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OT > Stroke > Flashcards

Stroke Flashcards

1
Q

Causes of stroke (Hemorrhagic stroke)

A 
Hemorrhagic stroke
■Hypertension
■Cerebral aneurysm
■Heavy alcohol use
■Arteriovenous malformation (Rupturing of vessel blood spilling everywhere)
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2
Q

Causes of stroke (Ischemic stroke)

A

Ischemic stroke:
■Thrombosis 血栓
◆Blood clot formation in cerebral artery called thrombus, and then the artery in the
brain is narrows and becomes completely blocked preventing normal blood flow.
■Embolism 栓子
◆The blood clot that forms elsewhere in the body and then travel to the brain, the
embolus lodges in the narrowed artery and blocks blood flow

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3
Q

Sx of stroke in frontal lobe

A

Muscle weakness

Motor learning and planning;

Executive functioning (intelligence, reasoning,problem solving);

Mood /personality/behavior;

Attention

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4
Q

Sx of stroke in parietal lobe

A

Intelligence (math)

Sensation

Spatial awareness(e.g. right/left discrimination)

ability to multi-task

language (naming objects, writing)

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5
Q

Sx of stroke in temporal lobe

A

Hearing (understanding spoken word)

Language

Memory (especially long term)

emotions (Stroke here can result in aggressive behavior, persistent talking, and changes in sexual interest/behavior)

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6
Q

Sx of stroke in Cerebellum (Cerebellar Stroke)

A

Dizziness

Nausea

Vomiting

Balance problems or unsteady walking

Fine motor problem

Clumsiness or jerky movements in an arm or leg

Slurred speech

Rapid movement of the eyes (nystagmus)

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7
Q

Sx of stroke in Brain Stem

A

Decreased levels of alertness

Trouble breathing

Regulation of sleep/wake cycles

Blood pressure

Double or blurred vision

Dizziness

Swallowing problems

Slurred speech

Weakness or paralysis of arms and legs

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8
Q

Sx of stroke in Occipital Lobe

A

visual field cuts

difficulty identifying color

hallucinations

difficulties with reading and/or writing

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9
Q

RIGHT BRAIN damage results in

A

memory deficits

motor & sensation deficits of the LEFT side of the body

spatial and perceptual problem

limited insight & impulsivity

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10
Q

LEFT BRAIN damage results in:

A

memory deficits

motor & sensation deficits of the RIGHT side of the body;

speech/language deficits (expressive vs. receptive or global)

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11
Q

Expressive Aphasia

A

Broca’s: can’t speak clearly but can understand

Partial loss of the ability to produce language (spoken, manual, or written), although comprehension generally remains intact

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12
Q

Receptive Aphasia

A

Wernicke’s: can speak fluently but it is incomprehensible

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13
Q

Spasticity vs. Rigidity

A

Spasticity: issues with upper motor neurons and is velocity dependent
(ex: variation in the speed causes variable muscle tone)

Rigidity: is NOT velocity-dependent

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14
Q

Type of rigidity

A

Lead-pipe rigidity 鉛管式僵直

cogwheel rigidity 齒輪狀僵直

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15
Q

Decerebrate Posture

A

upper extremities (UEs) are extended and internally rotated

Legs are extended

feet are in plantar flexion

occurs in brainstem stroke patients. This posturing indicates problems in the pons or midbrain

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16
Q

Decorticate Posture

A

The UEs are rigidly flexed at the elbows and wrists (legs also may be flexed.)

Indicates problems with the cerebral hemisphere or cervical spinal tract

17
Q

FTHUE Level 2 (Minimum Motion/Tasks/Key action)

A

Minimum Motion:

some voluntary motion of shoulder and elbow

Task:

a. Associated reaction 好手鬥力 （active motion）
b. Hand into lap 壞手自己放大腿 (combination of active motion in shoulder and elbow)

18
Q

FTHUE Level 3 (Minimum Motion/Tasks/Key action)

A

Minimum Motion:

做到Mass flexion pattern：
Shoulder between 30-60 degree
Elbow between 60-100 degree

Task:

a. Arm clearance during shirt tuch 抬起壞手用好手弄衫尾 (shoulder abduction)
b. Hold a pouch 舉包包 (finger flexion for mass grasp)

19
Q

FTHUE Level 4 (Minimum Motion/Tasks/Key action)

A

Minimum Motion:

做到Mass flexion pattern：
Shoulder 大過 60 degree
Elbow 大過 100 degree
**有點 elbow extension
**Lateral pinch 1.5 to 3 pounds

Task:

a. Stabilize a jar 拿穩水樽 (palmar grasp and wrist stability)
b. Ring a rag 扭毛巾 （shouder and elbow flexion）

20
Q

FTHUE Level 5 (Minimum Motion/Tasks/Key action)

A

Minimum Motion:

做到combine flexion and extension pattern：

  • *Lateral pinch 3 pounds 仲可以Release
  • *Grasping 5 pounds

Task:

a. Block and Box 木仔 （shoulder adduction/abduction; elbow flex/extend; grasp/release）
b. Eat with spoon 匙羹波子 （shoulder inter.rotation; Pronation/supination; wrist extension; Ulnar/Radial deviation; lateral pinch/tripod grip）

21
Q

FTHUE Level 6 (Minimum Motion/Tasks/Key action)

A

Minimum Motion:

表現isolated control in ULL against gravity
UL full extension
**Lateral pinch 超過 3 pounds
**Grasping 超過 5 pounds
***Poor control and coordination

Task:

a. Box on shelf 放上架 (Grasp and release)
b. Drink from glass 飲水 （forearm supination and pronation; controlled grasp and release）

22
Q

FTHUE Level 7 (Minimum Motion/Tasks/Key action)

A

Minimum Motion:

完美isolated control of all UL
***Good control and coordination

Task:
a. Key turning 開鎖 (supination/pronation)
b(1). Use chopsticks (慣用手)
b(2). Cip cloth peg(非慣用手)

23
Q

Ischemic Stroke Syndromes - Total Anterior Circulation infarcts (TACI)

A

Unilateral weakness (and/or sensory deficit) of the face, arm and leg

Higher cerebral dysfunction (dysphasia, visuospatial disorder)

Homonymous hemianopia

24
Q

Ischemic Stroke Syndromes - Partial Anterior Circulation infarcts (PACI)

A

Two of Sx of TACI

25
Q

Ischemic Stroke Syndromes - Posterior circulation infarcts (POCI)

A

One of the following:

Cranial nerve palsy and a contralateral motor/sensory deficit

Bilateral motor/sensory deficit

Conjugate eye movement disorder (e.g. horizontal gaze palsy)

Cerebellar dysfunction (e.g. balance, coordination, vertigo, nystagmus, ataxia)

Isolated homonymous hemianopia

26
Q

Ischemic Stroke Syndromes - Lacunar infarcts (LACI)

A

There is no loss of higher cerebral functions (e.g. dysphasia).

One of the following needs to be present for a diagnosis of a LACS:

Pure sensory stroke

Pure motor stroke

Sensorimotor stroke

Ataxic hemiparesis

27
Q

Acute phrase medical Tx of stroke

A

Thrombolytic treatment: 溶血劑
recombinant tissue plasminogen activators (r-tPA)

Surgery 降低顱內壓: Craniotomy & clot evacuation +/- shunting (for relieving intracranial pressure), if clot size is very large

28
Q

Operations targeting specific pathology for Hemorrhagic Stroke

A

Clipping of cerebral aneurysm

excision of arterio-venous malformation

29
Q

Blood Thinners”薄血丸 or Anti-Clotting Drugs (for prevention of thrombosis and/or stroke)

A

Anticoagulants抗凝血藥 (Warfarin; Dabigatran etexilate)

Antiplatelet 抗血小板藥(Clopidogrel ; Aspirin)

Sometimes, using both “Clopidogrel + Aspirin” together would be termed DAPT – Dual Antiplatelet Therapy

30
Q

Type of hemorrhagic stroke and Sx

A

Intracerebral hemorrhage
Subarachnoid hemorrhage

Hemorrhagic stroke may have,
headache/neck pain/vomiting/nausea

OT (5 decks)

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