CVA Flashcards
What is the cause of is stroke?
it is caused by the interruption of the blood supply to the brain, usually because a blood vessel bursts or is blocked by a clot. this cuts off the supply of damage to the brain tissue.
what are the symptoms of Stroke
sudden weakness or numbness of face or extremities often on one side
Confusion
Difficulty with speech production + comprehension,
seeing w/1 or both eyes + walking Dizzy,
loss of balance + coordination,
headache,
fainting or unconsciousness Neourlogical deficts > 24 hours upper motor neuron Lead to infration of brain tissue
what does the acronym FAST stand for?
F=Face drooping
A=Arm weakness
S=Speech Difficulty
T=Time to call 911
what are the dysfunctions of stroke besides motor paralysis?
sensory disturbances cognitive and perceptual dysfunction visual impairments personality and intellectual changes speech and language D/Os psychosocial implications decrease trunk/balance control decrease UE control
what are the two types of stroke?
ischemic
hemorrhagic
which is the most common type of stroke?
ischemic
which stroke is normally seen in order patients?
ischemic
which stroke is normally seen in younger patients
hemmorrhagic
what is an ischemic stroke?
occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot.
what are the kinds of ischemic strokes?
thrombotic
embolic
lacunar
what is a thrombotic stroke?
a clot formed in an artery that is already very narrow.
what is an embolic stroke?
a clot hat breaks off from another place in the blood vessels of the brain, or from some other part of the body, and travel up to the brain until it reaches an artery too small to pass through
what is a lacunar stroke?
produces small infarcts, usually in the deep brain structures
makes up approx 25% of ischemic strokes
result from an occulsion of small branches of larger cerebral arteries–middle cerebral, posterior cerebral, basilar, and not as much, but anterior cerebral and vertebral arteries
usually associated with hypertension
what damage can strokes cause?
dead tissue
edematous brain tissue
What allows the body to recover from a stroke months and even years after
neuroplasticity
what is neuroplasticity?
the brain’s ability to reroute neural pathways
what is a hemmorrhagic stroke?
occurs when a blood vessel in part of the brain becomes weak and bursts open
causes blood to leak into the brain
can be caused by defects in the brain such as aneurysm and arteriovenous malformation(AVM)
what is an aneurysm?
bulging of a wall of an artery as a result of weakness in the vessel wall
prone to rupture at any time
what are the two kinds of hemorrhagic strokes?
intracerebral
subarachnoid
what are the characteristics of an intracerebral hemmorrhage?
bleeding directly into brain substance
what conditions are often linked to intracerebral hemmorrhage strokes?
hypertention
blood vessel abnormalities
aneurysms
trauma
what are the clinical signs of intracerebral hemmorrhage?
usually focal-do not follow anatomic distribution of blood vessels, but move sphereically through the tissue plances
typically develop suddenly during activity
eventually bledding stops and clot is formed
what is a subarachnoid hemmorhage?
bleeding within the brain’s surrounding membrances and cerebrospinal fluid
slightly more common in women
95% are caused from aneurysm leakage
AVM bleeding
what are characteristics of a left-sided cerebral injuries=middle cerebral artery
loss of voluntary movement and coordination on the right side of the face, trunk, and extremities
impaired sensation
language deficits
difficulty with speech articulation due to decrease muscle control of lips, mouth, tongue, and vocal cords (dysarthria)
blind spots
slow and cautious personality
memory deficits
What are the language deficits of a left-sided cerebral injuries=middle cerebral artery
aphasia
What are the sensation deficits of a left-sided cerebral injuries=middle cerebral artery
impaired temp discrimination
pain
proprioception on right side of body
What are the characteristics of a right-sided cerebral injuries=middle cerebral artery
weakness of paralysis on the left side of the body-face arm trunk and leg
sensation impairement on left side of body such
spatial and perceptual deficits
uniateral neglect
dressing apraxia
defective vision
impulsive behavior
what is dressing apraxia?
when pt is unable to relate articles of clothing to the body
what are characteristics of an anterior cerebral artery stroke
rarely infarcted because of the side to side communication provided by the anterior communicating artery in the circle of willis symptoms: LE paralysis loss of sensation in contralateral body loss of conscious control of bowel balance problems lock of spontaneity memory impairment or loss
What are the characteristics of a vertebrobasilar stroke
visual disturbances impaired temp sensation impaired ability to read and/or name objects vertigo dizziness balance difficulty/ataxia paralysis of the face/limbs/tongue drooling and difficulty swallowing localized numbness loss of memory sudden loss of motor and postural, resulting in collapse but the pt is conscious
what is wallenberg’s syndrome?
result of occulsion of vertebral or cerebral artery: classic brainstem stroke possible symptoms: contralateral pain and temp loss ipsilateral horner's syndrome ataxia facial sensory loss palatal paralysis vertigo
what is global aphasia
loss of language skills only able to utter
middle cerebral
sensitive to gestures
appear to understand more than they can
what is brocha’s aphasia
caused by left CVA
poor speech production, misarticulating, simplified speech
broken speech
what is wernick’s Aphasia
caused by left CVA
impairment of understanding language. impaired auditory comprehensive use of few substantive words.
reading and writing are limited
limited math
what is anomic aphasia
difficulty with word retrieval. can’t find words
constantly having words on the tip of your tongue
LEFT CVA
what is dysarthria?
articulation disorder
NOT APHASIA
dysfunction in CNS
impairment in the muscles causing slurred/sluggish speech
what are the non modifiable stroke risk factors?
ethnicity-African Americans have a higher risk age-especially after 65 heredity-family Hx, genetic factors hypertension hyperlipidemia
what are the modifiable stroke risk factors?
smoking obesity geographic location diabetes oral contraceptives alcohol use drug abuse
What is a TIA?
transient ischemic attack
results from a temporary blockage of the blood supply to the brain
symptoms occur rapidly
how long do symptoms occur and last for a TIA
less than 24 hours
What are the symptoms of a TIA
fleeting blindness in one eye hemiparesis hemiplegia aphasia dizziness double vision staggering
what is hemiparesis?
weakness
what is hemiplegia?
paralysis
what makes a TIA different from a stroke?
short duration of symptoms
lack of permanent neurologic damage
What is a reversible Ischemic Neurologic Deficit(RIND)?
small stroke that completely resolves
like an ischemic stroke, typically occurs in the morning due to low BP during sleep and increase upon waking
what is a Partially Reversible Ischemic Neurologic Deficit(PRIND)?
episode that lasts more than 72 hours leaving minor neurological damage
what is subclavian steal syndrome?
rare condition resulting in the narrowing of the subclavian artery(runs down clavicle)
symptoms occur with exercise to the arm on the side of the narrowed vessel
blood is “stolen” from the brain and given to the exercised arm
what are the symptoms of subclavian steal syndrome?
light-headedness
numbness
weakness
what is a warning sign of subclavian steal syndrome?
atherosclerosis may be present in the arteries
does the nervous system have a high or low plasticity rate?
high especially during early development
when does most of the recovery take place in stroke patients?
approx 90% recovery takes place in the first 3 months
what are some stroke complications?
seizures
infection=pneumonia, UTI’s and pressure sores
DVT
what are the potential deficits after a stroke?
spatial neglect body neglect ideational apraxia organization and sequencing attention figure ground asterognosis initiation and perseverance visual agnosia problem solving
what is the clinical picture for stroke pt’s?
education
positioning
shoulder protection
contracture prvention
NDT, PNF, Rood, Brunnstrom, Neuro-IFRAH
weight bearing
supported reach activities
reach and manipulation
ADLS and IADLS
cognitive
visual and perceptual
psychosocialwhat are the precautions of stroke?
medical status/stability cardiac and respiratory precautions fall prevention skin integrity shoulder injury or pain contractures swallowing status poor safety awareness and impulsive behavior general safety concerns
what is antiplatelet therapy?
For ischemic strokes
Aspirin-not effective for mod to severe strokes, cerebral hemmorrhage or those at risk of bleeding
more effective with men
what is anticoagulants therapy?
for ischemic strokes
inhibits clotting
short term (2-3weeks)= heparin
Long term(1-3 months)=warfarian
What is thrombolytics therapy?
t-PA
for dissolution of an occluding thrombus if early detection (within 3 hours of onset)
