First Aid Neurology Part 3

Front 1

What is aphasia?

Back 1

Higher-order inability to speak

Front 2

What is dysarthria?

Back 2

Motor inability to speak

Front 3

Where is Broca's area? Describe Broca's aphasia

Back 3

Broca's area - inferior frontal gyrus

Broca's aphasia - Nonfluent aphasia with intact comprehension

Broca's Broken Boca

Front 4

Where is Wernicke's area? Describe Wernicke's aphasia

Back 4

Wernicke's area - superior temporal gyrus

Wernicke's aphasia - Fluent aphasia with impaired comprehension

Wernicke's is Wordy but makes no sense
Wernicke's = "What?"

Front 5

Describe Global aphasia

Back 5

Nonfluent aphasia with impaired comprehension. Both Broca's and Wernicke's areas affected.

Front 6

Describe Conduction aphasia

Back 6

Poor repetition but fluent speech, intact comprehension. Arcuate fasciculus - connects Broca's, Wernicke's area

Front 7

Where does the anterior cerebral artery supply?

Back 7

Medial surface of the brain, leg-foot area of motor and sensory corticies

Front 8

Where does the middle cerebral artery supply?

Back 8

Lateral aspect of brain, trunk-arm-face area of motor and sensory cortices, Broca's and Wernicke's speech areas (on dominant hemisphere), optic radiations, attention

Front 9

Where does the posterior artery supply?

Back 9

Visual cortex

Front 10

Describe the anterior communicating artery

Back 10

Most common site of circle of Willis aneurysm; lesions may cause visual field defects

Front 11

Describe the posterior communicating artery

Back 11

Common area of aneurysm, causes CN III palsy

Front 12

Describe the lateral striate

Back 12

Divisions of middle cerebral artery; supply internal capsule, caudate, putamen, globus pallidus. "Arteries of stroke"; infarct of internal capsule causes pure motor hemiparesis

Front 13

Describe watershed zones

Back 13

Between anterior cerebral/middle cerebral, posterior cerebral/middle cerebral arteries. Damaged in severe hypotension -> upper leg/upper arm weakness, defects in higher-order visual processing

Front 14

Describe infarcts of the PICA

Back 14

Infarcts causes Wallenberg's syndrome (nystagmus, ipsilateral ataxia, nausea, vomiting, Horner's syndrome)

Front 15

Describe basilar artery infarcts

Back 15

Infarct causes locked-in syndrome

Front 16

What are the consequences of a stroke in the anterior circle?

Back 16

General sensory and motor dysphasia, aphasia

Front 17

What are the consequences of a stroke in the posterior circle?

Back 17

Cranial nerve deficits (vertigo, visual defects), coma, cerebellar deficits (ataxia)

Front 18

Describe Berry aneurysms

Back 18

Occur at the bifurcation in the circle of Willis. Most common site is bifurcation of the anterior communicating artery. Rupture (most common complication) leads to hemorrhagic stroke/subarachnoid hemorrhage. ASsociated with adult polycystic kidney disease, Elhers-Danlos syndrome, and Marfan's syndrome. Other risk factors: advanced age, hypertension, smoking, race

Front 19

Describe Charcot-Bouchard micoaneurysms

Back 19

Associated with chronic hypertension; affects small vessls (e.g., in basal ganglia, thalamus)

Front 20

Describe epidural hematomas

Back 20

Rupture of middle meningeal artery (branch of maxillary artery), often secondary to fracture of temporal bone.

CT shows "biconcave disk" not crossing suture lines. Can cross falx, tentorium

Front 21

Describe subdural hematomas

Back 21

Rupture bridging veins. Venous bleeding (less pressure) with delayed onset of symptoms. Seen in elderly individuals, alcoholics, blunt trauma, shaken baby (predisposing factors - brain atrophy, shaking, whiplash)

Front 22

Describe subarachnoid hemorrhages

Back 22

Rupture of an aneurysm (usually berry aneurysm) or an AVM. Patients complain of "worst headache of my life." Bloody or yellow (xanthochromic) spinal tap. 2-3 days afterward, there is a risk of vasospasm (treat with calcium channel blockers)

Front 23

Describe parenchymal hematomas

Back 23

Caused by hypertension, amyloid angiopathy, diabetes mellitus, and tumor. Typically occurs in basal ganglia and internal capsule

Front 24

Describe what occurs in hemorrhagic stroke

Back 24

Intracerebral bleeding, often due to aneurysm rupture. May be secondary to ischemic stroke following reperfusion (increased vessel fragility)

Front 25

Describe what occurs in ischemic stroke

Back 25

Emboli block large vessels; etiologies include atrial fibrilation, carotid dissection, patent foramen ovale, endocarditis. Lacunar strokes block small vessels, are secondary to hypertension. Treatment: tPA within 3 hours

Front 26

Describe what occurs in Transient Ischemic Attacks (TIA)

Back 26

Brief, reversible episode of neurologic dysfunction due to focal ischemia. Typically, symptoms last for <24 hours

Front 27

Describe imaging of strokes

Back 27

Bright on diffusion-weighted MRI in 3-30 minutes, dark on CT in ~24 hours

Front 28

Describe the dural venous sinuses

Back 28

Venous sinuses run in the dura mater where its meningeal and periosteal layers seperate

Cerebral veins -> venous sinuses -> internal jugular veins

Front 29

Describe CSF formation and reabsorption

Back 29

CSF is made by ependymal cells lining the ventricles; it is reabsorbed by venous sinus arachnoid granulations

Front 30

What connects the lateral ventricle to the 3rd venticle

Back 30

foramen of Monro

Front 31

What connects the 3rd ventricle to the 4th ventricle

Back 31

Cerebral aqueduct/Aqueduct of Sylvius

Front 32

What connects the 4th ventricle to the subarachnoid space?

Back 32

Foramina of Luschka= Lateral

Foramina of Magendie = Medial