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Patho > neuro pt 1 > Flashcards

neuro pt 1 Flashcards

1
Q

types of brain insults

A

ischemia insults, acute insults, increased ICP, degenerative disorders

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2
Q

global ischemia

A

when blood flow cant meet metabolic demands, ischemia of the entire brain

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3
Q

focal ischemia

A

ischemia to one focal or specific portion of the brain

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4
Q

categories of strokes

A

ischemic or hemmorrhagic

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5
Q

categories of ischemic strokes

A

thrombolytic (disease), embolic (clots), or hypoxic (events)

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6
Q

thrombolytic strokes

A

most common, local action, build up of plaque, clot stays in one place, atherosclerosis

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7
Q

embolic strokes

A

clot originates somewhere in the body and travels to the brain, can be secondary to thrombotic

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8
Q

causes of ischemic strokes

A

atherosclerotic/cerebrovascular disease
cardiogenic source- A fib

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9
Q

artherolsclerosis

A

large vessel disease
build up of fats, cholesterol, and other substances in artery
20% of ischemic strokes
middle cerebral artery occlusion-most commone
anterior cerebral artery occlusion- least common

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10
Q

cerebral “small vessel disease”

A

-25% of ischemic strokes
-small and deep
-closely linked to hypertension
-leading cause of loss of function, disability, age-related congitive decline related to dementia, strokes, motor movement issues

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11
Q

clot embolism

A

embolism breaks off at or near side of a thrombus and travels to brain

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12
Q

TIA

A

short lived form of brain ischemia
-symptoms caused by cellular hypoxia without cellullar death
-warning sign
-15% of people expereince a full stroke within 3 months of TIA

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13
Q

cardiogenic source of stroke

A

20% of ischemic strokes
a fib
MI
endocarditis

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14
Q

unusual/unknown causes

A

35% of strokes
vasospasm after subarachnoid hemmorrhage
-cerebral vasoconstriction syndromes
-air or fat embolisms
-amniotic fluid following childbirth
tumors

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15
Q

ischemic penumbra

A

zone of reversible ischemia around core of irreversible infarction
salvageable in first few hours after ischemic stroke infarct

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16
Q

hemorrhagic strokes

A

burst blood vessel may allow blood to seep into and damage brain tissues unti clotting shuts off the leak

17
Q

process of brain hemorrhage

A
  1. rupture pf blood vessel
  2. bleeding goes into brain
  3. creates a focal hematoma that may get larger
  4. brain swells
  5. brain matter gets compressed
  6. coma/death
18
Q

symptoms of hemorrhagic strokes

A

-person feels a thunderclap headache
-contralateral hemiplegia
-leads to spasticity
-loss consciousness
-increased ICP
-coma/posturing/death

19
Q

causes & risk factors for hemorrhagic strokes

A

-unctrolled HTN
-anticoagulation therapy
-cerebral aneurysms
-arteriovenous malformations
-head trauma (open or closed)
-age (over 40)
-morbid obesity
-smoking/excessive alcohol
-drugs that spike BP (cocaine)
-more common among women
-post-orgasm hemorrhage

20
Q

types of hemorrhagic strokes

A

intracerebral hemorrhage
subarachnoid hemorrhage

21
Q

intracerebral hemorrhage- ICH

A

-from deep penetrating vessels
-causes injury to brain tissue by disrupting connecting pathways and causing localized pressure injury
-fast bleeding withint brain tissue itself
-life threatening
-most commonly caused by uncontrolled hypotension

22
Q

subarachnoid hemorrhage-SAH

A

intracranial bleeding into arachnoid and pia mater membranes on surface of brain tissue
-ruptured vessel-slow
-thunderclap headache
-bleeding into subarachnoid space
-slower process than ICH
-usually related to aneurysm
-often found in anterior circulation near circle of willis

23
Q

ICH process

A
  1. rupture vessel cause bleeding-hematoma
  2. brain tissue injury distal to the bleed from lack of O2 and ATP
  3. Spasm of adjacent vessels
  4. increases ICP from the hematoma
  5. as the brain swells it gets compressed by the skull
  6. loss of consciousness
  7. coma
  8. brain herniation
  9. left untreated-death
24
Q

brainstem stroke

A

very dangerous CVA
-controls vital functions
-HR/function
-lungs-rate/function
-swallowing
-eye movement
-facial movement & sensation
-hearing

25
Q

cerebellum strokes

A

psoterior circulation
-less common than right/left hemisphere (2-3%)
-ipsilateral motor symptoms
-problems with balance and coordination
-dizziness or vertigo
-nausea & vomitting
-cognitive and mood symptoms
-can have contralateral manifestations
-can cause brainstem compression

26
Q

warning signs

A

sudden numbness or weakness of face, arms, legs, especially one sided
-sudden confusion, troublr speaking, or understanding
-sudden troublr seeing in one or both eyes
-sudden trouble walking, loss of balance
-severe headache with no known cause
BEFAST

27
Q

Types of aphasia

A

wernickes
brocas
global
primary progressive

28
Q

wernickes

A

fluent aphasia- person speaks full long sentences that make NO sense (word salad)
-reading and writing severely impaired

29
Q

brocas

A

nonfluent aphasia- person can understand language but has difficulty getting own words out
-talk in short labored patterns
-may be able to read & write
-aka expressive aphasia

30
Q

global aphasia

A

most severe
-produce very few recognizeable words and understand little to no language
-cant read or write

31
Q

primary progressive

A

neurodivergent disorder causing slow progressive form of aphasia that worsens over time

32
Q

Ischemic Stroke Treatment

A

restore perfusion
-tissue plasminogen activator (t-PA)
-surgical intervention (thrombectomy)
-prevent secondary injury and further strokes
-supportive measures

33
Q

Hemorrhagic Stroke Treatment

A

stop/control bleeding
-removal of hematoma
surgical intervention (carniotomy, brain drains postop
-burr holes
-BP control
-manage ICP

34
Q

t-PA

A

dissolves blood clots and restores blood flow

35
Q

window of opportunity

A

4.5 hours for optimal outcomes from tPA

Patho (5 decks)

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