Module 1 Flashcards

1
Q

Stroke

A

aka Cerebrovascular accident (CVA) or brain attack

Medical emergency

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2
Q

According to the American Stroke Association

A

3rd leading cause of death nationally
About 795,000 Americans each year suffer a new or recurrent stroke
A stroke occurs every 40 seconds
Stroke kills more than 143,000 people a year. That’s about 1 of every 17 deaths
On average,every 3 to 4minutes someone dies of stroke.
Americans will pay about $68.9 billion in 2009 for stroke-
related medical costs

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3
Q

U.S. Stroke Deaths 35+, 1991-8, by County

This map clearly shows the “Stroke Belt,”

A

an area in the Southeastern U.S. and Mississippi Valley with a high rate of stroke mortality.

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4
Q

Signs and Symptoms: Stroke

A
Sudden, severe headache
Numbness- especially on one side
depends on where on the mother strip is affected 
Weakness- especially on one side
Trouble speaking or understanding
Logaria: Can’t stop talking 
Dizziness
Slurred Speech
Blurred Vision
Confusion
Trouble walking or loss of balance/coordination
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5
Q

Types of CVA

Ischemic

A

Interruption of the blood supply (not to all parts of the brain)
~85% of strokes
Cause: Fatty deposits lining the walls of the blood vessels (atherosclerosis)

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6
Q

Two major types of obstruction:

A

Thrombotic (blood clot)

Embolic (traveling blood clot)

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7
Q

Hemorrhagic

A
Bleeding in the brain (common in young)
Higher fatality rate, typically younger people
~15% of strokes
Many times genetic component 
Two types:
Aneurysm
Arteriovenous Malformation (AVM)
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8
Q

Transient Ischemic Attack (TIA)

A

Mini Stroke
Similar symptoms to a “real” stroke
Most symptoms disappear within an hour, although they may persist for up to 24 hours
The more frequently TIAs occur, the higher the possibility of stroke

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9
Q

Dianosising a stroke

A
Neurological exam
Motor function 
Muscle strength 
Cognitive function 
Vision (where in the field of vision lost)
Sensory function 
CT Scan and MRI
----Looking at the location of build up (hemoragetic) 
Arteriogram/Angiogram
Echocardiogram
Carotid Ultrasound
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10
Q

Treatment

A
Tissue Plasminogen Activator (tPA)
>>>>If someone can make it to the hospital within 3 hours, they will give the patient TPA to dislodge clot (unless hemoragic) 
Antiplatelet Therapy
Surgery or Endovascular Treatment
Rehabilitation hospital
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11
Q

Preventing a Stroke

A
Don’t smoke
Know your blood pressure
Eat healthy-  low salt, low fat, low cholesterol
Find out if you have any cardiac issues
Exercise
Limit alcohol
Maintain a healthy weight
Control diabetes
Get regular check-ups
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12
Q

Traumatic Brain Injury

A

An injury that disrupts the function of the brain
Range of severity
Can result in a range of impairment involving:
—Cognitive
—Physical
—Psychological

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13
Q

Causes: TBI

A

Falls (28%)
Motor vehicle-traffic crashes (20%)
Struck by/against (19%)
Assaults (11%)

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14
Q

TBI Stats

A

Of the 1.7 million who sustain a TBI each year in the United States:
50,000 die
235,000 are hospitalized
1.1 million are treated and released from an emergency department (Langolis, et al. 2006)
Number of people with TBI who do not go to the hospital is unknown

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15
Q

Type of TBI

Open

A

Skull is broken
Symptoms similar to a stoke
just one area

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16
Q

Closed

A

No skull damage
Injury spreads with swelling and bouncing
axons tear, and stetch

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17
Q

Concussion

A

Mild TBI

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18
Q

Lack of oxygen

A

Drowning, heart attack

19
Q

Other causes of TBI

A

Diffuse Axonal Injury
Penetrating Injury
Coup-Contrecoup Injury
Anoxic Brain Injury

20
Q

Signs of mild (determined at sight of injury) TBI (like concussion)

A

Headaches or neck pain
Trouble with such mental tasks as remembering, concentrating, or decision-making
Slow thinking, speaking, acting, or reading
Confusion
Decreased energy or motivation (frontal lobe)
Mood changes (feeling sad or angry for no reason)
Changes in sleep patterns
Dizziness, balance issues
Nausea
Increased sensitivity to lights, sounds, or distractions
Difficulty moving limbs or extremities
Blurred vision or ‘tired’ eyes
Tinnitus

21
Q

Moderate to severe TBI

A
Coma GCS
Vegetative State/Persistent Vegetative State
Minimally Conscious State
Agitation, Aggression,
Impulsivity
Post-traumatic Amnesia, Confusion
ATTENTION
22
Q

Evaluating TBI

A
Neurological Exam
Intracranial Pressure
Glasgow Coma Scale
   1 Eye Opening
   2 Best Verbal Response
   3 Best Motor Response
CT Scan
MRI
? Neurosurgical, ENT, Plastics involvement?
23
Q

TBI Treatment

A
CPR?
Surgery or Endovascular Techniques
Prevent other complications (infections, bed sores, muscle contractions, hydrocephalus)
Medications
calming meds by slow brain recovery 
Rehabilitation
24
Q

TBI Prevention

A

Wear a seat belt
Wear a helmet
Try to avoid falls around the home (handrails, stepstools, wet spots, safety gates)
Don’t drive under the influence
Firearm safety
Absorbable material for children’s playgrounds

25
Dementia
Loss of brain function Degenerative, Progressive or Treatable Usually first appears as forgetfulness
26
Symptoms: dementia
language, memory, perception, emotional behavior or personality, and cognitive skills; incontinence, swallowing problems
27
Degenerative Dementia
Typically occurs in people over age 60; risk increases as age increases
28
Two major types: dementia
Alzheimer’s Disease Vascular Dementia -----Someone who has have multiple stokes Also, chronic untreated high blood pressure
29
Management Of Dementia Evaluating: Wide range of tests including:
CT Head, MRI, blood tests, toxicity tests, liver function tests, urinalysis, thyroid tests
30
Aging | Two factors—longer life spans and aging baby boomers—
will combine to double the population of Americans aged 65 years or older during the next 25 years to about 72 million. By 2030, older adults will account for roughly 20% of the U.S. population
31
Main cause of death
1.Chronic diseases Cancer, diabetes, heart disease 2.Degenerative illnesses More than a quarter of all Americans and two out of every three older Americans have multiple chronic conditions, and treatment for this population accounts for 66% of the country’s health care budget.
32
Changes with healthy age | Physical changes
Range of Motion Strength Reaction Time Balance
33
Neurological changes
``` Decrease in grey matter Decrease in white matter Cerebral ventricles enlarge ------As brain think CSF fills in space Changes in neurotransmitter ```
34
Social changes
Circle of friends How do different societies treat their elderly? Impact on society, healthcare, politics, economy What are society’s expectations of how people “should act” as they grow older?
35
Cognitive changes
``` Semantic memory less affected ----——Changing in 30s Procedural memory stays about the same -----brush teeth Decreases noted in episodic memory and working memory- decreased ability to encode new events or facts ```
36
Chemical changes:
Decline in the synthesis of dopamine Decrease in serotonin production Decrease in glutamate
37
Role of genetics in huge
if we will get the disease if medicine for the disease will work Two people may be of the same chronological age, but differ in their mental and physical capacities.
38
Cognitive reserve | Influenced by
Biology Genetics Environment
39
How can we slow the effects of aging
Stay intellectually engaged Exercise Decrease stress Maintain a healthy diet
40
Assessment and treatment
Identification of Complicating Conditions: know difference between (assessment) Chronic medical condition Visual/auditory deficits (sensitivity, agnosia) Apraxia-plan/sequence motor activity Dysarthria Hemiparesis Emotional/psychological disorders
41
Analysis of Cognitive Abilities
``` Attention Memory Visuospatial skills Language Executive Function ```
42
Analysis of Language Production
``` Semantics Syntax Discourse Pragmatics Gesture ```
43
Analysis of Language Comprehension
``` Semantics Syntax Discourse Pragmatics Gesture ```
44
Quality of Life
Activity and participation in society