Chapter 9

Question 1

What is a CVA?

Answer 1

Cerebrovascular accident (or stroke) is an abnormal condition of the brain characterized by occlusion, or hemorrhage of a blood vessel, resulting in a lack of oxygen to the brain tissues that normally receive their blood supply from the damaged vessels.

Question 2

What is the consequence of CVA?

Answer 2

Results in loss of proper oxygenation to the brain cells and eventually cell death

Question 3

True or False

Recently there has been a move to use the term brain attack instead of store so that the public will become as familiar with CVA’s signs and symptoms are they are with a heart attack or myocardial infarction.

Answer 3

True

Question 4

True or False

CVA’s are the second leading cause of death worldwide, with nearly 4.6 million individuals suffering from the condition annually.

Answer 4

True

Question 5

True or False

CVA is more often encountered by individuals over 65 years of age, and African Americans seem to be more susceptible than Caucasians.

Answer 5

True (These two groups are more likely to suffer from CVAs as they tend to have a higher incidence of hypertension

Question 6

What is the major cause of CVA?

Answer 6

Atherosclerosis, these atherosclerotic plaques ont he blood vessel walls tend to form thrombi (a blockage composed of various substances, such as platelets, fibrin, and cellular elements at the point of origin)

Question 7

What is another group of individuals who are susceptible to cerebrovascular accidents?

Answer 7

Those suffering from atrial fibrillation, which is a disease that affects approximately 2 million americans. When a patient is experiencing atrial fibrillation, the two atria of the heart quiver instead of beating properly.

Question 8

What are the two types of CVA?

Answer 8

Ischemic

Hemorrhagic

Question 9

What is ischemic (occlusive) CVA?

Answer 9

Some form of a blockage in a cerebral blood vessel

Question 10

What is a thrombus?

Answer 10

Originates somewhere in the body and then circulates to another area where it becomes lodged in a blood vessel.

Question 11

What is an embolus?

Answer 11

Foreign object, quantity of air or gas

Question 12

True or False

The ischemic CVA occurs in 85% of patients, with 60% being thrombotic and 40% embolic.

Answer 12

True

Question 13

What is hemorrhagic CVA?

Answer 13

Result of a rupture of a blood vessel in the brain

Question 14

What is an aneurysm?

Answer 14

Weakening of ballooning of a blood vessel, with added pressure, the blood vessel ruptures and causes the stroke.

Question 15

What are the two types of hemorrhagic stroke?

Answer 15

Intracerebral and subarachnoid.

Question 16

True or False

Intracerebral strokes are twice as common as subarachnoid hemorrhagic strokes.

Answer 16

True

Question 17

When do cerebral hemorrhages occur?

Answer 17

Defective artery within the brain bursts and the surrounding tissue fills with blood

Question 18

When does subarachnoid hemorrhage occur?

Answer 18

Blood vessel on the surface of the brain ruptures and bleeds into the subarachnoid space.

Question 19

True or False

Hemorrhagic stroke has a higher mortality rate than occlusive stroke.

Answer 19

True

Question 20

What is the major difference between the signs and symptoms of embolic and thrombotic strokes?

Answer 20

Their onset. Embolic strokes tend to have abrupt onset, whereas the onset of thrombotic strokes is often difficult to determine as the symptoms are often not as severe.

Question 21

What are the signs and symptoms of both types of ischemic CVA?

Answer 21

Altered level of consciousness (from yawning to coma)
Sudden confusion
Pupils may be unequal and dilated, confusion and dizziness may be apparent
Ataxia (notable change in balance or coordination)
Vision changes (double vision, blind spots)
Hemianopia (loss of vision in half of the visual field in one or both eyes)
Speech changes (poorly articulated speech [dysarthria], to impairment of speech [dysphasia], to the inability to understand spoken words, to inability to speak at all [aphasia])
Difficulty swallowing
Deviation of the tongue
Drooling
Weakness, numbness, tingling in the face (hemiparesis - usually on one side of body)
Nausea
Vomiting
Sudden severe headache

Question 22

What are the signs and symptoms of hemorrhagic CVA?

Answer 22

Abrupt and rapid
Severe headache
Acute headache occurring in occipital region
High blood pressure
Neck pain and stiffness
Inability to stand or walk
Nausea
Vomiting
Altered level of consciousness

Question 23

What are the CPSS tests administered to a patient believed to have been suffering from a CVA?

Answer 23

Smile to look for weakness on one side of face
Hold both arms out with palm up and eyes closed for 10 seconds
Asked to repeat a simple sentence “You can’t teach an old dog new tricks”

Question 24

What is the primary goal in CVA treatment?

Answer 24

Minimize the cognitive and physical limitations associated with the cerebral ischemia or hemorrhage.

Question 25

True or False

The time of onset of CVA symptoms should be clearly established

Answer 25

True

Question 26

True or False

A patient experiencing CVA should be positioned semi-supinely

Answer 26

True