Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathophysiology > CVA > Flashcards

CVA Flashcards

1
Q

most frequently occurring neurologic disorder?

A

CV disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

a red stroke is a…

A

hemorrhagic stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

a white stroke is a…

A

ischemic stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

a lacunar stroke is a…

A

microvascular stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

CVA is also called…

A

brain attack and stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

cell damage in a CVA results from what

A

inadequate perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Greatest risk factor for cva

A

HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

2 types of CVA?

A

ischemic and hemorrhagic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

2 types of ischemic strokes?

A

thrombotic and embolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

this type of stroke is from a local source

A

thrombotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what causes a hemorrhagic stroke

A

ruptured BV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what does a hemorrhagic stroke cause

A

downstream ischemia, localized edema, and mass effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

def of ischemia?

A

inadequate blood supply to the tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

def of hypoxia?

A

inadequate oxygen supply to the tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

damage from a stroke depends on what

A

where event occurs and the size of the area affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is infarction

A

tissue death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is anoxic brain injury

A

cell death from hypoxia/anoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

where do emboli come from

A

large arteries, small arteries, major source cardiogenic, unsual, cryptogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

patent foramen ovale

A

hole in heart that causes right to left shunt; when blood goes from right to left atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is DVT provoked by

A

reduced mobility, dehydration, hypercoagulable state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how much cardiac output flows to the brain

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

are there more hemorrhagic strokes or ischemic

A

ischemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what did franklin D roosevelt die from

A

malignant HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

why has there been a reduction in CVA since 1950

A

dec incidence of CAD and uncontrolled HTN, better trmt from HTN, CAD,AFib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what causes CVA?

A

HTN, atrial fibrillation, diabetes, smoking, hyperlipidemia, hypercoagulable states, oral contraceptives, CHF, coronary atherosclerosis, structural heart disease, hypokalemia, genetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are some hypercoagulable states

A

cancer, factor 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what can increase plaque formation

A

diabetes, smoking, hyperlipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what type of CVA do atrial fibrillations cause

A

embolic ischemic strokes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

2 types of strokes?

A

TIA and CVA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is a stroke in evolution

A

stroke is still going on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is a complete stroke

A

stroke is over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what are the 4 arteries the circle of willis is fed by

A

internal carotid artery, external carotid artery, and 2 vertebral arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is a TIA

A

Episode of focal/localized cerebral ischemia that resolves fully and rapidly, usually within 1-24 hours, without evidence of cerebral infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

if someone has a TIA, its a blinking red light that what…

A

a CVA is prob gonna come soon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

mechanism of TIA

A

Transient embolus versus impending vascular occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

mechanism in a hemorrhagic CVA

A

disruption of the blood brain barrier; blood toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

mass lesion?

A

hematoma compresses underlying brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

4 categories of a hemorrhagic stroke

A

epidural, subdural, subarachnoid, intracranial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what type of blood is in an subdural hematoma

A

venous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

is an epidural hematoma rapid onset or slow onset

A

rapid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

is a subdural hematoma rapid onset or slow onset

A

slow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

which type of hematoma comes in contact with the brain

A

subdural hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

which hematoma is the dura pushed away from the skull

A

epidural hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

mechanism of an epidural hemorrhage

A

Skull fracture lacerates an artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

epidural hemorrhage symptoms

A

headache, nausea, vomiting, seizures, focal neurologic deficits (eg, visual field cuts, aphasia, weakness, numbness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what type of hemorrhage is seen on a CT without contrast

A

epidural hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what is a subdural hematoma

A

Tearing of bridging veins connecting cerebral hemispheres with dural vessels and superior sagittal sinus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what does cerebral atrophy lead to in elderly or pts with Hx EtOH

A

elongation of the distance the bridging veins must cross

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

when do symptoms come on for a subdural hematoma

A

may be none for hours to days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what are the symptoms of a subdural hematoma

A

headaches, confusion, behavioral changes, dizziness, nausea, vomiting, lethargy, weakness, apathy, seizures, loss of consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

MCC of Subarachnoid Hemorrhage

A

trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

MC nontraumatic cause of a Subarachnoid Hemorrhage

A

ruptured saccular/berry aneurysm

53
Q

what is an aneurysm

A

excessive localized enlargement of an artery caused by a weakening of the artery wall

54
Q

what does an aneurysm look like

A

Protruding bubble or sac on a blood vessel that balloons out over time

55
Q

3 types of aneurysms

A

saccular, fusiform, dissecting

56
Q

3 arterial layer from deep to superficial

A

tunica intima, media, and adventitia

57
Q

which arterial layer is the string muscular layer

A

tunica media

58
Q

what aneurysm is AKA a berry aneurysm

A

saccular aneurysm

59
Q

where does a saccular aneurysm bulge out

A

only one side of the artery wall

60
Q

where are saccular aneurysms more common in and near

A

circle of willis

61
Q

where does a fusiform aneurysm bulge out

A

all sides of BV

62
Q

which aneurysm type has a “neck” that connects the aneurysm to its main (“parent”) artery and a larger, rounded area called the dome

A

saccular aneurysm

63
Q

what are dissecting aneurysms formed thru?

A

accumulation of blood with a false lumen caused by a break in the intima of the blood vessel

64
Q

where are intracranial aneurysms located

A

bifurcations in/near circle of Willis

65
Q

MC intracranial aneurysms?

A

saccular

66
Q

more common overall aneurysm?

A

fusiform

67
Q

what can dissecting aneurysms be provoked by

A

trauma

68
Q

what type of intracranial aneurysm is from a congenital abnormality and degenerative changes

A

saccular/berry

69
Q

what are Mycotic aneurysms?

A

Arteritis caused by bacterial emboli/infection

70
Q

what is a giant aneurysm

A

form of saccular aneurysm >2.5 cm

71
Q

pseudoaneurysm/false aneurysm

A

External hematoma with a persistent communication to a leaking artery. Occurs when the vessel wall is injured and leaking blood collects in the surrounding tissue

72
Q

what layers of a BV does an aneurysm invove?

A

all of them

73
Q

MC CVA?

A

ischemic CVA

74
Q

what is an ischemic stroke caused by

A

thrombus or embolism

75
Q

what is the outcome of an ischemic CVA influenced by?

A

rate of onset and duration, collateral circulation, systemic circulation health, hypercoagulable state, high temp, glucose methanism

76
Q

an ischemic CVA better if the duration is _____ and the onset is _____

A

short duration, slow onset

77
Q

what does collateral circulation do to an ischemic CVA

A

helps

78
Q

how does systemic circulation health impact ischemic CVA

A

Hypotension can result in global cerebral ischemia

79
Q

how does hypercoagulable state impact ischemic CVA

A

increases microscopic thrombi, exacerbating vascular occlusion

80
Q

how does elevated temp impact ischemic CVA

A

makes it worse

81
Q

how does glucose mechanism impact ischemic CVA

A

hyper-, hypoglycemia worse

82
Q

what do ischemic neurons do

A

release enzymes that increase microemboli and cause further damage

83
Q

what is exotoxicity

A

during an ischemic stroke when damaged neurons cause an overreaction of certain NT such as glutamate and aspartate

84
Q

when neurons surround the ischemic or infarcted areas, what gets disrupted

A

plasma membranes

85
Q

what does Cellular edema cause compression of

A

capillaries

86
Q

compression of an artery on the left side of the brain will affect what side of the body

A

right (contralateral)

87
Q

compression of a nerve on the left side of the brain above the brainstem will affect what side of the body

A

right (contralateral)

88
Q

compression of a nerve on the left side of the brain below the brainstem will affect what side of the body

A

left (ipsilateral)

89
Q

penumbra?

A

cells at risk for damage if an ischemic stroke goes on for too long

90
Q

why can Cells in the penumbra remain viable for up to several hours

A

collateral flow

91
Q

what is the ischemic core

A

severe ischemia that leads to neuronal necrosis and glial cell damage

92
Q

do older or younger ppl have better collateral flow

A

older

93
Q

what are some ischemic CVAs accompanied by

A

spontaneous hemorrhage

94
Q

which type of ischemic CVAs are usually accompanied by spontaneous hemorrhage

A

embolic

95
Q

does conversion of an ischemic stroke worsen prognosis

A

no but it can change therapeutic options

96
Q

trmt for ischemic CVA without hemorrhage

A

give clot buster

97
Q

trmt for ischemic CVA with hemorrhage

A

do NOT give clot buster

98
Q

what are lacunar strokes usually related to

A

HTN, DM, HLD (hypertensive lung disease)

99
Q

what do lacunar strokes result from?

A

Microvascular atherosclerosis and small thrombi

100
Q

what can lacunar strokes lead to

A

vacular dementia

101
Q

symptoms of lacunar stroke

A

Pure motor hemiplegia, pure sensory stroke, clumsy hand (dysarthria), ataxia

102
Q

when would a person develop an Arterovenous malformation

A

they have them at birth but dont usually get Sx until 10-30yo

103
Q

what is an Arterovenous malformation

A

when arteries feed directly into veins through a tangle of malformed vessels

104
Q

what are ppl with arterovenous malformations at risk for

A

hemorrhage or compression

105
Q

symptoms of av malformations

A

cerebral hemorrhage, seizures, headache

106
Q

what type of cerebral hemorrhage is common in ppl with av malformations

A

subarachnoid

107
Q

what is a cavernous angioma

A

type of av malformation where clusters of abnormally formed capillaries with little or no interspersed brain tissue

108
Q

how are cavernous angiomas typically found

A

incidentally by imaging or workup for headache, seizures, stroke, or recurrent focal or multifocal neurologic signs

109
Q

these types of AV malformations used to be thought of as low risk but now it now appears that many are from genetic mutations and can form during life

A

cavernous angiomas

110
Q

what is capillary telangiectasis

A

Sinusoidal collections of abnormally dilated capillaries with interspersed normal brain tissue

111
Q

how is capillary telangiectasis diff from cavernous angiomas

A

capillary telangiectasis have interspersed normal brain tissue

112
Q

what sx do ppl with capillary telangiectasis have

A

most are asymptomatic and are accidentally discovered on MRI

113
Q

MC cerebral vascular malformation

A

venous angioma

114
Q

when do ppl with venous angiomas get diagnosed

A

at birth bc its a congential condition

115
Q

when is venous circulation developed

A

fetal development

116
Q

what are venous angiomas AKA

A

Developmental Venous Anomalies

117
Q

how are venous angiomas treated

A

they are not treated

118
Q

what is a venous angioma

A

An unusual cerebral drainage bc venous circulation is not developed with the central vein

119
Q

trmt for cva

A

Determine when patient was last “normal”

Rapid transport to a stroke center

CT w/o contrast to rule-out hemorrhagic stroke

Determine if to be treated by: Thrombolytic or Endovascular procedure

Management of blood pressure

Avoiding repeat events

Physical therapy.

120
Q

a ct without contrast rules out what type of stroke

A

hemorrhagic

121
Q

what is the typical thrombolytic trmt for someone who had an an acute ischemic stroke less than 4.5 hrs ago

A

tPA (tissue plasminogen activator)

122
Q

what is the typical thrombolytic trmt for someone who had an an acute ischemic stroke less than 24 hrs ago

A

mechanical thrombectomy

123
Q

what does tPA do

A

activates plasminogen to activate plasmin which helps restore blood flow to the brain

124
Q

why may someone not be able to receive tPA

A

high bp, concern for hemorrhagic stroke or hemorrhagic conversion, recent intracranial/spinal surgery, CVA, head trauma, History of cerebral aneurysm, Recent active internal bleeding,Low platelets, elevated INR (from blood thinners or liver malfunction).

125
Q

what are some typical tPA warnings

A

Advanced age

Hyper/hypoglycemia

Comorbidities (bacterial endocarditis, renal/hepatic dz, etc)

Pregnancy

126
Q

2 types of CVA trmt?

A

thrombolytic or endovascular procedure

127
Q

thromoblytic CVA trmt?

A

tPA

128
Q

endovascular trmt for CVA?

A

mechanical thrombectomy

129
Q

if blood pressure is too low during a stroke, what is that bad for

A

collateral circulation

Pathophysiology (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions