Exam 4 Stroke Questions With
Accurate Solutions Scored A+
NIH stroke scale - ANSWER-symptoms scored (0-2) / (0-4)
Glasgow coma scale - ANSWER-15 best
8 or less = coma
3 = totally unresponsive
Stroke types - ANSWER-thrombus, embolism, hemorrhage
You may hear the terms "brain attack" or "cerebrovascular accident (CVA)" used to
describe stroke. The use of "brain attack" is done to communicate the URGENCY of
recognizing the clinical manifestations of a stroke. In the hospital you may hear
overhead paged "Stroke Alert" ER.
etiology - ANSWER-brain has the highest metabolic rate of any of the organs in the
human body. Brain tissue is unable to store glucose or oxygen, so it has to have a
constant flow of blood to provide the oxygen and glucose needed for normal function.
The brain receives 25% of the cardiac output through the internal carotid and vertebral
arteries. Any disruption in blood flow will result in ischemia if there is no collateral
circulation available, and will rapidly lead to cell death. Blood flow can be disturbed by
occlusion or by rupture of a vessel.
Stroke description - ANSWER-brain requires a continuous supply of blood to provide
the oxygen and glucose that neurons need to function. A stroke occurs when blood flow
to the brain is interrupted. Inadequate blood flow causes ischemia to a part of the brain.
Wherever ischemia occurs to a part of the brain, cells die. The result is neurologic
deficits and tissue damage. Function such as movement, sensation, or emotion that
,were controlled by the affected area of the brain are lost or impaired. The severity of the
loss of function varies according to the location and extent of the brain damage.
Ischemic strokes are caused by vessel occlusion and account for about 88% of all
strokes that occur. Hemorrhagic strokes happen due to vessel rupture and account for
the other 12% of strokes.
incidence - ANSWER-Every 45 seconds someone in the United States has a stroke.
Every 3 minutes someone dies of a stroke. Over half of them are women. And death
rates are higher for minorities, especially among African-Americans. And strokes tend to
occur more often in the southern United States, referred to as the "stroke belt,' probably
due to the larger older population, tobacco use, obesity, and high fat diet more common
in the south.
The most effective way to decrease the burden of stroke is prevention.
risk factors - ANSWER-HTN, diabetes mellitus, genetic predisposition, prior TIAs, oral
contraceptives
include both modifiable and non-modifiable factors. Age is the biggest factor, but 28% of
all strokes occur in people that are younger than age 65. Starting on page 1390 in Lewis
describes the risk factors for stroke. Can you name a few?
(Non-modifiable: age, gender, race, ethnicity, family history, heredity. ....Modifiable:
HTN, heart disease, Diabetes, Smoking, abdominal obesity, physical inactivity, poor
diet, elevated cholesterol, smoking and drug use.
You may be surprised to see such conditions as diabetes and hypertension listed as
modifiable risk factors, but they are considered modifiable because they can be altered
through lifestyle changes and medical treatment. Atherosclerosis is a major cause of
, stroke as it can lead to thrombus formation and contribute to embolus development.
Atrial fibrillation is associated with stroke risk.
two main categories - ANSWER-ischemic and hemorrhagic, based on the pathology of
the lesion or infarct that develops
Transient Ischemic Attacks (TIA)
Temporary deficits
Impaired circulation
Medical or Surgical Tx - ANSWER-A TIA is a transient episode of neurologic
dysfunction caused by focal brain, spinal cord, or retinal ischemia, but without acute
infarction of the brain. Clinically symptoms typically last less than 1 hour. Although TIAs
resolve, one third will progress to an ischemic stroke.
attacks are brief, fleeting attacks of neurologic impairments caused by ischemia, usually
from fatty plaques or micro-emboli. RIND stands for ...Reversible Ischemic Neurologic
Deficit. They are the same in terms of symptoms. The difference is strictly the length of
time that symptoms last. The reason that symptoms are reversible with TIAs/RINDS is
because the ischemia has occurred without infarction. The interruption of blood flow is
incomplete and /or is very temporary. This prevents infarction. Do you remember what
infarction is? (tissue death - necrosis - that is caused specifically by a local lack of
oxygen due to obstructed blood supply to the area)
Symptoms can include visual loss in one eye, diplopia, light-headedness, speech
disturbances, numbness, variable changes in consciousness, and weakness or
paralysis on one side of the body, including facial droop. The symptoms of TIA or RIND
are focal symptoms - they affect one area. Global deficits such as confusion or lethargy
are not a part of TIAs or RINDs. The symptoms of TIAs and RINDs also do not
commonly wax and wane.
Accurate Solutions Scored A+
NIH stroke scale - ANSWER-symptoms scored (0-2) / (0-4)
Glasgow coma scale - ANSWER-15 best
8 or less = coma
3 = totally unresponsive
Stroke types - ANSWER-thrombus, embolism, hemorrhage
You may hear the terms "brain attack" or "cerebrovascular accident (CVA)" used to
describe stroke. The use of "brain attack" is done to communicate the URGENCY of
recognizing the clinical manifestations of a stroke. In the hospital you may hear
overhead paged "Stroke Alert" ER.
etiology - ANSWER-brain has the highest metabolic rate of any of the organs in the
human body. Brain tissue is unable to store glucose or oxygen, so it has to have a
constant flow of blood to provide the oxygen and glucose needed for normal function.
The brain receives 25% of the cardiac output through the internal carotid and vertebral
arteries. Any disruption in blood flow will result in ischemia if there is no collateral
circulation available, and will rapidly lead to cell death. Blood flow can be disturbed by
occlusion or by rupture of a vessel.
Stroke description - ANSWER-brain requires a continuous supply of blood to provide
the oxygen and glucose that neurons need to function. A stroke occurs when blood flow
to the brain is interrupted. Inadequate blood flow causes ischemia to a part of the brain.
Wherever ischemia occurs to a part of the brain, cells die. The result is neurologic
deficits and tissue damage. Function such as movement, sensation, or emotion that
,were controlled by the affected area of the brain are lost or impaired. The severity of the
loss of function varies according to the location and extent of the brain damage.
Ischemic strokes are caused by vessel occlusion and account for about 88% of all
strokes that occur. Hemorrhagic strokes happen due to vessel rupture and account for
the other 12% of strokes.
incidence - ANSWER-Every 45 seconds someone in the United States has a stroke.
Every 3 minutes someone dies of a stroke. Over half of them are women. And death
rates are higher for minorities, especially among African-Americans. And strokes tend to
occur more often in the southern United States, referred to as the "stroke belt,' probably
due to the larger older population, tobacco use, obesity, and high fat diet more common
in the south.
The most effective way to decrease the burden of stroke is prevention.
risk factors - ANSWER-HTN, diabetes mellitus, genetic predisposition, prior TIAs, oral
contraceptives
include both modifiable and non-modifiable factors. Age is the biggest factor, but 28% of
all strokes occur in people that are younger than age 65. Starting on page 1390 in Lewis
describes the risk factors for stroke. Can you name a few?
(Non-modifiable: age, gender, race, ethnicity, family history, heredity. ....Modifiable:
HTN, heart disease, Diabetes, Smoking, abdominal obesity, physical inactivity, poor
diet, elevated cholesterol, smoking and drug use.
You may be surprised to see such conditions as diabetes and hypertension listed as
modifiable risk factors, but they are considered modifiable because they can be altered
through lifestyle changes and medical treatment. Atherosclerosis is a major cause of
, stroke as it can lead to thrombus formation and contribute to embolus development.
Atrial fibrillation is associated with stroke risk.
two main categories - ANSWER-ischemic and hemorrhagic, based on the pathology of
the lesion or infarct that develops
Transient Ischemic Attacks (TIA)
Temporary deficits
Impaired circulation
Medical or Surgical Tx - ANSWER-A TIA is a transient episode of neurologic
dysfunction caused by focal brain, spinal cord, or retinal ischemia, but without acute
infarction of the brain. Clinically symptoms typically last less than 1 hour. Although TIAs
resolve, one third will progress to an ischemic stroke.
attacks are brief, fleeting attacks of neurologic impairments caused by ischemia, usually
from fatty plaques or micro-emboli. RIND stands for ...Reversible Ischemic Neurologic
Deficit. They are the same in terms of symptoms. The difference is strictly the length of
time that symptoms last. The reason that symptoms are reversible with TIAs/RINDS is
because the ischemia has occurred without infarction. The interruption of blood flow is
incomplete and /or is very temporary. This prevents infarction. Do you remember what
infarction is? (tissue death - necrosis - that is caused specifically by a local lack of
oxygen due to obstructed blood supply to the area)
Symptoms can include visual loss in one eye, diplopia, light-headedness, speech
disturbances, numbness, variable changes in consciousness, and weakness or
paralysis on one side of the body, including facial droop. The symptoms of TIA or RIND
are focal symptoms - they affect one area. Global deficits such as confusion or lethargy
are not a part of TIAs or RINDs. The symptoms of TIAs and RINDs also do not
commonly wax and wane.
