Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
36 Cards in this Set
- Front
- Back
|
what does the MCA supply?
|
- lateral surface of brain & basal ganglia & internal capsule
|
|
|
what does the ACA supply?
|
- medial surface of brain & narrow strip around parasagittal lateral surface
|
|
|
what does PCA supply?
|
- distributed to medial surface of occipital lobe - including primary visual cortex & visual association cortex
- also supplies thalamus |
|
|
what does variations in the circle of willis do to infarcts?
|
- end up different because of their different circle of willis & collateral blood flow
|
|
|
how can the external help communicate with internal carotid if it is occluded?
|
- back flow from the opthalmic connecting to the external going into the internal carotid
|
|
|
much of the sensory & motor cortex is supplied by who?
|
- MCA
|
|
|
how does ACA infarct present?
|
- Leg > arm
|
|
|
how does MCA infarct present?
|
- arm > leg
|
|
|
what do the lenticulostriate arteries do? where do they come from? what kinds of strokes are they associated with?
|
- supply the internal capsule & are involved with HTN & lacunes
- small vessel disease, come off of the MCA |
|
|
lenticulostriate: what does lenticulate supply? striate?
|
- lenticulate supplies lenticular nucleus which has the putamen & globus palldus
- striatal supplies striatum (with putamen & caudate) - also supply the posterior internal capsule |
|
|
how does the MCA run (along what fissure)? what does it do in this fissure?
|
- along the sylvian fissure
- bifurcates into superior & inferior division |
|
|
what does a lenticulostriate infarct present like?
|
- arms = legs (b/c supplies posterior internal capsule where CST fibers run)
- language spared |
|
|
what happens if the MCA infarct is on the left? on right?
|
- arm > leg
- language difficulty on left - dysprosody on right (difficulty putting out emotional content of language) |
|
|
what is dysprosody on right?
|
- happens with right MCA infarct
- difficulty putting emotion into language |
|
|
what artery interferes with language?
|
- MCA
- NOT ACA or lenticulostriate |
|
|
what do the superior & inferior portions of the MCA supply?
|
- superior: motor & sensory strip, Broca's area, frontal eye fields, superior parietal lobes
- inferior: wernicke's area, much of temporal lobe, inferior parietal lobule |
|
|
what happens with superior vs inferior MCA infarct?
|
- superior: motor cortex, hemiparesis (arms/face > legs), brocas aphasia (on left) & confabulation (on right)
- inferior: no hemiparesis, wernicke's aphasia (on left) & spatial problems (on right), visual deficit ("pie in sky" = contralateral superior quadrantanopia) |
|
|
what happens with PCA infarct?
|
- contralateral hemianopia (can have alexia without agraphia if interrupt fibers crossing in corpus callosum)
- if occlusion before branches to thalamus then there will be contralateral hemisensory deficit |
|
|
when do you get alexia without agraphia?
|
- left PCA infarct that disrupts posterior corpus callosum
|
|
|
what is Anton's syndrome?
|
- bilateral PCA infarcts (maybe emboli @ top of basilar artery)
- cortical blindness, sometimes with denial of deficit |
|
|
where do watershed infarcts occur?
|
- at areas of overlap between vascular territories
- can get these if have quick drop in BP with preexisting atherosclerosis |
|
|
what in "man in barrel" syndrome?
|
- watershed infarct b/w ACA & MCA
- sensorimotor strip in proximal arm & proximal leg |
|
|
where do hemorrhages most likely occur?
|
- 50% occur in basal ganglia (putamen)
- everything else is 10% - these are complications of HBP, small vessel disease, same kinds that gave rise |
|
|
which type of hemorrhage do you get TIA with?
|
- thrombosis = TIA
|
|
|
how does hemorrhagic stroke develop? what comes along with it?
|
- gradual development, headache & vomiting
|
|
|
what kind of stroke do you commonly get coma with?
|
- hemorrhagic
|
|
|
which kind of stroke is an early CT good? early MRI?
|
- early CT good for hemorrhagic
- early MRI good for thrombosis & embolism, usually neg for hemorrhagic |
|
|
where do fusiform aneurysms exist? saccular or "berry"?
|
- fusiform are the rest of the body (atherosclerosis, large arteries)
- saccular are in the brain & at vascular bifurcations |
|
|
why do aneurysms commonly occur in intracerebral arteries?
|
- have no external lamina
|
|
|
where are cerebral aneurysms most common?
|
- anterior circulation = 85%
- posterior circulation = 15% (at top of basilar) |
|
|
ruptured cerebral hemorrhages are associated with what type of hemorrhage?
|
- widespread subarachnoid hemorrhage
|
|
|
how do you treat cerebral aneurysms?
|
- clipping
- coiling - put clips and hope radiologists can put coils in there to thrombose the aneurysm |
|
|
what is an AV malformation?
|
- direct connection b/w arterial & venous circulation without capillary bed
- veins under arterial pressure - hemorrhage from venous side (intraparenchymal or subarachnoid) |
|
|
how do you treat AVM?
|
- usually resect part of brain, embolization, radiation
|
|
|
what types of glutamate receptors are thought to be involved in neurotoxicity in hypoxia or ischemia?
|
- ionotropic glutamate receptors (AMPA, kainite, NMDA)
- NMDA is what is permeable to Ca ions |
|
|
what happens if you block the glycine site on NMDA receptor?
|
- prevents channel from opening in response to glutamate
|
