CVA TIA, Pales I Flashcards Preview

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Flashcards in CVA TIA, Pales I Deck (49):
1

incidence of strokes

1 every 40 seconds

2

leading cause long-term disability in US

stroke

3

CVA

cerbro vascular accident
abrupt onset neuro deficit that is attributable to focal vascular cause

4

2 major types of stroke

hemorrhagic stroke
ischemic stroke

5

What is the penumbra in ischemia

brain tissue around cerebral necrosis that has reversible changes

6

main categories of causes of ischemic strokes

large artery thrombosis
embolism
lacunar

7

what are the originations of embolisms that can cause ischemic strokes

arterial: carotid or aorta
heart: atrial, valve or ventricular
paradoxical

8

what are the not common causes of stroke

watershed infarcts
hypercoagulable disorders
vasculitis
vasospasm
dissection of artery

9

what happens in large artery thrombosis

activate platelets and coagulation that cause occlusion

10

types of emboli that cause strokes

athersclerotic plaques and those from thrombi

11

source for paradoxical emboli

lower extremity DVT

12

atrial source of emboli

a fib, flutter
atrial septal aneurism
atrial tumors (myxoma)

13

what is afib

fast and ineffective atrial contraction leading to stasis and thrombus formation

14

atrial septal aneurysm

weakening and out-pouching of interatrial septum leading to stasis and thrombus formation (mural)

15

most common tumor in atrium

atrial myxoma

16

atrial myxoma

pieces of tumor may tear off and become emboli
associated thrombus can embolize artery down the stream

17

emboli from ventricular source

cardiomyopathy
myocardial infarction
ventricular aneurisms

18

majority of ventricular emboli are from what type

MI, stasis!

19

how do MIs lead to emboli

part of wall not moving so creates stasis and leads to thrombus formation

20

what can cause valvular sources of cardiac emboli

rheumatic mitral stenosis
prosthetic valves
infective and non-infective endocarditis
nonbacterial thrombotic endocarditis (malignancies and prothombotic states)
calcification of valves
bicuspid aortic valves
inflammatory valvulitis

21

causes of inflammatory valvulitis

libman sacks endocarditis (assoc with lupus)
behcet disease
syphilis

22

where to arterial embolic infarcts take place that affect brain

carotid artery atherosclerosis or stenosis

23

what is defect that can lead to paradoxical embolie

patent foramen ovale
need Tx atrial septal defect

24

lacunar infarcts occur where

subcortical areas of brain from small deep penetrating aa arising from big aa

25

increases risk for lacunar infarcts

atheroemboli
or lipohyalinosis

26

major factor lacunar infarct

HTN

27

25% ischemic strokes are what type

lacunar infarcts

28

Sx lacunar infarcts

frequently asymptomatic

29

lipohyalinosis

high pressure of L arteries transmitted to small arteries
hyperplasia small vessels
hyalinization of vessel walls
narrowing then occlusion

30

Watershed infarcts

ischemic infarcts of areas farthest from the large aa
most sensitive is when perfusion decreases

31

watershed infarcts develop in what conditions

sepsis
severe bleeding
severe dehydration

32

Where are the cortical border zones

between ACA and MCA
between MCA and PCA

33

3 parts that normally control state of homeostatic equilibrium

coagulation system
anticoagulation system
thrombolytic system

34

what leads to hypercoagulable states

promote coagulation over anti-coagulation

35

hypercoagulable states clot what type vessels

veins more than arteries

36

what are the hypercoagulable disorders

Factor V mutation
Protein C or S deficiency
antithrombin deficiency
plasminogen deficiency
prothrombin gene mutation

37

what disorders are more likely to cause arterial clotting

antiphospholipid antibody syndrome
hyperhomocysteinemia

38

what do you detect in antiphospholipid Ab syndrome

anticardiolipin Ab
Lupus anticoagulants

39

hypercoagulable states from other processes

cancer
pregnancy
hormone replacement therapy
prlonged bed rest or immobility, heart attack, stroke
myeloproliferative disorders such as polycythemia vera or essential thrombocytosis

40

vertebral dissection seen in what sport

golfing from cerebral dislocation

41

causes of strokes not hypercoagulation

vasculitis
vasospasm
moyamoya disease

42

vasospasms causing stroke seen in

subarachnoid bleeding, cocaine use

43

moyamoya disease

poorly understood occlusive disease involving large intracranial aa

44

stroke presentation depends on

size of affected vessel
area of brain supplied by affected vessel

45

hemiparesis

weakness of one side of body

46

hemiplegia

complete paralysis of one side of body

47

homonymous hemianopsia

loss of vision in same visual field of both eyes

48

acalculia

difficulty to perform simple math tasks

49

agnosia

inability to recognize objects, persons, sounds, shapes or smells