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
risk factors for stroke
``` ~Birth control ~smoke ~high blood pressure ~diabetes ~high cholesterol ~sedentary ~history of CVA ~A-fib ~age ~postmenopausal ~drinker ~African American ```
26
anterior cerebral artery syndrome- symptoms
~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
27
middle cerebral artery syndrome- symptoms
~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)
28
posterior cerebral artery syndrome- symptoms
~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
29
locked in syndrome
~They can feel and hear everything | ~They can understand
30
Stroke on the Right- symptoms
``` ~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
Stroke on the Left- symptoms
~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
Symptoms that appear when there's a stroke on a right or left
~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
When people are recovering from a stroke, they will often ask...
When am I going to get better?
34
Recovering from a stroke: what are some things that are going on that are helping
~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
Recovering from a stroke: what are some things that will help if they are flaccid?
~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
Roods techniques- types
``` ***Can be facilitative or inhibitory ~Stretch ~Jt manipulation ~Cutaneous touch ~Ice ~Heat ~Vestibular ~Auditory ~Visual ~Gustatory ~Olfactory ```
37
Roods techniques- Facilitative
~To increase the threshold- excitatory inputs | ~contraction
38
Roods techniques- Inhibitory
~To decrease the threshold | ~relaxation
39
Roods techniques- Stretch
~quick ~repetitive ~CMP ~Prolong
40
Roods techniques- Quick Stretch
~will jar the muscle a little bit to cause a contraction | ~facilitative
41
Roods techniques- repetitive stretch
~Can use a vibratory that is placed on the muscle belly ~>100 Hz- facilitative ~<100 Hz- inhibitory
42
Roods techniques- CPM stretch
continuous passive motion- is a repetitive passive motion (over 100 Hz)
43
Roods techniques- prolong stretch
~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
Roods techniques- Jt manipulation types
~traction ~low grade manipulations ~approxiations
45
Roods techniques- Jt manipulation Traction
relaxation
46
Roods techniques- Jt manipulation Low grade
relaxation
47
Roods techniques- Jt manipulation Approximation
contraction
48
Roods techniques- Cutaneous touch types
~Quick touch | ~Maintain touch
49
Roods techniques- Cutaneous touch quick
over the muscle belly- contracts the muscle
50
Roods techniques- Cutaneous touch maintained
calmed the muscle- relaxation
51
Roods techniques- Ice types
~quick strokes | ~prolonged
52
Roods techniques- Ice quick
Facilitative with the quick strokes- contraction
53
Roods techniques- Ice prolonged
If you leave it over time- relaxes- inhibits
54
Roods techniques- Heat
Relaxes them
55
Roods techniques- Vestibular types
~rocking ~spinning ~bouncing on the ball
56
Roods techniques- Vestibular rocking
relaxes us
57
Roods techniques- Vestibular spinning
contractions
58
Roods techniques- Vestibular bouncing on the ball
Bouncing on the ball ~Softly- relaxes ~Hard- contractions (and jt approx.)
59
Roods techniques- Auditory types
~loud | ~soft
60
Roods techniques- Auditory loud
facultative/ contractions
61
Roods techniques- Auditory soft
relaxes
62
Roods techniques- Visual types
~bright | ~soft
63
Roods techniques- Visual bright
Bright loud colors- awake/ contraction
64
Roods techniques- Visual soft
asleep/ relaxation
65
Roods techniques- Gustatory types
~sour | ~sweet
66
Roods techniques- Gustatory sour
Sour, etc- wake up/ contraction
67
Roods techniques- Gustatory sweet
Chocolate, etc- relaxation
68
Roods techniques- Olfactory types
~bleach | ~nice smells
69
Roods techniques- Olfactory bleach
Bleach, etc- wake up/ contraction
70
Roods techniques- Olfactory nice
Relaxing smells (coffee :) )