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Patho II > CVA > Flashcards

CVA Flashcards

1
Q

What is a CVA?

A
  1. A disturbance in cerebral circulation which causes a neurological deficit that can be permanent
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2
Q

What are the risk factors for a CVA?*

A
  1. hypertension
  2. diabetes mellitus
  3. cardiac disease
  4. elevated blood lipids
  5. peripheral vascular disease
  6. obesity
  7. cigarette smoking
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3
Q

What is ataxia?

A

unable to coordinate voluntary movement

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4
Q

What is aphasia?

A

the loss of ability to understand or express speech

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5
Q

What is apraxia?

A

unable to carry out particular purposeful movements

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6
Q

What is afferrent?

A

carry messages from body to CNS

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7
Q

What is efferent?

A

carry messages from CNS to body

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8
Q

What is stereognosis?

A

ability to perceive and recognize the form of an object in the absence of visual and auditory information, by using tactile information to provide cues from texture, size, spatial properties, and temperature, etc (wikipedia)

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9
Q

What is hemiplegia?

A

paralysis of one side of the body

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10
Q

What is hemiparesis?

A

partial paralysis limited to one side

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11
Q

What is nystagmus?

A
  • Rapid, rhythmic, repetitious, and involuntary eye movements.
  • Nystagmus can be horizontal, vertical, or rotary. Whatever form it takes, nystagmus is an abnormal eye finding and a sign of disease within the eye or the nervous system.
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12
Q

What is hemianopsia?

A

blindness in one half of the visual field of one or both eyes—called also hemiopia.

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13
Q

What is hyperreflexia?

A
  • overactive or overresponsive reflexes

- ie overreactive bladder

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14
Q

What are the classifications of CVA?

A
  1. Thrombotic
  2. Embolic infarction
  3. hemorrahage
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15
Q

What is a thrombic CVA?

A
  • caused by atherosclerotic plaques in combination with HTN
    1. plaques likely to form at branchings and curves of the arteries
    2. can be present for many years and never be symptomatic
    3. intermittent blockage can proceed to full blockage resulting in permanent damage
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16
Q

What is an embolic infarction?

A
  • embolus may originate in the heart, internal carotid, or carotid sinus.
    1. branches of middle cerebral artery most often infarcted; possibly due to its direct continuation from the internal carotid
  • NOTE–70% of CVA’s caused by either thrombosis or embolus.
17
Q

What is a hemorrhagic CVA?

A

usually a result of prolonged and progressive HTN

  1. most often affects smaller cerebral vessels
  2. Anerysm which have formed over time burst spilling blood into tissue
18
Q

What are the S/S of damage to frontal lobe?

A
  1. Changes in personality
  2. Emotional lability
  3. Judgment problems
  4. Attention problems
  5. Concentration problems
19
Q

What are the S/S f damage to the temporal lobe?

A
  1. Memory impairments

2. Difficulty processing language

20
Q

What are the S/S f damage to the parietal lobe?

A
  1. Memory deficits
  2. Sensory deficits
  3. Task integration deficits
    - apraxia
    - left/right discrimination
    - dysgraphia, dyscalculia
21
Q

What are the S/S f damage to the cerebellum?

A
  1. Balance, coordination, equilibrium disorders
    - ataxia
    - tremors
    - dysmetria
    - dysdiadocokinesia
22
Q

What are the primary differences b/t many neuromuscular disorders?

A

the etiology and onset of symptoms.

23
Q

What side of the brain is damaged in a L CVA?

A

Damage to Left side of Brain

-will see manifestations of symptoms in the R

24
Q

What side of the brain is damaged in a R CVA?

A

Damage to Right side of Brain

-will see manifestations of symptoms in the L

25
Q

What are the S/S of hemiplegia?

A
  • initially flaccid
  • over varying time periods, development of spasticity occurs:
    1. trunk and shoulder girdle initial site
    2. neck and head
    3. upper extremities
    4. lower extremities
26
Q

What are S/S of sensory disturbances?

A
  1. usually partial impairment of the discriminatory sensation.
  2. results in imbalance of sensory messages to the brain
  3. incoordinated movements
  4. may be so severe that it leads to loss of recognition of affected side. This is known as HEMINEGLECT.
27
Q

What are the S/S of L sided lesions?

A
  1. aphasia
    - expressive aphasia
    - receptive aphasia
    - global aphasia
    - anomic aphasia
  2. effects left side facial musculature and right side of neck, trunk, and right extremities (Right Hemiplegia)
  3. Processing delays
  4. bilateral apraxia
  5. difficulty preplanning and sequencing
  6. inappropriate use of objects
  7. compulsive
  8. low frustration tolerance
28
Q

What is expressive aphasia?

A

unable to effectively produce speech. (Broca’s area–frontal lobe).

29
Q

What is receptive aphasia?

A

unable to process incoming information (Wernicke’s area–temporal lobe)

30
Q

What is global aphasia?

A

Unable to process or produce speech and language.

31
Q

What is anomic aphasia?

A

able to talk and understand information, but difficulty naming objects

32
Q

What are S/S of R sided lesions?

A
  1. amnesic apraxia–inability to perform tasks previously known
  2. anosognosia–ignorance of the presence of disease (hemineglect)
  3. spatial disorientation
  4. effects right side of facial musculature and left side of neck and trunk and left extremities (Left Hemiplegia)
  5. excessive verbalizations
  6. short attention span/distractable
  7. inability to self correct
  8. poor judgment, unrealistic
  9. labile
  10. lethargic
  11. impulsive
33
Q

What are S/S of R or L sided lesions?

A
  1. decreased or absent point localization, 2 point discrimination
  2. agraphaesthesia- unable to recognize writing on the skin purely by the sensation of touch.
  3. astereognosis
34
Q

What are S/S of the eye post CVA?

A
  1. if optic chiasm is affected, results in ipsilateral hemianopsia: loss of vision in that half of the visual field
  2. gaze preference -with lesion of frontal lobe, will gaze to ipsilateral side of lesion.
35
Q

What are secondary S/S post CVA?

A
  1. Respiratory Deficiencies
  2. Spasticity and loss of Mobility
  3. Joint and muscle pain
  4. Scoliosis
  5. Gait deviations
  6. Mental and intellectual impairments
36
Q

How is a CVA diagnosed?

A
  1. thorough history
  2. angiography
  3. EEG
  4. Cranial CT and MRI
37
Q

How is a CVA treated?

A
  1. Medication- anticoagulant or antiplatelet agents
    - TPA–given if thrombotic or embolitic to dissolve clot
  2. Surgery
    - carotid endarterectomy – removal of blood clots and improve circulation
  3. Management of Bowel and Bladder Control
  4. Therapy goals
    - re-establish postural control
    - normalize sensory inputs
    - facilitate normal movement patterns within functional skills
    - prevent contracture/deformity and pain through maintenance of normal joint alignment
  5. Psychological Considerations
38
Q

What is the prognosis of a CVA?

A
  1. Three state study of survivors of CVA’s
    - 10% returned to work without impairment
    - 40% mild residual impairment
    - 40% disabled requiring special services
    - 10% need institutional care
  2. Most recovery generally within first 3 months, improvements can be seen up to 2-3 years later.

Patho II (23 decks)

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