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Stroke Flashcards

1
Q

Definition

A

interruption of blood flow and oxygen delivery to the brain

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2
Q

Most strokes are fatal (T/F)

A

F

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3
Q

ischemia

A

restricted blood supply (85% of strokes)

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4
Q

hemmorhage

A

bleeding (15% of strokes)

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5
Q

intracerebral

A

bleeding directly into the brain

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6
Q

subarachnoid

A

bleeding into spaces and spinal fluid around brain

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7
Q

types of ischemic strokes

A

thrombotic

embolic

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8
Q

Risk factors for ischemic stroke

A 
atherosclerosis 
hypothyroidism
oral contraceptives
sickle cell disease
coagulation disorders
polycythemia vera
arteritis
dehydration
afib
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9
Q

Risk factors for hemorrhagic stroke

A

hypertension
atriovenous malformation
anticoagulants
drug abuse (cocaine, amphetamines, alcohol)

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10
Q

Thrombosis

A

obstruction of blood flow d/t a localized occlusion of blood vessels

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11
Q

thrombotic infarction

A

thrombus or clot forms on atherosclerotic plaque

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12
Q

embolitic infarction

A

Embolus formed Elsewhere occludes an artery or arteriole

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13
Q

signs of stroke

A

altered consciousness
severe headache
increased blood pressure

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14
Q

signs of cerebellar hemorrhage

A

disequilibrium
nausea
vomiting

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15
Q

ischemic cascade

A

series of events resulting from a stroke

  • acidosis
  • altered calcium homeostasis
  • NT dysfunction
  • free radical production
  • cerebral edema
  • microcirculatory obstruction
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16
Q

Diagnositic tests for stroke

A

CT

MRI

17
Q

Post stroke impairments

A 
spasticity
weakness
balance impairment
paralysis
paresis
aphasia
visual disturbance
cognitive impairment
18
Q

paresis

A

muscle weakness, not quite paralysis

19
Q

aphasia

A

impairment of language

20
Q

VO2 in stroke survivers is normally…

A

very low
between 12 and 17 ml/Kg-min
(normal is 25-30)

21
Q

Why the low VO2?

A
  • reduction in the # of motor units capable of recruitment during exercise
  • reduced oxidative capacity of paretic muscle
  • sedentary lifestyle
22
Q

Other exphys problems in stroke survivors

A

low strength

low muscular endurance

23
Q

Left hemisphere lesions are typically associated with

A

language deficits

24
Q

Things you may note in a physical exam

A
  • changes in postural and stretch reflexes
  • difficulty with voluntary movement
  • weakness
  • abnormal synergistic organization of movements
  • impaired regulation of force
  • decreased reaction times
  • abnormal muscle tone
  • loss of ROM
25
Q

Screening for exphys post stroke

A

fasting blood draw
resting EKG
resting BP
temperature

26
Q

Best modalites for exercise testing for stroke

A

cycle ergometer

treadmill

27
Q

Why does an arm ergometer yield a peak VO2 30-35% less than a treadmill?

A

limited amount of muscle recruitment

greater strain on the cardiac system per unit of peripheral muscle mass recruited

28
Q

GXT considerations for stroke

A
  • take BP on unaffected arm
  • 4-12 mins goal
  • endpoint <= 120/110 mmHg
29
Q

Exercise programming: frequency & duration

A

30-60 mins aerobic activity most days

30
Q

Exercise programming: considerations

A

fall risk
CHECK BP BEGINNING, DURING, & END OF SESSION
monitor RPE
may need adaptive gloves to grasp weights
start slow to avoid fatigue and DOMS

31
Q

Exercise programming: intensity

A

40-70% peak VO2

32
Q

Exercise programming: strength prescription

A 
No published guidelines :(
2-3 days a week
8-10 lifts
10-15 reps
lighter weights
large muscle groups
33
Q

Exercise programming: goals

A

improving functional capacity
VO2 and strength/endurance for function
increase ROM and prevent joint contractures

34
Q

Stretch these muscles

A 
15-30s
emphasis on spastic muscle groups on hemiparetic side
- finger/wrist flexors
- elbow flexors
- shoulder adductors
- hip/knee flexors
- PF

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