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WEEK 1 Flashcards

1
Q

Stroke

A

(CBA –cerebral vascular attack): interruption of arterial blood to the brain, resulting indamaged brain tissue|
Cellular death occurs in 5 minutes

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2
Q

2 TYPES OF STROKE:

A
  1. ISCHEMIC STROKE >TIA
    2.HEMORRHAGIC STROKE- bleeding into the brain tissue itself or into the subarachnoid space or ventricles
    |>subarachnoid stroke
    |>intracerebral stroke
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3
Q

Incidence -

A

the number of new cases in a particular period of time

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4
Q

Prevalence –

A

the number of new and old cases in a particular period

of time

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5
Q

Morbidity –

A

rates of disability

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6
Q

Mortality –

A

rates of death

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7
Q

TRANSIENT ISCHEMIC ATTACK (TIA):

A

early warning signs of stroke A temporary focal loss of neurological function caused by ischemia.

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8
Q

 Ischemic stroke: (80%)- THERE ARE TWO TYPES

A

inadequate blood flow to the brain from partial or complete occlusion of an artery.
 There are two types: thrombotic and embloic

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9
Q

 Signs & Symptoms OF tia

A

depend on the blood vessel involved and the brain area that is ischemic.

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10
Q

 Carotid involvement:

A

may have temporary vision loss in one eye, transient hemiparesis (weakness to one side of your body), or a sudden inability to speak, numbness/ loss of sensation

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11
Q

 Vertebrobasilar involvement may include:

A

tinnitus, vertigo, ataxia (looking drunk), darkened or blurred vision, diplopia, ptosis, dysphagia, dysarthria, and unilateral/bilateral numbness or weakness

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12
Q

1/3

A

 1/3 individuals will not experince it again, 1/3 will have another TIA, the rest will experience a stroke.

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13
Q

Management of TIA

A

 Diagnostic tests: Cardiac monitoring & CT
 Pharmacological: 1) Antiplatelet aggregation agents(ASA, Plavix)
2) Anticoagulant agents: Coumadin (Warfarin)

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14
Q

Acute Care Goals: CVA:

A

Maintain patent airway
 Monitor for signs of neurologic deficit
 Decrease blood viscosity
 Control fluid & electrolyte balance
 Management of ICP
 Management of pain, hypovolemia, constipation, cerebral edema

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15
Q

Thrombotic stroke( ischemic)-

A

results from fatty deposits that enlarge over years in carotid and other cerebral vessels. Usually slow on their onset.

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16
Q

Embolic Stroke( ischemic)-

A

emboli or clot fragments break off and travel to cerebral arteries, usually originates from the heart or carotid artery.

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17
Q

HEMORRHAGIC STROKE-

A

usually caused by: a ruptured aneurysm, severe hypertension, or drugs like cocaine etc..
a patient will have headache, nuchal rigidity, and possible nausea.
usually after shitting really hard.

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18
Q

WHAT ARE THE CONSEQUENCES OF STROKE?

A

Third leading cause of death and disability in adults
• about 15% of sufferers die
• about 30% are left with moderate-severe disability

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19
Q

UNMODIFIABLE RISK FACTORS-

A

Age- increase risk with age

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20
Q

Agnosia-

A

, Agnosia- Inability to recognize familiar objects, persons, smells, shapes, even though the sensation is intact

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21
Q

Ataxia-

A

Impaired gait, unsteady, incoordination,

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22
Q

Dysphasia/aphasia-

A

Impaired capacity to interpret, formulate or express meaningful language, writing or gesturing,

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23
Q

Dysphagia-

A

Impaired swallowing

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24
Q

Hemiparesis-

A

Weakness on one side of the body

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25
Q

JUST LIKE A CAR ACCIDENT –

A 
What caused the accident?
What caused the stroke?
Where did the accident happen?
Which artery did the stroke happen in?
What damage occurred?
 (Where did the brain damage occur?)
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26
Q

RIGHT HEMISPHERE

A

Controls left side of body, Spatial abilities, Visual imagery, Music

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27
Q

LEFT HEMISPHERE

A

Controls right side of body, Language/Speech, Math, Logic

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28
Q

The Frontal Lobe has many ‘jobs’including:

A

movement, intellectual function, emotions, memory

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29
Q

PARIETAL LOBE-

•

A

located in the top middle of the cerebrum

• helps with sense of touch and with some complex visual perceptions

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30
Q

THE TEMPORAL LOBE

•

A

located in the bottom middle of the cerebrum

• helps hearing and speech

31
Q

THE OCCIPITAL LOBE

•

A

located in the rear of the cerebrum

• plays a major role in vision

32
Q

THE vertebrobasilar arterial system

A

SUPPLIES BRAIN STEM AND CEREBELLUM

33
Q

STROKE in the brain stem

A

breathing, heartbeat, articulate speech.

34
Q

Cerebellum stroke

A

Cerebellum stroke ruins smooth coordinated movement

35
Q

To differentiate stroke vs stroke mimics
&
ischemic vs hemorrhagic stroke,
requires (at least):

A 
•	History & neuro assessment (including stroke scale)
•	CT scan of the head
•	Blood work (including BS, CBC, INR)
•	Assessment of risk factors
ECG
36
Q

tPA

A

clot-busting drug that destroys an existing blood clot (- given 3 hours after onset of symptom, major side effect: cerebral hemorrhage, of BP critical during treatment and 24 hours after treatment)

37
Q

• Wernicke’s aphasia –

A

receives auditory speech impulses, but unable to comprehend them, Characterized by fluent, well-articulated speech, with intact tone, but inappropriate speech content that is unintelligible d/t poor word choices

38
Q

• Anomic or amnesic aphasia

A
  • probs finding correct names for certain stuff
39
Q

 Signs & Symptoms OF tia

A

depend on the blood vessel involved and the brain area that is ischemic.

40
Q

 Carotid involvement:

A

may have temporary vision loss in one eye, transient hemiparesis (weakness to one side of your body), or a sudden inability to speak, numbness/ loss of sensation

41
Q

 Vertebrobasilar involvement may include:

A

tinnitus, vertigo, ataxia (looking drunk), darkened or blurred vision, diplopia, ptosis, dysphagia, dysarthria, and unilateral/bilateral numbness or weakness

42
Q

1/3

A

 1/3 individuals will not experince it again, 1/3 will have another TIA, the rest will experience a stroke.

43
Q

Management of TIA

A

 Diagnostic tests: Cardiac monitoring & CT
 Pharmacological: 1) Antiplatelet aggregation agents(ASA, Plavix)
2) Anticoagulant agents: Coumadin (Warfarin)

44
Q

Acute Care Goals: CVA:

A

Maintain patent airway
 Monitor for signs of neurologic deficit
 Decrease blood viscosity
 Control fluid & electrolyte balance
 Management of ICP
 Management of pain, hypovolemia, constipation, cerebral edema

45
Q

Thrombotic stroke( ischemic)-

A

results from fatty deposits that enlarge over years in carotid and other cerebral vessels. Usually slow on their onset.

46
Q

Embolic Stroke( ischemic)-

A

emboli or clot fragments break off and travel to cerebral arteries, usually originates from the heart or carotid artery.

47
Q

HEMORRHAGIC STROKE-

A

usually caused by: a ruptured aneurysm, severe hypertension, or drugs like cocaine etc..
a patient will have headache, nuchal rigidity, and possible nausea.
usually after shitting really hard.

48
Q

WHAT ARE THE CONSEQUENCES OF STROKE?

A

Third leading cause of death and disability in adults
• about 15% of sufferers die
• about 30% are left with moderate-severe disability

49
Q

UNMODIFIABLE RISK FACTORS-

A

Age- increase risk with age

50
Q

Agnosia-

A

, Agnosia- Inability to recognize familiar objects, persons, smells, shapes, even though the sensation is intact

51
Q

Ataxia-

A

Impaired gait, unsteady, incoordination,

52
Q

Dysphasia/aphasia-

A

Impaired capacity to interpret, formulate or express meaningful language, writing or gesturing,

53
Q

Dysphagia-

A

Impaired swallowing

54
Q

Hemiparesis-

A

Weakness on one side of the body

55
Q

STROKE in the brain stem

A

breathing, heartbeat, articulate speech.

56
Q

Cerebellum stroke

A

Cerebellum stroke ruins smooth coordinated movement

57
Q

To differentiate stroke vs stroke mimics
&
ischemic vs hemorrhagic stroke,
requires (at least):

A 
•	History & neuro assessment (including stroke scale)
•	CT scan of the head
•	Blood work (including BS, CBC, INR)
•	Assessment of risk factors
ECG
58
Q

tPA

A

clot-busting drug that destroys an existing blood clot (- given 3 hours after onset of symptom, major side effect: cerebral hemorrhage, of BP critical during treatment and 24 hours after treatment)

59
Q

• Wernicke’s aphasia –

A

receives auditory speech impulses, but unable to comprehend them, Characterized by fluent, well-articulated speech, with intact tone, but inappropriate speech content that is unintelligible d/t poor word choices

60
Q

• Broca’s aphasia

A
  • expressive aphasia characterized by no fluent, telegraphic speech with outbursts of profanity, uninhibited speech and word-finding difficulties
61
Q

• Anomic or amnesic aphasia

A
  • probs finding correct names for certain stuff
62
Q

• Global aphasia-

A

loss of all expressive and receptive

63
Q

• Dysarthia

A

disturbance in the muscular control of speech

64
Q

• Dysphasia

A

impaired communitcation

65
Q

Primary assessment of the patient

A

with stroke is focused on cardiac, respiratory status, and neurological examination.

66
Q

Secondary assessment should include a comprehensive neurological examination of the patient including:

A

LOC (Glasgow Coma Scale), cognition, motor abilities, cranial nerve function, sensation, proprioception, cerebellar function, and deep tendon reflexes.

67
Q

Homonymous hemianopsia

A

(blindness in the same half of each visual field):

68
Q

Stroke complications

A

Risk of recurrent stroke is 5 to 20%
 5% for cardioembolic strokes
 20% for atherosclerotic strokes

69
Q

No significant diff between ischemic and hemorrhagic stroke.

A

Because destruction of neural tissue is the basis for neurological dysfunction regardless of the etiology. Therefore clinical mani. Related to the location in the brain the stroke occurred.

70
Q

Cerebral Angioplasty –

A

a balloon catheter to mechanically dilate vessels

71
Q

artherosclerosis

A

hardening and thickening of arteries

72
Q

tia vs stroke

A

in tia ischemia occurs without infraction but in a stroke infraction and cell death occur

73
Q

cerebral aneurysms are viewed

A

as the silent killers

74
Q

antiplatelet drugs

A

to prevent stroke in paitents who have had TIA

PNH (18 decks)

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