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Medical Conditions > CVA > Flashcards

CVA Flashcards

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USMLE® Step 1 flashcards
1
Q

CVA Description

A
  • Interruption of blood flow to the brain; inadequate supply of oxygen /
    nutrients
    -any part of the brain, mostly left
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2
Q

Ischemic Stroke

A

-most common
-blockage
-Thrombotic - blood clot in artery (night)
-Embolic - Clot that broke elsewhere & gets stuck in brain (day)
-Lacunar - small infract (motor deficits)

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3
Q

Hemorrhagic Stroke

A
  • BY aneurysm (vessel rupture)
    -Intracerebral hemorrhage -bleeding directly into brain
    -Subarachnoid hemorrhage- bleeding around brain (worst headache)
    -recover more slowly
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4
Q

Ischemic Stroke Risk factors

A

 History of hypertension
 Smoking
 Waist-to-hip ratio
 Diet risk score
 Regular physical activity
 Diabetes mellitus
 Alcohol intake
 Psychological stress
 Cardiac problems

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5
Q

Intracerebral hemorrhagic stroke risk factor

A

 Smoking
 Hypertension
 Diet
 Alcohol intake
 Waist-to-hip ratio
* Other: TIA’s, oral contraceptives, prior
CVA, infections / inflammation, ethnicity, geographical location, sleep apnea

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6
Q

CVA Incidence and Prevalence

A
  • 4th leading cause of death in US
  • 50% - 70% regain functional independence
  • 15% - 30% some permanent disability
  • Hemorrhagic strokes less frequent (20%)
  • Ischemic strokes (80%)
  • Depression affects 1/3 of stroke survivors
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7
Q

Peds stroke

A

-frequent in children younger than 2 CVA is 17 times more common in the perinatal period than later in childhood
 1.2 -13 cases / 100,000 children / yr
 50% ischemic
 50% -90% experience residual neuro deficits

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8
Q

FAST

A
  • Face drooping
  • Arm weakness
  • Speech difficulty
  • Time to call 911
    Also
  • Trouble with balance / coordination
  • Severe headache
  • Everyone’s different
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9
Q

Left-Sided : Middle Cerebral Artery symptoms

A

-Loss of voluntary movement and coordination on the right side
-Impaired sensation on right side
-Language deficits, called aphasia
-Blind spots on the right side
- Slow and cautious personality
- Memory deficits for recent or past events

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10
Q

Right-Sided : Middle Cerebral Artery symptoms

A

-Weakness (hemiparesis) or paralysis (hemiplegia) on the left side
- Impairment of sensation on the
left side
-3. Spatial and perceptual deficits
-Unilateral inattention (neglect), patient neglects the left side of the
body /environment
-Dressing apraxia, unable to relate the articles of clothes to the body
-Defective vision in the left halves of visual fields or left homonymous hemianopsia
-Impulsive behavior, quick

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11
Q

Anterior Cerebral Artery Stroke symptoms

A

-Paralysis of the lower extremity
-Loss of sensation in the contralateral toes, foot, and leg
- Loss of conscious control of bowel or bladder
-Balance problems in sitting, standing, and walking
-Lack of spontaneity of emotion, whispered speech, or loss of all communication
-Memory impairment

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12
Q

Vertebrobasilar Stroke symptoms

A

-visual disturbances
-Impaired temperature sensation
-Impaired ability to read and/or name objects
-Vertigo, dizziness
- Paralysis of the face, limbs, or tongue
-Clumsy movements of the hands
- Difficulty judging distance (dysmetria)
-Drooling and difficulty swallowing (dysphagia)
-Localized numbness
- Loss of memory
-Drop attacks

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13
Q

Wallenberg’s Syndrome

A

-rare, loss of consciousness quickly, usually fatal
-Classic brainstem stroke
 Contralateral pain / temperature loss
 Ipsilateral Horner’s syndrome
- Sinking of the eyeball, ptosis of the upper eyelid, and a dry, cool face
 Ataxia
-Loss of the ability to coordinate
 Dysphagia
- Swallowing deficits
 Facial sensory loss

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14
Q

Possible Complications

A

-Seizures
-Thromboembolism -
Infection

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15
Q

Transient Ischemic Attacks (TIA)

A
  • Temporary Blockage to the Brain
     Symptoms occur rapidly and last for <24 hours
     75% of TIA’s last < 5 min
     Symptoms: Fleeting blindness in one eye, Hemiparesis,
    Dizziness, Double vision, Staggering
     10-15% of clients who experience a TIA will have a CVA within 3 months
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16
Q

Subclavian Steal Syndrome

A

-narrowing of the subclavian artery
-blood is “stolen” from the brain and is delivered to arm.

17
Q

Small Strokes

A
  • May last longer than 24 hours
     Results in only minor neurological deficits
     RIND
  • A small stroke that completely resolves is called a reversible ischemic neurological deficit (RIND).
  • in the morning
     PRIND
  • more than 72 hours and leaves some minor neurological
    impairments is called a partially reversible ischemic neurologic deficit (PRIND)
18
Q

Neural plasticity:

A

brain’s ability to create new neural pathways through the life span

19
Q

Medical Management

A

-Antiplatelet Therapy
-Anticoagulants
-Thrombolytics (tPA)
-Surgical Interventions

20
Q

CVA Diagnosis

A
  • Computed Tomography (CT)
     Magnetic Resonance Imaging (MRI)
     Positron Emission Tomography (PET scan)
  • Invasive Technique
     Cerebral angiography
21
Q

Impact on Occupational Performance: Sensory

A

-loss of protective tactile functions
-Proprioceptive dysfunction
-Vestibular and postural dysfunction
-Visual Deficits
-Agnosia
- inability to recognize and identify objects or persons
-Astereognosis - can’t tell your holding keys
-Lesions in the left cerebral hemisphere
-Unilateral body inattention (or neglect)

22
Q

Impact on Occupational Performance: Motor

A

-cant carry out verbal request
-Abnormal muscle tone spasticity or flaccidity
-Associated Reactions
* Abnormal reflex movements
-Associated movements
* Accompany voluntary movements and are normal

23
Q

Impact on Occupational Performance: The Brain

A

-Mental
-communication
-Mood Disorders
-Emotional Deficits

23
Q

shoulder

A

-Hemiplegic shoulder -shoulder subluxation, pain, and immobility.
-Painful shoulder: flaccid or spastic muscle tone and with or without subluxation
-Fear of pain

23
Q

Agnosia
Aphasia
Apraxia

A

-loss of the ability to identify objects
-trouble reading speaking and writing
-cant make words with mouth

24
Q

Dysarthria
Dysphagia

A

-difficulty with speech cause of weak muscle
-difficulty swallowing

25
Q

Homonymous hemianopsia (hemianopia)

A

-makes you see only one side of the visual field of each of your eyes.
-easily startled

25
Q

Hemiparesis
Hemiplegia
Hypotonus

A

-weakness or partial paralysis on one side of the body
-paralysis on one side of the body
-decreased muscle tone

26
Q

Infract

A

localized area of ischemic necrosis

27
Q

Emotional lability

A

-exaggerated change on mood
-laugh at inappropriate time

Medical Conditions (12 decks)

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