Florida Atlantic University Cerebrovascular Accident Discussion Responses

Below I have 2 posts please provide a response for both. 150 words each with reference.

Part 1

Your response to your peers by extending, refuting/correcting, or adding additional nuance to their posts.

Risk Factors for Cerebrovascular Accidents

Cerebrovascular accident is another term used to refer to stroke, a medical emergency that damages the brain hindering the free flow of blood. Its symptoms include speaking and understanding difficulties, having trouble walking, and paralysis and numbness that may affect the face, the arms, and the legs. There are various risk factors of stroke, among them cigarette smoking, heavy drinking, lack of regular exercise, high blood cholesterol levels (Izzy et al., 2018). All these factors contribute to possibility of cerebrovascular accidents through interfering with the free flow of blood either by constraining the blood vessels or damaging them completely, rendering them useless. When blood cannot flow freely to the brain, most of the body functions are hindered leading to the cerebrovascular accident or stroke.

Cultures at Higher Risk

Studies have shown that the African Americans are at higher risk of falling into cerebrovascular accidents due to some of their cultures that contributes to the risk factors (Owolabi et al., 2017). For instance, high cholesterol levels are associated with the development of cerebrovascular accidents. Consumption of foods with high levels of fats is more common among the African Americans especially during their festivals and other celebrations that entail massive eating. The culture exposes them at higher risk of contracting cerebrovascular accidents and this explains why this ethnic group continue to be highly affected by stroke.

Scales for Scoring Deep Tendon Reflexes

Deep tendon reflexes, commonly referred as muscle stretch reflexes, are very crucial when it comes to neurological examination. When a quick stretch takes place in the muscle tendon unit, the muscle spindle receptor is stimulated leading to an increase in the firing of la afferents from the stimulated spindles. The grading for the deep tendon reflexes ranges from 0 to 4 with the + and – signs sometimes used to distinguish them from motor examination (Rodriguez-Beato & De Jesus, 2020). 0 is when there is no reaction at all or the reflex is absent. 1 signifies small reflex that is less than normal while 2 signifies the lower half of normal reflex. 3 is the upper half of the normal reflex while 4 is the increased reflex.

What to Expect in Diabetes Peripheral Neuropathy Patients.

Patients with diabetes peripheral neuropathy usually have their nerves damaged due to the chronically high blood sugar and diabetes levels. The nerve damages make a number of issues to be expected from someone suffering from this condition, one of them being numbness due to loss of sensitivity. Secondly, the person tends to have a loss of sensation and there are occasional episodes of pain in the legs, feet, and hands. This is so far the most common complication that is caused by diabetes.

Experience Encountered

The most memorable experience I have encountered was with a relative who was suffering from diabetes peripheral neuropathy. In my own assessment, the patient had completely lost his sense of touch due to the severe nerve damage. It happened that the patient could be in a situation that inflicts severe pain, but he could not feel anything. On one occasion, he was injured while farming, but he could not feel anything despite bleeding profusely.

References

Izzy, S., Rubin, D. B., Ahmed, F. S., Akbik, F., Renault, S., Sylvester, K. W., … & Feske, S. K. (2018). Cerebrovascular accidents during mechanical circulatory support: new predictors of ischemic and hemorrhagic strokes and outcome. Stroke, 49(5), 1197-1203.

Owolabi, M., Sarfo, F., Howard, V. J., Irvin, M. R., Gebregziabher, M., Akinyemi, R., … & Howard, G. (2017). Stroke in indigenous Africans, African Americans, and European Americans: interplay of racial and geographic factors. Stroke, 48(5), 1169-1175.

Rodriguez-Beato, F. Y., & De Jesus, O. (2020). Physiology, Deep Tendon Reflexes. StatPearls [Internet].

Below I have 2 posts please provide a response for both. 150 words each with reference.

Part 2

Your response to your peers by extending, refuting/correcting, or adding additional nuance to their posts.

Risk Factors of Cerebrovascular Accident

Cerebrovascular accident (CVA), also known as paralysis, or hemiplegia is one of the leading medical conditions with higher mortality rates alongside cancer and heart disease (Hoffmann et al., 2010). CVA is most common in older adults, but also affects young people. The leading risk factors include:

• Diabetes- people with diabetes mellitus have higher risks of hypertension and subsequent CVA.

• Hypertension- high blood pressure causes degeneration of the blood vessels, resulting to obstruction of blood flow and consequent damage on the heart.

• Heart disease- heart disease interferes with the blood flow to the cerebrum.

• Blood concentration- higher levels of hemoglobin in blood increases the risk of developing CVA.

• High cholesterol levels- causes inflexibility of the cerebral vessel walls. The vessels may be blocked in serious cases, causing CVA.

• Age-related degenerations – blood vessels tend to degenerate with aging.

Cultures that are at Higher Risk of Cerebrovascular Accident

Different population groups in the United States are disproportionately affected by cerebrovascular accident. African Americans are at higher risk of CVA since they have higher prevalence of hypertension, heart disease, and diabetes (Hoffmann et al., 2010). Hispanics is another population group with high risk of developing CVA. This is because they have the highest incidence and prevalence of obesity and diabetes mellitus which contribute to pathophysiology of cerebrovascular accident. It is worth noting that Black Americans have higher prevalence of hypertension as compared to Non-Hispanic Whites (Caucasians), Hispanics, and any other racial/ethnic groups in the United States of America (Hoffmann et al., 2010).

The 0 to 4+ Scale for Scoring Deep Tendon Reflexes

The 0 to 4+ scale for scoring deep tendon reflexes represents the grades in which tendon reflexes are graded or recorded. The scale is interpreted as follows:

0 – no response; may also indicate abnormal readings.

1+ – presence of a slight response; may be normal or abnormal.

2+ – a brisk response; denote a normal response.

3+ – a very brisk response; may or may not be normal.

4+ – a tap elicits a repeating reflex (clonus); always indicates an abnormal response.

Whether 1 + or 3 + responses are normal usually rely on the previous results; that is, the reflex history of the patient, the nature of other reflexes, and analysis of the associated findings, including muscle strength, muscle tone, or any other evidence of a disease. Generally, the asymmetry of reflexes often suggests an abnormality.

What to find in a Patient with Peripheral Neuropathy

Peripheral neuropathy refers to nerve damage that results from chronic high blood sugar and diabetes mellitus (Tesfaye & Selvarajah, 2012). Studies have shown that 60% to 70% of all individuals with diabetes mellitus will end up developing peripheral neuropathy (Tesfaye & Selvarajah, 2012). However, peripheral neuropathy is non inevitable nerve damage. According to Centers for Disease Control and Prevention (CDC), people with diabetes are capable of reducing their risks of developing peripheral neuropathy by monitoring their blood sugar levels (Tesfaye & Selvarajah, 2012).

Some of the common factors that you are likely to find in a patient with peripheral neuropathy include:

Loss of sensation,

Numbness,

Occasional pain in the feet, legs, or hands.

My Experience

I have gained a lot by providing care to diabetic patients. Socioeconomic factors, such as lack of health insurance coverage and inability to pay high medication cost are the leading causes of limited access to quality health care services in the United States. Diabetic patients who are not able to attend to regular clinical checkup end up developing peripheral neuropathy and other serious complications like heart disease, renal failure, hypertension and cerebrovascular accident.

References

Hoffmann, A., Chockalingam, P., Balint, O. H., Dadashev, A., Dimopoulos, K., Engel, R., … & Oechslin, E. (2010). Cerebrovascular accidents in adult patients with congenital heart disease. Heart, 96(15), 1223-1226.

Tesfaye, S., & Selvarajah, D. (2012). Advances in the epidemiology, pathogenesis and management of diabetic peripheral neuropathy. Diabetes/metabolism research and reviews, 28, 8-14.