CV Signs and Symptoms of Disease

Question 1

sudden weakness of the face, arm or leg, most often on one side of the body is the most common sign of ____.

other signs may consist of…

Answer 1

stroke

Sudden numbness of the face, arm, or leg, especially on one side of the body. Sudden confusion, trouble speaking or understanding speech (trouble speaking for 2 reasons - 1) face paralyzed 2) cannot get communication from brain to mouth to speak)

Question 2

more signs include…

what does this depend on?

Answer 2

Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance or coordination
Sudden severe headache with no known cause

depend on side (rt. lt) + location ant/post

Question 3

The signs of a stroke depend on the ___ of the brain that’s affected, the ___ of the brain, and how ____ the brain is injured.

Each person may have different stroke warning signs.

Stroke may be associated with a headache, or may be completely painless.

Answer 3

side, part, severely

Question 4

a _____ is the brain’s version of a heart attack, and it occurs when the blood supply to a region of the brain is lost. it is aka (2)

symtoms are usually ____ onset

Answer 4

brain attack, strok, cerebral infarction

sudden

Question 5

Symptoms may be short-lived (< 24 hrs in duration as occurring in a transient ischemic attack or TIA), or may be part of a full (completed) stroke.

what 3 easy symptoms are there to look for?

Answer 5

1. A twisted face best seen when the person smiles.
2. Slurred speech.
3. Ask the person to stretch out their arms and close their eyes. One side will drift down in a stroke.

Question 6

loss of mathematical skills

difficulty distinguishing sensory stimulations

loss of reading skills

Answer 6

acalculia:

agnosia:

alexia:

Question 7

temporary blindness in one eye (shade pulled down over one eye)

: abstention from eating (aphagopraxia: loss of ability to swallow)

: Impairment of language function, difficulties with speaking, reading and writing.

: impairment in the ability to perform complex tasks

: loss of muscular coordination, irregular muscular action, double vision

Answer 7

Amaurosis fugax

Aphagia

Aphasia

apraxia

Ataxia

Question 8

Impairment of clarity of speech

Impairment of language function (2 types 1 – hard to understand what others are saying 2– can’t find words to express themselves)

sensory disturbance

Answer 8

dysarthria

dysphasia - Receptive, Expressive

hemianesthesia

Question 9

: loss of one half of the visual field (homonymous: effects both eyes equally)

: blindness in outer field.

partial loss of movement on one side of the body

: total loss of movement on one side of the body

Answer 9

hemianopia

Homonymous hemianopia

hemiparesis:

hemiplegia

Question 10

: loss or impairment of motor function in a part due to lesion of the neural or muscular mechanism

: slight or incomplete paralysis

: abnormal sensations (burning, prickling, numbness)

: spinning sensation

Answer 10

Paralysis

Paresis

Paresthesia

Vertigo

Question 11

other symptoms of stroke

gait imbalance -

syncope -

inccordination

Answer 11

gait imbalance
Syncope - loss of consciousness

Question 12

what is the difference b/t these 2 strokes?

Answer 12

2 causes, 2 treatments

Question 13

what type os stroke is caused by loss of blood supply by obstruction

a few examples…

other causes of vessels narrowing…

Answer 13

ischemic - pl w/ replaced heart valve or w/ blood that doesnt have normal flow thru the heart are more prone to endocarditis.

1) Atherosclerosis
2) Embolism (Thrombus, Plaque, Fat or Vegetations - endocarditis - if vegetation ofn the rt side, embolism will be systematic, if on the lt it will go to the lungs)

other: Fibromuscular dysplasia, Arteritis, tumors

Question 14

these images best represent _______ stroke which is secondary to ___________.

Answer 14

ischemic, atherosclerosis (plaque rupture) *most of the time the embolism is thrombus, not plaque otherwise clotbusters wouldn’t work on ischemic stokes

Question 15

these are examples of _____.

Atheroma intimal thickening, relative ischemia of the vessel wall, which induces angiogenisis of vasa vasorum
Probability of intraplaque hemorrhage increases
Adventitial Vv microvessels within the atherosclerotic plaque are very fragile and prone to rupture
Causing acute obstruction of vessel

Answer 15

Ischemic Stroke: Atherosclerosis – Plaque Rupture

*sm emboli have to travel further to smaller vessels before they will cause stroke. TIA is aka sm strokes warning you

Question 16

these images best represent _____ stroke.

Emboli can be ___ or _____, also DVT of LE if atrial septal defect/PFO

Answer 16

ischemic - ebmbolic

carotid, cardiac

*PTO - patent foramen ovale. patients whose ovale’s stay open . affects ~20% of ppl

paradoxical (the opposite direction) EMBOLI . systemic arterial coming through venous. only way to get it is through a hole (like PTO)

Question 17

what type of stroke is this?

Answer 17

Hemorrhagic stroke – blooding occurs inside or around the brain tissue

Question 18

loss of blood supply by interruption of the artery

starts as Cerebral aneurysm. can be:
Congenital
Collagen vascular connective tissue disorders
Weakened from trauma, infection or atherosclerosis

AVM - all jumbled up – arteries into veins etc. all mixed up
Trauma

Answer 18

hemorrhagic stroke

Question 19

if an aneurysm or blood vessel breaks what type of stroke would one experience.

Answer 19

hemorrhagic

Question 20

this is a ____

Answer 20

cerebral hemorrhage

Question 21

which type of stroke is

a. treated with tissue plasminogen activator (tPa), a clot-busting drug that quickly restores blood flow through blocked arteries
b. require stopping the hemorrhage with thrombins, coils, etc.

Answer 21

a. ischemic
b. hemorrhagic

Question 22

what do the following stand for

TIA

RIND

CVA or Stroke

Answer 22

transient ischemic attach

reversible ischemic neurologic deficit

cerebrovascular acceident

Question 23

what has:

Symptoms <24 hours
Symptoms depend on area effected
Sensory/motor dysfunction of arm/leg, etc.
Speech impairment
Visual disturbances (monocular)
Neurological deficits
Etiology is embolic (carotid or heart) or ischemia from stenosis.

Answer 23

TIA (transient ischemic attach)

symptoms will completely disappear. related to where the emboli is in the brain

Question 24

what has

Symptoms > 24 hours but complete resolve with time
Symptoms and etiology the same at TIA

Answer 24

RIND (reversible ischemic neurologic deficit)

Question 25

what has: Permanent neurologic deficit Types: Acute – sudden onset, unstable Stroke in evolution – symptoms come and go, unstable Complete – no change in symptoms, stable

Answer 25

CVA (cerbrovascular accident)

Question 26

if a stroke occurs, what type of circulation will have symptoms on opposite side as the CVA? what vessels may does tis type of circulation contain?

Answer 26

anterior – CCA, ICA, MCA, ACA \*impulses cross midline to go to opposite side causing symptoms on the opp side. if arm lt parlyzed = ant rt coratid. affects frontal and parietal lobes of brain.


Question 27

name 2 possible anterior circulation symptoms of stroke

Answer 27

Unilateral paresis (weakness) and paresthesia (abnormal sensations) Dyshasia/aphasia – abnl or no speech. Lt dominant for speech in most people (97% rt handed person; 19% of left handed have speech on right and 68% are bilat) \*cerebrum makes us dif from other mammals. lets us speak reason, think. ANT symptoms = higher level and one sided. 

speaking. lt side is dominant for speech in most ppl (rt handed folks = lt brain dominant) Ant Lt ICA

cerebellum is rudimentary - breathing, walking, eating the things. POST symptoms. lt side

Question 28

what type of circulation symptoms incl Vision changes – usually bilat, diplopia (double vision) Paresthesia/anesthesia Vertigo Ataxia – difficulty with gait or touch (grabbing) Drop attacks (fall down) what vessels are included in this circulation?

Answer 28

posterior Vert, Basilar, PCA (vertebrobasilar insufficiency) \*occipital lobe and cerbellum
very rudimentary things like walk, stand, eat...

Question 29

what type of circulation may have the following symptoms: Vision changes: Amaurosis fugax – blindness in one eye, “like someone pulled a shade over my eye”. Same side as disease, ophthalmic artery. lack of perfusion to the opthalmic Homonymous hemianopia – blindness in outer field. Opposite side as lesion, CVA to frontal lobe. Behavioral abnormalities – confusion, ect. Usually Rt temporal lobe.

Answer 29

anterior \*total blindness in 1 eye 
ipsilateral ICA

Question 30

what is this demonstrating?

Answer 30

effects of stroke

Question 31

what are the following: Dizziness Syncope – loss of consciousness Headache Confusion

Answer 31

non-specific symptoms

Question 32

What do the following describe? False negative with severe stenosis/occlusion False positive with other lesions – AVF, aneurysm, sever AS (bilat), ECA stenosis F/U endarterectomy Workup for major vascular surgery or transplant what are they indicatios for?

Answer 32

carotid bruit - turbulence heard carotid US

Question 33

what are 4 risk factors for stroke? what other pathology has these risk factors?

Answer 33

Diabetes mellitus HTN Smoking Hyperlipidemia atherosclerosis

Question 34

which side is affected which system? Sudden numbness of face, right arm and leg

Answer 34

anterior. left

Question 35

what system Sudden confusion, trouble speaking or understanding which vessels?

Answer 35

anterior carotids

Question 36

which system which side Sudden trouble seeing in both eyes

Answer 36

posterior, bilateral

Question 37

which system, which size Sudden trouble seeing in right eye, blindness (“shade being pulled over my eye”)

Answer 37

anterior, right \*caused by lack of perfusion to the opthalmic artery. amerosus fujax

Question 38

which system? Sudden trouble walking, dizziness, loss of balance and coordination

Answer 38

posterior (vertebrals)

Question 39

which system Sudden severe headache with no known cause

Answer 39

trick question, this one is nonspecific.

Question 40

What is the term that describes a symptom of stroke resulting in impairment of language function, including difficulties with speaking? aphagia ataxia aphasia apraxia

Answer 40

aphasia

Question 41

When evaluating the extracranial cerebrovascular system for atherosclerotic disease, we are trying to identify a potential cause of venous thrombosis hemorrhagic strokes claudication ischemic strokes

Answer 41

ischemic

Question 42

What terminology describes stroke symptoms that last less than 24 hours and completely resolve? transient ischemic attack cerebrovascular accident I reversible ischemic neurologic deficit cerebral aneurysm

Answer 42

transient ischemic attach

Question 43

Symptoms of ataxia are most commonly associated with ischemic events of the right side of the brain anterior circulation left side of the brain posterior circulation

Answer 43

posterior circulation

Question 44

What is the term that describes turbulence heard in the carotid region with a stethoscope? vertigo TIA Berry aneurysm carotid bruit

Answer 44

carotid bruit