Stroke Flashcards
what is an ischemic stroke
when there is a blood clot that occludes a vessel in the brain (mostly middle cerebreal), resulting in hypoxia and neuronal cell death
what cerebral vessel has ischemic stroke most often
middle cerebral
an ischemic stroke can be of what two types
thrombotic or embolic
where is blood clot in thrombolic
occludes a cerebral artery
“occludes a cerebral artery “ describes what stroke
thromobtic
where is blood close in embolic
blood clot breaks off from somewhere in the body and blocks a smaller artery in the brain
“blood clot breaks off from somewhere in the body and blocks a smaller artery in the brain” describes what stroke
Embolic
what are the two types of stroke
ischemic (thrombotic and embolic)
hemmorhagic
what is hemmorhagic stroke
A hemorrhagic stroke is when there is a rupture of a blood vessel, again resulting in hypoxia and neuronal cell death.
a rupture of a vessel is an ishemic or hemmorganic stroke
hemmorgaic
an occlusion of a vessel is an ishemic or hemmorganic stroke
ischemic
what are the affected area of a stroke (very general)
Any area supplied by that blood vessel can be affected as well as the surrounding areas due to secondary cell death and/or swelling during a hemorrhagic stroke
why can surrounding areas be affected be a stroke
due to secondary cell death and/or swelling during a hemorrhagic stroke
with a right MCV CVA the most commonly affected areas of the brain are what
those involved in motor function of the right body (primary motor cortex), language (Broca’s area), swallowing (motor cortex), executive functioning (frontal lobe), memory (temporal lobe) and attention (parietal lobe).
language is in what brain area
brocas
memory is in what lobe
temoral
attention is in what lobe
parietal
executive functioning is what lobe
frontal
strokes have a higher prevalence in what groups of people
Strokes have a higher prevalence in males, people of African or South Asian heritage, and in middle-to-low income countries. Increased risk with age (>64 y/o).
true or false: more women are affected by strokes than men
false, men are
what heritages are more at risk for strokr
african or south asian
is there an age factor related to strokes
yes, at greater risk with age (greater than 64)
what age are you at greater risk for stroek
greater than 64
what are the modifiable risk factors for stroke
excessive drug/alcohol use, smoking, physical inactivity, diet, hypertension, hyperlipidemia, cardiac diseases, use of contraceptive/postmenopausal hormone, obesity.
what are the non modifiable risk factors
older age, race/ethnicity, heredity, sex
example the FAST signs
Face (drooping), Arms (whether arms can be raised without assistance, potential weakness in right arm), Speech slurring), and Time (reminds bystanders to seek immediate medical help).
fast signs indicate onset or termination of stroke
onset
true or false: no matter the location of the stroke, the impairments will be the same
false, depend on the location
what are the common symptoms of a strolke
hemiparesis/hemiplegia, speech difficulties (dysarthria, aphasia), dysphagia, ataxia, impaired spatial awareness (neglect), numbness, problems with balance/coordination, cognitive and visual deficits.
true or false: hemiplegia is associated with MS
false, with stroke
how can you get a differential diagnosis for stroke
Noncontrast CT scan: blood clot and areas of
insufficient blood flow can be detected. MRI can give more detail if needed.
Neurologic exam:
what does non contrast CT do for strokes
blood clot and areas of insufficient blood flow can be detected
what are the other associated conditions with stroke
vascular dementia, cardiac arrhythmias, other acute cardiac conditions (blood clots) and depression.
what are the main functional implications of a stroke (be general)
difficulty with ADLS
diff with ability to talk
productive issues (work)
leisure issues
may avoid social gatherings
increased dependency
explain some ADls stroke people deal with
eating, dressing, toileting, bathing, functional ambulation, stairs, cooking, housekeeping, driving, groceries
true or false, people with stroke have no isuseswith communication
false, the struggle with communication (especially if brocas)
why do some stroke patients avoid social gatherings
due to distress and anxiety because they are not able to communicate well and move with ease and have an increased risk of future stroke incidence.
what is stroke rehab with PT
Work on muscle strengthening, ROM, coordination and gait to improve strength/atrophy. Use neuroplasticity to regain impaired movements through specific and repetitive exercises.
what is stroke rehab in OT
Helps with daily skills to perform ADLs/IADLs and eventually productivity and leisure. Progressive return to daily activities helps improve mental health. Both through treatment activities and adaptation of environment. OTs can also assist with dysphagia depending on the site.
true or false: only SLP can assess dysphasia
OT can too depending on location
how do SLP help with stroke patients
help with aphasia/dysphagia to improve communication skills
can dieticians help for stroke
yes, improve their diet
why do stroke patients need social worker
they become more dependent on family
for family suppoer
what is the medical treatment for stroke
Ischemic CVA given Thrombolytic drugs (tPA) if within 4 hours (dissolves clot). Hemorrhagic CVA: evacuation of a hematoma/removal of bone flab (if needed). Potential neurosurgery (if possible and needed)
Other medications include anticoagulant, antiplatelet, blood pressure control and statins (reduce blood cholesterol levels).
Ischemic CVA are given what for treatment
thrombotic drugs (TPA) if within 4 hours to dissolve clot
within how many hours can we give thrombotic drugs
within 4 hours
what is the medical treatment for a hemmoragic stroke
Hemorrhagic CVA: evacuation of a hematoma/removal of bone flab (if needed).
what are some stroke medications
TPA
anticoagulant, antiplatelet, blood pressure control and statins (reduce blood cholesterol levels).
