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fall B 2024 > multi d final > Flashcards

multi d final Flashcards

1
Q

TIA (transient ischemic attack)

A

less than 24 hours
strong indicator of pending CVA (15% in 90 days)

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2
Q

how to manage TIA

A

observation
treatment of risk factors
anticoagulation
carotid endarterectomy

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3
Q

CVA

A

4th leading cause of death in US
sudden onset of neuro deficits within 24 hours

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4
Q

risk factors of CVA

A

older age
african american or hispanic
male
HTN
CAD
hyperlipidemia
elevated LDL levels
hyper-coagulable state
DMII
obesity
tobacco use
alcohol abuse
sedentary lifestyle

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5
Q

prevalence of strokes

A

12% of deaths globally
lifetime stroke risk is 25% for those >25 years of age

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6
Q

hemorrhagic stroke

A

blood leaks into brain tissue

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7
Q

ischemic stroke

A

clot stops blood supply to an area of brain
present with predetermined syndromes
can predict what vasculature will be affected

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8
Q

ICH (intracerebral hemorrhage)

A

10-15% of all strokes
from rupture of cerebral vessels
result of high BP

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9
Q

primary symptoms of ICH

A

spontaneous rupture of small vessels damaged by chronic hypertension

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10
Q

secondary symptoms of ICH

A

bleeding of cerebrovascular abnormalities, tumors, or impaired coagulation

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11
Q

ICH outcomes

A

associated with higher risk of fatality
damages brain cells
may increase pressure on brain or spasms in vessels

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12
Q

death prevalence in ICH

A

nearly half of all pts with primary ICH die within the first month after the acute event

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13
Q

lacunar stroke

A

25% of ischemic strokes
creates deep cavities in brain tissue
occlusion of vessels from the circle of willis

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14
Q

middle cerebral artery infarction presentation

A

contralateral hemiparesis
facial paralysis
sensory loss in face and UE

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15
Q

general info about MCAI

A

90% of all strokes
largest of the brain’s arteries
supplies most of outer frontal, parietal and temporal lobes

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16
Q

MCA syndrome

A

presents with neglect and poor motivation

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17
Q

MCA syndrome - Gerstmann syndrome

A

L/R disorientation
acalculia
agraphia
finger agnosia

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18
Q

anterior cerebral artery infarction

A

involves medial cerebral cortex
compromises motor and sensory of LE

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19
Q

ACAI left sided lesions

A

transcortical motor aphasia

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20
Q

ACAI right sided lesions

A

confusional state and motor hemineglect

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21
Q

superficial posterior cerebral artery infarction

A

visual and somatosensory deficits

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22
Q

larger PCAI

A

hemisensory loss
hemiparesis due to involvement of thalamus

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23
Q

where does the PCA supply?

A

occipital lobe
inferior temporal lobe
thalamus

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24
Q

vertebrobasilar infarction (VBI) presentation

A

ataxia
vertigo
headache
vomiting
oropharyngeal dysfunction
visual-field deficits
abnormal oculomotor findings

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25
Q

VBI - mid basilar artery

A

locked in syndrome
ipsilateral CN7 palsy
decreases level of consciousness
hemiparesis and hemitaxia
oculomotor deficits
arm posturing

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26
Q

VBI - intracranial vertebral artery

A

wallenburg syndrome
dizziness
diploplia

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27
Q

VBI - distal basilar artery

A

comatose state
defective vertical gaze
hemiparesis and hemitaxia
diplolia
speech difficulties
altered mental state
small, poorly reactive pupils
weakness
ataxia

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28
Q

VBI - origin of extracranial vertebral artery

A

dizziness
blurred vision
ataxia
vomiting

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29
Q

cerebellar infarction

A

loss of coordination
ataxia
nausea
vomiting
headache
dysarthria
vertigo

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30
Q

BEFAST stroke signs

A

balance
eyes
face
arms
speech
time

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31
Q

beyond BEFAST

A

numbness
sudden confusion
trouble seeing
trouble walking
severe headache

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32
Q

ischemic CVA management

A

cerebral hypo-perfusion
BP control
treatment of risk factors

33
Q

prognosis of ICVA

A

85% of all stroke types
13-23% mortality in 30 days

34
Q

tissue plasminogen activator

A

strongly recommended within 4-5 hours of stroke symptoms
NOT for hemmoragic stroke

35
Q

what scan is the earlier indicator for stroke?

A

MRI

36
Q

prognosis of hemorrhagic CVA

A

poor compared it ICVA
30 day mortality rate - 35-50%

37
Q

PT’s role in strokes

A

history
vitals are important
other tests and measures
dx, prog, POC
EDUCATION of pt and family

38
Q

national institutes of health stroke scale (NIHSS)

A

valid for size and severity
0 = no deficits
42 = worst deficits
must be trained

39
Q

NIHSS outcomes

A

very severe - >25
severe - 15-24
mild to moderate - 5-14
mild 1-5

40
Q

correlation of NIHSS score to discharge disposition

A

<5: 80% discharged to home
6-13: typically require ARF
>14: frequently require LT skilled care

41
Q

describe damage to cerebellum

A

motor dysfunction
postural control
equilibrium
coordination

42
Q

common deficits of cerebellar damage

A

dysdiadochokinesia
slurred speech
ataxia
unsteady gait
nystagmus

43
Q

conditions responsible for cerebellar damage

A

CVA
head trauma
alcoholism
tumors
toxins
MS
anything that causes oxygen deprivation

44
Q

UE coordination tests

A

RAM tests for dysdiadochokinesia
finger opposition
finger to nose
finger to clinician finger and back to nose

45
Q

LE coordination tests

A

heel to shin
toe to clinician finger
RAM

46
Q

balance observations

A

level of assistance required
# times balance lost
ability to maintain midline
duration of stance
use of support
direction of deviation of movement
presence of postural controls strategies

47
Q

how does normal cognition help balance?

A

paying attention to surroundings
making correct decisions about situations
remembering dangerous situations

48
Q

skin layers

A

epidermis
dermis
subcutaneous

49
Q

integ function

A

temp regulation
protection
sensation
excretion
immunity
blood reservoir
vitamin D synthesis

50
Q

cardiovascular conditions that affect integ

A

vascular insufficiency
lymphedema

51
Q

pulmonary conditions that affect integ

A

pulmonary edema
CF

52
Q

msk conditions that affect integ

A

osteomyelitis
open fracture

53
Q

neuromuscular conditions that affect integ

A

SCI
CVA
MS
loss of sensation

54
Q

endocrine conditions that affect integ

A

diabetes
liver disease

55
Q

general observation of integ

A

color
condition
temp
scars
hair loss
lesions

56
Q

common disorders of integ

A

dermatitis
trauma
infection
skin cancer
ulcers
burns

57
Q

most common type of skin cancer

A

basal cell carcinoma

58
Q

deadliest skin cancer

A

melanoma

59
Q

ABCDE rule

A

asymmetry
borders
color variants
diameter
elevation

60
Q

benign lesions

A

< 6 mm
uniform color
distinct borders
symmetric
seldom bleed or ulcerate
soft to firm
slow rate of growth or change

61
Q

malignant lesions

A

> 6 mm
multiple shades
irregular, blurred borders
asymmetric
often bleed or ulcerate
firm to hard
variable rate of growth

62
Q

burns

A

thermal
electrical
chemical

63
Q

superficial burns

A

epidermis only
no blisters
red
painful

64
Q

superficial partial thickness burns

A

epi and superficial dermis
blisters
red
painful

65
Q

deep partial thickness burns

A

majority of dermis
hair follicles/sweat glands intact

66
Q

full thickness burns

A

subcutaneous fat layer
minimal pain
susceptible infection
increased depth = decreasing pain

67
Q

subdermal burns

A

muscle, bone, adipose tissue
insensate

68
Q

arterial insufficiency wounds

A

intermittent claudication
pain with activity
decreased temp and pedal pulses

69
Q

venous insufficiency wounds

A

localized limb pain
pedal pulses present
increase skin temp
edema

70
Q

peripheral neuropathy

A

nerve damage
diminished sensation
cannot sense trauma

71
Q

neuropathic ulcers

A

PVD, peripheral neuropathy, infection
painless
absent pedal pulses if atherosclerosis
deep wound bed at pressure points
loss of sensation

72
Q

decubitus (pressure ulcers)

A

tissue ischemia

73
Q

stage 1 wound

A

intact, reddened skin that does not blanch

74
Q

stage 2 wound

A

shallow open ulcer with red/pink wound bed, denoting partial-thickness loss of dermis, without slough. Can present as open or ruptured blister

75
Q

stage 3 wound

A

subcutaneous fat may be visible but no bone, muscle or tendon exposed. May include tunneling or undermining

76
Q

stage 4 wound

A

muscle/tendon/bone exposure. Tunneling/undermining, eschar/slough over at least part of wound bed

77
Q

what to include in assessment for wounds

A

ROM
sensation
strength
functional mobility
NM coordination
balance
equipment used

78
Q

PT intervention in wound care

A

wound treatment/protection
strength/ROM/mobility training

fall B 2024 (19 decks)

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