Match the arteries listed in List I with the corresponding clinical manifestations of stroke given in List II. Select the correct answer using the codes provided below:

A. Anterior cerebral artery
B. Middle cerebral artery
C. Posterior cerebral artery
D. Vertebral artery

Appeared in: ESIC Nursing Officer-7July 2024

Explanation

The correct combination is A-2, B-1, C-4, D-3.
Anterior Cerebral Artery (ACA) occlusion (A) affects the medial sensorimotor cortex, leading to contralateral leg sensory deficits like loss of proprioception and fine touch (2).
Middle Cerebral Artery (MCA) occlusion (B) affects the lateral hemisphere, including Broca's and Wernicke's areas in the dominant hemisphere, causing aphasia (1).
Posterior Cerebral Artery (PCA) occlusion (C) affects the occipital lobe (visual cortex), leading to visual disturbances such as visual hallucinations (4).
Vertebral artery occlusion (D) affects the brainstem, which contains cranial nerve nuclei controlling speech and swallowing, resulting in dysarthria and dysphagia (3).

Option A: This option incorrectly matches all arteries. For example, it links the ACA to dysarthria/dysphagia (brainstem signs) and the MCA to visual hallucinations (occipital lobe signs).
Option C: This option incorrectly swaps the manifestations for the Middle and Posterior Cerebral Arteries. Aphasia is characteristic of an MCA stroke, not PCA, and visual hallucinations are characteristic of a PCA stroke, not MCA.
Option D: This option incorrectly swaps the manifestations for the Anterior Cerebral and Vertebral Arteries. Leg sensory loss is an ACA sign, not a vertebral artery sign, and dysarthria/dysphagia are vertebral/brainstem signs, not ACA signs.

Visual 1: Diagram: Circle of Willis showing the territories of the ACA, MCA, and PCA. This helps visualize which parts of the brain are affected by a blockage in each artery.
Visual 2: Illustration: Homunculus map showing the sensory and motor representation on the cerebral cortex. This clarifies why an ACA stroke affects the leg, while an MCA stroke affects the face and arm.

Clinical Relevance

Nursing practice connection: Knowing Correlation between cerebral arteries and clinical signs of stroke helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Recognizing stroke syndromes based on clinical presentation is a critical nursing skill for rapid assessment and intervention. Using the FAST (Face, Arm, Speech, Time) acronym helps in quick identification.
Nurses must perform a swallow screen on all suspected stroke patients before giving anything orally, as dysphagia (a sign of vertebral/brainstem stroke) poses a high risk of aspiration pneumonia.
Prompt identification of the stroke type and location helps the medical team decide on appropriate treatments like thrombolysis or thrombectomy, improving patient outcomes.

How to Approach the Question

First, analyze the two lists. List I contains major cerebral arteries, and List II contains neurological deficits.
Recall or deduce the primary brain region supplied by each artery in List I.
Match the brain region's function to the clinical signs in List II. For example, the occipital lobe is for vision, so a PCA stroke causes visual symptoms.
Match the Anterior Cerebral Artery (ACA) to the medial cortex (leg/foot function).
Match the Middle Cerebral Artery (MCA) to the lateral cortex (face/arm/speech function).
Match the Posterior Cerebral Artery (PCA) to the occipital lobe (vision).

Concept Tested & Keywords

Concept Tested: Correlation between cerebral arteries and clinical signs of stroke.
Stem keywords: arteries, clinical manifestations, stroke, Anterior cerebral artery, Middle cerebral artery, Posterior cerebral artery, Vertebral artery
Lead-in keywords: Match, Select the correct answer
Negative lead-in flag: false

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Practise the full ESIC Nursing Officer-7July 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.