SCRN EXAM QUESTIONS AND ANSWERS
100% CORRECT.
Penumbra - ANSWERSalvageable tissue
-oxygen
-blood pressure
-Glucose
Perfusion - ANSWERWhat oxygen delivers to the brain.
Above the necklace-Anterior Circulation= - ANSWERUnilateral deficits
Below the necklace-Posterior circulation= - ANSWERBilateral deficits
Circle of Willis-Collateral circulation= - ANSWERAneurysm
Cerebrum - ANSWERlargest part of the brain
Cerebrum: Frontal Lobe - ANSWERMotor function, personality, Brocca speech
Brocca's aphasia-frontal lobe - ANSWERproblem with the production and grammar
speech syntax, people know what they want to say but they cant produce the words.
temporal lobe - ANSWERSeizure, Wernicke speech, hearing
Wernicke's aphasia (receptive aphasia)-temporal lobe - ANSWERimpaired auditory
reception; speech may be fluent but is often meaningless or nonsensical
parietal lobe - ANSWERsensory input for touch and body position-neglect
-teach patient to scan the room
occipital lobe - ANSWERvision
basal ganglia - ANSWERHypertensive bleed
Thalamus - ANSWERsensory switchboard, located on top of the brainstem;
-Patient waxing and waning
-Patient asleep/awake
-Thalamic pain syndrome
thalamic pain syndrome - ANSWERa 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 - ANSWERBalance 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= - ANSWERWallenburg (Medulla)
Horner's Syndrome
Wallenberg syndrome - ANSWERNystagmus, Vertigo
Horner's syndrome - ANSWERipsilateral ptosis
miosis
anhidrosis
Ipsilateral - ANSWERon the same side of the body
Contralateral - ANSWERon the opposite side of the body
Miosis - ANSWERconstricted pupils
anhidrosis - ANSWERabsence of sweating
Locked-in syndrome - ANSWERPONS
How do you communicate with someone with locked-in syndrome? - ANSWERBlinking
eye movement
Cerebral Venous Thrombosis - ANSWERHypercoagulopathy state
Post-partum/PREGNANCY
Carotid or Vertebral dissection-TRAUMA - ANSWERTrauma most common cause
TX: anticoagulation
Arterio-venous Fistula - ANSWERPtosis-eyeball pops out
Hears swishing
,Carotid Cavernous Fistula - ANSWERArterial 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) - ANSWERType 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 - ANSWERSmall, thin walled torturous arteries
TX: surgery-re-establish blood flow to ischemic area
SYNANGIOSIS- creation of new vessels
Vasculitis- - ANSWERInflammation 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 - ANSWERAbnormal 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 - ANSWERtransient 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 - ANSWERa type of stroke that occurs when the flow of blood to the
brain is blocked
Neuroplasticity - ANSWERis 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 - ANSWERBegins 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: - ANSWERBalance
Eyes
Face
Arms
Speech
Time
7 D's of stroke care - ANSWERDetection-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 - ANSWERDoor 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? -
ANSWERBlood/Hemorrhage
Blood is WHITE
100% CORRECT.
Penumbra - ANSWERSalvageable tissue
-oxygen
-blood pressure
-Glucose
Perfusion - ANSWERWhat oxygen delivers to the brain.
Above the necklace-Anterior Circulation= - ANSWERUnilateral deficits
Below the necklace-Posterior circulation= - ANSWERBilateral deficits
Circle of Willis-Collateral circulation= - ANSWERAneurysm
Cerebrum - ANSWERlargest part of the brain
Cerebrum: Frontal Lobe - ANSWERMotor function, personality, Brocca speech
Brocca's aphasia-frontal lobe - ANSWERproblem with the production and grammar
speech syntax, people know what they want to say but they cant produce the words.
temporal lobe - ANSWERSeizure, Wernicke speech, hearing
Wernicke's aphasia (receptive aphasia)-temporal lobe - ANSWERimpaired auditory
reception; speech may be fluent but is often meaningless or nonsensical
parietal lobe - ANSWERsensory input for touch and body position-neglect
-teach patient to scan the room
occipital lobe - ANSWERvision
basal ganglia - ANSWERHypertensive bleed
Thalamus - ANSWERsensory switchboard, located on top of the brainstem;
-Patient waxing and waning
-Patient asleep/awake
-Thalamic pain syndrome
thalamic pain syndrome - ANSWERa 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 - ANSWERBalance 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= - ANSWERWallenburg (Medulla)
Horner's Syndrome
Wallenberg syndrome - ANSWERNystagmus, Vertigo
Horner's syndrome - ANSWERipsilateral ptosis
miosis
anhidrosis
Ipsilateral - ANSWERon the same side of the body
Contralateral - ANSWERon the opposite side of the body
Miosis - ANSWERconstricted pupils
anhidrosis - ANSWERabsence of sweating
Locked-in syndrome - ANSWERPONS
How do you communicate with someone with locked-in syndrome? - ANSWERBlinking
eye movement
Cerebral Venous Thrombosis - ANSWERHypercoagulopathy state
Post-partum/PREGNANCY
Carotid or Vertebral dissection-TRAUMA - ANSWERTrauma most common cause
TX: anticoagulation
Arterio-venous Fistula - ANSWERPtosis-eyeball pops out
Hears swishing
,Carotid Cavernous Fistula - ANSWERArterial 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) - ANSWERType 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 - ANSWERSmall, thin walled torturous arteries
TX: surgery-re-establish blood flow to ischemic area
SYNANGIOSIS- creation of new vessels
Vasculitis- - ANSWERInflammation 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 - ANSWERAbnormal 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 - ANSWERtransient 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 - ANSWERa type of stroke that occurs when the flow of blood to the
brain is blocked
Neuroplasticity - ANSWERis 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 - ANSWERBegins 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: - ANSWERBalance
Eyes
Face
Arms
Speech
Time
7 D's of stroke care - ANSWERDetection-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 - ANSWERDoor 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? -
ANSWERBlood/Hemorrhage
Blood is WHITE
