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Flashcards in CVA Deck (58):
1

What is the cause of is stroke?

it is caused by the interruption of the blood supply to the brain, usually because a blood vessel bursts or is blocked by a clot. this cuts off the supply of damage to the brain tissue.

2

what are the symptoms of Stroke

sudden weakness or numbness of face or extremities often on one side
Confusion
Difficulty with speech production + comprehension,
seeing w/1 or both eyes + walking Dizzy,
loss of balance + coordination,
headache,
fainting or unconsciousness Neourlogical deficts > 24 hours upper motor neuron Lead to infration of brain tissue

3

what does the acronym FAST stand for?

F=Face drooping
A=Arm weakness
S=Speech Difficulty
T=Time to call 911

4

what are the dysfunctions of stroke besides motor paralysis?

sensory disturbances
cognitive and perceptual dysfunction
visual impairments
personality and intellectual changes
speech and language D/Os
psychosocial implications
decrease trunk/balance control
decrease UE control

5

what are the two types of stroke?

ischemic
hemorrhagic

6

which is the most common type of stroke?

ischemic

7

which stroke is normally seen in order patients?

ischemic

8

which stroke is normally seen in younger patients

hemmorrhagic

9

what is an ischemic stroke?

occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot.

10

what are the kinds of ischemic strokes?

thrombotic
embolic
lacunar

11

what is a thrombotic stroke?

a clot formed in an artery that is already very narrow.

12

what is an embolic stroke?

a clot hat breaks off from another place in the blood vessels of the brain, or from some other part of the body, and travel up to the brain until it reaches an artery too small to pass through

13

what is a lacunar stroke?

produces small infarcts, usually in the deep brain structures
makes up approx 25% of ischemic strokes
result from an occulsion of small branches of larger cerebral arteries--middle cerebral, posterior cerebral, basilar, and not as much, but anterior cerebral and vertebral arteries
usually associated with hypertension

14

what damage can strokes cause?

dead tissue
edematous brain tissue

15

What allows the body to recover from a stroke months and even years after

neuroplasticity

16

what is neuroplasticity?

the brain's ability to reroute neural pathways

17

what is a hemmorrhagic stroke?

occurs when a blood vessel in part of the brain becomes weak and bursts open
causes blood to leak into the brain
can be caused by defects in the brain such as aneurysm and arteriovenous malformation(AVM)

18

what is an aneurysm?

bulging of a wall of an artery as a result of weakness in the vessel wall
prone to rupture at any time

19

what are the two kinds of hemorrhagic strokes?

intracerebral
subarachnoid

20

what are the characteristics of an intracerebral hemmorrhage?

bleeding directly into brain substance

21

what conditions are often linked to intracerebral hemmorrhage strokes?

hypertention
blood vessel abnormalities
aneurysms
trauma

22

what are the clinical signs of intracerebral hemmorrhage?

usually focal-do not follow anatomic distribution of blood vessels, but move sphereically through the tissue plances
typically develop suddenly during activity
eventually bledding stops and clot is formed

23

what is a subarachnoid hemmorhage?

bleeding within the brain's surrounding membrances and cerebrospinal fluid
slightly more common in women
95% are caused from aneurysm leakage
AVM bleeding

24

what are characteristics of a left-sided cerebral injuries=middle cerebral artery

loss of voluntary movement and coordination on the right side of the face, trunk, and extremities
impaired sensation
language deficits
difficulty with speech articulation due to decrease muscle control of lips, mouth, tongue, and vocal cords (dysarthria)
blind spots
slow and cautious personality
memory deficits

25

What are the language deficits of a left-sided cerebral injuries=middle cerebral artery

aphasia

26

What are the sensation deficits of a left-sided cerebral injuries=middle cerebral artery

impaired temp discrimination
pain
proprioception on right side of body

27

What are the characteristics of a right-sided cerebral injuries=middle cerebral artery

weakness of paralysis on the left side of the body-face arm trunk and leg
sensation impairement on left side of body such
spatial and perceptual deficits
uniateral neglect
dressing apraxia
defective vision
impulsive behavior

28

what is dressing apraxia?

when pt is unable to relate articles of clothing to the body

29

what are characteristics of an anterior cerebral artery stroke

rarely infarcted because of the side to side communication provided by the anterior communicating artery in the circle of willis
symptoms: LE paralysis
loss of sensation in contralateral body
loss of conscious control of bowel
balance problems
lock of spontaneity
memory impairment or loss

30

What are the characteristics of a vertebrobasilar stroke

visual disturbances
impaired temp sensation
impaired ability to read and/or name objects
vertigo dizziness
balance difficulty/ataxia
paralysis of the face/limbs/tongue
drooling and difficulty swallowing
localized numbness
loss of memory
sudden loss of motor and postural, resulting in collapse but the pt is conscious

31

what is wallenberg's syndrome?

result of occulsion of vertebral or cerebral artery:
classic brainstem stroke
possible symptoms:
contralateral pain and temp loss
ipsilateral horner's syndrome
ataxia
facial sensory loss
palatal paralysis
vertigo

32

what is global aphasia

loss of language skills only able to utter
middle cerebral
sensitive to gestures
appear to understand more than they can

33

what is brocha's aphasia

caused by left CVA
poor speech production, misarticulating, simplified speech
broken speech

34

what is wernick's Aphasia

caused by left CVA
impairment of understanding language. impaired auditory comprehensive use of few substantive words.
reading and writing are limited
limited math

35

what is anomic aphasia

difficulty with word retrieval. can't find words
constantly having words on the tip of your tongue
LEFT CVA

36

what is dysarthria?

articulation disorder
NOT APHASIA
dysfunction in CNS
impairment in the muscles causing slurred/sluggish speech

37

what are the non modifiable stroke risk factors?

ethnicity-African Americans have a higher risk
age-especially after 65
heredity-family Hx, genetic factors
hypertension
hyperlipidemia

38

what are the modifiable stroke risk factors?

smoking
obesity
geographic location
diabetes
oral contraceptives
alcohol use
drug abuse

39

What is a TIA?

transient ischemic attack
results from a temporary blockage of the blood supply to the brain
symptoms occur rapidly

40

how long do symptoms occur and last for a TIA

less than 24 hours

41

What are the symptoms of a TIA

fleeting blindness in one eye
hemiparesis
hemiplegia
aphasia
dizziness
double vision
staggering

42

what is hemiparesis?

weakness

43

what is hemiplegia?

paralysis

44

what makes a TIA different from a stroke?

short duration of symptoms
lack of permanent neurologic damage

45

What is a reversible Ischemic Neurologic Deficit(RIND)?

small stroke that completely resolves
like an ischemic stroke, typically occurs in the morning due to low BP during sleep and increase upon waking

46

what is a Partially Reversible Ischemic Neurologic Deficit(PRIND)?

episode that lasts more than 72 hours leaving minor neurological damage

47

what is subclavian steal syndrome?

rare condition resulting in the narrowing of the subclavian artery(runs down clavicle)
symptoms occur with exercise to the arm on the side of the narrowed vessel
blood is "stolen" from the brain and given to the exercised arm

48

what are the symptoms of subclavian steal syndrome?

light-headedness
numbness
weakness

49

what is a warning sign of subclavian steal syndrome?

atherosclerosis may be present in the arteries

50

does the nervous system have a high or low plasticity rate?

high especially during early development

51

when does most of the recovery take place in stroke patients?

approx 90% recovery takes place in the first 3 months

52

what are some stroke complications?

seizures
infection=pneumonia, UTI's and pressure sores
DVT

53

what are the potential deficits after a stroke?

spatial neglect
body neglect
ideational apraxia
organization and sequencing
attention
figure ground
asterognosis
initiation and perseverance
visual agnosia
problem solving

54

what is the clinical picture for stroke pt's?

education
positioning
shoulder protection
contracture prvention
NDT, PNF, Rood, Brunnstrom, Neuro-IFRAH
weight bearing
supported reach activities
reach and manipulation
ADLS and IADLS
cognitive
visual and perceptual
psychosocial

55

what are the precautions of stroke?

medical status/stability
cardiac and respiratory precautions
fall prevention
skin integrity
shoulder injury or pain
contractures
swallowing status
poor safety awareness and impulsive behavior
general safety concerns

56

what is antiplatelet therapy?

For ischemic strokes
Aspirin-not effective for mod to severe strokes, cerebral hemmorrhage or those at risk of bleeding
more effective with men

57

what is anticoagulants therapy?

for ischemic strokes
inhibits clotting
short term (2-3weeks)= heparin
Long term(1-3 months)=warfarian

58

What is thrombolytics therapy?

t-PA
for dissolution of an occluding thrombus if early detection (within 3 hours of onset)