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WEEK 1 Flashcards

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1
Q

Stroke

A

(CBA –cerebral vascular attack): interruption of arterial blood to the brain, resulting indamaged brain tissue|
Cellular death occurs in 5 minutes

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2
Q

2 TYPES OF STROKE:

A
  1. ISCHEMIC STROKE >TIA
    2.HEMORRHAGIC STROKE- bleeding into the brain tissue itself or into the subarachnoid space or ventricles
    |>subarachnoid stroke
    |>intracerebral stroke
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3
Q

Incidence -

A

the number of new cases in a particular period of time

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4
Q

Prevalence –

A

the number of new and old cases in a particular period

of time

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5
Q

Morbidity –

A

rates of disability

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6
Q

Mortality –

A

rates of death

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7
Q

TRANSIENT ISCHEMIC ATTACK (TIA):

A

early warning signs of stroke A temporary focal loss of neurological function caused by ischemia.

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8
Q

 Ischemic stroke: (80%)- THERE ARE TWO TYPES

A

inadequate blood flow to the brain from partial or complete occlusion of an artery.
 There are two types: thrombotic and embloic

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9
Q

 Signs & Symptoms OF tia

A

depend on the blood vessel involved and the brain area that is ischemic.

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10
Q

 Carotid involvement:

A

may have temporary vision loss in one eye, transient hemiparesis (weakness to one side of your body), or a sudden inability to speak, numbness/ loss of sensation

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11
Q

 Vertebrobasilar involvement may include:

A

tinnitus, vertigo, ataxia (looking drunk), darkened or blurred vision, diplopia, ptosis, dysphagia, dysarthria, and unilateral/bilateral numbness or weakness

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12
Q

1/3

A

 1/3 individuals will not experince it again, 1/3 will have another TIA, the rest will experience a stroke.

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13
Q

Management of TIA

A

 Diagnostic tests: Cardiac monitoring & CT
 Pharmacological: 1) Antiplatelet aggregation agents(ASA, Plavix)
2) Anticoagulant agents: Coumadin (Warfarin)

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14
Q

Acute Care Goals: CVA:

A

Maintain patent airway
 Monitor for signs of neurologic deficit
 Decrease blood viscosity
 Control fluid & electrolyte balance
 Management of ICP
 Management of pain, hypovolemia, constipation, cerebral edema

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15
Q

Thrombotic stroke( ischemic)-

A

results from fatty deposits that enlarge over years in carotid and other cerebral vessels. Usually slow on their onset.

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16
Q

Embolic Stroke( ischemic)-

A

emboli or clot fragments break off and travel to cerebral arteries, usually originates from the heart or carotid artery.

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17
Q

HEMORRHAGIC STROKE-

A

usually caused by: a ruptured aneurysm, severe hypertension, or drugs like cocaine etc..
a patient will have headache, nuchal rigidity, and possible nausea.
usually after shitting really hard.

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18
Q

WHAT ARE THE CONSEQUENCES OF STROKE?

A

Third leading cause of death and disability in adults
• about 15% of sufferers die
• about 30% are left with moderate-severe disability

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19
Q

UNMODIFIABLE RISK FACTORS-

A

Age- increase risk with age

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20
Q

Agnosia-

A

, Agnosia- Inability to recognize familiar objects, persons, smells, shapes, even though the sensation is intact

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21
Q

Ataxia-

A

Impaired gait, unsteady, incoordination,

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22
Q

Dysphasia/aphasia-

A

Impaired capacity to interpret, formulate or express meaningful language, writing or gesturing,

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23
Q

Dysphagia-

A

Impaired swallowing

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24
Q

Hemiparesis-

A

Weakness on one side of the body

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25
JUST LIKE A CAR ACCIDENT –
``` What caused the accident? What caused the stroke? Where did the accident happen? Which artery did the stroke happen in? What damage occurred? (Where did the brain damage occur?) ```
26
RIGHT HEMISPHERE
Controls left side of body, Spatial abilities, Visual imagery, Music
27
LEFT HEMISPHERE
Controls right side of body, Language/Speech, Math, Logic
28
The Frontal Lobe has many ‘jobs’including:
movement, intellectual function, emotions, memory
29
PARIETAL LOBE- | •
located in the top middle of the cerebrum | • helps with sense of touch and with some complex visual perceptions
30
THE TEMPORAL LOBE | •
located in the bottom middle of the cerebrum | • helps hearing and speech
31
THE OCCIPITAL LOBE | •
located in the rear of the cerebrum | • plays a major role in vision
32
THE vertebrobasilar arterial system
SUPPLIES BRAIN STEM AND CEREBELLUM
33
STROKE in the brain stem
breathing, heartbeat, articulate speech.
34
Cerebellum stroke
Cerebellum stroke ruins smooth coordinated movement
35
To differentiate stroke vs stroke mimics & ischemic vs hemorrhagic stroke, requires (at least):
``` • History & neuro assessment (including stroke scale) • CT scan of the head • Blood work (including BS, CBC, INR) • Assessment of risk factors ECG ```
36
tPA
clot-busting drug that destroys an existing blood clot (- given 3 hours after onset of symptom, major side effect: cerebral hemorrhage, of BP critical during treatment and 24 hours after treatment)
37
• Wernicke’s aphasia –
receives auditory speech impulses, but unable to comprehend them, Characterized by fluent, well-articulated speech, with intact tone, but inappropriate speech content that is unintelligible d/t poor word choices
38
• Anomic or amnesic aphasia
- probs finding correct names for certain stuff
39
 Signs & Symptoms OF tia
depend on the blood vessel involved and the brain area that is ischemic.
40
 Carotid involvement:
may have temporary vision loss in one eye, transient hemiparesis (weakness to one side of your body), or a sudden inability to speak, numbness/ loss of sensation
41
 Vertebrobasilar involvement may include:
tinnitus, vertigo, ataxia (looking drunk), darkened or blurred vision, diplopia, ptosis, dysphagia, dysarthria, and unilateral/bilateral numbness or weakness
42
1/3
 1/3 individuals will not experince it again, 1/3 will have another TIA, the rest will experience a stroke.
43
Management of TIA
 Diagnostic tests: Cardiac monitoring & CT  Pharmacological: 1) Antiplatelet aggregation agents(ASA, Plavix) 2) Anticoagulant agents: Coumadin (Warfarin)
44
Acute Care Goals: CVA:
 *Maintain patent airway*  Monitor for signs of neurologic deficit  Decrease blood viscosity  Control fluid & electrolyte balance  Management of ICP  Management of pain, hypovolemia, constipation, cerebral edema
45
Thrombotic stroke( ischemic)-
results from fatty deposits that enlarge over years in carotid and other cerebral vessels. Usually slow on their onset.
46
Embolic Stroke( ischemic)-
emboli or clot fragments break off and travel to cerebral arteries, usually originates from the heart or carotid artery.
47
HEMORRHAGIC STROKE-
usually caused by: a ruptured aneurysm, severe hypertension, or drugs like cocaine etc.. a patient will have headache, nuchal rigidity, and possible nausea. usually after shitting really hard.
48
WHAT ARE THE CONSEQUENCES OF STROKE?
Third leading cause of death and disability in adults • about 15% of sufferers die • about 30% are left with moderate-severe disability
49
UNMODIFIABLE RISK FACTORS-
Age- increase risk with age
50
Agnosia-
, Agnosia- Inability to recognize familiar objects, persons, smells, shapes, even though the sensation is intact
51
Ataxia-
Impaired gait, unsteady, incoordination,
52
Dysphasia/aphasia-
Impaired capacity to interpret, formulate or express meaningful language, writing or gesturing,
53
Dysphagia-
Impaired swallowing
54
Hemiparesis-
Weakness on one side of the body
55
STROKE in the brain stem
breathing, heartbeat, articulate speech.
56
Cerebellum stroke
Cerebellum stroke ruins smooth coordinated movement
57
To differentiate stroke vs stroke mimics & ischemic vs hemorrhagic stroke, requires (at least):
``` • History & neuro assessment (including stroke scale) • CT scan of the head • Blood work (including BS, CBC, INR) • Assessment of risk factors ECG ```
58
tPA
clot-busting drug that destroys an existing blood clot (- given 3 hours after onset of symptom, major side effect: cerebral hemorrhage, of BP critical during treatment and 24 hours after treatment)
59
• Wernicke’s aphasia –
receives auditory speech impulses, but unable to comprehend them, Characterized by fluent, well-articulated speech, with intact tone, but inappropriate speech content that is unintelligible d/t poor word choices
60
• Broca’s aphasia
- expressive aphasia characterized by no fluent, telegraphic speech with outbursts of profanity, uninhibited speech and word-finding difficulties
61
• Anomic or amnesic aphasia
- probs finding correct names for certain stuff
62
• Global aphasia-
loss of all expressive and receptive
63
• Dysarthia
disturbance in the muscular control of speech
64
• Dysphasia
impaired communitcation
65
Primary assessment of the patient
with stroke is focused on cardiac, respiratory status, and neurological examination.
66
Secondary assessment should include a comprehensive neurological examination of the patient including:
LOC (Glasgow Coma Scale), cognition, motor abilities, cranial nerve function, sensation, proprioception, cerebellar function, and deep tendon reflexes.
67
Homonymous hemianopsia
(blindness in the same half of each visual field):
68
Stroke complications | 
Risk of recurrent stroke is 5 to 20%  5% for cardioembolic strokes  20% for atherosclerotic strokes
69
No significant diff between ischemic and hemorrhagic stroke.
Because destruction of neural tissue is the basis for neurological dysfunction regardless of the etiology. Therefore clinical mani. Related to the location in the brain the stroke occurred.
70
Cerebral Angioplasty –
a balloon catheter to mechanically dilate vessels
71
artherosclerosis
hardening and thickening of arteries
72
tia vs stroke
in tia ischemia occurs without infraction but in a stroke infraction and cell death occur
73
cerebral aneurysms are viewed
as the silent killers
74
antiplatelet drugs
to prevent stroke in paitents who have had TIA

PNH (18 decks)

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