Stroke Flashcards
What makes you able to still try to perfuse to the brain if something is blocked
Circle of Willis
Circulation is all connected
What does stroke deal with
Perfusion
How much of cardiac output is needed to go to the brain for optimal functioning
20%
What happens if there is increased blood flow, swelling, etc and it squeezes out at brainstem
Often results in death
What is a major cause of strokes
Atherosclerosis
Hardening and thickening of arteries
If an artery is described as having laminar flow, we know that is
Good, no blockages or swelling of arteries
Turbulent flow is bad
Where is a major spot for clots
Middle cerebral artery (branches off near circle of Lewis)
Cerebrovascular disease ranks ____ as a cause of death in USA and ____ cause of permanent disability in the USA
3rd
1st
Definition of stroke
Brain injury caused by sudden disruption of blood flow to the brain
Modifiable risk factors for stroke
Smoking Diabetic Hyperlipidemia Hypertension Heart disease Obesity
Non modifiable risk factors for strokes
Age (doubles for every decade over 65)
Race (African Americans > whites)
Possibly heredity
Time lost =
Brain lost
What does F A S T stand for in trying to detect a stroke
F- face (symmetric)
A- arm (strength and movement)
S- speech (patterns and understanding)
T- time (= brain; call squad, do not drive)
TIA (transient ischemic attack) is a mini or silent stroke. What is it caused by
Temporary interruption in blood supply to the brain
Amaurosis is
Temporary blindness of one eye (related to a stroke)
How quickly will one recover from a TIA
24 hours
Approximately ____ of all strokes are preceded by a TIA
1/3
What are the two types of strokes
Ischemic (most common)
Hemorrhage (spontaneous bleeding in brain)
What are the two types of ischemic strokes
Thrombotic
Embolic ( always starts from heart)
Why is someone with a fib. At risk for a stroke
Your heart beats so fast and doesn’t pump out much of the blood. It forms a pool in your atrium and clots form. If a clot then gets pumped out it could cause an Embolic stroke
What should you know about a CAT scan with a stroke pt
Should be done within 30 minutes of arriving
Do not use contrast
Thrombotic stroke
Blood clot forms in artery of brain and obstructs blood flow
Symptoms progress in first 72 hours as damage increases
Embolic strokes
Blood clot travels to brain
Most often associated with cardiac disorders
Onset is sudden
Where is the most common site for emboli to lodge
Middle cerebral artery
Hemorrhagic stroke
Intracerebral hemorrhage
Occurs when a blood vessel in or around brain ruptures (rupture of an aneurysm)
Hemorrhagic stroke
Subarachnoid hemorrhage
Bleeding in brain fills the cerebrospinal fluid-filled space on the surface of the brain (rupture of an aneurysm)
“Worst headache of my life”
What are two signs that determine you may be having a hemorrhagic stroke
Vomiting w/o being nauseous
Can’t touch chin to neck
What is the primary diagnostic test for strokes
CT
Cerebral angiogram/ arterial gram
Shows blood flow through arteries
You can see where clot is or where blood is leaking
Change in anything neuro tells change in
Perfusion
Ipselsteral
Occurring on same side
Contra lateral
Opposite side sees the symptoms
Clinical manifestations of a stroke
Motor function
Mobility
Respiratory function
Swallow and speech
Gag reflux problem
Left brain damage will be seen on
Right side of body
Aphasia
Loss of the power of expression
Expressive aphasia
Difficulty speaking or writing
Broca’s area affected (motor speech)
Receptive aphasia
Difficulty in understanding written or spoken language
Wernicke’s area affected
Dysarthria
Disturbance of the muscular control of speech
Broca’s area and wernicke’s area is on the ____ side of the body
Left
Clinical manifestations of a stroke
Affect
Difficulty controlling emotions
Depression
Loss/change in body image
Inappropriate responses
If stroke on left side they know what is going on. Stroke on right side
Neglect of whole side
Spatial-perceptual alterations of a stroke
Incorrect perception of self or illness
Homonymous hemianopsia
Agnosia( inability to recognize objects)
Homonymous hemianopsia
Blindness occurs in same half of the visual fields of both eyes
Elimination can be affected by strokes
Increased incontinence
Increased constipation d/t decreased sensation
Hemiparesis
Weakness of one side
Numb/ tingling feeling
Hemiplegia
Paralysis on one side of body
Ataxia
Failure of muscular coordination
Alexia
Reading problems
Agraphia
Writing problems
Agnosia
Difficulty using an object correctly
Dysphagia
Difficulty swallowing
Hypotonia
Flaccidity
Hypertonia
Spasticity
If your pt has a speech problem assume
They have a swallowing problem
NPO
Right brain damage causes
Left side paralyzed Quick, impulsive behavior Memory deficits: performance Neglect of left side of body Impaired sense of humor and judgement Loss of depth perception
Left side brain damage causes
Paralyzed right side Slow, cautious behavior Memory deficit: language Distress and depression about disability Easily frustrated Aphasia, reading problem Difficulty writing
