recovery from a stoke the late management Flashcards
who is involved in the rehabilitation of a stroke patient
multidisciplinary team, goal orientated
What are the stages in recovery from stroke
First few days- resolution of stroke and repercussion of ischeamic penumbra.
weeks/months- neuronal plasticity (brain changes and adapts through forming new synapses)
define neuronal plastcity (change made in the brain after a stroke)
brain changes and adapts forming new synapses
dendrite sprouting
synaptic remodelling.
what are the 3 main aims of post stroke management
increasing personal care and independence
motility
social activities.
which hemisphere in the brain is affected is visual information is lost on the right
left
which side of the hemisphere is affected in neglect, and in which lobe does it occur
right hemisphere
(does not happen in the left hemisphere)
parietal lobe.
what type of defect is neglect
visual or somatosensory
which aspect of the brain helps you perceive where something is? ventral or dorsal
dorsal
which aspect of the brain helps you perceive what something is? ventral or dorsal
ventral
define agnosia
Modality-specific inability to access semantic knowledge of an object (or other stimulus)
define visual agnosia
Unable to recognise common object by sight alone. May be able to do so when allowed to use other modalities, e.g. touch
define prosopoagnosia
inability to recognise faces.
how long are you banned from driving post stroke
minimum is 1 month.
when is driving 100% not allowed
seizure within the past year
visual field defect, visual neglect.
how might a patient still be able to drive a car if they have limb weakness
adapt the car.
define dyspraxia
loss of ability to conceptualise, plan and execute complex sequence of motor tasks
what defect of the brain causes dyspraxia
Loss of cortical pathways for initiating and performing skilled actions
where might an anatomical lesion be which causes dyspraxia
left inferior parietal lobe
supplementary motor area
What are the commonly used transfer methods
Hoist, standing hoist, ETAC turner, banana board
what must be included in a patients discharge package post stroke
patient’s ability and whether a carer is required
are friends or family willing to provide care.
are there any modifiable risks
adaptations and accessibility of the environment they will be discharged into.
where is information obtained from to form the patients dischargee package
History from patient, family and friends
Ward based multidisciplinary assessment
OT environmental visit to place of discharge
define spastic hemipareitic gait
one sided walk in which the legs are held together and move in a stiff manner, the toes seeming to drag and catch.
how can a hemiparetic gait be corrected
Splints to correct foot drop, physiotherapy, manage spasticity, walking aides
define spasticity
Hyperexcitability of the stretch reflex (due to tendon or tissue shortenting)
what are the consequences of spasticity
Loss of function: impaired balance, manual dexterity
Unable to maintain skin hygiene in flexures
Pain
how is spasticity managed
physiotherapy and splinting to maintain joint range of movement
drugs- botulinum (local) and baclofen (systemic)
Is it a combination of personal and environmental factors which cause impairment, limitation and restrictions in the body
True
what impact does stroke have upon the family
depression
