SCRN Exam 2023 Questions with Verified Answers

Penumbra - Answer- Salvageable tissue -oxygen -blood pressure -Glucose Perfusion - Answer- What oxygen delivers to the brain. Above the necklace-Anterior Circulation= - Answer- Unilateral deficits Below the necklace-Posterior circulation= - Answer- Bilateral deficits Circle of Willis-Collateral circulation= - Answer- Aneurysm Cerebrum - Answer- largest part of the brain Cerebrum: Frontal Lobe - Answer- Motor function, personality, Brocca speech Brocca's aphasia-frontal lobe - Answer- problem with the production and grammar speech syntax, people know what they want to say but they cant produce the words. temporal lobe - Answer- Seizure, Wernicke speech, hearing Wernicke's aphasia (receptive aphasia)-temporal lobe - Answer- impaired auditory reception; speech may be fluent but is often meaningless or nonsensical parietal lobe - Answer- sensory input for touch and body position-neglect -teach patient to scan the room occipital lobe - Answer- vision basal ganglia - Answer- Hypertensive bleed Thalamus - Answer- sensory switchboard, located on top of the brainstem; -Patient waxing and waning -Patient asleep/awake -Thalamic pain syndrome thalamic pain syndrome - Answer- a condition caused by damage to the thalamus resulting in burning or tingling sensations and possibly hypersensitivity to things that would not normally be painful such as light touch or temperature change Cerebellum - Answer- Balance and coordination Left (Dominant) Hemisphere Stroke - Answer- -Left gaze preference (looks toward stroke area) -Right hononomous hemianopia -Right hemiparesis -Right hemisensory loss -Aphasia Right (Nondominant) Hemisphere Stroke - Answer- -Right gaze preference -Left hononomous hemianopia -Left hemiparesis, plegia -Left hemisensory loss *Neglect-left *Agnosia (failure to recognize objects) Posterior circulating stroke syndromes= - Answer- Wallenburg (Medulla) Horner's Syndrome Wallenberg syndrome - Answer- Nystagmus, Vertigo Horner's syndrome - Answer- ipsilateral ptosis miosis anhidrosis Ipsilateral - Answer- on the same side of the body Contralateral - Answer- on the opposite side of the body Miosis - Answer- constricted pupils anhidrosis - Answer- absence of sweating Locked-in syndrome - Answer- PONS How do you communicate with someone with locked-in syndrome? - Answer- Blinking eye movement Cerebral Venous Thrombosis - Answer- Hypercoagulopathy state Post-partum/PREGNANCY Carotid or Vertebral dissection-TRAUMA - Answer- Trauma most common cause TX: anticoagulation Arterio-venous Fistula - Answer- Ptosis-eyeball pops out Hears swishing Carotid Cavernous Fistula - Answer- Arterial venous connection between carotid artery and cavernous sinus---"the bulging red eye" -can be high-flow or low-flow -high flow results in patients with atherosclerosis and HTN with carotid aneurysms that rupture within sinus or secondary to closed head trauma (*basal skull fracture*) -S&S of high-flow: headache and confusion; *orbital bruit Carotid cavernous fistula (CCF) - Answer- Type A-High pressure Type B-Low pressure Type C-Low pressure Type D-Low pressure Moyamoya disease - Answer- "Puff of Smoke" Japanese, young female, genetic Small, thin walled torturous arteries Spontaneous stenosis, eventual occlusion TX: antiplatelet, CCB, surgery Moyamoya - Answer- Small, thin walled torturous arteries TX: surgery-re-establish blood flow to ischemic area SYNANGIOSIS- creation of new vessels Vasculitis- - Answer- Inflammation of blood vessels Answer: Steriod cavernous angioma - Answer- "less common than AVM. Similar to cavernous angioma elsewhere (liver). Formed by large irregular thin-walled vascular channels. Most are asymptomatic, may cause bleeding, epilepsy, or focal neuro problems" CT Scan=PURPLE LESION Dural arteriovenous fistula - Answer- Abnormal arteriovenous shunts that occur in the POSTERIOR DURA Usually acquired from trauma and associated with obstruction of venous sinus Stroke mimics - Answer- -Todd's Paralysis (postictal) -migraine with aura -Bell's Palsy -Hypoglycemia -MS -Hypertensive encephalopathy -Wernicke's -Central venous sinus thrombosus -ICH - SAH/SDH/EDH -Brain tumor -Conversion disorder -Meningitis/Encephalitis/Abscess TIA - Answer- transient ischemic attack....mini stroke, no dead tissue. Warning sign of potential or future stroke Symptoms resolve in minutes to hours No permanent neurological deficits Visual difficulties Carotid stenosis Carotid endarectomy Ischemic stroke - Answer- a type of stroke that occurs when the flow of blood to the brain is blocked Neuroplasticity - Answer- is remodeling process of the brain -creating new pathways via PT, OT, Speech -Neuroplasticity of penumbra is continuous repetition of the deficit-ROBOTIC repetition. Neuroplasticity & Stroke Recovery - Answer- Begins 1-3 days post stroke -Regains lost function after injury -Success of recovery depends on DESIRE of individual to gain functional ability The BE FAST acronym stands for: - Answer- Balance Eyes Face Arms Speech Time 7 D's of stroke care - Answer- Detection-Facial droop, arm weakness Dispatch-Ambulance gets PT Delivery-Pt deliver to ER Door-Pt arrives Data-CT scan Decision-Should tPA be given Drug-what drug Door to treatment Times - Answer- Door to ED physician exam=10 min Door to Stroke expertise=15 min Door to CT scan= 20 min Door to CT interpretation= 45 min Door to lab results= 45 min Door to Drug (rt-PA)= 60 min (2018: 45 min) A CT Scan without contrast can reveal what in the presence of headache? - Answer- Blood/Hemorrhage Blood is WHITE Ischemia/edema does not show up for 12-24 hours Brain parenchyma is gray Hypodensity on CT Scan - Answer- Hypo