Deficits in motor planning - Unable to complete sequence - May take longer to learn task - difficulty initiating and performing a task

Stroke #2 Flashcards by Kaleb Zier

What’s the most common cause of long term disability?

Stroke

How well did you know this?

Not at all

Perfectly

What is a stroke?

Acute onset of neurologic dysfunction secondary to abnormality in cerebral circulation. Resultant symptoms correspond to the involvement of certain brain areas

How well did you know this?

Not at all

Perfectly

What is a CVA?

Refers to symptoms, Problems in the brain

Terms are used interchangeably with stroke

How well did you know this?

Not at all

Perfectly

What are the types of CVA?

Ischemic-tissue died due to lack of blood flow
Hemorrhage-abnormal bleeding
Atherosclerosis

How well did you know this?

Not at all

Perfectly

How long do symptoms of TIA last?

1-24 hours

no permanent damage

How well did you know this?

Not at all

Perfectly

What side does a CVA effect?

Right CVA = Left hemiporesis

How well did you know this?

Not at all

Perfectly

What’s in the Frontal Lobe?

Motor cortex and premotor cortex
Broca's area (motor aspects of speech)
Emotions & Behaviors
Personality
Inability to attend to a task

How well did you know this?

Not at all

Perfectly

What happens when you have a problem in the frontal lobe?

Attention
Memory-(ability to store experiences and perceptions for later recall)
Confabulation (inappropriate words or fabricated stories)
Confusion
Perseveration (Repetition of words, thoughts or acts not related to a context)
Executive functions (planning, acting and performing a task)

How well did you know this?

Not at all

Perfectly

What happens if there is damage in the pre-frontal cortex?

Impulsiveness
Impaired organization and sequencing
Impaired judgement

How well did you know this?

Not at all

Perfectly

What is multi-infarct dementia?

Scattered areas of brain are damaged

How well did you know this?

Not at all

Perfectly

What is delirium?

Acute confused state

How well did you know this?

Not at all

Perfectly

What does the temporal lobe consist of?

Auditory cortex

Wernicke’s area (language reception & comprehension)

How well did you know this?

Not at all

Perfectly

What are the types of Aphasia?

Receptive Aphasia (Wernicke's) = Difficulty understanding spoken or written words
Expressive Aphasia (Brocca's) = Inability to speak or express language
Global - impairments in both

How well did you know this?

Not at all

Perfectly

What is Dysphagia?

Difficulty swallowing

How well did you know this?

Not at all

Perfectly

What happens when there are problems in the parietal lobe?

Neglect (ignore the affected side of body)
Sensory cortex and somatosensory cortex
Perception and spatial relationships
Integrates sensory and visual information (Aphasia, Agnosia-ability to identify common objects by feeling it)

How well did you know this?

Not at all

Perfectly

What is apraxia?

Deficits in motor planning

Unable to complete sequence
May take longer to learn task
difficulty initiating and performing a task

How well did you know this?

Not at all

Perfectly

What are the types of Apraxia?

Ideomotor - Can’t perform a task when asked, but can do it automatically
Ideational - Purposeful movements not possible (automatically or on command)

How well did you know this?

Not at all

Perfectly

What is Dysarthria?

Lesion in a location that mediates speech production

Volitional and automatic actions impaired (chewing, swallowing, slurred speech)

How well did you know this?

Not at all

Perfectly

What is neglect?

Patient does not register stimuli from one side of the body
(vision may be intact but cant process info)
Denial of deficits are often present

What is in the occipital lobe?

Primary visual cortex and visual association area

What are some problems if the stroke is in the occipital lobe?

Visual field cuts

Hallucinations & Illusions

What is a Homonymous hemianopsia?

Pt will have deficits on right or left of both sides of eye

What happens with a Cerebellum stroke?

Ipsilateral problems
Coordinates voluntary movement
Balance and equlibrium
Dysdiadochokinesis-(rapid alternating movement)

What happens with brain stem strokes?

Attention, arousal and consciousness go out

What is Ataxia?

Drunken sailor gait (need to call a taxi)

Where do most of the problems occur in the brain?

Circle of willis | Middle cerebral Artery

What does the middle cerebral artery (MCA) supply?

Frontal, parietal, temporal lobes

What will you see with a MCA stroke?

``` Contralateral hemiparesis Aphasia (Wernicke's and brocca's) Ataxia (drunken sailor gait) Neglect Loss of depth perception Agnosia (inability to process sensory info, can't tell what object is by feeling it) Contralateral homonymous hemianopsia The more proximal the infarct the more extensive the damage ```

What does the anterior cerebral artery (ACA) supply?

Frontal and Parietal

What will you see with a ACA stroke?

Contralateral hemiparesis and sensory loss Urinary incontinence Problems with imitation and bimanual tasks Apraxia - deficits in motor planning

What does the posterior cerebral artery supply?

Occipital, cerebellum, brain stem

What are the deficits with PCA?

``` Contralteral hemiplegia Occipital infarct (homonymous hemianopsia bilateral or contralateral) Visual agnosia (can't recognize things) Memory defects Dyslexia ```

What happens with PCA stroke thats more in the central territory?

``` Contralateral Hemiparesis Occlusion of the thalamic branches (Hemianesthesia, thalamic pain - persistent and unpleasant sensation sensory impairments, involuntary movements, oculomotor palsies Paresis of eye movements ```

What's a lacunar strokes?

Small vessels deep in white matter are affected

What happens c a lacunar stroke?

Ataxia contralateral hemiparesis pure sensory stroke or pure motor Involuntary movements

What is Vertebrobasilar artery syndrome?

Wide variety of symptoms Cerebellar deficits Crania nerve deficits

What happens with a Right CVA?

``` Left hemiparesis left sensory loss neglect or denial impaired judgment and reasoning difficulty grasping a task rigidity and though memory impairments difficulty perceiving emotions ```

What happens with a Left CVA?

``` Right hemiparesis right sensory loss Aphasia (broca's or Wernicke's) Memory impairments related to language Perservation slow, cautions behaviors, disorganized Aware of impairments difficulty with problem solving highly distractible difficulty expressing positive emotions Apraxia (Motor planning) ```

What are some deficits regardless of place?

Visual field cuts (crazy double H thing can't pronounce) emotional abnormalities Cognitive deficits

What are the most common motor deficits?

Muscle function, control activitation coordination changes in muscle tone (flaccid immediately then spastic) Abnormal synergies

What are some synergies after a stroke?

Patient is unable to move an isolated limb segment without producing movement in rest of limb -flexion and extension synergies

When does the acute phase of rehab start?

24-72 hours post stroke | want to get pt up and moving, early stimulation of affected side can make things recover fast

What happens in the subacute phase of rehab?

Intensive, inpatient rehab 3 hours a day best outcomes within first 3 weeks of stroke

What happens in the chronic phase of rehab?

More than 6 months post stroke Outpatient or home PT Can continue to make gains

What are the Brunnstrom stages of recovery?

Stage 1- period of flaccidity, no movement of limbs Stage 2- basic limb synergies, minimal voluntary movement, spasticity begins to develop Stage 3- Voluntary control of synergies, spasticity increases Stage 4- Movement combinations that don't follow path of synergies, spasticity decrease Stage 5- More difficult movement patters are learned Stage 6- Full recovery

What's the first thing you do with a stroke patient?

Take their blood pressure