Stroke Flashcards
stroke
cerebrovascular accident
blood supply to the brain is interrupted, no O2, tissue dies
ischemic stroke
87%
blocked blood vessel (clog in the drain)
*can use tPA (clot busting drug) within ~3 hours of symptom onset
thrombotic stroke
type of ischemic stroke
blood clot
at the site of the clot
embolic stroke
type of ischemic stroke
moving particle (often from the heart) that breaks off and gets lodged somewhere else
hemorrhagic stroke
13%
BLEEDING - ruptured blood vessel
can be AVM or aneurysm that burst
often c/o headache first
no tPA
intracerebral (bleeding into the brain tissue)
subarachnoid (into the subarachnoid space)
TIA
transient ischemic attack
“mini stroke”
- temporary obstruction of blood flow from blockage
- no lasting damage, but warning sign for future strokes
risk factors
- older age, women, black, fam history, prior strokes, HTN (leading cause), diabetes, heart disorders, smoking, obesity
FAST
Facial drooping
Arm weakness
Speech difficulties
Time to call 911
motor impairment
contralateral to the lesion
paresis = weakness
plegia = paralysis
loss of trunk and postural control and sitting balance
impaired reactions and strategies
requires automatic adjustments to prevent falls
1. ankle - slow sway at ankles
2. hip - big hip sway
3. stepping - to widen BOS
UE impairments
subluxation: partial dislocation of shoulder joint from weak mx, gravitational pull, spastic mx
structural changes to soft tissue structures - shortened mx, contractures, over stretched
communication impairments
- global aphasia: loss of all language abilities
- broca’s aphasia: broken speech, expressive, words are appropriate but pauses/omits, typically aware of deficit (be patient, may get frustrated)
- wernicke’s: receptive, fluid, non sensical, lack of comprehension
- anomic aphasia: trouble finding words
- dysarthria: disorder of articulation (motor movements involved)
perceptual impairments
- spatial relations - where objects are in space
- spacial neglect (inattention, not responding to stimuli, not visual field deficit)
- body neglect - shaving only half of face, not using affected side
- form constancy - ID object despite variations
- figure ground - fore/background
- visual closure - ID partially covered object
perceptual impairments - agnosias
- visual: unable to ID an object by looking at it
- somatoagnosia: can’t recognize own body parts
- phosphagnosia: unable to recognize faces
- anosagnosia: lack of understanding of their deficits
cognitive impairments
initiation, attention, organization, sequencing, problem solving
apraxia
praxis = 2 step process resulting in purposeful movement (1. idea and 2. production)
difficulty completing planned movements
ideational apraxia
no idea/concept of what to do