Cerebrovascular Disorders (CVD) Flashcards
1
Q
Primary Cerebrovascular Disorder (CVD)
A
Stroke
2
Q
Other name for Stroke
A
Cerebral Vascular Accident
(CVA);
Brain Attack
Cerebral Thrombosis
Apoplexy
3
Q
Give at least five (5) Risk Factors for CVA
A
- Hypertension (Greatest Risk Factor)
- Heart Disease
- Diabetes Mellitus
- Sleep Apnea
- Blood Cholesterol Levels
- Smoking
- Sickle Cell Disease
- Substance Abuse
- Living in the Stroke Belt
4
Q
Enumerate Possible Causes of CVA (there are 3 identified)
A
- Thrombosis
- Embolism
- Hemorrhage
5
Q
RESERTS
A
Cardio-Embolic Stroke
6
Q
Types of Human Brain Stroke
A
- Hemorrhagic
- Ischemic
- Atherosclerosis
7
Q
Identified Types of Stroke
A
- Ischemic Stroke
- Hemorrhagic Stroke
8
Q
Classifications of Ischemic Stroke
A
- TIA
- Thrombotic
- Embolic
9
Q
RESERTS!
A
Amaurosis Fugax
10
Q
Classifications of Hemorrhagic Stroke
A
- Intracerebral Hemorrhage
- Intracranial (Cerebral) Aneurysm
- Arteriovenous Malformations
- Subarachnoid Hemorrhage
11
Q
Intracerebral Hemorrhage
A
Pons is a deep structure, and most often inaccessible for surgery
12
Q
Types of Intracranial (Cerebral) Aneurysm
A
- Berry aneurysm
- Saccular aneurysm
- Fusiform aneurysm
- Mycotic aneurysm
13
Q
Mycotic aneurysm
A
Most likely Secondary to infection
14
Q
One of the three causes of Stroke that tends to occur during sleep or soon after arising
A
Thrombosis
15
Q
The most common cause of Cerebral Thrombosis is _______ usually affecting an El____ Person
A
Atherosclerosis;
Thrombosis;
Elderly Person
16
Q
An umbrella term that refers to a functional abnormality of the CNS that occurs when the normal blood supply to the brain is Disputed
A
Cerebrovascular Disorders (CVD’s)
17
Q
It is the third leading cause of death after Heart Disease and Cancer.
A
Cerebrovascular Disorders (CVDs)
18
Q
Since it is the 3rd leading cause of death after heart disease and cancer, it is considered as a Major Cause of D_____
A
Cerebrovascular Disorders are considered a Major Cause of Disability
19
Q
Incidence of CVDs increases with ___, most occurring in people who are over ____ years old
A
CVD Incidence increases with Age, most occurring in people who are over 65 Years Old
20
Q
A condition in which Neurologic Deficits result from a sudden decrease in blood flow to a Localized Area of the Brain
A
Stroke
21
Q
This is one of the three causes of Stroke that most commonly affects the Younger Population Group
A
Embolism
22
Q
This is one of three causes of Stroke that is most frequently caused by Rheumatic Heart Disease and Myocardial Infarction
A
Embolism
23
Q
Give at least 4 Other Risk Factors (excluding the identified 9 Actual Risk Factors)
A
- Family History of Stroke
- Sedentary Lifestyle
- Recent Viral and Bacterial Infections
- Previous TIA
- Autoimmune Disorders
- Clotting Disorders
- Menopause
24
Q
Embolism as a Possible Cause of Stroke, can be a Result of what 2 other Identified Disorders of the Heart
A
Rheumatic Heart Disease
&
Myocardial Infarction
25
The Symptoms of Embolism occur at ______ and Progress _____
Sx of Embolism occur *At Any Time* and **Progresses Rapidly**
26
It is one of the three identified possible causes of Stroke that is usually caused by Rupture of Cerebral Artery in a Patient with
1. Severe Hypertension,
2. Subarachnoid/Intracerebral Hemorrhage,
3. Rupture of an Aneurysm,
4. AV Malformation,
5. Hypocoagulation
*Hemorrhage*
27
What are the probable root causes of Hemorrhage that could lead to Stroke? (There are 5 identified, can give three only or more)
1. Severe Hypertension
2. Hypocoagulation
3. Rupture of an Aneurysm
4. AV Malformation
5. Subarachnoid/Intracerebral Hemorrhage
28
It is one of three identified possible causes of Stroke that are frequently more severe and destructive than other CVA’s because they affect Large Portions of the Brain
**Hemorrhage**
29
A category of human brain stroke where there is a presence of Clot causing an ______ Stroke
Ischemic Stroke;
*Embolic Stroke*
30
A category of human brain stroke where there is a presence of Plaque causing a ______ Stroke
Ischemic Stroke;
*Thrombotic Stroke*
31
A category of human brain stroke that is caused by Burst Aneurysm causing bleeding in the Subarachnoid Space
Hemorrhagic Stroke; r/t
Subarachnoid Hemorrhage
32
A category of human brain stroke that is caused by Torn Artery causing bleeding in the Intracerebral Space
Hemorrhagic Stroke;
*Intracerebral Hemorrhage*
33
A type of stroke that results from blockage and/or stenosis of a cerebral artery or stopping blood flow and ultimately causing Brain Infarction
Ischemic Stroke
34
This type of stroke accounts for 80% of all Stroke
Ischemic Stroke
35
In this type of stroke, the blockage is secondary to a blood clot (either thrombus or emboli), or from the stenosis of a vessel resulting in the building up of a plaque
Ischemic Stroke
36
Give the three (3) Classifications of Ischemic Stroke
1. Transient Ischemic Attack
2. Thrombotic Stroke
3. Embolic Stroke
37
A classification of Ischemic Stroke that is sometimes called Mini-Stroke
TIA
38
A classification of Ischemic Stroke that is considered a warning signal of an Ischemic Thrombotic Stroke
TIA
39
Give at least 2 Etiologies of TIA (there are total of 5)
1. Inflammatory Artery Disorders
2. Sickle Cell Anemia
3. Thrombosis
4. Emboli
5. Atherosclerotic Changes in Cerebral Blood Vessels
40
Give at least 2 Manifestations of TIA (there are total of 4)
1. **Aphasia** - language disorder; trouble understanding & speech
2. Visual Disturbances; **blurring of vision**
3. **Amaurosis Fugax** - temporary painless loss of vision in one or both eyes
4. **Contralateral numbness or weakness** of the leg, hand, forearm, and corner of the mouth
41
“Fleeting Darkness”; A transient Monocular or Binocular Visual Loss — a temporary loss of vision in one or both eyes caused by a temporary reduction or blockage of blood flow to the retina or optic nerve, often due to a blood clot or plaque traveling from the carotid artery or heart
Amaurosis Fugax
42
A classification of Ischemic Stroke that is caused by Occlusion of a Large Cerebral Vessel by a **Thrombus**
Thrombotic Stroke
43
A classification of Ischemic Stroke that most often occur in older people who are resting or sleeping
Thrombotic Stroke
44
The most common locations of Thrombi are the (there are 3 identified):
1. Internal Carotid Artery
2. Vertebral Arteries
3. Junction of the Vertebral and Basilar Arteries
45
A classification of Ischemic Stroke in which it affects only One Region of the Brain that is Supplied by a Single Cerebral Artery
Thrombotic Stroke
46
A classification of Ischemic Stroke that Occurs Rapidly but Progresses Slowly — often begins with a TIA and continues to worsen over __-__ Days — **“STROKE in _______”** — when the maximum Neurologic Deficit has been reached, usually in __ Days —— “**________ STROKE**”
*Thrombotic Stroke*;
Worsens over 1-2 Days — “**STROKE IN EVOLUTION**”;
Max NeuroDeficit Reached usually in 3 Days — “**COMPLETED STROKE**”
47
A classification of Ischemic Stroke that occurs when a blood clot traveling through the cerebral blood vessels lodge into the vessels to narrow to permit further movement
Embolic Stroke
48
Frequent sites of Cerebral Emboli (there are total of 2 identified):
1. Bifurcations of Vessels — **Carotid Arteries**
2. Bifurcations of Vessels — **Middle Cerebral Arteries**
Note: BIFURCATIONS - the state of being divided into two branches or parts (e.g. blood vessels branching out into two parts)
49
A type of Stroke that occurs when a Cerebral Blood Vessel Ruptures — blood enters the brain tissues compressing adjacent tissues and causing blood vessel spasm and cerebral edema
*Hemorrhagic Stroke / Intracranial Hemorrhage*
50
A type of Stroke in which it accounts for about 15-20% of Stroke; there is an Extravasation of blood into the brain or subarachnoid space
Hemorrhagic Stroke / Intracranial Hemorrhage
51
A classification of Hemorrhagic Stroke that involves bleeding Into the Brain Tissue
Intracerebral Hemorrhage
52
A classification of Hemorrhagic Stroke that came from a Spontaneous Rupture of Small Vessels and accounts for approximately __% of Hemorrhagic Strokes and is caused Chiefly by Uncontrolled _________
Intracerebral Hemorrhage;
80%;
Uncontrolled Hypertension
53
A classification of Hemorrhagic Stroke that is most common in Patients with HTN and Cerebral _________, because degenerative changes from these diseases cause Rupture of the Blood Vessels
Intracerebral Hemorrhage;
Cerebral Atherosclerosis;
54
A classification of Hemorrhagic Stroke may result from certain types of:
1. Arterial Pathologies
2. Brain Tumors
3. The use of Medications
Intracerebral Hemorrhage
55
A classification of Hemorrhagic Stroke where the bleeding occurs most commonly in the:
1. Cerebral Lobes
2. Basal Ganglia
3. Thalamus
4. Brain Stem (mostly Pons)
5. Cerebellum
Intracerebral Hemorrhage
56
A classification of Hemorrhagic Stroke there occasionally, the bleeding ruptures the wall of the Lateral Ventricle and causes *Intraventricular Hemorrhage*, which is frequently _______
Intracerebral Hemorrhage;
FATAL
57
A classification of Hemorrhagic Stroke where there is a Dilation of the Walls of a Cerebral Artery that develops as a result of weakness in the Arterial Wall;
This tends to occur at the *Bifurcations* and branches of the Carotid Arteries and the Vertebrobasilar Arteries at the Circle of _______; Range in size from smaller than __mm to larger than __mm
Intracranial (Cerebral) Aneurysm;
Involves Circle of Willis Arteries;
Smaller than 15mm to larger than 50mm
58
A classification of Hemorrhagic Stroke where the cause of these aneurysms are ______; research is ongoing
Intracranial (Cerebral) Aneurysm;
UNKNOWN Causes
59
A classification of Hemorrhagic Stroke where it was speculated that it may be a result of the following possible causes:
1. Developmental Defect in the Vessel Wall;
2. Degeneration or Fragility of the Vessel Wall due to Conditions such as Atherosclerosis,
3. Congenital Defect of the Vessel Wall
4. Hypertensive Vascular Disease
5. Head Trauma
6. Advancing Age
Intracranial (Cerebral) Aneurysm
60
A classification of Hemorrhagic Stroke that is caused by an Abnormality in the ________ Development that leads to a tangle of Arteries and Veins in the Brain that lacks a Capillary Bed leading yo dilation of the Arteries and Veins and Eventually it ______
Arteriovenous Malformations (AVM);
Abnormality in the Embryonal Development;
Eventual Rupture
61
A classification of Hemorrhagic Stroke that is considered the common cause of Hemorrhagic Stroke in *Young People*
Arteriovenous Malformations (AVM)
62
A classification of Hemorrhagic Stroke that involves hemorrhage into the subarachnoid space)
Subarachnoid Hemorrhage
63
A classification of Hemorrhagic Stroke that may occur as a result of an
1. AVM,
2. Intracranial Aneurysm,
3. Trauma, or
4. HTN
Subarachnoid Hemorrhage
64
A classification of Hemorrhagic Stroke wherein the most causes ate a _______ Aneurysm in the area of the Circle of Willis and a Congenital ____ of the Brain
Subarachnoid Hemorrhage;
Leaking Aneurysm — Congenital AVM of the Brain
65
Alterations to integrate, interpret, and attend to sensory data.
Sensoriperceptual Deficits
66
Deficits in Vision, Hearing, Equilibrium, Taste, Sense of Smell, Ability to Perceive Vibration, Pain, Warmth, Cold, Pressure, Proprioception (body’s sense of position)
Sensoriperceptual Deficits
67
Most COMMON CLINICAL MANIFESTATION of Stroke and what body parts does this involve?
**Weakness** involving the
1.Face
2.Arm
3.Leg
68
Give at least 3 identified Clinical Manifestations of Stroke (total of 6 as **Most Common**)
1. Weakness of the Face, Arms, Legs
2. Numbness on one side
3. Loss of Vision
4. Speech Difficulties
5. Sudden and Severe Headache
6. Difficulties with Balance
69
The Clinical Manifestations of Stroke varies according to the _____ Involved and the area of the Brain affected;
It is always ____ in Onset, _____ and usually _____-sided
Varies according to the Cerebral Artery Involved;
Always **SUDDEN** in Onset;
**FOCAL**;
Usually **ONE-SIDED**
70
Loss of half of the visual field of one or both eyes
Hemianopia
71
Loss of Vision in the Nasal Field of the Right Eye and Temporal Field of the Left Eye
Hemianopsia
72
Same half of Vision Loss is missing in each eye
Homonymous Hemianopia
73
Loss of Vision in the Temporal half of both fields
Bitemporal Hemianopsia
74
The inability to recognize one or more subjects that were previously familiar
Agnosia
75
The inability to carry out some motor pattern
Apraxia
76
The client has a disorder of attention, the person cannot integrate and use perceptions from the affected side of the body or the environment on the affected side and ignores the part
Neglect Syndrome
77
Give the five Enumerated Clinical Manifestation of Stroke:
1. Sensoriperceptual Deficits
2. Cognitive and Behavioral Changes
3. Communication Disorder
4. Motor Deficits
5. Elimination Disorders
78
Give at lease three Cognitive & Behavioral Changes due to Stroke (there are total of 5)
1. Changes in LOC
2. Emotional Lability
3. Loss of Self-Control
4. Decreased Tolerance for Stress
5. Memory Loss; Decreased Attention span, poor judgment, inability to think abstractly
79
It is a manifestation of stroke wherein it is the result of a stroke affecting the dominant hemisphere;
The left hemisphere is about 95% of Right-handed people and 70% of Left-handed people
Communication Disorder
80
A clinical manifestation of Stroke that refers to affectation of both speech (the mechanical act of articulating language through spoken words) and language (vocal or written formulation of ideas to communicate thoughts and feelings)
Communication Disorder
81
An inability to use or understand language
Aphasia
82
A motor speech problem
Expressive Aphasia (Broca’s Aphasia)
83
A sensory speech problem
Receptive Aphasia (Wernicke’s Aphasia)
84
Language dysfunction in both Understanding and Expressions
Mixed / Global Aphasia
85
Any disturbance in Muscular Control of Speech
Dysarthria
86
Give at least 3 Motor Deficit Manifestations of Stroke (there are a total of 6 identified)
1. Quadriplegia
2. Paraplegia
3. Hemiplegia
4. Hemiparesis
5. Flaccidity
6. Spasticity
87
Depending on the Area of the Brain involved, strokes may cause ____, _____, and _____
MOTOR DEFICIT
Weakness
Paralysis
Spasticity
88
Control of Urination may be altered resulting in Urine Frequency, Urgency, or Incontinence
Elimination Disorders
89
Changes in bowel elimination resulting from changes in LOC, Immobility, and Dehydration
Elimination Disorders
90
Surgical Managements for Hemorrhagic Stroke
1. Endovascular Treatment
2. Aneurysm Coiling and Craniotomy
91
Surgical Treatments for Ischemic Stroke
1. Angioplasty
2. Catheter Embolectomy
3. Carotid Endarterectomy
92
Treatment as a Preventive Measure for Clients at risk for Embolic and Thrombotic Stroke
Antithrombotic Drugs
93
Prednisone, Dexamethisone are included in what medication treatment for stroke
Corticosteroids
94
Barbiturates, Phenytoin are included in what type of medications for Stroke
Anticonvulsants
95
Ticlopidine, Aspirin Clopidogrel are included in what type of Agents (meds) for stroke that is Contraindicated with Hemorrhagic Stroke Patients?
Antiplatelet Agents
96
Give at least three Assessment and Diagnostic Tests used for Stroke
1. CTScan or MRI
2. Cerebral Angiography
3. Lumbar Puncture
4. 12-Lead ECG
5. History and Complete Physical and Neurological Examination
