Cerebrovascular Sign & Symp. Of Disease Flashcards by Tabitha Colllins

______% all strokes caused by significant carotid stenosis

< 25%

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What is the most common type of stroke?

Ischemic stroke

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Atherosclerosis causes stenosis which leads to ______blood supply & _______

1) Decreased

2) cerebral ischemia

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_______ presents the highest risk of TIA/stroke

ICA stenosis

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

Cerebral ischemia

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Stroke can be caused by _______ embolus

Cardiac

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What is the strongest risk factor for stroke?

1) HTN

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

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What is a dissection?

Intimal tear that leads to thrombus/ embolus formation

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What is polycythemia Vera ?

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

increased risk of thrombus/embolus formation

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________ & _________ can lead to stroke

1) vasospasm

2) intracranial hemorrhage

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What is the #1 cause of vascular disease?

Atherosclerosis formation

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

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

5 platelets

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Where does Atherosclerosis formation occur??

Within & beneath the intima

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______ mm IMT measurement that indicates risk for stenosis

> 1.2 mm

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What is the most common cerebrovascular site for atherosclerosis formation?

2nd most common?

1) CCA bifurcation

2) origin of the CCA

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Modifiable rusk factors for stroke can be…..

Reduced or controlled to reduce the risk of stroke

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

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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What is the main risk factor for stroke?

HTN

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What is a TIA

Symptoms?

Transient ischemic attack

Symptoms last <24 hrs

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What is RIND?

Symptoms?

Reversible ischemic neurological deficit

Resolve over time
>24 hrs but < 72hrs

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What is a CVA?

Symptoms?

Cerebrovascular accident

Symptoms or damage is permanent

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What is a brain infarction?

Insufficient blood supply to the brain due to stenosis or occlusion

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What is a subarachnoid hemorrhage?

Rupture of intracranial vessels

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What is hemispheric symptoms?

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

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

1) left paresis, paresthesia | 2) right paresis, paresthesia

Stroke is the _____ leading cause of death in the US

4th

85% of strokes are caused by _____

Ischemia (other causes include hemorrhage, vasospasm)

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

1) atheroma 2) CCA bifurcation 3) cardiac emboli

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

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

What does the Neurological exam evaluate? (7)

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

General appearance evaluates 4 things. List them

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

Cognition evaluates covers....

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

Examination of cranial nerves evaluates...

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

Sensory exam evaluates.....

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

With the Reflex exam ....

A reflex hammer is used to assess deep tendon reflexes

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

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

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

1) Normal, easily palpable pulses that | 2) are in sync

Where do you listen for a CCA stenosis?

At the level of the carotid bifurcation to identify a possible bruit *ask the patient to hold their breath while listening for flowspunds

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

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

Bruits are described as.... (3)

1+ mild 2+ moderate 3+ severe

A bruit that occurs throughout the cardiac cycle indicates_______

A possible severe stenosis

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

Significant reduction in flow

A bruit can be missed if ......

Cardiac output is low

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

1) 20mmHg | 2) subclavian steal

List the symptoms of cerebrovascular disease (5)

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

Carotid bruit heard through systole & diastole usually indicates a _________

Significant stenosis

Bilateral bruits heard proximally can indicate____

Aortic valve stenosis

Carotid artery massage is used to .......

Assess the cause of syncope

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

1) cricoid cartilage | 2) 5-10 seconds

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

Carotid sinus hypersensitivity is present

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

1) occluded carotid | 3) TIA/CVA

List the ICA disease symptoms

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

Paresthesia is

Tingling of the skin

Paresis is

Weakness

Define Paralysis

Unable to move

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

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

Amaurosis Fugax is ________________ Can be referee to as _____________

1) Temporary partial or total monocular blindness | 2) TIA of the eye

Ophthalmic artery branches from the ________

ICA

Amaurosis fugax is caused by _______ side stenosis RICA stenosis leads to ____ amaurosis fugax

Ipsilateral Right

List the vertebral/basilar disease symptoms

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

Vertigo

Unable to maintain equilibrium

Ataxia

Lack of coordination

Bilateral homonymous hemisnopia

Half of the field of view disrupted in each eye

Drop attack is

Falling to the ground without loss of consciousness

Dysphasia

Trouble swallowing

List the MCA disease symptoms

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

1) Wernicke aphasia (AKA) is...

1) receptive aphasia | 2) totally in comprehensive, unable to understand speech, speak, or follow directions

ACA disease symptoms

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

PCA disease symptoms

1) dyslexia | 2) cons

Broca Apasia is (AKA ______)

1) expressive aphasia | 2) can understand others & follow directions but unable to speak

Cerebrovascular Sign & Symp. Of Disease Flashcards

(70 cards)