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Nursing Science 2 > Cerebrovascular Disease > Flashcards

Cerebrovascular Disease Flashcards

1
Q

Paresis

A

partial paralyasis/weakness

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2
Q

Hemiparesis

A

incomplete paralysis affecting one side of the body

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3
Q

Hemiplegia

A

Paralysis of one side of the body

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4
Q

Aphasia

A

loss of ability to speak/write

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5
Q

Aphasia

A

loss of ability to speak/write

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6
Q

Apraxia

A

inability to execute motor act

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7
Q

Dysarthria

A

poorly executed speech

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8
Q

Agnosia

A

loss of recognition (shapes/people)

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9
Q

Hemianopia

A

Blindness for 1/2 vision field

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10
Q

Dysphagia

A

Difficulty swallowing

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11
Q

Blood supply to the brain includes branches of the aorta, internal carotid artery and vertebral artery

A

Carotid artery divides into ACA, MCA and PCA

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12
Q

Circle of Willis

A

protect brain from ischemia by providing collateral blood flow and alternative blood flow pathways.

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13
Q

Regulation of CBF is by

A

vasodilation and constriction in response to O2, H+ and CO2 changes

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14
Q

CVD is defined as

A

any abnormality of the brain caused by pathological process in the blood vessels

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15
Q

Brain utilises

A

15-20% of CO per min

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16
Q

CVA can be classified as

A

Ischemic or haemorrhagic

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17
Q

Patho of ischemic stroke

A

Occlusion of the intracranial artery/ vessel lumen due to thrombus or emobli causing occlusion. Increased CO2, reduced O2 = increased blood brain volume which causes a headache. Loss of O2 decreases ATP and forms lactic acid, proteases and phospholipase enzymes are activated which decrease pH and can cause acidosis. This also leads to an increase in ROS, Na, Ca which draws fluid in and causes cytotoxic edema. The damage depends on the location and duration

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18
Q

Transient ischemic attack

A

resolves in 24 hours and self resolves - warning sign of CVA, minimal long term issues

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19
Q

4 lobes of the cortex

A

Frontal - movement, execute function,
Parietal - Sensory info
Temporal - Hearing, memory, smell, language, recognition
Occipital - vision

Brainstem - HR, BP , Breathing, GI, Conciousness
Cerebellum - muscle coordination, balance

20
Q

Smoking can cause a stroke by

A

tabacco irritants damaging the endothelium in the CVA, which becomes a site for atherosclerosis, plaque forms and obstructs blood flow

21
Q

Strokes happen when

A

there is a sudden and complete blockage of a cerebral artery

22
Q

Plaques sit in the lumen and have constant stress from blood flow and can become unstable, can rupture and cause a thrombogenic reaction

A

chemicals that enhance the clotting process such as thromboxane, endolthelin create a clot which obstructs and completely occludes the vessel

23
Q

Embolism

A

breaks off from one location, gets lodged in another area away from its original site, typically with a smaller diameter.

24
Q

Stagnant blood flow can form a clot due to

A

Atrial fibrillation or heart attack, it formed in the left atrium it has a direct route to the brain

25
Q

If a clot forms in a vein or the right atrium

A

it can get lodged in the pulmonary artery and cause pulmonary embolism

26
Q

Lacunar stroke

A

often deep branches of the MCA feeding the basal ganglia, giving pure motor or sensory deficit

27
Q

Thrombotic stroke

A

thrombus in the cerebral arteries due to atherosclerosis, inflammatory disease or stenosis

28
Q

Risk factors modifiable

A 
Smoking - increases risk by 50%,
Increased alcohol,
Obesity,
Hyperlipidemia, 
HTN,
Unstable DM,
Heart disease,
Decreased activity,
Chlamydia pneumonia
29
Q

Risk factors non modifiable

A

Age, Gender, genetics, ethnicity

30
Q

Ischemic penumbra

A

is preserved for some time due to collateral circulation at the circle of willis and surrounds the ischemic core of necrotic tissue, it can survive if blood flow is restored quickly enough

31
Q

Due to lack of glucose and oxygen

A

high build-u of sodium and calclium in the cells causing cytotoxic edema due to H2o following Na = build up of ROS of membranes causing cellular damage

32
Q

Over a period of 4-6 hours

A

inflammation damages the BBB, increasing CSP which can push onto brainstem and affect breathing and conciousness

33
Q

ACA stroke

A

numbness,
sudden muscle weakness,
leg

34
Q

MCA stroke

A

Face, numbness / sudden muscle weakness

35
Q

Broca’s area

A

slurred speech / difficulty understanding

36
Q

PCA stroke affects

A

Vision/language

37
Q

Symptoms acronym

A

F acial drooping
A rm weakness
S speech difficulties
T ime

38
Q

Diagnosis of stroke

A

CT or MRI or angiography

rule out haemorrhage

39
Q

Treatment of stroke

A

reestablish blood flow quickly, particularly in penumbra.
- Thrombolytic enzymes (a-TPA)
- activates body’s clot busting mechanisms
- time limit of 4.5 hours
- binds to fibrin of a thrombus and converts to plasmin which initiates fibrinolysis (clot breakdown)
ASPIRIN - prevents MORE clots
SURGERY - physically remove clot, endovascular coil or clipping

40
Q

A stent can be placed

A

to prevent further strokes

41
Q

Monro - Kellie Hypothesis

A

sum of intracranial volumes of brain, blood and CSF remains constant, an increase in one component must be offset by a decrease in another component by decreasing CSF

42
Q

Post stroke treatment

A

Antihypertensives,
Anticoagulants, unless hemorrhagic,
Lipid-lowering if ischemic (statins).

43
Q

Two types of hemmorhagic stroke

A

intracerebral - within the brain tissue,

subarachnoid - area surrounding the brain

44
Q

Patho of hemorrhagic stroke

A 
weakened blood vessel, 
bleeding,
increase in CBP,
compression,
spasm,
ischemia,
45
Q

o2 therapy is contraindicated in stroke

A

because it can cause ROS due to the blockage - oxygen won’t reach the required area

Nursing Science 2 (11 decks)

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