Neuro, Test 1, Clinical

Front 1

When do you manipulate pCO2 in the treatment of stroke?

Back 1

ans: only in the case of increased Intracranial Pressure (ICP). (ex. Brain tumor, massive cerebral hemorrhage, etc).

Front 2

How do you treat someone with ICP?

Back 2

ans: the pt. is hyperventilated to lower pCO2. Blood vessels contrict which reduces cerebral blood flow which reduces intracranial pressure.

Front 3

The leading risk factor for Cerebral Vascular Disease:

Back 3

ans: HTN

Front 4

Anterior cerebral artery syndrome causes ____ hemiparesis and ____ deficit primarily involving the ___.

Back 4

ans: contralateral hemiparesis and hemisensory deficit primarily involving the leg. The arm is affected to a lesser degree, and the face is usually spared.

Front 5

The face is usually spared in what kind of a stroke?

Back 5

ans: Anterior cerebral artery syndrome.

Front 6

____ supplies the media portion of the hemispheres.

Back 6

ans: Anterior Cerebral artery

Front 7

____ supplies the bulk of the lateral portion of the hemispheres.

Back 7

ans: Middle Cerebral artery

Front 8

a MCA sydrome causes ___ hemiparesis and ____ deficit primarily involving the ____, then the _____, and then the _____.

Back 8

ans: contralateral hemiparesis and hemisenosry deficit involving the Face >arm > leg.

Front 9

A typical ____ stroke may have a dense facial paralysis, 1-2/5 muscle strength in the upper extremeties, and 4/5 strength in the lower extremeties.

Back 9

ans: Middle cerebral artery syndrome.

Front 10

infarcts in this area cause language deficits and/or aphasia.

Back 10

ans: MCA territory.

Front 11

The Posterior Cerebral Artery supplies _____lobes.

Back 11

ans: Occipital and posterior temporal lobes.

Front 12

Humunculus is not relevant in the ____ area strokes.

Back 12

ans: Posterior Cerebral artery

Front 13

Pts. may demonstrate contralateral homonymous hemianopia (can't see out of the eye on the opposite side of the infarct) in ___ blockage.

Back 13

ans: Posterior Cerebral artery.

Front 14

What supplies the thalamus with blood?

Back 14

ans: the PCA

Front 15

What do the two vertebral arteries come together to form?

Back 15

ans: the single basilar artery

Front 16

If this artery is blocked in the dominant hemisphere, patients may have a receptive aphasia (in most cases, in the left side)

Back 16

ans: Posterior Cerebral artery

Front 17

The vertebrobasiliar artery supplies the:

Back 17

ans: pons and midbrain, and the proximal course supplies the brainstem

Front 18

What are the symptoms of brainstem disease?

Back 18

ans: Dizziness, diplopia, dysarthria, locked-in syndrome.

Front 19

____ controls consciousness and is spared in locked-in syndrome.

Back 19

ans: Reticular activating system.

Front 20

A basilar artery occlusion where there is a large infarct in the base of the pons results in ___ being spared and ____ being effected.

Back 20

ans: RAS are spared and all descending motor pathyways through the brainstem are involved EXCEPT those that control vertical eye movements.

Front 21

___ happens if a deficit in blood flow happens for more than 6 hours.

Back 21

ans: neuronal cell death.

Front 22

In a TIA (revised definition), ___ imaging is ____.

Back 22

ans: MRI imaging is normal.

Front 23

Transient Monocular Blindness occurs in ___ TIA affecting ___ circulation.

Back 23

ans: Carotid TIA (on same side as eye blindness) affecting retinal circulation. **weakness and numbness occur on contralateral side.

Front 24

New def. of TIA:

Back 24

ans: Symptoms lasting < or = 1 hr. and no infarct on imaging.

Front 25

A person with Right Carotid Artery blockage may experience ___ sided weakness and numbness.

Back 25

ans: LEFT.

Front 26

Dizziness, Diplopia, Dysarthria, and Dysphagia indicate:

Back 26

ans: vertibrobasial TIA (brainstem symptoms)---
Dysarthria: difficulty w/ speech articulation.

Front 27

What population is the ABCD2 scale trying to catch?

Back 27

ans: the 5% of the 1/3 of patients who are likely to have a stroke after a TIA in the first 48 hours.

Front 28

What score on the ABCD2 scale means a pt. who just had a TIA NEEDS to get to the hospital?

Back 28

ans: 6-7. BUT, if someone has >3 and has an event w/in 72 hours, he/she needs to be brought into the hospital.

Front 29

A hemodynamic cause for TIA requires a carotid lumen to be narrowed to ____ and an impairment in ____

Back 29

ans: <2mm.
(Normal carotid lumen is 1cm.)
impairment in collateral circulation

Front 30

___ TIA is suggested by spells that are short lived and stereotyped.

Back 30

ans: hemodynamic

Front 31

___ TIA is suggested by spells that last longer and may be more heterogeneous.

Back 31

ans: emboli

Front 32

person presents w/: Gait disturbance, slowing of thoughts or actions (demented), Urinary Incontinence:

Back 32

ans: NPH (normal pressure hydrocephalus)
"Wet, wobbly, and wild"s

Front 33

Principle symptoms of obstructive hydrocephalus are:

Back 33

ans: HA, nausea, and blurred vision.

Front 34

What is the #1 cause of TBI?

Back 34

ans: MVA

Front 35

What is the Glasgow scale of brain injury?

Back 35

ans: 1) Basis: eyes open, best verbal, best motor
2) Mild: 13-15
3) moderate: 9-12
4) severe: < or = 8

Front 36

What is the def. of brain dead?

Back 36

ans: all functions, high and low centers, have ceased.

Front 37

What do you want to rule out before doing a spinal tap? How do you rule it out?

Back 37

ans: rule out obstructive hydrocephalus.
CT or MRI.

Front 38

What's MCC for hydrocephalus?

Back 38

ans: under absorption of the CSF

Front 39

What's the most common surgical way to manage hydrocephalus?

Back 39

ans: w/ a shunt.

Front 40

Most common complication of shunting:

Back 40

ans: over or under drainage.

Front 41

If you drain too much CSF, what are some complications?

Back 41

ans: subdural hematoma b/c ventricular system shrinks up and the brain pulls away from the dura of the skull w/ tearing of veins.

Front 42

What stage of UMN lesion results in: flaccid paralysis, areflexia, and hypotonia?

Back 42

ans: Acute-stage lesions (result in transient spinal shock)

Front 43

What's cut (in general) if the pt has:
spastic paresis, hypertonia (flexors of arms, extensors of legs), loss/reduction of superficial abdominal and cremasteric reflexes, Babinski sign, and clonus

Back 43

ans: Chronic-stage UMN lesion.

Front 44

What lesions result in:
Flaccid paralysis, areflexia, muscle atrophy, fasciculations and fibrillations?

Back 44

ans: LMN lesion.

Front 45

Hemisection of spinal cord results in:

Back 45

ans: Brown-Sequard syndrome.

Front 46

What is Romberg sign?

Back 46

ans: tests for sensory dystaxia. Standing pt. is more unsteady w/ eyes closed. Caused by dorsal column syndrome