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Cardiovascular system > Stroke > Flashcards

Stroke Flashcards

1
Q

what are the major risk factors for stroke include

A 
high blood pressure
diabetes
heart disease
smoking
age
gender
race
ethnicity
personal history of strokes
family history of strokes
TIA
brain aneurysms
arteriovenous malformations
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2
Q

what are other risk factors for stroke include

A 
alcohol use
illegal drug use
certain medical conditions
lack of physical activity
overweight
obesity
stress
depression
unhealthy cholesterol levels
unhealthy diet
use of NSAIDS
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3
Q

what else can lower the risk of stroke

A

following a heart healthy lifestyle and taking medication

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4
Q

what is the main risk factor for strokes

A

high blood pressure

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5
Q

state 4 acute treatments for stoke

A

stroke unit
thrombolysis
aspirin
hemicraniectomy

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6
Q

state a treatment for ischaemic stroke

A

tissue plasminoegn activator given intravenously in the arm

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7
Q

what is the primary prevention of stroke

A

it is a reference to the treatment of individuals with no history of stroke

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8
Q

what is the secondary prevention of stroke

A

it is a reference to the treatment of individuals who have already had a stroke or transient ischaemic attack

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9
Q

what heart diseases are major risk factors for stroke

A

coronary heart disease
cardiomyopathy
heart failure
atrial fibrillation

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10
Q

how can atrial fibrillation be a risk factor for a stroke

A

atrial fibrillation can cause blood clots that can lead to a stroke

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11
Q

how can smoking be a risk factor for a stroke

A

smoking can damage blood vessels and raise blood pressure

smoking may reduce the amount of oxygen that reaches your body’s tissues

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12
Q

how can age be a risk factor for stroke

A

your risk of stroke increases as you get older

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13
Q

how can gender be a risk factor for stroke

A

woman are more likely to die from strokes,

also woman who take birth control pills are at slightly higher risk of stroke

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14
Q

how can race be a risk factor for stroke

A

strokes occur more often in african american, alaskan native, and american indian adults than in white, hispanic, or asian american adults

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15
Q

what are brain aneurysms?

A

aneurysms are balloon-like bulges in an artery that can stretch and burst

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16
Q

what are arteriovenous malformations

A

these are tangles of faulty arteries and veins that can rupture within the brain

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17
Q

when are arteriovenous malformations present

A

these may be present at birth, but are often not diagnosed until they rupture

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18
Q

how much does stroke cost the UK each year?

A

over 5 billion

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19
Q

what are symptoms of stroke

A 
loss of power
loss of sensation
loss of speech
loss of vision
loss of coordination
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20
Q

if stroke is at the back of the brain what is the common clinical feature present

A

the loss of coordination

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21
Q

describe stroke symptoms

A 
unable to speak in proper sentences
weak muscles in their mouth and their face
speech can become slurred
loss of vision
vision can be lost just in one eye
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22
Q

what is aphasia?

A

it relates to production of speech

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23
Q

what is a question that needs to be asked in relation to vision?

A

can you move your eyes across the midline?

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24
Q

what is a stroke

A

it is damage to part of the brain due to blockage of a blood vessel by thrombus or embolus

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25
Q

what is a stroke also due to

A

haemorrhage from rupture of a blood vessel

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26
Q

when does an ischaemic stroke occur?

A

it occurs as a result of an obstruction within a blood vessel supplying blood to the brain

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27
Q

what percentage of ischaemic strokes account for all strokes

A

87%

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28
Q

what are the vertebral arteries

A

they are the major arteries of the neck

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29
Q

what do the vertebral arteries typically originate from

A

the subclavian arteries

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30
Q

what is the role of the vertebral arteries

A

they provide the blood supply to the upper spinal cord, brainstem, cerebellum, and posterior part of the brain

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31
Q

what is the role of the internal carotid artery

A

it supplies the brain, eye and other internal parts

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32
Q

what is the role of the external carotid artery

A

it supplies the neck, face and other external parts

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33
Q

what does the carotid system suuply

A

it supplies most of the hemispheres and cortical deep white matter

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34
Q

what does the vertebrobasilar system supply

A

it supplies the brain stem, cerebellum and occipital lobes

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35
Q

what is the cortex of the brain?

A

it is the outer layer of the cerebrum, it is composed of folded grey matter and plays an important role in consciousness

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36
Q

what is a cortical homunculus

A

it is a distorted representation of the human body, based on a neurological map of the areas and proportions of the human brain dedicated to processing motor functions, or sensory functions, for different parts of the body

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37
Q

what causes an ischaemic stroke

A

a blocked artery

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38
Q

what are the causes of a haemorrhage stroke

A

leaking or bursting of a blood vessel

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39
Q

what are the causes of a transient ischaemic stroke

A

temporary disruption of blood flow to the brain

doesn’t cause permanent damage

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40
Q

what are the causes of stroke

A

blockage of a vessel with thrombus or clot
disease of vessel wall
disturbance of normal properties of blood
rupture of vessel wall

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41
Q

describe a haemorrhage stroke

A

haemorrhage

blood leaks into brain tissue

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42
Q

describe ischaemic stroke

A

clot stops blood supply to an area of the brain

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43
Q

what is carotid stenosis

A

it is narrowing of the carotid arteries

44
Q

what are the carotid arteries

A

they are the 2 major arteries that carry oxygen-rich blood from the heart to the brain

45
Q

what is carotid stenosis caused by

A

a build-up of plaque inside the artery wall that reduces blood flow to the brain

46
Q

what else can cause carotid stenosis

A

an atheroma

i.e. carotid stenosis can be caused by a condition atherosclerosis

47
Q

what is carotid stenosis also called

A

carotid artery disease

48
Q

what is carotid stenosis most often caused by

A

atherosclerosis

49
Q

when does a cardioembolic stroke occur

A

when the heart pumps unwanted materials into the brain circulation

50
Q

what does a cardioembolic stroke result in

A

the occlusion of a brain blood vessel and damage to the brain tissue

51
Q

what is a lacunar stroke

A

it is a type of ischaemic stroke

52
Q

when does a lacunar stroke occur

A

it occurs when blood flow to one of the small arteries deep within the brain becomes blocked

53
Q

what are rarer causes of stroke

A

carotid dissection: idiopathic or trauma

54
Q

what is carotid dissection

A

it is a breakdown of the layers of the carotid artery that causes the wall to tear

55
Q

what does a tear in the wall from carotid dissection may cause

A

stenosis and occlusion

56
Q

what is meant my an occlusion

A

it is a flap of the vessel wall protruding into the opening

57
Q

what part of the brain is affected by a stroke

A 
the left or the right
carotid territory
vertebrobasilar territory
cerebral hemispheres
brainstem
cortex
deep white matter
58
Q

what can you tell from the symptoms and signs observed of a stroke

A 
what side of the brain is affected
whether the lesion is in the brainstem
whether the cortex is involved
if the lesion is in the deep white matter
what blood vessel is involved
59
Q

why should localisation of a stroke be bothered with

A

it confirms the diagnosis of stroke
allows better selection of imaging
it gives an indication of cause
it gives an indication of prognosis

60
Q

what are 4 subtypes of stroke

A

total anterior circulation stroke
partial anterior circulation stroke
lacunar stoke
posterior circulation stroke

61
Q

what is a visual field defect

A

is is a loss of part of the usual field of vision

62
Q

what does a visual field defect not include

A

severe visual impairment of either one eye or both

63
Q

what is a unilateral field loss the result of

A

an optic nerve lesion anterior to the optic chiasm

64
Q

what is bitemporal hemianopia

A

it is the medical description of a type of partial blindness where vision is missing in outer half of both the right and left visual field

65
Q

what is homonymous hemianopia

A

it is the loss of half of the field of view on the same side in both eyes

66
Q

when does homonymous hemianopia occur

A

it occurs frequently in stroke and traumatic brain injuries due to the way part of the optic nerve fibres from each eye crossover as they pass to the back of the brain

67
Q

what is total anterior circulation stroke syndrome

A

it refers to the symptoms of a patient who clinically appears to have suffered from a total anterior circulation infarct, but who has not yet had any diagnostic imaging to confirm the diagnosis

68
Q

what is partial anterior circulation stroke syndrome

A

it refers to the symptoms of a patient who clinically appears to have suffered from a partial anterior circulation infarct

69
Q

what percentage of strokes are total anterior circulation strokes?

A

20%

70
Q

what are things to remember with regards to stroke

A

the symptoms come on rapidly

and the symptoms depend on which part of the brain is affected

71
Q

what are modifiable risk factors for stroke

A

high blood pressure

atrial fibrillation

72
Q

what are non-modifiable risk factors for stroke

A

age
race
family history

73
Q

state investigations of stroke

A 
blood tests
ECG
CT
MRI
carotid doppler
ECHO
74
Q

what is thrombolysis

A

it is the dissolution of a blood clot, especially as induced artificially by infusion of an enzyme into the blood

75
Q

what are contraindications to thrombolysis

A

age

76
Q

what is stroke thrombolysis

A

it is if your stroke is caused by a blood clot

77
Q

what is carotid endarterectomy

A

it is a surgical procedure used to reduce the risk of stroke by correcting stenosis in the common carotid artery or internal carotid artery

78
Q

what can cause the formation of a blood clot in the artery

A

rupture of the plaque

79
Q

what is aspiration pneumonia a complication of

A

pulmonary aspiration

80
Q

what is pulmonary aspiration

A

it is when you inhale food, stomach acid, or saliva into your lungs

81
Q

what is the penumbra?

A

it is the area surrounding an ischaemic event such as thrombotic or embolic stroke

82
Q

what is thrombolysis

A

it is the dissolution of a blood clot, especially as induced artificially by infusion of an enzyme into the blood

83
Q

what is collateral circulation?

A

it is the circulation of blood established through enlargement of minor vessels and anastomosis of vessels with those of adjacent parts when a major vein or artery is functionally impaired

84
Q

basically describe collateral circulation

A

it is the circulation that occurs through the modified vessels

85
Q

what is infarction

A

it is obstruction of the blood supply to an organ or region of tissue, typically by a thrombus or embolus, causing local death of the tissue

86
Q

what is a thrombus

A

it is a blood clot formed in situ within the vascular system of the body and impedes blood flow

87
Q

what is a CT angiogram

A

it is a test that uses X-rays to provide detailed pictures of the heart and the blood vessels that go to the heart, lung, brain, kidneys, head, neck, legs and arms

88
Q

what are risks of thrombolysis include

A

brushing or bleeding at the access site
damage to the blood vessel
migration of the blood clot to another part of vascular system
kidney damage in patients with diabetes or other pre-existing kidney disease

89
Q

what is a haemorrhage

A

it is an escape of blood from a ruptured blood vessel

90
Q

what does haemorrhage depend on?

A

the size of the stroke

91
Q

what is clot retrieval

A

it is surgical treatment for acute stroke that involves the mechanical removal of a blood clot from a patient’s brain

92
Q

when is clot retrieval offered?

A

as a treatment for patients who have experienced a stroke as the result of narrowing of the arteries in their brain

93
Q

what does the hyper dense MCA sign refers to?

A

focal increased density of the middle cerebral artery on CT and is a direct visualisation of thromboembolic material within the lumen

94
Q

what is the middle cerebral artery

A

it is by far the largest cerebral artery and is the vessel most commonly affected by cerebrovascular accident

95
Q

what is the stroke described as if it is caused by a blood clot

A

ischaemic stroke

96
Q

how may an ischaemic stroke be treated

A

a clot-bursting drug to try and disperse the clot and return the blood supply to your brain

e.g.
plasminogen activator
or
alteplase

97
Q

what does hemicraniotomy refer to

A

the surgical removal of hand of the cranium to enable brain surgery

98
Q

how is an ischaemic stroke treated

A

tissue plasminogen activator

this is given intravenously in the arm

99
Q

how does tissue plasminogen activator work

A

by dissolving the clot and improving blood flow to the part of the brain being deprived of blood flow

100
Q

what is secondary prevention of stroke aimed at?

A

reducing the risk of recurrence after a first stroke or transient ischaemic attack

101
Q

what is a transient ischaemic attack?

A

it is a brief episode of neurological dysfunction resulting from an interruption in the blood supply to the brain or the eye

102
Q

what is sometimes a precursor of a stroke?

A

a transient ischaemic attack

103
Q

what can a transient ischaemic attack be classed as?

A

a mini stroke

104
Q

what is a transient ischaemic attack caused by

A

a temporary disruption in the blood supply to part of the brain, resulting in a lack of oxygen to the brain

105
Q

what can a transient ischaemic attach cause

A

sudden symptoms similar to stroke

106
Q

what is carotid endarterectomy

A

it is a surgical procedure used to reduce the risk of stroke by correcting stenosis in the common carotid artery or internal carotid artery

Cardiovascular system (34 decks)

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