cerebrovascular history and physical
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What are three reasons why a Bruit is heard?
- 1. stenosis
- 2. tortuous vessels
- 3. valves-stenosis
Is a Bruit symptomatic or asymptomatic?
What is the difference between TIA and CVA?
TIA lasts less than 24 hours and usually only lasts minutes.
CVA lasts greater than 24 hours and causes a permanent neurological damage.
TIA stand for what?
Transient Ischemic Attach
CVA stands for what?
Is TIA symptomatic or asymptomatic?
Is CVA symptomatic or asymptomatic?
What is the chance of a CVA occurring after a TIA within 3 months?
What is the chance of a CVA occurring after a TIA within the first 2 days after the initial symptoms?
50 % or a half of CVA occur within 2 days of a TIA.
What does RIND stand for?
Reversible Ischemic Neurologic Deficit
Is RIND symptomatic or asymptomatic?
What are the six causes of strokes?
- 1.) Atherosclerosis
- 2.) Embolism from the heart
- 3.) Hypertension
- 4.) Dissection
- 5.) Pre-thrombotic (Deficiencies in prothrombin
- 6.) Vasopasm
How does Atherosclerosis cause strokes?
Hemodynamically significant. (Blood flow is being restricted and changed)
75% area reduction
50% diameter reduction of lumen
How does Embolism from the heart cause a stroke?
Causes a Cardioembolic stroke
- An arrhythmia of Lt. Atrium, atrial fibrillation, prosethic heart valve,
- damaged cardiomyopathy, mitral stenosis, bacterial endocarditis
How does Hypertension cause a stroke?
Injury to small vessels, puts stress on arteries.
How does Dissection cause a stroke?
False lumen, narrows true lumen
(Carotid A. or Vertebral A.)
What does Pre-thrombotic cause a stroke?
Proteins C or S deficiency
Antithrombin 3 deficiency
What does Vasospasm cause a stroke?
Subarachnoid hemorrhage (SAH)- Have vasospasm which is a problem after a hemorrhage.
muscle contracts, reduces blood flow
What is the anterior circulation also called?
What arteries does the anterior circulation include?
- 1.) ICA
- 2.) MCA's
- 3.) ACA's
What are 6 signs and symptoms of the anterior circulation?
- 1.) Monocular visual disturbance
- 2.) Amaurosis Fugax
- 3.) Aphasia
- 4.) Mono or hemiparesthesia
- 5.) Mono or hemiparesis
- 6.) Homonymous hemianopia
What sign and symptoms can be considered part of both the anterior and posterior circulation?
What vessels are involved in the posterior circulation?
- 1.) PCA
- 2.) Vertebrals
- 3.) Basilar
What are the 9 signs and symptoms of posterior circulation?
- 1. Homonymous hemianopia
- 2. Paraesthesias of any or all extremities
- 3. Paresis of any or all extremities
- 4. Ataxia
- 5. Drop attacks
- 6. Diplopia
- 7. Dysphagia
- 8. Dysarthria
- 9. Vertigo
What are 6 non-specific sign or symptoms?
- 1. confusion
- 2. dizziness
- 3. headache
- 4. impaired mental status
- 5. loss of memory
- 6. syncope
What is monocular visual disturbance?
What should be checked when monocular visual disturbance?
Transient or complete loss of vision in one eye.
Check ICA and Ophthalmic A. on the same side as the eye with problems.
Amaurosis Fugax can be considered the same as ________________ but with a difference because of _______________.
same as Monocular visual disturbance
is a Emboli problem
What is Amaurosis caused by?
Vision loss due to a temporary reduction in retinal artery or ophthalmic artery blood flow which causes retinal hypoxia.
Described as Shade pulled over eye.
Check ICA and ophthalmic A. on the same side as symptoms.
What is Aphasia?
without speech or unable to communicate.
What is Homo or hemiparesthesia?
What to check?
1-sided numbness, tingling sensation
check the opposite side as problem.
What is Mono or hemiparesis?
What is homonymous hemianopia?
Partial loss of visual field in both eyes.
What is Paraesthesia of any or all extremities?
a numbness or tingling sensation "pins or needles" or "falling asleep" caused by a reduction in blood supply to nerves.
- Can be:
- both arms,
- one arm and one leg,
- both legs
What is paresis of any or all extremities?
What is Ataxia?
Gait disturbance or touch an article with the hand.
What is Drop Attacks?
Sudden musculature weakness, do not lose consciousness.
What is Diplopia?
"Double Vision" or Bilateral visual blurring
too images from one object
What is Dysphagia?
What is Dysarthria?
When there is difficultly speaking and pronouncing words due to problems with the muscles that help people talk.
What is vertigo?
More than just a dizziness feeling.
It is a spinning sensation
What are the 5 Different Types of Aphasias?
- 1.) Auditory
- 2.) Motor or Broca's
- 3.) Visual
- 4.) Sensory
- 5.) Global
What is specific about "Auditory Aphasia"?
an impairment in understanding spoken language that is not attributed to hearing loss.
What is specific about "Motor" or "Broca's Aphasia"?
Have difficulty communicating orally and in writing.
What is specific about "Visual Aphasia"?
Inability to perceive written words.
What is specific about " Sensory Aphasia"?
have problems understanding spoken and written language.
What is specific about "Global Aphasia"?
People have difficulty both expressing and understanding written and oral communication.
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