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19 Cards in this Set
- Front
- Back
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What are the two etiologies of CVA |
1) Ischemic (85%)· Thrombus: Clot within the cerebral arteries Embolus: Traveling matter that occludes cerebralarteries 2) Hemorrhagic (15%) – Abnormal bleeding as aresult of a ruptured vessel Subarachnoid Subdural AV MalformationsN |
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How does Ischemic Penumbra present |
Blood flow 20-50% of normal Excesive glutamate facilitates calcium entry and nuerotoxic by products activated |
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How does Thrombic present? |
Plaque deposits and decreases lumen Blood flow reduces thus reducing oxygen to tissues Complete occlusion cause cell death |
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How does Embolic Present |
A-fib, MI, or Valvular disease, clot breaks away Clot lodges in a cerebral blood vessel Perfusion, cell death occurs |
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How does Hemorrhagic Present |
ICH - vessel malformation and vessel integrity decreases SAH - Anueysms and vessel malformations. 90% berry anuerysm AVM - congenital anomalies. Communicate directly, become dilated and form masses |
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Describe Right Hemi Dominance |
L hemiparesis and sensory loss V: Left neglect, difficult processes visual cues B: Quick impulsive poor judgement I: Difficulty with abstract, rigidity of thought, difficulty with whole idea of task E: Difficulty perceiving emotions and ecpressing neg emotions TP: fluctuations in performance |
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Describe Left Hemi Dominance |
R hemiparesis and sensory loss V: Broca's, global aphasia, difficulty processing verbal cues B: Slow, Cautious, disorganized I: Highly distractable, preservation, difficulty initiating E: Difficulty expressing positive emotions TP: Ideational Apraxia |
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What is the MOI of SCI |
· Excessive spinal flextion · Concussion – blow or violent shaking · Contusion – glial tissue and cord remain intact · Laceration – glia is disrupted and cord may betorn · Complete transection |
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What are the two types of SCI
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Incomplete: Partial preservation of motor function and/or sensory function below LOI extending to S4-S5 Complete: No sensory or motor functino preserved in the segment s4-s5 |
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How are spinal cord injuries classified |
a) Complete – no sensory or motor function b) Incomplete – only sensory function c) Incomplete – Motor preserved below neurologicallevel and > half key muscle has grade <3/5 d) Incomplete - Motor preserved below neurologicallevel and ≥ half key muscle has grade ≥3/5 e) Normal: motor and sensory function are normal |
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What are the types of SC Leisons |
-Partial spinothalamic tract lesion - pain temp and tough below dermatone -Partial cord lesion - loss of all modalities of several derm, loss of pain and temp below specific -Complete cord lesion - Bilateral loss of all modalities and leg weakness -Central cord lesion - Bilateral loss of pain and temp. preservation of proprioception |
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How are SCI Manifested |
-Muscle Tone - atrophy, spasticity -ANS - AD -Skeletal Changes - Scoliosis -Pain/Fatigue - Nerve root or overworking -Respiratory - Pneumonia or High cerv = IND breathing -CV - risk of DVT -Metab - Insulin resistance, increase BF -Bladder - Neurogenic bladder, UTI -Sexual Dys - Menses 3-6mo / HL: no ej LL: no er -Sleep - Apnea |
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What is Autonomic Dysreflexia |
Occurs above T6 - elevates BP causes headache and vasoconstriction Common with over extended bladder |
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S/S of Autonomic Dysreflexia |
BP increase Goosbumps above lesion Blurred vision Nasal Congestion increase anxiety without cause |
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Triggers for Autonomic Dysreflexia |
Full bladder Kidney stones Pressure ulcers DVT Insect bites Labor Contractions |
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What to do with a patient with Autonomic Dysreflexia |
Medical emergency Elevate head (sit the patient up) Remove Noxious stimuli |
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What are the two types of Traumatic brain injuries |
Open - Skull fx/ torn meninges/ brain exposure/ risk of infection Closed- No Skull Fx/ Neural tissue damaged/ dura remains intact/ risk of ICP |
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What occurs with primary TBI Damage |
Damage at impact site Coup-contracoup injury Diffuse exonal injury laceration to cerebral tissue |
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What occurs with Secondary TBI Damage |
Changes due to brain reaction to trauma Axonia - hippocampus, cerebellum effected Seizures - Stress, poor nutrition, drug use, Infection ICP - Dec Responsiveness, severe headache, vomitting, inc bp, dec HR, irritability |
