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2nd term topics. (Dm,CVA, and other neurologic disorders) > CVA > Flashcards

CVA Flashcards

1
Q

-refers to a functional abnormality of the CNS that occurs when the blood supply to the brain is disrupted

A

Cerebrovascular Disorders

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2
Q

-results from ischemiato a part of the brain or hemorrhage into the brain that results in death of brain cells.
-physical, cognitive, emotional, & financial impact
-stroke

A

Cerebrovascular Accident

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3
Q

lack of blood supply

A

ischemia

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4
Q

temporary focal loss of neurologic function caused by ischemia (analogous to angina in CAD)

A

Transient Ischemic Attacks (TIA)

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5
Q

-may be due to micro-emboli that temporarily block blood flow
• most resolve within 3 hours

A

Transient Ischemic Attacks (TIA)

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6
Q

warning sign of progressive cerebrovascular disease

A

Transient Ischemic Attacks (TIA)

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7
Q

neurologic metabolism is altered

A

> 30

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8
Q

metabolism stops

A

2 minutes

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9
Q

brain cell death

A

<5 mins

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10
Q

brain dead

A

10-15 mins

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11
Q

how many percentage of cardiac output goes to the brain

A

20% (approximately 750-1000ml per minute)

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12
Q

cell death

A

infarction

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13
Q

Non modifiable risk factors for CVA

A

•age - occurrence doubles each decade >55 years
•gender - equal for men & women; women die more frequently than men
•race - African Americans, Hispanics, Native Americans,
Asian Americans – higher incidence
• heredity - family history, prior transient ischemic attack, or prior stroke increases risk

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14
Q

Modifiable risk factors for CVA

A

*High blood pressure
* Diabetes
Cigarette smoking
TIA
* High blood cholesterol
Obesity
Heart disease
Atrial fibrillation
Oral contraceptive use
Physical inactivity - sedentary
Sickle cell disease.
Asymptomatic carotid stenosis
Hypercoagulability

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15
Q

thrombotic - plaque
•embolic
-occlusion

A

ischemic 87%

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16
Q

most common CVA

A

ischemic

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17
Q

-intracerebral hemorrhage
•subarachnoid hemorrhage
-bleeding

A

Hemorrhagic

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18
Q

13%

A

hemorrhagic

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19
Q

• inadequate blood flow to the brain from partial or complete occlusions of an artery

A

Ischemic

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20
Q

extent of ischemic stroke depends on?

A

-rapidity of onset
-size of the lesion
-presence of collateral circulation

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21
Q

-mechanism of brain wherein it will find a new route or new artery for blood supple if there is blockage

A

collateral circulation

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22
Q

TYPE OF ISCHEMIC

-formation of plaques in the large and small vessels of the brain
-starts with injury to a blood vessel wall and formation of blood clot then thrombosis develops from atherosclerotic plaque from narrowed blood vessels.

A

thrombotic

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23
Q

-lumen of the blood vessels narrow → then becomes occluded → infarction

A

thrombotic

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24
Q

common type of ischemic stroke

A

thrombotic

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25
Q

what diseases do thrombotic associated with?

A

HPN and diabetes mellitus

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26
Q

->60% of strokes.
-50% are preceded by TIA

A

thrombotic

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27
Q

development of cavity in place of infarcted brain tissue - results in considerable deficits - motor hemiplegia, contralateral loss of sensation or motor ability

A

lacunar stroke

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28
Q

left or right stroke

A

hemiplegia

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29
Q

upper or lower
* for spinal cord injury only, hindi sa stroke

A

paraplegia

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30
Q

whole body weakness

A

tetraplagia

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31
Q

new term for tetraplegia

A

quadraplegia

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32
Q

-common sites of atherosclerosis in the brain (thrombotic)

A

• external carotid artery
• left and right common carotid artery
• left and right subclavian artery
O innominate artery

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33
Q

-associated with cardiac disorders
-embolus lodges in and occludes a cerebral artery

A

embolic

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34
Q

embolic results in?

A

infarction & cerebral edema of the area supplied by the vessel

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35
Q

second most common cause of stroke 24%

A

embolic

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36
Q

-emboli originate in endocardial layer of the heart

A
  • atrial fibrillation, MI, infective endocarditis, rheumatic heart disease, valvular prostheses
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37
Q

-any age group
-recurrence common if underlying cause not treated

A

embolic

38
Q

•caused by bleeding into the tissues of the brain
• account for approximately 15% of all strokes

A

hemorrhagic stroke

39
Q

hemorrhagic stroke is result from?

A

• result from bleeding into the brain tissue itself or into the subarachnoid space or ventricles

40
Q

-bleeding within the brain caused by a rupture of a vessel

-commonly occurs during activity

A

intracerebral hemorrhage

41
Q

important cause of intracerebral hemorrhage

A

hypertension

42
Q

other causes of intracerebral hemorrhage

A

-other causes: vascular malformations, coagulation disorders, anticoagulation, trauma, brain tumor, ruptured aneurysms

43
Q

-sudden onset of symptoms with progression

A

itracerebral hemorrhage

44
Q

-neurological deficits, headache, nausea, vomiting, decreased LOC, and hypertension

A

intracerebral hemorrhage

45
Q

prognosis for intracerebral hemorrhage

A

poor - 50% die within weeks

46
Q

-often a sudden onset of symptoms that progress over minutes to hours because of ongoing bleeding

A

intracerebral hemorrhage

47
Q

enumerate the manifestations for intracerebral hemorrhage

A

neurologic deficits,
headache,
nausea & vomiting,
decreased levels of consciousness

48
Q
  • intracranial bleeding into the cerebrospinal fluid-filled space between the arachnoid and pia matermembranes on the surface of the brain
A

subarachnoid hemorrhage

49
Q

-intracranial aneurysm → rupture of aneurysm

A

subarachnoid hemorrhage

50
Q

common caused of subarachnoid hemorrhage

A

rupture of cerebral aneurysm (congenital or acquired)

51
Q

where do subarachnoid hemorrhage majority occur?

A

the circle of willis

52
Q

other causes of subarachnoid hemorrhage

A

arteriovenous malformation (AVM),
trauma,
illicit drug abuse

53
Q

incidence of subarachnoid hemorrhage

A
  • incidence: 6-16/100,000
54
Q

increases with age and more common in women

A

subarachnoid hemorrhage

55
Q

warning symptoms of subarachnoid hemorrhage

A

severe bursting headache
“worst headache of one’s life “

56
Q

symptoms of subarachnoid hemorrhage

A

-change of LOC,
neurological deficits,
nausea,
vomiting,
seizures,
stiff neck

57
Q

BE FAST

A

balance
eyes

face
arms
speech
timing

58
Q

symptoms of CVA

A

-sudden numbness or weakness of face, arm or leg
-sudden confusion
-sudden trouble with vision
-sudden trouble with walking, dizziness
-sudden severe headache

59
Q

Symptoms of CVA
Visual Deficits

A

-homonymous hemianopsia
•loss of peripheral vision
-diplopia

60
Q

Symptoms of CVA
Sensory deficits

A

paresthesia (peripheral neuropathy)

61
Q

symptoms of cva
verbal deficits

A

-expressive aphasia
-receptive aphasia
-global aphasia

62
Q

symptoms of cva
motor deficits

A

-hemiparesis - weakness of LorR
-hemiplegia - paralysis
-ataxia -uncoordinate movers
-dysarthria- diff in forming words
-dysphagia - diff in swallowing

63
Q

-paralyzed left side: hemiplegia
-left-side neglect

A

Right brain damage

64
Q

-spatial-perceptual deficits
•tends to deny or minimize problems
•rapid performance, short attention span

A

right brain damage

65
Q

•Impulsive, safety problems
•impaired judgment
• impaired time concepts

A

right brain damage

66
Q
  • paralyzed right side: hemiplegia
    • impaired speech/ language aphasias
A

left brain damage

67
Q
  • impaired right/left discrimination
    *slow performance, cautious
A

left brain damage

68
Q

• aware of deficits, depression, anxiety
• impaired comprehension related to language

A

left brain damage

69
Q

enumerate the manifestations of right brain damage

A

*paralyzed left side: hemiplegia
•left-side neglect
“spatial-perceptual deficits
•tends to deny or minimize problems
•rapid performance, short attention span
•Impulsive, safety problems
•impaired judgment
• impaired time concepts

70
Q

enumerate the manifestations of left brain damage

A
  • paralyzed right side: hemiplegia
    • impaired speech/ language aphasias
  • impaired right/left discrimination
    *slow performance, cautious
    • aware of deficits, depression,
  • anxiety
    • impaired comprehension related to language
71
Q

Symptoms of cva
affect

A

“difficulty controlling emotions
“exaggerated or unpredictable emotional response
“depression / feelings regarding changed body image and loss of function

72
Q

symptoms of cva
intellectual function

A

-memory and judgment
-left-brain stroke: cautious in making judgments
-right-brain stroke: impulsive & moves quickly to decisions
-difficulties in learning new skills

73
Q

Symptoms of CVA
Spatial-Perceptual Alterations-4 Categories

A

•1. Incorrect perception of self and illness
•2. Erroneous perception of self in space - may neglect all
input from the affected side (worsened by homonymous hemianopsia)
•3. Agnosia- inability to recognize an object by sight, touch
or hearing
•4. Apraxia- inability to carry out learned sequential movements on command

74
Q

agnosia

A

inability to recognize an object by sight, touch
or hearing

75
Q

apraxia

A

inability to carry out learned sequential movements on command

76
Q

Symptoms of CVA
Elimination

A

Elimination
-most problems with elimination occur initially and are temporary
“prognosis for normal bladder function is excellent when only one hemisphere of brain is affected.

77
Q

•a clinical grading system to predict prognosis and outcome in patients with subarachnoid hemorrhage

A

hunt and hess scale

78
Q

h&h
grade 1

A

Asymptomatic or mild headache, slight nuchal rigidity

79
Q

h&h
grade 2

A

Nuchal rigidity, moderate to severe headache

80
Q

h&h
grade 3

A

Drowsy, confused or mild focal defic

81
Q

h&h
grade 4

A

Stupor, moderate to severe hemiparesis, early decerebrate

82
Q

h&h
grade 5

A

Coma, decerebrate rigidity

83
Q

diagnostic tests

A

cranial ct scan
cerebral angiography
mri

84
Q

diagnostic test for ischemic stroke

A

cerebral angiography

85
Q

is the primary diagnostic test used after a stroke

A

Cranial CT scan

86
Q

•classifies the appearance of subarachnoid hemorrhage on
CT scan and is used in predicting cerebral vasospasm

A

Fisher Grading Scale

87
Q

Fisher grading scale
Grade 1

A

none

88
Q

Fisher grading scale
Grade 2

A

Difuse, thin layer of blood

89
Q

Fisher Grading scale
grade 3

A

Localized clot or thick layer of blood

90
Q

Fisher Grading scale
grade 4

A

Intracerebral or intraventricular blood

2nd term topics. (Dm,CVA, and other neurologic disorders) (3 decks)

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