Module 2 Flashcards
_ or _ is defined as an acute onset of neurological dysfunction due to an abnormality and cerebral circulation that results in signs and symptoms that correspond to involvement of specific focal areas of the brain
Stroke or cerebral vascular accident (CVA)
Stroke is the_cause of death in the US and the_cause of disability. _ are affected at a greater rate than_until the age of?
Stroke is the #4 cause of death
Stroke is the #1 cause of disability
Males are affected at a greater rate than females, up until the age of 85
TIAs, HTN, obesity, alcohol, smoking, heart disease, and diabetes myelitis are all_for stroke. Age, race, gender, prior stroke, and family history of stroke are?
Modifiable risk factors: TIAs, HTN, obesity, alcohol, smoking, heart disease, and diabetes myelitis
Unmodifiable risk factors: age, race, gender,’s prior stroke, and family history of stroke
What is the acronym and meaning of the warning signs or stroke?
FAST:
Facial weakness – uneven smile or facial droop
Arm weakness – uneven arm reach
Speech – slurred or unintelligible
Time – time to call 911
With a _, symptoms may last a few minutes to several hours but resolve within 24 hours. Common causes are? (Four)
TIA – transient ischemic attack
For common causes: (CORE) cerebrovascular spasm, overmedication, reduced perfusion, and emboli
_% five strokes are preceded by a TIA
15%
Two classifications and associated percentages for stroke
Ischemic stroke – 80%
Hemorrhagic stroke – 20%
Which type of stroke is caused by a cerebral thrombus or emboli? Which type is categorized as intracerebral, subarachnoid, or arteriovenous malformation (AVM)?
Ischemic (cerebral thrombosis and embolus)
Hemorrhagic (intracerebral, subarachnoid, arteriovenous malformation)
Stroke of the_hemisphere is characterized by: visual – perceptual deficits, impulsive/poor judgment, poor awareness of deficits, and difficulty with problem-solving & grasping tasks. Requires?
Stroke in the right hemisphere ( left hemiparesis/sensory loss)
Requires constant reminder to look/ be aware of left side
Strength of the left hemisphere results in right? (Two) slow and cautious?_/_Deficits. Difficulty?_Emotions/lability
Results in right hemiparesis and sensory loss
Slow and cautious behavior
Speech/language deficits
Difficulty initiating tasks
Negative emotions/lability
The _ _ _ is a branch of the internal carotid artery that supplies the medial cerebral hemisphere (frontal and parietal lobe’s) and subcortical structures.
Anterior cerebral artery -ACA
Arterial cerebral artery syndrome results in_hemiplegia/hemiparesis, sensory loss- with the _ being affected more than then _, and usually no?
Results in contralateral hemiplegia/hemiparesis
Sensory loss is usually greater in the lower extremity than the upper extremity,o
Usually no facial involvement
The _ _ _, is a branch of the internal carotid artery that supplies the lateral cerebral hemisphere (frontal, Temporal, and parietal lobe’s) and the sub cortical structures.
Middle cerebral artery – MCA
Middle cerebral artery syndrome results in_hemiplegia/hemiparesis, sensory loss, and the_ and_ are usually more involved than the _.
Results in contralateral hemiplegia/hemiparesis
Sensory loss
Upper extremity and face are usually more involved than the lower extremity
The internal carotid artery supplies? (Two) complete occlusion? Incomplete occlusion?
Supplies the ACA and MCA
Complete occlusion: usually results in death
Incomplete occlusion: produces combination of ACA and MCA characteristics
The_ _ _ supplies the occipital, medial and inferior temporal lobe’s, upper brainstem, midbrain, and posterior diencephalon
Posterior cerebral artery – PCA
Posterior cerebral artery syndrome causes_ hemiplegia/hemiparesis,_loss,_impairments, and?
Contralateral hemiplegia/hemiparesis
Sensory loss
Visual impairments
Thalamic pain syndrome
What is the most common site of occlusion in stroke?
Middle cerebral artery
_ _ are caused by deep small vessel disease and are consistent with specific anatomical sites. Are associated with? (Two)
Lacunar syndromes
Associated with hypertensive hemorrhage and diabetic microvascular disease
Lacunar syndromes usually SPAIRS? (Three) four examples?
Usually SPAIRS: consciousness, language, and visual fields
Four examples: pure motor lacunar stroke, pure sensory Lacunar stroke, ataxic hemiparesis, dysarthria/clumsy hand syndrome
The _ _ supplies the cerebellum, medulla, pons, and internal ear. Complete occlusion frequently results in?
Vertebrobasilar artery
Complete occlusion frequently results in death
Incomplete occlusion of the vertebrobasilar artery produces a tremendous variety of symptoms that can be _ and/ or _, and includes?(4)
Can be ipsilateral and/or contralateral
Includes: locked in syndrome, bulbar palsy, Wallenberg syndrome, and vestibular & cerebellar deficits
_ _ causes tetraplegia and lower bulbar paralysis (CN V-VII)
Locked in syndrome
_ _ causes ipsilateral pain and temperature lost in the face and contralateral pain and temperature lost over 50% of the body. A.k.a.? Can also cause? (Two)
Wallenberg syndrome
AKA: lateral medullary syndrome
Can also cause: ataxic gait and nystagmus
_ _ can cause miosis, ptosis, and increased sweating.
Horner’s syndrome
_ _ for strokes includes: improving cerebral profusion (increase O2 & blood thinning meds), BP management, neurosurgical management, and prevention of secondary impairments (dVT’s, pressure ulcers, contractures).
Medical management for stroke
Common prescription for: thrombus? Hypertension? Cholesterol?
Thrombus – Coumadin or tPA
Hypertension – Procardia
Cholesterol – Lipitor
Common prescription for seizures? Spasticity?
Seizures – Dilantin
Spasticity – baclofen
Common prescriptions for pain? Insomnia? Depression?
Pain – Vicodin
Insomnia – Ambien
Depression – Paxil
Standard descriptive terminology for levels of consciousness? (Five) – in increasing order of severity
Normal
Lethargic
Obtundation
Stupor
Coma
_ is described as drowsy and able to respond briefly._Is described as difficult to arouse and confused.
Lethargic – drowsy and able to respond briefly
Obtundation- difficult to arouse and confused
_ as described as unresponsive but can be awakened by intense stimuli._Is just unresponsive
Stupor – unresponsive but can be awakened by intense stimuli
Coma – unresponsive
What three parameters are included in the Glasgow coma scale? Three Ranges?
Parameters: eye-opening, best motor response, and verbal response
Ranges:
13–15 = mild, 9–12 = moderate, less than or equal to 8 = severe
Three types of neuromotor disorders associated with communication and swallowing problems?
DVD
Dysarthria, verbal apraxia, dysphagia
Three types of aphasia associated with communication and swallowing problems?
GWB
Global aphasia, Wernicke’s aphasia, Broca’s aphasia
Broca’s aphasia is aka?(2) Wernicke’s aphasia is aka? (2)
Broca’s- Nonfluent or expressive aphasia
Wernicke’s- fluent or receptive aphasia
_ involves an impaired motor – speech system._ does not impair speech muscles.
Dysarthria – impaired motor – speech system
Verbal apraxia – non-impaired speech muscles
_ is defined as impaired swallowing
Dysphagia
