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Path II > Path II final Vascular diseases > Flashcards

Path II final Vascular diseases Flashcards

1
Q

Brain receives what percent of cardiac output and oxygen in body?

A

15% CO

20% O2

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2
Q

Cerebrovascular Disease Classification

A

1) Parenchymal Diseases
2) Infarcts due to local vascular obstruction
3) Hemorrhages within the brain parenchyma of subarachnoid space

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3
Q

parenchymal injuries

A

One of three major types of Cerebrovascular Disease (5% of them)

Associated with GENERALIZED REDUCTION IN BLOOD FLOW

Example: Global Hypoxic-Ischemic Encephalopathy

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4
Q

infarcts due to local vascular obstruction

A

One of three major types of Cerebrovascular Disease (80%)

AKA Stroke (Ischemic Stroke)

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5
Q

Hemorrhages within the Brain Parenchyma

A

One of three major types of Cerebrovascular Disease (15% of CVD)

AKA Stroke (Hemorrhagic Stroke)

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6
Q

CVD stroke

A

AKA Ischemic Stroke

Due to LONG TERM hypertension ->Hyaline Arteriosclerosis (causes obstruction of vessels less than 300 microns)

Blood can’t flow to tissue so it undergoes ischemia

People have neurological deficits due to lack of blood flow

IRREVERSIBLE

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7
Q

cause of ischemic stroke?

A

LONG TERM hypertension which leads to Hyaline Arteriosclerosis

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8
Q

What type of sclerosis is associated with Ischemic Stroke?

A

hyaline arteriosclerosis

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9
Q

is ischemic stroke damage reversible?

A

No; irreversible

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10
Q

what is the general cause of a stroke?

A

atherosclerosis

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11
Q

Mechanism of a stroke

A

Atherosclerosis->platelet activation-> thrombi formation

thrombi can obstruct blood vessels and the brain

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12
Q

what is the most common location of thrombi formation?

A

bifurcation of the common carotid artery and Birfurcation of the internal carotid artery

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13
Q

what artery is the most common location of an ischemic stroke?

A

middle cerebral artery

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14
Q

what test do you perform to identify ischemic stroke?

A

geroge’s test

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15
Q

most common cause of ischemic stroke?

A

thrombosis!!

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16
Q

stroke in internal carotid requires what?

A

operation

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17
Q

Lacunar Area

A

Found in the mid-brain

Full necrosis and atrophy occurs here if there is a lack of blood flow

Most common infarction is associated with atherosclerosis (Followed by platelet formation and thrombosis leading to complete obstruction of blood flow)

Can also occur with a thrombi-embolism

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18
Q

Where is the Lacunar Area?

A

In the mid-brain

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19
Q

source of thrombosis/emboli

A

The HEART

1) Mitral Stenosis (reduced BF)
2) Artificial Valves

20
Q

mitral stenosis and thrombosis/emboli

A

Mitral Stenosis causes reduced blood flow

Thrombi are loose and can go into circulation -> Brain

Example: Bacterial Endocarditis can lead to ischemic hemorrhagic stroke (mechanical obstruction of the lumen -> Bacteria released into the parenchyme)

21
Q

bacterial endocarditis and thrombosis/emboli

A

Bacterial Endocarditis can lead to ischemic hemorrhagic stroke (mechanical obstruction of the lumen -> Bacteria released into the parenchyme)

22
Q

Artificial Valves and thrombosis/emboli

A

Artificial valves used when there is valvular insufficiency

Can promote thrombosis that can go into circulation (Thrombocytes develop)

Must take anti-coagulants for rest of life

23
Q

Hemorrhagic stroke is ___% of Cerebrovascular disease

A

15%

24
Q

Hemorrhagic stroke: 2 types

A

1) Intercerebral/Parenchymal

2) Subarachnoid Hemorrhagic Stroke

25
Q

Intercerebral/Parenchymal Stroke

A

A type of Hemorrhagic Stroke

Due to LONG TERM hypertension

Deposition of hyaline-like substances in the vascular wall -> Increased pressure causes rupture of these vessels and leakage into the brain

Vascular cell is more brittle from hypertension -> Rupture of the vessel wall

Brain is soft/gel-like and easily damaged

Blood can cause atrophy of the tissues and acts like a toxin to the tissues it contacts

26
Q

Intercerebral/Parenchymal Stroke is due to what?

A

LONG TERM hypertension

Vessels become brittle and rupture, leaking blood into the brain

27
Q

Problems with High Blood Pressure and Hemorrhagic Stroke

A

Causes rupture of hyalinized blood vessels

Sudden increase in BP causes rupture

Mechanical damage leads to degradation of the artery

Brain tissue is soft and like gel -> Blood causes atrophy of the tissue (like a toxin) when in contact with brain outside of vessel

28
Q

Usually happens in people under 50

A

subarachnoid Hemorrhagic stroke

29
Q

occurs around the brain, not in it

A

subarachnoid Hemorrhagic stroke

30
Q

Usually occurs when aneurysms that are at the bifurcation rupture

A

subarachnoid Hemorrhagic stroke

31
Q

Rupture of the blood vessels of the subsrachnoid space (Generally cerebral arteries that are part of the Circle of Willis)

A

subarachnoid Hemorrhagic stroke

32
Q

What vessels are typically involved in Subarachnoid Hemorrhagic Stroke?

A

Cerebral Arteries that are part of the Circle of Willis

33
Q

2main types of aneurysms

A

1) Beri (Sacular; less than 1cm diameter)

2) Giant (Up to 5cm diameter)

34
Q

Size of Beri Aneurysm

A

4-7mm diameter

No more than 1cm diameter

35
Q

death of beri aneurysm

A

People die at age 48-50

36
Q

signs/symptoms of beri Aneurysm

A

Vague signs and symptoms that usually only appear when rupture develops

37
Q

Giant aneurysm size

A

Can be up to 5cm (pin-pong ball)

38
Q

Manifestation of giant cell aneurysm

A

similar to brain tumor

headache, nausea, vomiting, papilledema

39
Q

What resolves a TIA?

A

Fibrinolytic activity of blood

40
Q

How long does it take a TIA to resolve?

A

They resolve within 24 hours

41
Q

Manifestations of TIA

A

1) Amaurosis Fugax (Unilateral vision loss)

42
Q

Amourosis fugax

A

Occurs with TIA

Painless, temporary unilateral loss of vision

Due to temporary thrombosis of the Opthalmic Artery

Causes ischemia to retina

Emboli can obstruct blood flow (most commonly due to an emboli from a stenosed carotid artery)

Vision loss lasts for the period of time that the clot obstructs the flow

43
Q

Has similar symptoms to Amaurosis Fugax

A

temporal arteritis

44
Q

Most common sources of emboli in Amaurosis Fugax

A

Plaque or clot from stenosed carotid artery

Other sources are heart or heart valves and arterial spasms

45
Q

How long does vision lost las with Amaurosis Fugax?

A

Only for as long as the obstruction prevents blood flow

46
Q

how to handle a TIA

A

Sit down and call 911

Give anti-coagulants which can prevent future TIA’s

Path II (21 decks)

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