CVA

Question 1

What is the cause of is stroke?

Answer 1

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.

Question 2

what are the symptoms of Stroke

Answer 2

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

Question 3

what does the acronym FAST stand for?

Answer 3

F=Face drooping
A=Arm weakness
S=Speech Difficulty
T=Time to call 911

Question 4

what are the dysfunctions of stroke besides motor paralysis?

Answer 4

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

Question 5

what are the two types of stroke?

Answer 5

ischemic

hemorrhagic

Question 6

which is the most common type of stroke?

Answer 6

ischemic

Question 7

which stroke is normally seen in order patients?

Answer 7

ischemic

Question 8

which stroke is normally seen in younger patients

Answer 8

hemmorrhagic

Question 9

what is an ischemic stroke?

Answer 9

occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot.

Question 10

what are the kinds of ischemic strokes?

Answer 10

thrombotic
embolic
lacunar

Question 11

what is a thrombotic stroke?

Answer 11

a clot formed in an artery that is already very narrow.

Question 12

what is an embolic stroke?

Answer 12

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

Question 13

what is a lacunar stroke?

Answer 13

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

Question 14

what damage can strokes cause?

Answer 14

dead tissue

edematous brain tissue

Question 15

What allows the body to recover from a stroke months and even years after

Answer 15

neuroplasticity

Question 16

what is neuroplasticity?

Answer 16

the brain’s ability to reroute neural pathways

Question 17

what is a hemmorrhagic stroke?

Answer 17

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)

Question 18

what is an aneurysm?

Answer 18

bulging of a wall of an artery as a result of weakness in the vessel wall
prone to rupture at any time

Question 19

what are the two kinds of hemorrhagic strokes?

Answer 19

intracerebral

subarachnoid

Question 20

what are the characteristics of an intracerebral hemmorrhage?

Answer 20

bleeding directly into brain substance

Question 21

what conditions are often linked to intracerebral hemmorrhage strokes?

Answer 21

hypertention
blood vessel abnormalities
aneurysms
trauma

Question 22

what are the clinical signs of intracerebral hemmorrhage?

Answer 22

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

Question 23

what is a subarachnoid hemmorhage?

Answer 23

bleeding within the brain’s surrounding membrances and cerebrospinal fluid
slightly more common in women
95% are caused from aneurysm leakage
AVM bleeding

Question 24

what are characteristics of a left-sided cerebral injuries=middle cerebral artery

Answer 24

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

Question 25

What are the language deficits of a left-sided cerebral injuries=middle cerebral artery

Answer 25

aphasia

Question 26

What are the sensation deficits of a left-sided cerebral injuries=middle cerebral artery

Answer 26

impaired temp discrimination pain proprioception on right side of body

Question 27

What are the characteristics of a right-sided cerebral injuries=middle cerebral artery

Answer 27

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

Question 28

what is dressing apraxia?

Answer 28

when pt is unable to relate articles of clothing to the body

Question 29

what are characteristics of an anterior cerebral artery stroke

Answer 29

``` 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 ```

Question 30

What are the characteristics of a vertebrobasilar stroke

Answer 30

``` 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 ```

Question 31

what is wallenberg's syndrome?

Answer 31

``` 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 ```

Question 32

what is global aphasia

Answer 32

loss of language skills only able to utter middle cerebral sensitive to gestures appear to understand more than they can

Question 33

what is brocha's aphasia

Answer 33

caused by left CVA poor speech production, misarticulating, simplified speech broken speech

Question 34

what is wernick's Aphasia

Answer 34

caused by left CVA impairment of understanding language. impaired auditory comprehensive use of few substantive words. reading and writing are limited limited math

Question 35

what is anomic aphasia

Answer 35

difficulty with word retrieval. can't find words constantly having words on the tip of your tongue LEFT CVA

Question 36

what is dysarthria?

Answer 36

articulation disorder NOT APHASIA dysfunction in CNS impairment in the muscles causing slurred/sluggish speech

Question 37

what are the non modifiable stroke risk factors?

Answer 37

``` ethnicity-African Americans have a higher risk age-especially after 65 heredity-family Hx, genetic factors hypertension hyperlipidemia ```

Question 38

what are the modifiable stroke risk factors?

Answer 38

``` smoking obesity geographic location diabetes oral contraceptives alcohol use drug abuse ```

Question 39

What is a TIA?

Answer 39

transient ischemic attack results from a temporary blockage of the blood supply to the brain symptoms occur rapidly

Question 40

how long do symptoms occur and last for a TIA

Answer 40

less than 24 hours

Question 41

What are the symptoms of a TIA

Answer 41

``` fleeting blindness in one eye hemiparesis hemiplegia aphasia dizziness double vision staggering ```

Question 42

what is hemiparesis?

Answer 42

weakness

Question 43

what is hemiplegia?

Answer 43

paralysis

Question 44

what makes a TIA different from a stroke?

Answer 44

short duration of symptoms | lack of permanent neurologic damage

Question 45

What is a reversible Ischemic Neurologic Deficit(RIND)?

Answer 45

small stroke that completely resolves | like an ischemic stroke, typically occurs in the morning due to low BP during sleep and increase upon waking

Question 46

what is a Partially Reversible Ischemic Neurologic Deficit(PRIND)?

Answer 46

episode that lasts more than 72 hours leaving minor neurological damage

Question 47

what is subclavian steal syndrome?

Answer 47

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

Question 48

what are the symptoms of subclavian steal syndrome?

Answer 48

light-headedness numbness weakness

Question 49

what is a warning sign of subclavian steal syndrome?

Answer 49

atherosclerosis may be present in the arteries

Question 50

does the nervous system have a high or low plasticity rate?

Answer 50

high especially during early development

Question 51

when does most of the recovery take place in stroke patients?

Answer 51

approx 90% recovery takes place in the first 3 months

Question 52

what are some stroke complications?

Answer 52

seizures infection=pneumonia, UTI's and pressure sores DVT

Question 53

what are the potential deficits after a stroke?

Answer 53

``` spatial neglect body neglect ideational apraxia organization and sequencing attention figure ground asterognosis initiation and perseverance visual agnosia problem solving ```

Question 54

what is the clinical picture for stroke pt's?

Answer 54

``` 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 psychosocial ```

Question 55

what are the precautions of stroke?

Answer 55

``` 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 ```

Question 56

what is antiplatelet therapy?

Answer 56

For ischemic strokes Aspirin-not effective for mod to severe strokes, cerebral hemmorrhage or those at risk of bleeding more effective with men

Question 57

what is anticoagulants therapy?

Answer 57

for ischemic strokes inhibits clotting short term (2-3weeks)= heparin Long term(1-3 months)=warfarian

Question 58

What is thrombolytics therapy?

Answer 58

t-PA | for dissolution of an occluding thrombus if early detection (within 3 hours of onset)