STORKES Flashcards
Two types of strokes
Ischemic
Hemorrhagic
FAST mnemonic
Facial drooping
Arm weakness
Speech difficulties
Time to call emergencies
Thrombotic stroke
A thrombotic stroke is a blood clot that forms inside an artery that supplies blood to the brain. The clot interrupts blood flow and causes stroke. (blockage)
Embolic stroke
An embolus is a blood clot or other debris circulating in the blood. When it reaches an artery in the brain that is too narrow to pass through, it lodges there and blocks the flow of blood.
TIA (brief period of lose of oxygen)
Transient= brief, temporary, fleeting
Ischemic= lacking blood supply
Attack= episode, event
What is TIA
A mini-stroke, a warning sign that a stroke can occur at any time (treat as a medical emergency)
-Blood flow to the brain is blocked for a short period of time
-Symptoms of a TIA reside with no permanent damage (1/3 of people that have TA usually don’t get a stroke)
Ischemic stroke pathophysiology
Blockage of cerebral vessel which reduces blood supply and causes cell death
Ischemic stroke cause
Thrombotic
Embolic (cause: Atrial fibrillation)
Ischemic stroke risk factors
Non-modifiable: Race, gender, age, heredity
Modifiable: HTN, cardiac diagnosis, diabetes, smoking, high fat diet, high cholesterol, drug abuse, oral contraceptives, alcohol use, lack of daily exercise.
Hemorrhagic stroke pathophysiology
Bleeding in the brain that decreases blood flow and increases pressure on the brain tissue
Hemorrhagic stroke cause
Non-traumatic subarachnoid (hemorrhage on the outside or surface of brain)
Intracerebral (Bust/bleeding in actual brain tissue)
Intraventricular (starts filling blank spaces)
Hemorrhagic stroke risk factors
Modifiable: Smoking, hypertension, drug use
Non-modifiable: Age, gender, race
Stroke clinical manifestations (usually same for both)
Right brain damage
Left brain damage
Basilar
Neuromotor function
Communication: more common in L-sided stroke
-Receptive aphasia
-Expressive aphasia (know what you are talking about but can’t form the words to tell)
-Dysarthria (Sounds like they are talking with mouth full)
Affect: unable to control emotions
Memory changes; judgment changes, bowel and bladder problems
Spatial-perceptual alterations: more common in R-sided stroke
Right side brain damage (left side of body affected)
Short attention span
Impulsive
Deny problems (huge fall risk)
Left side brain damage (right side of body affected)
Dysphagia- language center is on the L side of brain
Slow performance
Aware of deficits
Impaired comprehension (understanding instructions)
Basilar ( A type of posterior stroke, which means it affects circulation at the back of the brain)
Dizziness
Ataxia (lack of coordination)
Tinnutus
Nausea/vomiting
Articulation of speech
Swallowing
Motor function (clinical manifestation)
Most obvious effect of stroke (first thing patient notices) (some weakness)
Include impairment of:
-Mobility
-Flaccidity (They aren’t moving anything on affected side) (happens first)
-Spacity (Stiffness of muscle)
-Respiratory function (make sure to assess ABCs)
-Swallowing and speech
-Gag reflex
-Self-care abilities
Communication (clinical manifestation)
Dysphasia refers to impaired ability to communicate
Used interchangeably with aphasia
-Nonfluent
-Minimal speech activity with slow speech
-Fluent
-Speech is present but contains little meaningful communication
Affect (mood) (clinical manifestation)
-Patients who suffer a stroke may have difficulty controlling their emotions
-Emotional responses may be exaggerated or unpredictable
-May be magnified by depression, changes in body image, and
loss of function
Intellectual function (clinical manifestation)
-Both memory and judgment may be impaired as a result of stroke
-Although impairments can occur with strokes affecting either side of the brain, some deficits are related to hemisphere in which the stroke occurred (some impairments are relative to the side)
Spatial-perceptual alterations (clinical manifestation)
-Stroke on the right side of the brain is more likely to cause problems in spatial-perceptual orientation
-Incorrect perception of self and illness (deny that they had stroke)
-Unilateral neglect (neglects all input from unaffected side, vision disturbance)
-Agnosia (inability to recognize object based on sight, touching, and feeling)
-Apraxia (Inability to carry out and learn sequential commands)
Spatial-perceptual alterations (clinical manifestation)
-Stroke on the right side of the brain is more likely to cause problems in spatial-perceptual orientation
-Incorrect perception of self and illness (deny that they had stroke)
-Unilateral neglect (neglects all input from unaffected side, vision disturbance)
-Agnosia (inability to recognize object based on sight, touching, and feeling)
-Apraxia (Inability to carry out and learn sequential commands)
Elimination (clinical manifestations) (hopefully temporary issue)
-Most problems with urinary and bowel elimination occur initially and are temporary (Can also occur from dehydration because they aren’t being fed)
-When a stroke affects one hemisphere of the brain, the prognosis for normal bladder function is excellent
Diagnostic studies
CT scan (This shows what type of stroke it is) (do not delay a CT scan for a stroke patient for anything)
MRI
Carotid doppler or U/S
Echo
Labs
-Hypercoagulable labs (Blood clots more easily)
-Cholesterol
-Platelets (too many platelets)
