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65 Cards in this Set
- Front
- Back
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What are 5 signs of stroke?
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sudden numbness/weakness in face arm or leg, esp. on one side of body
sudden confusion, trouble speaking/understanding sudden trouble seeing in one or both eyes sudden trouble walking/dizziness/loss of balance or coordination sudden, severe headache w. no known cause |
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definition of aphasia (Rosenbek, LaPointe and Wertz)
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impairment due to:
acquired & recent damage of the CNS. Effects ability to comprehend and formulate language. Multimodal disorder w/ variety of impairments in: auditory comprehension, reading, oral-expressive language and writing. Disrupted lg. may be influenced by physiological inefficiency or impaired cognition, but it cannot be explained by dementia, sensory loss, or motor dysfunction. |
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What is the exception to Rosenbek, LaPointe and Wertz' definition of aphasia?
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Primary Progressive Aphasia...
doesn't "erupt", it "creeps" |
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disrupted language can be influenced by...?
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a. physiological inefficiency
b. impaired cognition |
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disrupted language cannot be explained by...
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dementia
sensory loss motor dysfunction |
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Aphasia is...
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acquired & recent (except for primary progressive aphasia)
damage to CNS a multimodal disorder explained by physiological inefficiency |
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name the 4 modalities affected by aphasia
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oral-expressive language
auditory comprehension reading writing |
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Name 4 causes of aphasia
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CVA (cerebrovascular accident)
infection (e.g., meningitis) trauma (TBI) tumor |
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What are the 8 risk factors for stroke?
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high blood pressure
diabetes mellitus smoking high cholesterol heavy drinking obesity lack of exercise heart disease |
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name and define the two types of blood pressure.
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Systolic: the highest number. Pressure created by contraction of heart muscle and elastic recoil of aorta
Diastolic: lower number. Reflects resistance in small arteries throughout body & load against which the heart must work. The relaxation of the heart ventricles between beats. |
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Healthy adult blood pressure?
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110/75
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blood pressure at age 60?
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130/90
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measurement used for blood pressure?
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mmHg
millimeters mercury |
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to reduce risk of stroke by ____%, one should lower BP by ____mmHg systolic and ____mmHg diastolic
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38%
10-12 mmHg systolic 5-6 mmHg diastolic |
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name two main categories of CVAs
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Ischemic
Hemorrhagic |
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Name the 2 types of Ischemic strokes.
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Thrombotic stroke
Embolitic stroke |
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When we don't know whether stroke is caused by a thrombus or an embolism, we call it a...
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thrombo-embolitic stroke
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___% of strokes are Ischemic.
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75-85%
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Ischemic (Occlusive) strokes usually occur in the ...
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Middle Cerebral Artery (MCA)
or Internal Carotid Artery (ICA) |
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blockage results in...
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cerebrovascular inefficiency
(deprivation of blood flow) |
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define cerebral thrombosis
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a blood clot in a plaque-narrowed artery which blocks blood flow.
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Define TIA
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Transient Ischemic Attack
A warning stroke. Temporary blockage that causes a sudden, immediate reduction of blood flow (temporary cerebrovascular insufficiency) |
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What happens with a TIA?
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Temporary cerebrovascular insufficiency lasting a minute or hours. No cell death occurs, but displays immediate consequence.
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A TIA indicates a problem in the __________________.
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Internal Carotid Artery
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Describe the treatment for a TIA.
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administration of Clotbuster (enzymes that dissolve clot) to break up clot.
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1. Thrombus = ?
2. Embolism = ? |
1. plug, blockage
2. blockage caused by clot that was formed elsewhere (often in the heart) that travels through blood stream until it gets lodged in a smaller vessel |
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describe ischemia, infarct, and astrocytes
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Ischemia is the occlusion, Infarct is the damaged tissue that liquifies and dissipates leaving a cavity, astrocytes are the rim around the cavity.
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A thrombus is located _________.
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... in its place of origin.
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2 causes of thrombosis...
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ARTERIOsclerosis: variety of pathological conditions causing thickening, hardening, loss of elasticity of vessel walls.
ATHEROsclerosis: FORM OF arteriosclerosis. Thickening due to LOCALIZED deposits of lipids (fat and fibrous material) |
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Describe a cerebral embolism.
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Sudden, NO TIA. Clot forms somewhere else, circulates and then plugs when it gets to vessel too small to pass. Commonly originate from wall of heart.
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Arteriosclerosis and Atherosclerosis often occur in 3 spots. Name them.
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MCA, ICA, Basilar Artery
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Can a thrombus be part of an embolism?
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No, but an embolism can be part of a thrombus.
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What is the I.V. med used when a person has a thromboembolitic cerebrovascular accident?
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T-pa: Tissue plasminogen activator (clotbuster)
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Name and describe a non-pharmeceutical method to removing a thrombus.
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Clot Retriever
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can an embolism be 'fixed' or 'stationary'?
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Yes. Both a thrombus and an embolism can be 'fixed' or 'stationary', but only a thrombus exists in its 'place of origin'.
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20% of all strokes are ________.
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Hemorrhagic
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What causes a hemorrhage?
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Extreme fluctuation in blood pressure.
Traumatic injury Weakness in blood vessel wall |
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What happens in a hemorrhage?
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break in blood vessel wall, blood flows out, pools around surrounding tissue, rapidly expands.
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___% of hemorrhagic stroke victims survive.
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50% (but less than half of those that survive are functional)
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Name the 2 major categories of hemorrhagic stroke.
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INTRAcerebral: within brain or brain stem
EXTRAcerebral: btwn brain & skull (rupture of vessels in meninges) |
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Extracerebral hemorrhage is frequently caused by...
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head injury
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Name the 3 types of extracerebral hemorrhage
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subdural
subarachnoid (most common) extradural |
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What is the most common extracerebral hemorrhagic event and what is it characterized by?
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subarachnoid hemorrhage: severe, violent headache
nausea vomiting |
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what is the location of a subarachnoid hemorrhage.
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under the arachnoid membrane... geesh!
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Can a subarachnoid hemorrhage be prevented?
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Yes. Can be identified and Dx'd before rupture and surgically repaired.
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describe what happens when a person has a subarachnoid hemorrhage...
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swelling & blood from hemorrhage compress neighboring structures - this is why recovery of skills happens. Swelling goes down, skills come back.
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an aneurysm is most common in people ages ___-___.
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can occur at any age, but is most common in 25-50 yo
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What is the most common cause of a subarachnoid hemorrhage?
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aneurysm
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What are the causes of an aneurysm?
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congenital (malformation)
anything that could weaken vessel wall (TBI) |
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what are the most common locations for an aneurysm?
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ICA (30%)
ACA (30%) MCA (25%) BA (10%) |
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90% of _______________ hemorrhages are due to high blood pressure.
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Intracerebral
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What are the structures that are affected by an intracerebral hemorrhage?
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thalamus
basal ganglia brainstem cerebellum |
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Why is there an increase in thalamic stroke?
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easier to block the smaller vessels that run off the MCA... can be result of clotbuster meds
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What determines the manifestation of an intracerebral hemorrhage?
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the size and location of hemorrhage will manifest in different symptoms by application of pressure on neighboring tissue
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t/f Tissue affected by an intracerebral hemorrhage is destroyed
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False. Pressured is applied, but tissue is not destroyed.
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Give and spell term that describes the temporary affectation of surrounding structures.
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diaschesis
connected areas "go on strike" for a few weeks. Return in 3-6 months. |
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Provide timeline of neurological stability and recovery post-stroke.
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wait 2-3 weeks before giving prognosis
effects are continuous for awhile after 3-4 wks, damage is chronic acute events will dissipate and stabilize Now recovery will start to occur. |
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If patient does NOT have an ischemic attack, they may have a ...
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Reversible
Ischemic Neurological Deficit |
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1. acute=
2. stable= |
1. Event is not over. Damage still occuring
2. No more damage. Stroke not getting worse. |
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acute effects of stroke last approximately _____ hours.
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24-72 hours
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when do we determine severity?
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once patient is stable, however if treatment is started immediately (within first month) improvements may be greater.
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Recovery of occlusive stroke
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gradual but continuous months past onset
would improve w/o Tx, but improvements are greater w. Tx |
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Recovery of hemorrhagic stroke
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very little progress in first few months
recovery is delayed, but it will happen |
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Recovery of TBI
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classic stair step (up/plateau... up/plateau...)
if injured when young, problems can occur later: adolescents may have problems with lang. & memory |
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Name 4 kinds of stroke
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TIA: quick attack & then over (on/off)
RIND: stroke in progress Occlusion: (acute/chronic) Hemorrhage: (acute/chronic) |
