Stroke Flashcards by Bailey Pontius

What makes you able to still try to perfuse to the brain if something is blocked

Circle of Willis

Circulation is all connected

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What does stroke deal with

Perfusion

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How much of cardiac output is needed to go to the brain for optimal functioning

20%

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What happens if there is increased blood flow, swelling, etc and it squeezes out at brainstem

Often results in death

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What is a major cause of strokes

Atherosclerosis

Hardening and thickening of arteries

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If an artery is described as having laminar flow, we know that is

Good, no blockages or swelling of arteries

Turbulent flow is bad

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Where is a major spot for clots

Middle cerebral artery (branches off near circle of Lewis)

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Cerebrovascular disease ranks ____ as a cause of death in USA and ____ cause of permanent disability in the USA

3rd

1st

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Definition of stroke

Brain injury caused by sudden disruption of blood flow to the brain

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Modifiable risk factors for stroke

Smoking
Diabetic
Hyperlipidemia 
Hypertension 
Heart disease 
Obesity

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Non modifiable risk factors for strokes

Age (doubles for every decade over 65)
Race (African Americans > whites)
Possibly heredity

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Time lost =

Brain lost

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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)

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TIA (transient ischemic attack) is a mini or silent stroke. What is it caused by

Temporary interruption in blood supply to the brain

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Amaurosis is

Temporary blindness of one eye (related to a stroke)

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How quickly will one recover from a TIA

24 hours

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Approximately ____ of all strokes are preceded by a TIA

1/3

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What are the two types of strokes

Ischemic (most common)

Hemorrhage (spontaneous bleeding in brain)

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What are the two types of ischemic strokes

Thrombotic

Embolic ( always starts from heart)

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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

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What should you know about a CAT scan with a stroke pt

Should be done within 30 minutes of arriving

Do not use contrast

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Thrombotic stroke

Blood clot forms in artery of brain and obstructs blood flow

Symptoms progress in first 72 hours as damage increases

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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

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 ```