to ischemia |
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Term
| What does a drop in systemic BP mean in relation to watershed infarcts? |
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Definition
bilateral watershed infarcts in two watershed zones
ACA-MCA and MCA-PCA watershed zones |
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Term
| An occlusion of ICA leads to what kind of watershed infarct? |
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Definition
| ACA-MCA watershed zone infarct |
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Term
| What is man in a barrel syndrome? |
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Definition
| a patient who has disproportionate weakness of both arms while maintaining mobility of face and lower limbs. |
|
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Term
| what causes man in a barrel syndrome? |
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Definition
| watershed infarcts that effect bilateral supratentorial brain lesions of the prerolandic area |
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Term
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Definition
| a cerebrovascular disease producing temporary brain ischemia |
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Term
| What is the mechanism of a TIA? |
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Definition
| temporary narrowing of a vessel followed by return of blood flow before permanent damage occurs |
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Term
| What are three causes of TIA? |
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Definition
-thrombus formation on vessel wall
-embolism occluding vessel but then dissolving
-vasospasm |
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Term
| What is the time frame for the neurologic deficits of a TIA? |
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Definition
| <24 hours, but typically 10 mins |
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Term
| Would a hemorrhage ever cause a TIA? |
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Definition
| no, that would be a stroke |
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Term
| What are two clues to figure a TIA was the cause of transient neurologic deficits? |
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Definition
-typical vascular pattern (as in MCA, ACA, PCA)
-positive for stroke risk factors |
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Term
| What are 4 things that could cause a transient loss of consciousness without other focal features? |
|
Definition
-basilar artery TIA
-seizure
-orthostasis (postural hypotension)
-Cardiogenic syncope (vasovagal or arryhthmia) |
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Term
| What are 3 causes of ischemic stroke? |
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Definition
-vasospasm
-thrombotic infarct
-embolic infarct |
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Term
| What are three sources of thrombotic material that could lead to embolic infarcts? |
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Definition
-cardioembolic
-artery to arterty
-dissection of carotid or vertebral-->thrombus-->embolizes |
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Term
| How does a patent foramen ovale contribute to ischemic strokes? |
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Definition
| allows a venous thromboembolism to bypass the lungs and pass directly from right to left heart and then to brain |
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Term
| what are the two special tests used to diagnose a patent foramen oval? |
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Definition
-TCD
-TEE (transesophageal echocardiogram) |
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Term
| How can an ischemic stroke be classified by size of vessel? |
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Definition
Large vessel infarct= MCA, PCA, ACA
Small= small penetrating vessels that supply deep structures (LACUNAR because they resemble small lakes or cavities pathologically) |
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Term
| Lacunar infarcts are usually associated with small vessel diseased by ____________ |
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Definition
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Term
| What are 4 reasons the vessel in a lacunar infarct could become occluded |
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Definition
-lipohyalinosis
-atherosclerosis
-thrombus
-small embolus |
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Term
| A lacunar stroke that caused ataxic hemiparesis would cause damage to what brain structure? |
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Definition
| damage to proprioceptive or cerebellar circuitry rather than the cerebellum |
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Term
| What would a thalamic lacunar infarct cause? |
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Definition
| contralateral somatosensroy deficits with or without thalamic pain syndrome |
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Term
| What would a basal ganglia lacunar infarct cause |
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Definition
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Term
| Seizures occur in ______% of stroke patients |
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Definition
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Term
| Atherosclerotic disease commonly leads to _______ of the ICA just beyond the carotid bifurcation |
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Definition
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Term
| What are three branches that the thrombi formed in the ICA especially embolize to? |
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Definition
-MCA
-ACA
-opthalmic artery (w/ monocular visual loss) |
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Term
| An occlusion of the ICA could be asymptomatic due to good collateral flow via the _________ and/or_________ |
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Definition
-anterior communicating artery
-posterior communicating artery |
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Term
| What is carotid endarterectomy? |
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Definition
| atheromatous material is shelled out from the internal carotid artery |
|
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Term
| What is an example of an anticoagulant drug? |
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Definition
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Term
| What can cause a carotid or vertebral dissection? |
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Definition
| trauma, cough, sneeze, etc causes tear in the layer of the artery. blood burrows in and a vessel protrudes into the lumen. stenosis with reduced flow or a thrombus is formed which can embolize |
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