Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuromuscular > Stroke > Flashcards

Stroke Flashcards

1
Q

BE FAST

A

Balance: LOB or coordination loss
Eyes: vision changes
Face: drooping, asymmetries
Arm: raise both simultaneously and check for differences
Speech: ask person to repeat a statement, check for Dysarthria: slurring
Time: get to ER, 3 hour window after seen “normal” to get tPA to dissolve the clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Motor Impairments of Stroke

A

-interference with smooth and purposeful movement
-hypotonia/faccidity
-hypertonia/spasticity

-tonal changes will result in impaired joint alignment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Normal Postural Tone

A

-tone sufficient to hold us upright against gravity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pyramid of Postural Reflex Mechanism

A

-Normal Postural tone
-Primitive movement patterns
-Righting reactions
-Protective Extension Reactions
-Equilibrium Reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Primitive Movement Patterns/Reflexes

A

-provide basis for mocement paptterns that progressively shoow more coordination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Righting Reactions

A

-provide orientation of the head and alignment of other body parts
-critical for development as upright individuals

ex: inability to lift head in supine, keeping head rotated away from weaker side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Protective Extension Reactions

A

-1st line of defense against chanfes in our postural balance, CoG over BoS changes
-parachute reactions or protective stepping

ex: client does not extend arm when falling, client doesn’t move impaired leg to prevent falling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Equilibrium Reactions

A

-extension of protective reaction allows us to maintain balance by adjusting the location of CoG
-cocontracting muscles or making adjustments

ex: clinent doesnt lengthen weight bearing side of trunk when shifting, clien does not increase muscular stability when shifting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Atypical Synergies

A

-predictable movement patterns occurring during voluntary attempts
-result of loss of selective mmt strategies
-tone changes or neuro disorganization
-impaired timing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

UE Flexion Synergy

A

-Scapular Elevation
-Scapular Retraction*
-Shoulder Abd & ER
-Elbow flexion*
-Forearm Supination
-Wrist flexion*
-Finger Flexion*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

UE Extension Synergy

A

-Scapular Depression*
-Scapular Protraction
-Shoulder extension*
-Shoulder add*
-Shoulder IR*
-Elbow Extension
-Forearm Pronation*
-Wrist Extension
-Finger flexion*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

UE Resting Synergy

A

-Scapular Depression
-Scapular Retraction
-Shoulder extension
-Shoulder add
-Shoulder IR
-Elbow flexion
-Forearm Pronation
-Wrist flexion
-Finger Flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

LE Flexion Synergy

A

-Pelvic elevation*
-Pelvic retraction*
-Hip Flexion*
-Hip Abd
-Hip ER
-Knee Flexion
-Ankle DF
-Foot Inversion*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

LE Extension Synergy

A

-Pelvic depression
-Pelvic protraction
-Hip extension
-Hip Add*
-Hip IR*
-Knee Extension*
-Ankle PF*
-Foot Inversion*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

LE Resting Synergy

A

-Pelvic elevation
-Pelvic retraction
-Hip Flexion
-Hip Add
-Hip IR
-Knee Extension
-Ankle PF
-Foot Inversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Sensory Impairments of Stroke

A

-disorders of tactile, proprioception, complex sensory systems
-disorders of movement secondary to sensory (lack of feedback and proprioception)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Visual/Perceptual Impairments

A

-Disorders of body image: neglect, no longer mirror images
-visual disorders
-Disorders of spatial thought (awareness of surroundings)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cognitive/Communication Impairments of Stroke

A

-imaired memoory
-disorientation
-Impaired judgement, problem solving
-decreased concentration span
-personality changes
-aphasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Predictors of Poor Rehab Outcome

A

-Dementia
-Global Aphasia
-Previous Stroke
-Older age
-incontinence
-severe visuospatial deficits
-Persistent sensory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Goals of Rehabilitation

A

-maximize functional independence
-Return to most optimal living environment
-Improve Quality of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Functional Independence

A

ability to handle one’s needs without assistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Quality of Life

A

-one’s ability to pursue pleasureable activites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Neurorehabiliation

A

-interventions useful for assisting the recovery of pt with neuro lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Neurophysiological Approaches

A

-PNF: proprioception neuromuscular facilitation
-Brunnstrom: Movement therapy for hemiplegia
-NDT: neurodevelopmental techniques
-Neuro-IFRAH: Neuro-integrative Rehab and habilitation
-Rood: sensorimotor retraining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Cerebrovascular Disease

A

-abnormality of the brain from pathologic processes of blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Ischemia

A

-decreased blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Infarction

A

-death of tissue due to lack of blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Thrombosis

A

-clot in vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Embolism

A

-blood clot from elsewhere travels to the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Hemorrhage

A

-bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Ischemic Stroke

A

-clot or disturbance to blood flow
-87%
-large vessels-50% have warning TIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Hemorrhagic Stroke

A

-burst of bloodvessel leading to lack of blood to tissues
-13%
Intracerebral: inside of parenchyma (cortical or subcortical)-10%
Subarachnoid-3%

33
Q

Stroke

A

-acute event related to inturruption of blood supply or bleeding of a blood vessel
-last more than 24h
-5th leading COD in US
-2nd in world
-most common in older poppulations

34
Q

Transient Ischemic Attack

A

-mini stroke
-brief episode of neuro dysfunction froom brain or retinal ischemia
-usually <1 hours
-not more than 24h
-most are 15-20 mins

-90 day risk after TIA is 3-17%
-highest risk in first 30d
-18% risk in the next 10 years

35
Q

Mimickers of Stroke

A

-hypoglycemia
-Hypoxia
-seizure
-migraines (Todd’s Paralysis: weak on side of attack)
-MS Attack (more slow)
-Brain Tumor swelling

36
Q

NOT a Stroke

A

-loss of consciousness
-syncope/fainting
-Numbness in both feet
-waxing and waning confusion
-Diffuse weakness
-Numbness in one hand or foot (usually too small an area)
-Pain

37
Q

Modifiable RK for Strokes

A

-HTN
-Diabetes
-High cholesterol
-smoking
-OCP
-pregnancy

38
Q

ACA Stroke

A

-rare
-hemiparesis contra leg weakness
-urinary incontinence
-slowness, delay
-akinetic mutism: no motivation to speak
-longer term

39
Q

MCA Stroke

A

-common
-hemiparesis contra face and arm weakness
-global aphasia if on dominant side (initially)
-neglect (non-dominant worse than >dominant)
-sensory loss
-Cortical sensory loss
-Gaze deviation: look away from weak side

40
Q

Dominant Hemisphere

A

-pays attention to both sides

41
Q

Non-Dominant Hemisphere

A

-looks only on the contra side

42
Q

PCA Stroke

A

-homonymous hemianopsia
-visual hallucination, color abnormalities
-cortical blindness
-contra sensory
-alexia: inability to read
-basilar syndrome

43
Q

Veterbobasilar Stroke

A

-inpsi cranial nerve/face, contra body
-sensory
-vertigo
-diplopia, dysarthria, dysphagia
-nausea
-hearring loss

44
Q

Cardioembolic Infarction

A

-most cerebral emboli come from heart
-atrial fibrillation
-heart attack
-usualy in multiple areas in brain

45
Q

Atrial Fibrillation

A

-5x increase stroke risk
-2x increased risk of death

Treat:
-warfarin, anticoagulants

46
Q

Embolic Infarction

A

-aorta
-large intracranial arteries
-patent foramen ovale

47
Q

Embolic Stroke of Uncertain Source

A

-don’t know location

48
Q

Small Artery Occlusion (Lacune)

A

-BC within brain
-<1.5cm
-penetrating vessles of putamen, caudate, internal capsule, thalamus
-face, arm, leg equally

49
Q

Lacunar Infarction Syndrome

A

-small stroke
-better prognosis
-affects thalamus and has bigger symptoms

50
Q

Lacunar Infarction: Pure Motor Stroke

A

-hemiparesis of face, arm, leg
-internal capsule or base of pons

51
Q

Lacunar Infarction: Pure Sensory Stroke

A

-face, arm, leg
-posteriorlateral thalamus

52
Q

Lacunar Infarction: Sensorimotor Stroke

A

-thalamus and internal capsule

53
Q

Lacunar Infarction: Dysarthria

A

-clumsy hand syndrome
-base of pons

54
Q

Lacunar Infarction: Ataxia: Hemiparesis

A

-pons/internal capsule or subcortex

55
Q

Thalamic Stroke

A

-contra sensory loss to all modalities
-spontaneous pain and dysethesias
-mild hemiparesis

56
Q

Rare Causes of Strokes

A

-inherited, inflammatory disorders, hematologic disorders, radiation, cocaine

57
Q

Approach for Acute Ischemic Stroke

A
  1. Stabilize Patient
  2. Ischemic vs. Hemorrhagic
  3. Last known normal
  4. NIHSS Score
  5. Candidate for acute thrombolytics
  6. Candidate for endovascular intervention
58
Q

Door to Needle Time

A

-time from entering hospital to when TPA is given
-usually 60, goal is 45m
-every 30 min, 10% decrease in probability

59
Q

tPA/tNK

A

-Tissue plasminogen activator
-clot busting medication
-for acute strokes
-doesn’t change death, but function in 3 months

0-90m: need 5
91-180m: need 9
181-270m: need 15

Contraindications:
->4.5 hours last known normal (risk of hemorrhage goes up)
-hemorrhage
-Head trauma in last 3m
-high BP 185/110
-endocarditis or aortic dissection
-bleeding disorder
-glucose <50

60
Q

Endovascular Intervention

A

-if area of clot is not completely dead (Perfusion>diffusion)
-clot can be pulled out
-24h

61
Q

BP Management with tPA

A

-in ICU for 24h (no PT possible bleeding)
-check BP frequently
-maintain BP of 180/105

62
Q

Post-Stroke Management

A

-want BP high to increase blood flow post tPA to get through swelling (180/105)
-no tPA BP goal 220/110
-sugar control
-antiplatelet/anticoagulants

if worse: head down (reverse trtendelenburg)

Secondary prevention

63
Q

Post Stroke Complications

A

-edema
-hemorrhagic conversion: blood pools in the brain, inschemic to hemorrhagic stroke
-infection
-aspiration
-MI
-DVT

64
Q

Carotid Endarterectomy

A

-remove plaque from carotid

65
Q

Old vs. New Stroke Imaging

A

DWI:
-New: white
-Old: holes

T2:
-New: grey
-Old: white

66
Q

Recovery from Stroke/Outcomes

A

-best recovery in 3-6m
-motor recovers better than language and spatial attention
-proximally better first
-prevent contractures

67
Q

Limitations to Recovery: Stroke

A

-size
-limited therapy
-depression
-aphasia, neglect, apathy
-spasticity/contractures
-medications
-recurrent stroke

68
Q

Hemorrhagic Conversion

A

blood pools in the brain, inschemic to hemorrhagic stroke

69
Q

Intracerebral Hemorrhagic Stroke

A

-subcortical
-cortical: avms, tumors

70
Q

Subarachnoid Hemorrhagic Stroke Causes

A

-aneurysms, avms, venous, trauma

71
Q

Signs of Intracranial Hemorrhagic Stroke

A

-neuro deficits onset
-headache, vomitting, decreased consciousness
-CT shows blood fast
-only way to differentiate hemorrhagic or ischemic

72
Q

Causes of Intracranial Hemorrhagic Stroke

A

-HTN
-trauma
-avm: rupture of arteriovenous malformation
-aneruysm
-brain tumor bleeding
-hemorrhagic conversion
-bleeding disorders
-amyloid angiopathy

73
Q

Intracranial Hemorrhagic Stroke due to HTN

A

-putamen
-hemiphere
-thalamus
-cerbellum
-pons

74
Q

Intracranial Hemorrhagic Stroke Prognosis

A

-more likely to kill you, but better outcomes than ischemic

75
Q

Intracranial Hemorrhagic Stroke: Treatment

A

-treat increased pressure
-intubate
-surgery
-BP management

76
Q

Subarachnoid Hemorrhagic Stroke (stats)

A

-80% of SAH caused by aneurysm burst (effects of inittial, recurrent hemorrhage, vasopasm)
-10% die before medical attention
-40% die within 3 m
-50% have disabilites

77
Q

Aneurysm Rupture s/s

A

-sudden explosive headache
-los of consicousness
-photophobia
-stiff neck
-seizure
-nausea
-half have sentinel hemorrhage: warning leaking

78
Q

Venous Stroke

A

-thrombosis of venous sys
-can be ischemic or hemorrhagic
-pregnancy

Signs:
-headache
-focal neuro signs
-hemorrhage
-altered mental status

Neuromuscular (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions