Final Exam Flashcards
Stroke warning signs
- Sudden numbness
- Sudden tingling
- Sudden headache
- Sudden confusion
- Sudden trouble speaking
- Sudden balance issues
- Sudden trouble seeing
FAST
Face, Arms, Speech–Time to call 911!
How many people are affected by stroke each year?
795,000
How many strokes per year are first or new strokes?
610,00
What percentage of strokes are ischemic?
87%
Transient Ischemic Attack
Stroke that resolves within 24 hours; 1/2 fail to report, 1/4 die within one year
Which ethnicities are more prone to stroke?
African American and Hispanic (2-3x more likely than whites)
Layers of the brain
- Scalp
- Cranium
- Dura mater
- Arachnoid
- Subarachnoid space
- Pia mater
- Cerebral cortex
Central and Lateral fissure names
Rolandic and Sylvian
Broadmann’s Areas 44, 45
Broca’s aphasia
Broadmann’s Areas 22, 39, 40, 41, 42
Associated with Wernicke’s area
Arcuate fasciculus
Fibers that connect Broca’s and Wernicke’s areas–vital for repetition
Insula Cortex
Expressive language and motor speech
Basal ganglia
Very important for cognitive and language information
Internal Capsule
Contains both ascending and descending axons; damage can cause significant motor and sensory deficits
Internal corotid
Feeds into MCA, which covers majority of cortex
Watershed regions
Regions without major blood supplies–more likely to be damaged in a stroke
Ischemia v. Infarction
Tissue damage v. tissue death
Thrombosis
Build up of plaque causing a blockage
Embolism
Plaque travelling from elsewhere in the body, causing a blockage
Hypoperfusion
Decreased bloodflow due to any of the above
Penumbra
The area around the stroke where some neurons will recover and some will not
Medical treatment for plaque
Surgical removal; tPA (for hemorrhagic only); stents
Anteriovenous malformation (AVM)
Web of blood vessels, typically found in young adults
Cerebral dominance
Left hemisphere in right-handed adults; right hemisphere for 15% of left-handed adults; bilateral for 15% of left-handed adults
Aphasia is NOT
- Slurred speech
- confused langauge due to cognitive deficit
- Pragmatic problem
Literal paraphasia
Phonologic errors
Semantic paraphasia
semantically-related but incorrect word
Limitations Localization Models
Damage to only Broca’s or Wernicke’s areas does not cause aphasia, but damage in other areas can
Broca’s Aphasia
Anterior lesions; deficits in fluency and word retrieval; agrammatic output, 3-4 words per breath; poor, nonfluent repetition; generally preserved receptive language and self-monitoring
Wernicke’s aphasia
Posterior lesions; deficits in comprehension and self-monitoring; preserved fluency; paragrammatisms and neologisms
Global aphasia
Severe impairments in all language functions; basic comprehension deficits; stereotypies in output
Conduction aphasia
Lesions on the arcuate fasciculus; expression and comprehension are good but repetition is impaired; poor oral reading
Transcortical aphasia
Motor–Broca’s+spared repetition
Sensory–Wernicke’s+spared repetition
Interviewing guidelines
- Quiet place
- Consider including family
- make pt comfortable
- Explain who you are and why you’re here
- Get pt’s story
- Treat pt with respect
- Communicate on pt’s level
Interviewing tips
- Ask open-ended questions
- Allow client to express feelings as well as physical symptoms
- Be cautious regarding how much information you provide and when
- Record information
Stroke scales
- NIH–15 item exam for acute patients
- FIM–measures independence post-stroke
- Stroke Impact Scale
- BOSS (burden of stroke scale)`
Modalities in Assessment
Input: Auditory and visual
output: spoken, written, and gestural
