Cerebral Testing

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  1. How much does the brain weigh?
    How much total % of CO?
    How much does the body's oxygen supply does the brain receive?
    • 2% of total body weight
    • Receives 15% of CO
    • Consumes 20% of the body's oxygen supply
  2. What four vessels supply blood directly to the brain?
    2 internal carotid arteries - Anterior Circulation

    2 vertebral arteries - Posterior Circulation
  3. Where does the CCA bifurcate?
    at the upper border of the thyroid or C4
  4. What are three possible cerebral collateral pathways?
    1.) Ophthalmic A via ECA branches

    2.) Anterior Communicating A.

    3.) Posterior Communicating A.
  5. Does the ICA have any extracranial branches?
    NO, only intracranial branch- Ophthalmic A.
  6. What is a way to indentify ECA and ICA that is not 100% accurate?
    Use the temporal tap.

    If on ECA will detect augmentations in diastole because will be tapping on Superifical Temporal A.
  7. What is intimal thickening?
    What is the abbreviation for intimal thickening?
    Who is affected by this?
    What should you do when doing an ultrasound?
    What is a way to fix this?
    • *Small particles of plaque are deposited within intima that causes thickening.
    • *IMT
    • *Happens with aging
    • *Measure the intimal thickness.
    • *CEA- Carotid Endarterectomy
  8. What does CIMT stand for?
    Carotid Intima-Media Thickness
  9. What does CAD stand for?
    Coronary Artery Disease
  10. What is fibromuscular hyperplasia?
    happens after a CEA because the media feels naked b/c missing intima. So the intimal media begins to try to cover itself up and gets thicker. It's not plaque build up.
  11. What is another name for fibromuscular hyperplasia?
    Myointimal Hyperplasia
  12. What is a another name for Myointimal Hyperplasia?
    Fibromuscular Hyperplasia
  13. What does FMD stand for?
    What is it?
    Who usually gets it the most?
    What does it look like on ultrasound?
    What is the most common place?
    What is the most common place in the ICA?
    • Fibromuscular Dysplasia
    • Media has abnormal growth and swells.
    • Seen more in women and Asian descent.
    • String of pearls
    • Distal Renal Artery
    • Distal ICA
  14. What does FMD stand for?
    Why does it happen?
    Fibromuscular Dysplasia

    It just happens! Genetic?

    Doesn't happen after  CEA.
  15. What does FMD stand for?
    What does it look like on ultrasound? (2)
    Fibromuscular Dysplasia

    1.) String of beads - looks bumpy.

    2.) Focal areas higher velocities
  16. What are the two types of plaque and the descriptions of each?
    • 1.) Uncomplicated
    •           Uniform between intima and media
    • 2.) Complicated
    •           Edges, cap becoming irregular
  17. What are 6 common causes of stroke?
    • 1.) Atherosclerosis
    • 2.) Embolis
    • 3.) Hypertension
    • 4.) Dissection
    • 5.) Prethrombotic
    • 6.) Vasospasm
  18. How could Embolis cause a stroke? (2)
    could be from heart from the left atrium.

    Atrial Fib
  19. How can hypertension cause a stroke? (2)
    vessel walls can rupture.

    Vessel walls are damaged, so intima wants to repair itself, so intima thickening.
  20. How can a dissection cause a stroke?
    Creates a false lumen so thrombosis formation.
  21. How can Prethrombotic States cause a stroke?

    What are some of these? (3)
    clotting disorders

    • 1.) Protein C deficiency
    • 2.) Protein S deficiency
    • 3.) Antithrombin 3 deficiency
  22. How can a Vasospasm cause a stroke? (2)
    SAH- Subarachnoid hemorhage

    So constricts, narrowing diameter causing higher resistance.
  23. What is one way that can cause a Vasospasm? (3)
    bleeding in the head- head trauma

    extra pressure on the arterials

    Patient will experience stroke like symptoms
  24. How long does the symptoms of a TIA last?

    What does a TIA stand for?

    Chance of CVA?
    less than 24 hours but usually only lasts a few minutes.

    Transient Ischemic Attack

    Almost a 10% chance of a CVA in 3 months.
  25. What does RIND stand for?

    What are the symptoms of  RIND?
    Reversible Ischemic Neurological Deficient

    Symptoms lasts longer than 24 hours, but return back to totally normal after usually 3 weeks.
  26. What does CVA stand for?

    How long does the symptoms last?

    Cerebrovascular Accident

    Lasts greater than 24 hours.

    Permanent neurological damage, never 100%
  27. What vessels are in the anterior circulation?
    • 1.) ICA
    • 2.) ACA
    • 3.) Anterior Communicating A.
    • 4.) MCA
  28. What vessels are in the posterior circulation?
    • 1.) Vertebrals
    • 2.) Basilar
    • 3.) Posterior Cerebral A.
    • 4.) Posterior Communicating A.
  29. If you loose the forward flow component in the ICA Distal, What can it signify?
    Could be a problem in the ACA or MCA.
  30. What are the main symptom of Anterior Circulation?
    1-sided issues - Unilateral
  31. What is the main symptom of Posterior Circulation?
    Both sided issues - Bilateral
  32. What are the 6 signs and symptoms of anterior circulation?
    • 1.) Monocular Visual Disturbance
    • 2.) Amaurosis Fugax
    • 3.) Aphasia
    • 4.) Mono or hemiparesthesia
    • 5.) Mono or hemiparesis
    • 6.) Homonymous hemianopia?hemianopsia
  33. What is monocular visual disturbance?
    Complete loss of vision in one eye.
  34. So if someone has monocular visual disturbance where should you look?
    Focus on the ICA or Ophthalmic of the eye with problems.
  35. What is Amaurosis Fugax?

    What is it caused by?
    Patient describes a shade being pulled over eye.

    It is a emboli problem in the retinal or ophthalmic artery
  36. What is general aphasia mean?
    why does it happen?
    without speech or unable to communicate

    Dysfunction in the brain
  37. What does mono or hemiparesthesia mean?

    Where should you scan?
    1 sided numbness, tingling sensation.

    Scan opposite side as problem.
  38. What is mono or hemiparesis?
    1 sided paralysis

    movement is impaired b/c of weakness but can still move
  39. What does homonymous hemianopia mean?
    partial loss of visual field in both eyes
  40. What are the 9 sign and symptoms of posterior communication?
    • 1.) homonymous hemianopia
    • 2.) paraesthesia of any or all extremities
    • 3.) paresis of any or all extremities
    • 4.) ataxia
    • 5.) drop attacks
    • 6.) Diplopia
    • 7.) Dysphagia
    • 8.) Dysarthria
    • 9.) Vertigo
  41. What is homonymous hemianopia?
    Partial loss of visual field in both eyes
  42. What is paraesthesia of any or all extremities?

    What causes it?
    Numbness or tingling of both arms or both legs or one of each.

    Caused by a reduced blood supply to nerves.
  43. What does paresis of any or all extremities mean?
    Paralysis or impaired movement or loss of voluntary movement.
  44. What does ataxia mean?
    Gait disturbance or trouble touching an article with the hand.
  45. What are drop attacks?
    Sudden musculature weakness, but do not lose consciousness.
  46. What is diplopia?
    Double vision- Bilateral visual blurring

    Two images from one object.
  47. What is dysphagia?
    Difficultly swallowing
  48. What is dysarthria?

    What causes it?
    people have difficultly speaking and pronouncing words.

    due to impairment of the muscles that help people talk
  49. What is vertigo?
    dizziness or a spinning sensation
  50. What are 6 non-specific signs and symptoms?
    • 1.) Confusion
    • 2.) Dizziness
    • 3.) Headache
    • 4.) Impaired mental status
    • 5.) Loss of memory
    • 6.) Syncope
  51. Specifically --- when someone has aphasia, arm paralysis or arm paresis --- where is the problem usually at?
    Disease in MCA.
  52. Specifically --- when someone has leg paralysis or incontinence --- where is the problem usually at?
  53. Specifically --- if someone in coma or has dysplexia --- where is the problem usually at?
  54. What does kinking or coiled vessels cause?

    Which causes?
    causes higher velocites

    can hear a Bruit
  55. Is a bruit in the ECA or ICA more dangerous?

    ICA more serious

    bruit can signify a high grade stenosis in the ICA.
  56. What are four possible shapes of vessels in ICA?
    1.) coiled

    2.) kinked

    3.) C-shaped

    4.) S-shaped
  57. What should you do if ICA or ECA coils or kinks?
    Need to document.

    Need to know will hear Bruit b/c of shaped and possible not stenosis.
  58. What are Lacunar Strokes?
    Causes what?
    Can you see in the ultrasound?
    • Blockages in small arteries deep in the brain.
    • Leukoaraiosis- scattered loss of white matter in the brain.
    • NO vessels to small to see.
  59. What does the FAST stand for?
    F - facial dropping

    A - arm weakness

    S - Speech

    T - Time
Card Set:
Cerebral Testing
2015-02-22 16:04:26
Core II
Cerebral TEsting
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