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PT 10116 - Neuro Exam > CVA Part 1 > Flashcards

CVA Part 1 Flashcards

1
Q

what is cerebrovascular disease

A

non traumatic sudden loss of neurological function d/t interruption of blood flow to brain

can have motor, sensory, cognition, perception, language and consciousness problems

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2
Q

what is the golden period for early acute management

A

4-8 mins

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3
Q

what is the golden period for stroke rehab

A

3-6 mo.

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4
Q

stroke is _____ leading cause of death

A

4th

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5
Q

stroke is most common cause of _____ in adults/elderly

A

disability

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6
Q

weight of adult brain

A

1500 grams or 1 kg or 2% of BW

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7
Q

normal cerebral BF

A

50 or 60 mL / 100g grams of brain tisuee

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8
Q

the brain can produce _____ every 24 hrs

A

150g glucose and 72L oxygen

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9
Q

upon interruption of cerebral blood flow irreversible damage occurs after ____

A

4-8 mins

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10
Q

what is ischemic penumbra

A

lethargic cells that are reversible

they surround the irreversible damage

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11
Q

what is the significance of ischemic penumbra

A

after 8 mins the penumbra dies = irreversible damage grows

need to treat in 4-8 mins to reverse the damage

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12
Q

normal range BF

A

100% or 50 gm-min

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13
Q

metabolic changes BF

A

80% or 40 gm-min

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14
Q

mild ischemia BF

A

60% or 30 gm-min

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15
Q

moderate ischemia or penumbra BF

A

40% or 20 gm-min

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16
Q

severe ischemia BF

A

20% or 10 gm-min

17
Q

stroke risk factors: non-modifiable

A

> 65 yo

M>F but equal at menopause

AA>ASIAN>WHITES

genetics

hx of previous stroke or TIA

18
Q

why is TIA a risk factor for stroke

A

after 5 yrs of TIA - at risk of major stroke

19
Q

discuss TIA

A

temporary interruption of BF to brain

deficits last for few mins to hours but no more than 24 hrs c no residual sx

no blockage on MRI

20
Q

discuss RIND

A

focal neurologic deficits fully recover w/in a week

more than 24 hrs but less than 1 wk

after 1 wk no more deficits and findings on MRI

21
Q

discuss stroke in evolution

A

stepwise incremental inc in neurologic deficits

SD
SD + W
SD + W + D
SD + W + D + CoordProb

22
Q

discuss completed stroke

A

no further deterioration in neurologic status - stabilized na

no progression unless mag ka attack ule

23
Q

temporal classification of stroke

A

TIA
RIND
completed stroke

24
Q

etiologic classification of stroke

A

ischemic
hemorrhagic

25
Q

discuss ischemic stroke

A

90% most common type

from dec pressure or BF

endothelial injury theory
lipid infiltration theory
unified hypothesis

26
Q

what are the kinds of ischemic stroke

A

thrombotic
embolic
lacunar

27
Q

discuss thrombotic ischemic stroke

A

40% most common ischemic stroke

blood clot blocks BF - atherosclerosis

affects larger arteries

insidious onset - during sleep
- HA - weakness - sleep - ngiwi

28
Q

discuss embolic ischemic stroke

A

30% most common ischemic stroke

dislodged clot - usually cardiac origins (CABG pts)

from aorta

sudden onset - occurs in morning p physical activity

29
Q

hallmark of embolic ischemic stroke

A

seizures, aphasia and unilateral neglect

30
Q

discuss lacunar ischemic stroke

A

10% most common ischemic stroke

from uncontrolled HTN or DM

affects lenticulostriate arteries

insidious or sudden

pure motor or pure sensory

31
Q

discuss hemorrhagic stroke

A

10% - rarest type of stroke

over dilated vessels - rupture of aneurysm = loss of consciousness

catastrophic - 50-70% mortality
but if recovered - best prognosis

32
Q

discuss hemorrhagic intracerebral stroke

A

10-15% most common type of hemorrhagic stroke

does not follow anatomic pattern - dissects through tissue planes = VERY MASSIVE

assoc c charcot-bouchard
- d/t long standing HTN

younger pts and dramatic onset

33
Q

discuss hemorrhagic subarachnoid stroke

A

5-10% most common type of hemorrhagic stroke

at dural space around brain

can be:

  1. saccular: degen of tunica adventitia = lose outside support
  2. AVM: tangled arteries and veins = fusion of blood = burst d/t diff pressures

worst HA of my life

F > M

34
Q

management classification of stroke

A

TIA

major stroke - stable and severe deficits

deteriorating stroke - neuro status deteriorates p hospi

young stroke - younger than 45 yo

PT 10116 - Neuro Exam (24 decks)

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