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Adult Neuro One > stroke pt 1 > Flashcards

stroke pt 1 Flashcards

1
Q

how long does it take for brain cells to die?

A

3-5 minutes

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2
Q

what are the 2 kinds of strokes? which is more common?

A

1 - ischemic* more common
2 - hemorrhagic

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3
Q

ischemic stroke

A

sudden interruption of blood flow to the brain

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4
Q

hemorrhagic stroke

A

bursting of blood vessels

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5
Q

which type of stroke is more severe?

A

hemorrhagic

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6
Q

stroke is the ___th leading cause of dead

A

5

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7
Q

what region of the US are strokes the most prevalent in?

A

southeastern

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8
Q

there is 1 stroke every _____ seconds in the US

A

40

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9
Q

atherosclerosis def

A

condition in which fatty desposits called plaque build up on the inner walls of the arteries and cause narrowing of blood vessels

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10
Q

what are 3 common sites for atherosclerosis?

A

common carotid, MCA, vestibular/basilar arteries

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11
Q

thrombus

A

a blood clot attached to the interior wall of an artery or vein

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12
Q

embolis

A

a blood clot formed somewhere else in the body and travels to cerebral circulation

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13
Q

What type of hemorrhage?
rupture of cerebral vessel with subsequent bleeding into the brain

A

intracerebral

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14
Q

what type of hemorrhage?
nontraumatic spontaneous hemorrhage small blood vessels weakened by antherosclerosis leading to an aneurysm

A

cerebral h

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15
Q

what type of hemorrhage?
bleeding into subarachnoid space typically from saccular or berry aneurysm affecting large blood vessels. can be due to mechanical damage or congenital defects

A

subarachnoid

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16
Q

what type of hemorrhage?
congenital defect characterized by tange of arteries and veins with agenesis of an interposing capillar system

A

arteriovenous malformation (AVM)

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17
Q

name some major risk factors for stroke

A

hypertension, heart disease, disorders of heart rhythm, diabetes m,

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18
Q

what are some modifiable stroke risk factors

A

smoking, physical activity, obesity, diet

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19
Q

what are some non-modifiable stroke risk factors

A

family history, age, gender, race

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20
Q

T or F: stroke is the leading cause of long term disability

A

T

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21
Q

FAST (stroke)

A

face drooping
arm weakness
speech difficulty
time to call 911

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22
Q

what three areas are involved in a stroke

A

infarct core
penumbra
benign oligemia

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23
Q

salvageable area after a stroke

A

penumbra (lots of edema though)

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24
Q

non-salvageable area after stroke

A

infarct core

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25
Q

is cerebral circulation mostly aerobic or anaerobic?

A

aerobic

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26
Q

what happens to cerebral circulation when ischemia develops

A

it switches to anaerobic metabolism which causes a lot of glutamate to be released. glutamate attracts calcium which leads to free radicals. free radicals cause edema, increased pressure and more neuronal death

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27
Q

what are some clinical signs of elevated intracranial pressure

A
  • decreased consciousness
  • widened pulse pressure
  • increased HR
  • cheyne-stokes respiration
  • vomiting
  • unreactive pupils
  • papilledema
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28
Q

transient ischemic attack (TIA)

A

temporary interruption of blood supply to the brain
*this is a warning sign that something is going on

29
Q

what are TIAs not considered stroke?

A

symptoms last less than 24 hours and there is no residual brain injury

30
Q

severity of stroke depends on what 4 things related to vascular supply

A

1 - location
2 - size
3 - nature and function of structures involved
4 - collateral blood flow

31
Q

what 2 major arteries make up the circle of willis

A

carotid and vertebral/basilar

32
Q

this artery supplies the frontal lobe, parietal lobe, and subcortical structures

A

anterior cerebral artery

33
Q

clinical signs of ACA stroke

A
  • contralateral hemiparesis and sensory loss
  • apraxia
  • akinetic mutism
  • urinary incontinece
34
Q

is the LE or UE more affected with ACA stroke?

A

LE

35
Q

this artery supplies the frontal, temporal, and parietal lobes, and subcortical structures

A

MCA

36
Q

clinical signs of MCA stroke

A
  • contralateral spastic hemiparesis and sensory loss
  • aphasia
  • spatial and perceptual deficits
  • contralateral homonymous hemianopsia
37
Q

is the UE or LE more affected with MCA stroke?

A

UE

38
Q

contralateral hemianopsia

A

temporal field is absent on one side and nasal is absent on the other *perception is in tact but vision is gone

39
Q

the MCA and ACA are supplied by?

A

internal carotid artery
*so if you have this kind of stroke symptoms are a mix of ACA and MCA

40
Q

uncal herniation

A

rising ICP causes portions of the brain to move from one intracranial compartment to another

41
Q

this artery supplies the occipital obe, medial and inferior temporal lobe, upper brainstem, midbrain, and thalamus

A

PCA

42
Q

prosopagnosia

A

inability to recognize faces

43
Q

agnosia

A

the inability to recognize familiar objects

44
Q

thalamic pain syndrome is caused by what kind of stroke

A

PCA

44
Q

this artery supplies the cerebellum and medulla

A

vertebral

45
Q

this artery supplies the pons, internal ear, and cerebellum

A

basilar

46
Q

locked in syndrome

A

individual is aware and capable of thinking but is paralyzed and cannot communicate
*can only move eyes vertically

47
Q

locked in syndrome is a result of what kind of stroke

A

basilar artery

48
Q

what are 3 key features of a brainstem stroke

A

sudden vertigo, ataxia, and diplopia

49
Q

phases of stroke (5)

A

0-24hrs = hyperacute
1-7day = acute
7day-3mth = early subacute
3-6mth = late subacute
>6mth = chronic

50
Q

when is the max potential for recovery after stroke

A

0-3mth

51
Q

what are 3 things the glasgow coma scale assess?

A

1 - eye opening
2 - verbal response
3 - motor response

52
Q

scoring for glasgow coma scale

A

out of 15:
<8 = severe
9-12 = moderate
13-15 = minor

53
Q

eye opening response scale (GCS)

A

4 - spontaneously
3 - to speech
2 - to pain
1 - no response

54
Q

verbal response scale (GCS)

A

5 - oriented x3
4 - confused
3 - inappropriate words
2 - incomprehensible sounds
1 - none

55
Q

motor response scale (GCS)

A

6 - obeys commands
5 - moves to localized pattern
4 - withdraws from pain
3 - abnormal flexion
2 - abnormal extension
1 - none

56
Q

wernicke’s area

A

inability to comprehend speech

57
Q

broca’s aphasia

A

inability to produce speech

58
Q

dysarthria is due to lesions where?

A

primary motor cortex, primary sensory cortex, or cerebellum

59
Q

dysphagia is most common in what kind of stroke

A

brainstem

60
Q

what does the mini-mental status exam assess?

A

cognitive function

61
Q

scoring of MMSE

A

21-24 = mild cog impairement
16-20 = mod cog impair
<15 = severe cog impair

62
Q

altered emotional status comes from a lesion in what 3 areas

A

frontal lobe, hypothalamus, limbic system

63
Q

pseudobulbar affect

A

emotional outbursts of uncontrolled or exaggerated laughing or crying that are inconsistent with mood

64
Q

patients with agnosias often have a lesion where

A

right parietal cortex

65
Q

T or F: persistent incontinence is a poor prognosis for functional recovery

A

T

66
Q

you patient has been immobilized for multiple days due to a stroke and now complains of pain and tightness in his calf. what could this be

A

a DVT

67
Q

your patient has been immobilized for multiple days due to a stroke and is now complaining of chest pain, is tachycardic and has a persistent cough. What could it be?

A

pulmonary embolism

Adult Neuro One (10 decks)

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