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Strokes- Exam 2

Terms in this set (74)

3rd leading cause of death
Stroke/CVA
Involves the interruption of blood flow to the brain either due to a blocked blood vessel or a rupture
Stroke/CVA
What happens as a result of stroke?
Loss of oxygen and nutrients to the brain which can cause brain damage
True or False? Stroke can occur in ANY part of the brain and site will determine loss of function
True
The brain consumes about ___ % of oxygen used by the entire body
20%
What is extremely important to the brain?
Blood supply
Arteries supply front, top, and side portions of the cerebral hemisphere
Anterior circulation
Arteries supply the brainstem, cerebellum, back and undersurface of the cerebral hemisphere
Posterior circulation
2 areas of circulation are further characterized as what 2 portions?
Extracranial

Intracranial
Portion arising from outside the skull and traveling toward the brain
Extracranial portion
Portion arising from within the skull
Intracranial portion
What arteries are involved in the Circle of Willis?
1) anterior communicating
2) anterior cerebral
3) internal carotid
4) posterior communication
5) posterior cerebral A
Protects the brain should one of the four major supplying arteries coming up from the neck be blocked
Circle of Willis
When one of the major vessels supplying the brain is occluded, either within the circle of Willis or proximal to it, the communicating arteries will what?
enlarge to compensate for the occlusion
This system is imperfect though and can fail to prevent strokes
Circle of Willis
Name the two types of strokes.
Ischemic and hemorrhagic
Type of stroke that is BLOCKAGES; includes atherothrombotic, lacunar and embolic infarctions
Ischemic stroke
Type of stroke that is BLEEDING; include intracerebral and subarachnoid
Hemorrhagic stroke
Most common type of stroke- accounts for 80% of all cases
Ischemic stroke
Damaged area of ischemic strokes- what are the two area!
1) tissue died because of blood supply lost
2)peripheral area with temporary dysfunction as a result of edema
Process of edema takes how long?
4-5 months
Name the order of the physiological events following ischemic stroke:
1-membranes surrounding leak potassium and ATP
2-fluid accumulates
3-irreversible cell death occur within 5-10 minutes
4-zone of injury (penumbra and area of hypermia form- do have potential for recovery.
Life threatening event in which part of the brain does not receive enough oxygen, usually due to a blood cot lodged in a cerebral artery
ischemic stroke
occurs when a blood clot forms in one of the arteries supplying the brain and obstructs blood flow
thrombosis
occurs in arteries that have been damaged by atherosclerosis and causes stuttering.
occuts during sleep and wake up the next morning with paralysis
Thrombosis
Greatest risk factor for this type of stroke is hypertension
Lacunar stroke
Results from occlusion of small branches of larger cerebral arteries
Lacunar stroke or penetrating artery diesase
Lacunar strokes have small infarcts and typically go undetected. true or false.
true
Occurs when a clot that has formed elsewhere (THROMBUS) breaks off (EMBOLUS), travels up the blood stream until it reaches an artery too small to pass through and consequently blocks the artery
Embolism
Embolic material with 20% of ischemic strokes occurring from cardiac source emboli. True or False?
True
Embolic strokes typically occur during nighttime activities. true or false?
FALSE, daytime
Blood clot
Embolism
Accounts for 20% of all strokes (burst pipe) and can be compared to an aneurysm
Hemorrhagic stroke
Bulging out of wall and weakness in vessel wall, can rupture at any time!
Aneurysm
Hemorrhagic stroke and aneurysms are more common in older people. True or False?
FALSE, younger people (genetically linked)
2 types of hemorrhagic strokes?
1) Intercerebral Hemorrhage and Subarachnoid Hemorrhage
Accounts for high % of death rates
hypertension
swelling and bleeding
increased pressure
clinical signs: convulsions, decrease alertness, headache, vomiting
Intercerebral Hemorrhage
5-10% of all strokes
more common in women
most caused by leakage of blood in aneurysm
Extra fluid in closed cranial cavity
clinical signs: terrible headache, altered state of consciousness, vomiting
Subarachnoid Hemorrhage
Results from a temporary blockage of the blood supply to the brain
Symptoms occur rapidly and last less than 24 hours
TIA- transient ischemic attack
True or False? 75% ischemic strokes last less than 5 minutes.
True
One imperative thing to note about TIA?
DETECT THE CAUSE TO DECREASE STROKE RISK IN THE FUTURE
RINDS and PRINDS stand for...
small strokes
what does RINDS stand for?
reversible ischemic neurologic deficits

(small stroke that completely resolves itself)
What does PRINDS stand for?
Partially reversible ischemic neurologic deficit

(lasts more than 72 hours and leaves minor neurologic deficits)
Rare condition caused by the narrowing of the subclavian artery that runs under the clavicle
Subclavian Steal Syndrome
Blood is "stolen" from the brain and instead is delivered to the exercised arm.
Subclavian Steal Syndrome
Strokes affect more African Americans and there is an increased risk of people 65 or older. True or False?
True
There is a risk factor for strokes for obesity especially when the weight is centered where?
in the abdomen
If you have a history of TIA, you are at risk...
At risk for having a stroke within 2 years
You are at risk for strokes geographically if..
If you are in "stroke belt" states
You are at risk for strokes with Asymptomatic carotid bruits which is..
A murmur heard in the carotid artery
Some stroke warning signs?
Sudden numbness/tingling
Sudde confusion
Sudden trouble seeing
Sudden trouble walking
Sudden severe headache
Recovery for strokes can occur when..
When swelling decreases
It is hard to predict functional return and the rate of recovery is better for younger individuals. True?
True
Left cerebral hemisphere controls most functions on the __ side of the body.
Right
Some symptoms of LEFT sided cerebral injuries: middle cerebral artery are..
Loss of voluntary movement right side of the face
Impaired sensation including temperature discrimination on right side of body
Dysarthria
etc
problems with articulation of speech due to disturbances in muscle control
Dysarthria
Blind spots in the visual field usually on the left or right side?
Right side
Right cerebral hemisphere controls most of the functions on the ___ side of the body
Left!
One symptom of right sided cerebral injury is unilateral neglect. What is that?
Patient neglects left side of the body of left side of environment
Impulsive behavior and dressing aphasia is a symptom of which cerebral injury?
Right sided cerebral injury
Occlusion to posterior portion of the brain (brainstem, cerebellum, thalamus, and parts of occipital and temporal lobes)
Vertebrobasilar Stroke
Name some symptoms of vertebrobasilar stroke
-visual disturbances
-impaired temperature sensation
-impaired ability to read or name objects
-vertigo/dizziness
drop attacks- loss of motor and postural control
Brainstem stroke or lateral medullary syndrome
rare, often fatal
often results in coma
if one survives, recovery is good
Wallenberg's syndrome
of Wallenberg's Syndronme, an ipsilateral symptom
sinking of eyeballs, ptosis of upper eyelid and a cool dry face on the affected side
Herner's Syndrome
Name three secondary complications of strokes
1) Seizures
2) Infection
3)Thromboembolism- DVT (deep vein thrombosis)
Name 4 Medical managements of strokes
1) Antiplatelet therapy
2) Anticoagulents
3) Trombolytics
4) Surgical intervention
Aspirin is described counts as what type of stroke therapy?
Antiplatelet therapy
This medical management prevents formulation of emboli
Anticoagulent
T-PA therapy is applied in the acute treatment of MI's and strokes to dissolve an occluded thrombosis.
Trombolytics
If a client has DVT do you get them out of bed?
NO!!!
Stroke affects motor functions such as flexor synergy. What makes up flexor synergy?
Scapular retraction and depression
shoulder adduction and internal rotation
elbow flexion
forearm pronation
wrist, finger and thumb flexion
adduction
Name three mental functions of strokes
Initiation
Recognition
Attention
Name three emotional functions of strokes
Depression
Irritability
Low tolerance for stressful situations
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