Brainscape's Knowledge GenomeTM

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


See full index

Bringman Neuro > Stroke > Flashcards

Stroke Flashcards

1
Q

Mini stroke resolves in 24 hours

A

TIA - Transient Ischemic attack. Also called pin stroke or mini-stroke

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

Types of stroke

A

Hemorrhagic stroke Occlusive

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

Common feature of Hemorrhagic stroke

A

Headache very common, accounts for 20% of strokes

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

Which is more common occlusive or hemorrhagic stroke

A

Occlusive 80%

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

Types of Hemorrhagic aneurism BA

A
  • AVM- arterial venous malformation (Fusiform) - artery and vein mingled together –(congenital defect). Very common b/c intracranial pressures rise rapidly,- silent killer- increased BP, or valsalva later in life could cause hemorrhagic stroke.
  • intracerebral hemorrhage- rupture of cerebral vessel w/ bleeding into brain
  • cerebral hemorrhage- typically in smaller vessels weakened by atherosclerosis
  • subarachnoid hemorrhage- occurs from saccular or berry aneurysm (rupture associated with Valsalva ie. bathroom use) and causes bleeding into subarachnoid space- Berry aneurism- looks like berry- out pouching of the vessel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment of Hemorrhagic stroke

A

Coil or clip

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

Used for aneurism that has or has not ruptured

A

Clip

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

Used when aneurism has not yet ruptured

A

Coiling –bird’s nest of wire that the aneurism is filled with. Coil would NOT fix a rupture.

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

Effects of Hemorrhagic aneurism on the brain O2UCH2IS

A
  • Occlusion of the artery- eventually Pressure away from the actual site
  • Occlusion of other arteries
  • Uncle herniation
  • Cells distal to bleed become starved of blood
  • Headaches - prolonged
  • High blood pressure
  • Increased ICP
  • Scattered wide spread symptoms- difficulty to decide where issue is stemming from
  • Hemorrhagic midline shifts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of people does Hemorrhagic stroke affect?

A

younger people

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

2 types of occlusive stroke- TE

A

Thrombolytic- buildup of plaque, lipid hypothesis. caused by poor eating- systemic inflammation, cholesterol medications does not decrease rate of stroke

Embolytic- Placque breaks off,

80% of occlusive stroke are MCA- FACE

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

Embolytic

A

Blood clot (easiest to get rid of) using tPA- tissue plasminogen activator- breaks off and flows to the brain, can occur from air embuli, fat embuli and cancer. tPA should be administered within 3h of the manifestation

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

Thins blood & breaks up blood clots Needs to be administered within 3 hrs after the pt. goes to ER. Made from bats.

A

tPA

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

Risk factor if tPA is mistakenly administered with a hemorrhagic stroke. 

A

if Dr. don’t know when stroke started and its origin they will not administer tPA but will give cumadin instead.

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

Minor stroke symptoms

A

Lasting symptoms with minor deficits- Limb paresis / paralysis, foot drop, eg, distal part of limb etc.

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

Major stroke symptoms

A

Complete (entire side) paralysis Speech problems, cognative issues including memory and planning, harder for them to get back to some level of functioning.

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

Occlusive but lots of tiny clots breaks off from bigger clot causing tiny strokes in brain -could be caused from doing an endartdectomy in carotid vertebrae.

A

Shower stroke

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

Tests done after an occlusive stroke:

A
  • Echocardiogram
  • Carotid ultrasound
  • CT
  • MRI
  • BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Risk Factors for Stroke BAD2 SHA2P

A
  • Birth control – don’t smoke
  • Sedentary lifestyle
  • Hereditary / family history
  • Diet
  • A-fib
  • Aging
  • Post-menopausal
  • Drinking
  • African American
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Symptoms of ACA Syndrome- AIL 710-711 table

A
  • LE affected more than UE
  • Apraxia- difficulty / inability to perform task /move
  • Incontinence – high risk of skin breakdown (moisture)
  • Hemiperesis LE
  • Apatethic Akenetic Mutism
  • Slowness
  • Lack of spontaneity
  • Motor inaction
  • Contralateral grasp & sucking reflex impaired.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Symptoms of MCA Syndrome U SHAPe- FAST

A
  • UE affected more than LE
  • 80% strokes are MCA
  • Homonymous Hemianopsia- Know how to draw pic- left occlusion causes losses in right visual field
  • Aphasia
  • Perceptual deficits
  • If right sides MCA. then pt. becomes a pusher, left sided neglect.
  • Hemeperesis face and arm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Symptoms of PCA Syndrome CV

Check in red book to get details 652

A

Cerebellum – balance & coordination Visual Issues, spacial & memory

Hemianopsia

Contralateral hemiplegia

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

Symptoms of Vertebral Basilar Artery Syndrome

A

Locked in Syndrome

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

Rood’s Technique- facilitatory

A

Way to increase or decrease threshold- normal resting threshold is +3 so nervous system is inhibited or excited in order to maintain the threshold but when contraction is desired we need to create an imbalance in order to increase the treshold to +5 so this is facilitated by the Rood’s technique.

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

Bronstrum stroke recovery scale- Stages

Synergistic patterns

A

1 = Lowest no associated reactions / flaccid

2 = Small synergistic movements when pt. asked to flex or extend the limb / might be able to illicit an associated reaction

3 = voluntary control of movement synergy- little that they could illicit

4 = Movement combination that does not follow the synergy pattern

5 = able to move even more out of the synergy pattern

6 = no synergy anymore could do technical tasks

26
Q

When should finger flexion & wrist function be addressed in therapy? pt. fingernail may grow into skin. Also skin breakdown

A

First day

27
Q

If patient is trying to do too many tasks they may look regressed but actually they may be able to do more with their arm

A

T

28
Q

Which synergy should be tested first in stroke patients for UE?

A

Extensor- because they are the weakest

UE synergies last longer then LE

29
Q

Unilateral neglect cause from

A

Right sided injury- pt. will be a pusher

Pt. will be impulsive, quick with movement, unaware of impairment. poor judgement, don’t realize they have had a stroke, issues with negative emotions, frustration with constructive feedback, memory problem and spatial issues.

30
Q

Left CVA pathology

A

Broca’s & Werneke’s aphasia, Global Aphasia- pt. usually overly aware of their impairment.

Will have fear issues, afraid of their impairment so may need to do a lot of coaxing and be patient with them.

Memory impairments related to language.

31
Q

Personality trait that affects both L & R sided stroke patient

A

Labile - unstable personality,problems with neurological processing, crying but not sad So pull a Schaefer, cry for 2 minutes then off to therapy. Laugh at inappropriate things, Apathetic, get depressed so will be on antidepressants. Can get irritable, confused, short attention span, issues with executive higher function.

32
Q

Recovery of stroke

A

Will see angeogenesis but wouldn’t happen fast, some plasticity depending on size of damage.

In order for plasticity to occur you need a stimulus

We can create neuroplasticity by therapy, environment to make new connections

Collateral blood flow,

During the recovery process the pt. will sleep a lot so don’t wake them cause sleep is good but once out of this phase we need to get them up and moving since this creates neuroplasticity. This causes loading of the muscle, which sends signals to brain which send signal back to the muscle for cocontraction. be mindful of limb alignment when you get them up , pinching alignment etc.

Neuroplasticity is easer to occur if body is not flaccid.

33
Q

Positional Changes - ATNR- AKA

A

Fencing position turning head to one side- by positioning a patient in bed we could change the flexor or extensor threshold of the patient. Nose facing the sound side to encourage the opposite arm to flex.

With someone with a 3, turn their head to the involved side to reduce the flexor tone

34
Q

STNR

A

Patient neck is always more in the flexed position- remove pillows from head and keep them completely supine. Will encourage arm extension

35
Q

TLR

A

If head is in supine position increase the extensor time. Side lying- WB side increases extensor and opposite side increases flexion

36
Q

PSR

A

Can be best friend or worst enemy- pressure on ball of involved foot

37
Q

Positioning stroke patient

A

One side cannot feel or move the other side can
Educate hemiplegic patients to not change position
Hemiplegic shoulder at risk for subluxations (test sulcus sign at 90 bilaterally) do in upright position
If patient has subluxations already
Passive ROM still has to be done on the spastic and flaccid side / arm- Make sure to touch with hand to ensure humeral head tracts in glenoid fossa

follow 2 hr rule for positioning.

38
Q

Obligatory synergistic patters following a CVA

A

After a sroke pt. reverts back to synergistic patterns in UE & LE
Extent depends on the stroke severity
What happening in UE & LE? Contraction
Synergies flexor extensor UE & LE & a combined synergy

39
Q

Flexor synergy UE

A

Scapular retraction, elevation, shoulder abduction elbow flexion forearm supination, wrist finger flexion

40
Q

Extensor synergy UE

A

Scapular protraction shoulder ext & abd, pronation, writ & finger flexion

41
Q

LE synergy is the most

A

Typically patients will have a combination of the two

Synergy helps with transfers its better than for them to be flaccid

Use synergy to classify patients

42
Q

Hemiplegia

A

Paralysis

43
Q

Hemiparesis

A

minor????

44
Q

Right vs. left side stroke -Right Hemisphere

A

Left hemiplegia/paresis

left side sensory loss

Visual - Perceptual Impairment

left side unilateral neglect

agnosis

visuospatial disorders

disturbances of body image and scheme

difficulty processing visual cues

Behavioral Deficits

quick, impulsive

poor judgement, unrealistic

inability to self-correct

poor insight & awareness of impairments, denial of disability

Intellectual Deficits

difficulty with abstract reasoning or problem solving

difficulty synthesizing info & grasping whole idea of task

rigidity of thought

memory impairments, typically related to spatial perceptual info

Emotional Deficits

difficulty w/ ability to perceive emotions

difficulty with expression of negative emotions

Task Performance

fluctuations of performance

45
Q

Labile

A

Pathological emotional expression, generally due to neurological degeneration or other complications; may or may not be mood-congruent. In other words, the patient might sob uncontrollably in an only moderately sad situation (an excessive but mood-congruent reaction), or he or she might also cry when upset or angry (a mood-incongruent reaction). Labile affect is also known as pseudobulbar affect, emotional incontinence, or involuntary emotional expression disorder (IEED).

46
Q

Symptoms of R sided CVA

A

Right CVA usually becomes pushers to the left side
Typically impulsive
Quick with movement
Unaware of their environment- does not know they have CVA- watch what you say and how you verbalize it
Problems with negative emotions & expressing them
Sometimes could get a bit chippy with constructive criticisms
Memory / spatial relationships – difficulty dealing with time

47
Q

Symptoms of L sided CVA

A

Wernicke, Broca’s & Global aphasia

Lability / labile – e.g. crying but not sad

Apathy

Irritable

Confusion, short attention span

Overall inability to perform executive functions

48
Q

Recovery

A

Angiogenesis

Eventual plasticity- need stimulus to work, stimulation creates connections

Collateral blood flow

When these are all happening patient will sleep a lot

Patient education / family education

Be mindful of limb alignment- hyperextension

49
Q

Rood’s technique- Stretch

A

Quick stretch facilitatory– jars the muscle to influence it to contract
Repetitive > 100 HZ excites - place on < 100 HZ or repetitive stretch inhibits (relax) 10HZ is CPM
Prolonged stretch – inhibitory (serial casting)
Joint Minipulation

50
Q

Cutaneous touch

A

Quick stroke over a muscle belly excites someone, maintained touch causes relaxation. Pediatrics – tight clothing & cuddling / hug- warmth relaxes them

51
Q

ICE

A

Facilitatory – excites, however prolonged icing relaxes & becomes inhibitory

52
Q

Heat

A

Never use heat for excitation its for relaxation

53
Q

Vestibular

A

Bouncing and spinning patients to stimulate them

rocking to relax them

54
Q

Auditory

A

Loud voice/ clapping, bright colors facilitatory, soft voice soothes,

55
Q

Visual

A

Bright colors stimulates, light colors relaxes

56
Q

Gustatory

A

Excite pt. with early stage TBI - stimulate with lemon/lime sour stuff

Inhibit chocolates, wine

57
Q

Olfactory

A

When u smell bleach it’s excitatory in bad way subjective

58
Q

Rood’s technique

A

Stretch

Cutaneous touch

ICE-
Heat
Vestibular
Auditory
Visual
Gustatory
Olfactory

59
Q

Advantages for Bronstrum

A

Put pt. in a synergy in order to illicit a movement and get them out of flaccidity

60
Q

Right vs. left side stroke -Left Hemisphere

A

Right hemiplegia/paresis

right side sensory loss

Visual - Perceptual Impairment

Broca’s aphasia

Wernicke’s aphasia

global aphasia

difficulty processing verbal cues, verbal commands

Behavioral Deficits

slow cautious behavioral style

disorganized

often very aware of impairments & extent of disability

Intellectual Deficits

disorganized problem solving

difficulty initiating tasks, processing delays

highly distractible

memory impairments, typically related to language preservation

Emotional Deficits

difficulty with expression of positive emotions

Task Performance

Apraxia common: difficulty planning and sequencing movements

  • ideational
  • ideomotor
61
Q
A

Bringman Neuro (7 decks)

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