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Stroke epi Flashcards

1
Q

is there increase in death rates associated with stroke

A

decrease mortality

there is better care following stroke

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2
Q

what does decrease mortality mean for us as PT

A

people are presenting with more sever deficits

shifting to improving peoples QOL

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3
Q

TPA is used for what kind of stroke

A

ischemic

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4
Q

what does TPA do

A

clot busting medication, used to dissolve the blood clot and restore regular blood flow to the brain

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5
Q

what is a ischemic stroke - simple

A

a blood clot stops the flow of any more blood to the brain

the tissue beyond this point needs o2 and the removal of Co2

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6
Q

what is a hemo stroke simple

A

when the blood vessel going to the brain bursts

the blood settle on the brain > this leads to compression of these structires

lead to disperse sysmtoms

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7
Q

risk factors that increase the liklehood stroke - everyone

A

HTN
smoking
CVD - heart disease
DM
previous stroke

age, sex, race

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8
Q

what is the greatest risk factor for a stroke

A

previous stroke

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9
Q

risks specific for women

A

birth control and preg

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10
Q

specific to black women

A

sickle cell disease

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11
Q

sex and risk factors

A

we have done lots of experiments on men and not women

that is why we know about men

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12
Q

age and stroke

A

risk doubles every 10 year after 55

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13
Q

75% of stroke occur in what population

A

65+

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14
Q

can stroke occur in a younger populations

A

yes

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15
Q

what is the relationship between race and stroke

A

social related factors

more then genetic differences

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16
Q

do strokes occur more in men or women

A

men

but more women die

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17
Q

what systoms to women report more with stroke

A

non focal:

headache
fatigue
cog changes
generalized malaise
weakness

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18
Q

APO

A

adverse preg outcomes

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19
Q

what is a endovascular thrombectomy

A

a minimally invasive surgical procedure used to treat acute ischemic stroke.

EVT involves the removal of a blood clot from a blocked artery in the brain, which can restore blood flow and prevent further brain damage.

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20
Q

why is HTN a risk factor for stroke

A

too much high pressure stretches the tissue

blood can add more tissue to protect from the damage (block)
or
the tissue cannot hold and breaks (rupture)

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21
Q

stroke and DM

A

there is more glucose in the blood then normal

increase in glucose leads to fatty deposists or clots in the blood vessels (block)

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22
Q

type 1 DM

A

not enough insulin produced by the pancreas

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23
Q

type 2 DM

A

the body is not receptive to insulin

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24
Q

what are the three factor the DM lead to the leads to atherlosis

A

systematic inflammation

arterial stiffness

endothelial dysfunction

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25
CVD and stroke
CVD leads to atherosclerosis - thickening and hardening of the art (block) plaque can break open and cause a clot - travels to the brain
26
what is CAD
plaque buildup in the arteries of your heart.
27
what is PAD
most often is plaque buildup in the arteries of the legs, but it can also build up in your arms or pelvis
28
what is Carotid artery disease
plaque buildup in the neck arteries.
29
what is the effect of carotid disease
It reduces blood flow to the brain.
30
Renal artery stenosis
plaque buildup in the arteries that supply blood to your kidneys
31
what is Vertebral artery disease
atherosclerosis in the arteries that supply blood to the back of the brain
32
what is the function of the back of the brain
controls body functions that are needed to keep you alive. basic funtions
33
what is Mesenteric artery Ischemia
plaque buildup in the arteries that supply the intestines with blood.
34
what is the back defintion of a stroke
rapid onset of neuro symptoms vascular territory caused by underlying CVD lasting longer 24 hours
35
signs of a stroke
numbness of the - face, arms, or leg, especially on onside of the body confusion or trouble speaking trouble seeing one or both eyes trouble walking, dizziness, balance server headache with no know cause
36
FAST
F - face droops while smiling A - does on arm drift down when lifting arms up S - speech is slurred or repeating the same phrase T - time, if you see these call 911
37
what is hemiparesis
weakness or the inability to move on one side of the body
38
what is apraxia
pick up a comb and you want to brush your teeth with it
39
what is the most common type of stroke
MCA
40
what part of the brain does the mCA serve
lateral
41
what do we see with left hemisphere MCA
right hemiparesis right sensory loss right homo hemianopsia dysarthria aphasia apriaxia
42
what is dysarthria
hard time speaking
43
what is reflective aphasia
wernickes word salad
44
what is expressive aphasia
can understand language but cannot express speech
45
right hemiparesis what part of the brain
primary motor cortex and the internal capsule
46
right sensory loss brain
primary sensory cortex and the internal capsule
47
right homo hemianopsia brain
optic tract optical radiation of the internal capsule
48
dysarthria brain
corna radiada hypoglossal and facial nerve
49
apraxia brain
partial or premotor
50
right hemp MCA symptoms
left hemiparesis, sensory loss, homo hemianopsia, dysarthria left side neglect flat effect anosognosia asomatognosia poor decision making
51
anosognosia
unaware of neuro defects
52
asomatognosia
he experience that one's body has faded from awareness. loss of ownership of ones own body part
53
neglect of the left environment brain
partial association cortex in right brain
54
flat effect brain
frontal lobe and amygdala
55
anosognosia brain
partial cortex
56
asomatognosia
right posterior partial cortex
57
what does the pCA supply
occiptal lobe medial temporal lobe thalamus
58
what is the function of the thalamus
the bodies information relay station
59
PCA effects
* Contralateral homonymous hemianopsia * Visual agnosia * Prosopagnosia (difficulty naming people on sight) * Dyslexia (difficulty reading) without agraphia (difficulty writing), color naming (anomia), and color discrimination problems * Memory defect * Topographic disorientation
60
what is Visual agnosia
an impairment in recognizing visually presented objects, despite otherwise normal visual field, acuity, color vision, brightness discrimination, language, and memory
61
what is Topographic disorientation
an acquired inability to navigate the environment in daily life
62
ACA supplies what
medial part of the brain frontal lobe
63
her ACA issues
personality logical thought contralateral voluntary movement motor and sensory loss ( Mutism
64
in ACA do we lose more UE or LE motor and sensory loss
more LE than UE
65
what is mutism
the inablity to speak becasue of brain
66
book ACA symptoms
Contralateral hemiparesis involving mainly the LE (UE is more spared Contralateral hemisensory loss involving mainly the LE (UE is more spared) Urinary incontinence Problems with imitation and bimanual tasks (two hand task), apraxia Abulia (akinetic mutism), slowness, delay, lack of spontaneity, motor inaction Contralateral grasp reflex, sucking reflex. Can be asymptomatic if circle of Willis is competent
67
Contralateral hemiparesis involving mainly the LE (UE is more spared) brain
Primary motor area, medial aspect of cortex, internal capsule
68
Contralateral hemisensory loss involving mainly the LE (UE is more spared) brain
Primary sensory area, medial aspect of cortex
69
Urinary incontinence brain
Posteromedial aspect of superior frontal gyrus
70
Problems with imitation and bimanual tasks (two hand task), apraxia brain
Corpus callosum
71
right brain damage results in
left side neglect spatial perceptual deficits imparied judgement
72
left brain damage results in
speech-lang impairment
73
what is a lacunar stroke
occlusion of smaller vessels - penetrating branches of the circle of willis cells distal to the occlusion dies - these are small areas
74
critically located infract for lacunar stroke
this leads to greater deficits including paralysis and sensory loss
75
what happen a few months after a lacunar stroke
necrotic brain cells are absorbed by macrophage activity and a small cavity (lake)
76
lacunar stroke: what happens if there is a infract of the corona radiata
leads to ataxic hemiparesis
77
PICA CVA is also called a
wallenberg syndrome
78
what area of the brain does the pICA serve
the inferior cere and dorsalateral medulla
79
what is wallenburg
a neurological condition caused by a stroke in the brain stem, specifically in one of the arteries that provides blood to the cerebellum
80
symtoms of a PICA or wallenburg syndrome
balance problems (leaning) facial numbness and eye droop hoarseness and trouble swallowing dizzness isplateral the lesion
81
what do the vertobasilar arteries serve
lateral regions of the medulla and the cere
82
what does the basilar artery supply
pons and the cere
83
what does vestibularbasilar stroke present with
nausea and vertigo isp face paralysis contra limb paralysis
84
what can you do to differenciate between nausea and vertigo
postive HIT - peri issue not a central issue
85
what is the penumbra
the shadow around the dead cells these cells ahve not decided whether they are going to die or live
86
how do we resolve the physiological damage from stroke
decrease local edema resorption of local toxins evascularization of pnumbra
87
what is neuroplascity
the sprouting of new synpatic connections
88
where does neuroplascity occur
occurs next to the lesion and in random part of the brain
89
what are the 10 tenents of neuroplascity
Use it or lose it Use it and improve it Specificity Repetition matters Intensity matters Time matters Salience matters Age matters Transference Interference
90
what is the acute phase
less then a month post stroke
91
what is the subacute phase
1-6 months post stroke
92
what is the chronic stage
longer than 6 months
93
when does stroke recovery peak
1-3 months
94
can you still make progress past the 1-3 month window
yes
95
role of the PT in the iCU
mobilize the pt discharge planning
96
role of the PT in Acute care
mobilze and DC planning
97
role of the IPR
get pt functional enough to get home, SNF, LTC
98
role of the home
max home independence prepare for community integration
99
role of the OP
max community integration
100
role of the community based
reduce loss of gains improve health and wellness
101
Role of PT SNF
functional enough to return home of LTC
102
Role of PT in the LTC
maintain/improve function
103
where do most stroke pt go after hospital stay
IPR next SNF
104
acute to intermediate concerns following stroke
UI, UTI pressure ulcers blood clots pneumonia
105
chronic concerns following stroke
depression sexual dysfunction contractures -
106
where do we see most contracture for stroke pt's
ankles and shoulders
107
what side do you gaurd on
the effected side

Neuromus 2 (17 decks)

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