Csd 450 Test 3

Front 1

What are the two functions of the spinal cord?

Back 1

1) Conducts action potentials (transmission of info, to and from the brain; "transmits any kind of motor info. Info up and down"--class notes).
2) relates to "it's segment" (all sensory info for each body segment flows through spinal cord. "Like Michelin man" --class notes)

Front 2

How does the spinal cord conduct sensory information to the brain?

Back 2

-Some sensory info directly to the brain.
-Other info processed at level of spinal cord first, then to the brain (reflexes)

Front 3

What is it called when the spinal cord processes information at the level of the spinal cord first and then conducts it to the brain?

Back 3

Reflexes

Front 4

What type of tract does spinal cord have?

Back 4

-Descending tracts (motor)
-Ascending tracts (sensory)

Front 5

Cross section of the spinal cord

Back 5

-White matter (carries info either up or down/to and from the brain)
-Grey matter (tons of nuclei, all located in the center. Contains cell bodies/synapses related to sensory OR motor activity).

Front 6

Spinal Cord White matter

Back 6

Carries info either up or down, to or from the brain

Front 7

Spinal cord grey matter

Back 7

-Tons of nuclei; all located in the center
-Contains cell bodies/synapses related to sensory OR motor activity.

Front 8

What does the size of grey matter relate to?

Back 8

Complexity of segment it innervates.

(The hand has a lot of grey matter = highest sensory and motor innervation.)

Front 9

4 Nerve Roots of each Spinal Cord Section:

Back 9

2 Anterior (ventral) roots = carry axons away from ventral horn of spinal cord.

2 Posterior (dorsal) roots = carry sensory info into spinal cord; ascends to brain or reflex (at that location)

Front 10

What do the Anterior (Ventral) nerve roots of the spinal cord do?

Back 10

carry axons away from ventral horn of spinal cord

Front 11

What do posterior (dorsal) nerve roots of spinal cord do?

Back 11

-Carry sensory info into spinal cord;
-Ascends to brain
OR reflex at that location.

Front 12

Corticospinal tracts: What direction? Synapse where?

Back 12

-Descending motor.
-Synapse on motor nuclei in anterior half of spinal cord.

Front 13

Spinal Cord Roots:

Back 13

Axons coming in (sensory) or going out (motor).

Front 14

Dorsal root:

Back 14

Sensory axons bring in sensory information

Front 15

Dorsal ganglia

Back 15

Right outside vertebrae.
All cell bodies of sensory fibers (pain, touch, temperature), which make up dorsal root.

Front 16

Two spinal cord roots (sensory and motor) will join to form ___________.

Back 16

The spinal nerve.

Front 17

The spinal nerve.

Back 17

Two spinal cord roots (sensory and motor) will join to form it.

Front 18

Damage to the right ventral root:

Back 18

Paralyzes muscles on the RIGHT side

Front 19

Damage to the dorsal root interrupts sensation on __________.

Back 19

The same side.

Front 20

Where does the spinal cord end?

Back 20

Around L1-L2 Vertebrae.

Front 21

What happens below L1/L2 Vertebrae?

Back 21

Spinal cord ends and spinal column contains only spinal nerves.

Front 22

The name of a mass of spinal nerves. Spell.

Back 22

Cauda equina (tail of horse).

Front 23

What is Stretch Reflex (6 different points)?

Back 23

-Basic neuromechanism.

-Spinal Cord: Messages/signals to and from cortex; also deals with issues at it's own level (reflex).

-Reflex: at the level of the spinal cord.

-Maintain muscle tone: Keeps relaxed muscles slightly active (minimum tension)

-Increases tension of selected muscle groups: enough tone for activity to take place immediately

-Provides background for postural muscle tone: superimpose voluntary activity on top of.

Front 24

Structure of Stretch Reflex:

Back 24

Muscle spindle (all along skeletal muscles, at various intervals):

-Long thin stretch receptor (sensory)

-Encapsulated (3-4 mm long): located in varying numbers on most voluntary skeletal muscles; some have more/less of them.

-Large bundles of skeletal muscles: Extrafusal muscle fibers (any voluntary muscle); Parallel to extrafusal muscle fibers; Lengthwise along muscles.

Front 25

-Large bundles of skeletal muscles (as relates to muscle spindle). 3 key points.

Back 25

-Extrafusal muscle fibers (any voluntary muscle);
-Parallel to extrafusal muscle fibers;
-Lengthwise along muscles.

Front 26

-Encapsulated (as relates to muscle spindle). 3 key points.

Back 26

-(3-4 mm long):
-located in varying numbers on most voluntary skeletal muscles;
-some have more/less of them.

Front 27

Where is muscle spindle?

Back 27

all along skeletal muscles, at various intervals

Front 28

What are three basic characteristics of muscle spindle?

Back 28

-Long thin stretch receptor (sensor)

-Encapsulated (3-4 mm long)

-Large bundles of skeletal muscles

Front 29

Stretch Reflex Muscles:
Inside of capsule:

Back 29

Modified striated muscle fibers.

Front 30

What is the shape of the capsule called? What are two more specific classifications?

Back 30

-Fusiform (shape).

-Intrafusal: inside fusiform

-Extrafusal: outside fusiform

Front 31

Inside fusiform = _________

Back 31

Intrafusal

Front 32

Outside fusiform = _________

Back 32

Extrafusal

Front 33

Where is muscle spindle attached?

Back 33

Attached to extrafusal on skeletal muscle at both ends, parallel to muscle fiber.

Front 34

Large group of sensory fibers: ________. Does what?

Back 34

-Primary afferent Ia.
-Takes info from muscle spindle to spinal cord.

Front 35

2nd Part of Stretch Reflex: Motor.
Where are fibers?
Where are neurons?
Where are axons from?

Back 35

-Fibers in motor root of spinal cord.
-Large neurons in anterior horn: "Anterior horn Cells"
-Each anterior horn cell gives rise to one large axon.

Front 36

"Anterior Horn Cells" = __________

Back 36

Large neurons in anterior horn

Front 37

Each anterior horn cell gives rise to...

Back 37

...One large axon

Front 38

What are the names of the Axons from the Anterior horn cells?

Back 38

1) Alpha Motor Neuron
2) Gamma Motor Neuron

Front 39

Where does the Alpha Motor Neuron come from? What does it do?

Back 39

-Comes from the Anterior horn cells.

-Innervates bulk of muscles it is going to.

-Axon that exits from anterior horn cell in spinal cord.

-Innervates muscle groups that contain 10-200 individual muscle fibers

-Keeps branching out when it gets to muscle fiber

-Muscle fiber it went to = extrafusal muscle fiber

Front 40

Muscle fiber Alpha Motor Neuron went to

Back 40

Extrafusal muscle fiber

Front 41

The muscle groups innervated by the Alpha Motor Neuron contain ______ individual muscle fibers.

Back 41

10-200

Front 42

Where is Gamma Motor Neuron from? What does it do?

Back 42

-It's a large axon that exits from Anterior horn cell.

-Influenced by info from basal ganglia and Cerebellum.

-Smaller than Alpha Motor Neuron.

-Goes to intrafusal muscle fibers

-Larger fibers conduct impulses faster, so Gamma is slower than Alpha.

Front 43

____________ Neuron is influenced by Ganglia and Cerebellum.

Back 43

Gamma Motor Neuron

Front 44

Which is smaller, Alpha Motor Neuron or Gamma Motor Neuron?

Back 44

Gamma Motor Neuron

Front 45

Which is larger, Alpha Motor Neuron or Gamma Motor Neuron?

Back 45

Alpha Motor Neuron

Front 46

Which muscle fiber does Gamma Motor Neuron go to?

Back 46

Goes to intrafusal muscle fibers.

Front 47

Larger muscle fibers conduct impulses __________; therefore, since _________ Neuron is larger than _________, it's impulse is __________.

Back 47

Larger muscle fibers conduct impulses FASTER;
therefore, since ALPHA MOTOR Neuron is larger than GAMMA MOTOR NEURON, it's impulse is FASTER.

Front 48

Another name for Stretch Reflex

Back 48

Reflex Arc

Front 49

What happens with Stretch Reflex (step by step)

Back 49

* Muscle is stimulated; stretches extrafusal/ intrafusal muscle fibers.

* Sensory information reported through dorsal root (to dorsal horn).

1) Intrafusal fibers are attached to both ends to Extrafusal Muscle fibers

2) Extrafusal muscle stretches, will stretch muscle spindle.

3) Primary afferent Ia will be stimulated inside spindle

4) Relays to dorsal ganglia in spinal cord -- One synapse (monosynaptic)

5) Synapse with Alpha Motor Neuron inside Spinal Cord

6) Immediate reaction of Alpha Motor Neuron = knee jerk reflex

Front 50

Primary Afferent Ia does what?

Back 50

-Relays to dorsal ganglia in spinal cord
-One synapse (monosynaptic)
-Synapse with Alpha Motor Neuron inside Spinal Cord
-Immediate reaction of Alpha Motor Neuron = knee jerk reflex

Front 51

Spell all Cranial Nerves, + place of neuron, + sensory/motor/both

Back 51

I) Olfactory:
N/A, Sensory

II) Optic:
N/A, Sensory

III) Oculomotor:
Midbrain, Motor

IV) Trochlear:
Midbrain, Motor

V) Trigeminal
Pons, Both

VI) Abducens
Pons, Motor

VII) Facial
Pons, Both

VIII) Vestibulochoclear
Pons, Sensory

IX) Glossopharyngeal
Medulla, Both

X) Vagus
Medulla, Both

XI) Spinal Accessory
Medulla, Motor

XII) Hypoglossal
Medulla, Motor

Front 52

Cranial Nerve I:

Back 52

-Olfactory
-Sensory (smell)
-From Mucosa in nose to brain.

Front 53

Cranial Nerve II:

Back 53

-Optic
-Sensory (vision)

Front 54

Cranial Nerve III:

Back 54

-Oculomotor
-Nucleus in midbrain

-Motor: To the eye. Reflection to light. 4 of the 6 eye muscles controlled by Oculomotor nerve.

Front 55

Cranial Nerve IV:

Back 55

-Trochlear
-Nucleus in midbrain

-Motor: To the eye. 5th of the 6 muscles to the eye.

Front 56

Cranial Nerve V:

Back 56

-Trigeminal
-Nucleus in pons

-BOTH: Sensory and Motor

Sensory: 3 Major divisions =
1) Opthalmic division: sensory to forehead/eyes
2) Maxillary division: sensory to upper lip, palate, nasal (Obicularis oris; palatoglossus; Levator Veli Palatini)
3) Mandibular division: sensory to lower jaw, lower lip (Mentalis-lip, masseter-jaw, mylohyoid-jaw). Sensation from anterior 2/3rd of tongue: pain, touch, pressure, temperature. Not taste.

Motor: Muscles of mastification ~memory hint: chew TRIdent gum. (Temporalis and Masseter, Tensor Tympani, Tensor Veli Palatini, Mylohyoid, Anterior belly of digastic.

Front 57

Opthalmic division

Back 57

-Trigeminal: sensory to forehead/eyes

Front 58

Maxillary division

Back 58

Trigeminal: sensory to upper lip, palate, nasal

Muscles: Obicularis oris; palatoglossus; Levator Veli Palatini

Front 59

Mandibular division

Back 59

Trigeminal: sensory to lower jaw, lower lip. Sensation from anterior 2/3rd of tongue: pain, touch, pressure, temperature. Not taste.

Muscles: Mentalis-lip, masseter-jaw, mylohyoid-jaw

Front 60

Provides sensory information for following muscles: Obicularis oris; palatoglossus; Levator Veli Palatinii

Back 60

V. Trigeminal

Front 61

Provides sensory information for following muscles: Mentalis-lip, masseter-jaw, mylohyoid-jaw

Back 61

V. Trigeminal

Front 62

Provides motor component for following muscles: Temporalis and Masseter, Tensor Tympani, Tensor Veli Palatini, Mylohyoid, Anterior belly of digastic.

Back 62

Muscles of mastification
V. Trigeminal

Front 63

The acoustic reflex is mediated by contraction of both the _______ muscle (innervated by Cranial Nerve ______) and the _______ (innervated by Cranial Nerve _________).

Back 63

The acoustic reflex is mediated by contraction of both the TENSOR TYMPANI muscle (innervated by Cranial Nerve V. TRIGEMINAL) and the STAPEDIUS (innervated by Cranial Nerve VII. FACIAL).

Front 64

Damage to the motor component of Trigeminal:
If it happens further up vs. if it happens further down.

Back 64

If it happens further up, both sides will be effected.

If it happens further down, only one side will be effected.

Front 65

Cranial Nerve VI

Back 65

Abducens
Nucleus in the Pons.

-Motor: Eye. 6th muscle, extrinsic eye. Allows the eye to go up and down and all around.

Front 66

Cranial Nerve VII

Back 66

Facial Nerve
Nucleus in Pons

Both Sensory and Motor:

MOTOR TO:
-Stapedius, Stylohyoid, Posterior belly of the digastic
-All muscles of facial expression: Levator Labii Superior, Depressor Labii Inferior, Zygomatic
-Tear glands, mucous membranes of the nose, *hard and soft palate.

SENSORY FROM:
-Concha of auricle
-Walls of acoustic meatus
-External tympanic membrane
-Taste from anterior 2/3rd of tongue
-Sensation from *hard and soft palate.

Front 67

Which nerve is motor to Stapedius, Stylohyoid, Posterior belly of the digastic?

Back 67

VII Facial

Front 68

Which nerve is motor to Levator Labii Superior, Depressor Labii Inferior, Zygomatic.

Back 68

VII Facial

Front 69

Which nerve is motor to tear glands, mucous membranes of the nose, hard and soft palate

Back 69

VII Facial

Front 70

Which nerve is sensory to: -Concha of auricle
-Walls of acoustic meatus
-External tympanic membrane
-Taste from anterior 2/3rd of tongue
-Sensation from hard and soft palate.

Back 70

VII Facial

Front 71

Facial nerve provides __________ innervation, from both sides of cortex. This means ___________ and _________ innervation.

Back 71

Facial nerve provides BILATERAL innervation, from both sides of cortex. This means IPSILATERAL and CONTRALATERAL innervation.

Front 72

____________ is innervated by the facial nerve bilaterally.
____________ is innervated unilaterally and contralaterally.

Back 72

FOREHEAD is innervated bilaterally.
REMAINING FACIAL MUSCLES are innervated unilaterally and contralaterally.

Front 73

The following muscles mediate facial expression reflexes. Describe.
-Corneal reflex
-Stapedius
-Sucking

Back 73

-Corneal reflex = close eye
-Stapedius = response/protection to loud noise
-Sucking = response to touching sensation near mouth.

Front 74

What is the biggest component of the Facial Nerve?

Back 74

The motor component.

Front 75

What happens with a Facial Nerve, Upper Motor Neuron lesion?

Back 75

-At the level of the cortex (cell body or axon):
-Forehead is okay on contralateral side (because of bilateral representation).
-Lower face is NOT okay on contralateral side.
-Common with Dysarthria
-Drooling

Front 76

What happens with a Lower Motor Neuron Lesion with Facial Nerve VII?

Back 76

-Bell's Palsy
-At level of brainstem or axon
-Ipsilateral = cross over has already happened
-Forehead and face droop. Axon damaged.

Front 77

At what level is an Upper Motor Neuron lesion for the Facial Nerve VII?

Back 77

At the level of the cortex. Cell body or axon.

Front 78

At what level is an Lower Motor Neuron lesion for the Facial Nerve VII?

Back 78

At the level of the brainstem or axon.

Front 79

Cranial Nerve VIII

Back 79

Vestibulocochlear (aka Acoustic)
-Nuclei in Pons

Sensory:
-Somatic afferent; carries 2 special sensations:
1) Vestibular, from semicircular canals
2)Auditory, via 8th auditory nerve (from cochlea).

Front 80

Stretch reflex: 2 possibilities when neuron picks up.

Back 80

Neuron picks up: --takes info contralaterally to motor horn nuclei or --takes info ipsilaterally to the same side.

Front 81

Name for neurons that are in grey matter of spinal cord, and connect sensory neurons to motor neurons. Spell.

Back 81

Interneurons

Front 82

What is the function of intrafusal fibers?

Back 82

1) Inform nervous system of length and rate of change in extrafusal fibers. 2) Informs how much change and how fast change took place, so motor can adjust.

Front 83

Golgi Tendon Organs. What are they? What is their function?

Back 83

Another type of stretch receptor.
-Specialized, located next to tendons near where muscles insert. -Smaller nerve endings. -Protect muscle form extra stress where it inserts (too much stress tears muscle) - Tension reducer.

Front 84

This type of stretch receptor protects muscle form extra stress where it inserts. Spell.

Back 84

Golgi Tendon Organs.

Front 85

What are the 6 levels of motor organization, and what do they all do?

Back 85

1) Lower Motor Neuron -- Final Common Pathway. Origin: spinal cord

2) Nuclei in Brainstem: regulates reflex activity.

3) Extrapyramidal System: Automatic aspects of motor performance; subconscious.

4) Upper Motor Neurons: voluntary motor activity.

5) Cerebellum: controls motor activity, but doesn't initiate.

6)Cerebral Level (highest): Planning, and programming aspects of movement. --"Conceptual planning level" (imagine walking to each building on campus).

Front 86

Blood supply has _____ # of arterial systems.

Back 86

2

Front 87

Anterior Circulation is what?

Back 87

Paired common carotid arteries from heart through neck, then branch off

Front 88

Internal Carotid Artery

Back 88

Ventral surface of the brain, posterior to optic chiasm; largest portion branches off to Middle Cerebral Artery.

Front 89

The largest portion of the ________ __________ Artery branches off to the ________ ________ Artery.

Back 89

The largest portion of the INTERNAL CAROTID Artery branches off to the MIDDLE CEREBRAL Artery.

Front 90

Middle Cerebral Artery

Back 90

-Major part of Internal Carotid Artery continues as this, when it reaches cortex.
-Comes up at lateral sulcus between temporal and parietal lobes; spreads out, feeds blood to all lobes.
-Then branches go deeper to: basal ganglia, diencepahalon, internal capsule, insula.

Front 91

This Artery comes up at lateral sulcus between temporal and parietal lobes. Spell.

Back 91

Middle Cerebral Artery.

Front 92

This Artery branches deeper to basal ganglia, diencepahalon, internal capsule, insula. Spell.

Back 92

Middle Cerebral Artery.

Front 93

This Artery is in the ventral surface of the brain, posterior to optic chiasm. Spell.

Back 93

Internal Carotid Artery.

Front 94

Occlusion of Middle Cerebral Artery causes what?

Back 94

Contralateral hemiplegia and sensory loss (touch, tactile discrimination).

Front 95

Posterior Cerebral Arteries (2)

Back 95

Each carries blood to diencephalons and medial part of occipital lobe.

Front 96

What happens when there is an occlusion of the Middle Cerebral Artery on the left side?

Back 96

-Language dominant side.
= Aphasia (loss of comprehension and use).

Front 97

Disorder characterized by loss of comprehension and use of language. Spell.

Back 97

Aphasia.

Front 98

What happens when there is an entire occlusion of the Middle Cerebral Artery?

Back 98

Severe Aphasia (loss of comprehension and use).

Front 99

In addition to Aphasia, what happens when there is an occlusion of the Middle Cerebral Artery on some particular branches?

Back 99

Wernicke's aphasia (auditory comprehension).
-Production okay; fluent sentences.

Front 100

Disorder characterized by auditory comprehension problems. Spell.

Back 100

Wernicke's Aphasia.

Front 101

What happens when there is an occlusion of the Middle Cerebral Artery anteriorally?

Back 101

Broca's aphasia: posterior portion of frontal lobe. -Better comprehension than Wernicke's. -Problems with complex sentence structures. -Problems with speech production.
-Agrammatism: disfluent, telegraphic.

-OR-
-Apraxia of speech: -problems with voluntary motor programming. -Foot of motor strip; 3rd frontal convolution.
-Comprehension reading, writing is okay.

Front 102

What is the term for disfluent, telegraphic speech production? Spell.

Back 102

Agrammatism.

Front 103

Disorder characterized by problems with speech production. Spell.

Back 103

Broca's aphasia.

Front 104

Disorder characterized by problems with voluntary motor programming. Spell.

Back 104

Apraxia of speech

Front 105

Occlusion of Middle Cerebral Artery can result in:

Back 105

Aphasia, Broca's aphasia, apraxia of speech.

Front 106

Anterior Cerebral Artery

Back 106

-Inferior and medial surfaces of frontal lobe.
-Enters between 2 hemispheres
-Head of caudate, then curves around corpus callosum, optic chiasm.
-Then curves over top: anterior communciating artery.

Front 107

This artery is in the inferior and medial surfaces of frontal lobe.

Back 107

Anterior Cerebral Artery

Front 108

Occlusion of the Anterior Cerebral Artery bilaterally =

Back 108

both legs paralyzed

Front 109

Occlusion of the Anterior Cerebral Artery contralateral hemiplegia =

Back 109

lower limbs impacted.

Front 110

Posterior Communicating Artery:

Back 110

-Assist in keeping blood pressure adjusted.
-Extends from bifurcation.
-Connects to posterior blood supply.
-Connects to anterior supply with posterior supply.

Front 111

Blood supply: Posterior Circulation

Back 111

-2 vertebral arteries from heart, pass into base of the skull via foramen magnum.
-Ventral/anterior surface of medulla.
-Branches off to: posterior inferior cerebellar artery, and feeds posterior portion of cerebellum.
-At junction of medulla and pons, two vertebral arteries merge to form: Basilar artery -- gives off many branches.

Front 112

Anterior Circulation includes which arteries?

Back 112

-Internal Carotid and Middle Cerebral Artery

Front 113

What are the two arterial systems?

Back 113

Anterior circulation and Posterior circulation

Front 114

At junction of medulla and pons, two vertebral arteries merge to form this. Spell.

Back 114

Basilar artery -- gives off many branches.

Front 115

Posterior Cerebral Arteries (2)

Back 115

Basilar artery splits again at most superior portion of the pons. Gives blood to almost entire surface of cerebellum (via the superior cerebellar artery).
-Splits again; complete bifurcation to... Posterior Cerebral arteries.
-Each carries blood to the diencephalons and medial part of the occipital lobe.

Front 116

Homonymous Hemianopsia

Back 116

-Visual field problems
-Possibly caused by occlusion (stroke) in posterior blood supply
-Occlusion of the posterior cerebral artery will cause this contralaterally.

Front 117

Occlusion of the posterior cerebral artery will cause: (spell)

Back 117

Contralateral homonymous hemianopsia.

Front 118

Vertebral and basilar system together, blood supply goes to:

Back 118

-Cervical portion of spinal cord,
-Medulla, pons, midbrain,
-Cerebellum
-Parts of occipital and temporal lobe
-Cochlea/vestibular system.

Front 119

What together gets blood supply to:

-Cervical portion of spinal cord,
-Medulla, pons, midbrain,
-Cerebellum
-Parts of occipital and temporal lobe
-Cochlea/vestibular system.

Back 119

Vertebral and basilar system together

Front 120

"Arterial Circle of Willis"

Back 120

-Ventral/inferior surface of brain.
-Components include:

-Anterior and posterior blood supply connected.
-Middle Cerebral Artery (MCA)
-Two Anterior cerebral arteries
-Anterior communicating artery.
-Back to Middle Cerebral Artery
-Posterior communicating artery
-Little pieces of posterior cerebral artery
-Joins arterial supply of the brains two systems (anterior/posterior)

Front 121

Joins arterial supply of the brains two systems (anterior/posterior). Spell.

Back 121

"Arterial Circle of Willis"

Front 122

Anastomoses. What is it? Describe.

Back 122

-"plan B"
-Functional adaptation.
-Provides alternate vascular route to vital organs, in case an artery is blocked.
-Anastomotic connections between vertebral systems are extensive.
-Superficial; ON surface of brain
-Capillaries keep branching, getting smaller.
Smaller anastomotic connections are less effective,
-Can't supply blood fast enough
-Larger are more efficient.

Front 123

Provides alternate vascular route to vital organs, in case an artery is blocked.

Back 123

Anastomoses

Front 124

Smaller anastomotic connections are:

Back 124

-Less effective,
-Can't supply blood fast enough

Front 125

Larger anastomotic connections are:

Back 125

More efficient.

Front 126

Anastomotic Connections in the Circle of Willis

Back 126

If an area is blocked, need blood from other areas
-Brain has high metabolic requirements
-Very little exchange of blood through communicating arteries.
-Circle of Willis MAY act as "safety valve" when there are differences in pressure in these arteries.
-Flow depends on pressure (not deprivation)
-Blood flows in both directions; depends on where pressure is greater.

Front 127

Blood flows in ___________; depends on where ________ is greater.

Back 127

Blood flows in BOTH DIRECTIONS; depends on where PRESSURE is greater.

Front 128

Arteries feeding into Circle of Willis, that might occlude and cause major problems:

Back 128

-In from Internal Carotid (feeds anterior portion) OR
-In from Vertebral Artery (posterior portion)

Front 129

Brain has ________ metabolic requirements

Back 129

Brain has HIGH metabolic requirements

Front 130

Blood flow depends on what?

Back 130

Pressure

Front 131

How much exchange of blood through communicating arteries?

Back 131

Very little.

Front 132

An occlusion of arteries feeding into Circle of Willis would cause:

Back 132

-Serious effect on blood flow.
-Severity of disturbance depends on functioning of communicating arteries.
-Now these are important: -Posterior communicating artery
- Anterior communicating artery.

Front 133

What is a stroke?

Back 133

-It is a Cerebrovascular accident (CVA). A "brain attack".
-A stroke is damage to the brain because blood flow in the brain has been interrupted.

Front 134

Blood interruption to certain areas of the brain can be caused either by ________ (about 80% of strokes) or by __________ (about 20% of stokes.

Back 134

Blood interruption to certain areas of the brain can be caused either by A BLOCKAGE (about 80% of strokes) or by A HEMORRHAGE (about 20% of stokes.

Front 135

Blockage (Occlusive stroke) is of 2 types: (spell)

Back 135

1) Thrombosis
2) Embolism

Front 136

Hemorrhage

Back 136

Type of stroke. Bleeding in the brain often caused by aneurysm.

Front 137

Most common location of hemorrhage.

Back 137

Subarachnoid hemorrhage.

Front 138

What are the 5 warning signs of stroke?

Back 138

1) Numbness, weakness or paralysis in face, arms or leg (especially on one side of the body).
2) Sudden blurred or decreased vision in one or both eyes
3) Difficulty speaking or understanding simple sentences
4) Sudden severe headache
5) Loss of balance or coordination when combined with another sign; unexplained dizziness, unsteadiness or fall.

Front 139

What are the risk factors of stroke?

Back 139

1) High blood pressure
2) Diabetes mellitus
3) Smoking
4) High cholesterol
5) Heavy drinking
6) Overweight and Obesity
7) Lack of exercise
8) Heart disease.

Front 140

Most stroke sufferers are ___ years or older

Back 140

Most stroke sufferers are 65 YEARS or older

Front 141

Everyone over _________ years is in the higher risk category for stroke.

Back 141

Everyone over 65 YEARS is in the higher risk category for stroke.

Front 142

Stroke risk _______ every decade over _______ years old.

Back 142

Stroke risk DOUBLE every decade over 50 years old.

Front 143

Men have ________% _________ risk of stroke.

Back 143

Men have 25% GREATER risk of stroke. (Due to hypertension and poor health habits).

Front 144

More than ______% of all women 55 or older have _______.

Back 144

More than 50% of all women 55 or older have HIGH BLOOD PRESSURE.

Front 145

Women comprise more than _______% of all stroke fatalities.

Back 145

Women comprise more than 60% of all stroke fatalities.

Front 146

Stoke is the ________ cause of death in women.

Back 146

Stoke is the 2ND LEADING cause of death in women.

Front 147

In order of risk, what is the demography of individuals who have strokes?

Back 147

1) African Americans
2) Native Americans or Alaska Natives.
3) Asian or Pacific Islander
4) Baby Boomers
5) Hispanics or Latinos
6) Older Americans
7) Whites
8) Women
9) Youth

Front 148

About ____ to _______ suffer from stoke each year.

Back 148

About 400,000 to 500,000 suffer from stoke each year.

Front 149

Stroke is the _______ cause of death for the entire population.

Back 149

Stroke is the THIRD LEADING cause of death for the entire population.

Front 150

By 2050, stroke will increase:
in men by ________%
and in women by _________%

Back 150

By 2050, stroke will increase:
in men by 167%
and in women by 140%

Front 151

In 2050, the number of first strokes will increase ______ times for a total number of 1 million first strokes.

Back 151

In 2050, the number of first strokes will increase 2.5 times for a total number of 1 million first strokes.

Front 152

What is blood pressure:

Back 152

The pressure of the blood in arteries rises and falls as the heart and muscles of the body cope with varying demands: exercise, stress, sleep, etc.

Front 153

Blood pressure _______ during the day.

Back 153

Blood pressure FLUCTUATES during the day.

Front 154

What are the two types of blood pressure?

Back 154

1) SYSTOLIC (the highest number, is the pressure created by the contraction of the heart muscles and the elastic recoil of the aorta as blood surges through it).
2) DIASTOLIC: (when the ventricles of the heart relax between beats; this number reflects the resistance of all the small arteries throughout the body and the load against which the heart must work).

Front 155

Systolic Blood Pressure is:

Back 155

The highest number, is the pressure created by the contraction of the heart muscles and the elastic recoil of the aorta as blood surges through it

Front 156

Diastolic Blood Pressure is:

Back 156

When the ventricles of the heart relax between beats; this number reflects the resistance of all the small arteries throughout the body and the load against which the heart must work.

Front 157

The following relates to what type of blood pressure? (spell) --When the ventricles of the heart relax between beats; this number reflects the resistance of all the small arteries throughout the body and the load against which the heart must work.

Back 157

Diastolic Blood Pressure

Front 158

The following relates to what type of blood pressure? (spell) --The highest number, is the pressure created by the contraction of the heart muscles and the elastic recoil of the aorta as blood surges through it

Back 158

Systolic Blood Pressure

Front 159

How is blood pressure recorded?

Back 159

By giving the systolic and diastolic pressure expressed in millimeters of mercury.

Front 160

What blood pressure reading should a normal healthy young adult have?

Back 160

110/75:

110 (systolic) /75 (diastolic).

Front 161

Type of stroke where the artery is blocked, so brain is deprived of blood (spell).

Back 161

Ischemic stroke

Front 162

Type of stroke caused by bleeding (spell)

Back 162

Hemorrhagic stroke

Front 163

What is Thrombus?

Back 163

The clot/fatty tissue.

-Causes a thrombotic stroke.

Front 164

What will cause an embolitic stroke?

Back 164

-Embolism

Front 165

Ischemic (Occlusive) stroke is cause mostly in _________ or in __________.

Back 165

Ischemic (Occlusive) stroke is cause mostly in MIDDLE CEREBRAL ARTERY or in INTERNAL CAROTID ARTERY.

Front 166

What is Ischemic (Occlusive Stroke) mostly caused by?

Back 166

CVA -- Cerebrovascular inefficiency.

Front 167

CVA -- Cerebrovascular inefficiency can be either ______ or _________.

Back 167

CVA -- Cerebrovascular inefficiency can be either THROMBOTIC or EMBROLIC.

Front 168

What happens with deprivation of blood flow?

Back 168

Areas die.

Front 169

What are warning signs for Transient Ischemic Attack (TIA)?

Back 169

1) Blurred vision, numbness
2) Temporary cerebrovascular inefficiency.
3) Immediate, sudden reduction of blood flow (blockage)
4) Can last a minute or hours, then goes away.

Front 170

What is happening with Transient Ischemic Attack?

Back 170

-No cell death yet, but immediate consequence
-Usually indicates problem in Internal Carotid Artery
-Treatable with meds within a few hours (mostly anticoagulants).

Front 171

The following are warning signs for __________? (Spell)
1) Blurred vision, numbness
2) Temporary cerebrovascular inefficiency.
3) Immediate, sudden reduction of blood flow (blockage)
4) Can last a minute or hours, then goes away.

Back 171

Transient Ischemic Attack (TIA).

Front 172

Transient Ischemic Attack usually indicates problem in _________.

Back 172

Transient Ischemic Attack usually indicates problem in INTERNAL CAROTID ARTERY.

Front 173

Warning signs for Transient Ischemic Attack (TIA)

Back 173

1) Blurred vision, numbness
2) Temporary cerebrovascular inefficiency.
3) Immediate, sudden reduction of blood flow (blockage)
4) Can last a minute or hours, then goes away.

Front 174

What is happening with Transient Ischemic Attack?

Back 174

-No cell death yet, but immediate consequence.
-Usually indicates a problem in internal carotid artery
-Treatable with meds within a few hours

Front 175

T/F Transient Ischemic Attack is treatable with meds.

Back 175

True

Front 176

What is a Cerebral Thrombosis?

Back 176

-Gradual buildup
-Sometimes preceded by TIA warning signs
-Thrombus: plug or blockage.
-Located in it's place of origin; fixed in one location.
-Small blood clot can be the final straw that plugs into the tiny opening (this plug is an emboslism traveling from elsewhere).

Front 177

What are the causes of thrombosis?

Back 177

-One of the LARGE ARTERIES (Middle Cerebral Artery, Internal Carotid Artery, Basilar) GETS BLOCKED due to:
1) Arteriosclerosis: overall, generic term for a variety of chronic pathologic conditions affecting blood vessel walls: thickening, hardening, loss of elasticity.
2) Atherosclerosis: a form of arteriosclerosis. Area of thickening due to localized deposits of lipids (fatty deposits and fiberous material).

Front 178

What is happening with a Thrombosis?

Back 178

1)Deprivation of blood causes an area of brain cells to die: necrosis (means cell death).
2) This tissue is called an infarct: softens, liquefies and is removed naturally, leaving a cavity on the brain's surface.
3) Astrocytes form a rim around the cavity
4)Increased blood clotting when aterial lumen (opening) becomes smaller.
5) Less flow = increased clot

Front 179

The overall, generic term for a variety of chronic pathologic conditions affecting blood vessel walls: thickening, hardening, loss of elasticity.
(spell)

Back 179

Arteriosclerosis

Front 180

Term for an area of thickening due to localized deposits of lipids (fatty deposits and fiberous material). (spell)

Back 180

Atherosclerosis

Front 181

This term means cell death. Spell

Back 181

Necrosis

Front 182

This is the term for softened, liquefied dead tissue that is removed naturally, leaving a cavity on the brain's surface

Back 182

Infarct

Front 183

_________ is the occlusion (the cause).
_________ is the damaged tissue (the effect).
Spell both.

Back 183

ISCHEMIA is the occlusion (the cause).
INFARCT is the damaged tissue (the effect).

Front 184

Term for a plug or blockage that is located in it's place of origin; fixed in one location. spell

Back 184

Cerebral Thrombosis

Front 185

Cerebral Embolism

Back 185

-An occlusion.
-Sudden, no warning sign; not preceded by TIA.
-CLOT FORMED SOMEWHERE ELSE.
-Circulates in system, plugs later when it gets to a location that is too small.
-Develops slowly, big or small
-Most common sources: from walls of heart.
-Breaks off; flows in blood supply.
-Can be a part of a thrombus
-Can be any piece of "debris"

Front 186

Type of Occlusion where the clot formed elsewhere. Spell.

Back 186

Cerebral Embolism

Front 187

Most common source of Cerebral Embolism

Back 187

From walls of heart.

Front 188

This type of Occlusion is sudden, with no warning signs (spell).

Back 188

Cerebral Embolism

Front 189

Combination of thrombus and embolism?

Back 189

Thromboembolitic

Front 190

Thromboembolitic

Back 190

-When we have no idea or a combination of both thrombus and embolism
-Can both be treated with meds within a few hours.

Front 191

What are some meds for Thromboembolitic?

Back 191

-T-pa: Tissue plasminogen activator
-Clot Busting Meds.
Reduce plaque deposits, little pieces break off and get plugged in smaller blood vessels.
-Clot Retreiver: Stent to remove clots (looks like a wine corkscrew).

Front 192

This type accounts for 20% of all strokes; 5-10% in the US. (spell).

Back 192

Hemorrhagic

Front 193

What can cause a Hemorrhage?

Back 193

1) Extreme fluctuation in blood pressuer
2) Traumatic injury
3) Weakness in blood bessel wall

Front 194

The following are causes of this type of stroke:
1) Extreme fluctuation in blood pressure
2) Traumatic injury
3) Weakness in blood vessel wall

Back 194

Hemorrhagic

Front 195

In this type of stroke, there is a break in blood vessel wall, blood flows out and pools in surrounding tissue, rapidly expanding.

Back 195

Hemorrhagic

Front 196

What are the 2 major categories of Hemorrhage?

Back 196

1) Intracerebral: within the brain or brainstem.
2) Extracerebral: Mostly between the brain and skull; rupture of blood vessel in meninges.

Front 197

This category of Hemorrhage is within the brain or brainstem.

Back 197

Intracerebral

Front 198

This category of Hemorrhage is mostly between the brain and skull; a rupture of blood vessel in meninges.

Back 198

Extracerebral

Front 199

Extracerebral Hemorrhage is frequently caused by:

Back 199

head injury.

Front 200

Extracerebral Hemorrhage could be one of three places:

Back 200

1) Subdural (below dura)
2) Subarachnoid (most common)
3)Extradural

Front 201

Subarachnoid Hemorrhage

Back 201

-Most common extracerebral event
-Associated with severe violent headache, nausea, vomiting.
-Caused by rupture of blood vessels below arachnoid membrane
-If diagnosed before rupture, can be surgically repaired.
50% can survive after 30 days.
-Irreversible brain damage
-Most common cause -- aneurysm

Front 202

Most common cause of Subarachnoid Hemorrhage. (spell)

Back 202

Aneurysm

Front 203

-Most common extracerebral event
-Associated with severe violent headache, nausea, vomiting.

Back 203

Subarachnoid Hemorrhage

Front 204

What is an Aneurysm?

Back 204

Most common cause of subarachnoid hemorrhage.
-Artery weak spot will get thinner and thinner. Over time, will break and bleed.
-Can occur at any age. Most common at 25-50

Front 205

What are the causes of Aneurysm?

Back 205

-#1 cause: Congenital (malformation)
-Anything that weakens wall (truama)

Front 206

What are the most common locations of Aneurysm?

Back 206

--At the bifurcation of arteries at base of brain:
-ICA (30%)
-ACA (30%)
-MCA (25%)
-BA (10%)

Front 207

Intracerebral hemorrhage

Back 207

-Happens within the cerebrum
-90% are due to high blood pressure.
-Happen around subcortical structures of the Thalamus, Basal ganaglia, Brainstem, Cerebellum.
-Bleeding determines manifestations (whether it's in the R or L hemisphere).
-Depends on size and location: get different symptoms.
-Puts pressure on tissue "in the neighborhood." Doesn't destroy tissue, just puts pressure.
-No extra space in the brain.

Front 208

T/F Intracerebral hemorrhage destroys tissue neighboring the bleed.

Back 208

False. Doesn't destroy tissue, just puts pressure.

Front 209

What are the stages following stroke?

Back 209

Acute --> Stable --> Recovery

Front 210

What happens during/characterizes the Acute stage following a stroke?

Back 210

-Lots of changes during the first month.
-Acute effects 24-72 hours post-stroke will dissipate.

Front 211

What happens during/characterizes the Stable stage following a stroke?

Back 211

*First month Post-Onset is Crucial!
-The patient is left with a particular severity after the acute effects have dissipated, post-stroke. If "severe" at end of first month, diagnosis will be severe.
-You can still have recovery, but within "severe aphasia"
-What you have is what you get at the end of the first month.
-Greatest recovery during first few weeks
-SLP should work with person the first 3-6 months (as soon as possible).

Front 212

What happens during/characterizes the Recovery stage following a stroke, depending on the type of stroke?

Back 212

Occlusive: Gradual, but continuous, months pass onset. Has nothing to do with treatment. If we were involved, all the points would just be higher. Recovery is happening anyways, so strike while the iron is hot.
-Hemorrhagic: First few months have little progress. Delayed recovery... eventually will happen
-Traumatic (TBI): classic stair-step. Up/plateau... Up/plateau. If young when head injury occurred, could be problems later.

Front 213

Why might a head injury at a young age later cause the adolescent to "not do well."

Back 213

-Academic requirements increasing
-Language and memory. Other variables.
-There are special tests for this that look at memory, cognition, language skills and executive functioning.