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7333 Bringman > Exam 3- Stroke part 1 > Flashcards

Exam 3- Stroke part 1 Flashcards

1
Q

A stroke is usually ___ but can be ___

A

~usually appears suddenly

~can appear slowly

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2
Q

Some of the slow appearing strokes

A

~TIAs, pin stroke, mini strokes

~hemorrhagic

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3
Q

2 main types of strokes

A

Ischemic/ Occlusive and Hemorrhagic

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4
Q

what is the most common type of stroke

A

80% of strokes are occlusive

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5
Q

Hemorrhagic- some details

2 things associated with it

A

~High blood pressure

~Associated with headaches

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6
Q

Hemorrhagic- Common types

A

~berry aneurism
~AVM (arteriosus venous malformation)

MB: I also have intracerebral hemorrhage and cerebral hemorrhage in my notes. I also have subarachnoid hemorrhage as being paired with the berry aneurysm. Don’t have that lecture recorded so unable to verify.

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7
Q

Hemorrhagic- berry aneurism

A

an out pouching of the circle of willis

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8
Q

Hemorrhagic- AVM

A

abnormal connection of the artery and vein

AVM = arteriovenous malformation

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9
Q

Hemorrhagic- 3 courses for an aneurism

A

~Pick up on a scan when looking for it
~Pick it up on a another scan (looking at something different)
~it pops

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10
Q

2 ways to fix an aneurism

A

Clip and coil

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11
Q

Clip for an aneurism

A

~can be used for an aneurism that has or has not been popped
~Need a craniotomy

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12
Q

Coil for an aneurism

A

~for people for not ruptured
~a birds nest of wire that fills the hole
~will cause the body to fill back in the aneurism
~Do not need a craniotomy

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13
Q

Hemorrhagic- Will have cell death

5

A

~cell starved of blood distal to bleed
~pressure on cells right at the site; usually occlude broken artery
~pressure away from the site; can act like a contra coup injury
~other arteries can be occluded
~may have uncal herniation and/or midline shift

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14
Q

Hemorrhagic- will present in therapy

4

A

~wide spread
~will be hard to decide where their symptoms came from
~will be younger
~rarely will fully recover

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15
Q

Occlusive- 2 types

A

~thrombolytic

~embolytic

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16
Q

Occlusive- Thrombolytic

A

Build up of plaque, etc that will cause a blockage in the artery

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17
Q

Occlusive- Embolytic

A

Blood/plaque/ air/ fat/cancer breaks off and moves

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18
Q

Occlusive- Embolytic- blood

4

A

~We can do a good a good job getting rid of blood clots with TPA tissue plasminogen activators- thins blood and gets rid of blood clots
~need to give these to someone within 3 hours
~More than 3 hours, the structures distally already starting to die
~Its not worth the risk to thin the blood that much

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19
Q

Occlusive- Embolytic- fat

A

can caused post surgery

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20
Q

TIA

A

symptoms resolve within 24 hours

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21
Q

Some details on how you know it is a Major stroke

6

A 
~Complete paralyze on one side 
~High cortical processes loss
~Has come cognitive loss
~Speak problems
~Visual problems
~Much harder for pt to return to function
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22
Q

Some details on how you know it is a minor stroke

3

A

~Still the same person you were before- personality stays the same
~Steppage gait; foot drop; some limb paresis
~A little sensory or motor deficit; distal portion of the UE or LE

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23
Q

Some details on how you know it is a shower stroke/ what is it?
(4)

A

~Occlusive, but sometimes when a clot breaks off and a lot of little clots will break off too
~Lots of little strokes all over
~Can occur after surgeries when you are trying to prevent/correct for a stroke- endarterectomy (plaque build up in the carotids)
~The plaque can lead to a shower stroke if all the plaque is not sucked up

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24
Q

some Diagnosis Tests to test for possible stroke

3

A

~Echocardiogram- did it happen from a build up of blood settling in the heart
~CT/ MRI
~Carotid US- did it happen form a build up from plaque in the carotids

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25
Q

risk factors for stroke

A 
~Birth control 
~smoke
~high blood pressure
~diabetes
~high cholesterol
~sedentary
~history of CVA
~A-fib 
~age
~postmenopausal
~drinker 
~African American
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26
Q

anterior cerebral artery syndrome- symptoms

A

~Contralateral issues
~LE more than UE- hemiparesis and hemisensory loss
~More apraxia (inability to perform a task)
~Problems with imitation and bimanual tasks
~Slowness, delay, lack of spontaneity, motor inaction
~High risk of Incontinence issues
~Higher risk of skin break down

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27
Q

middle cerebral artery syndrome- symptoms

A

~80% have MCA
~80% of MCA have occlusive
~UE worse than LE- hemiparesis and hemisensory loss
~Aphasia (problems with speak)- motor speech impairment
~Perception deficits
~Limb-kinetic apraxia
~Homonymous hemianopia (be able to draw this); Unilateral neglect (think of Bob)

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28
Q

posterior cerebral artery syndrome- symptoms

A

~Visual issues
*homonymous hemianopsia
*can be bilateral homonymous hemianopsia with some degree of macular sparing
*visual agnosia
*prosopagnosia
~Cerebellar issues- balance and coordination
~Memory defect

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29
Q

locked in syndrome

A

~They can feel and hear everything

~They can understand

30
Q

Stroke on the Right- symptoms

A 
~Visual problems 
~Unilateral defect
~Impulsive
~Poor judgment
~Quick with movements
~Unaware of impairments
~Rigid in their thoughts (stubborn)
~Emotional with negative emotions (and expressing them) and get upset with constructive criticism 
~Have problem with time; spatial awareness
31
Q

Stroke on the Left- symptoms

A

~Right motor issues
~Speak issues (know problems with W and B; Express and receptive)
~Local aphasia
~Disorganized
~Slow and cautious; overly aware of their impairments
~They think they are doing horrible/ afraid/ etc; have to talk them into doing something
~Have some processing delays

32
Q

Symptoms that appear when there’s a stroke on a right or left

A

~Visual- homonymous hemianopsia
~Lability- unstable personality (person can be crying and they don’t have a reason to)
~Apathy, irritable, anxiety, depression
~Confusion, short attention span, loss of memory
~Inability to preform executive functions

33
Q

When people are recovering from a stroke, they will often ask…

A

When am I going to get better?

34
Q

Recovering from a stroke: what are some things that are going on that are helping

A

~Angiogenesis, plasticity, collateral blood flow helps with recovery
~Thinning the blood, keeping the inflammatory response down
~Pts are going to sleep a lot!
~Neuroplasticity- need stimulus (we will help to cause it) to help cause new connections and strengthen the old ones
~Have to start moving them fast so that something will start to form in the brain

35
Q

Recovering from a stroke: what are some things that will help if they are flaccid?

A

~go into weight bearing to cause compression in jts
~will get them to have muscle firing
~Be careful to make sure that when you are doing this that the pt is in proper alignment so that they do not have impingements later

36
Q

Roods techniques- types

A 
***Can be facilitative or inhibitory 
~Stretch
~Jt manipulation 
~Cutaneous touch
~Ice
~Heat
~Vestibular
~Auditory
~Visual
~Gustatory 
~Olfactory
37
Q

Roods techniques- Facilitative

A

~To increase the threshold- excitatory inputs

~contraction

38
Q

Roods techniques- Inhibitory

A

~To decrease the threshold

~relaxation

39
Q

Roods techniques- Stretch

A

~quick
~repetitive
~CMP
~Prolong

40
Q

Roods techniques- Quick Stretch

A

~will jar the muscle a little bit to cause a contraction

~facilitative

41
Q

Roods techniques- repetitive stretch

A

~Can use a vibratory that is placed on the muscle belly
~>100 Hz- facilitative
~<100 Hz- inhibitory

42
Q

Roods techniques- CPM stretch

A

continuous passive motion- is a repetitive passive motion (over 100 Hz)

43
Q

Roods techniques- prolong stretch

A

~inhibitory
~Serial casting- you will put the person at the end range, recast and move them farther into the range
~trying to get spasticity to release

44
Q

Roods techniques- Jt manipulation types

A

~traction
~low grade manipulations
~approxiations

45
Q

Roods techniques- Jt manipulation Traction

A

relaxation

46
Q

Roods techniques- Jt manipulation Low grade

A

relaxation

47
Q

Roods techniques- Jt manipulation Approximation

A

contraction

48
Q

Roods techniques- Cutaneous touch types

A

~Quick touch

~Maintain touch

49
Q

Roods techniques- Cutaneous touch quick

A

over the muscle belly- contracts the muscle

50
Q

Roods techniques- Cutaneous touch maintained

A

calmed the muscle- relaxation

51
Q

Roods techniques- Ice types

A

~quick strokes

~prolonged

52
Q

Roods techniques- Ice quick

A

Facilitative with the quick strokes- contraction

53
Q

Roods techniques- Ice prolonged

A

If you leave it over time- relaxes- inhibits

54
Q

Roods techniques- Heat

A

Relaxes them

55
Q

Roods techniques- Vestibular types

A

~rocking
~spinning
~bouncing on the ball

56
Q

Roods techniques- Vestibular rocking

A

relaxes us

57
Q

Roods techniques- Vestibular spinning

A

contractions

58
Q

Roods techniques- Vestibular bouncing on the ball

A

Bouncing on the ball
~Softly- relaxes
~Hard- contractions (and jt approx.)

59
Q

Roods techniques- Auditory types

A

~loud

~soft

60
Q

Roods techniques- Auditory loud

A

facultative/ contractions

61
Q

Roods techniques- Auditory soft

A

relaxes

62
Q

Roods techniques- Visual types

A

~bright

~soft

63
Q

Roods techniques- Visual bright

A

Bright loud colors- awake/ contraction

64
Q

Roods techniques- Visual soft

A

asleep/ relaxation

65
Q

Roods techniques- Gustatory types

A

~sour

~sweet

66
Q

Roods techniques- Gustatory sour

A

Sour, etc- wake up/ contraction

67
Q

Roods techniques- Gustatory sweet

A

Chocolate, etc- relaxation

68
Q

Roods techniques- Olfactory types

A

~bleach

~nice smells

69
Q

Roods techniques- Olfactory bleach

A

Bleach, etc- wake up/ contraction

70
Q

Roods techniques- Olfactory nice

A

Relaxing smells (coffee :) )

7333 Bringman (23 decks)

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