Phys: Cerebral Blood Supply and Clinical Correlation Flashcards Preview

Neuro anatomy Exam 1 > Phys: Cerebral Blood Supply and Clinical Correlation > Flashcards

Flashcards in Phys: Cerebral Blood Supply and Clinical Correlation Deck (48)
Loading flashcards...
1
Q

What surfaces of brain will ACA perfuse?

A

Anterior and medial surface

2
Q

What lobes of brain will ACA perfuse?

A

Frontal (cognitive) to anterior parietal (sensory center)

3
Q

ACA will perfuse what structure that connects the two hemispheres?

A

Corpus Callosum

4
Q

2/3 of strokes happen in which artery?

A

MCA

5
Q

The superior MCA perfuses what lobes?

A

Lateral/inferior frontal lobe (cognitive)

Anterior/lateral parietal lobe (sensory)

6
Q

The inferior MCA perfuses what lobes?

A

Lateral temporal lobe (auditory and memory)

Lateral occipital lobe (vision)

7
Q

Choose Left MCA/Right MCA or both:

Aphasia (loss of ability to produce/understand speech)

A

Only left MCA

Language intact in Right MCA

8
Q

Choose Left MCA/Right MCA or both:

Dysarthria (difficulty swallowing)

A

Both

9
Q

Choose Left MCA/Right MCA or both:

Hemiparesis (sensory loss)

A

Both
R in a left MCA
L in a right mca

10
Q

Choose Left MCA/Right MCA or both:

Visual field defect

A

Left MCA

Will have neglect of L visual field/L visual field cut in a Right MCA

11
Q

Choose Left MCA/Right MCA or both:

Poor conjugate gaze

A

Both
R in a left MCA
L in a Right MCA

12
Q

Choose Left MCA/Right MCA or both:

Spatial disorientation

A

Right MCA

Difficult reading, writing, calculating in a Left MCA

13
Q

Choose Left MCA/Right MCA or both:

Apraxia (inability to complete already learned tasks on command)

A

Left MCA

flat affect in a Right MCA

14
Q

Choose Left MCA/Right MCA or both:

Impulsive

A

Right MCA

Cautious with a Left MCA

15
Q

What are the small perforating arteries that branch off the MCA and supply the basal ganglia (movement generation) and the internal capsule (corticospinal tract)?

A

Lenticulostriate Arteries

16
Q

When the lenticulostriate arteries are blocked what is it called?
What is it referred to when internal capsule involved?
What deficits when basal ganglia involved?

A
  • Lacunar infarct
  • Referred to as “pure motor hemiparesis” when internal capsule involved
  • Motor control and motor planning deficits when basal ganglia involved
17
Q

What structures does the PCA supply?

A

Occipital lobe, poteromedial temporal lobes, thalamus

18
Q

If your sign/symptom is central post-stroke pain, what structures are involved?

A

Thalamus

19
Q

If your sign/symptom is involuntary movements, what structure are involved?
Choreoasthetosis - face/trunk/extremities
Intention tremor - shake when try and do something
Hemiballismus - big circular movements

A

Subthalamus

20
Q

When a vertebrobasilar artery syndrome occurs, you see locked-in syndrome. What is that?
What symptoms?
What stays in tact?

A

Can’t move anything but their eyes
-Basilar artery thrombosis and bilateral infarction of ventral pons
-Acute hemiparesis, anarthria
What stays intact?
-Preserved consciousness and sensation
-Vertical eye movements and blink remain intact
Mortality = 59%

21
Q

Patient has an ACA, they will experience hemiparesis (mild weakness) or hemiplegia (severe weakness) due to what structure involved?
Ipsilateral/contralateral?
LE/UE?

A

medial aspect of Motor cortex
Contralateral
LE>UE

22
Q

Patient has an ACA, they will experience hemisensory loos due to what structure involved?
Ipsilateral/contralateral?
LE/UE?

A

Medial aspect of sensory cortex
Contralateral
LE>UE

23
Q
Patient has an ACA, they will experience apraxia. What is apraxia? 
What structures (2) are involved?
A

Apraxia - inability to complete already learned tasks on command
Supplementary motor area (integration) and corpus callosum

24
Q

Due to corpus callosum involvement in an ACA, what type of task will patient have difficulty with?

A

Bimanual tasks

25
Q

Due to frontal cortex involvement in an ACA, what type deficits will the patient present with?

A

Significant cognitive deficits (agitation, memory, emotional liability, motor preservation)

26
Q

Due to prefrontal cortex involvement in an ACA, what type of task will patient have difficulty with?

A

Lack of spontaneity, motor inaction, slowness and delay, difficulties with executive function tasks (attention)

27
Q

What type of aphasia will a patient with an ACA present with due to involvement of the supplementary motor area?

A

Transcorticol aphasia (loss of ability to produce/understand speech)

28
Q

T/F, a patient with an ACA will present with contralateral grasp reflex/sucking reflex

A

T: due to corpus callosum or frontal lobe?

29
Q

What additional syndrome will a patient with ACA involvement of the supplementary motor area present with?

A

Alien hand syndrome - randomly do things w/o patient’s knowledge

30
Q

Due to posteromedial aspect of superior frontal gyrus involvement in an ACA, what sign will a patient present with?

A

Urinary incontinence

31
Q

ACA treatment strategies (4):

A
  1. Minimize external distractions
  2. Closed chain, big muscle exercises (squats, steps)
  3. Bimanual activities (tackle UE deficits)
  4. Function-based training (WALK)
32
Q

Patient has an MCA, they will experience paresis due to what structure involved?
Ipsilateral/contralateral?
LE/UE?

A

Motor cortex and internal capsule

  • Contralateral
  • UE and face>LE
33
Q

Patient has an MCA, they will experience sensory loss due to what structure involved?
Ipsilateral/contralateral?
LE/UE?

A

sensory cortex and internal capsule

  • Contralateral
  • UE and face>LE
34
Q

Patient has an MCA, they will experience:
motor speech impairment -
receptive speech impairment -
global aphasia -
…due to involvement of what structures?

A

motor speech impairment - Broca’s (dominant hemi)
receptive speech impairment - Wernicke’s (dom)
global aphasia - Both broca’s and wernicke’s

35
Q

Patient has an MCA, they will experience perceptual deficits if the parietal sensory association cortex of the non dominant hemisphere is involved? What are the signs and symptoms?

A

Perceptual deficits - unilateral neglect (unable to perceive entire left side of vision), depth perception, spatial relations

36
Q

With an MCA in a patient, they will experience apraxia (inability to complete already learned tasks on command) just like a patient with an ACA would. However, the structure involved is different.

What is the structure in a MCA? (could be two)

A

Premotor or parietal cortex

37
Q

Patient has an MCA, they will experience visual deficits due to what structure involvement?

A

Optic radiation in internal capsule

38
Q

Patient has an MCA, due to the frontal eye field or descending tract involvement, what sign will the patient present with?

A

Loss of conjugate gaze

39
Q

A lacunar stroke is possible with MCA involvement. What sign/symptom will patient present with?
What structure of brain?

A

Pure motor hemiplegia

Lenticulostriate arteries that branch off the MCA found in internal capsule

40
Q

MCA treatment strategies (3)

A
  1. Incorporate speech strategies into activities
  2. UE functional training (Closed kinetic chain)
  3. Sensory reintegration is key
41
Q

Patient has a PCA and is experiencing homonymous hemianopsia.
What is that?
What structures (2) are involved?

A

homonymous hemianopsia - lose same side of vision in both eyes
- Visual cortex or optic radiation

42
Q

Patient has a PCA involving their bilateral occipital lobe. What signs and symptoms will they experience?

A

Cortical blindness - blindness on both sides

43
Q

Patient has a PCA and is experiencing visual agnosia.
What is that?
What structure is involved? (Dom or Nondom?)

A

Visual Agnosia - lose ability to recognize familiar things/people/voices (auditory agnosia)
- Occipital lobe (dom side)

44
Q

Patient has a PCA and is experiencing prosopagnosia.
What is that?
What structure is involved?

A

prosopagnosia - unable to associate faces

- Visual association cortex

45
Q

Patient has a PCA involving their dominant calcarine lesion and the posterior part of their corpus callosum.

What signs and symptoms will they experience?

A

Dyslexia

46
Q

Patient has a PCA involving their dominant inferomedial portions of the temporal lobe.

What signs and symptoms will they experience?

A

Memory deficits

47
Q

Patient has a PCA and is experiencing topographic disorientation.
What is that?
What structure is involved?

A

topographic disorientation - difficulty reading map, familiar location cues to find their way)
- Non dominant visual area

48
Q

PCA treatment strategies (4):

A
  1. Gradually increase visual challenges
  2. Visual deficits can significantly impact balance
  3. Visual breaks
  4. May require external aids initially to assist in improving visual deficits