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NBCOT LAST Attempt > CVA > Flashcards

CVA Flashcards

1
Q

ischemia/cerebral infarction

A

embolism (cardiac/atrial sources)
- blood flow blocked, causing ischemia (lack of 02 in brain)
- due to age, gender, ethnicity, genetics
- hypertension, cardiac disease, glucose metabolism, cigarettes, alcohol, drugs, obesity, diet, exercise, emotional stress

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2
Q

hemorrhage

A

(subarachnoid or intracerebral types)
- blood vessel bursts in brain, causes pooling, interrupting blood flow
- result in cerebral anoxia & aneurysm
- due to AVM, ANEURYSM, age
- due to HBP, birth control, cigarettes, alcohol, drugs

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3
Q

MCA stroke

A

MOST COMMON CVA, LARGEST BRANCH TO ICA (supplies frontal, temporal, parietal lobes)
= contralateral hemiplegia: arms, face, tongue
- sensory deficits
- Hemianesthesia
- dominant hemisphere: contralateral homonymous hemianopsia & aphasia
- head deviated towards side with lesion
- anosognosia, visual perception,
- L MCA CVA: Aphasia & apraxia
- R MCA CVA: Unilateral neglect & spatial dysfunction

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4
Q

hemianesthesia

A

one sided loss of sensation

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5
Q

subarachnoid hemorrhage

A

bleeding in space surrounding brain
- aneurysm near surface of brain bursts, blood leaks into space between skull & brain

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6
Q

intracerebral hemorrhage

A

(hemorrhagic)
- ruptured blood vessel inside brain, causing blood to leak into brain tissue

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7
Q

cerebral anoxia

A

oxygen supply completely interrupted in the brain

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8
Q

embolism

A

clot, artery obstructed

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9
Q

deep hypertensive intracerebral hemorrhage

A
  • involves ruptured saccular aneurysms, bleeding malformations, or spontaneous lobar hemorrhages
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10
Q

TIA

A

transient ischemic attack
- blood flow briefly interrupted
- mild, isolated symptoms, repetitive
- lasts few minutes to several hours with symptoms clearing completely
- can be sign of larger CVA
- due to atherosclerotic disease

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11
Q

frontal lobe

A
  • motor control (premotor cortex)
  • problem solving (prefrontal cortex)
  • planning, behavior reg
  • speech production (Broca’s)
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12
Q

temporal lobe

A
  • hearing
  • language comprehension (Wernicke’s)
  • memory/information retrieval
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13
Q

parietal lobe

A
  • touch perception (somatosensory cortex)
  • body orientation
  • sensory discrimination
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14
Q

occipital lobe

A
  • sight
  • visual reception/interpretation
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15
Q

cerebellum

A

balance & coordination

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16
Q

brainstem

A

involuntary responses

17
Q

which brain artery is part of the circle of wilis?

A

internal carotid artery

18
Q

facial analgesia or trigeminal neurologia

A

painful sensations (electric shock) on one side of face

19
Q

L hemisphere deficits w/CVA

A

LOGIC
- receptive/expressive language (aphasia)
- reading & writing (alexia & agraphia)
- learning new info
- apraxia
- math (acalculia)
- R side movement, sensory info processing, visual reception
- bilateral motor praxis
- verbal memory, bilateral auditory reception/processing

is slow, cautious, frustrated & unmotivated

20
Q

R hemisphere deficits w/CVA

A

CREATIVITY
- humor
- abstract thinking/information interpretation
- visual spatial/spatial perceptual
- swallowing (dysphagia), slurred speech (dysarthria)
- has short attention span
- prosopagnosia
- no orientation to person, place, time
- depth perception
- can’t hear tonal variations
- unable to attend to L side environment/body (neglect), sensory info, visual reception, motor praxis
- nonverbal memory
- emotional lability
- nonverbal auditory information

is impulsive, denies deficits (anosognosia), inappropriate comments, talks excessively, confabulation, euphoria, constant smiling, overestimates abilities

21
Q

cerebellum deficits w/CVA

A
  • coordination/balance
  • eye movement (nystagmus, ocular dysmetria, poor pursuit)
  • reflexes abnormal (head, torso)
  • dysarthria
  • ataxia

is dizzy, vomiting, nauseous, has headache

22
Q

internal carotid artery CVA

A

similar to MCA CVA
- contralateral hemiplegia, hemianesthesia, homonymous hemianopsia
- dominant hemisphere: aphasia, agraphia, acalculia, R/L confusion, finger agnosia
- non dominant hemisphere: perceptual dysfunction, unilateral neglect, anosognosia, attention deficit, topographic memory loss

23
Q

anterior cerebral artery CVA

A

FRONTAL LOBES
- contralateral: LE weakness (more severe than UE), hemiplegia
- grasp reflex
- incontinence
- apraxia
- apathy, mute
- mental changes: confusion, disorientation, whispering, slow processing, distractibility, limited verbalizations, amnesia
- primitive reflexes & incontinence
- LE cortical sensory loss
- total artery occlusion: contralateral hemiplegia (face, tongue, prox arm muscle severe weakness), spastic paralysis of distal LE

24
Q

posterior cerebral artery CVA

A

TEMPORAL & OCCIPITAL LOBES, BRAINSTEM
- Broad, multiple symptoms
- Sensory motor deficits
- Involuntary movement disorders
- postural tremors
- hemiataxia
- memory loss
- astereognosis
- dysesthesia
- kinesthesia
- contralateral homonymous hemianopsia
- anomia, topographic disorientation, visual agnosia
- thalamic pain (neuropathic pain)
- hemisensory loss
- alexia

25
Q

cerebellar artery CVA

A

CEREBELLUM
- Ipsilateral ataxia, facial analgesia
- contralateral loss of sensation of pain and temperature. hemiparesis
- Dysphagia, dysarthria
- nystagmus

26
Q

what should be prevented following a CVA?

A

DVT in LEs due to bedrest
- clots can dislodge, travel to lungs, be deadly

27
Q

when is the most crucial time for improvement after a CVA?

A

first 3-6 months

28
Q

complications of a CVA

A

pneumonia, cardiac disease

29
Q

cerebral arteriovenous malformation (AVM)

A

abnormal tangled collections of dilated blood vessels resulting from congenital malformed vascular structures

30
Q

CVAs occur every

A

40 seconds
- person dies every 4 minutes

31
Q

causes of death ranked

A
  1. heart disease
  2. cancer
  3. CVA
32
Q

vertebrobasilar system results in

A

pseudobulbar signs (dysarthria, dysphagia, emotional instability), tetraplegia

33
Q

modifiable risk factors of a CVA

A

hypertension, cardiac disease, afib, diabetes mellitus, smoking, alcohol abuse, hyperlipidemia

34
Q

nonmodifiable risk factors of a CVA

A

age (increase), gender (more males), race (AA, Latino), heredity

35
Q

how is CVA dx?

A

CT scan, PET scan, SPECT, MRI transcranial & carotid doppler, ECG, echocardiography, blood work

36
Q

immediate medical management for a CVA

A

airway maintaince, adequate O2, IV fluids/alt feeding routes for nutrition, prevent bed sores, treat underlying cardiac dysfunction

37
Q

pharmacology following CVA

A
  • antithrombolytics (antiplatelet & anticoagulants- aspirin, heparin): reduce infarction area
  • thrombolytics (t-PA) in acute strokes to restore blood flow, open cerebral arteries
38
Q

Pusher syndrome

A
  • following left or right brain damage in which patients actively push away from the non-hemiparetic side, leading to a loss of postural balance
  • if unsupported = loss in lateral posture, falling on to their paretic side
  • use mirror to help them orient their body to see whether they are actually upright (they perceive their body as upright when it is in fact tilted towards the side of the lesion)

NBCOT LAST Attempt (50 decks)

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