CVA Flashcards Preview

Post Midterm Patho > CVA > Flashcards

Flashcards in CVA Deck (36):
1

What is a Cerebrovascular Disease? CVA

Stroke

2

Define what a CVA is. What is it? What is it due to?

an acute neurological deficit d/t ischemia

3

If a CVA is an acute neurological deficit d/t ischemia, what does this mean in regards to perfusion to the brain?

Lack of perfusion to the brain.

4

There are 2 Types of CVAs. Name them and explain what it is.
1.
2.

1. Ischemic CVA
- obstructed or occluded vessel causing lack of perfusion to the brain tissue

2. Hemorrhagic CVA
- vessel severed in cranium --> hemorrhage --> brain compression

5

Ischemic CVA: the vessel can be occluded why? (2)

1. Embolus
2. Thrombosis

6

The risks for CVA

1. Modifiable (5)

2. Unmodifiable (4)

1. HTN, atherosclerosis, Hyperlipiedmia, DM, Smoking

2. Aging, males, prior strokes, familial history

7

If the modifiable risk factors for CVA are managed, can a stroke be avoided?

Yes

8

The patho for CVA involves the brain being sensitive to what two things?
Can the brain utilize anarerobic metabolism?

Oxygen and glucose
The brain relies on aerobic metabolism for ATP

9

What are the two forms of stroke?

1. Ischemic CVA
2. Hemorrhagic CVA

10

Explain the patho for Ischemic CVA:

Occlusion of the vessel --> focal ischemia --> necrotic core (dead tissue which will have loss of function) --> pneumbra around the necrotic core (tissue that is lacking perfusion but still alive) --> penumbra will become smaller and necrotic core bigger if there is not an intervention to increase the blood supply to the brain

11

What does focal ischemia mean?
What does global ischemia mean?

1 hemisphere affected
Most of the brain is obstructed (BIG PROBLEM!)

12

1. Explain the patho for Hemorrhagic CVA:
2. What usually causes this? (4)
3. What are the two complications from this?

1. severed vessel --> hemorrhaging --> compression
2. Htn and ageing (also aneurysms and tumors)
3. Coma and death

13

Define TIA
is this a large or mini stroke?

Transient Ischemic Attack
Mini stroke

14

Transient Ischemic Attack: what is occuring to the neurological deficit? d/t what?

acute, brief, neurological deficit d/t acute focal ischemia

15

1. Is a TIA reversible?
2. Is the ET/Patho of TIA similar to CVA?
3. Does a TIA involve a necrotic core? Penumbra?

1. Yes
2. yes
3. No nectrotic core, yes penumbra

16

Why would a TIA have a pneumbra?

The tissue is not being properly perfused, but there is no necrosis occuring.

17

Does a TIA involve permanant damage?

No.

18

If you have a TIA, what does this do for your risk of future TIA's or strokes?

Increases the risk

19

The manifestations for CVA depend on what?

Are the mnfts an acute onset?

the location, size of vessel, and area of brain distal to the vessel

Yes they are an acute onset

20

The mnfts for a CVA in the left hempishere would present in the right side of a patient. Why?

D/t to the decaustation of the pyramids, the fibers cross over.

21

What are the 3 main symptoms of a CVA?

1. Unilateral weakness or numbness in face, arm, and or leg (1 or more)
2. Speech alteration
3. Altered vision in 1 eye

22

How is CVA Dx (3)

1. Labs
2. EEG
3. MRI/CT scans

23

What labs are looked at for CVA? (3)
Expla

CBC, INR, lipids

24

1. Why assess the INR?
2. Why assess the lipids?

1. Clotting time (for TPA)
2. Hyperlipedima can lead to atherosclerosis

25

What is the electroencephogram looking at?

Conductivity of the brain tissue

26

What is the MRI/CT scan looking for?

Differentiating between Ischemic and Hemorrhagic stroke

27

The treatment for strokes main focus is to preserve AND salvage what?

Life! Penumbra!

28

What is the Stat treatment for Ischemic stroke.

ASA (antiplatelet) 160 mg, then taper down

29

What is the purpose of administering the antiplatelet?

Not allowing platelets to aggregate

30

When would TPA be given to a patient?

When they meet the criteria and it is an ischemic stroke.

31

The treatment for CV risk factors includes what? (2)

statins to decrease cholesterol
antihypertensives to decrease BP

32

Sx for stenosis for patients with ischemic stroke. What is this procedure called? what is the time frame post stroke for it to be done?

Carotid endoarterectomy done within 2 weeks of CVA

33

What would the stenosis be?

Narrowing of the blood vessel d/t atherosclerosis

34

To prevent recurrence involves what? (2)

Reducing risk factors
Blood thinners to prevent thrombus reappearing

35

Would a blood thinner ever be given to a patient experiencing a hemorrhagic stroke?

Nope you crazy lady.

36

To prevent extension involves what?

preventing complications, be aware of aspirations