Cerebral Vascular Accident (CVA) Flashcards by Damaris Dominguez

What is a Stroke or a CVA?

Is an interruption in the blood flow that causes an
inadequate supply of oxygen and other nutrients
to reach portions of the brain or brain stem

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What are the three main types of strokes?

Ischemic, Hemorrhagic, Lacunar

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What are some warning signs of a stroke ?

Sudden numbness or weakness of the face, arm
or leg, especially on one side of the body
Sudden confusion, trouble speaking or
understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance
or coordination
Sudden, severe headache with no known cause.
FAST (Face, Arms, Speech, Time)

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What is the function of the cerebrum?

Largest part of the brain

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What is the cortex ?

Outer layer of the cerebrum; controls most of our

conscious processes

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What is the function of the Frontal Lobe?

higher cognitive functions such as
– Memory, judgment, and executive functions
– Voluntary eye and other motor movements
- Emotional expression and Contains Broca’s area (expressive language)

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What are the four lobes of the brain?

Frontal, Parietal, Occipital, and Temporal

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What is the function of the Temporal Lobe?

Wernicke’s area which is the center for receptive

speech, Understanding what is said to us

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What is the function of the parietal lobe?

The sensory cortex and integrates sensory information

and relating to spatial perception

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What is the function of the occipital lobe?

All visual processing whether it be sensory, actual

sight, or motor, which is the eye movements

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What is the function of the Thalamus ?

Connects sensory and motor inputs to all parts of the

cerebrum

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What is the function of the hypothalamus?

Regulates endocrine and autonomic functions

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What is the limbic system responsible for ?

Emotions, sexual arousal, behavior expression, STM

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True or False

The ANS is responsible for controls involuntary functions of cardiac muscle, smooth muscle and glands

True

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What is the sympathetic Nervous system responsible for?

Heart rate increase
• Smooth muscle of vessels
• Constrict skin, coronary and
abdominal blood vessels
• Bronchial dilation
• Decreased peristalsis
• Pupillary dilation
• Accommodation for far vision
• Increased sweat
• Decreased saliva production

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What is the Parasympathetic Nervous System Responsible for?

• Decreased heart rate
• Dilation of coronary vessels
• Bronchial dilation
• Increased peristalsis
• Pupillary constriction
• Increased saliva production
• Increased pancreatic
enzyme and insulin
secretion

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What is the anterior circulation of the blood supply to the brain?

Internal Cartiod Artery (ICA)
• External carotid artery (ECA)
• Anterior cerebral artery
(ACA)
• Middle cerebral artery
(MCA)

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What is the posterior circulation of the blood supply to the brain?

• Vertebral artery
• Basilar artery
• Posterior inferior cerebellar
artery (PICA)
• Anterior inferior cerebellar
artery
• Superior cerebellar artery
(SCA)
• Posterior cerebral artery
(PCA)

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What structures does the Middle Cerebral Artery suppl0y (MCA)?

supplies the frontal, temporal, and parietal lobes

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What structures does the Anterior Cerebral Artery suppl0y (ACA)?

supplies the portions of the frontal lobe

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What makes up the anterior portion of the circle of willis?

Common and internal carotids
Hemispheric dysfunction
Middle cerebral artery (MCA)
Anterior Cerebral Artery (ACA)

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What makes up the posterior portion of the circle of willis?

Joins internal carotids and vertebrobasilar
circulation to create an anastomosis of the vessels
and preserve the autoregualtory cerebral
circulation
– Venous: Drains from the cerebral and jugular veins
and the dural sinus

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What are the extracranial vessels?

Vertebral Arteries- from the
subclavian-extracranial
posterior circulation
• Right Common Carotid-
(RCA)
• Left Common Carotid- (LCA)
• These divide into-
– External carotid
– Internal carotid

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What makes up the intracranial vessels?

• Internal carotid
• Anterior cerebral artery
(ACA)
• Middle cerebral arteries
(MCA)

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Which artery tends to be the most common abnormality in the brain?

Most common abnormality is no posterior | communicating artery

Define Hemorrhagic CVA

Rupture of a blood vessel or aneurysm with leakage of blood outside the normal vessels around the cerebral tissues

When an artery suddenly bursts (caused by a clot) and releases blood within the brain tissues and causes a sudden increase of pressure in the skull is known as what type of hemorrhage?

Intracerebral hemorrhage (ICH)

What is it called when a cerebral aneurysm ruptures causing a release of blood into the subarachnoid space, causing a sudden increase in pressure in the skull?

Subarachnoid hemorrhage (SAH)

What are some of the signs and symptoms of a Hemorrhagic CVA?

Sudden onset of headache and vomiting Severely elevated blood pressure and focal neurologic deficits that progress over minutes * Begins with bleeding from small, deep vessels * Develop gradually over minutes, hours and days * Release of blood into the brain tissue and surrounding structures * Edema disrupts all function of the region

Define AVM (Arteriovenous malformation)

abnormal connection of vessels near the surface | of the brain

A Hemorrhagic CVA is more common in what population?

Younger population as it is often due to a congenital deformity.

What is the most common cause of a subarachnoid hemorrhage?

Leakage from the aneurysm is the most common cause

What are symptoms of a subarachnoid hemorrhage?

``` Increase intracranial pressure from a accumulation of blood in the subarachnoid space •Headaches and vomiting •Altered state of conscious •Sleepiness •Stupor •Agitation and Restlessness •Coma ```

What is the most common type of stroke?

ischemic cva

What kind of cva is described as a sudden loss of function due to a loss of blood supply to an area of the brain that controls function

ischemic cva

what are some causes of an ischemic cva?

Caused by a partial or complete blockage of an artery that supplies the brain –Thrombotic/Artherothrombotic –Embolic infarct –Crytogenic strokes

what are some signs and symptoms of an ischemic cva

* Sudden weakness or numbness of the face, arm, hand, leg on one side of the body * Loss of speech or difficulty speaking or understanding speech * Dimness or loss of vision in one eye * Unexplained dizziness * Unsteadiness or sudden falls

Artherosclerosis is responsible for 60% of what type of CVA?

Ischemic

How is a thrombotic CVA caused?

•Blood clot forms and obstructs artery •Most often occurs where arteries divide or turn Onset during sleep is common

T or F: The symptoms of a thrombotic CVA are shown immediately.

F-Progressive symptoms that occur over several hours or days

T or F: TIA’s (Transient Ischemic Attacks) precede actual infarction approximately half of the time

True

what is an embolism?

a clot breaks off and travels until it blocks an artery

T or F: Embolic CVA is cardiogenic

True

What is the most common vessel occluded by a cardiac emboli?

MCA

T or F: Seizures are associated with embolic strokes

True

What type of CVA is characterized as small infarcts usually in deep non cortical parts of the cerebrum and brainstem, including the basal ganglia, thalamus, pons, internal capsule and deep white matter

Lacunar Stroke

T or F: a lacunar stroke may go undetected

true

What is a common risk factor of a lacunar stroke?

HTN

What is a brief episode of neurologic dysfunction caused by focal disturbance of brain known as?

Transient Ischemic Attack (TIA) | Symptoms usually last for less than one hour

T or F: If you have a TIA, there is always evidence of an infarct?

F-No evidence of infarct

What is known as a loss of voluntary movement and coordination on right side of face, trunk, and limbs with impaired sensation, including temperature discrimination, pain, and proprioception on right side

Left Middle Cerebral Artery Infarct (MCA)

What is the inability to understand speech; impairs reading, writing, and speaking and it occurs with a left middle cerebral artery infarct?

Aphasia

What are some symptoms of a Left Middle Cerebral Artery Infarct?

Blind spots in visual fields usually on right side Slow and cautious personality Memory deficits for recent or past events Dysarthria (uncoordinated movements of the jaw)

All of the following characterize what condition? Loss of voluntary movement and coordination on left side of face, trunk and limbs •Impaired sensation on left side •Spatial and perceptual deficits •Unilateral neglect •Dressing apraxia •Impulsive behavior and errors in judgment •Left visual field deficits

Right Middle Cerebral Artery Infarct

All of the following characterize damage to what artery? •Contralateral hemiplegia or hemiparesis, greater in the leg than in the arm •Loss of sensation in contralateral toes, foot and leg •Loss of bowel and bladder control •Problems with sitting/standing balance and walking •Lack of emotion, whispered speech or the loss of all communication •Memory loss or impairment •Generalized slowness and distractibility

Anterior Cerebral Artery (ACA)

All of the following characterize damage to what artery? •Varied symptoms as artery supplies upper brain stem, temporal and occipital lobes •Contralateral hemiplegia/paresis –Greater in face and arm than leg •Sensory and motor deficits •Involuntary movement disorders •Intention tremor •Contralateral Homonymous hemianopsia •Memory loss •Alexia, asterognosis •Visual Agnosia (inability to recognize visual objects)

Posterior Cerebral Artery

What is alexia?

not being able to identify words

what is asterognosis?

not being able to recognize objects by touching them

``` What CVA is characterized by the following? •Visual disturbances •Vertigo/dizziness •Balance disturbances •Paralysis of face, limbs or tongue •Dysmetria (lack of coordination) •Dysphasia (difficulty with swallowing) ```

Vertebrobasilar CVA

What are some other complications of CVAs?

``` •Seizures •Infection –Aspiration pneumonia –UTI •Deep vein thrombosis (DVT) •Contractures •Decubiti •Depression •Falls ```

What are some precautions for CVAs?

* Anticoagulant meds/blood thinners * Seizure * Hemiplegic UE handling * Skin integrity * Diet (type and consistency) * Fall risk