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cases for neurophysiology > Stroke > Flashcards

Stroke Flashcards

1
Q

what is an ischemic stroke

A

when there is a blood clot that occludes a vessel in the brain (mostly middle cerebreal), resulting in hypoxia and neuronal cell death

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2
Q

what cerebral vessel has ischemic stroke most often

A

middle cerebral

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3
Q

an ischemic stroke can be of what two types

A

thrombotic or embolic

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4
Q

where is blood clot in thrombolic

A

occludes a cerebral artery

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5
Q

“occludes a cerebral artery “ describes what stroke

A

thromobtic

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6
Q

where is blood close in embolic

A

blood clot breaks off from somewhere in the body and blocks a smaller artery in the brain

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7
Q

“blood clot breaks off from somewhere in the body and blocks a smaller artery in the brain” describes what stroke

A

Embolic

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8
Q

what are the two types of stroke

A

ischemic (thrombotic and embolic)
hemmorhagic

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9
Q

what is hemmorhagic stroke

A

A hemorrhagic stroke is when there is a rupture of a blood vessel, again resulting in hypoxia and neuronal cell death.

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10
Q

a rupture of a vessel is an ishemic or hemmorganic stroke

A

hemmorgaic

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11
Q

an occlusion of a vessel is an ishemic or hemmorganic stroke

A

ischemic

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12
Q

what are the affected area of a stroke (very general)

A

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

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13
Q

why can surrounding areas be affected be a stroke

A

due to secondary cell death and/or swelling during a hemorrhagic stroke

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14
Q

with a right MCV CVA the most commonly affected areas of the brain are what

A

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).

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15
Q

language is in what brain area

A

brocas

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16
Q

memory is in what lobe

A

temoral

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17
Q

attention is in what lobe

A

parietal

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18
Q

executive functioning is what lobe

A

frontal

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19
Q

strokes have a higher prevalence in what groups of people

A

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).

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20
Q

true or false: more women are affected by strokes than men

A

false, men are

21
Q

what heritages are more at risk for strokr

A

african or south asian

22
Q

is there an age factor related to strokes

A

yes, at greater risk with age (greater than 64)

23
Q

what age are you at greater risk for stroek

A

greater than 64

24
Q

what are the modifiable risk factors for stroke

A

excessive drug/alcohol use, smoking, physical inactivity, diet, hypertension, hyperlipidemia, cardiac diseases, use of contraceptive/postmenopausal hormone, obesity.

25
Q

what are the non modifiable risk factors

A

older age, race/ethnicity, heredity, sex

26
Q

example the FAST signs

A

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).

27
Q

fast signs indicate onset or termination of stroke

A

onset

28
Q

true or false: no matter the location of the stroke, the impairments will be the same

A

false, depend on the location

29
Q

what are the common symptoms of a strolke

A

hemiparesis/hemiplegia, speech difficulties (dysarthria, aphasia), dysphagia, ataxia, impaired spatial awareness (neglect), numbness, problems with balance/coordination, cognitive and visual deficits.

30
Q

true or false: hemiplegia is associated with MS

A

false, with stroke

31
Q

how can you get a differential diagnosis for stroke

A

Noncontrast CT scan: blood clot and areas of
insufficient blood flow can be detected. MRI can give more detail if needed.
Neurologic exam:

32
Q

what does non contrast CT do for strokes

A

blood clot and areas of insufficient blood flow can be detected

33
Q

what are the other associated conditions with stroke

A

vascular dementia, cardiac arrhythmias, other acute cardiac conditions (blood clots) and depression.

34
Q

what are the main functional implications of a stroke (be general)

A

difficulty with ADLS
diff with ability to talk
productive issues (work)
leisure issues
may avoid social gatherings
increased dependency

35
Q

explain some ADls stroke people deal with

A

eating, dressing, toileting, bathing, functional ambulation, stairs, cooking, housekeeping, driving, groceries

36
Q

true or false, people with stroke have no isuseswith communication

A

false, the struggle with communication (especially if brocas)

37
Q

why do some stroke patients avoid social gatherings

A

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.

38
Q

what is stroke rehab with PT

A

Work on muscle strengthening, ROM, coordination and gait to improve strength/atrophy. Use neuroplasticity to regain impaired movements through specific and repetitive exercises.

39
Q

what is stroke rehab in OT

A

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.

40
Q

true or false: only SLP can assess dysphasia

A

OT can too depending on location

41
Q

how do SLP help with stroke patients

A

help with aphasia/dysphagia to improve communication skills

42
Q

can dieticians help for stroke

A

yes, improve their diet

43
Q

why do stroke patients need social worker

A

they become more dependent on family
for family suppoer

44
Q

what is the medical treatment for stroke

A

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).

45
Q

Ischemic CVA are given what for treatment

A

thrombotic drugs (TPA) if within 4 hours to dissolve clot

46
Q

within how many hours can we give thrombotic drugs

A

within 4 hours

47
Q

what is the medical treatment for a hemmoragic stroke

A

Hemorrhagic CVA: evacuation of a hematoma/removal of bone flab (if needed).

48
Q

what are some stroke medications

A

TPA
anticoagulant, antiplatelet, blood pressure control and statins (reduce blood cholesterol levels).

49
Q
A

cases for neurophysiology (14 decks)

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