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NEC 3 > CEREBROVASCULAR DISORDERS > Flashcards

CEREBROVASCULAR DISORDERS Flashcards

1
Q

The functional abnormality of the CNS when the normal blood supply to the brain is disrupted

A

CEREBROVASCULAR DISORDERS

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2
Q

What is cerebrovascular disorders

A

The functional abnormality of the CNS when the normal blood supply to the brain is disrupted

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3
Q

What is stroke?

A

The primary type of CVD

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4
Q

Types of stroke

A

-Ischemic stroke
- Hemorrhagic stroke

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5
Q

Aka as cerebrovascular accident

A

Ischemic stroke

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6
Q

Brain attack

A

Ischemic stroke

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7
Q

Sudden loss of function resulting from disruption of the blood supply to a part of the brain

A

Ischemic stroke

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8
Q

What is ischemic stroke?

A

-Aka as cerebrovascular accident
-Brain attack
-Sudden loss of function resulting from disruption of the blood supply to a part of the brain

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9
Q

Types of ischemic stroke

A
  1. large artery thrombotic strokes
  2. small penetrating artery thrombotic strokes
  3. Cardiogenic embolic strokes
  4. Cryptogenic stroke
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10
Q

What is large artery thrombotic stroke?

A

Caused by atherosclerotic plaques in the large blood vessels of the brain causing infarction

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11
Q

What is small penetrating artery thrombotic strokes?

A

affect one or more vessels and are the most common type of ischemic stroke; leaves a cavity after death or infarcted tissue

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12
Q

What is cardiogenic embolic strokes?

A

Associated with cardiac dysrhythmias, usually atrial fibrillation

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13
Q

What is cryptogenic stroke?

A

-have no known cause
- Also known as “stroke of unknown cause

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14
Q

-have no known cause
- Also known as “stroke of unknown cause

A

Cryptogenic stroke

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15
Q

Caused by atherosclerotic plaques in the large blood vessels of the brain causing infarction

A

large artery thrombotic stroke

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16
Q

affect one or more vessels and are the most common type of ischemic stroke; leaves a cavity after death or infarcted tissue

A

small penetrating artery thrombotic strokes

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17
Q

Associated with cardiac dysrhythmias, usually atrial fibrillation

A

cardiogenic embolic strokes

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18
Q

What is the main issue of the large artery thrombotic stroke?

A

Lack of oxygen-ischemia- lead to necrosis

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19
Q

a cellular metabolic event

A

Ischemic cascade

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20
Q

occurs after blood obstruction

A

Ischemic cascade

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21
Q

in ischemic cascade how many blood decreases?

A

blood decrease less than 25 ml per 100g of blood per minute

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22
Q

blood decrease less than 25 ml per 100 mg of blood per minute

A

ischemic cascade

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23
Q

Aerobic respiration of neurons fails

A

ischemic cascade

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24
Q

switches to anaerobic respiration

A

ischemic cascade

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25
Q

it generates large amounts of lactic acid, causing a change in the PH

A

anaerobic respiration

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26
Q

describe the characteristics of ischemic cascade

A

-a cellular metabolic event
-occurs after blood obstruction
-blood decrease less than 25 ml per 100 mg of blood per minute
-Aerobic respiration of neurons fails
-switches to anaerobic respiration

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27
Q

An area of low cerebral blood flow

A

Penumbra region

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28
Q

may be salvaged with timely intervention

A

Penumbra region

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29
Q

increase in intracellular calcium and the release of glutamate

A

Penumbra region

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30
Q

activate a number of damaging pathways; extends the stoke

A

glutamate

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31
Q

Characteristics of penumbra region

A

-An area of low cerebral blood flow
- May be salvaged with timely intervention
- increase in intracellular calcium and the release of glutamate

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32
Q

Toxic to brain if it increases and leads to necrosis

A

Glutamate

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33
Q

due to anaerobic activity

A

Glutamate

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34
Q

Memory enhancement

A

Glutamate

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35
Q

Characteristics of glutamate

A

-memory enhancement
- toxic to brain if it increases and leads to necrosis
- due to anaerobic activity
-memory enhancement

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36
Q

Clinical Manifestations of Ischemic stroke

A

MOTOR LOSS
-hemiplegia
-hemiparesis

COMMUNICATION LOSS
-Dysarthria
-Dysphasia
-Apraxia

PERCEPTUAL DISTURBANCES
-visual-perceptual disturbances
-homonymous hemianopsia

SENSORY LOSS
-Loss of Proprioception
-Agnosia

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37
Q

Loss of voluntary control over motor movements

A

Motor loss

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38
Q

What is motor loss?

A

Loss of voluntary control over motor movements

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39
Q

What is hemiplegia?

A

-Paralysis of one side of the body
-caused by a lesion of the opposite side of the brain

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40
Q

What is hemiparesis?

A

-weakness of one side of the body
-refer to pt

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41
Q

Paralysis of one side of the body

A

Hemiplegia

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42
Q

Weakness of one side of the body

A

Hemiparesis

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43
Q

caused by a lesion of the opposite of the brain

A

hemiplegia

44
Q

difficulty in speaking; paralysis of the muscles

A

dysarthria

45
Q

impaired speech or aphasia (loss of speech), which can be expressive aphasia, receptive aphasia or global (mixed) aphasia

A

Dysphasia

46
Q

Types of aphasia

A

-Expressive aphasia
- Receptive aphasia
- Global (mixed) aphasia

47
Q

Inability to perform a previously learned action

A

Apraxia

48
Q

What is Dysarthria?

A

difficulty in speaking; paralysis of the muscles

49
Q

What is Dysphasia?

A

impaired speech or aphasia (loss of speech), which can be expressive aphasia, receptive aphasia or global (mixed) aphasia

50
Q

What is apraxia?

A

Inability to perform a previously learned action

51
Q

caused by disturbances of the primary sensory pathways between the eye and visual cortex

A

visual-perceptual disturbances

52
Q

What is visual-perceptual disturbances?

A

caused by disturbances of the primary sensory pathways between the eye and visual cortex

53
Q

Loss of half of the visual field

A

Homonymous Hemianopsia

54
Q

The affected side of vision corresponds to the paralyzed side of the body

A

Homonymous Hemianopsia

55
Q

What is homonymous hemianopsia?

A

-Loss of half of the visual field
-The affected side of vision corresponds to the paralyzed side of the body

56
Q

Deficit in the ability to recognize previously familiar objects perceived by one or more of the senses

A

Agnosia

57
Q

Cognitive impairment and psychological effects

A

Frontal Lobe Damage

58
Q

Impairment of learning capacity, memory or other higher cortical intellectual functions

A

Frontal Lobe Damage

59
Q

What is Frontal Lobe Damage?

A

Impairment of learning capacity, memory or other higher cortical intellectual functions

60
Q

What are the Frontal Lobe Damage?

A

-limited attention span
- difficulties in comprehensive
-forgetfullness
-lack of motivation

61
Q

How to assess a child with ADHD?

A

-offer several tasks

62
Q

Characteristics of Autistic Child?

A

head banging >8 minutes

63
Q

What is Transient Ischemic Attack?

A

-a warning of impending stroke
- a neurologic deficit typically lasting less than 1 hour
- sudden loss of motor, sensory, or visual function due to temporary ischemia in the brain.

64
Q

A warning of impending stroke

A

Transient Ischemic Attack

65
Q

A neurologic deficit typically lasting less than 1 hour

A

Transient Ischemic Attack

66
Q

Sudden loss of motor, sensory, or visual function due to temporary ischemia in the brain

A

Transient Ischemic Attack

67
Q

Diagnosis of Ischemic Stroke

A

-Non-contrast CT Scan
- 12-Lead Electrocardiogram (ECG)
- Carotid Ultrasound
- CT Angiography
- MRI

68
Q

What is non-contrast CT Scan?

A

Determine if the event is ischemic or hemorrhagic

69
Q

Medical Management of Ishemic Stroke

A

-Antithrombotic
-Thrombolytic Therapy

70
Q

Examples of Antithrombotic Drug

A

-Warfarin (Coumadin)
-Acetylsalicylic Acid/Aspirin

71
Q

What is warfarin?

A

-an anticoagulant
- slows down blood clotting
- given to patients with atrial fibrillation

72
Q

What is Acetylsalicylic Acid?

A

-Antiplatelet
-best option if warfarin is contraindicated

73
Q

Best option if warfarin is contraindicated

A

Acetylsalicylic Acid

74
Q

What is thrombolytic therapy?

A

Dissolves the blood clot that is blocking blood flow to the brain

75
Q

Dissolves the blood clot that is blocking blood flow to the brain

A

Thrombolytic therapy

76
Q

The DNA Composition of of Thrombolytic Therapy

A

Recombinant t-PA (tissue type plasminogen activator)

77
Q

What is recombinant t-PA?

A

-a genetically engineered form of t-PA
- a thrombolytic substance made naturally by the body

78
Q

what is kinase?

A

attenuated-weakened bacteria

79
Q

Surgical Management of Ischemic Stroke

A

-Carotid Endarterectomy
- Carotid Angioplasty & Stenting

80
Q

What is carotid endarterectomy?

A

The removal of an atherosclerotic plaque or thrombus from the carotid artery

81
Q

What is carotid angioplasty & stenting?

A

-A less invasive procedure that is used for severe stenosis
- A carotid stent is placed inside the carotid artery at the site of the blockage and provides support to keep the artery open

82
Q

A carotid stent is placed inside the carotid artery at the site of the blockage and provides support to keep the artery open

A

Carotid Angioplasty & Stenting

83
Q

The removal of an atherosclerotic plaque or thrombus from the carotid artery

A

Carotid endarterectomy

84
Q

Post Surgical Management of Ischemic Stroke

A

-Maintain adequate blood pressure levels
-Weakness on one side of the body
- Always maintain patent airway

85
Q

Why we need to maintain adequate blood pressure levels?

A

Hypotension is avoided to prevent cerebral ischemia and thrombosis

86
Q

Why there is a weakness on one side of the body?

A

Thrombus formation is suspected

87
Q

What equipment/supply must be readily available?

A

Emerceny airway supplies must be available

88
Q

What is hemorrhagic stroke?

A

-Caused by bleeding into the brain tissue, the ventricles, or the subarachnoid space
- Has more severe deficits and a longer recovery phase than ischemic stroke

89
Q

Pathophysiology of Hemorrhagic stroke

A

-exposure to blood
- sudden entry of blood into the subarachnoid space
-increases ICP
-compresses and injures brain tissue

90
Q

Clinical Manifestations of Hemorrhagic stroke (Left Hemispheric Stroke)

A

-Paralysis or weakness on right side of the body
- Right visual field deficit
- Aphasia (expressive, receptive, or global)
- Altered intellectual ability
- Slow, cautious behavior

91
Q

Clinical Manifestations of Hemorrhagic stroke (Right Hemispheric Stroke)

A

-Paralysis or weakness on left side of the body
- Left visual field deficit
- Spatial-perceptual deficits
- Increased distractibility
- Impulsive behavior and poor judgement
- Lack of awareness of deficits

92
Q

Medical Management of Hemorrhagic Stroke

A

-Fresh frozen plasma & vitamin K
- Antiseizures (phenytoin, phenobarbital)

93
Q

Surgical Management of Hemorrhagic Stroke

A

Craniotomy

94
Q

What is craniotomy?

A

-Done if diameter of the hematoma exceeds 3 cm and the glasgow coma scale score decreases
-prevents bleeding in an unrupted aneurysm or further bleeding in an already ruptured aneurysm

95
Q

Post-Operative Complications of Craniotomy

A

-KORSAKOFF’S syndrome
-Intraoperative embolization
-Postoperative Internal Artery Occlusion
- Gastrointestinal Bleeding

96
Q

Characterized by amnesia, deficits in explicit memory, and confabulation

A

Korsakoff’s syndrome

97
Q

Caused by severe deficiency of thiamine (Vitamin B1)

A

Korsakoff’s syndrome

98
Q

What is korsakoff’s syndrome?

A

-Characterized by amnesia, deficits in explicit memory, and confabulation
-Caused by severe deficiency of thiamine (Vitamin B1)

99
Q

Nursing Management of Hemorrhagic Stroke

A

-Bed rest with sedation (as prescribed)
- HOB is elevated 15 to 30 degrees
- Pain management for neck pain
-Anti-embolism stockings
- Seizure precaution

100
Q

Rationale of Bed rest with sedation

A

Prevents agitation and stress

101
Q

Why HOB needs to be elevated?

A

To promote venous drainage and decrease ICP

102
Q

Purpose of wearing anti-embolism stockings

A

Prevents deep vein thrombosis

103
Q

What is the Goal for hemorrhagic stroke?

A

-To allow the brain to recover from the initial insult
- To prevent or minimize the risk of rebleeding
- To prevent or treat complications

104
Q

Why we need to give fresh frozen plasma & vitamin K?

A

If bleeding is caused by anticoagulation

105
Q

Antiseizures must be given:

A

Given prophylactically

106
Q

Seizures can occur

A

Seizures can occur after intracerebral hemorrhage

NEC 3 (16 decks)

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