Long Term Management of Stroke (6) Flashcards

1
Q

First few days - natural recovery

A

Resolution of oedema, reperfusion of ischemic penumbra

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2
Q

Weeks/months

A

Neuronal plasticity, cortical remodelling - dendrite sprouting, synaptic remodelling

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3
Q

Neglect occurs in which specific stroke?

A

Right parietal lobe

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4
Q

What is neglect?

A

Visual/somatosensory, failure to attend to/monitor your left side, can be confused with visual field defect/loss of sensation

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5
Q

Visual perception

A

Dorsal - where

Ventral - what

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6
Q

Agnosias

A

Inability to understand what an object is/other stimulus, can apply to any sensory modality, not just sensory

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7
Q

Visual agnosias

A

Unable to recognise common object by sight alone

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8
Q

Prosopoagnosia

A

Inability to recognise faces

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9
Q

Driving and DVLA

A

Absolute ban for 1 month, banned if seizure within past year, visual neglect, visual field defect, cognitive impairment, limb weakness - adapted vehicle

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10
Q

Dyspraxia

A

Loss of ability to conceptualise, plan and execute complex sequence of motor actions (loss of cortical pathways for initiating and performing skilled actions)

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11
Q

Where would lesions cause dyspraxia?

A

Left inferior parietal lobe/supplementary motor area

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12
Q

What difficulties would dyspraxia cause?

A

Identifying and knowing how to use objects, copying drawings, walking, dressing

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13
Q

Transfers

A

Hoist, standing hoist, ETAC turner, banana board

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14
Q

Apraxia

A

Inability to perform particular purposive actions

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15
Q

Environmental adaptions

A

Ramps, wet room, rocker knife (used one handed)

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16
Q

Spastic hemiparetic gait

A

Stiff legged (spasticity of ankle plantar flexors and knee flexors), short, slow steps, risk of falls (weak ankle, unable to dorsiflex), loss of righting reflexes

17
Q

Management of gait

A

Split to correct foot drop, physiotherapy, manage spasticity, walking aides

18
Q

Walking aides

A

Sticks, frames, improve stability by extending base of support

19
Q

What is spasticity

A

Hyperexcitability of stretch reflex, co-existent tendon or soft tissue shortening

20
Q

What does spasticity cause

A

Loss of function (impaired balance, manual dexterity), pain, unable to maintain skin hygiene in flexures

21
Q

Treatment of spasticity

A

Physio, splinting (maintain joint range of movement)

22
Q

Drug treatment of spasticity

A

Botulinum toxic injections (local) and baclofen (systemic)

23
Q

WHO classification of disability

A
  • Health condition
  • Impairment of body structures and functions
  • Limitations of activities
  • Restriction of participation in society
  • Environmental factors
  • Personal factors