Stroke Anatomy and Types Quiz
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Questions and Answers

Which of the following is NOT a common cause of hemorrhagic stroke?

  • Atherosclerosis (correct)
  • Hypertension
  • Head Injury
  • Aneurysm

What is the name of the arterial network at the base of the brain that supplies blood to the cerebrum?

  • Circle of Willis (correct)
  • Basilar artery
  • Vertebral artery
  • Internal carotid artery

Which type of stroke is characterized by a blood clot forming within a cerebral vessel?

  • Hemorrhagic stroke
  • Embolic stroke
  • Lacunar stroke
  • Thrombotic stroke (correct)

What are the primary types of ischemic strokes?

<p>Thrombotic and embolic (B)</p> Signup and view all the answers

What is the name of the process that narrows blood vessels due to fatty plaque buildup?

<p>Atherosclerosis (A)</p> Signup and view all the answers

What is the main difference between an embolic stroke and a thrombotic stroke?

<p>The cause of the blockage (A)</p> Signup and view all the answers

Which of the following is NOT a typical location for a stroke within the brain?

<p>Cerebellum (D)</p> Signup and view all the answers

What is the approximate percentage of strokes that are ischemic in nature?

<p>70% to 80% (B)</p> Signup and view all the answers

Which of these options are NOT a direct consequence of blood vessel rupture in hemorrhagic stroke?

<p>Formation of a blood clot within a cerebral vessel. (D)</p> Signup and view all the answers

What is the primary function of the internal carotid arteries?

<p>To supply blood to the brain (D)</p> Signup and view all the answers

Which arteries are included in the carotid system that supplies blood to the brain?

<p>Internal carotid arteries and common carotid arteries (A)</p> Signup and view all the answers

Where does the left common carotid artery originate from?

<p>Aortic arch (B)</p> Signup and view all the answers

What is the name of the anastomotic circle formed by the terminal branches within the cranial vault?

<p>Circle of Willis (C)</p> Signup and view all the answers

What is the primary pathway for blood to reach the brain from the heart?

<p>Aorta to the common carotid arteries (C)</p> Signup and view all the answers

Which arteries do the vertebral arteries pair with in the brain's blood supply system?

<p>Internal carotid arteries (A)</p> Signup and view all the answers

How many common carotid arteries are there in total in the human body?

<p>Two (C)</p> Signup and view all the answers

Which arteries supply the majority of the cerebrum?

<p>Branches from the Circle of Willis (C)</p> Signup and view all the answers

What is the primary risk factor for hemorrhagic stroke?

<p>Advancing age (A)</p> Signup and view all the answers

What is a common symptom at the onset of a cerebral hemorrhage?

<p>Headache (B)</p> Signup and view all the answers

What does the 'A' in F.A.S.T. stand for when assessing for a stroke?

<p>Arms (D)</p> Signup and view all the answers

What characterizes a Transient Ischemic Attack (TIA)?

<p>Symptoms lasting less than 24 hours (A)</p> Signup and view all the answers

What risk is associated with a Transient Ischemic Attack (TIA)?

<p>Maximal risk of stroke immediately after the event (B)</p> Signup and view all the answers

What is the most common cause of an embolic stroke?

<p>Atrial fibrillation (D)</p> Signup and view all the answers

What characterizes the ischemic penumbra in the context of a stroke?

<p>It maintains some metabolic activity and can potentially recover. (D)</p> Signup and view all the answers

Which subtype of ischemic stroke involves small vessel disease?

<p>Small vessel disease (C)</p> Signup and view all the answers

What is oligemia in the context of ischemic stroke?

<p>A condition with blood flow above the ischemic threshold (B)</p> Signup and view all the answers

What role do regulatory T lymphocytes (Treg) play in stroke recovery?

<p>They suppress proinflammatory cytokine production. (D)</p> Signup and view all the answers

During which condition might stroke be classified as stroke of undetermined etiology?

<p>After excluding large artery disease and small vessel disease (C)</p> Signup and view all the answers

What is a common consequence of cellular death in the core area of an ischemic stroke?

<p>Irreversible damage to neuronal cells (B)</p> Signup and view all the answers

Which of the following is NOT associated with small vessel disease?

<p>Atherosclerosis (A)</p> Signup and view all the answers

What process occurs when brain cells switch to anaerobic metabolism due to lack of oxygen?

<p>Decreased ATP production (A)</p> Signup and view all the answers

What effect does lactic acid have on brain cells during ischemia?

<p>It disrupts the normal acid-base balance. (D)</p> Signup and view all the answers

What is a major consequence of excessive intracellular calcium levels during excitotoxicity?

<p>Stimulation of AMPA receptors (B)</p> Signup and view all the answers

Which of the following best describes excitotoxicity?

<p>A mechanism leading to cell death (B)</p> Signup and view all the answers

What ultimately occurs as a result of blood-brain barrier dysfunction during ischemic events?

<p>Greater permeability to harmful substances (A)</p> Signup and view all the answers

Which two factors primarily determine the extent of cerebral damage following ischemia?

<p>Degree and duration of ischemia (C)</p> Signup and view all the answers

What is the role of proteases during excitotoxicity?

<p>To digest cell proteins (D)</p> Signup and view all the answers

What consequence arises from ATP-reliant ion transport pumps failing during ischemia?

<p>Depolarization of the cell membrane (D)</p> Signup and view all the answers

Flashcards

Brain Blood Supply

The blood supply to the brain is provided by two main systems: the carotid system and the vertebral system.

Internal Carotid Artery Branches

The internal carotid artery branches into several arteries, including the ophthalmic, posterior communicating, choroidal, anterior cerebral, and middle cerebral arteries.

Vertebral Arteries

The vertebral arteries are two arteries that travel upwards from the neck towards the brain, playing a crucial role in supplying blood to the posterior part of the brain.

Circle of Willis

The Circle of Willis is a network of arteries at the base of the brain that ensures consistent blood flow by connecting the vertebral and carotid systems.

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Common Carotid Artery Origins

The left common carotid artery originates from the aortic arch, while the right common carotid artery originates from the brachiocephalic trunk.

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Artery Journey to the Brain

The vertebral and internal carotid arteries rise from the neck and fuse into a network at the base of the brain, called the Circle of Willis.

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Circle of Willis: Back-up Blood Supply

The Circle of Willis provides a backup blood supply to the brain, ensuring that even if one artery is blocked, blood can still flow to the brain.

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Importance of Circle of Willis

The Circle of Willis is a crucial network of arteries that ensures consistent blood flow to the brain, protecting it from damage.

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Stroke

A sudden medical emergency involving a disruption of blood flow to the brain, causing damage to brain tissue.

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Ischemic Stroke

Stroke caused by blockage of a blood vessel in the brain, leading to reduced blood flow.

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Hemorrhagic Stroke

Stroke caused by bleeding into the brain tissue, usually due to ruptured blood vessels.

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Lacunar Stroke

A stroke occurring in deep brain structures beneath the cortex (thalamus, basal ganglia, or pons).

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Atherosclerosis

A build-up of fatty plaques in blood vessels, narrowing them and reducing blood flow.

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Thrombotic Stroke

A blood clot forming within a blood vessel, blocking blood flow.

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Embolic Stroke

A blood clot from elsewhere in the body travels to the brain and blocks a smaller blood vessel.

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Transient Ischemic Attack (TIA)

Temporary blockage of blood flow to the brain, causing neurological deficits that last for less than 24 hours.

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F.A.S.T. Test

A group of symptoms suggesting a stroke, used as a quick test to assess urgency.

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Infarct Core

The area of brain tissue directly affected by a stroke, where cells die due to lack of oxygen.

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Ischemic Penumbra

The area surrounding the infarct core that is at risk of being damaged by the stroke but may still be saved.

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Oligemia

Reduced blood flow to an area of the brain that is not severe enough to cause cell death.

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Regulatory T Lymphocyte (Treg)

A type of immune cell that helps regulate the inflammatory response and protect the brain from further damage after a stroke.

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Interleukin-10 (IL-10)

A cytokine that has anti-inflammatory properties and protects the brain during a stroke.

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Apoptosis

The process by which cells die due to lack of oxygen and nutrients.

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What happens to brain cells during ischemic stroke?

Lack of oxygen causes brain cells to switch from aerobic to anaerobic metabolism, leading to decreased ATP production and lactic acid buildup.

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What is excitotoxicity?

A harmful process where excess calcium influx into neurons activates damaging enzymes, leading to cell death.

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How does excitotoxicity affect the cell membrane?

The damaged cell membrane becomes more permeable, allowing harmful chemicals and ions to enter the cell, further contributing to cell death.

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What is the role of free radicals in ischemic stroke?

Free radicals, produced during ischemia, damage cell components and contribute to the inflammatory response.

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What happens to the blood-brain barrier during ischemic stroke?

The blood-brain barrier, normally protecting the brain, becomes dysfunctional during ischemia, allowing harmful substances to enter the brain.

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What is postischemic inflammation?

An inflammatory response following ischemia, involving immune cells and inflammatory molecules, further contributes to brain damage.

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How does the duration of ischemia affect brain damage?

The extent of brain damage depends on the duration and severity of the ischemic event.

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What is the ischemic cascade?

A cascade of events triggered by ischemia, culminating in neuronal, glial, and endothelial cell death.

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What is the "golden hour" in acute ischemic stroke?

During this period, the medical team focuses on diagnosing the stroke and ruling out other conditions that mimic stroke symptoms. It also involves assessing if the patient is a good candidate for rt-PA treatment.

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What is a hemorrhagic stroke?

A type of stroke caused by the rupture of a blood vessel within the brain, leading to bleeding and compression of brain tissue.

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Define subarachnoid hemorrhage.

Hemorrhagic stroke where blood accumulates in the subarachnoid space, often caused by head trauma or a ruptured aneurysm.

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What is intracerebral hemorrhage?

Accumulation of blood within the brain tissue caused by a ruptured blood vessel.

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How does cerebral edema occur in stroke?

The weakening of the blood-brain barrier, allowing fluid to leak into the brain, leading to swelling.

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What is infarction in stroke?

The death of brain cells due to a lack of oxygen and nutrients.

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What happens when a cell dies through necrosis?

The release of glutamate and toxic chemicals into the surrounding environment, damaging nearby neurons.

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What is the process of apoptosis?

This process involves the breakdown of mitochondria, releasing toxins and apoptotic factors into the cell.

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Study Notes

Stroke: Cerebrovascular Accident

  • Stroke is an acute neurologic deficit caused by a vascular disorder injuring brain tissue.
  • Stroke is a leading cause of mortality and morbidity in the United States.

Cerebral Circulation

  • Blood flow to the brain is supplied by two internal carotid arteries (anteriorly) and vertebral arteries (posteriorly).
  • The internal carotid artery branches into several arteries: ophthalmic, posterior communicating, choroidal, anterior cerebral, and middle cerebral.
  • The brain is supplied by two systems of arteries: a vertebral system (paired vertebral arteries) and a carotid system (paired internal carotid arteries).
  • The Circle of Willis is an anastomotic circle of arteries connecting the vertebral and carotid systems. It supplies most of the cerebrum's arterial blood.

Vertebral Arteries

  • The approximate locations of V1 and V2 vertebral artery segments are shown (graphic included).

Branches of the Aorta

  • The illustration depicts many major arteries branching off the aorta, including the common carotid arteries, vertebral arteries, and subclavian arteries. (graphic included)
  • The right and left common carotid arteries differ in origin; the left arises from the aortic arch; the right from the brachiocephalic trunk.

Common Carotid Artery

  • There is one common carotid artery on each side of the body.
  • These arteries differ in origin.
  • The left common carotid artery originates from the aortic arch within the superior mediastinum.
  • The right common carotid artery originates from the brachiocephalic trunk posterior to the right sternoclavicular joint.

Carotid Artery Bifurcation

  • A graphic displays a carotid artery bifurcation.

Arteries to the Brain

  • The graphic shows major arteries supplying blood to the brain, including the vertebral artery, carotid artery, and arch of the aorta.

Brain Anatomy Structures

  • A cross-sectional diagram of the brain labels various anatomical structures, including foramina, canals, and parts of the surrounding bone structure.

Blood Supply to the Brain

  • The vertebral and internal carotid arteries travel up from the neck to the cranium.
  • The terminal branches of these arteries create the Circle of Willis, an anastomotic circle.
  • Branches from the Circle of Willis supply most of the cerebrum.

Major Arteries in the Brain

  • A diagram illustrates the brain, highlighting sections of major arteries within the brain's structure(internal carotid artery, vertebral artery, anterior cerebral artery, middle cerebral artery, basilar artery).

Ischemic Stroke Classifications

  • Ischemic stroke (85%): includes large-artery atherosclerosis, small-vessel occlusion, cardio-embolism, cryptogenic, other.
  • Hemorrhagic stroke (15%): includes intracerebral hemorrhage, intracerebral hemorrhage, subarachnoid hemorrhage.

Lacunar Stroke

  • A stroke within the deeper structures of the brain (thalamus, basal ganglia, or pons) is called a lacunar stroke.

Ischemic Stroke Types

  • The graphic illustrates embolic, ischema, and athero-thrombotic ischemic stroke subtypes.

Ischemic Stroke Pathophysiology

  • Ischemic strokes occur due to the disruption of blood flow in cerebral vessels.
  • In the core area of stroke, reduced blood flow leads to cell death.
  • The ischemic penumbra is the region surrounding the core with moderately reduced blood flow, potentially recoverable with prompt intervention.
  • A range of factors initiate the ischemic cascade, such as excitotoxicity, oxidative stress, and microvascular injury.
  • The extent of cerebral damage is determined by the degree and duration of ischemia.

Hemorrhagic Stroke Pathophysiology

  • Hemorrhagic stroke is caused by bleeding into brain tissue.
  • Blood vessel rupture can result in edema, compression of brain tissue.
  • Hemorrhages can be due to hypertension, aneurysms, trauma, or drugs.
  • Elevated pressure from brain swelling can cause secondary ischemia.

Classification of Hemorrhagic Stroke

  • Intracerebral hemorrhage (ICH): Blood within brain substance.
  • Subarachnoid hemorrhage (SAH): Blood accumulation around brain.

Hemorrhagic Stroke Symptoms

  • A sudden, severe headache is a common symptom of hemorrhagic stroke.
  • Loss of consciousness and contralateral hemiplegia (weakness on the opposite side of the body) can be seen in some situations.

Stroke Symptoms and Diagnosis

  • F.A.S.T., a method of rapid stroke evaluation: Facial movements asymmetry, arm weakness, speech difficulties, time to call emergency services.

Transient Ischemic Attack (TIA)

  • TIAs are ischemic cerebral neurologic deficits lasting less than 24 hours.
  • They are analogous to "brain angina," offering a warning sign for potential stroke.
  • The risk of stroke is highest immediately after a TIA.

Regulatory T Lymphocytes (Treg)

  • Treg cells mitigate the enhanced production of TNF-α and IFN-γ.
  • These cells are key mediators of the cerebroprotective effect, suppressing proinflammatory cytokines.
  • Depletion leads to increased inflammatory brain damage.

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Stroke: Cerebrovascular Accident - NURS 210B Spring 2024-2025 PDF

Description

Test your knowledge on the anatomy of strokes and their classifications. This quiz covers various aspects of hemorrhagic and ischemic strokes, including their causes, types, and the arterial networks involved in brain circulation. Challenge yourself and learn more about this critical health topic.

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