EXAM #2: CVA-Horner's Syndrome Flashcards
what is the leading cause of long term disability?
2nd leading cause of death?
cerebrovascular accident (CVA)
aka stroke
what is the most common type of CVA? what is it?
ischemic
blocked blood flow often due to atherosclerosis
what is a hemorrhagic CVA?
ruptured blood vessel often due to HTN, aneurysms, and arteriovenous malformations
what are non-modifiable risk factors of CVA?
age
african americans > european americans
women
what are modifiable risk factors?
CV disease and HTN
diabetes
lifestyle (SAD, obesity, tobacco use, drugs)
how does a CVA develop?
disrupted blood flow to the brain
true or false. CVA S&S have a sudden onset
true
what are S&S of CVA? (5)
WORST ever - severe headache
multi-segmental hemi face and/or extremity numbness and weakness/paralysis
visual disturbance
speech, swallowing impaired
unexplained dizziness or falls
what should be included in your systems review for CVA?
history and observation
scan:
resisted testing w/ multiple joint weakness
neuro tests –> (+) babinski, clonus, DTRs, & UMN findings (multi-segmental weakness)
what kind of referral for CVA?
emergency referral
what are causes of posterior circulation compromise?
CVA
pathological joint instability
atherosclerosis, clot, or embolism - most commonly in internal carotid
sudden arterial dissection (excessive rot/ext/tx stress)
tumors
VBI - vertebrobasilar insufficiency
presyncope
in PCC, ischemia of the arteries feeding the inner ear, brain stem, and cerebellum includes:
vertebral artery
basilar and posterior cerebral arteries & their branches
what are affected functions from a PCC?
brain stem houses cranial n. and respiratory center
cerebellum regulates coordination
the basilar artery most frequently supplies what nerve?
trigeminal nerve
PCC S&S –>
5 Ds:
And:
3 Ns:
5 Ds:
- dysarthria (speech)
- dysphagia (swallowing)
- diplopia (double vision)
- dizziness
- drop attacks (w/o loss of consciousness)
And: (2)
- ataxia: incoordination due to cerebellar disorder
- headAche - worst ever
3 Ns:
- nausea
- nystagmus - involuntary rotary eye movement creating spinning sensation
- numbness/paresthesia’s in face/extremities
what kind of referral for PCC?
emergency
what is presyncope dizziness?
near fainting/light headedness just before LOC without illusion of spinning
how is presyncope dizziness caused?
cardiovascular or non-cardiovascular (i.e. high stress or medication)
how is presyncope dizziness developed?
reduction of blood flow from heart to brain
what are S&S of presyncope dizziness?
generalized weakness
giddiness
sweating
pallor (pale, not looking well)
5 Ds And 3 Ns
what kind of referral for presyncope dizziness?
emergency referral
what is vertigo?
illusion of spinning or rotary motion caused by asymmetries in the vestibular system
what are the two types of vertigo?
which one is 90% of the cases?
peripheral and central
peripheral
what is the most common type of peripheral vertigo?
benign paroxysmal positional vertigo (BPPV)
what is the primary cause of peripheral vertigo?
unknown
How does peripheral vertigo develop? ____________ becomes free floating in ______________
crystals become free floating in semi circular canals
what is the primary cause of central vertigo?
CVA or tumor
what are secondary causes of central vertigo?
trauma creating a brain injury or upper cervical instability
infection
demyelination (MS)
migraine HAs
how does central vertigo develop? Due to ______ to what 3 structure?
due to ischemia to cerebellum, brainstem or vestibular nuclei