recovery from a stoke the late management

Question 1

who is involved in the rehabilitation of a stroke patient

Answer 1

multidisciplinary team, goal orientated

Question 2

What are the stages in recovery from stroke

Answer 2

First few days- resolution of stroke and repercussion of ischeamic penumbra.
weeks/months- neuronal plasticity (brain changes and adapts through forming new synapses)

Question 3

define neuronal plastcity (change made in the brain after a stroke)

Answer 3

brain changes and adapts forming new synapses
dendrite sprouting
synaptic remodelling.

Question 4

what are the 3 main aims of post stroke management

Answer 4

increasing personal care and independence
motility
social activities.

Question 5

which hemisphere in the brain is affected is visual information is lost on the right

Answer 5

left

Question 6

which side of the hemisphere is affected in neglect, and in which lobe does it occur

Answer 6

right hemisphere
(does not happen in the left hemisphere)
parietal lobe.

Question 7

what type of defect is neglect

Answer 7

visual or somatosensory

Question 8

which aspect of the brain helps you perceive where something is? ventral or dorsal

Answer 8

dorsal

Question 9

which aspect of the brain helps you perceive what something is? ventral or dorsal

Answer 9

ventral

Question 10

define agnosia

Answer 10

Modality-specific inability to access semantic knowledge of an object (or other stimulus)

Question 11

define visual agnosia

Answer 11

Unable to recognise common object by sight alone. May be able to do so when allowed to use other modalities, e.g. touch

Question 12

define prosopoagnosia

Answer 12

inability to recognise faces.

Question 13

how long are you banned from driving post stroke

Answer 13

minimum is 1 month.

Question 14

when is driving 100% not allowed

Answer 14

seizure within the past year

visual field defect, visual neglect.

Question 15

how might a patient still be able to drive a car if they have limb weakness

Answer 15

adapt the car.

Question 16

define dyspraxia

Answer 16

loss of ability to conceptualise, plan and execute complex sequence of motor tasks

Question 17

what defect of the brain causes dyspraxia

Answer 17

Loss of cortical pathways for initiating and performing skilled actions

Question 18

where might an anatomical lesion be which causes dyspraxia

Answer 18

left inferior parietal lobe

supplementary motor area

Question 19

What are the commonly used transfer methods

Answer 19

Hoist, standing hoist, ETAC turner, banana board

Question 20

what must be included in a patients discharge package post stroke

Answer 20

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.

Question 21

where is information obtained from to form the patients dischargee package

Answer 21

History from patient, family and friends
Ward based multidisciplinary assessment
OT environmental visit to place of discharge

Question 22

define spastic hemipareitic gait

Answer 22

one sided walk in which the legs are held together and move in a stiff manner, the toes seeming to drag and catch.

Question 23

how can a hemiparetic gait be corrected

Answer 23

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

Question 24

define spasticity

Answer 24

Hyperexcitability of the stretch reflex (due to tendon or tissue shortenting)

Question 25

what are the consequences of spasticity

Answer 25

Loss of function: impaired balance, manual dexterity
Unable to maintain skin hygiene in flexures
Pain

Question 26

how is spasticity managed

Answer 26

physiotherapy and splinting to maintain joint range of movement
drugs- botulinum (local) and baclofen (systemic)

Question 27

Is it a combination of personal and environmental factors which cause impairment, limitation and restrictions in the body

Answer 27

True

Question 28

what impact does stroke have upon the family

Answer 28

depression