Chapter 3. Cerbrovascular Accidents (CVA) Flashcards
(43 cards)
Define STROKE
Sudden, FOCAL neurologic deficit, resulting from ISCHEMIA (clogged blood vessel) or HEMORRHAGE (ruptured blood vessel)
What are (3) Etiologys of a CVA
- Thrombosis (solid mass of platelets and/or fibrin that forms locally in a vessel-clogging blood flow)
- Embolus (a piece of a thrombus that has broken free and is carried toward the brain by the bloodstream-blood clot, air bubble, piece of fatty deposit
- Hemorrhage (ruptured blood vessel in brain)
It is important to know if you have a __ or ___ before giving a drug against CVA
-HEMORRHAGE or CLOT
What is the Mechanism of a Stroke
- Atherosclerosis is formation of PLAQUE
- vessel narrowing
- stenosis (abnormal narrowing) ulceration of lesions, thrombus, EMBOLI
What percentage of formation of clot is in Cerebral arteries or smaller branches in a THROMBUS?
60%
-can still have COME Collateral formation
What is collateral formation
Extra PATHWAYS for blood to flow during a Thrombus etc.
-survival technique by the body
WHERE does an embolism come from and WHAT is it
- 16% comes from heart, internal carotid, or carotid sinus
- it is a dislodged thrombus
What is the most common place for a stroke
MCA- Middle Cerebral Artery
How do Thrombus form
Forms from platelet adhesion and coagulations, leading to ischemia with infarct
What is a Hemorrhage
abnormal bleeding due to vessel rupture
Is there a chance to develop new Collaterals when an EMBOLISM is formed
No, because the embolism happens so quickly
A Thrombus can lead to ___ and then further on even lead to an __
- ischemia with infarct
- Embolism
WHAT occurs within hours, peaks at 4 days due to tissue necrosis/rupturing of cell membranes and can push against your pons (breathing center), making it extremely hard to breath
Cerebral edema (swelling in the brain)
What is the acronym for TIA and what is the possible cause
- Transic Ischemic Attack
- Transient Systemic Arterial hyoptension
What are some symptoms/signs of ANTERIOR Cerebral Artery Infarct
- LEFTside neglect
- Contralateral hemiparesis (LE)
- Sensory loss (LE)
- Incontinence
- Apraxia (can’t move arm)
What are some symptoms/signs of MIDDLE Cerebral Artery Infarct (most common!!)
- Contralateral hemiplegia (UE)
- Sensory deficit (UE and face)
- Homonymous Hemianopsia (loss of half of the field of view in both eyes)
- If left hemi»aphasia
- if right hemi» neglect on left side
What are the 2 possibilities for an Internal Carotid Artery Infarct
- Comma
- Death
What is ‘Contralateral Hemianesthesia’ in POSTERIOR Cerebral Artery
Contralateral (opp. side of body)
-anesthesia on one side of the body
‘Locked in syndrome’ comes from which artery infarct; and what is it?
VERTEBRAL Artery Infarct
- can last for months/weeks/years
- quadraplegia
- only has vertical gaze
- can’t speak, yet full consciousness
What are the (5) Artery infarcts?
- Anterior
- Middle
- Posterior
- Internal
- Vertebral
What is Ashworth’s Scale for Grading SPASTICITY for 0 and 4
0- no increase in tone
4-affected parts RIGID in FLEXION or EXTENSION
What is Brunnstrom Synergy Pattern for UPPER extremity flexion
- scapular retraction
- shoulder external rotation
- shoulder abduction to 90 degrees
- elbow flexion
- forearm supination, wrist and finger flexion
What is Brunnstrom Synergy Pattern for LOWER extremity extension
- hip extension
- adduction and internal rotation
- knee extension
- anke plantar flexion and inversion
Define Dysarthria
Difficulty speaking (but physically) -may have affected respiration, articulation, possible impaired chewing/swallowing
