Definitions and mechanism (3 compo) Flashcards
what is hemorrhagic stroke
bleeding of the brain, weak broken blood vessels, blood accumulates and compresses the surrounding brain tissue
types of haemorrhagic stroke (2)
intracerebral (ICH) - bleeding in the cerebral cortex/within the brain tissue
subarachnoid (SAH) - bleeding into the sub arachnoid space
which type of stoke has the highest mortality rate
ischemic stroke
% of hamorrhagic and ischemic
15%; 85%
stroke management
stabilize vitals (BP, breathing, heart function, swallowing)
CT scan - location, type of stroke, Dx
blood thinner/ anti-platelet meds (aspirin) for ischemic
cranial surgery to remove piece of skull bone to allow blood, reduce pressure; to clip the point of rupture
define hemiplegia
partial weakness in the one side of the body, more severe than hemiparasis (complete weakness)
why does stroke affect one side of the body?
one side of the brain controls the opposite side of the body at medulla/brain stem
what is low tone
muscle weakness, floppy muscle.
afferent input:
increased threshold of spindle activation
reduced spindle activity level/sensitivity
efferent input:
disruption of the motor sensor of the brain, info can’t get down to the targeted muscle
is high or low tone more diasbiling?
low
which side of the brain control language and speech? what area its called?
L; broca’s motor speech area (frontal), wenickes speech centre (temporal)
frontal lobe functions
voluntary mvmt
broca’s area
temporal lobe functions
hearing and memory (hippocampus)
wernickes speech centre (understanding)
broca vs wernickes
the actually talking vs understanding (meaningless word)
parietal lobe function
sensory (pressure, touch, temp, pain, proprioception, spatial awareness)
occipital lobe function
vision
how much CO goes to brain? how much O2 ?
15%
25%
Physio neuro management
Posture (lying, sitting, standing, getting in and out of bed/chair)
Balance. Gait. Stairs. Led with stronger leg up, weaker leg down
Transfer - type of support, # of assistance
What’s important to the pt - help them achieve that
E.g. play with grandkids - squatting, crutching = hip, knee, trunk flexion, ankle DF
Family members? Role in the family? Carer?
GP/pharmacist: meds prescription review, cholesterol (statin), blood sugar level, BP
OT - stress, home/work set-up modification, ergonomics, handrail at home, education on use of walking aids
Is work supportive? Can take time off/ WFH? Financial problem?
Social worker: physical/social/emotional support. Connect pt to activity groups.
Neuro: medical management
CT head scan
Monitor vitals - HR, BB, SpO2, BP
Carotid Doppler - ultra sound scan on neck to check for clots/thrombus/circulation
Bloods (cholesterol, diabetes/blood sugar)
ECG, feeding tube, chest x-ray
AVERT after stroke
Infarct medical management
Thrombectomy
Thrombolysis
Carotid endarterectomy
Meds: aspirin, anti-platelets (blood thinner), anti-coagulant therapy, BP, statin
Haemorrhage medical management
Surgery: craniotomy
Med: decrease BP, reverse effects of blood thinners
Aneurysm medical management
Surgery: clipping/coiling
Purpose of AROM
Test the function of the joint
Ability to do functional activities
Willingness to move
Movement that cause pain
To build an exercise program
Strength (at least against gravity)
Co-ordination
Csp myotome
C1 flexion
C2 extension
C3 side flexion
C4 elevation
C5 shoulder ABD
C6 elbow FLEX
C7 elbow EXT
C8 thumb ext
T1 finger ADD/ABD
LSP myotome
S1 PF
L2 hip flex
L3 knee ext
L4 DF
L5 toe ext
S2 knee flex
