CV Signs and Symptoms of Disease Flashcards
sudden weakness of the face, arm or leg, most often on one side of the body is the most common sign of ____.
other signs may consist of…
stroke
Sudden numbness of the face, arm, or leg, especially on one side of the body. Sudden confusion, trouble speaking or understanding speech (trouble speaking for 2 reasons - 1) face paralyzed 2) cannot get communication from brain to mouth to speak)
more signs include…
what does this depend on?
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance or coordination
Sudden severe headache with no known cause
depend on side (rt. lt) + location ant/post
The signs of a stroke depend on the ___ of the brain that’s affected, the ___ of the brain, and how ____ the brain is injured.
Each person may have different stroke warning signs.
Stroke may be associated with a headache, or may be completely painless.
side, part, severely
a _____ is the brain’s version of a heart attack, and it occurs when the blood supply to a region of the brain is lost. it is aka (2)
symtoms are usually ____ onset
brain attack, strok, cerebral infarction
sudden
Symptoms may be short-lived (< 24 hrs in duration as occurring in a transient ischemic attack or TIA), or may be part of a full (completed) stroke.
what 3 easy symptoms are there to look for?
- A twisted face best seen when the person smiles.
- Slurred speech.
- Ask the person to stretch out their arms and close their eyes. One side will drift down in a stroke.
loss of mathematical skills
difficulty distinguishing sensory stimulations
loss of reading skills
acalculia:
agnosia:
alexia:
temporary blindness in one eye (shade pulled down over one eye)
: abstention from eating (aphagopraxia: loss of ability to swallow)
: Impairment of language function, difficulties with speaking, reading and writing.
: impairment in the ability to perform complex tasks
: loss of muscular coordination, irregular muscular action, double vision
Amaurosis fugax
Aphagia
Aphasia
apraxia
Ataxia
Impairment of clarity of speech
Impairment of language function (2 types 1 – hard to understand what others are saying 2– can’t find words to express themselves)
sensory disturbance
dysarthria
dysphasia - Receptive, Expressive
hemianesthesia
: loss of one half of the visual field (homonymous: effects both eyes equally)
: blindness in outer field.
partial loss of movement on one side of the body
: total loss of movement on one side of the body
hemianopia
Homonymous hemianopia
hemiparesis:
hemiplegia
: loss or impairment of motor function in a part due to lesion of the neural or muscular mechanism
: slight or incomplete paralysis
: abnormal sensations (burning, prickling, numbness)
: spinning sensation
Paralysis
Paresis
Paresthesia
Vertigo
other symptoms of stroke
gait imbalance -
syncope -
inccordination
gait imbalance
Syncope - loss of consciousness
what is the difference b/t these 2 strokes?
2 causes, 2 treatments
what type os stroke is caused by loss of blood supply by obstruction
a few examples…
other causes of vessels narrowing…
ischemic - pl w/ replaced heart valve or w/ blood that doesnt have normal flow thru the heart are more prone to endocarditis.
1) Atherosclerosis
2) Embolism (Thrombus, Plaque, Fat or Vegetations - endocarditis - if vegetation ofn the rt side, embolism will be systematic, if on the lt it will go to the lungs)
other: Fibromuscular dysplasia, Arteritis, tumors
these images best represent _______ stroke which is secondary to ___________.
ischemic, atherosclerosis (plaque rupture) *most of the time the embolism is thrombus, not plaque otherwise clotbusters wouldn’t work on ischemic stokes
these are examples of _____.
Atheroma intimal thickening, relative ischemia of the vessel wall, which induces angiogenisis of vasa vasorum
Probability of intraplaque hemorrhage increases
Adventitial Vv microvessels within the atherosclerotic plaque are very fragile and prone to rupture
Causing acute obstruction of vessel
Ischemic Stroke: Atherosclerosis – Plaque Rupture
*sm emboli have to travel further to smaller vessels before they will cause stroke. TIA is aka sm strokes warning you
these images best represent _____ stroke.
Emboli can be ___ or _____, also DVT of LE if atrial septal defect/PFO
ischemic - ebmbolic
carotid, cardiac
*PTO - patent foramen ovale. patients whose ovale’s stay open . affects ~20% of ppl
paradoxical (the opposite direction) EMBOLI . systemic arterial coming through venous. only way to get it is through a hole (like PTO)
what type of stroke is this?
Hemorrhagic stroke – blooding occurs inside or around the brain tissue
loss of blood supply by interruption of the artery
starts as Cerebral aneurysm. can be:
Congenital
Collagen vascular connective tissue disorders
Weakened from trauma, infection or atherosclerosis
AVM - all jumbled up – arteries into veins etc. all mixed up
Trauma
hemorrhagic stroke
if an aneurysm or blood vessel breaks what type of stroke would one experience.
hemorrhagic
this is a ____
cerebral hemorrhage
which type of stroke is
a. treated with tissue plasminogen activator (tPa), a clot-busting drug that quickly restores blood flow through blocked arteries
b. require stopping the hemorrhage with thrombins, coils, etc.
a. ischemic
b. hemorrhagic
what do the following stand for
TIA
RIND
CVA or Stroke
transient ischemic attach
reversible ischemic neurologic deficit
cerebrovascular acceident
what has:
Symptoms <24 hours
Symptoms depend on area effected
Sensory/motor dysfunction of arm/leg, etc.
Speech impairment
Visual disturbances (monocular)
Neurological deficits
Etiology is embolic (carotid or heart) or ischemia from stenosis.
TIA (transient ischemic attach)
symptoms will completely disappear. related to where the emboli is in the brain
what has
Symptoms > 24 hours but complete resolve with time
Symptoms and etiology the same at TIA
RIND (reversible ischemic neurologic deficit)
what has:
Permanent neurologic deficit
Types:
Acute – sudden onset, unstable
Stroke in evolution – symptoms come and go, unstable
Complete – no change in symptoms, stable
CVA (cerbrovascular accident)
if a stroke occurs, what type of circulation will have symptoms on opposite side as the CVA?
what vessels may does tis type of circulation contain?
anterior
– CCA, ICA, MCA, ACA
*impulses cross midline to go to opposite side causing symptoms on the opp side. if arm lt parlyzed = ant rt coratid.
affects frontal and parietal lobes of brain.
name 2 possible anterior circulation symptoms of stroke
Unilateral paresis (weakness) and paresthesia (abnormal sensations)
Dyshasia/aphasia – abnl or no speech. Lt dominant for speech in most people (97% rt handed person; 19% of left handed have speech on right and 68% are bilat)
*cerebrum makes us dif from other mammals. lets us speak reason, think. ANT symptoms = higher level and one sided. speaking. lt side is dominant for speech in most ppl (rt handed folks = lt brain dominant) Ant Lt ICA cerebellum is rudimentary - breathing, walking, eating the things. POST symptoms. lt side
what type of circulation symptoms incl
Vision changes – usually bilat, diplopia (double vision)
Paresthesia/anesthesia
Vertigo
Ataxia – difficulty with gait or touch (grabbing)
Drop attacks (fall down)
what vessels are included in this circulation?
posterior
Vert, Basilar, PCA (vertebrobasilar insufficiency)
*occipital lobe and cerbellum very rudimentary things like walk, stand, eat…
what type of circulation may have the following symptoms:
Vision changes:
Amaurosis fugax – blindness in one eye, “like someone pulled a shade over my eye”. Same side as disease, ophthalmic artery. lack of perfusion to the opthalmic
Homonymous hemianopia – blindness in outer field. Opposite side as lesion, CVA to frontal lobe.
Behavioral abnormalities – confusion, ect. Usually Rt temporal lobe.
anterior
*total blindness in 1 eye ipsilateral ICA
what is this demonstrating?
effects of stroke
what are the following:
Dizziness
Syncope – loss of consciousness
Headache
Confusion
non-specific symptoms
What do the following describe?
False negative with severe stenosis/occlusion
False positive with other lesions – AVF, aneurysm, sever AS (bilat), ECA stenosis
F/U endarterectomy
Workup for major vascular surgery or transplant
what are they indicatios for?
carotid bruit - turbulence heard
carotid US
what are 4 risk factors for stroke?
what other pathology has these risk factors?
Diabetes mellitus
HTN
Smoking
Hyperlipidemia
atherosclerosis
which side is affected which system?
Sudden numbness of face, right arm and leg
anterior. left
what system
Sudden confusion, trouble speaking or understanding
which vessels?
anterior
carotids
which system which side
Sudden trouble seeing in both eyes
posterior, bilateral
which system, which size
Sudden trouble seeing in right eye, blindness (“shade being pulled over my eye”)
anterior, right
*caused by lack of perfusion to the opthalmic artery. amerosus fujax
which system?
Sudden trouble walking, dizziness, loss of balance and coordination
posterior (vertebrals)
which system
Sudden severe headache with no known cause
trick question, this one is nonspecific.
What is the term that describes a symptom of stroke resulting in impairment of language function, including difficulties with speaking?
aphagia
ataxia
aphasia
apraxia
aphasia
When evaluating the extracranial cerebrovascular system for atherosclerotic disease, we are trying to identify a potential cause of
venous thrombosis
hemorrhagic strokes
claudication
ischemic strokes
ischemic
What terminology describes stroke symptoms that last less than 24 hours and completely resolve?
transient ischemic attack
cerebrovascular accident
I
reversible ischemic neurologic deficit
cerebral aneurysm
transient ischemic attach
Symptoms of ataxia are most commonly associated with ischemic events of the
right side of the brain
anterior circulation
left side of the brain
posterior circulation
posterior circulation
What is the term that describes turbulence heard in the carotid region with a stethoscope?
vertigo
TIA
Berry aneurysm
carotid bruit
carotid bruit
