Internal Med 1 Test 3 - Stroke Flashcards
What is basic pathology of YIN closed syndrome organ stroke?
Internal Wind with Cold-Phlegm or Cold-Damp-Phlegm sealed in body, obstructing internal organs.
What is basic pathology of YANG closed syndrome organ stroke?
Internal Wind with Heat-Phlegm or Phlegm-Fire sealed in body, obstructing internal organs.
List all possible ETIOLOGY (causes) of Wind-Stroke.
external wind; excessive emotional strain/upset; over-indulging in ruch fatty food; excessivealcohol consumption; overwork; constitutional tendency toward Phlegm/LIV yang excess; advanced age; excessive sexual activities
List possible PATHOLOGY (patterns) of Wind-Stroke.
LIV yang rising, with Wind and Fire surging upwards. Deficient LIV & KID yin unable to anchor & restrain yang, causing internal movement of Wind. Heat-Phlegm/Wind-Phlegm/Damp-Phlegm disturbing organs & head. Depleted channels leading to external Wind lodging in channels. Qi deficiency with blood stasis.
Wind-Stroke has 4 crucial points for making dx.
- Identify character of disease. 2. Distinguish organ vs. channel stroke. 3. Differentiate closed vs flaccid collapse syndromes if organ stroke. 4. Determine likely progression, assess prognosis.
Channel Stroke - Depleted Channels with Wind Invasion - indications?
No loss of consciousness. Sudden facial paralysis, dysphasia, maybe fever and chills, arthralgia. T: normal, twc. P: floating&wiry / wiry&thready
Channel Stroke - Depleted Channels with Wind Invasion - tx?
Expel Wind, nourish blood, unblock channels
Channel Stroke - Depleted Channels with Wind Invasion - Formula?
Da Qin Jiao Tang (Major Large Gentiana Decoction) IF early/middle stage with internal heat. Use Xiao Xu Ming Tang (Minor Extend Life Decoction) if yang qi deficient with W-C-D invading channels.
Channel Stroke - LIV and KD Yin Deficiency with Rising LIV Yang and Wind - indications?
Progressive unilateral motor dysfunction, weakness, paralysis/numbness of extremities, facial paralysis, dysphasia, may develop over hours/days. Dizziness/vertigo, tinnitus, HA (often temporal/vertical), pressure behind eyes, blurring vision, sudden loss of vision in one eye, facial flushing, irritability and restlessness, insomnia or restless dream-disturbed sleep, lower back ache, hypertension. T: red with little/no coat. P: thready, wiry and rapid.
Channel Stroke - LIV and KD Yin Deficiency with Rising LIV Yang and Wind - tx strategy?
Sedate LIV, extinguish wind, nourish yin, anchor yang
Main difference in organ vs channel stroke sx?
Loss of consciousness vs none
Organ Stroke - CLOSED syndrome sx?
Loss of consciousness, eyes may be open, mouth clenched shut, hands clenched shut, limbs in rigid spasm, wheezing, no sweat (pores closed), urine retained, constipation, tongue stiff/deviated/greasy, pulse slippery
Organ Stroke - flaccid collapse syndrome sx?
Sudden loss of conscioussness, eyes closed, mouth may be open, hands relaxed, limbs in flaccidd paralysis, snoring/shallow breathing, sweating is copious/persistent (pores open), incontinence of urine and stool, tongue is flaccid and pale, pulse is thready, faint, barely palpable
Organ Stroke - what is pathology of closed vs flaccid collapse syndrome?
Closed is sealing of evil qi (Heat/Cold/Phlegm + internal Wind) within the body. Flaccid collapse is outward escape of yang qi.
What is basic pathology of YANG closed syndrome organ stroke?
Internal Wind with Heat-Phlegm or Phlegm-Fire sealed in body, obstructing internal organs.
What is basic pathology of YIN closed syndrome organ stroke?
Internal Wind with Cold-Phlegm or Cold-Damp-Phlegm sealed in body, obstructing internal organs.
Sequelea of Wind-Stroke: Hemiplegia may be due to?
Qi Deficiency with Blood Stasis or Ascendant LIV Yang with Obsruction of Channels
Hemiplegia due to Qi Deficiency with Blood Stasis - indications?
Motor impairment, paralysis, numbness or complete loss of sensation on oneside of body. Deviation of eyes and mouth. Frequent urination/incontinence. BP normal or slightly elevated. T: white coat. P: moderate.
Hemiplegia due to Qi Deficiency with Blood Stasis - tx strategy?
Tonify qi, invigorate blood, unblock channels
Hemiplegia due to Qi Deficiency with Blood Stasis - basic Formiula?
Bu Yang Huan Wu Tang
Hemiplegia due to Ascendant LIV Yang with Obsruction of Channels - indications?
Motor impairment, paralysis, numbness or complete loss of sensation on one side of body. HA, dizziness, tinnitus, facial flushing, irritability, hypertension. T: red with little/no coat OR red and stiff OR quivering. P: wiry and slippery OR wiry, thready and rapid.
Hemiplegia due to Ascendant LIV Yang with Obsruction of Channels - tx strategy?
Settle the LIV, subdue yang, extinguish Wind, unblock channels