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Vascular registry Review > Cerebrovascular Sign & Symp. Of Disease > Flashcards

Cerebrovascular Sign & Symp. Of Disease Flashcards

1
Q

______% all strokes caused by significant carotid stenosis

A

< 25%

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2
Q

What is the most common type of stroke?

A

Ischemic stroke

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3
Q

Atherosclerosis causes stenosis which leads to ______blood supply & _______

A

1) Decreased

2) cerebral ischemia

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4
Q

_______ presents the highest risk of TIA/stroke

A

ICA stenosis

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5
Q

Embolization of atherosclerotic material which lodges in a distal artery & leads to _______

A

Cerebral ischemia

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6
Q

Stroke can be caused by _______ embolus

A

Cardiac

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7
Q

What is the strongest risk factor for stroke?

A

1) HTN

* shearing forces of the blood can exert too much pressure on intracranial vessels leading to hemorrhage

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8
Q

What is a dissection?

A

Intimal tear that leads to thrombus/ embolus formation

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9
Q

What is polycythemia Vera ?

A

Thickening of the blood reduces flow & may lead to ischemia distally

  • increased risk of thrombus/embolus formation
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10
Q

________ & _________ can lead to stroke

A

1) vasospasm

2) intracranial hemorrhage

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11
Q

What is the #1 cause of vascular disease?

A

Atherosclerosis formation

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12
Q

Atherosclerosis formation is accumulation of ______, _______, ______, ________ & ________

A

1) atheroma
2) smooth muscle
3) collagen
4) fibrin

5 platelets

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13
Q

Where does Atherosclerosis formation occur??

A

Within & beneath the intima

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14
Q

______ mm IMT measurement that indicates risk for stenosis

A

> 1.2 mm

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15
Q

What is the most common cerebrovascular site for atherosclerosis formation?

2nd most common?

A

1) CCA bifurcation

2) origin of the CCA

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16
Q

Modifiable rusk factors for stroke can be…..

A

Reduced or controlled to reduce the risk of stroke

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17
Q

List the risk factors for stroke (& how to reduce them if applicable)

A

1) HTN (treated with medication)
2) diabetes (treated with med)
3) hyperlipidemia (treated w/ med)
4) smoking (quit)
5) inactivity (exercise)
6) obesity (exercise & diet)
7) poor nutrition (change eat habits)
* other major risk factors
8) gender (> men, women die more)
9) race (blacks > whites)
10) age (increase with age)
11) fam hx of TIA or stroke

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18
Q

What is the main risk factor for stroke?

A

HTN

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19
Q

What is a TIA

Symptoms?

A

Transient ischemic attack

Symptoms last <24 hrs

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20
Q

What is RIND?

Symptoms?

A

Reversible ischemic neurological deficit

Resolve over time
>24 hrs but < 72hrs

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21
Q

What is a CVA?

Symptoms?

A

Cerebrovascular accident

Symptoms or damage is permanent

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22
Q

What is a brain infarction?

A

Insufficient blood supply to the brain due to stenosis or occlusion

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23
Q

What is a subarachnoid hemorrhage?

A

Rupture of intracranial vessels

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24
Q

What is hemispheric symptoms?

A

Specific symptoms are related to right & left brain with loss of functionality

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25
Q

Right brain controls left side of body- RICA stenosis = ________

Left brain controls right side of body- LICA stenosis = ________

A

1) left paresis, paresthesia

2) right paresis, paresthesia

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26
Q

Stroke is the _____ leading cause of death in the US

A

4th

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27
Q

85% of strokes are caused by _____

A

Ischemia (other causes include hemorrhage, vasospasm)

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28
Q

______ in the ______ is the most common cause of stroke, _____ is the second

A

1) atheroma
2) CCA bifurcation
3) cardiac emboli

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29
Q

The neurological exam is to identify ___________ in the _______ & differentiate ________ from _______ lesions

A

1) an abnormality
2) nervous system
3) peripheral
4) central nervous system lesion

30
Q

What does the Neurological exam evaluate? (7)

A

1) general appearance
2) cognition
3) examination of cranial nerves
4) motor system evaluation
5) sensory exam
6) reflex exam
7) coordination & gait evaluation

31
Q

General appearance evaluates 4 things. List them

A

1) level of consciousness (do they know basic facts, year, season, President)
2) personal hygiene/dress (clean, dress appropriate for temp)
3) posture & motor activity (involuntary movements or tremors)
4) vital signs

32
Q

Cognition evaluates covers….

A

Comprehension, attention & calculation, ability to follow simple commands & orientation

33
Q

Examination of cranial nerves evaluates…

A

evaluation smell, sight, muscle movement in the face, speech, hearing

34
Q

Sensory exam evaluates…..

A

pain sensation (pin prick), light touch sensation (brush), position sense, stereognosis, graphesthesia, & extinction

The

35
Q

With the Reflex exam ….

A

A reflex hammer is used to assess deep tendon reflexes

36
Q

The clinical examination for cerebrovascular disease is evaluated by _____, ______, & ______

A

1) palpitation ( palpate by placing two fingers over the artery)
2) auscultation
3) blood pressure

37
Q

Bounding pedal pulses refers to ________________ that are ______ with the heartbeat

A

1) Normal, easily palpable pulses that

2) are in sync

38
Q

Where do you listen for a CCA stenosis?

A

At the level of the carotid bifurcation to identify a possible bruit

*ask the patient to hold their breath while listening for flowspunds

39
Q

________stenosis, ______ hematocrit & _______ cardiac output can cause bilateral bruits

A

1) aortic valve stenosis
2) low hematocrit
3) increased cardiac output

40
Q

Bruits are described as…. (3)

A

1+ mild

2+ moderate

3+ severe

41
Q

A bruit that occurs throughout the cardiac cycle indicates_______

A

A possible severe stenosis

42
Q

> 90% stenosis does NOT usually cause a bruit due to……

A

Significant reduction in flow

43
Q

A bruit can be missed if ……

A

Cardiac output is low

44
Q

The BP in the arms should not differ more than _______ or a ______ is suspected in the arm with the lower pressure

A

1) 20mmHg

2) subclavian steal

45
Q

List the symptoms of cerebrovascular disease (5)

A

1) carotid bruit
2) headache
3) dizziness
4) syncope
5) dysarthria (disturbed speech)

46
Q

Carotid bruit heard through systole & diastole usually indicates a _________

A

Significant stenosis

47
Q

Bilateral bruits heard proximally can indicate____

A

Aortic valve stenosis

48
Q

Carotid artery massage is used to …….

A

Assess the cause of syncope

49
Q

The carotid artery is massaged at the level of the ______ for _____

A

1) cricoid cartilage

2) 5-10 seconds

50
Q

Carotid sinus massage will lead to bradycardia & hypotension if ……

A

Carotid sinus hypersensitivity is present

51
Q

Carotid sinus massage should NOT be performed on patients with an ________ or _______

A

1) occluded carotid

3) TIA/CVA

52
Q

List the ICA disease symptoms

A

1) unilateral symp. W/ contralateral side stenosis(lt side disease= rt side symptoms)
2) parestheia
3) paresis
4) paralysis
5) Broca Aphasia
6) Hollenhorst plaques
7) amarosis fugax

53
Q

Paresthesia is

A

Tingling of the skin

54
Q

Paresis is

A

Weakness

55
Q

Define Paralysis

A

Unable to move

57
Q

Hollenhorst plaques are _______ that originates from atherosclerotic lesions in the _______ carotid artery or aorta & lodge on the small branches of ________

A

1) cholesterol emboli
2) ipsilateral (same side)
3) retinal artery
* usually identifies by an optometrist on a standard vision exam because the patient is asymptotic

58
Q

Amaurosis Fugax is ________________

Can be referee to as _____________

A

1) Temporary partial or total monocular blindness

2) TIA of the eye

59
Q

Ophthalmic artery branches from the ________

A

ICA

60
Q

Amaurosis fugax is caused by _______ side stenosis

RICA stenosis leads to ____ amaurosis fugax

A

Ipsilateral

Right

61
Q

List the vertebral/basilar disease symptoms

A

1) vertigo
2) ataxia
3) bilateral visual blurring or double vision
4) bilateral homonymous hemisnopia
5) bilateral paresthesia
6) drop attack
7) dysphasia

62
Q

Vertigo

A

Unable to maintain equilibrium

63
Q

Ataxia

A

Lack of coordination

64
Q

Bilateral homonymous hemisnopia

A

Half of the field of view disrupted in each eye

65
Q

Drop attack is

A

Falling to the ground without loss of consciousness

66
Q

Dysphasia

A

Trouble swallowing

67
Q

List the MCA disease symptoms

A

1) Wernicke aphasia
2) dysphasia
3) behavioral changes
4) severe hemiparesis in contralateral face:arms

68
Q

1) Wernicke aphasia (AKA) is…

A

1) receptive aphasia

2) totally in comprehensive, unable to understand speech, speak, or follow directions

69
Q

ACA disease symptoms

A

1) loss of coordination
2) incontinence
3) severe leg hemiparesis or hemiplegia in contralateral leg
4) facial dropping or asymmetry

70
Q

PCA disease symptoms

A

1) dyslexia

2) cons

71
Q

Broca Apasia is (AKA ______)

A

1) expressive aphasia

2) can understand others & follow directions but unable to speak

Vascular registry Review (5 decks)

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