CVA s&s through diagnosis

Question 1

Deficits in a CVA depend on what situation?

Answer 1

depends on the area of the brain affected

Question 2

What kind of deficit occurs with CVA?

Answer 2

contralateral deficits

Question 3

3 px associated with damage of the left hemisphere in the brain

Answer 3

Motor px
“Aphasias” (speech/language)
Aware of difficulties leads to depression

Question 4

5 px associated with damage due to the right hemisphere

Answer 4

Motor px
spatial-perceptual deficits (visual changes)
impaired judgment
unilateral neglect
denies problem (I'm fine)

Question 5

name 4 mobility deficits associated with CVA

Answer 5

hemiparasthesia (half body is numb/tingles)
hemiparesis (1-sided weakness)
hemiplegia (unilateral paralysis)
hyporeflexia—> hyperreflexia (spastic)

Question 6

Motor deficit associated with CVA that involves the general lack of coordination

Answer 6

Ataxia

Question 7

6 total motor deficits that may occur with CVA

Answer 7

mobility
ataxia
respiratory function
swallowing & speech (dysarthria)
gag reflex
difficulty providing self-care

Question 8

4 total communication deficits in CVA

Answer 8

expressive aphasia
receptive aphasia
dysarthria
dysphagia

Question 9

The communication deficit name that involves damage to Brocas Area (towards the front of the brain)

Answer 9

Expressive aphasia

Question 10

The type of aphasia that normally occurs with right-sided hemiplegia

Answer 10

expressive aphasia

Question 11

This type of aphasia involves that pt having difficulty expressing themselves (can’t be understood)

Answer 11

expressive aphasia

Question 12

Aphasia in which there is damage to Wernicke’s area

Answer 12

receptive aphasia

Question 13

The pt cannot understand, only hears noise when others speak, and cannot read

Answer 13

receptive aphasia

Question 14

the communication deficit involving poor coordination with slurred speech, forming words is muscularly difficult

Answer 14

dysarthria

Question 15

Aspiration involves this type of communication deficit

Answer 15

dysphagia

Question 16

double vision

Answer 16

diplopia

Question 17

visual changes under special-perceptual deficits

Answer 17

diplopia

loss of peripheral vision

Question 18

special-perceptual deficit that involves the loss of half of the patients visual field

Answer 18

homonymous hemianopsia

Question 19

Unilateral neglect and loss of half of visual field fall under which special-perceptual deficit?

Answer 19

homonymous hemianopsia

Question 20

5 special-perceptual deficits

Answer 20

visual changes
homonymous hemianopsia
apraxia
agnosia
prosopagnosia

Question 21

define apraxia

Answer 21

unable to do a previously learned action

Question 22

agnosia means

Answer 22

unable to recognize familiar objects

Question 23

prosopagnosia means

Answer 23

unable to recognize faces

Question 24

CVA affect elimination by what mechanism?

Answer 24

they have an atonic bladder

Question 25

Atonic bladder is also called?Causes what?

Answer 25

spastic bladder/urinary retention

Question 26

Non-modifiable CVA risks

Answer 26

age (55-65 risk begins, double after each decade)
male (but most women die from strokes who have them)
family history (parents/siblings)
African americans

Question 27

Modifiable CVA risks

Answer 27

HTN (dash diet)
Heart disease (a-fib increases chances=20%)
Diabetes Mellitus (type II are 5x more likely)
High cholesterol (LDLs)
ETOH/tabacco
abdominal obesity

Question 28

Name American Heart Associations 8 D’s in the stroke chain of survival

Answer 28

Detection (face, arms, speech, time, or tongue)
Dispatch (alert ems)
Delivery
Door of hospital (with 10 min ED MD must do exam)
Data (12 lead EKG, CT scan, is it hemorrhagic or embolic?, TIA?)
Decision (tx:if ischemic stroke, administer thrombolytic therapy=tpa)
disposition (ICU admittance within 3 hours)

Question 29

3 Scale used by hospital with CVAs

Answer 29

Cincinnati Pre-Hospital Stroke Scale/Fast test
Glascow Coma scale
NIH stroke scale

Question 30

CVA 7 diagnostic tests that may be done with the first two being most important

Answer 30

Non-contrast CT scan**
MRI**
CTA (ct angiography)
MRA (magnetic resonance angiography)
Transcranial Doppler (non-invasive,small vessel detector)
Cerebral angiography
Lumbar puncture (risk with increased intracranial pressure, must be last resort, and invasive)

Question 31

name 4 types of communication deficits

Answer 31

expressive aphasia
receptive aphasia
dysarthria
dysphagia

Question 32

AHA 8D’s in the stroke chain of survival

Answer 32

detection (face, arms, speech, time/tongue)
dispatch (911/EMS)
delivery
door of hospital (within 10 min, ER MD assesses)
data (12 EKG, CT scan)
decision (thrombolytic therapy for ischemic!)
disposition (ICU admittance within 3 hours)