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P2F Neuro > 4] Background And Manage Of CVA > Flashcards

4] Background And Manage Of CVA Flashcards

1
Q

What is the stroke risk test?

A

Face
Arm (decreased range)
Slurred speech
Time (window is closing)

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2
Q

What is an ischemic stroke?

A

A clot blocks or impairs blood flow

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3
Q

What is an hemorrhagic stroke?

A

The blood vessel ruptures causing a blood leak in the brain

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4
Q

Majority of strokes are what kind?

A

Ischemic

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5
Q

WHat is a TIA?

A

Not a stroke but has similar Sx that resolve within 24 hours

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6
Q

Accounts for 87% of strokes

A

Ischemic

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7
Q

What is the test for DVT and you DF them and they complain of pain?

A

Homan sign

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8
Q

Most common type of ischemia stroke

A

Embolic

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9
Q

Define embolic stroke

A

Blood clot formed at other location in the circulatory system; blockage breaks off and goes up

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10
Q

Embolic stroke:

Cardiac origin most common; 80% of cardiac emboli include?

A

MCA

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11
Q

May be paradoxical; congenital such as patent foramen ovale, DVT

A

Embolic stroke

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12
Q

Define thrombotic stroke

A

It’s a blood clot that develops at clogged part of the vessel; they are higher up

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13
Q

Typically related to abnormalities within the vessel wall like atherosclerosis, arthritis, dissections and external compression of the vessels

A

Thrombotic stroke

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14
Q

Common precursor of thrombotic stroke?

A

HTN

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15
Q

Thrombotic strokes can also be caused by?

A

Hematologist disorders and/or hypercholesterolemia

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16
Q

With what disease are they likely to have thrombotic stroke?

A

A-fib

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17
Q

Large vessel thrombosis in carotid and vertebral arteries can lead to severe what strokes?

A

Thrombotic

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18
Q

Define lacunar strokes

A

Small vessel stroke that occurs distally; branches off a large artery

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19
Q

What kind of stroke is typically associated with chronic HTN and diabetic microvascular disease?

A

Lacunar stroke

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20
Q

What kind of pt has lacunar strokes?

A

Diabetic

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21
Q

Size of infarct 2 mm to 3 cm in size

A

LACUNAR STROKE

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22
Q

Account for roughly 25% of ischemic strokes

A

Lacunar strokes

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23
Q

What are the 3 main types of stroke?

A

Ischemic
Hemorrhagic
TIA (transient ischemic attack)

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24
Q

What are the 3 types of ischemic strokes?

A

Embolic
Thrombotic
Lacunar

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25
Q

What are the 6 types of lacunar strokes?

A 
Pure motor
Pure sensory
Sensorimotor
Ataxia hemiparesis
Dysarthria
Clumsy hand syndrome
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26
Q

Ataxic hemiparesis is seen in?

A

Cerebellum

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27
Q

If a pt has right CVA and pure sensory what do they have?

A

Neglect

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28
Q

Common causes of this stroke:

  • hypertensive bleed
  • ICH in the presence of an AVM or tumor
  • ruptured aneurysm
A

Hemorrhagic

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29
Q

75% of hemorrhagic strokes caused by a bleeding blood vessel occur in ppl who have ?

A

HTN

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30
Q

Anterior cerebral artery (ACA) supplies?

A

Medial aspect of frontal and parietal lobes

And subcortical structures like basal ganglia

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31
Q

Middle cerebral artery (MCA) supplies?

A

Entire lateral aspect of cerebral hemisphere

Frontal, temporal, parietal

32
Q

Posterior cerebral artery (PCA) supplies?

A

Occipital lobe, medial and inferior temporal lobe, upper brain stem, midbrain, thalamus

33
Q

DO hemorrhagic strokes follow an artery distribution?

A

NO

34
Q

What signs and symptoms can differentiate between hemorrhagic and ischemic?

A

Vomiting, headache, impaired consciousness

35
Q

Which brain scan is best to do for strokes?

A

CT scan

36
Q

What is the most common hemorrhagic stroke?

A

Anterior communicating artery aneurysm

37
Q

WHy would TIA be confused with lacunar strokes?

A

Because they follow a vascular distribution

38
Q

Reversible; no infarction of cerebral tissue

A

TIA

39
Q

How soon do ppl who have had a TIA, have it again?

A

Within 3 months but half of these happen within 48 hours

40
Q

Work up essential to determine the cause and prevent future stroke

A

TIA

41
Q

Ischemic infarct may convert into a ?

A

Hemorrhagic lesion

42
Q

Thrombi can do what leading to small hemorrhages?

A

They can migrate, lyse and reperfuse into an ischemic area

43
Q

In hemorrhagic conversion, what happened to capillaries and small blood vessels?

A

They get damaged and no longer maintain their integrity

44
Q

Hemorrhagic conversions are more common in?

A

Large infarcts such as an occluded MCA

45
Q

WHat does TPA stand for?

A

Tissue plasminogen activator

46
Q

What does TPA do?

A

It’s a powerful clot buster – does thrombolysis

47
Q

To use TPA you have to rule out what first?

A

Hemorrhagic stroke

48
Q 
Personality
Behavior
Emotions
Judgement
Planning
Problem solving
Intelligence
Speaking and writing
Concentration
Self awareness
A

Frontal lobe

49
Q 
Interpreting language
Touch sensation
Pain
Temperature
Vision
Hearing
Memory
Spatial perception
A

Parietal lobe

50
Q 
Wernicke's area (understanding)
Memory
Hearing
Sequencing
Organizing
A

Temporal lobe

51
Q

Interprets vision

Light, color, movement

A

Occipital lobe

52
Q

What 3 ways do strokes present the same on either side?

A

Opposite side weakness and sensory deficits

Memory deficits

53
Q

2 presentations on Left sided stroke

A

Speech and language deficit

Slow, cautious behavior

54
Q

2 presentations on right side stroke

A

Spatial perceptual deficits

Quick, impulsive behavior

55
Q

Clinical signs of brain stem strokes

A

Changes in: breathing, movement, mvmt of eye sensation, HR, MP

56
Q

Clinical signs of cerebellar strokes

A 
Abnormal reflexes of head and torso
Impaired coordination
Ataxic gait (uncoordinated mvmt)
Balance issues
Dizzy
Vomit
57
Q

Thalamic pain syndrome clinical signs

A

Involuntary mvmt
Contra hemiplegia
Vertical eye mvmt weak

58
Q

Thalamic pain syndrome is occlusion of?

A

Central territory of PCA

59
Q

Medial medullary “dejerine” syndrome is an occlusion of?

A

Vertebral artery, medullary branch

60
Q

Ipsi signs of dejerine

A

Paralysis with atrophy of 1/2 of tongue with deviation to paralyzed side

61
Q

Contra signs of dejerine syndrome

A

UE and LE paralysis

Impaired tactile and proprioceptive info

62
Q

Lateral medullary syndrome (Wallenbergs) is an occlusion of?

A

PICA or vertebral artery

63
Q

Contra signs of wallenbergs syndrome

A

Impaired pain and thermal sense over 50% of body

64
Q

What is the “locked in syndrome”

A

Occlusion of basilar artery

65
Q

Clinical signs of basilar artery syndrome

A

Quad hemiparesis
Bilateral cranial nerve palsy
SPARED conscious and sensation
Pt cant move or speak but is A xO

66
Q

Lateral inferior pontine syndrome is occlusion of?

A

AICA

67
Q

Acute stroke patients on typically on bed rest for how long?

A

24 to 48 hours

68
Q

MAP ranges for ischemic

A

May run up to 130-140

69
Q

MAP range for hemorrhagic

A

Needs to be less than 110

70
Q

WHat does it mean if MAP ranges are too high for pt?

A

They’re at risk for bleeding

71
Q

Hemorrhagic strokes may present similar to?

A

TBI

72
Q

If pt is moving in synergistic pattern do what?

A

Gravity minimized, spasticity testing

73
Q

Reorganization is dependent on?

A

ENVIRONMENT

74
Q

How to reduce spasticity for pts with stroke?

A

PROM and stretching with slow gradual mvmts.

DO NOT DO SUDDEN QUICK MVMTS

75
Q

What kind of tasks should you do

A

Variable

P2F Neuro (5 decks)

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