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Exam 4
Lecture 10- stroke pathophys
52
Archaeology
6th Grade
12/12/2013

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Term
brain is depedent on-
Definition
cont blood flow
Term
brain recieves _% of CO an d-% of O2
Definition
15, 20
Term
*brain has little glycogen
Definition
Term
*flow to brain is autoregulated, what is
Definition
Term
*blood flow to brain is 50ml/min
Definition
Term
hypoxia of BP < _ can stimulate blood flow to brain-
problem is _ causes loss of conciousness
Definition
30
impaired nueral funct
Term
stroke is result of-
Definition
impaired blood flow to brain
Term
2 mian forms of stroke-
which is more common
whihc more severe
Definition
hemorrhage
ischemia
ischemic
hemorrhagic
Term
*risk factors for stroke overlap with cardiovasc disease like age, smoking, diabetes, htn
Definition
Term
stroke is _ leading cause of death
Definition
4th
Term
in the US, strokes overlap with
Definition
obesity
Term
cardiac arrest= _ ischemia to brain
Definition
generalized
Term
stroke is _ ischemia to brain
Definition
focal
Term
hemorrhagic can occur in what 2 placces
Definition
parenchyma
meningeal
Term
what test is good to diff hemorr and ischm
which appears earlier?
Definition
CAT scan
ischemic
Term
3 hemorrhages causes by tramua
Definition
epidural
subduralsubarachnoid
Term
most common cause of non tramutic hemorrhagic strokre-
Definition
berry aneurysm bursting
Term
increases _ causes water influx in hemorrhagic stroke
Definition
protein
Term
increased _ can collapse vessles in hemorr stroke
Definition
incracranial pressure
Term
what causes oxidative damamge in hemorr stroke
Definition
Fe (normal protection from O2 stress not present in this brain part)
(brain may be discolored for yrs)
Term
parenchymal hemorrhages are most often due to?
what parts of rain most often hit-3
Definition
HTN
basal ganglia, thalmus, pons
Term
brain is supplies by what artiereis-2
Definition
basilar
internal carotid
Term
the arteris that supply the brain converge at the _
Definition
circle of Willis
Term
what 2 arteries in the brain coem fromt he carotid?
which one comes from the basilar?
Definition
ACA and MCA
PCA
Term
which artery supplies 80% of blood to hemispheres?
why is this important?
Definition
MCA
major site for emboli
Term
characterisitcs of emboli in ACA
Definition
paresis loss contralateral in leg and foot
Term
char. of emboli in MCA
Definition
aphasia, unilateral motor dysfunction
Term
char of emboli in PCA
Definition
visual distb, memory dysfnct
Term
basilary artery occulsion can cause occulomotor and balance problems
Definition
Term
vertebral artey occulsion can produce effects like basilar artery
Definition
Term
major risk factor for thrombus is-
Definition
astherosceorotic plaques
Term
chronic HTN causes waht to degenerate
-when the tissue around degnerates its called
Definition
small vessesl deep in brain
lacunar infarcts
Term
what are the prinicpal fidning of soeone with vascular demementia
Definition
lacunar infarcts
Term
stroke is deficit that last sfor how long
Definition
>24 hrs
Term
transient ischemic attack is deficit that-
Definition
resvoles within 24 hrs
Term
2 types of cell death in vessel occlusion for stroke-
Definition
necrotic
apoptotic
Term
hich cell death occurs at the core
Definition
necrotic
Term
which cell death has cell swelling and lysis
Definition
necrotic
Term
which cell death invovles pro inflamm cytokines-> reactive oxygen species
Definition
necrotic
Term
after few days f the aute inflamm response of necrotic death it shofts to-
Definition
repair/anti infalmm molcecules
Term
whihc cell death results in glial scar
Definition
necrotic
Term
whcih cell death occurs in the penumbra
Definition
apoptotic
Term
*in apoptptisis cell death not all the cells in the area died and resume nromal funct, this si whn desicon is to program cell death or fix it
Definition
Term
main advtg of apoptoic cell death is-
Definition
no inflamm or collateral damage
Term
the most impt determingin factro if a cell lives or dies in the penumbra is-
Definition
excititoxicity/ excess glutamate in extra cell
Term
* in ischemia cell depolarize and rlease Glu, and astrocytes are impaired to be abel to uptake it
Definition
Term
Glu release in ischemia is followed by what electroyltes-
Definition
K efflux
Term
the problme with too muhc Glu is-
Definition
activate NMDA-> Ca influx->apoptosis
Term
NMDA recpotr anatgs dont affect the core death, but can reduce size of infacrt thru penumbra*
Definition
Term
what 3 misc tx can reduce infarct size
Definition
cannbinoids
adenosene
hypothermia
Term
stroke rehab invovles-
Definition
neuronal plasticity
Term
plastiicty can be inhibited by what-3
Definition
glial scars and meylin and inflamm
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